HOSPITAL SAFETY

Sally Forsberg, RN

NO ONE really wants to go to the hospital, but sometimes, a hospital stay may be necessary to provide healing through surgery, treatments or medications.  Hospitals can be an absolutely joyful place, for example at the birth of your child.

Every day in the U.S., many lives are saved through modern technology, and through the knowledge and skill of physicians, nurses, and other healthcare providers.

To provide a high level of safe, quality care, our local hospitals adhere to a large number of standards and guidelines as required by state and national regulatory agencies (e.g. the Florida Agency for Healthcare Administration, Centers for Medicare & Medicaid Services, the Joint Commission).

TO PROVIDE a high level of safe, quality care, our hospitals adhere to a large number of standards and guidelines as required by state and national regulatory agencies such as the Florida Agency for Healthcare Administration, Centers for Medicare & Medicaid Services and the Joint Commission.

Even with adherence to these standards, hospitals may pose dangers which jeopardize your safety. No surgery, treatment, or medication is without some risk. And, infections and medical errors may also cause potential harm for you or your loved ones.  You can help yourself by mitigating safety risks in the hospital.  Here are six tips to help keep you or your loved ones safe when hospitalized:

• Ask Questions: Studies have shown that patients who are actively involved in their care have better outcomes.  Do not be afraid to speak up when you do not understand something. Your healthcare team wants to provide you with education so ask your healthcare providers if there is any written reference material that you can take home with you. Also, never leave the hospital without having a copy of your discharge instructions and a  medication list that explains how to care for you at home.  Understanding all aspects of your care will help you recover sooner.

• Prevent Infections: The best way to prevent infection is to practice “hand hygiene” at all times.  Hand hygiene means either washing your hands with soap and water for at least 15 seconds, or using an alcohol based hand sanitizer. Observe if your healthcare providers are washing their hands or using the alcohol sanitizer to clean their hands prior to providing your care. Also, encourage your visitors to use the alcohol sanitizer or wash their hands upon entering or exiting your room. Visitor hand hygiene is beneficial for your safety as well as for the visitor.

•  Know and Understand Your Medications: Keep a list of your medications with names, dosage, times taken, etc. and bring this list with you to the hospital. Your doctor needs this information at the time of admission to provide the best care for you. Educate yourself on your medications and their side effects. Ask questions about whether to take a medication with or without food. When you are ready for discharge, be sure that your nurse gives you a list of medications that your doctor wants you to take when home.

The medication list should have the name of the medication, the dose (e.g. 10 mg), the frequency of taking the medication (e.g. daily, twice per day, etc), the route of the medications (e.g. oral or by mouth), and any special instructions that you should follow. If a maintenance medication is not on your medication list given to you at discharge, ask why it was omitted.  A maintenance medication is any medication you have taken consistently over time to manage a chronic condition (e.g. medications for high blood pressure, diabetes, thyroid disease, etc.).

• Patient Identification: Prior to receiving any medications, testing, or treatments, your nurse or healthcare provider should always ask you to identify yourself in two ways.  For example, the nurse may ask you to state your name and date of birth.  By using two identifiers, your healthcare providers assure that they are treating the correct patient, and keeping you safe from receiving the wrong medication or test. Your healthcare providers should ask you to identify yourself every time you receive a medication, have a test or receive treatment. Two patient identifiers should be checked regardless of whether you are in the hospital, or having an outpatient test, procedure, or surgery.

IF YOU are having surgery, make sure the hospital staff follows “Universal Protocol.”

•  Surgery Safety: If you are having surgery, make sure the hospital staff follows “Universal Protocol.”  Universal Protocol involves taking a “timeout” to assure everything is correct prior to starting the surgery.  A key component of the Universal Protocol is site marking.  Site marking assures that the surgeon will operate on the correct body part (e.g. left knee). The Joint Commission, an organization that accredits and oversees quality of care in healthcare facilities, states that the number one sentinel event (serious error) is wrong site surgery.

You can keep yourself safe from wrong site surgery by making sure that your surgery site is marked prior to entering the operating room.  Your nurse will verify the surgery site with you, with your surgeon, and with the surgical team.  Also, when signing the consent for surgery, assure it lists the correct procedure and correct part of the body involved in the surgery.

•  Have an Advocate: If possible, always have an advocate when you are in the hospital.  An advocate can be a family member or friend.  Hospitalization is stressful, and when you are under stress, you do not hear and comprehend as you would when you are well and healthy.  An advocate should be someone who knows you well, and can help you by listening to instructions or by asking questions of your healthcare providers. Your advocate should be someone you trust to help you feel safe while in the hospital. Your advocate can also ask questions when you are too sick to ask yourself. He or she can speak up for you if they perceive that something is amiss, and possibly alert your healthcare team to subtle changes in your condition.

• You hold the key to your own safety: Be an active participant in your healthcare.  Never be afraid to speak up regarding any aspect of your medical care if you do not understand or if you feel something is not “quite right.”  Healthcare providers will hear many patients say, “I don’t want to be a bother,” or “I don’t want to get anyone in trouble.”  Many hospitals have a designated Patient Advocate who is an impartial person available to help patients with problem solving an issue. Even if there is no designated Patient Advocate in your hospital, there is always a Nurse Manager, Charge Nurse or Nursing Supervisor available 24 hours per day to assist you with any issues that arise.

THE 411 ON HOSPITAL SAFETY

• The Joint Commission: www.jointcommission.org
• The Agency for Healthcare Research and Quality: www.ahrq.org
• The Institutes for Healthcare Improvement: www.ihi.org
• The Leapfrog Group for Patient Safety: www.leapfroggroup.org

Sally Forsberg has been a registered nurse for almost 30 years.  She received her Bachelor’s Degree in Nursing (BSN) from Thomas Jefferson University in Philadelphia, Pennsylvania, and her Master’s Degree in Business Administration (MBA) from the University of Miami, Coral Gables, Florida. Sally has many years of hospital experience in various clinical and nursing leadership roles as a staff RN, Nurse Manager, and Director of Nursing, as well as expertise in leading patient safety and quality programs. She holds certifications in Nursing Administration, Advanced (CNAA), as a Certified Professional in Healthcare Quality (CPHQ), as a Certified Professional Coder for Hospitals (CPC-H), and as an Inpatient Obstetric Nurse (RNC). Sally has been married for 31 years to Paul Forsberg, the Fire Chief for the City of Melbourne.

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