You can contribute to health care safety.

While you are in the hospital, many people will enter your room, from doctors and nurses to aides and technicians. The following information will help make your hospital stay safe and comfortable.

Don't Be Afraid to Ask...

A number of people may enter your hospital room. Be sure to:

• Ask for the ID of everyone who comes into your room.
• Speak up if hospital staff don't ask to check your ID.
• Ask if caregivers have washed their hands before they touch you.
• If you are told you need certain tests or procedures, ask why you need them, when they will happen, and how long it will be before you get the results.

Fighting Infections

While you're in the hospital to get well, you should know that there is the possibility of developing an infection. The single most important thing you can do to help prevent infections is to wash your hands and make sure that everyone who touches you-including your doctors and nurses-wash their hands, too.

You, your family and friends should wash hands:

1. after touching objects or surfaces in the hospital room
2. before and after eating
3. after using the restroom

It is also important that your healthcare providers wash their hands with either soap and water or with an alcohol-based hand cleaner every time, both before and after they touch you. Healthcare providers know to practice hand hygiene, but sometimes they forget. You and your family should not be afraid or embarrassed to speak up and ask them to wash their hands.

Preventing Medication Errors

By taking part in your own care, you can help the members of your health care team avoid medication errors. Here’s how:

Happy Birthday to You! Wash your hands with soap and warm water for 15 to 20 seconds. That's about the same amount of time that it takes to sing the "Happy Birthday" song twice. No Soap? No Problem Alcohol-based hand cleaners are as effective as soap and water in killing germs. To use, apply the cleaner to the palm of your hand and rub your hands together. Keep rubbing over all the surfaces of your fingers and hands until they are dry.

Be sure that all of your doctors know what medications you have been taking, including prescription drugs, over-the-counter medications, herbal and vitamin supplements, natural remedies and recreational drugs.

Be sure that all of your doctors know of any allergies you may have—to medications, anesthesia, foods, latex products, etc.

When you are brought medications or IV fluids, ask the person to check to be sure you are the patient who is supposed to receive the medications. Show that person your ID bracelet to double-check. Remember--you play an important role in helping to reduce medication errors.

Know Your Meds While you are hospitalized, your doctor may prescribe medications for you. Be sure that you understand exactly what they are and why they are being prescribed. Use this checklist to help you get the information you need from your doctor:

• What is the name of the medicine?
• What is its generic name?
• Why am I taking this medicine?
• What dose will I be taking?
• How often, and for how long?
• What are the possible side effects?
• Can I take this medicine while taking my other medications or dietary supplements?
• Are there any foods, drinks or activities that I should avoid while taking this medicine?

Preventing Falls

DVT: Lower Your Risk Deep-vein thrombosis (DVT) occurs when blood clots form in the legs and block circulation. The clots can lodge in the brain, heart or lungs, causing damage or even death. When you're hospitalized and in bed with limited physical activity, your risk of DVT increases. Ask your doctor about using compression boots or stockings and/or blood thinners to prevent DVT during your stay. Tell your doctor or nurse if you have any of the following warning signs: A leg cramp or charley horse that gets worse Swelling and discoloration in your leg, upper arm or neck Unexplained shortness of breath Chest discomfort that gets worse when you breathe deeply or cough Light-headedness or blacking out

Patients often fall because they are on medications that make them dizzy, they are weak and unsteady due to illness or medical procedures, or because they've been sitting or lying down for too long. For your safety, please:

• Always call for assistance before getting out of bed.
• Wear properly-fitting shoes with nonskid soles.
• Keep the call button within easy reach.
• Have necessary items within reach, such as your glasses, tissues, the telephone, and anything else you need.
• When you get assistance, rise slowly from your bed or chair to prevent dizziness.
• Walk close to the wall and hold onto the handrail while in the bathroom.

Our policy is to provide a safe environment that protects your health and safety, and that of our staff, visitors, and volunteers. If a patient demonstrates harmful behavior, for example, pulling IVs, tubes, medical equipment, etc., or risks a fall, it may become necessary to use restraints or seclusion to protect the patient and others. These techniques will only be used when other options have proven ineffective.

You and your family are important in helping us to keep you safe. We may be asking you to help us identify tools or techniques that help you control your behavior. Your involvement is important.

Caring for patients is a team effort, and family members are an important part of that team. We encourage families to ask questions and help us meet the patient's needs in order to promote rapid recovery and a quick return home.

• Families and friends can help to ensure a safe environment.
• Make sure brakes on wheelchairs are engaged when assisting patients in and out of wheelchairs.
• Ask for assistance when you are unsure.
• Please do not untie a soft protective device unless you check with the nursing staff.
• Bring non-skid footwear to the hospital for your family member to use.
• Give the staff a list of medications that your family member is currently taking.
• Stay with your family member if he or she is confused.
• Bring things that are familiar to your family member, such as gowns, blankets, or pillows.
• Hospital bed side rails can cause fall-related injuries as well as bed entrapment. Patients who are confused, restless, sedated, or have a lack of muscle control are at risk.
  Let the staff know if there are any reasons why bed rails should not be used.

Falls: Are You At Risk?

Certain conditions make us more likely to fall, or have other injuries. Here are just a few:

• Medications
  The more medicines you take, the more likely you are to feel dizziness or other risky side effects. Tell all of your caregivers about all of the drugs you are taking. Ask them about any side effects that might place you at risk for a fall. Get up slowly from a sitting or lying position.
• Walking difficulties
  Shuffling, weakness, stooped posture, inability to walk in a straight line, numbness or tingling of toes can make falls more likely. Ask your doctor about helpful devices such as canes or walkers, and learn how to use them correctly.
• Chronic conditions that interfere with thinking, such as Alzheimer's Disease
• Impaired vision or hearing
• Two or more falls in the past six months
• Fear of falling

If you feel unsteady on your feet, talk to your doctor about a cane or walker. You may also discuss Bay Regional Medical Center's Balance and Mobility Program. To learn more about the program, call the Center for Rehabilitation at (989) 667-6600.

Preventing Falls

• Always follow your doctors' orders and nurses' instructions about whether you must stay in bed or if you need help going to the bathroom.
• When you need help, use your call light and wait for the nurse or assistant to come and help you. Make sure to use the call light at the first sign of needing to use the bathroom.
• Ask the nurse for help if you feel dizzy or weak getting out of bed. If you must get up without waiting for help, sit in bed awhile before standing. Then get up carefully and slowly begin to walk.
• Wear non-skid slippers whenever you walk in the hospital. If you don't have any, tell your nurse.
• Remain lying or seated while waiting for assistance. Please be patient. Someone will answer your call as quickly as possible.
• Do not tamper with side rails that may be in use. Side rails are reminders to stay in bed, and are designed to ensure your safety.
• Walk slowly and carefully when out of bed. Do not lean on rolling objects such as IV poles, bedside tables, or furniture.

Protecting Your Skin

Diet:

• Eat foods from all five food groups every day, unless your physician or dietitian has prescribed a special diet for you. Each food group provides you with different nutrients.
• Eat different foods from each group every day.
• Eat three to four times a day. Eat liquid meals with extra protein, vitamins, and calories if you are unable to eat solid foods.

Skin Care

• Look at your skin every day.
• Use lotion to keep your skin from getting dry.
• Raise your body across the sheets, rather than dragging yourself across.
• Do not use "donut" shaped cushions to sit on.

Positioning

• Change your position often. (Every hour while in a chair, every two hours while in bed.)
• Clean your skin soon after urine or stool leaks on your skin. (If you use adult diapers or pads, use ointment on your skin as a moisture barrier.)

For bed bound individuals

• Reposition every two hours. Use pillows or wedges to keep bony areas from direct pressure on the bed. Use pillows or a device to relieve pressure from the heels. Do not position directly on the hip bones. Elevate the head of the bed as little as possible and for the shortest time possible.

For chair bound individuals

• Reposition at least every hour.
• Shift your weight every 15 minutes if able.

Condition H was created to address the needs of patients in case of emergency, or when patients are unable to get the attention of a health care provider. This call will provide our patients and families with a way to call for immediate assistance when they feel they are not receiving adequate medical attention in an emergency situation.

When To Call

• If a noticeable medical change in the patient occurs that needs immediate attention and the health care team is not recognizing the concern.
• If there is a breakdown in how care is being given and/or confusion over what needs to be done for the patient in an emergency situation.

To access Condition H, please call 894-6900 from a hospital phone. The operator will ask for caller identification, room number, patient name and patient concern. The operator will immediately activate a Condition H, and a team of medical professionals will be sent to the room to assess the situation. Additional personnel will be called as needed.

Condition H is proof that we want you to be partners in our care. If you have any questions, please discuss them with the nurses or other caregivers.