Keeping in mind the potential for error in hospitals today, a Spokesperson for hospitalized loved is an essential healthcare team member needed to speak up and ask questions. Part 1 of this work showed Spokespersons how to speak up and express concerns to healthcare providers. (Missed Part 1? See it here Speak up to Protect a Hospitalized Loved One – Part 1 of 2). This part provides a listing of items to consider or print to help ensure patient care is safe, understood, and in alignment with the goals for the patient.
As a Spokesperson for the patient make sure to:
Report to the Nurse immediately– if the patient experiences:
- Sudden or increased pain, shortness of breath, vomiting, bleeding, profuse sweating, or apprehension.
- New symptoms such as confusion, agitation, shaking, bruising, slurred speech, seizures, blurred vision, suddenly unresponsive or a fall.
Also tell Nurse if the patient has:
- No bowel movement in two days, sudden diarrhea, new rash, or reddened areas on (or breaks in) the skin such as a heel, tailbone, elbow or back of head. Or just about anything out of the ordinary.
Patient Safety and Resources
Make sure of positive identification of the patient before any procedure, medication, lab draw, etc. is done. Often patient name and date of birth is checked. Ensure the information on the patient wristband is correct!
- Ask for a rapid response evaluation or the Nurse to call the doctor if patient is unexpectedly worse and you feel this is not getting adequate attention.
- Patient falls can be serious. Ask for help before the patient gets out of bed.
- Take extra safety precautions with confused patients.
- Ask to speak with the Nurse Manager or Supervisor regarding any concerns with patient care.
Everyone must clean their hands with hand foam or soap and water when entering the room. Note – Some types of infection require soap and running water to remove the germs. Ask the Nurse if this pertains to your loved one.
- Discourage the patient from eating “finger foods” – such as sandwiches, crackers, toast, etc.
- If the patient has a urinary catheter, make sure the insertion area is cleaned daily. Ask for the urinary catheter to be removed as soon as possible.
- Report to the Nurse any wet or loose I.V. (intravenous) tubing or wound dressing.
Personal Care – Ensure the patient has:
- Mouth care at least once a day and is repositioned in bed several times each day and night.
- Accurately measured intake and output – or ask the nurse how to measure fluid intake and save output for the Nurse to measure.
- Ordered activity such as exercise, getting out of bed, and walking with proper assistance. This lowers the risk of blood clots, constipation, and breathing problems while promoting strength and patient self esteem
- A call bell is in reach as appropriate and valuables are kept at home.
- A review of planned activities for the day and expect routine nursing assessment and care.
Prevent Medication Mistakes – Make sure to:
Ensure the patient is being identified two different ways before receiving any medication. Often, this is name and date of birth but may also include scanning the wristband with a special device.
- Keep a list of each medication, when it should be given, the dose and actions, and common side effects. Review allergies or reactions before taking any medication. Ask the doctor and Nurse to tell you if medications are changed. Do not give the patient medicines from home while s/he is in the hospital without first getting approval from the hospital doctor.
Communications – Ask questions, ask questions, and ask questions!
- Be present during bedside report by Nurses between shifts to ensure correct or missing information is relayed.
- Ask doctors to visit the patient with the Nurse present.
- Write down questions to ask the doctor when the appropriate time comes.
- Control visits and inquiries from others. Send email messages to update family & friends regarding the patient. Do not use social media such as Facebook as this allows others to know you and the patient are not home.
- Ask the Nurse about dietary restrictions before bringing outside food to the patient.
- Ask the Nurse to destroy any written plan of care or other documents you do not wish to keep. These forms may contain confidential patient information.
- Ensure the patient understands and agrees to procedures and surgeries and proper consents are reviewed and signed.
- Follow up and ask about lab, x-ray, CT, and procedural results.
- Understand follow up care – for example wound care, Home Healthcare, doctor appointments, changes in medications, and instructions before discharge.
- Understand rights regarding Medicare coverage and early discharge.
- Understand that copies of medical records of the patient may involve a fee.
Keep in mind all of this information also pertains to you if you are a patient as well! Make sure you are involved with your care and SPEAK UP to understand it!