PATIENT GUIDE Key Information For Your Stay
SPEAK UP! Ask Questions and Voice Concerns ALL ABOUT ADVANCE DIRECTIVES
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FEEL AT HOME
As the area’s newest midscale, extended stay hotel, we offer a more casual kind of longer stay, including all of the comforts and conveniences you need to be at your best.
• Fully Equipped Kitchens • Free WiFi
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http://www.ihg.com/candlewood/hotels/us/en/tucson/tuscw/hoteldetail From $69+ tax. Valid through 12/31/16. Rate is for Standard Room type. Not valid with other offers and is based on availability. Present guide at check in to obtain discount. Rate from $99+ tax during February and March, 2016.
Welcome us into your home, we’ll treat you like family. Coming home after a stay in the hospital may require extra care or medical support. That’s where we come in. Whether it’s home health for recovery or hospice for comfort care, our home care teams are here for you and your family. Call us, and let’s talk about how we can help you.
520-441-9914 NorthwestHomeHealthAZ.com An affiliate of Oro Valley Hospital
BROOKDALE-ORO VALLEY
Closer relationships live here every day.
Come discover the many comforts of our caring community.
For more information, call (520) 544-4300.
Brookdale Oro Valley Alzheimer’s and Dementia Care
10175 North Oracle Road | Oro Valley, AZ 85704 24475-P2-0815-ROP KS
www.brookdale.com
BROOKDALE® is a trademark of Brookdale Senior Living, Inc., Nashville, TN, USA
CO N T E N TS WELCOME. . . . . . . . . . . . . . . . . . . . . . . 2 PHONE DIRECTORY.. . . . . . . . . . . . . . 3 OUR COMMITMENT TO CARE.. . . . 4 RAPID RESPONSE TEAM. . . . . . . . . . 6 FAST FACTS ABOUT YOUR STAY.. . 7 SPECIAL SECTION . . . . . . . . . . . . . . . 12 ADULT VACCINES. . . . . . . . . . . . . . . . 19 HOSPITAL INFECTIONS. . . . . . . . . . . 20 RIGHTS & RESPONSIBILITIES. . . . . . 22 ADVANCE DIRECTIVES. . . . . . . . . . . 24 SUPPORT FOR CAREGIVERS. . . . . . . 25 LEAVING THE HOSPITAL. . . . . . . . . . 26 AFTER-HOSPITAL CARE. . . . . . . . . . . 28 FOOD & MEDICATION SAFETY. . . . 29 PATIENT PORTAL. . . . . . . . . . . . . . . . . 32
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Take Charge of Your Care
Speak Up, Plus 7 Key Ways to Take Charge of Your Care n Choose a Support Person n Check IDs n Pay Attention to Your Care n 5 Ways to Fight Infections n Don’t Ignore Pain n Prevent Falls n Prepare for Surgery n
On Our Cover Speak Up! Ask Questions and Voice Concerns. . . . . . . . . . . . . . . 12 All About Advance Directives. . . . . . . . 24
The editorial content displayed here is the responsibility of PatientPoint. This material is for your educational use only. It does not contain, nor should it be construed as containing, medical advice. Talk to your doctor before making any lifestyle or treatment changes. Sponsors are responsible for the material provided, and your healthcare provider’s participation in the program does not represent an explicit or implied endorsement of any material presented. The people shown are models and are not known to have any health condition. Images are for illustrative purposes only. Image credits: Getty Images, iStockphoto. ©2015 PatientPoint ®
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Emergency Urgent Care Behavioral Health Cardiology Ear, Nose & Throat Endocrinology Gastroenterology General Surgery Hand Surgery Infectious Disease Inpatient Rehabilitation Unit Interventional Radiology Minimally Invasive Surgery Nephrology Neurology Oncology Orthopedics Outpatient Therapy Plastic Surgery Pulmonology Radiology Urology Vascular Surgery
Thank You for Trusting Us Welcome to Oro Valley Hospital. Since the doors opened at Oro Valley Hospital in 2005, we have made it our mission to provide compassionate, customer-focused care based on our core values of excellence, integrity, service, safety and teamwork. From the moment you arrive at Oro Valley Hospital, our attentive professional team will work hard to provide the quality of personalized care you have come to expect. Because we are committed to excellence, we know quality care involves more than good medicine. Our culture is warm and welcoming. Every staff member is dedicated to making your stay safe, pleasant and comfortable, and assisting you to get well and back to your daily activities. We are pleased to provide you with this guide that contains information about our commitment to your care and safety. The entire staff of Oro Valley Hospital is honored and privileged to be of service to you. Thank you for choosing Oro Valley Hospital for your healthcare needs. Sincerely, Jae L. Dale CEO
Oro Valley Hospital is not, in any way, responsible for the advertisements in this booklet. Oro Valley Hospital makes no representation or endorsement of any kind related to the advertised services, entities, or businesses. Oro Valley Hospital receives no remuneration in exchange for any advertisement. 112015
Phone Directory Key Numbers Main: 520-901-3500 | Billing: 520-901-3920 Gift Shop: 520-901-3500 | Medical Records: 520-901-3560
Calling from INSIDE the hospital? Dial the last four digits only.
OTHER HOSPITAL SERVICES Admitting 520-901-3514
Medical Records 520-901-3560
Chaplain External 520-901-3500
Patient Accounts 520-901-3542 (Cashier)
Chaplain Internal Dial 0 and page chaplain
Rancho Vistoso 520-818-2000 Urgent Care
Dietitian 520-901-3599 Hospital 502-901-3500 Switchboard
Security Dial 0 and page security Senior Circle 520-901-3631
Local Calls dial 9 + local number For more information on the resources available at Oro Valley Hospital, visit www.OroValleyHospital.com.
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Our Commitment to Care Patient Satisfaction Matters to Us How’s your stay? Are you getting the care you need? Are your doctors and nurses listening and responding to your questions or requests? Our goal is to provide the best quality care. To do so, we ask for feedback from patients like you.
During Your Stay
Please speak with your nurse or nursing supervisor if you have any questions or concerns about your care. If your issue is still not resolved, you may: n
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MAKING A DIFFICULT HEALTHCARE DECISION?
Sometimes a healthcare choice can involve an ethical concern— such as a wish to refuse life-saving treatment or a disagreement over advance directives (see p. 24). Our Ethics Committee can help your team of support people make difficult decisions. For help, contact the Facility Compliance Officer Administration at 520-901-3549.
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ontact Oro Valley Hospital Administration at C 520-901-3549. ile a complaint with your state or Quality F Improvement Organization (QIO). See Rights and Responsibilities p. 23 for contact information.
How are we doing? We want you to be satisfied with your care. To help, speak up if we can … Respond quicker to your needs Explain things more clearly Help keep your room clean or quiet Ease your pain Help you understand your medicine plan
After Your Stay
Once you leave our care, we will continue to seek your feedback through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. This survey is designed to be a standardized tool for measuring and reporting satisfaction across all hospitals in the U.S. After you are released from the hospital, you may be selected to participate in the HCAHPS survey. The telephone survey asks multiple choice questions on key care topics, such as:
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doctor and nurse communication
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medicine and discharge information
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pain management and staff responsiveness
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overall quality of the hospital environment
The HCAHPS survey is backed by the U.S. Department of Health and Human Services. The survey is used to improve the quality of healthcare. HCAHPS makes survey results public so hospitals are aware of where changes are needed. The results also enable healthcare consumers to review and compare hospitals before choosing a healthcare provider.
Want to Know How We Score? You can review and compare the quality, care and safety ratings for different hospitals at: n Medicare Hospital Compare, uses HCAHPS results and other data: www.medicare.gov/hospitalcompare You also can find information on hospitals through these accrediting organizations: n Healthcare Facilities Accreditation Program (HFAP): www.hfap.org n The Joint Commission: www.qualitycheck.org
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Rapid Response Team Special Support to Prevent Emergencies During your stay, you have access to a special service called the Rapid Response Team. You can call this service, and a critical-care team will check on you or your loved one and provide help before there is a life-threatening emergency.
WHEN to Call Rapid Response Call for help if you notice: n
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c hanges in heart rate or drop in blood pressure c hange in respiratory (breathing) rate or oxygen levels c hanges in urine output (much more or less urine) c hange in mental status or level of consciousness
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a ny time you are worried something might be wrong a ny change in the patient’s condition that needs immediate attention and the healthcare team is not responding, or if you continue to have serious concerns after speaking with the healthcare team
HOW to Call Rapid Response Step 1: Dial 5555 on bedside phone. Step 2: Tell the operator: your name, room number, patient’s name and your concern. Step 3: The Rapid Response Team will be sent to your room.
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Fast Facts About Your Stay An A-Z Guide to the Most Frequently Asked Questions ATM
For your convenience, an ATM is located in the Emergency Department lobby.
Cafeteria
Located: First floor near the main entrance. Monday through Friday Hours: n Breakfast: Monday through Friday, 7:00 a.m. to 10:00 a.m. n Lunch: Monday through Thursday, 11:00 a.m. to 2:00 p.m. Friday, 11:00 a.m. to 1:00 p.m. Closed weekends. Lantanas welcomes you, your families and guests to dine in or purchase takeout food. We provide a wide selection of hot meals, snacks and beverages. Patients who wish to dine in the cafeteria need to obtain a pass from their nurse. Patients accompanied by a nurse may eat in the cafeteria at no cost by showing their hospital wristband to the cashier.
Calling Your Nurse
If you have an urgent need that can’t wait until your nurse makes hourly rounds, you may push the call button at your bedside. When the button is pressed, a light will signal the nursing staff indicating you need assistance. A nursing staff member will answer the call as promptly as possible. A call button also is located in the bathroom.
VISITING THE HOSPITAL? Thanks for taking the time to support your loved one’s care and recovery. See p. 10–11 for important visitor information.
Cellphones
The use of Bluetooth or similar hands-free devices may interfere with patient care equipment. Please refrain from using them if a member of the healthcare team asks you not to use these devices in a patient room.
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Facts About Your Stay continued Coffee Bar
The Desert Rain coffee bar is located on the first floor near the main entrance and is open Monday through Friday from 7:00 a.m. to 3:00 p.m., and 8:00 a.m. to 12:00 p.m. on Sundays from October to April. Closed Saturday.
Electrical Appliances
Only battery-operated devices are allowed in patient rooms. Do not use electric hair dryers, curling irons, razors, heating pads, portable heaters, VCRs/DVRs, computers or other electric devices.
Fire Safety
For your protection, fire and disaster drills are routinely conducted. If a drill occurs, please remain in your room and stay calm. Your door will be closed, and staff will alert you if you need to take special action.
Gift Shop
Location: First floor to the left of the main entrance. Hours of Operation: Monday through Friday: 9:30 a.m. to 2:00 p.m. Closed on weekends, but if you need help, you can ask the volunteer at the main information desk on Saturday from 8:00 a.m. to noon.
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Hourly Rounding
During the day, someone will make rounds hourly and ask you about the 4 P’s: n Pain: What is your pain level? n
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otty: Do you need assistance to P the restroom? osition: Do you need to change P your position in the bed? ersonal: Are all the personal P items you need within your reach?
Housekeeping Services
We are committed to keeping our hospital as clean as possible. If you have any concerns about the cleanliness of your room or need something cleaned, please call our housekeeping department at 520-901-3596.
Interpretive and Hearing Services
Good communication is vital to the healthcare system. Patient needs for communication services are addressed through the use of interpretive services for the hearing impaired, translator services for non-English speaking patients and verbal communication of written information for the visually impaired. If you have a need for any of these services, please alert one of the members of your healthcare team.
Lost and Found
The hospital’s lost and found is in the Security office near the entrance to the Emergency Department. To find lost items, dial 0 for the operator and ask for security.
Mail and Flowers
Deliveries occur daily. Any mail received after you leave the hospital will be forwarded to your home address. Flowers will be delivered to your room unless your medical condition or area (such as ICU) prohibits it. Please note: Patients who have elected to be confidential do not appear on our patient list, so we are unable to accept flowers, cards or emails for them.
Medicines
Please do not bring any medications (prescription, over-the-counter or illegal drugs) to the hospital. All medications you take while a patient must be FDA approved, prescribed by your physician, dispensed by the hospital pharmacy and administered by a trained professional. Patients are not permitted to administer their own medications or to keep personal medications, unless pre-approved by the hospital physician.
Parking
Visitor parking is free and plentiful in designated parking lots. Courtesy wheelchairs are available if you need assistance getting to and from
your car. To request a Security escort to your vehicle, dial 0 from any hospital phone.
Patient Meals
You will receive three meals a day during your stay (with physician’s approval). Times may vary slightly depending on your floor. reakfast: 7:30 a.m. to 8:30 a.m. B Lunch: Noon to 1:00 p.m. n Dinner: 5:00 p.m. to 6:00 p.m. n n
Visitors are encouraged to use the hospital cafeteria.
Personal Valuables
Please take extra care with eyeglasses, contact lenses, hearing aids and dentures. They should be stored in the bedside table in a container with your name when not in use. Oro Valley Hospital cannot be responsible for personal belongings kept in your room. If you have valuables and cannot arrange to send them home, please ask your nurse for assistance to place these items in the hospital safe. An inventory list of your safeguarded items will be kept in your patient chart until your discharge.
Public Restrooms
Please do not use the bathrooms in patient rooms. They are reserved only for patients in order to protect their health. Public restrooms are located throughout the hospital, including the Emergency Department lobby and the main hospital lobby near the gift shop.
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Facts About Your Stay continued Quiet Nights
Sleep helps healing. To promote a quiet, restful night of sleep, we offer ear foams, “please close the door” signs, a warm moist washcloth before bedtime and a tranquil channel on TV.
Security
To reach security, please dial 0, and the operator will assist you.
Smoking
Smoking can be hazardous in a hospital, especially in areas where oxygen is being used. Smoking is prohibited in the hospital and must be confined to designated outside areas. Effective January 2, 2015, Oro Valley Hospital will be a smoke-free facility. If interested, please speak with your physician about help to quit smoking. They can refer you to a smoking cessation program. Quitting will reduce a patient’s risk of developing lung infections while in the hospital.
posted on the wall inside the room. We encourage you to provide this number to your family and friends so they can call you directly, or they may call the main hospital number at 520-901-3500 and give the operator your name, room number or extension.
TV
Each patient room has a TV at no charge. Please be considerate of others by keeping the TV volume down and turning it off at bedtime. You will find a channel listing guide in your room.
Vending Machines
Vending machines are located off the main corridor near Outpatient Services. We also have a beverage vending machine located on the fourth floor in the ICU waiting area.
Visiting Hours n
Telephone
All patient rooms have phones. To place a local call, dial 9 + the local number. There is no charge for local calls. To place long distance calls, dial 0 to reach the operator. Long distance calls must be charged to your home phone, calling card or placed collect. Calls cannot be billed to your hospital account. Each patient room has its own phone number
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General: 8:00 a.m. to 8:00 p.m. Note: Although visitors are allowed outside these hours, it is discouraged to allow maximum rest for all patients. Children under age 12 may visit when accompanied by an adult and with nurse authorization. ICU: Hours may vary. Note: Visitors are limited to immediate family age 12 and older.
Wireless Internet Service
Oro Valley Hospital offers free wireless access from nearly anywhere in the hospital. Select Hospital Guest Wireless from your network settings and open your Internet browser. A screen will open asking you to agree to the terms and conditions of use. Click on Accept terms and conditions and submit.
Your Room
Your room is assigned based on your medical condition and room availability. For your safety, please observe these guidelines: n If you need help to lower bed rails, please call for assistance.
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lways use bedroom slippers A or the “no-slip� socks provided when you are out of bed. ever use a bedside cabinet N or the over-the-bed table for support. It may move under your weight. e careful when walking on B floors wet from cleaning. They may be slick. sk for assistance getting in and A out of a wheelchair. Please tell your nurse about any unsafe conditions.
Visitor Guidelines We encourage well-wishers for emotional support and recovery. To provide a restful and safe environment, we ask that visitors follow these guidelines: n Be considerate of other patients by keeping noise to a minimum. n Refrain from visiting if you have a cold, sore throat or any contagious disease. n Observe no visiting and precaution signs before entering the room. n Do not smoke. n Leave the room during tests or treatments if asked.
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Take Charge of Your Care You are the center of your healthcare team. Let this special guide help you get the best results from your hospital stay.
Speak Up!
During your stay, our doctors, nurses and staff will treat you and your family as partners in your care. One important way that you can be involved is to speak up. Ask questions, voice your concerns, and don’t be afraid to raise any issues relating not only to your care and treatment, but also to overall hospital services. In the pages that follow, you’ll find a step-by-step guide to making the most of your hospital stay—steps for taking charge of your care, getting the information you need, asking questions and interacting with hospital staff.
Ask Yourself Is there anything else the hospital should be aware of to improve my care experience?
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7 Key Ways
TO TAKE CHARGE OF YOUR CARE SPEAK UP. Ask questions and voice concerns. It’s your body, and you have the right to know. PAY ATTENTION. Always double-check that you are getting the right treatments and medicines from the right hospital staff. EDUCATE YOURSELF. Learn about your medical condition, tests and treatment options, so you know why following your care plan is so important. FIND A SUPPORT PERSON. Pick someone to help speak up for your care and needs during your stay. KNOW YOUR MEDS. Understand what your medicines treat, why you need them and how to take them for the best results. CHECK BEFORE YOU GO. Make an informed decision when selecting additional healthcare services. Choose only accredited providers who meet patient safety and quality standards. Go to www.qualitycheck.org to learn more. PARTICIPATE IN YOUR CARE. You are the center of your healthcare team. Make sure you know what’s happening every step of the way—from admission through discharge.
Source: The content within the “Take Charge of Your Care” section reinforces the safety and quality care goals and standards issued by The Joint Commission and other hospital accreditation organizations.
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TAKE CHARGE OF YOUR CARE continued
Choose a Support Person A trusted friend or family member can be a big help during your hospital stay. Select one key person to be your healthcare advocate. If you become stressed or your ability to communicate changes, this person can stand in for you—and stand up for your care.
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ask questions you might not think of and write down information double-check your medicines and treatments watch for signs your condition is getting worse and ask for help
Don’t forget to tell the staff who you’ve picked to be your support person.
Check IDs
While you are here, many people will care for you (doctors, nurses, aides, orderlies), and these same people will care for many patients. To prevent errors in your care: A sk to see the ID of everyone who comes into your room, so you know the name and job of the person caring for you. If you do not see an ID badge, contact your nurse immediately. peak up if hospital staff does not S check your ID. Any time staff enters your room to give you medicine, transport you, or perform procedures or treatments, state your name and birth date.
Always double-check your name with staff to avoid errors.
This may seem repetitive at times, but it helps ensure you receive the correct care.
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Pay Attention To Your Care n
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Tell your nurse if something doesn’t seem right.
You Are Key You are the most important member of your healthcare team.
Know what time you normally get medicine, and tell your nurse if you don’t get it.
Understand your treatment
Request drawings or illustrations to help you learn about your condition.
Ask questions
Read and understand all medical forms before signing. Ask if you need information explained.
Speak up about pain Know your medicines Plan early for a successful discharge
If your treatment involves medical equipment, practice using it with your nurse before you leave the hospital. Don’t be afraid to ask for a second opinion. The more information you have, the better you will feel about making decisions. Talk to your doctor and family about whether you want life-saving actions taken.
And Remember, Take Charge of Your Communication Ask About Jargon: I f you hear a medical term you don’t understand, ask what it means.
“Teach Back”: After you get instructions or an explanation, repeat back what you thought you heard so you can double-check that you understood.
Take Notes: W rite down any key facts your doctor tells you so you won’t forget.
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TAKE CHARGE OF YOUR CARE continued
5 Ways to Fight Infections The hospital is a place you come to get well, but you also can come in contact with germs that can make you feel worse. Reduce your chances of infection by taking these safety precautions. 1 Clean your hands. n after touching hospital objects or surfaces n before eating n after using the restroom 2 Ask hospital staff members to clean their hands. This should be standard practice, but don’t be afraid to remind them if they forget or to ask them to wear gloves when touching you. Ask visitors to clean their hands too!
No Soap? No Problem. Alcohol-based hand cleaners are as effective as soap and water for killing germs. To use, apply the cleaner to the palm of your hand, and rub your hands together. Keep rubbing over all the surfaces of your fingers and hands until they are dry.
3 Cover if you are sick. If you get an infection, limit the spread of germs by sneezing and coughing into tissues you promptly throw away, and avoid touching other people. Ask the staff if there is anything else you should do—like wear a surgical mask—to prevent the spread of germs. 4 Keep an eye on bandages or dressings. If a dressing on a wound or IV becomes loose or wet, let your nurse know. Also, if you have a catheter or drainage tube, tell your nurse if it becomes loose or dislodged. 5 Keep your vaccinations up-to-date. Make sure you are as protected as possible from the spread of infection. Check with hospital staff about whether it’s safe for you to receive any vaccines you might need.
Tell friends and family not to visit if they are sick. And make sure all your guests wash their hands when they enter your room. 16
Don’t Ignore Pain No one knows how much pain you are in but you. Tell your doctor or nurse when pain strikes or if it comes back again after it goes away. Talk about your pain level throughout the course of your stay.
Ask yourself, then share with your nurse. n
Where does it hurt?
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When does it hurt?
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Does it keep you from doing things—like sleeping, dressing, eating?
Which words describe your pain? q aching
q cramping
q pressure
q shooting
q bloating
q cutting
q pulling
q soreness
q burning
q dull
q radiating
q stabbing
q comes and goes
q numbing
q searing
q throbbing
q constant
q pressing
q sharp
q tightness
How bad is it on this pain scale? Wong-Baker FACES® Pain Rating Scale
0 No Hurt
2 Hurts Little Bit
4 Hurts Little More
6 Hurts Even More
8 Hurts Whole Lot
10 Hurts Worst
*Copyright 1983, Wong-Baker FACES® Foundation, www.WongBakerFACES.org. Used with permission.
You’re the Expert on Your Pain Starting to get uncomfortable? Pain medicine not working? Speak up. You may need to get more of the current pain medicine you are on or switch to a different kind of medicine to get relief. Don’t try to ignore painful symptoms. Managing your pain will help with your healing process. Talk to your doctor or nurse when pain strikes.
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TAKE CHARGE OF YOUR CARE continued
Prevent Falls While you are here, you may feel dizzy or weak. Illness, procedures, medicines or even just lying down for too long can make you less steady on your feet. To keep yourself safe: Use the nurse call button for help getting out of bed. n Your nurse may give you a colored wristband that lets the staff know you might need special assistance to keep you safe from falling. n Ask for help going to the bathroom or walking around. (And use hospital handrails when they’re available.) n Wear nonslip socks or footwear. n Keep often-used items within easy reach (glasses, remote, tissues, etc.). n Make sure your wheelchair is locked when you get in or out of it. Never step on the footrest. n Make sure your robe or pajamas don’t drag on the floor. They can cause you to trip. n Ask your nurse to show you how to properly walk with your IV pole, drainage bags or any other equipment. n If you see a spill on the floor, report it immediately. Patients of all ages are at risk for falls. It’s better to be extra careful than risk another medical problem. n
Prepare for Surgery Before your procedure, make sure you and your surgical staff confirm: n
your name
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the type of surgery you are having
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the body part to be operated on—In fact, hospital staff will mark the correct spot on your body. Make sure you or your support person checks that it’s correct.
Take simple steps like these to help prevent medical mistakes.
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Ask your surgeon to take a “time out” to check: you’re the right person, getting the right surgery, on the right body part.
Adult Vaccines
Which Vaccines You Need to Protect Your Health Vaccines work with your immune system to help protect you from infections and disease. As you age, you’re more at risk of certain health conditions because your immune system isn’t as strong as it used to be. And if you do get sick, the symptoms can be more serious than when you were younger. Three types of vaccines are especially important for older adults, including:
Influenza Vaccine— The flu
vaccine is recommended for all ages every year, and there is a higher-dose vaccine for adults over age 65. You need the vaccine every year because the flu virus changes over time.
Zoster or Herpes Zoster Vaccine—This vaccine protects
against shingles. It’s one dose and is recommended for all adults age 60 and up. Shingles causes rash, blisters and severe pain.
Pneumococcal Vaccines—
Recommendations recently changed for pneumonia vaccines. Even if you already received one vaccine, you may still need another. Talk to your doctor about the vaccination schedule that’s right for you. Pneumococcal conjugate or PCV13: You need one dose of this vaccine if you are age 65 or older and didn’t receive it at a younger age. It’s best to get this one before the PPSV23 vaccine (see below). Wait at least 12 months if you receive the PPSV23 first. Pneumococcal polysaccharide or PPSV23: If you are age 65 or older, you need one dose of this vaccine, ideally 6 to 12 months after receiving the PCV13 vaccine (see above).
Talk to Your Doctor Your doctor is your best source for information about vaccines. Which vaccines are right for you depend on your age, other health conditions you have (including pregnancy) and where you travel.
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Prevent Hospital Infections Take Steps to Reduce Your Risk During Your Stay According to the U.S. Department of Health and Human Services, 1 in 25 patients gets a healthcare-associated infection while staying at the hospital. Often, these happen because hospital procedures and equipment can expose internal parts of your body to germs. The chart below lists common infections and steps you can take to prevent them.
INFECTION
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HOW IT STARTS
Catheter-Associated Urinary Tract Infections (UTI)
Germs enter your urinary tract while using a tube to drain urine
Surgical Site Infections
Germs affect the site of your surgery—either on your skin or internally
Central Line-Associated Bloodstream Infections
Germs enter your bloodstream through a large tube that’s inserted in a vein near your neck, chest or groin
Ventilator-Associated Pneumonia
Germs enter your lungs through a tube in your mouth, nose or neck used to help you breathe
Superbugs
A superbug is a germ that causes a bacterial, viral or fungal infection, but does not respond to the usual treatments. Common strains include MRSA and C.diff. MRSA can spread from person to person through touching hands or infected objects and often causes skin infections. C.diff is a type of bacteria that can affect people who take antibiotics. It can cause diarrhea and other serious digestive conditions. Protect yourself by taking the steps below, and only take antibiotics that are prescribed for you by your doctor. And remember, wash your hands and ask everyone you see during your stay to wash his or her hands too.
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fever burning pain bloody or frequent urination redness pain drainage of cloudy fluid fever r ed skin and soreness at site fever chills
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cough mucus fever chills shortness of breath
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clean hands before touching area keep urine bag below level of bladder to prevent backflow don’t tug, pull, twist or bend the tube secure catheter to your leg and ask every day if it’s still needed o not shave surgery site (irritation increases d risk of infection) clean hands before touching area don’t let visitors touch or dress your wound ask your nurse to show you how to care for your wound c lean hands before touching area make sure staff wears gloves, gown, cap, mask and sterile drape when handling tube speak up if your bandage comes off, looks wet or dirty, or if your skin looks sore avoid touching tube or letting visitors touch tube ask that tube be removed as soon as possible c lean hands before touching area ask if it’s safe to raise the head of your bed know how often the inside of your mouth needs to be cleaned and speak up when it hasn’t happened ask that the tube be removed as soon as possible
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Rights & Responsibilities You Have the Right To:
e treated in a dignified and respectful B manner and to receive reasonable responses to reasonable requests for service Effective communication that provides information in a manner you understand, in your preferred language with provisions of interpreting or translation services at no cost, and in a manner that meets your needs in the event of vision, speech, hearing or cognitive impairments; information should be provided in easy to understand terms that will allow you to formulate informed consent Respect for your cultural and personal values, beliefs and preferences Personal privacy, privacy of your health information and to receive a notice of the hospital’s privacy practices Pain management Accommodation for your religious and other spiritual services Access, request amendment to and obtain information on disclosures of your health information in accordance with law and regulation within a reasonable time frame Have a family member, friend or other support individual to be present with you during the course of your stay, unless that person’s presence infringes on others’ rights, safety or is medically contraindicated Care or services provided without discrimination based on age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, and gender identity or expression Participate in decisions about your
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care, including developing your treatment plan, discharge planning and having your family and personal physician promptly notified of your admission Select providers of goods and services to be received after discharge Refuse care, treatment or services in accordance with law and regulation and to leave the hospital against advice of the physician Have a surrogate decision-maker participate in care, treatment and services decisions when you are unable to make your own decisions Receive information about the outcomes of your care, treatment and services, including unanticipated outcomes Give or withhold informed consent when making decisions about your care, treatment and services Receive information about benefits, risks, side effects to proposed care, treatment and services; the likelihood of achieving your goals and any potential problems that might occur during recuperation from proposed care, treatment and service and any reasonable alternatives to the care, treatment and services proposed Give or withhold informed consent to recordings, filming or obtaining images of you for any purpose other than your care Participate in or refuse to participate in research, investigation or clinical trials without jeopardizing your access to care and services unrelated to the research Know the names of the practitioner who has primary responsibility for your care, treatment or services and the names of other practitioners providing your care
ormulate advance directives F concerning care to be received at end-of-life and to have those advance directives honored to the extent of the hospital’s ability to do so in accordance with law and regulation; you also have the right to review or revise any advance directives Be free from neglect; exploitation; and verbal, mental, physical and sexual abuse An environment that is safe, preserves dignity and contributes to a positive self-image Be free from any forms of restraint or seclusion used as a means of convenience, discipline, coercion or retaliation; and to have the least restrictive method of restraint or seclusion used only when necessary to ensure patient safety Access protective and advocacy services and to receive a list of such groups upon your request Receive the visitors whom you designate, including but not limited to a spouse, a domestic partner (including same sex domestic partner), another family member, or a friend. You may deny or withdraw your consent to receive any visitor at any time. To the extent this hospital places limitations or restrictions on visitation; you have the right to set any preference of order or priority for your visitors to satisfy those limitations or restrictions Examine and receive an explanation of the bill for services, regardless of the source of payment
You Have the Responsibility To: rovide accurate and complete P information concerning your present medical condition, past illnesses or hospitalization and any other matters concerning your health
Tell your caregivers if you do not completely understand your plan of care Follow the caregivers’ instructions Follow all medical center policies and procedures while being considerate of the rights of other patients, medical center employees and medical center properties
Regarding Problem Resolution, You Have the Right To: Express your concerns about patient care and safety to hospital personnel and/or management without being subject to coercion, discrimination, reprisal or unreasonable interruption of care; and to be informed of the resolution process for your concerns. If your concerns and questions cannot be resolved at this level, contact the accrediting agency indicated below: Arizona Department of Health Services 150 N. 18th Ave., Suite 450 Phoenix, AZ 85007 602-364-3030 Fax 602-792-0466 Livanta BFCC-QIO Program 9090 Junction Dr., Suite 10 Annapolis Junction, MD 20701 877-588-1123 Fax (Appeals): 855-694-2929 Fax (All Other Reviews): 844-420-6672 Office of Quality and Patient Safety The Joint Commission One Renaissance Blvd. Oakbrook Terrace, IL 60181 800-994-6610 Email: patientsafetyreport@ jointcommission.org
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Advance Directives A Simple and Smart Way to Take Charge of Your Care One of the most important decisions you can make about your care is to fill out advance directives in case you can no longer speak for yourself. Advance directives are legal documents that let others know your wishes about the type of care you want. And they will only be used if you become unconscious or too ill to communicate yourself. Directives can include:
Living Will
FILL OUT YOUR FORMS
Make sure you submit advance directives each time you go to the hospital so your most current information and wishes are on file. You do not need a lawyer to fill these out. For more information and to obtain the forms you need, contact your nurse.
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This set of instructions explains the type of lifeprolonging medical care you wish to accept or refuse. It can include your wishes about the use of CPR if your heart stops, a ventilator if you stop breathing, or feeding tubes or IVs if you cannot eat or drink.
Durable Power of Attorney for Healthcare
This is a legal document that names your healthcare proxy—someone who can make medical decisions for you if you’re unable to do so. An official healthcare proxy can represent your wishes on emergency care but also on other medical issues like potential treatment options, blood transfusions, kidney dialysis, etc. Choose someone you trust, discuss your medical wishes, and make sure the person agrees to represent you in this role.
Healthcare Surrogate
A person (agent) appointed to make medical decisions on your behalf if you are unable to do so. This person is sometimes chosen by patients themselves, or, depending on state regulations, may be chosen by the patient’s doctor in certain circumstances. If you are choosing your own healthcare surrogate, choose someone you know well and trust to represent your preferences. Be sure to discuss this with the person before naming him or her as your agent.
Support for Caregivers
How to Play a Role in Your Loved One’s Recovery
We encourage patients to pick a key person to support them during their hospital stay. Whether you are that primary support person, or just one of many people caring and supporting your loved one, you can play an important role in making sure your loved one gets the safest and best care both here—and beyond the hospital.
What to Know Before You Leave
Caregivers can help ensure the best outcome for their loved one after a hospital stay by getting the answers to these three questions: n
n
n
hat is the next step for medical W care (home or facility, follow-up with primary care physician or physical therapy, etc.)? Help your loved one arrange the details to make this happen—financial plan, transportation, scheduling, etc. hat new and former medicines W does my loved one need to take? Help your loved one understand the details—timing, dosing instructions, side effects, prescription refills, etc.
Caregivers Need Care Too If you feel like you need a break or help, reach out to friends and family. And consult the resources listed here. RESOURCES n National Alliance for Caregiving www.caregiving.org n
n
Family Caregiver Alliance www.caregiver.org Caregiver Action Network www.caregiveraction.org
hat health warning signs do I W need to watch for and what do I do if they happen? Help your loved one by writing these symptoms down, as well as the name and contact number to call.
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Before You Leave the Hospital
A successful recovery after your stay starts with a solid plan before you go.
Plan Early to reduce your chances of being readmitted and
increase your chances for a healthy recovery. Take steps as soon as possible during your stay to plan for a successful transition from the hospital.
To begin, ask your nurse to have your discharge planner contact you to review the following: n your discharge plan n your complete medicine list and instructions n your upcoming appointments n what to do if you don’t feel well
A Reason To Plan Early If you need a rehabilitation facility, nursing home, skilled care or other service after your stay, you’ll need time to find and weigh your options. For help comparing services in your area, go to: n www.medicare.gov/nursinghomecompare n www.medicare.gov/homehealthcompare n www.qualitycheck.org 26
Checklist for Discharge Make sure you have the following information before you leave the hospital.
pD ischarge summary. This includes why you were in the hospital, who cared for you, your procedures and medicines.
Not Ready To Leave? You have the right to appeal your discharge if you don’t agree with the decision that you are ready to leave the hospital. Speak with your discharge planner or physician and share your concerns. You also may need to reach out to Medicare, Medicaid or your insurance company.
pM edicine list. This includes all your new and former prescriptions, overthe-counter medicines, vitamins and supplements. Ask if there are any medicines you can stop taking or that are not good to take together. Also make sure you know why, how and when to take each one. pP rescriptions. Check that your pharmacy has your new prescriptions and that you have a plan to get them filled. p Follow-up care instructions. Beyond medicine, this can include: n warning signs to watch for n foods or activities to avoid n daily living adjustments n tests or appointments (like how to get into bed) n how to care for incisions or n who to call with questions use equipment pA fter-hospital services. Know how much support you’ll need in these areas: n Personal care: bathing, eating, dressing, toileting n Home care: cooking, cleaning, laundry, shopping n Healthcare: taking your medicines, doctor’s appointments, physical therapy, wound care, injections, medical equipment p Local Resources. Ask your discharge planner for help finding local after-care services or other support groups. Try the teach back method. Repeat back what you hear the discharge planner say to make sure you understand the details correctly. 27
After-Hospital Care Quick Guide to Recovery Options for After Your Stay
After-hospital care that fits your needs is important. Make sure you understand what your hospital staff recommends for you.
Home Healthcare— Care
provided by professionals in your home to help maintain or restore health. Includes: home care services such as housekeeping and meal preparation; personal care services such as bathing, dressing or eating; and healthcare services such as physical therapy or skilled nursing.
Independent Living—
Communities with individual, private apartments or homes. Includes: meals, housekeeping, maintenance, social activities and possibly transportation.
Assisted Living— Individual units or apartments, usually in a longterm care facility. Includes: home and personal care services, as well as help managing health conditions
and medicine routines—plus social activities and transportation. Medical staff is on-site 24 hours.
Nursing Home— Long-term care
facility for individuals who don’t need a hospital, but can’t be cared for at home. Includes: all daily living and personal care services, 24-hour skilled nursing care, plus social activities and events. Special units often available for people with Alzheimer’s disease or memory loss. Some nursing homes also offer short-term rehabilitative stays for patients recovering from an injury or illness.
Hospice— Care program that
provides support for terminally ill patients and families in hospitals, facilities or homes, depending on the patient’s condition. Includes: 24-hour help with pain control, symptom management and emotional or spiritual support.
To get started evaluating or finding after-hospital care resources in your area, visit:
n
Eldercare Locator www.eldercare.gov
n
National Respite Network and Resource Center www.archrespite.org
Contact your health insurance, Medicare or Medicaid to find out what care and services are covered for you, and to obtain help with costs. 28
Foods & Medication Safety This chart will help you steer clear of side effects that can be caused by pairing certain foods and medications. Did you know foods you eat could affect the medicine you take? Eating or drinking certain foods can cause your body to absorb medicine slower or faster. This can make medicine less effective or cause troubling side effects. The chart below lists some common drug-food interactions, but it does not include every medication or food interaction. Be sure to ask your doctor or pharmacist about possible interactions between food, vitamins, supplements, herbals or other drugs before taking any prescription or over-the-counter medications. DRUGDrug CLASS Class
RX MEDICATION Prescription Medication
COMMENTS Comments
Analgesics (pain relievers)
Percocet, Roxicet
COMMENTS Avoid drinking alcohol. Take with food to reduce upset stomach. Avoid overthe-counter Tylenol (acetaminophen)containing products. It’s unsafe to take more than 4,000 mg of acetaminophen in 24 hours.
(acetaminophen/ oxycodone) Tylenol #3
(acetaminophen/ codeine) Anti-arrhythmics (irregular heart beat)
Cordarone, Pacerone
(amiodarone)
Avoid eating grapefruit and drinking grapefruit juice. May take with or without food, but take the same time each day.
Antibiotics
Ampicillin Penicillin
Take on an empty stomach for best absorption.
Cipro (ciprofloxacin) Doxycycline Tetracycline
To improve absorption, avoid antacids, iron-containing foods and calcium-rich dairy products.
Flagyl (metronidazole) Tindamax (tinidazole)
Avoid alcohol while taking and for 3 days after finishing the medication. Take with food to prevent upset stomach; take probiotics (yogurt or supplements) to prevent diarrhea.
Griseofulvin
Take with fatty food (ice cream, whole milk or cheese) for better absorption.
Anti-coagulants (blood thinners)
Coumadin, Jantoven
Avoid sudden increase or decrease in foods rich in vitamin K (green leafy vegetables, avocados, soybeans, green tea, bacon, butter, cheese) and multivitamins with vitamin K. Check with your doctor or pharmacist for a complete list. Limit alcohol and cranberry juice.
Antidepressants
Paxil (paroxetine) Prozac (fluoxetine) Zoloft (sertraline)
Avoid drinking alcohol; avoid use of nicotine or tobacco products.
Continued on next page.
(warfarin)
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Foods & Medication Safety continued
DRUG CLASS
RX MEDICATION
COMMENTS
Antipsychotics
Clozaril (clozapine)
Avoid drinking alcohol and caffeine.
Abilify (aripiprazole) Seroquel (quetiapine)
Avoid drinking alcohol and grapefruit juice.
Dilantin (phenytoin)
Take on an empty stomach at the same time every day. Avoid calcium or antacids within 2 hours of taking medicine.
Carbatrol, Tegretol
Avoid eating grapefruit and drinking grapefruit juice.
Depakote (divalproex) Lamictal (lamotrigine) Lyrica (pregabalin) Topamax (topiramate) Zarontin
Avoid drinking alcohol.
Cholesterol
Lipitor (atorvastatin) Mevacor (lovastatin) Zocor (simvastatin)
Avoid eating large amounts of grapefruit or grapefruit juice (greater than 1 quart per day). Do not eat oat bran within 2–4 hours of taking medicine.
Diabetes Drugs
Glucophage
Avoid drinking alcohol. If diabetes is well controlled, limit alcohol to 1–2 drinks per day consumed with a meal.
Anti-seizure
(carbamazepine)
(ethosuximide)
(metformin) DiaBeta (glyburide) Glucotrol (glipizide) Amaryl (glimepiride)
Gastrointestinal Drugs Reglan
(metoclopramide)
Avoid drinking or limit alcohol. Take 30 minutes before meals.
Nexium
Take at least 1 hour before meals.
Tagamet (cimetidine)
Avoid drinking alcohol, caffeine and nicotine.
Colcrys (colchicine)
Avoid eating grapefruit and drinking grapefruit juice.
Zyloprim (allopurinol)
Take after meals.
(esomeprazole) Prilosec (omeprazole)
Gout Medications*
*If you have gout, avoid large amounts of purine-rich foods (anchovies, beef stock gravies, sardines, shellfish, asparagus, lentils and red meat— especially pork). Check with your doctor or pharmacist for a complete list. High Blood Pressure
ACE Inhibitors Monopril (fosinopril) Prinvil, Zestril
(lisinopril) Vasotec (enalapril)
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Avoid potassium-based salt substitutes and eating large amounts of foods high in potassium (almonds, bananas, cantaloupe, kidney beans, oranges/orange juice, potatoes with skin, tomato juice, spinach).
DRUG CLASS
RX MEDICATION
COMMENTS
High Blood Pressure (continued)
Calcium Channel Blockers Calan (verapamil) Cardizem (diltiazem) Plendil (felodipine) Procardia (nifedipine)
Avoid drinking Seville (sour) orange juice, eating grapefruit, and drinking grapefruit juice.
Beta Blockers Tenormin (atenolol)
Avoid drinking orange juice. Do not take calcium products within 2 hours of taking medicine.
Lopressor
Take with or immediately after meals. Do not take calcium products within 2 hours of taking medicine.
Diuretics Aldactone
Avoid potassium-based salt substitutes and eating large amounts of foods high in potassium (bananas, cantaloupe, kidney beans, potatoes with skin, tomato juice, spinach).
(metoprolol tartrate)
(spironolactone) Dyrenium
(triamterene) Midamor (amiloride)
Limit caffeine when taking Calan.
Immunosuppressant Drugs
Neoral, Sandimmune
Avoid eating grapefruit and drinking grapefruit juice. Avoid potassium-based salt substitutes and eating large amounts of food high in potassium (almonds, avocados, bananas, cantaloupe, kidney beans, oranges/orange juice, potatoes with skin, spinach).
MAO Inhibitors
Eldepryl, Zelapar, Emsam (selegiline) Marplan
Avoid foods high in tyramine (aged cheese, avocado, banana, bologna, pepperoni, salami, pickled herring, liver, raisins, yeast extracts, red wine, sour cream). Avoid drinking large amounts of alcohol and caffeine (chocolate, coffee, tea).
(cyclosporine) Prograf (tacrolimus) Rapamune (sirolimus)
(isocarboxazid) Nardil (phenelzine) Parnate
(tranylcypromine) Osteoporosis
Bisphosphonates Fosamax (alendronate) Boniva (ibandronate) Atelvia (risedronate)
Take on an empty stomach with 8 oz. of water in the morning before breakfast. Do not take any other drugs, vitamins or food within 30 minutes (60 minutes for ibandronate) of taking medicine. Remain upright, not reclining or lying down, for 1 hour after taking.
Thyroid Hormones
Levoxyl, Synthroid, Unithroid, Tirosint
Take on an empty stomach 30–60 minutes before breakfast with 8 oz. of water. Avoid eating walnuts, soybean flour, dietary fiber, and calcium products within 4 hours of taking medicine.
(levothyroxine)
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Patient Portal Get Connected with My Health Home Patient Portal You can have online access to your hospital inpatient records—test results, medications, procedure information, diagnoses and discharge instructions—through a secure Patient Portal. Information from your hospital stay is usually available 36 hours after you are discharged.
It’s quick to set up an account.
Ask a staff member or stop by Registration. You will need to show your photo ID and share your email address. You will receive an email with a link to the Portal so you can finalize your account setup.
It’s easy to use and convenient. IT’S FREE.
My Health Home Patient Portal is free—provided by Oro Valley Hospital to help you become a healthier, more informed patient.
GET AN ACCOUNT TODAY.
The Portal has user-friendly navigation, and you can access it from any computer or mobile device with Internet connection, at any time. Once you set up your account, bookmark the site to make it convenient to check in regularly to view and download your information. When information is added, or if there has been a requested change to your Portal account (such as password, email/username or other contact information) we will send you an email.
It’s secure.
Your information in the Portal is kept confidential. Only you—and those you authorize—will be able to Ask us! And learn see or gain access to the information in your Portal. more at www. We will not share, sell or lease your personal OroValleyHospital. information with any outside party not affiliated com. For help using with our organization. the Portal, call our toll-free Help Line For extra security, each time you log in, you will enter at 877-456-9617, your username (email address) and password, and 24 hours a day, answer your security question. seven days a week.
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Green Valley’s Best Kept Secret • Dedicated, Loving Care • Excellent ‘A’-Quality Rating • Medicare/Medicaid Certified • 24-Hour Skilled Nursing Care
Santa Rita Nursing and
Rehabilitation Center
• Respite Care Available • Long-Term Care in a Home-Like Environment • Short-Term Rehabilitation Stays
Santa Rita Nursing and Rehabilitation Center Provides Comprehensive Nursing and Rehabilitation Services with Consistent, Dedicated and Reliable Staff. When you or a family member are discharged from a Tucson hospital, come back home to Green Valley and save the daily drive into town for your therapy.
Tours of Our Remodeled Facility Are Always Welcome! 150 N. La Cañada | Green Valley, AZ 85614
(520) 625-0178 | www.santaritacare.com
XNLV132574
Creating Community at a Place Called Home 160 N. LA CANADA DR. | GREEN VALLEY, AZ 85614 | (520) 625-7737
Registered Nurse available 24/7 • Game room • TV lounge Mini theater with surround sound • Covered patio with BBQ Spa with exercise pool and massage room • Elegant dining Exercise room with state-of-the-art equipment Garden views from every room • Lounges with fireplaces Library and business center • Dog park Valerie@ArroyoGardens.com | www.ArroyoGardens.com
SPEC220086
Spring of 2016