Preview Safe & Sound™ Engagement Resources
Contact us for more information or to subscribe:
[email protected] | 847.208.6074
M
y dad lost his life to a cascade of “never events” in his hospital
care after a successful lung transplant to cure IPF. Our family sat beside his hospital bed for 7 months as he fought back from every infection, fall,
THE CARE PARTNER ™ PROJECT
blood clot and more. The Care Partner Project is my way of transforming our family’s grief into something good for
Karen Curtiss, Founder The Care Partner Project
other families (and for his nurses who grieved dad’s outcome, too). No one is more patient-centered than a patient’s family Care Partners. Why not educate and engage patients’ families to pitch in and cover the small details that can make a big difference in patient care? Our Safe & Sound Engagement™ resources are uniquely engaging in 3 ways: •
Laser-focused on patient safety best practices
•
Written and designed by consumer marketing professionals
•
“All about” nurturing good partnerships among patients, providers and family
How to Get the Care You Want for the People You Love
OUR MISSION We are dedicated to demystifying health care with plain language and simple “to do” checklists to help patients’ loved ones support their care with confidence and grace.
The result? Vulnerable patients have informed, capable, and proactive Care Partners.
The theme for International Patient Safety Day, September 17, is patient engagement. If you’ve read this far, you’re likely very engaged, yourself!
Providers can rely on patients’
Implementation of Safe & Sound Engagement Resources takes no
Care Partners as “second eyes
time at all. Show the world your leadership this September! Let’s talk.
and ears” to support safe and sound care.
Karen Curtiss
C ON TAC T U S :
[email protected] (Download our e-flyer to share with your colleagues.) 847.208.6074 One East Erie Street, Suite 525-411 Chicago, IL 60611
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Table of Contents Checklists: How to Help Support Safe & Sound Hospital Care How to Help Support a Loved One’s Planned Admission • How to Help Prepare for a Loved One’s Hospital Stay . . . . . . . . . . . . . . . . . . . . . . . . 9
How to Help Support a Loved One’s Hospital Stay
How to Help Prevent Superbug Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
• How to Help Prevent Sepsis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
• How to Help Prevent C. Diff Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
• How to Help Prevent a UTI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
• How to Help Prevent a Fall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.
• How to Help Prevent Medication Mix-ups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
• How to Help Prevent a Blood Clot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
• How to Help Prevent Bed Sores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.
• How to Help Prevent Pneumonia from a Ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . 24
• How to Help Support Good Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
• How to Help Support a Loved One’s Hospital Care from Afar . . . . . . . . . . . . . . . . . . . . 26
• How to Take Care of the Caretakers – Especially You! . . . . . . . . . . . . . . . . . . . . . . . . 27.
How to Help Support Pregnancy, Birth, and Recovery
• How to Help a Loved One Through Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
• How to Help a Loved One Through Labor & Delivery . . . . . . . . . . . . . . . . . . . . . . . . 32
• How to Help a Loved One Recover After Childbirth . . . . . . . . . . . . . . . . . . . . . . . . . 33
How to Help Plan for Discharge and Support Recovery
• How to Help a Loved One Transition from Hospital to Home . . . . . . . . . . . . . . . . . . . . 37
• How to Help Manage Medications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
• How to Help Avoid Medication Mix-ups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
How to Help Plan for Discharge and Support Recovery continued
• How to Help Safety Proof Your Loved One’s Home . . . . . . . . . . . . . . . . . . . . . . . . . 40
• How to Monitor Your Loved One’s Recovery, Spot Setbacks, and Get Medical Help . . . . . . . . 42
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Table of Contents Checklists: How to Help Support Informed Decisions, Specialized Care How to Help Support Safe Surgery
• How to Help Get Good Info for Surgery Decisions . . . . . . . . . . . . . . . . . . . . . . . . . . 47
• How to Help Choose a Surgeon, Hospital, and Date for Surgery . . . . . . . . . . . . . . . . . . 48
• How to Help Your Loved One Prepare For Surgery . . . . . . . . . . . . . . . . . . . . . . . . . 49
• How to Help Your Loved One on the Day of Surgery . . . . . . . . . . . . . . . . . . . . . . . . 50
• How to Help Your Loved One Immediately After Surgery . . . . . . . . . . . . . . . . . . . . . . 51
Help Support a Loved One’s Emergency Care
• How to Help Prepare Ahead for an ER Visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Checklists: How to Confirm Diagnoses & Make Informed Care Decisions
• How to Help Confirm Diagnoses and Treatment Options . . . . . . . . . . . . . . . . . . . . . . 67
Checklists: How to Help Prepare for Doctor Appointments
• In-Office Doctor Appointments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
• Telehealth Doctor Appointments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Patient Forms: For Easier Record Keeping
• Medications Record Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
• Patient Pain Map Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
• Daily Care Notes Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
• Fall Prevention Flags . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
• Medicines to Take After Leaving the Hospital Form . . . . . . . . . . . . . . . . . . . . . . . . . 74
• How to Help Plan for Care After a Hospital Stay Form . . . . . . . . . . . . . . . . . . . . . . . . 75
• How to Help Get Supplies for Recovery Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
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C H EC K LISTS: HOW TO HELP SUP P O RT SAFE & SO UND HO SP I T AL CA R E
How to Help Support a Loved One’s Planned Admission Enhance experience of your care with resources for mindful preparation for a planned admission.
Your Logo As your loved one’s Care Partner, be prepared for a lot of “paperwork” and a lot of information coming your way! These tips will help you stay organized and feel confident that nothing slips through the cracks. • Store the medical records on your own phone and your loved one’s phone. • Keep any paper records in a binder or folder. • Take this folder to the hospital to collect all the paperwork your loved one will receive. Everything will be in one place!
HO W TO HELP
PREPARE FOR A LOVED ONE’S HOSPITAL STAY: It’s important to have your loved one’s medical history at your fingertips. Know the user name and password for their medical records on their patient portal. (Note, they may have several portals, depending on the number of doctors and hospitals that have treated them.) Patients’ medical records can have errors—so get corrections, as needed.
Consider making paper copies to share with doctors or nurses who may ask, especially if you want to make sure any errors are noted.
Make sure all of your loved one’s doctors have the same set of complete and correct records.
Know all the medications and vaccines your loved one has taken over the past year. Use our handy form for these details.
Know the name, address, and phone number of your loved one’s pharmacy.
Medical providers cannot share info with you about your loved one without the patient’s legal written permission. Doctors may have their own Privacy/HIPAA forms, but you can also download one from a government site from the state where your loved one lives.
Make copies of insurance cards and a photo ID or snap pics with your phone.
Go to your loved one’s doctor appointment(s) with them.
Together create a list of questions and topics to cover during any pre-admission doctor appointments.
List questions in order of priority.
• Bring a notebook and pens. Leave them in the room with your notes for the next “Care Partner” who will arrive for your loved one. Note any special “to do’s.” For example, “Please follow up on Dad’s blood test results.” • Use our handy note form for ideas about details to track – and remember!
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Take notes on doctor’s answers or ask to record on your phone so you and your loved can listen and take notes later. Explain as a benefit to the doctor, e.g., “We will listen to the recording later, so we won’t have to call your office if we miss something today.”
Have email addresses and phone numbers for friends and family you need to keep informed.
Make sure you know whether your loved one wants visitors, and if so, who is permitted—or not. Before a scheduled hospital stay, organize shifts of caring family members or friends so, ideally, someone is with your loved one around the clock around the clock, or as permitted by the hospital. Just ask!
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C H EC K LISTS: HOW TO HELP SUP P O RT SAFE & SO UND HO SP I T AL CA R E
How to Help Support a Loved One’s Hospital Stay Engage patients and families to help support your safe care.
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HO W TO HELP
PREVENT SUPERBUG INFECTIONS:
Always wash your hands with soap and warm water, or use alcohol gel or foam: • Before you touch your loved one, and • Whenever you enter or leave your loved one’s room.
As needed, kindly remind visitors and others to wash their hands before touching your loved one. It’s okay to speak up. In a rush, even nurses and doctors may forget this step, but it could be a life-saver!
ABOUT “SUPERBUG” INFECTIONS: Dangerous and difficult-tofight infections such as MRSA (mersa), VRE, and CRKP are called “superbugs.” The germs are invisible and they’re everywhere in every hospital—even on clothing.
RISK FACTORS: All patients are at risk for “Superbug” infections.
Help make sure your loved one washes their hands and uses a soft-bristled brush to gently clean under nails, especially after using the bathroom and before eating.
Use alcohol wipes to clean away germs from any surfaces your loved one and others may touch, such as... • Cell phone.
• Grab rails.
• Doorknobs.
• IV pole.
• Call buttons.
• TV remote.
• Tray table (top, sides, drawer and underneath).
• Room phone.
• Toilet handle.
• Bedside table.
• Bed rails.
• Sink handles.
• Wheelchairs.
• Inhalers.
• Room chairs.
Be sure to clean again after every touch or contact by anyone.
Ask for alcohol-based hand cleanser to put within easy reach for your loved one. Note: It’s okay to ask for alcohol wipes and gel, and a nail brush. If you buy them yourself, choose well-known brands.
Make sure nurses and doctors use clean stethoscopes and thermometers.
GET A NURSE IF: Your loved one shows signs of (or complains about) the following:
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• Oozing, pus, redness, or tenderness around surgery stitches.
• Breaks in the skin.
• Diarrhea.
• Skin rash.
• Nausea.
• Chills, shivering.
• Fast breathing.
• Bumps or spots that look like boils, bug bites, or pimples.
• Confusion.
• Body aches.
• Extreme pain.
• Cramps.
• Fast heartbeat.
• No appetite.
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• Headache.
HO W TO HELP
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PREVENT SEPSIS:
When a central line is inserted, ask: “Are you using a central line bundle and checklist?”
ABOUT SEPSIS (Bloodstream Infection): Germs can invade the body through cuts or breaks in the skin, resulting in serious
Watch to make sure that nurses and doctors always: • Wash their hands thoroughly before touching your loved one. • Use sterile instruments and supplies.
infection, called Sepsis, that’s
• Clean the skin with an alcohol wipe.
carried through the body in the
• Choose the safest spot. (Ask, “Why?” if groin is chosen.)
bloodstream.
RISK FACTORS: Use of a tube and bag system called an IV or “Central Line” to deliver fluids is a common risk. However, any break in the skin or intestinal tract can be
• Use a clean sheet to drape your loved one’s body • Wear a mask. • Cover the area with a sterile pad.
Make sure any openings in the skin are kept covered at all times.
COMMON LOCATIONS FOR CENTRAL LINES AND IVS:
a risk. Also, sepsis can occur
•
CENTRAL LINE
when someone is suffering from multiple infections.
CHECK OUT EndSepsis.org.
IV LINES often, but not always, go in the hand or arm.
• •
•
CENTRAL LINE can go in the groin, but it’s not the safest place.
GET A NURSE IF: Your loved one shows signs of (or complains about) the following:
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• Chills.
• Shivering.
• Confusion.
• Headache.
• Diarrhea.
• Nausea.
• Extreme pain.
• Fast breathing.
• Fast heartbea.
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ABOUT C. DIFF INFECTIONS: C. diff is another type of infection from germs in hospitals. It causes diarrhea and dehydration that can lead
HO W TO HELP
PREVENT C. DIFF INFECTIONS:
If your loved one has been on antibiotics in the past year, or lives in a nursing home or long-term care facility, make sure these facts are part of the medical record. To be on the safe side, tell your loved one’s nurses yourself.
Follow our “How-To Guide” for preventing Superbug infections.
Alcohol-based cleansers kill Superbugs, but not C. diff germs! So, it’s necessary to wipe down all surfaces with bleach wipes, too. Clean these surfaces when your loved one first arrives and after every touch/contact by anyone. • Cell phone.
• TV remote.
• Doorknobs.
• Toilet handle.
• Call buttons.
• Sink handles.
All patients are at risk of
• Room phone.
• Room chairs.
C. diff, especially those:
• Faucets. • Inhalers.
• Tray table (top, sides, drawer and underneath).
• Grab rails.
• Bedside table.
• IV pole.
• Wheelchairs.
to heart failure.
RISK FACTORS:
• Age 65+. • Recently using antibiotic medicines. • With a prior history of C. diff. • With a history of long bouts of diarrhea. • A weak immune system. • Living in a nursing home or other long-term care facility.
• Bed rails.
Pay special attention to cleaning toilet levers and faucets.
NOTE: It’s okay to ask hospital staff for bleach wipes. If necessary, buy a trusted brand to use.
Make sure you and your loved one wash hands with warm water and soap before eating and after using the bathroom. A soft soapy nail brush helps clean under nails where C. diff can hide.
Bring clean clothes to the hospital for your loved one to wear home. Store in a suitcase or plastic bag to keep them germ-free.
As soon as you get home, wash all clothing you and your loved one wore in the hospital with warm water, detergent, and bleach. Use a clothes dryer to help kill germs. Share this tip with visitors, too!
Don’t forget to clean personal items, such as: • Phone.
• Pens.
• Ipod.
• Laptop.
• Glasses
GET A NURSE IF: Alcohol wipes won’t kill C. diff germs, so be sure to also clean with bleach wipes.
Your loved one shows signs of (or complains about) the following: • Diarrhea (may be bloody) • Chills
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• Loss of appetite
• Nausea
• Stomach pains, cramps
• Fast/racing heartbeat
HO W TO HELP
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PREVENT A UTI:
Every day, ask if the Foley catheter (shown below) can be removed.
ABOUT URINARY TRACT INFECTIONS: A urinary tract infection (UTI) can develop when germs enter the body through a plastic tube (Foley catheter) used to drain urine from the bladder.
When it’s no longer needed, ask the doctor for a written order to take the Foley catheter out. If not taken out as ordered, politely remind at every shift change until the tube and bag are removed.
Ask about the cleaning plan for the Foley catheter. (Daily is ideal.)
To prevent urine from going back into your loved one’s body, keep an eye on the tube for kinks and tangles, and straighten them. Make sure the bag hangs below your loved one’s stomach area so urine can’t back up the tube.
Make sure the urine bag is replaced when full.
GET A NURSE IF: Your loved one shows signs of (or complains about) the following: The bladder, kidneys, and urethra can all become infected. Another name for this is CAUTI,
• Chills.
• Headaches.
• Body ache.
• Pain or a burning feeling in the stomach area.
which stands for Catheter
• Confusion.
Associated Urinary Tract
• Lower back pain.
Infection.
• Shivering.
RISK FACTORS: Use of a Foley catheter tube
NOTES:
and bag system
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• Blood in urine bag. (You may see a slightly pink color.)
HO W TO HELP
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PREVENT FALLS:
Look for things in your loved one’s room that might cause a trip and fall. • Point out all furniture and equipment on wheels. • Discuss ways to move around the room without leaning on wheeled items for support.
If your loved one has a history of falling or any problems with their balance: • Ask about getting a cane or walker, and using bed rails.
ABOUT FALLING: Falls can happen to anyone in an unfamiliar place. Most patients are tired, weak, or sleepy from medications, or suffering from conditions affecting balance.
RISK FACTORS: ALL PATIENTS—regardless of age or strength—are at risk for falls. Past history of falling or problems with balance carry extra risk.
• Ask about the hospital’s fall protection equipment, such as low beds, floor padding, and bed alarm. • Discuss the possibility of a room for your loved one close to the nurses’ station.
Make sure someone helps your loved one go back and forth to the bathroom or commode, and that someone is on standby in your loved one’s room for every trip.
Hang our “CAUTION!” signs in can’t-miss spots in your loved one’s room, such as on doors or over the head of the bed.
Ask for non-skid socks, or bring slippers, for your loved one to wear out of bed.
If you are able, lend your arm for support when your loved one walks. Please don’t risk injury to yourself—it’s okay to ask for help.
Watch to make sure the hospital gown and any IV tubes won’t trip your loved one.
GET A NURSE IF YOUR LOVED ONE FALLS. . . • Hit a call button immediately. • Put a blanket over her/him. • Go in the hall and call for help, if necessary. • Do not move your loved one. • Ask for a meeting with your loved one’s nurses and a nursing supervisor to discuss: 1. How the fall happened, and 2. What will be done to help make sure your loved one doesn’t fall again.
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Your Logo ABOUT MEDICATION MIX-UPS:
HO W TO HELP
PREVENT MEDICATION MIX-UPS:
Make sure your loved one’s allergies and any bad experiences with medicines in the past are included on the medical record — and highlighted in a bold way.
important for you to help, too.
Research the pros and cons of every drug prescribed for your loved one. Make notes about the potential side effects and interactions at MedlinePlus. If you have any concerns, bring them up immediately with the attending doctor or nurse.
There is no such thing as “too
Before a nurse ever gives a medicine, ask:
Safety steps are followed each time a patient gets a medication in the hospital. Even so, it’s
safe” for your loved one!
• What is the medicine you’re planning to give? • What is it for? • What is the dose? • Who prescribed it? • Say: “Let’s confirm that it’s for (your loved one’s name).”
RISK FACTORS: Patients tend to get several medications in the hospital. Many look alike and some names sound alike. Nurses can be distracted, especially when others talk or interrupt them
• For medicines in an IV bag, ask: “What time do you think this bag will run out?” If the bag empties completely, get a nurse, especially if you see blood creeping up the IV tube.
Don’t talk to or distract nurses when they are giving medicines. However, speak up immediately if you sense a mistake is being made. For example, wrong patient, wrong medicine, wrong time, wrong dose, or wrong way.
Record every time your loved one gets a medicine.
If your loved one is 65 or older, check the Beers List, too. For children, check the Kids’ List. Both have info about medications considered potentially unsafe or “iffy” for these age groups.
while giving a medication.
GET A NURSE IF . . . TRUST YOUR GUT:
Your loved one shows signs of (or complains about) the following:
You know your loved one
• Diarrhea.
best. Every medication (or
• Stomach cramps.
combination of meds) could
• Coughing.
affect your loved one in a way
• Wheezing.
that’s not expected.
• Difficulty breathing.
Always get a nurse if you have worries about anything that “just doesn’t seem right.”
• Difficulty swallowing. • Swelling face. • Swelling/itchy eyes. • Rash or hives.
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• Confusion, anxiety, restlessness. • Light-headedness, dizziness, fainting. • Swelling in neck. • Bluish lips. • Cool, clammy skin. • Chest pain. • Unusual sweating.
HO W TO HELP
Your Logo ABOUT BLOOD CLOTS: Blood clots can form in the deep veins of legs and arms. Sometimes, a piece of a clot breaks off and travels to the lungs—this is called a pulmonary embolism or PE for short—which is why they are serious problems.
PREVENT BLOOD CLOTS:
Tell doctors and nurses you’re concerned about blood clots.
Discuss these precautions with your loved one’s doctor: • Special stockings, boots, or arm bands that pulse, • Regular and frequent walks if possible, • A prescription for a blood thinner.
Watch for the signs of blood clots, listed below, for at least one month after your loved one leaves the hospital.
Remember that blood clots can form even if your loved one feels 100% “back-to-normal” in other ways.
If okay with the doctor, encourage walks and exercise after your loved one leaves the hospital.
GET A NURSE IF: Your loved one shows signs of (or complains about) the following: • Swelling in a leg or arm. • Pain or a burning feeling in a leg or arm.
RISK FACTORS: y Surgery (especially stomach, hip or knee). y Family history of clotting.
• A charley-horse (cramp-like) pain that doesn’t go away pretty quickly, persists, or grows worse. • Shortness of breath, difficulty breathing.
NOTES:
y Diabete. y Smoking. y Birth control and other hormone pills. y Obesity. y Spinal cord injury. y Multiple injuries. y Lack of exercise.
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Your Logo ABOUT BED SORES: Also known as pressure wounds, bed sores are pits or breaks in the skin in bony areas that don’t get much blood flow, or in folds of skin where sweat collects. Any break in the skin can be a dangerous tunnel for infection. Bed sores are much easier to prevent than heal.
RISK FACTORS: • Thin skin. • Stroke. • Lung conditions. • Cancer treatments. • Diabetes. • Spinal cord injury. • Bed/chair-bound. • Poor circulation. • Very thin or overweight . • Age 65 or older.
WHAT TO LOOK FOR: • Any breaks/scrapes in the skin. • Abnormally white patches of skin, especially on bony areas. • Pinkness, redness or swelling in the skin that doesn’t go away in minutes. • Areas of skin that are extra-warm.
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HO W TO HELP
PREVENT BED SORES:
Help make sure your loved one changes positions every two hours— or more often if your loved one can manage it. It helps to set a timer!
Ask for an alternating air pressure mattress and some type of pad to absorb moisture.
Make sure your loved one has foam cushions between ankles and knees, for elbows, and back of the head.
If the hospital gown or sheets become wet, get help to change them as soon as possible. If you are able-bodied, help change the sheets.
Help make sure that nothing rubs or scratches your loved one’s skin—ask nurses about barrier cream for fragile skin areas.
When your loved one gets out of bed, either alone or with help, make sure it’s done very gently to avoid scraping any skin.
Ask the attending doctor about “upping” the protein in your loved one’s diet. Ask if it’s okay for you to bring high-protein snacks, drinks or food.
It’s okay to ask for the hospital wound care specialist if you have any concerns. Remember, bed sores are much easier to prevent than heal!
MAKE SURE NURSES CHECK YOUR LOVED ONE’S SKIN EVERY DAY— OR EVEN MORE OFTEN. back of head behind ears
• •
THIS IS WHERE NURSES WILL LOOK:
•
1. The bony areas, and 2. Areas where sweat collects: • Between buttocks, • Between folds of fat, • Under breasts.
IF SKIN PROBLEMS APPEAR: Make sure no pressure is put on the abnormal areas of skin for the next 24-48 hours, or until the skin is back to normal.
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•
• •
• •
•
•
elbows hip bones tailbone “sit” bones
•
•
knees
•
•
heels
Your Logo ABOUT PNEUMONIA FROM A VENTILATOR: Patients who need a machine to help them breathe can get a lung infection (pneumonia) if germs get into the breathing tube. This type of pneumonia is also called VAP, which stands for Ventilator Associated Pneumonia.
RISK FACTORS: y Use of a ventilator. y Lung disease. y Age 65 and older.
NOTE: Sometimes patients on ventilators have their hands
HO W TO HELP
PREVENT VENTILATOR PNEUMONIA:
Ask about the sterile steps used to put the breathing tube into your loved one.
Ask for a daily check of your loved one’s ability to breathe without machine help.
Help make sure your loved one’s back and head are always at least at a 30-degree angle by raising the mattress. • If your loved one slumps, tell a nurse right away. • If you are able-bodied, ask if you can help position your loved one to sit up straighter. • Be on the lookout for bed sores on your loved one’s tail bone and “sit bones.” Follow our checklist to prevent bed sores.
Ask about medicines to help prevent your loved one from getting stomach ulcers (sometimes caused from the breathing tube).
Ask about care for your loved one’s teeth, gums, and tongue every four hours to kill germs that could go from mouth to lungs. Make sure these are used every time:
bound to keep them from
• A toothbrush with soft bristles and 1.5% peroxide toothpaste.
pulling out the tubes by
• A vacuum tool to pull germs and waste from the mouth.
accident. This may be scary for
• A chlorhexidine rinse. (It tastes bad but it works!)
your loved one and may even cause a panic attack. Get a
GET A NURSE IF:
nurse to help ease your loved
You see:
one’s fears.
• The tube come loose. • A pool of water inside the tube. (If in doubt, call a nurse.) Your loved one shows signs of or complains about: • Fever, chills, shivering, body aches, headaches, confusion. • White patches or sores in your loved one’s mouth or on the lips. • Cough with phlegm (can be yellow or green). • Increasing need for suctioning. • Need for higher settings on the breathing machine
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HO W TO HELP
SUPPORT GOOD COMMUNICATION:
Your #1 Care Partner “job” is to help prevent infection. This is as simple as
AS YOUR LOVED ONE’S CARE PARTNER, YOU ARE AN INVALUABLE MEMBER OF THE TEAM. You know your loved one best and can help express their
speaking up to ask anyone who touches your loved one to wash their hands first. This includes visitors, nurses, doctors, and all other hospital staff. Of course, you will, too!
Ask to participate in doctor visits (“rounds”) or any bedside shift
needs, questions and concerns.
change conversations, possibly by phone or iPad if you cannot be
And, there are many ways you
there in person.
can be an extra pair of eyes, ears and hands to help support the medical team in providing safe and sound care.
Ask the nurses to let you know times for morning rounds and bedside shift changes.
Keep a notebook and pen in your loved one’s hospital room to record notes and questions to ask. This is a great way for those staying in shifts to share info. Use our handy form!
Know how to call for extra care, if necessary.
Stay focused on what’s right for your loved one.
Speak up if you have any concerns at all. You know your loved one best, and they may be too
Please keep in mind that serious, life-saving work goes
sick or too medicated to speak for themselves.
Show your attitude of gratitude. Polite manners and thoughtful acts
on every minute of every day in
of kindness promote the best teamwork!
every hospital. It’s important to
Think of the hospital as a peaceful HUSH
be respectful of everyone’s time
Zone—Help Us Support Healing. Speak in
and skills, but it’s also important
low, quiet tones and keep your movements
to speak up for your loved one’s
as calm and unhurried as possible. Be sure
needs whenever necessary.
to ask visitors to respect the HUSH Zone, as well.
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Medical providers cannot share info with you about your loved one without their written permission. So, help your loved one complete:
HIPAA Form allowing medical team to share info with you,
Medical Power of Attorney,
Advance Directive/Living Will. Fill-in-the-blank versions are available for download on government sites in your loved one’s state. (Forms can be customized). Try to have good conversations when filling out these forms with your loved one. Everyone is entitled to have their choices reflected in their documents.
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SUPPORT A LOVED ONE’S HOSPITAL CARE FROM AFAR:
It’s important to have your loved one’s medical history on hand. { Know the username and password to their records and check them over. { Be sure to get corrections if you spot anything missing or incorrect. (Especially, medications!) { Let the medical team know right away because it takes time to get records changed! As a Care Partner, you have an important job making sure that all your loved one’s doctors have sound information to help them make sound decisions.
When your loved one is in the hospital, buddy up with a nurse for updates and info. { Call the nurse’s station every day at the same time. { The best time is 2pm – 5pm. Try to talk to the same nurse each time. { If your loved one is in Intensive Care (ICU), call twice a day, 7am and 7pm.
For every call with a hospital nurse, ask about: { Tests ordered and results { Medications started and stopped. (Why?) Vital signs. (Any trends?) { Daily case conference notes about your loved one. { Your loved one’s spirits.
Arrange for good communication during your loved one’s hospital stay:
No matter how stressed or worried you may be, try for an attitude of gratitude. After your loved one is discharged, consider sending thank-you notes to those who helped you.
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{ Visit your loved one by smart phone or iPad. { Ask to participate in doctor visits (“rounds”) or any bedside shift change conversations by phone or iPad. { Ask the nurses to let you know times for morning rounds and bedside shift changes.
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TAKE CARE OF THE CARETAKERS —ESPECIALLY YOU! TAKE GOOD CARE OF YOURSELF!
Chances are you can’t do this job alone! Organize shifts of caring family members or friends so, ideally, someone is with your loved one around the clock, or whenever permitted by the hospital.
• Stay warm, rested, and hydrated—lots of water! It’s okay to ask for pillows and blankets for your comfort. • Try to get a little exercise. Stretches and walks do wonders for body, mind, and soul. • Feel free to use the hospital chapel. The hospital can arrange for a visit from a rabbi, priest, or minister for your loved one, too.
HELPFUL RESOURCES: If you need additional help or advice, you may want to reach out to a professional patient advocate:
Just ask! • Bring some distractions—a book, magazines, a deck of cards, soothing music. These are nice to share with your loved one whenever they are up to it.
• AdvoConnection, • Greater National Advocates, • National Association of Healthcare Advocacy.
HELP LIGHTEN THE LOAD FOR HOSPITAL STAFF: • When your loved one needs ice, water, a blanket, or any other small amenity, ask if you can help by getting these yourself. • If you are able-bodied, offer to help change the sheets. • Keep your loved one’s room neat and orderly. Clutter can cause a fall! • When making a trip to the cafeteria, consider bringing something back to the nurses! Coffee? Tea? Water? Treat? So appreciated!
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C H EC K LISTS: HOW TO HELP SUP P O RT SAFE & SO UND HO SP I T AL CA R E
How to Help Support Pregnancy, Birth & Recovery Engage mothers-to-be and their partners with simple steps to support safe outcomes.
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DURING PREGNANCY:
Read reliable sources about pregnancy and what is happening in each trimester.
PREGNANCY CARE PARTNERS: A mom-to-be and infant have the best chance for a healthy pregnancy and delivery when supported by an informed and
Discuss getting care with a midwife or doula (with/without doctor).
Go to all appointments, or as many as you can. Together, make up a list of questions to ask the doctor/midwife and take notes. (Create a notebook just for the pregnancy so all info will be in one place.)
Ask the doctor/midwife about:
engaged Care Partner.
• Vitamins and nutrition, especially folic acid (for the baby’s brain development).
As a potential Care Partner,
• Urgent warning signs to watch for during pregnancy.
look over all the “To-Do’s” for
• Pre-eclampsia and eclampsia: What are they? Warning signs?
supporting someone you care about through pregnancy,
• The birth plan, along with any concerns and preparations for labor and delivery.
delivery, and recovery. Use these
• C-section rate.
tips together!
• Lamaze classes.
RISKS TO PREGNANCY:
• All anticipated costs, your insurance coverage and out-of-pocket expenses.
y Heart disease. y High blood pressure. y Diabetes. y Kidney disease. y Use of recreational drugs. y Smoking. y Drinking alcoholic beverages. y Underweight or overweight. y Age 40+.
• Monitoring blood pressure or oxygen saturation at home with a pulse oximeter or blood pressure cuff. (Available online or most major stores.)
Tour the hospital where the baby will be delivered and ask for its C-section and infection rates. Look up its safety rating at Medicare.gov/care-compare and HospitalSafetyScore.org.
HELP YOUR LOVED ONE CONTACT A DOCTOR, GO TO AN EMERGENCY ROOM OR URGENT CARE CENTER FOR: • Vaginal bleeding.
• Chest pain.
• Clear fluid leaking from vagina.
• Severe nausea or vomiting.
• Fast heartbeat.
• Headache that won’t go away, and is worsening.
• Redness or pain in leg that feels like a charley-horse that won’t go away.
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• Cramping. • Changes in vision.
• Trouble breathing, shortness of breath.
• Inability to pee or fully relieve bladder.
• High blood pressure.
• Puffiness or fluid build-up.
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HO W YO TOUR HELP HO W TO HELP LO V ED O NE
THROUGH LABOR & DELIVERY: Help prevent infections for mother, baby and yourself! Make sure you and everyone else who comes close to your loved one washes their hands first with warm, soapy water or a hand cleanser, such as Purell.®
Be prepared to stay in the hospital 24/7 until discharge day. Bring a notebook and pen—ideally the pregnancy notebook you started.
During labor, ask how you can help. Time contractions? Get ice chips? Massage back? Make calls to friends and loved ones? Offer supportive words/encouragement to help minimize stress.
PREGNANCY CARE PARTNERS: Look over all the “To-Do’s” for supporting someone you care about through delivery and recovery. Do you feel capable or have the time to participate? If not, no worries and no shame. Sometimes the best Care Partner is someone who can help their loved one find another!
RISKS & CONCERNS: • Failure to spot problems early and respond quickly. • Hospital infections. • Excessive bleeding (hemorrhage). • Blood clots. • Complications from health conditions like heart disease, diabetes, and high blood pressure. • Complications due to age (40+, especially).
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Get to know everyone involved on the medical team—make note of their names and roles.
Make sure you have records of medications your loved one normally takes and, if necessary, ask how/when they will be administered. Ask about other medications that may be needed and when they will be given—look them up on MedlinePlus. Use our handy notes form to help you know details to track!
Ask about risks of severe bleeding/hemorrhage and prevention. Ask: how do you monitor blood loss?
Organize a support team of friends and family to pitch in and help during the first weeks following birth. There are good apps to help you!
Watch the monitors measuring heart rate and oxygen levels. No worries if you need help understand the readings—just ask the nurses. They’ll be glad to have you as a second pair of eyes!
GET A NURSE IMMEDIATELY IF: The mother or baby seem to be in distress or “going downhill,” or if you see or your loved one tells you about: • Vaginal bleeding, clotting blood.
• High blood pressure.
• Fast heartbeat. (watch on the monitors).
• Foul-smelling vaginal discharge.
• Redness or pain in leg that feels like a charley-horse that won’t go away.
• Mental confusion, unusual sluggishness, slurring words, fainting.
• Trouble breathing, shortness of breath.
• Headache that won’t go away, and is worsening.
• Chest pain.
If nurses are not responding to your concerns, you may call for a “Condition Help.” Dial “O”/operator on the hospital land line and say: “I need a rapid response team in room #___.”
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RECOVER AFTER CHILDBIRTH:
Continue all good hand-washing practices to protect both mother and baby.
In the hospital, think ahead to recovery at home. Ask about specific instructions for home care of both the mother and her newborn.
Ask about medications—use our handy discharge Medication Record to take notes.
Be present for the discharge conversation your loved one will have with a nurse just before going home. (Often, Care Partners leave to get the car, but that can wait!) Final instructions are critical and a good time to ask questions! Take notes or ask to record the conversation on your phone.
Make sure the discharge care plan includes:
SUPPORT DURING RECOVERY AFTER CHILDBIRTH: The first three months after
{ List of warning signs, especially life-threatening complications, and how to respond. { Also, be sure to get contact info for doctors, hospital help line, and any other resources for immediate medical help.
childbirth are called the “4th
{ Warning signs of excessive bleeding and blood clots.
Trimester” as a woman’s body
{ Signs of depression and anxiety.
recovers from the physical and
{ Lactation and breastfeeding support contact information.
emotional stresses of pregnancy
{ The time and date of first follow-up medical appointments for mother and baby.
and delivery. Be on the lookout for any setbacks—physical, mental, or emotional—and help make sure your loved one gets immediate medical attention.
RISKS & CONCERNS: y Excessive bleeding. y Infected stitches (if C-section or episiotomy performed).
Go to any follow-up doctor appointments, prepared with a list of all questions the new mother and you may have.
Have candid conversations with your loved one about their emotions and feelings. Ask, “How are you really doing?”
CONTACT A DOCTOR OR GO TO AN ER/URGENT CARE CENTER FOR: • Vaginal bleeding.
• Foul-smelling vaginal discharge.
• Trouble breathing, shortness of breath.
• Severe nausea or vomiting. • Headache that won’t go away, and is worsening.
y Hospital infection.
• Fast heartbeat.
y Blood clots.
• Redness/pain in leg; a charleyhorse that won’t go away.
• Cramping.
• High blood pressure. • Chest pain.
• Inability to pee or fully relieve bladder.
• Fever, chills, body aches.
• Puffiness or fluid build-up.
y Anxiety. y Depression, ranging from “the blues” to suicidal thoughts.
• Redness, pain and swelling at stitch areas.
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• Changes in vision.
C H EC K LISTS: HOW TO HELP SUP P O RT SAFE & SO UND HO SP I T AL CA R E
How to Help Plan for Discharge & Support Recovery Prevent readmissions with practical planing tools for patients and families.
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Your Logo CARE PARTNERS ARE KEY: The Discharge Conversation! Make sure you’re able to be present with your loved one for their discharge meeting with the nurse. Take good notes and speak up with questions. You may ask permission to record the discharge conversation on your phone, especially if you explain that you
TRANSITION FROM HOSPITAL TO HOME:
Ask for a meeting with a discharge planner early in your loved one’s stay, ideally on Day One.
On the day of discharge, be sure to stay with your loved one during the entire discharge conversation. This is no time to get the car—a very common practice!
Discuss the home environment for safety equipment that may be needed.
Ask where to rent or buy any needed medical equipment or supplies. TIP: Many communities have lending programs through churches and senior centers.
Ask when the hospital stay records will be sent to your loved one’s main doctor.
don’t want to bother them later with a call in case you miss an important detail.
PLEASE NOTE:
Confirm follow-up doctor appointments needed (when, with which doctors).
Find out if follow-up tests are needed or if there are prescriptions to fill.
If your loved one doesn’t have any support for recovery at home, it is okay to say: “This is an unsafe
Record the medications administered the day of discharge, including the time and dose.
discharge.”
Cover driving limitations (if any), and any other limits, like exercise.
The hospital will then hold off
Ask about signs or symptoms to watch for, when to get medical attention, and if there’s a hospital hotline.
discharge until support care can be arranged.
Find out if skilled care is needed—for example, speech therapy, physical therapy, occupational therapy, wound care.
Get specifics on any diet and nutrition needs, including groceries to buy or remove from the home.
Ask if your loved one could benefit from electronic monitoring equipment which reports info directly to the doctor. Will hospital supply?
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MANAGE MEDICATIONS: During a hospital stay, it’s common for doctors to adjust patients’ medications and routine for taking their prescriptions. There may be medications at home that are not needed anymore, or may be in different doses than needed going forward. It’s really important to make sure these are removed to help prevent any medication mix-ups—which can be dangerous! Do not flush or throw these medications in the garbage—it’s unhealthy
Be sure to ask nurses and doctors about medications your loved one may need that don’t require a prescription, such as those for: y Headaches. y Sleeplessness. y Pain.
for Mother Earth, as they make their way into our water systems. Instead, take unusable medications to a safe disposal location. Some pharmacies, hospitals and public safety centers—such as your local fire department— will take them off your hands and dispose of them responsibly.
OLD MEDICATIONS TO DISPOSE OF:
Medication Name
y Cold/Sinus. y Allergies. y Nausea. y Diarrhea. y Quitting smoking. y Nutrition (vitamins, herbs, protein supplements). Ask for recommendations of those that will not interfere, or cause bad side effects, when taken with the new prescriptions your loved one is taking. Why not double-check with the pharmacist who fills your loved one’s prescriptions? They are a wonderful resource and will be glad to know you’re being so careful.
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Form
Dosage
Doctor
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AVOID MEDICATION MIX-UPS: In the hospital, there are many steps involved in making sure a patient gets the correct medication—yet, mistakes occur sometimes. Use our Medication Record to have a clear plan of what your loved one takes and when. If your loved one’s home is in assisted living, memory support, longterm care or rehab, make doubly sure that:
You complete the Medication Record.
Your loved one’s Medication Record is shared with everyone involved in their care.
HOW PATIENTS ARE AT RISK OF OVERDOSING AT HOME: y Patients are typically given a dose of medication before leaving the hospital.
The staff has several copies.
All nursing supervisors are aware of all medications taken the day of discharge and any changes to your loved one’s prior medication routine.
You call to follow up and confirm all details.
y The patient may take another dose too soon by mistake if they’re in the habit of taking the same medication before bed, or if their residential community administers medications on a schedule. y The second dose, taken in error, can send them right back to the hospital. Yes, it happens... more often than you can imagine! Another reason why your help as a Care Partner to your loved one is invaluable!
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SAFETY-PROOF LOVED ONE’S HOME: SAFETY-PROOFING SUPPLIES:
Try to plan ahead for the home adjustments and supplies your loved one is likely to need after a hospital stay. Talk to a case manager or discharge planner as
Non-slip rubber mat for the tub or shower.
Grab-bars for the shower and next to the toilet (towel bars are not strong or secure enough to handle any weight).
Shower sponge with long handle.
Shower chair.
soon as you can. They will fill you
Elevated toilet seat.
in on what to anticipate and what
Portable commode.
items to have on hand for a safe
Hospital bed.
and sound recovery at home.
Hoyer lift (helps in/out of bed and chairs).
Most of these items can be
Shoehorn with a long handle.
ordered online. They should
Sock aid to help put on socks.
arrive promptly enough so
Dry shampoo.
that you won’t have to spend precious time running from store
Reacher with long handle to pick up items from the floor or help with dressing.
to store.
Cane, crutches, walker, wheelchair.
Preventing falls is a top priority.
Blood pressure monitor.
Pulse oximeter.
Bathroom scale.
Small blankets for chair, recliner, and sofa sitting.
Non-skid socks or a good-fitting pair of slippers.
Extra batteries for the TV remote.
Phone chargers.
SAFETY-PROOF THE HOME: Try to imagine what it would be like to move around the home with less energy or physical limitations. Look for ways to make everyday life both convenient and safe for your loved one.
Consider setting up one room to serve most needs, ideally on the main floor close to a bathroom or portable commode. Equip with a bed, cell phone, TV, remote (with extra batteries), comfy chair, laptop, iPad, chargers, and any other creature comforts close by.
Remove throw rugs in the house—they’re a tripping hazard!
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SAFETY-PROOF YOUR LOVED ONE’S HOME
2:2
Consider an electronic thermostat that controls heat and air through an app on the phone.
Repair any uneven floors.
Place nightlights in halls, bathrooms, the kitchen, and any other rooms your loved one may use at night.
Remove any loose wires or extension cords that could cause a trip, or where equipment could become entangled.
SAFETY-PROOF THE BATHROOM: The bathroom is where most accidents occur. Water, slippery tiles, and hard porcelain surfaces make a perfect storm for disaster. These little spaces need a lot of attention!
SAFETY-PROOF THE KITCHEN:
Put glasses, plates, bowls, silverware and all food items in easy reach so that no tip-toes or bending is required.
Make sure the eating table and chair are sturdy and positioned so they don’t create a hazard.
Make sure entrances and pathways are wide enough to fit a wheelchair or walker if needed.
Keep the fridge and cabinets stocked with foods recommended for recovery and good health.
Secure grab bars to the shower/tub wall and next to toilet either horizontally or vertically — not diagonally.
Remove food and drink items discouraged by doctors.
Consider a portable commode or raising the toilet seat height using an elevated seat.
Install non-slip suction mats or rubber silicone decals in the tub or shower floor to prevent falls.
Be mindful of water on the floor and wipe it up immediately.
Make sure the towels are in easy reach of the shower or tub.
Make sure the shower curtain slides easily.
Clean up any messy drips from shampoo, soaps, or lotions.
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RECOGNIZE RECOVERY SETBACKS:
Sometimes, patients ignore
Go over this list with your loved one every day for at least a month after leaving the hospital. It will help both of you stay on the lookout for early signs of complications.
signs of health problems after
Increase in pain — anywhere!
a hospital stay, hoping they will “just go away.” This is fairly common — no one wants to
Headaches or fever.
Coughing, congestion.
More frequent need to urinate, especially at night.
Bulging neck veins.
Blood in urine or stool, rectal bleeding.
Light-headed, dizzy.
Diarrhea.
Confusion.
Chest pain, indigestion, heartburn.
Sores or raised red bumps that look like insect bites, open oozing sores, or open breaks in skin.
Heart thumping or fluttering.
Increasing redness or swelling around wound/stitches.
Don’t hesitate to call your
Trouble breathing, shortness of breath.
Any oozing from wound(s) or stitches.
loved one’s doctor for any
Nausea, vomiting.
Sadness, hopelessness.
think about going back to the hospital! Care Partners have an important role to play, monitoring a loved one’s recovery and, possibly, providing moral support, can help ensure that any medical complications are spotted and treated early.
health problems you see or your loved one tells you about. Trust your gut. It’s okay to call about anything that “just doesn’t seem right” concerning your loved one’s physical, mental, or emotional wellbeing.
Appetite not mproving/ loss of appetite.
Swelling in stomach, ankles, legs.
Weight gain of 2+ lbs. in just a day or two.
Burning or pain in legs or arms.
Trouble walking.
Trouble sleeping.
Body chills, body aches.
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Lack of energy.
Others suggested at discharge:
C HEC KL IS TS : HOW TO HELP SUP P O RT I NFO RM E D DE CI SI O NS, SP E CI ALI Z ED C A R E
How to Help Support Safe Surgery Support a good experience of care with simple to-do’s that help patients and families mindfully prepare for surgery – and fully support recovery.
Your Logo There is no such thing as “routine surgery.” Even the most common operations have risks, and ALL are a risk for infection. When surgery is recommended, and it’s not urgent, here’s how you, as a Care Partner, can help your loved one increase their chances for the best possible outcome. Get independent 2nd or 3rd
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GET GOOD INFO FOR MAKING A DECISION ABOUT SURGERY: KNOW THE RISKS: Explore Options and Possible Alternatives to Surgery
Try to go to all doctor visits with your loved one.
Help your loved one prepare a good list of topics to cover with every doctor consulted, starting with your loved one’s goals and priorities! Examples to consider: • “Wellness wishes”—your loved one’s vision, hopes and priorities for quality of life after surgery (or any alternative treatment that might be offered)
opinions from doctors who don’t
• Concerns or fears about the recommended surgery
know one another. (Some doctors
• The pros and cons of the recommended surgery
are reluctant to disagree with a doctor who’s a friend.) Talk to Board Certified doctors known to— • Take time to listen and respond to patients’ questions and concerns. You may have to “ask around” for suggestions from you friends and family. • Operate in a highly rated hospital. Use these helpful and reliable
Some questions to consider asking: • Is surgery the only choice? • What are some alternatives to surgery? (For every alternative), what are the results compared to surgery? • What if I put off surgery for awhile? (Pros and cons?) • What if I decided not to have this surgery at all? (Pros and cons?) • What are my costs for surgery (and any alternative treatment options)? • What if I can’t afford surgery or other treatments • How do I know what my insurance will cover?
sources to find hospital ratings:
• How much time would I miss from work?
• Hospital Safety Grade
• Would I need to have help at home during recovery?*
• Hospital Compare As always, go to every doctor appointment and take good notes for your loved one.
CARE PARTNER, YOUR HELP IS INVALUABLE!
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• What would my medications cost? • Would I need physical or occupational therapy? Wound care? • What resources are available to help with costs?
Urge your loved one to ask as many questions—of as many doctors—as needed in order to feel comfortable making a decision. Use our “How-To” Guides for planning help during your loved one’s recovery.
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CHOOSE A SURGEON, HOSPITAL, AND A DATE FOR SURGERY MINIMIZE RISKS! Help your loved one interview potential surgeons
Planned surgery allows time for planned conversations! Often, patients don’t realize they have a choice of doctors to perform any recommended surgery. Every surgery carries risk, so taking the time to find a surgeon who is skilled and follows best practices to minimize risk is a rewarding investment of time. A Care Partner is critical for helping loved ones find the best doctor, hospital, and date for surgery. Why? It can be an exhausting process…just when a patient is likely feeling down and worried about their health. Your caring help means the world! Follow the suggestions on our “How-To” Guides to help explore surgery options and help your loved one make final decisions using these questions on this page for further conversations with doctors. The more information you help your loved one collect, the greater peace of mind will result. And that’s worth everyone’s time!
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regarding the most critical concerns. Be sure to take good notes for your loved one!
What are the potential complications with my surgery? If infection isn’t mentioned—always a risk!
How many of these surgeries have you personally performed? If not hundreds or thousands
Do you use a checklist in your OR (operating room) before starting surgery? If the answer is NO. The practice of using a checklist confirms the right patient, right procedure, and all vital medical details.
Does the surgical team introduce themselves in the OR before starting a surgery? If the answer is NO. Studies show that teams who know each other’s names have better communication during surgery, and better results.
When is an antibiotic given prior to surgery? If not within 60 minutes before surgery starts.
Do you screen for MRSA and Covid prior to surgery? If NO for either. (Patients can ask for these tests, however.)
MORE QUESTIONS FOR SURGEONS THAT COULD BE HELPFUL FOR YOUR LOVED ONE.
Can we schedule surgery mid-week? Are you planning a vacation or time off? surgeries mid-week means your surgeon is more likely to be available in case of complications afterward.
How is your hospital rated for safety and quality? (Look up at Hospital Safety Grade and Hospital Compare.)
Who would actually perform my operation? You alone, or will you have assistants?
If assistants participate, how many of these surgeries have they done?
If assistants are medical students/residents, what would they do in my surgery? (Patients may state a preference on these practices.)
Will you be performing or supervising any other surgeries during mine? (Patients may state a preference on these practices.) 46
Your Logo Pack a tote with items for your loved one and yourself:
A favorite personal item.
A warm sweater, scarf, hat— hospitals have chilly areas. (It’s okay to ask for a blanket for yourself and loved one!)
Headphones and favorite or soothing music on phone or tablet.
Antibacterial hand cleaner.
Antibacterial surface wipes.
Our “How-To” Guides for
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YOUR LOVED ONE PREPARE FOR SURGERY:
Read the surgeon’s pre-surgery instructions. Help make sure your loved one follows these instructions “to a T!”
For 2 to 3 days before surgery, remind your loved one to shower with a strong antibacterial shampoo and body soap, with a final shower just before going to the hospital. The surgeon will likely recommend chlorhexidine soap and may provide it. It’s sold in most drugstores, too!
If your loved one is having surgery on a “twin organ” (like kidneys or lungs), or on an arm or leg, help avoid confusion over which side requires surgery. Put a large piece of duct or masking tape over the side that should NOT be cut. Write a big, bold “NO!” on this tape for the side that should not be touched by the surgeon.
using these cleansing supplies to help keep your loved one safe from infection.
Chargers for phone and other electronics you bring.
Notebook and pen.
All notes and records you’ve made and kept for your loved one on their healthcare.
Books, magazines,etc..
Keep your loved one warm. In cold weather, warm up the car first. Make sure their hair is dry. Bring an extra sweater or other soft, warm clothing. Hospitals have some very chilly areas!
Fill out a Medication Record with your loved one. Bring it to the hospital with all of your loved one’s current medications.
Prepare to stay with your loved one 24/7 while hospitalized. Use our handy “How-To” Guides so you will know how to help during their hospital stay.
It’s okay to organize “shifts” with other family members and friends. Be sure to tell them about our Hospital Stay Guides, too!
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ON THE DAY OF SURGERY: DETAILS TO CONFIRM UPON CHECK-IN:
DETAILS TO KNOW & DOCUMENTS TO BRING!
Photo ID of your loved one
Insurance card(s)
Up-to-date list of medications, including vitamins, herbs, and nonprescription medicines
Record of any alcohol, tobacco and recreational drug use (No one will judge. For safe care, doctors need to know everything that’s in your loved one’s system.)
List of recent shots and vaccinations, with dates
Medical Power of Attorney,
Advance Directive,
List of doctors who treat your loved one, and their contact info,
Our handy “How-To” Guides for patients’ Care Partners.
GOOD COMMUNICATION IS GOOD FOR EVERYONE!
Your loved one’s name.
Type of surgery.
Any special communication needs due to hearing, speech, or language differences.
Current medications.
Allergies.
Last time your loved one had anything to eat or drink.
How long the surgery is expected to take.
If you can expect updates during the surgery.
The possibility of providing additional oxygen for your loved one after surgery.
CONFIRM THE SURGICAL TEAM WILL:
Take a “Time Out” or “Huddle” just before the surgery to confirm your loved one’s medical details.
Introduce team members to each other.
Use a surgical checklist.
Clip (don’t shave) hair that may need to be removed.
Give an antibiotic. (Who is responsible? What time?)
Review your loved one’s medications, allergies, and any other special conditions, such as any hearing, speech, or language differences.
Is your loved one hearing-, sight-, or speech-impaired? Speak another language? Please let all medical providers know
Keep your loved one warm to protect their immune system!
so they can take special care when communicating with your loved one.
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HO W TO HELP
IMMEDIATELY AFTER SURGERY: Care Partner, you are the extra layer in the safety net all great hospitals want for their patients.
Care Partners monitor monitors! Immediately after surgery, your loved one will still be asleep and transferred to a recovery area to gradually wake up. Any surgery is a shock to the system, so this is a critical time to monitor the after-effects. Most patients are put on electronic medical monitoring devices ... but these are not always perfect. So,
Wait in the hospital during surgery and sit beside your loved one in the recovery area.
Make sure your loved one is warm. It’s okay to ask for an extra blanket or even two!
Follow up on post-surgery antibiotics
Ask the surgeon: Were there complications during surgery? (If so, ask:) “What were they?”
of yourself as a monitor, too.
Ask that a copy of the surgery notes be included in your loved one’s electronic medical record.
Notice anything that doesn’t
Begin planning for recovery care at home with our helpful “How-To” Guides.
sit beside your loved one and think
seem right? Get a nurse right away! They will be grateful for your extra watchful eyes and ears on their patient.
GET A NURSE DURING RECOVERY IF: A monitor alarm goes off. Your loved one shows signs of or complains about: • Chills, shivering.
• Any struggle for breath.
• Nausea.
• Headache, confusion.
• Vomiting.
• Pain.
• Choking.
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C HEC KL IS TS : HOW TO HELP SUP P O RT I NFO RM E D DE CI SI O NS, SP E CI ALI Z ED C A R E
How to Help a Loved One’s Emergency Care Support a good experience of care. Equip those at high risk for emergency care with simple steps that help ease anxiety and promote collaborative care.
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DO YOUR HOMEWORK: A hospital emergency room (ER) may not be your only choice if an emergency arises. Become acquainted with the kind of care offered at your local Immediate Care Center. Typically, they have shorter waits, comfortable surroundings, less noisy “bustle”
HO W TO HELP
PREPARE FOR AN ER VISIT: Whether or not you have a chronically ill or elderly loved one, being prepared for a hospital emergency room visit is a good idea for every member of the family. Some simple prep for ER visits can minimize potential complications and maximize efficiencies in care.
CREATE A “GRAB & GO” KIT: Organize medical records and info in a folder or notebook.
Two or more copies of important documents: { Photo ID of your loved one. { Insurance card(s)—front and back. { Medical Power of Attorney.
and all the testing equipment that
{ Advance Directive.
hospital ER’s have—usually at a
{ List of doctors who treat your loved one, along with their contact info.
lower cost!
KEY CONSIDERATION: If your loved one requires transportation by ambulance to the hospital, ask if you can ride along. It helps to explain that you can help keep your loved one calm and as alert as possible.
{ List of all recent hospitalizations with dates, reasons for admission, and outcome. { List of all surgeries your loved one has ever had, dates of each.
CDs or thumb drives with any scans performed (EKG, CAT, MRI). Be sure to know the login for your loved one’s electronic medical records.
Medication Records:
Be sure to include your loved one in all conversations. If your loved one is hearing- or visuallyimpaired, or differently-abled in any way, make sure the doctor knows so extra care can be taken to make sure your loved one is included—and not just a bystander in their own medical care.
Use our Medication Record form to organize your loved one’s medication history. { List current and recent medications, including vitamins, herbal remedies, and any drugstore meds. (If you have time, put all medications in a baggie and bring.) { Include of alcohol, tobacco and recreational drug use. (No one will judge—this is important.) { List recent shots and vaccines, with dates for each. Note: You may have a long wait, so remember to bring any medications your loved one may need to take before the doctor is able to see them.
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HOW TO HELP PREPARE FOR AN ER VISIT
2:4
WHEN YOU CHECK IN:
PACK A TOTE WITH ITEMS FOR YOUR LOVED ONE AND YOURSELF:
Provide photo ID, insurance card, and Medical Power of Attorney.
A favorite personal item of comfort. (sweet treat? religious item?)
Tell admission clerk that you have all medical records and an up-to-date medication list with you.
A warm sweater, neck scarf, hat. ER waiting rooms can be very chilly!
If your loved one suffers from dementia, or is experiencing confusion, ask if the hospital offers a separate “quiet room” to help your loved one feel calm and secure.
A light blanket. (The kind you get on the airline is a good example —it folds up compactly but offers warmth.)
If your loved one is experiencing confusion, let all care providers know if this is a temporary condition or their usual mental state. In older people, onset of confusion can be a red flag for infection, often a urinary tract infection.
Items such as a small fidget-widget, or an Ipad with games, music or video to help quell anxiet. (Don’t forget earphones, though! )
Noise-canceling headphones.
Sunglasses to shield eyes from fluorescent lights in the hospital.
Bottles of water and powder packs of Gatorade.
If a nurse or doctor suggests a medication to calm an upset or agitated loved one, ask about:
Healthy snacks like little packs of nuts, granola bars, protein bars.
• A quiet room, instead. • If a quiet room is not an option and your loved one is truly disruptive and does not respond to the items you’ve brought in your “go bag,” a medication may be ordered.
Contact list of others to call for help, or comfort to your loved one.
Antibacterial hand cleaner, such as Purell.®
• Ask before it’s given to your loved one:
Antibacterial surface wipes.
1. Name of drug (its common name).
The Beers List* and Kids’ List* of medications considered risky for seniors and children.
2. Does it have Black Box warning? Is it on the Beers List* or the Kids’ List?* • Look it up on MedlinePlus.
Chargers for phone and other electronics you bring.
• If on either of these lists, or if you have any concerns at all, ask: “Are there alternative medications?”
Notebook and pen.
Ask: “When do you think a doctor will see us?” *Medications can affect people differently at different ages, so some medications carry agerelated precautions. If 65 or older, check the Beers List for medicines that may be harmful for seniors to take. For children, check the KIDs List. COPYRIGHT © 2023 THE CARE PARTNER PROJECT™
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HOW TO HELP PREPARE FOR AN ER VISIT
WHILE WAITING FOR CARE:
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Help your loved one clearly describe their medical concerns to all care providers. Your notes will help!
Discuss with your loved one exactly what they are feeling. Where is pain? What is their pain level on a 1-10 scale? Take good notes!
For each test, ask:
Ask your loved one:
• What will we learn?
• What do you think is wrong? Why?
• What are your worries?
• Is this information a “nice to know” or “need to know” in order to diagnose or treat?
• What is your goal for treatment today? What do you want to happen today?
• Ask the doctor for their initial thoughts, or diagnosis.
• What are your questions for the doctor?
Take notes of this conversation to share with your loved one’s doctor and other care providers seen in the ER.
For every diagnosis, ask: “What else could it be?”
AT THE POINT OF DIAGNOSIS:
Consider taking a photo of your notes with your phone, then give your notes to the admission desk and tell them you are prepared to meet the doctor. This may be a gentle way of nudging you higher on the waiting list.
Take time to fully understand the diagnosis—don’t rush. Ask, “Is there anything else it could be?”
Review and understand any new prescriptions.
DURING EXAM WITH A DOCTOR:
• What are the side effects?
Stay with your loved one.
• If new prescriptions are started, what is the length of time the medication will be needed?
Ask if you can record conversations so you can take can take notes later and be fully present during time with the doctor.
• Ask, “Is this medication on the Beers List or the KIDs’ List?” Or look it up yourself.
If helpful, ask if you can FaceTime the visit with someone else who may be involved with the care of your loved one.
DURING THE DISCHARGE CONVERSATION:
You may ask to record the discharge conversation on your phone. Explain that your loved one and you don’t want to miss any important details.
Review your loved one’s Medication Record with the nurse. Tell the nurse of any medications that have been taken that day and/or a few days prior, including herbs, vitamins, and any other non-prescription remedies.
Ask questions and ask for plain terms. If your loved one doesn’t understand anything their care providers are saying, ask them to use plain terms. (You didn’t go to medical school!) It’s important that they share information in everyday language anyone can understand.
Ask for a copy of record of visit, including the doctor notes.
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HOW TO HELP PREPARE FOR AN ER VISIT
RECOVERY AT HOME:
NOTES:
Review existing and new prescription list.
Use our handy Medication Record form to create a new list of everything your loved one needs to take after going home from the hospital.
Monitor closely any changes over the next 24-72 hours after taking new prescriptions. Look up on MedlinePlus.
Keep daily record of when medication is taken.
Use this handy Medication Record!
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CHECKLISTS: HOW T O HE LP CO NFI RM DI AG NO SE S AND MAKE IN FO RM E D CARE DE CI SI O NS
How to Confirm Diagnoses & Make Informed Care Decisions Education and engage patients and families to help prevent misdiagnosis and participate in shared decisionmaking for treatment.
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HO W TO HELP
CONFIRM YOUR DIAGNOSIS & TREATMENT OPTIONS: The following questions cover important
Little known fact: up to 40% of diagnoses are incorrect. That’s why it’s so important to ask a lot
topics. Add your own! Be sure to ask the same questions of every doctor to compare “apples to apples.”
of questions and see at least two
QUESTIONS TO ASK:
different doctors for information
What does my diagnosis mean? (What is my problem? What do I have?)
and treatment choices. Getting the right diagnosis is often like solving a mystery, and it’s really up to the patient and their Care Partner to dig for clues and answers. It can take lots of doctor visits and lots of research, but it’s worth the time and effort. Patients often worry that they will offend their main doctors if they get second or third opinions. This concern is common and understandable, but here’s the truth: good doctors encourage their patients to collect as much information as they can —they know from experience that the more information, the better any health care decisions. Don’t give up—remember, two heads are better than one! (And if your doctor is not on
• Ask for the “medical name,” and then for a “regular way” to describe it. • What else could it be?
3 2 4
How serious is this condition? 1 On a 1-5 scale with “1” being “No worries, 5 easy to treat/cure/live with” and a “5” meaning it’s “life threatening and must be treated immediately.”
• Why? What is your reasoning?
How would you treat me for this condition?
What other ways are used to treat this condition?
What are the benefits of each way to treat this condition?
What are the risks or complications for each way to treat my condition? • How common are the risks and complications? • What are the immediate, medium-term, and long-term side effects?
Are there other discomforts associated with the treatments? • Are these permanent or temporary? • How can these discomforts be treated?
How long will treatment last?
How long before I can get back to my normal activities?
What is my short-item outlook post-treatment?
board with your getting different
Are there long-term concerns or effects of this condition and treatment?
opinions, maybe it’s time to give
What are my costs?
up on that doctor!)
What are my options if I can’t afford treatment?
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C H EC KLISTS: HOW TO HE LP P RE P ARE FO R DO CT O R AP P O I NT M E NT S
How to Help Prepare for Doctor Appointments Equip patients to prepare for meetings with their doctors so both derive maximum value from time together.
HO W TO
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PREPARE FOR EVERY MEETING WITH YOUR DOCTOR:
Don’t be afraid to speak up
A little prep before your doctor appointment—office or online telehealth— can make all the difference in your quality of care. Regardless of the type of appointment, make every minute count! Take time to prepare:
for “plain speak!” If your doctor uses medical terms you don’t understand,
A written agenda: • Your goals for meeting (in priority order).
simply say so. Don’t stop
• Your questions and concerns (in priority).
asking questions until you
• Notes on how you feel physically and emotionally.
feel confident that you understand what they are telling you. You don’t want to leave any meeting with your doctor feeling confused or bewildered about your health! Invite someone to go with you. Studies show that patients forget a lot of what their doctors say (completely normal!) These conversations are packed with lots of good
You can email this agenda to your doctor in advance or upload to their portal, if you wish. Call the office to let them know your agenda is there. Make copies to take with you—for yourself, the doctor, and anyone who goes with you.
A list of all current and recent medications: • Prescription medicines. • Non-prescription medicines. • Vitamins and supplements. • Herbal remedies. • Vaccination history. • Details of tobacco, alcohol, or recreational drug use.
info. Someone at your side,
Download our Medications Record form to make keeping track of your medications a cinch.
or by FaceTime, can take
Your medical history:
notes or help you remember your agenda. Nothing missed!
• Chronic/ongoing medical conditions or symptoms. • Hospitalizations (why, date, and outcome). • Surgeries (type, date, and outcome). • Allergies. This information may be on your electronic portal. However, it is always a good idea to have it at your fingertips. Your doctor may not have had time to review it before meeting with you – and portals can have errors! (Check your portal regularly and make sure errors are corrected.) continued
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HOW TO PREPARE FOR EVERY MEETING WITH YOUR DOCTOR
NOTES:
Your pain map: • Download our Pain Map form to help you “plot” your pain symptoms.
• Using this tool will help give your doctor a clearer understanding of your pain, including: 1. Severity and frequency. 2. Triggers. 3. What it feels like. 4. When it started. 5. What provides relief.
Name and phone of your pharmacy.
Calendar to record appointment(s).
Pen and paper for notes.
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HO W TO
PREPARE FOR A TELEHEALTH MEETING WITH YOUR DOCTOR: IS TELEHEALTH RIGHT FOR YOU?
Don’t be afraid to speak up for “plain speak!” If your doctor uses medical terms you don’t understand, simply say so. Don’t stop asking questions until you feel confident that you understand what they are telling you. You don’t want to leave any meeting with your doctor feeling confused or bewildered about your health! Invite someone to be with you. Studies show that patients
When telehealth might be your best option: • Will it takes weeks or months to see your doctor? • Worried about spreading your germs – or picking up others’—in a doctor’s waiting room? • Short on time or patience with traffic? NOTE: Sometimes it’s possible to get a telehealth sooner than an in-office appointment. Your doctor’s call, of course! When telehealth might NOT be your best option: • Your doctor needs to perform a physical exam. • You’re most comfortable with in-person meetings. • You are uncomfortable with the technology involved. • Your home doesn’t have a strong or reliable wifi signal. • You’re concerned about internet security or other privacy issues.
forget a lot of what their doctors say (completely normal!) These conversations are packed with lots of good info. Someone at your side, or by FaceTime, can take notes or help you remember your agenda. Nothing missed!
HOW TO PREPARE FOR YOUR TELEHEALTH APPOINTMENT: A little prep before your doctor appointment—in office or by telehealth— can make all the difference in your quality of care. Regardless of the type of appointment, make every minute count! Take time to prepare:
A written agenda: • Your goals for meeting (in priority order). • Your questions and concerns (in priority). • Notes on how you feel physically and emotionally. You can email this agenda to your doctor in advance or upload to their portal, if you wish. Call the office to let them know your agenda is there. Provide your agenda to anyone you ask to join you in meeting with your doctor. continued
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HOW TO PREPARE FOR A TELEHEALTH MEETING WITH YOUR DOCTOR
2:2
Your pain map:
A list of all current and recent medications:
• Download our Pain Map form to help you “plot” your pain symptoms.
• Prescription medicines. • Non-prescription medicines. • Vitamins and supplements. • Herbal remedies. • Vaccination history. • Details of tobacco, alcohol, or recreational drug use.
• Using this tool will help give your doctor a clearer understanding of your pain, including: 1. Severity and frequency. 2. Triggers. 3. What it feels like. 4. When it started. 5. What provides relief.
Download our Medications Record form to make keeping track of your medications a cinch.
Name and phone of your pharmacy.
Thermometer and any other home medical devices.
Calendar to record appointment(s).
Pen and paper for notes.
Your medical history:
FOR YOUR TELEHEALTH APPOINTMENT:
• Chronic/ongoing medical conditions or symptoms.
In addition to all prep you need for an office meeting with your doctor, your online meeting requires a few more steps:
• Hospitalizations (why, date, and outcome). • Surgeries (type, date, and outcome).
Find a quiet place for your meeting.
• Allergies.
Make sure you have good lighting (so the doctor can see your skin tone—a guage of your health).
This information may be on your electronic portal. However, it is always a good idea to have it at your fingertips. Your doctor may not have had time to review it before meeting with you—and portals can have errors!
Test your technology. • Internet, computer, sound—leave no room for Murphy’s Law! • Test the meeting login your doctor’s office provides right away.
(Check your portal regularly and make sure errors are corrected.)
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Helpful Forms for Patients & Families Promote patient safety and a good experience of care with simple tools that support communication and partnerships with providers.
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One East Erie Street, Suite 525-411, Chicago, IL 60611
847.208.6074
TheCarePartnerProject.org
Print out these handy signs to put around the hospital room to remind the patient about fall prevention.
One East Erie Street, Suite 525-411, Chicago, IL 60611
847.208.6074
TheCarePartnerProject.org
Print out these handy signs to put around the hospital room to remind the patient about fall prevention.
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HO W TO HELP
GET SUPPLIES FOR RECOVERY: START WITH:
WOUND CARE:
Thermometer.
Bandages.
Call bell.
Gauze.
Night light.
Tapes.
Flashlight with new batteries.
Ostomy pouches, supplies.
Extra batteries for TV remote.
Barrier cream.
Weight scale.
Other ointments.
Non-skid socks, good-fitting slippers.
Cleanser.
Compression socks or stockings. After a hospital stay, patients
BEDROOM & RESTING:
Antibacterial soap, foam, or gel.
FOR MOVING AROUND:
Cane.
Bed rails.
Crutches.
Foot stool.
Walker.
even before your loved one
Head or neck supports.
Wheelchair.
leaves the hospital.
Foam cushions (to prevent bed sores).
Scooter.
one’s care, but many won’t. It’s
Heel cushions.
Other:
okay to ask a nurse or hospital
“Doughnut” pillow.
case manager to help you decide
Disposable sheet protectors.
MEDICAL DEVICES:
what to get.
Hospital bed.
Blood pressure cuff.
Sitz bath.
Thermometer.
Bed pan or portable urinal.
Diabetes test supplies.
Standing security pole.
Glucose monitor.
Other:
Insulin pump.
often need special supplies. It’s best to have these on hand
Many will apply to your loved
They are very familiar with all of these items and may have ideas about certain products that are best for your loved one. They’ll be glad to know you’re thinking ahead!
CPAP machine.
BATHROOM:
Peak flow meter.
Grab rails.
Apnea monitor.
Shower seat.
Room monitor.
Non-skid bath mats or strips.
Medical alert phone service.
Raised toilet seat.
NUTRITION/GROCERIES:
Disposable underwear.
Protein shakes, bars.
Night light.
Other:
Other:
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Thank you for going the extra mile to ensure your loved one gets the best health care! Please share The Safe & Sound™ checklists with your family and friends!
Nothing in life prepares your patients and their loved ones to manage a serious illness. Safe & Sound™ resources express your empathy and commitment to care that meets patients where they are. Together, you are prepared to partner for patient-centered care.
Ready to partner for patients? Let’s talk! 847.208.6074 |
[email protected]
One East Erie Street, Suite 525-411, Chicago, IL 60611 | 847.208.6074 | TheCarePartnerProject.org