According to a study published in the journal Health Affairs last year, one in three hospital patients is accidentally harmed. Karen Curtiss, a former market researcher, discovered this the hard way. Her father succumbed to a host of medical errors in the hospital after a successful lung transplant, and her husband spent a year and a half recovering from a virulent strain of staph contracted in the hospital following routine surgery. "After that, my old job had zero interest for me," Curtiss says. Instead, she changed careers and wrote a handbook on hospital safety and created a nonprofit oranization to advance the cause. Here are her top tips for safety.
Never go solo. You should always bring someone with you, and that person needs to be prepared for the task. In the hospital, your care partner has two number-one jobs. The first is to facilitate communication with the medical staff. "Bring a notebook," Curtiss says. "It's often like a telephone game when information is transferred from shift to shift. Ask to be present and contribute your notes. If they've gotten something wrong, speak up."
Demand a sterile setting. The care partner's other number-one job is to make sure everyone who comes near the patient washes hands and uses sterile instruments. "It's really hard to ask doctors and nurses to wash. You're not going to be popular." What's the best way? "Own your feelings and your fears. Say, 'I am really concerned about superbugs, I know you are too, so could you wash your hands?' If a nurse says, I have gloves on, remember that they protect the nurse, not your loved one." To underline your seriousness, Curtiss recommends lining up bottles of anti-bacterial cleanser on the tray table. "It makes a statement about your germ-free boundary. There's no reason why there shouldn't be sterile covers on stethoscopes or blood-pressure cuffs. Superbugs can even be transmitted on fabrics.
Get an independent second opinion. If you have a planned surgery, always get a second or even third opinion, Curtiss says, and bring your care partner to the appointment to take notes. "Patients forget up to 80 percent of what they're told. Be sure too to an independent source for the second opinion, not a friend of your doctor."
Ask if the surgical team uses a checklist. That's the team you want. Make sure they introduce themselves to each other. "There's solid evidence that when people don't know each other's names, it inhibits communication."
Double-check medications. "There are something like 14 safety steps, but errors do happen, and there can be a lot simply because of the sheer volume of doses." Don't interrupt a nurse in the process of administering medications — "They're often doing math in their heads" — but make sure you ask what's being administered and the dosage beforehand. Double-check this information against your notes.
Be particularly mindful on the day of discharge. Say you take a blood thinner, normally at night. If they've given it to you in the morning at the hospital and you take it at home that night, you're over-dosing. Have a list of your meds and dosages, in your wallet. If you're not that organized, throw all your meds in a baggie and bring them with you to the hospital. Also keep track of problem like allergies and adverse reactions.
Stay alert once the patient has returned home. "Twenty-percent of patients end up back in the hospital within 30 days. A common reason is that people don't know the early warning signs of trouble. If the patient has picked up an infection, it might not appear for a couple of days. A staph infection can look like a little bug bite." If you're the advocate, Curtiss recommends checking in at least every day and looking hard for potential problems and complications. Make sure the patient is doing follow-up doctor appointments and taking meds correctly. "Pill organizers help, and there are smartphone apps that will remind you when to take a pill."
Curtiss says, "Remember, it's not about the people, it's about the systems. That's how mistakes arise. So get blame out of the conversation. Her book, Safe and Sound in the Hospital, gives more information on how to avoid medical mistakes.
