ospital care has become hazardous to the patient's health. According to the Fifth Annual HealthGrades Patient Safety in American Hospitals Study, 2008, nearly a quarter of a million deaths in hospitals nationwide were found to be preventable.
A Hospital Stay Will Affect All of Us
All of us will at some point have to deal with our own hospitalization or the hospitalization of a loved oneâ€”a parent, spouse, relative or good friend, and cope with the realities of what is happening in hospitals today. In a nutshell, there is a nationwide, drastic nursing shortage. Insurance companies require physicians to see too many patients in too little time. Many hospitals are under financial duress because of uninsured patients, patients who don't pay their bills and demands for new, expensive technology. Because of the baby boomer generation, there are more older patients with multiple medical issues that require hospitalization. Every physician and nurse I interviewed said this: "Hospital care is in crisis. You must have someone with a patient at all times. Loved ones are patients' best advocates."
"Place antibacterial gel next to the patient's bed and ask everyone to use it."
There is something everyone can do immediately to improve the chances of surviving a hospital stay. There must always be someoneâ€”a family member or good friendâ€”to act as a sentinel to oversee hospital care in an effort to prevent medical errors. The hospitalized patient cannot do this for himself. If you or a loved one has to go into the hospital, the number one priority is to enlist a family member or good friend to act as an advocate caregiver to oversee and monitor the hospital medical care.
9 Rules For The Advocate Caregiver
- Act as the patient's eyes and ears. Get a notebook. Write down the patient's name, hospital room, the physicians' and primary nurses' names and contact information, the patient's diagnosis and treatment plan. Keep a daily log of patient progress.
- Help prevent medication mistakes. Medication errors are among the most common medical errors, harming at least 1.5 million people every year according to the Institute of Medicine. Write down the patient's medications and dosages. Get a list from the patient's physician. List what the medication looks like, the shape and color of any pills, the names on the labels of bottles or IV bags. Create a detailed description as labels and bottles can look alike. Make sure that you recognize the medication when it is administered. If you don't, ask questions. Be assertive. Also make sure the patient's allergies to medications are in his/her chart. Repeat this information to your loved one's primary nurse.
- Prevent patient name mistakes. Check with each hospital staff member who either comes to pick up the patient for a procedure or who will administer a treatment. Make sure they have the correct patient name and that the correct procedure or treatment is listed. Repeat this checklist with each hospital staff person.
- Prevent surgery on the wrong body part. Accompany the patient to the operating room and request to see the surgeon. Ask this doctor to mark on the patient's body the correct site to be operated on and which surgery is to be performed. If the surgeon is not available, ask to see the anesthesiologist and other staff involved in your loved one's case and repeat this same checklist with each one.
- Prevent the spread of hospital-acquired infectious diseases. Among the most virulent are MRSA and pneumonia. Wash your hands. Ask every person who comes in contact with the patient, including the physicians and nurses, to wash their hands or put on a fresh pair of disposable gloves before touching the patient. Place antibacterial gel next to the patient's bed and ask everyone to use it.
- Know how to reach the doctors. Show up during doctor's rounds. Ask the primary nurses what time the doctors do rounds and simply be present in the patient's room. Have your notebook handy. Prepare questions ahead of time about the patient's diagnosis, treatment and prognosis. Ask the doctor how he/she wants to be contacted. Write down phone numbers, office hours, time of hospital rounds, email address and how that doctor wants to be contacted. Provide him/her with your phone numbers and the best times to reach you. If you can't be available during rounds or if you live out of town, call the patient's primary nurse and ask that a note be placed in the patient's chart for the physician to call you. Leave your phone numbers and times available. You can also call the nurses' station during rounds and ask to speak to the physician. If you still have trouble reaching the doctor, fax a note to the physician's office asking for him/her to call youâ€”note phone numbers and times you are available.
- Get to know the patient's primary nurses. No other nurse will do. Only ask questions or make requests of the primary nurse. Hospital staff dresses alike. You don't want to ask a technician for pain medication for your loved one. Your request may never make it to the person who can actually give the medication. Establish a personal relationship with the patient's primary nursesâ€”this means night shift primary nurses, too. Humanize the patient to the primary nurses. You want each one to see your loved one as a human being, not just as the liver cancer in room #202.
- Prepare for holidays, weekends and nights. Nurse-to-patient ratios increase at these times and doctors can be away. Either be with the patient as much as possible, or share this responsibility with your family advocate team members. You can also hire a sitter or companion to fill in for you.
- Above all, try to be with the patient as much as possible. You don't want your loved one, who might be in pain, calling for a nurse who doesn't come. All nurses and physicians interviewed for my book said, "Patients with involved family members get more attention." For a short period of time, you will help facilitate this. You could save a life.
No hospital staff member is intentionally causing errors. Everyone is trying to do the best job they can. As a family member or good friend, you can do your part by contributing to everyone's goal: the health and well-being of the patientâ€”your loved one.
2009 Martine Ehrenclou
Author of award winning book, Critical Conditions: the Essential Hospital Guide To Get Your Loved One Out Alive (Lemon Grove Press).