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Have a "Hawk Eye" in the hospital

If you travel anywhere in Arkansas, you can't help but see the hawks sitting silently above the fields, watching calmly and listening intently. And if you've ever gotten too close to a hawk's nest, you know how fast they can move and how loud they can be in order to protect their young. The next time you or a loved one has to enter the hospital, think back on those hawks; that same quiet attention to detail and fast action can make you a powerful patient advocate and a strong member of the care team.

Before Going to the Hospital

Some hospitalizations occur suddenly while others are planned well in advance. If the situation allows you to plan ahead, consider the following:

  • If you smoke, try to quit at least two weeks before the hospitalization. If you can't quit, let the hospital staff know. They may be able to provide you with support to help with withdrawal symptoms.
  • Do some research. Make sure your doctor is in our network by going to our website or calling Customer Service. You also can learn more about your doctor and hospital by searching online.
  • Arrange for someone to be at the hospital with you. Make sure they understand why you are going to the hospital and are aware of any other health concerns you may have. This person or persons will be your "hawk" eyes and ears if you are sedated or recovering.
  • Make a list of all your medications, or bring them with you. Include any over-the-counter medications, like aspirin; these medications can be as important to your doctor as your prescription medications.

At the Hospital

As a patient, or as the advocate for your loved one, you are part of the care team. If you see something that doesn't look right, or you hear information that may not be correct, ask questions. If you still are not satisfied, don't hesitate to alert the doctor, a nurse or a hospital administrator. By being polite and quiet when things are going well, you will be taken seriously when you do speak out regarding an issue.

As a Patient:

  • Be sure your doctor is aware of any allergies to medications, food, latex or tape adhesive.
  • Be honest if you have an addiction to alcohol or drugs. Your doctor may be able to help you with withdrawal, and not letting the doctor or hospital know could create a serious health situation for you.
  • Ask if the hospital has adopted a surgical checklist. If not, ask what your surgeon and anesthesiologist will do to be sure the requirements are met.
  • Ask if you need antibiotics prior to the operation. Also, if you typically require antibiotics before dental work, tell your doctor.
  • Ask for the surgical site to be marked before you are sedated so you know it is the correct location. Make sure your advocate knows the location as well.
  • Do not shave the surgical site yourself. The hospital staff should use clippers, not razor blades, to prepare the site.

As a Patient Advocate:

  • Be sure you wash your hands frequently and be sure others (family, nurses, doctors) wash theirs every time they come in the room. If someone doesn't, say something. Be sure the doctors and nurses wear gloves when doing wound care, dressing changes, IV site changes etc.
  • Politely tell any sick visitors that they should wait to visit when they — and the patient — are better.
  • Keep a record of all activities and conversations and include times and names of all people involved. What medicine was given? Was there a change? Which doctor rounded? What tests or procedures were done? Did the results get back to the doctor?
  • Ask what medications are being given. If something is new, ask what it does and find out if there could be side effects.
  • If the stay in the hospital is lengthy, be sure the staff keeps your loved one from developing bedsores by frequently turning him or her.
  • Ask whether a medicine is needed to prevent blood clots.
  • Report any broken or malfunctioning equipment, including call lights, wheelchairs, bedside tables, hand-sanitizer dispensers or bathroom handrails. If it is not working, it may cause problems.
  • Talk to each nurse at shift change about fall prevention. Falls are frequent in hospitals because of sickness, age, incontinence, medication effects and being in a strange environment. Combine your common sense and knowledge of your loved one with the nurse's professional experience. What changes have occurred in your loved one that may increase the risk of falling?
    • Is the room cluttered or too dark?
    • Are wheels locked on wheelchairs and other equipment?
    • Are the toilet seat and the bed at the appropriate height?
    • Would a regular bathroom schedule be safer than waiting for an urgent call of nature?
    • Is the call-light working and reachable?
    • As your loved one improves, is the activity level expanded so that muscle strength and conditioning improves?
  • If there is a central line, watch for signs of infection. Pay strict attention to hand washing and gloves. Talk to the doctor daily regarding how long the central line needs to stay in.
  • Watch any wound dressings; if they come off or need to be changed, tell someone.
  • Be sure urine catheter bags are below your loved one's center of gravity. Discuss with the doctor and nurses what can be done to prevent infections from the urinary catheter and make sure it happens.
  • If your loved one is on a ventilator, ask about bed elevation and how often his or her mouth should be cleaned.
  • Watch your loved one's intake at meals. If food consistently is uneaten, tell the doctor.

Before Leaving the Hospital

Once again, it is important for the patient and advocate to listen, ask questions and take notes. Too often, patients do not follow their doctors' discharge instructions and end up being re-admitted to the hospital. You may be able to avoid re-admittance by asking the following:

  • Is special care needed for any catheters, surgical incision sites or IV sites?
  • What medications will be taken? Will any previous medications be discontinued?
  • When is the follow-up appointment?
  • Will dressings need to be changed at home?
  • Are home health services needed?

Being part of the care team when someone needs medical attention is a huge responsibility, but by being like a hawk — quietly watching and listening intently and speaking up when you have a concern — you can be sure you or your loved one gets the best care possible.

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