The Natural Connection

I have been pretty busy lately getting ready for National Patient Safety Awareness Week, which by the way, happens to be March 9-15, 2003. If it kind of snuck up on you, don’t be embarrassed. I only heard about it myself a few weeks ago, when a pamphlet designed to educate patients about what they can do to help prevent medical errors arrived in the mail, courtesy of the U.S. Government. 

Now I find that the general public has trouble getting excited about information that comes in government pamphlets, especially around income tax time. But this medical errors stuff is getting a lot of folks’ attention these days, and I thought that it really would be a good idea if the community knew what experts in healthcare are recommending to patients who find themselves in need of hospital care. 

We all know that medical errors can and do occur in wide variety of settings, but according to the National Patient Safety Foundation, there is a “new consensus among government agencies, medical societies, and the business community that hospitals are ‘ground zero’ when it comes to patient safety”. It is widely understood that most medical errors do not occur as a simple result of one person’s mistake or negligence, but as a result of “systems failures”. And in this era of high-tech medicine, hospitals are one huge bundle of systems, where lots of good—and not so good—things can happen. 

The exact magnitude of the number deaths caused by medical errors that occur annually in the USA is a hot topic for debate, but is estimated by the Institute of Medicine to be at least 44,000 each year, ranking ahead of deaths from breast cancer, motor vehicle accidents, or AIDS. Thankfully, there is a lot you can do to be sure that your hospital stay is not as one of my patients described, “like a bad episode of TV Medical Jeopardy”, but a safe and healing experience. 

Just in case you didn’t get your own 12 page copy of the U.S. Department of Health and Human Services pamphlet, “Ways YOU can help YOUR FAMILY Prevent Medical Errors!” in the mail, here’s some current information to tape to your refrigerator and take along with you to your next doctor’s appointment or when you go to the hospital.  

Be sure that your hospital team is aware of the names and doses of all of the medications that you are taking, including your herbs and vitamins. (Too many patients only know that they take “a funny shaped heart pill, a yellow sugar pill, and an herb thing my wife got me for energy from her sister”.) This is especially important if you have to be admitted on an emergency basis, when the doctors on call may not be your usual physician, or have access to your outpatient medical record. Many herbal preparations, and even some vitamins, can have serious interactions with prescription medications, interfere with general anaesthesia, or cause increased bleeding after surgery.  

Tell your doctors if you have ever had a bad reaction to any medication, or to dyes used in medical procedures. Keep a list of your allergies. It is not helpful to know that you were allergic to “a little white pill” you took for “some kind of infection once”. 

Ask everyone who comes into your room to identify themselves, tell you their name, and why they are there. You have a right to question anyone who is involved with your care. Most hospitals require employees to wear name badges, and if your doctor needs to speak to an employee about your situation, it helps to know that person’s name, rather than “it was the skinny girl in the white blouse”. 

Make sure that all health professionals involved in your care have important information about you. Do not assume that everyone knows everything they need to help you. It is important that you communicate directly with your doctors and nurses any changes in your condition, and not rely solely on your hospital roommate to give your doctor a message. 

Insist that hospital staff check your armband before they give you oral medications, or put anything in your IV fluid, to be sure that it is meant for you. Ask your doctor to let you know if you will be receiving any new medications, and question the nurse if you are receiving a medication that looks unfamiliar.  

Staff should also check your armband before you are taken for any test or procedure, to make sure that they have the right patient and have the right procedure planned. If you are going to have surgery, be sure that you and your surgeon agree on what type of surgery is planned—including which side, if that is an issue. Patients might be interested to know that in the attempt to decrease the occurrence of wrong-site surgery, The American Academy of Orthopaedic Surgeons urges its members to sign their initials directly on the site to be operated on before the surgery. Some patients even write “NO” on the wrong side, just to be safe. 

Ask everyone who helps care for you-- doctors, nurses, technicians--and your visitors, if they have washed their hands. This is probably the most important way to help prevent hospital-acquired infections, and often sadly neglected by health care teams. A recent study found that when patients checked whether their health care workers washed their hands, the staff washed their hands more often and used more soap. Don’t forget to wash your own hands as well every time you touch soiled dressings, catheters, or after going to the bathroom.

When it comes to medical testing and procedures, know that “more is not always better”. It is a good idea to find out why a test or treatment is needed, and how it can help you. More testing does not necessarily mean better health outcomes. Some tests have serious complications, and you may be better off without them.

If you have a test, “no news is not always good news!” No news could mean there is no news—reports can go astray, go to the wrong doctor, be misfiled, etc. Be sure that you ask for and receive the results to all of your tests. Since some test results may not come back until after you leave the hospital, be sure you know how to contact your doctor for your results after discharge.

Speak up if you have questions or concerns. Report anything unusual to your doctor and your nurses. Consider asking a family member or a close friend to act as a “Patient Advocate”, someone who can help you navigate the confusing health care system while you are ill and not at your best. Many hospitals also have Patient Advocates or Patient Representatives who will perform this function for you if needed.

Become an active member in your health care team. It is the single most important way that you can help prevent medical errors. Research shows that patients who are more involved with their care tend to get better results. Get answers from reputable sources and do not be afraid to ask for a second opinion, especially if you have a complicated or unusual problem. A new website sponsored by the National Library of Medicine, www.medlinePLUS.gov is a good place to find accurate information on the internet.

Due to space limitations, this column did not address the important issue of medication errors, a common cause of death and disability, especially in the elderly. A future column will cover this topic. To receive list of resources about Patient Safety, write to The Natural Connection, c/o Dr. Pauline Bellecci, PO Box 777, Waycross, GA 31501 or contact us on our web site www.swampdocs.com

©2000-2003 Pauline M. Bellecci, MD