SPEAK UP!
Ask Questions and Voice Concerns
ALL ABOUT ADVANCE DIRECTIVES
PATIENT GUIDE Key Information For Your Stay
SUCCESSFUL DISCHARGE How to Plan Ahead
FREE! Take This Copy Home With You Brought to you by:
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Having cancer is hard. Finding help shouldn’t be. The American Cancer Society is here for you when you need us, where you need us. ©2015 American Cancer Society, Inc. No. 030890
CO N T E N TS WELCOME. . . . . . . . . . . . . . . . . . . . . . . 2 ABOUT US. . . . . . . . . . . . . . . . . . . . . . . 3 PHONE DIRECTORY.. . . . . . . . . . . . . . 4 OUR COMMITMENT TO CARE.. . . . 5 RAPID RESPONSE (HELP Line). . . . . 7 FAST FACTS ABOUT YOUR STAY.. . 8 Plus TV Channel Guide SPECIAL SECTION . . . . . . . . . . . . . . . 14 PREVENT INFECTIONS. . . . . . . . . . . . 22 ADULT VACCINES. . . . . . . . . . . . . . . . 24 RIGHTS & RESPONSIBILITIES. . . . . . 25 ADVANCE DIRECTIVES. . . . . . . . . . . 27 SUPPORT FOR CAREGIVERS. . . . . . . 28 LEAVING THE HOSPITAL. . . . . . . . . . 29 AFTER-HOSPITAL CARE. . . . . . . . . . . 32 UNDERSTANDING YOUR BILL. . . . . 33 HOSPITAL RESOURCES.. . . . . . . . . . . 35 STAFF DEFINITIONS. . . . . . . . . . . . . . 36 FOODS & MEDICATION SAFETY. . . 37 PATIENT PORTAL. . . . . . . . . . . . . . . . . 40
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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 Identification 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 Manage Your Meds n
On Our Cover Speak Up! Ask Questions and Voice Concerns. . . . . . . . . . 14 All About Advance Directives. . . . . . . . 27 Successful Discharge How to Plan Ahead. . . . . . . . . . 29
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 ®
Welcome Thank You for Trusting Us
MISSION STATEMENT
To be the community leader in improving the health of the people in the City of Barstow and surrounding communities by providing healthcare in a safe, compassionate and fiscally responsible manner. Consistent with this mission, the employees are encouraged to “Keep the Patient at the Heart of Our Care.”
Thank you for choosing us for your healthcare needs. All our physicians, staff and volunteers are committed to ensuring you receive quality care in a safe and compassionate environment that promotes wellness and healing. This patient guide provides information that may help make you more comfortable and answer questions you may have about your hospital stay at Barstow Community Hospital. If you have any questions, do not hesitate to ask; our staff members have the time. Barstow Community Hospital has been a vital and growing part of the Barstow community for more than 55 years and is honored to have the opportunity to serve you in our new facility. We are fully accredited by The Joint Commission, designated Baby Friendly by World Health Organization (WHO) and United Nations Children’s Fund (UNICEF), designated as a Nurses Improving Care for Health System Elders hospital (NICHE) and a member of the American Hospital Association. We have implemented hourly and leadership rounding—a more team-based and proactive approach to patient care that ensures we are exceeding your needs. During your stay in our hospital, you can expect to be checked on by one of our caregivers on the following schedule: n n
From 6:00 a.m. to 10:00 p.m.: rounding every hour From 10:00 p.m. to 6:00 a.m.: rounding every two hours
If there is anything we can do to make your stay with us more comfortable, just ask any of our employees. We wish you a speedy recovery, and thank you for choosing Barstow Community Hospital. Sincerely, Steven Foster, CEO
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Barstow Community Hospital is not, in any way, responsible for the advertisements in this booklet. Barstow Community Hospital makes no representation or endorsement of any kind related to the advertised services, entities, or businesses. Barstow Community Hospital receives no remuneration in exchange for any advertisement. 122015
About Us Why We Are the Right Choice for Your Care The new Barstow Community Hospital (BCH) opened to the community October 13, 2012, nearly 55 years after the original Barstow Community Hospital opened across the street.
The New BCH
The new BCH is a modern, 30-bed acute care hospital that provides greatly expanded patient care areas, increased patient privacy and security, advanced technology, the ability to remain operational during disasters and a plan that allows for future expansion to serve our growing community.
Original BCH
The original Barstow Community Hospital closed the same day the new hospital opened. From its inception, BCH has been a success story of community commitment. From 1953 to 1956, community members raised funds to build the original hospital. The original Barstow Community Hospital was completed and dedicated in June 1957; however, the hospital remained vacant for more than six months because it didn’t have enough operating money to open. Funds to open BCH weren’t provided until local voters gave the city legal authority to run the facility in a 1957 election. In January 1958, Barstow Community Hospital, a one-story, 26-bed facility (the 100 nursing wing) opened. In 1962, the 200 nursing wing, the original Emergency Room, chapel and kitchen were built, increasing bed capacity to 40. In 1968, further expansion added the 300 nursing wing (including the OB area), lobby and administration area, extending the hospital capacity to 56 beds.
CONTACT US 820 E. Mountain View St. • Barstow, CA 92311 PH: 760-256-1761 • www.barstowhospital.com
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Phone Directory Key Numbers Main: 760-256-1761 | Financial Counselor: 760-957-3238 Gift Shop: 760-957-3124
OTHER HOSPITAL SERVICES Administration 760-957-3221
Medical Records 760-957-3228
Admitting (inpatient) 760-957-3130
One-Call Scheduling 760-255-4224 Outpatient 760-957-3131 or Registration 760-957-3199
Case Management 760-957-3266 Community 760-957-3347 Outreach
Physical Therapy 760-256-2800
Emergency 760-957-3030 Department
Physician Referral 760-255-4224
Food and Nutrition 760-957-3335 Services
Quality Department 760-957-3204
Human Resources 760-957-3206
Radiology 760-957-3325 Senior Circle 760-957-3347 Association
Laboratory 760-957-3313 Lost & Found 760-957-3028
BILLING Anesthesiologist Medical Billing 915-779-1716 Unlimited, Inc. ER Department Physician Rainbow Basin 800-355-2470 Emergency Physicians Hospital 844-550-2788
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Hospitalists RTI Patient Customer Service 800-355-2470 Pathology Rand Medical Billing 805-578-8300 Radiologist Interpretation Affiliated Professional Services, Inc. 800-841-5200 ext. 3240
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
n
Contact the quality director at 760-957-3090. ile a complaint with your state or Quality F Improvement Organization (QIO). See Rights and Responsibilities p. 26 for contact information.
?How gniod are ewwe erdoing? a woH 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 keep your your pain Help room clean or quiet Help you understand Ease your pain your medicine plan Help you understand your medicine plan
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. 27). Our BioEthics Committee can help your team of support people make difficult decisions. For help, call 760-957-3090 or ext. 3090 from within the hospital.
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Our Commitment continued 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 an 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
n
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 (HELP Line) Special Support to Prevent Emergencies During your stay, you have access to a special service called the Rapid Response Line. 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 lifethreatening emergency.
WHEN to Call the HELP Line Call for help if you notice: n
n
n
n
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
n
n
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 the HELP Line Step 1: Dial 2222 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 Automated Teller Machine (ATM)
For your convenience, there is an ATM located in the Emergency Room waiting area.
Cafeteria
Location: In the basement
VISITING THE HOSPITAL? Thanks for taking the time to support your loved one’s care and recovery. See p. 12 for important visitor information.
Hours: Monday through Friday: 7:00 a.m. to 5:00 p.m. (closed 10:00 a.m. to 10:30 a.m. and 2:00 p.m. to 2:30 p.m.) Weekends and holidays: 7:00 a.m. to 2:00 p.m. (closed 10:00 a.m. to 10:30 a.m.) The cafeteria, open to all visitors, provides a variety of selections prepared daily, including hot entrées and accompaniments, made-to-order grill items, cold sandwiches, salads, fruits, snacks, desserts and beverages.
Calling Your Nurse
Use the intercom system in your room for direct voice contact with the nursing station. Extending from the intercom is a pillow speaker that can be clipped to your bed for convenience. To call the nursing station, press the top bar marked “Nurse,” and a staff member will respond via the intercom. When a nursing staff member answers, please make your request in a normal speaking voice. Some beds have the nurse call button built into the side rail. Please clarify with your nurse as to which nurse call system you have.
Cellphones
For patient rest and recovery and the comfort of other hospital guests, we discourage cellphone usage in the hospital. The use of a cell phone camera or any camera is not permitted on the hospital’s grounds.
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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.
Environmental Services
The Environmental Services staff clean your room daily. If there is a housekeeping problem, notify your nurse, and the concern will be taken care of as soon as possible.
Fire Safety
For your safety, we periodically conduct fire and disaster drills. If you hear an alarm, stay where you are. In the event of an actual emergency, hospital staff will notify you of what actions need to be taken. The staff is trained in fire protection and safety.
Gift Shop
Location: Main lobby, east of the information desk. Hours of Operation: Monday through Friday: 9:00 a.m. to 5:00 p.m. Saturday: 10:00 a.m. to 2:00 p.m. The hospital’s gift shop, Mojave Vista, is stocked by the hospital’s Auxiliary with stuffed toys, books, jewelry, gifts for special occasions, home decorations, balloons, fresh flowers, baby items, candy, gum and more. The proceeds from the gift shop are donated back to the community through the Auxiliary’s giving plan and scholarships. Cash, debit cards and credit cards accepted.
Guest Meals
Guest meals are provided to patient visitors (if providing assistance to patient) during patient meal service upon request by nursing. Senior Circle members visiting a loved one also are provided one guest tray per day.
Hearing Impaired
We will make all reasonable efforts to provide auxiliary aids and services that are necessary to ensure effective communication to patients and/ or companions who are hearing impaired. Upon request or belief that such service is necessary, hospital personnel will make a Talk to You (TTY) available to the hearing-impaired patient’s room.
Interpreters
We contract with a language translation service via the telephone for patients that may need this service. If interpreter service is needed, please inform your nurse.
Lost and Found
If you lose or misplace personal property while at the hospital, contact a staff member. Security personnel will check if the item has been turned into the hospital’s lost and found. If the items still cannot be located, security personnel will take your contact information and the missing item’s description. If it’s turned in later, security will try to contact you and have the item returned. Hospital security maintains a log of valuable items such as purses, credit cards, jewelry, cash, electronic equipment, keys, etc. Items of lesser value are kept in the Environmental Services
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Facts About Your Stay continued office, which you can contact at 760957-3028 or ext. 3028, if calling from within the hospital. Found items left unclaimed for 30 days are donated to a local charity or discarded.
Police will ticket or tow all vehicles parked in no parking zones or in handicapped areas without the appropriate placard.
Mail and Flowers
A group of volunteer ministers are available to all patients and their families. Please contact your nurse to request a visit from the on-call minister.
A hospital volunteer will deliver mail and packages to you. Individual florists deliver flowers to patient rooms. Please note that flowers are prohibited in the intensive care unit. Any mail received after your discharge will be forwarded to your home address. You make take outgoing mail to the nursing station or give to your attending nurse. Postage stamps are available in the gift shop.
Newspapers
Through an arrangement made between the hospital Auxiliary and Desert Dispatch, the Barstow-area newspaper is provided free to patients Monday through Friday. You also may purchase newspapers outside the Emergency Department entrance and the main hospital entrance.
Parking
There is ample parking for visitors and patients in front of the hospital (north side). The parking lot on the east side of the hospital is reserved for physicians, volunteers and employees. Please observe the reserved parking and handicapped areas. Red curbs designate no parking areas and are the jurisdiction of the Barstow Police Department. 10
Pastoral Care
Patient Meals
Food and Nutrition Services provides healthy, well-designed meals to meet the nutritional and therapeutic needs of patients. A registered dietitian prepares menus to ensure the physician-prescribed diet meets nutritional standards set by state and federal regulations. A food service professional provides daily assistance with food selections and preferences for all patients. Patient meals are served based on the following schedule: Breakfast: 7:30 a.m. Lunch: 12:00 p.m. Dinner: 5:30 p.m. Cold meals are provided to patients who miss regular servicing times. Patients who prefer to have foods from outside the Food and Nutrition Service department are welcome to do so as long as they stay within their prescribed hospital diet. If foods need to be refrigerated, they may be placed in the unit’s refrigerator. However, outside foods must contain the patient’s name and the date placed into the refrigerator. All foods will be discarded after 24 hours. Note: Once food goes into a patient room, it is not permitted inside the unit refrigerator.
If you have any questions regarding the food service provided or your prescribed therapeutic diet, please ask to speak with the dietitian or a food and nutrition representative.
Personal Belongings and Valuables
Valuables such as jewelry, important papers, credit cards, keys, wallets, rings and cash in excess of $5 should be sent home. If you are unable to do so, the hospital has a safe that is specifically used to ensure the security of patient valuables. Inform the nurse that you have valuables, and an envelope will be brought to you in which you can place your items. This envelope with your belongings will then be placed in the hospital’s safe and will be returned to you at discharge. Contact lenses, eyeglasses, hearing aids and dentures should be stored in your bedside stand when not in use. Please don’t put them on your bed or food tray—they may be damaged or lost. The hospital assumes no responsibility for personal property retained by the patient.
Public Restrooms
Visitors are not to use the bathrooms in patient rooms. They are reserved only for patients in order to protect their health. Public restrooms are located next to the elevators.
Smoking
Smoking and/or the use of any tobacco products is not permitted anywhere in the hospital or on hospital grounds. As a tobaccofree campus, tobacco products are banned in every work and public area, including hospital buildings,
grounds and parking lots, extending to the inside of all vehicles while parked at the hospital facilities. With a physician’s order, we can provide patients with viable alternatives, e.g., nicotine gum or patches.
Telephone
All patient rooms have phones. We ask that family members and friends call between 7:00 a.m. and 9:00 p.m. only, except in emergencies. Family and friends can reach you by dialing the appropriate nurses’ station so they may connect the call: n Medical/Surgical (rooms 1 through 20): 760-957-3318 n ICU: 760-957-3330 n Obstetrics: 760-957-3323 If they are unsure of which unit of the hospital you’re in, they can reach you by dialing the general hospital number at 760-256-1761 and then dial 0 for the operator. You may use your bedside phone to make calls by dialing 8 and then the phone number, including area code.
Vending Machines
Vending machines offering beverages and snacks are located in the cafeteria (basement), in the emergency department waiting room, and just outside the Mojave Vista Gift Shop (near the main entrance). They are available during visiting hours.
Visiting Hours*
General: 8:00 a.m. to 8:00 p.m. Maternity: No children younger than 12 permitted except siblings of newborns. Unrestricted visiting for patient’s partner or spouse.
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Facts About Your Stay continued Intensive Care Unit (ICU): Immediate family only, including no visitors under the age of 12 (babies of a mother patient are permitted). Visitors ages 12 through 18 need adult supervision by someone other than the patient. Visitors may be asked to leave the room by ICU staff due to the patient’s condition. *We retain the right to enforce clinical restrictions on visitation.
Wireless Internet
Free wireless Internet service is available throughout the hospital and in all patient rooms. The “Guest Wireless” network is for use by the hospital’s guests and visitors. To connect: 1. Enable your wireless card. 2. Open your Internet browser. 3. Agree to the terms of use. There is no registration and no configuration of the network.
Your Room
Your room assignment is based on your admitting diagnosis and bed availability. To keep you comfortable, beds are electrically operated for adjustments, and your nurse will show you how to operate your bed properly. Bedside rails are for your protection. They may be raised if you are resting, recovering from surgery or taking certain medications. For help, ask your nurses during their rounding or, for immediate assistance, use your call button. The building is temperature controlled by a building system. It has been designed to keep a constant temperature that is in the range of 68 to 75 degrees. Please notify the nursing staff if your room is uncomfortable, and he or she will make every effort to help with your comfort.
Visitation Policy
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Barstow Community Hospital understands that having loved ones by your side can help with your healing and care. You have the right to choose and prioritize visitors from among family, friends, partners, personal care aides or other individuals (regardless of the person’s gender or your relationship to the person). You also can choose a support person to be present throughout your stay, unless that person’s presence affects your health or the rights or safety of other patients. If you have any questions about your visitation rights, contact our Admitting Department at ext. 3238.
TV CHANNELS 20 Travel Channel
3 Fox Sports West
21 A&E
4 NBC
22 Biography
5 KTLA
23 E!
6 ESPNU
24 Lifetime
7 ABC
25 TV Land
8 NBATV
26 TBS
9 KCAL
27 TN
10 NBC Sports Network
28 AMC
11 FOX
29 FOX Movie Channel
12 Cartoon Network
30 FOX News
13 KCOP
31 CNN
14 KMEX
32 CNBC
15 Animal Planet
33 USA Network
16 Discovery
34 Barstow Community Hospital
17 National Geographic
35 Barstow Community Hospital
18 Science Channel
36 Barstow Community Hospital
19 History Channel
37 Expectant Mother’s Education
Quick Quiz! By the age of 65, how many years of the average American’s life is spent in front of the TV? o 2 years o 5 years o 9 years o 12 years Answer: With 4 hours of viewing each day or 28 hours a week, by age 65 TV-viewing time can equal roughly 9 years!
?
2 CBS
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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.
A support person can: n
n
n
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 Identification
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
n
n
n
n
n
n
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 run 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 which 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 or exit your room. 18
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?
n
When does it hurt?
n
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, gown and slippers 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. 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
n
the type of surgery you are having
n
the body part to be operated on—In fact, your surgeon 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.
Manage Your Meds Whether you take one medicine or five, it’s important to know what you are taking and why. Ask your doctor these questions about any new (and current) medicines you take: n
n
n
n
n
n
n
hat is the name of my W medicine? Generic name? hy am I taking it? How will W it help? When will it start working? hat dose? How often? W How long? hat is the best time (morning, W night, etc.) or way to take it (with food, with water)?
Prevent Medicine Errors Be sure your doctors and nurses know: n All the prescription drugs, over-the-counter medicines and herbal or vitamin supplements you take. n Any allergies you have to medicines, anesthesia, foods, latex, etc. n That your name matches the name on the medicine (use your ID bracelet to double-check).
hat are possible side effects? W What do I do if they happen? re there any foods, drinks or A activities to avoid? What do I do if I miss a dose?
Remember, Take Charge of Your Medicines
Think you’re due for your next dose? Wondering if this new medicine can replace one you already take? Want to make sure all your medicines and supplements are safe to take together? Don’t be afraid to ask.
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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 Methicillin Resistant Staphylococcus Aureus (MRSA) and Clostridium Difficile (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.
SYMPTOMS n n n n
n n n
n
n
n n
fever burning pain bloody or frequent urination redness pain drainage of cloudy fluid fever r ed skin and soreness at site fever chills
PREVENTION n n
n n
n
n n n
n n
n
n
n
n n n n n
cough mucus fever chills shortness of breath
n n n
n
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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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.
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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.
Rights & Responsibilities You Have the Right To:
Be treated in a dignified and respectful 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 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
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Rights & Responsibilities cont. 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 Formulate advance directives 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 clinical 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
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Examine and receive an explanation of the bill for services, regardless of the source of payment
You Have the Responsibility To:
Provide accurate and complete 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 regulatory agency indicated below: Quality Department 820 E. Mountain View St. Barstow, CA 92311 760-957-3090 California Department of Health Services 464 W. 4th St., Suite 529 San Bernardino, CA 92401 909-383-4777
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. They will only be used if you become unconscious or too ill to communicate yourself. Directives can include:
Living Will
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.
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 case manager.
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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. 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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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
n
Family Caregiver Alliance www.caregiver.org Caregiver Action Network www.caregiveraction.org San Bernardino County Family Caregiver Support Program 909-891-3900
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 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 n San Bernardino County Department of Aging: 909-891-3900
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Before You Leave continued
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 case manager, nurse or physician to 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 case manager 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. 30
Top Questions to Ask Before Discharge 1. What number can I call 24 hours a day if I have questions or concerns? Who is my contact? 2. Has my follow-up appointment been scheduled? With whom? Do I have a ride there? 3. What are key warning signs I need to watch out for? Whom do I call if they happen? 4. What special equipment do I need? What special instructions do I need (wound care, injections, etc.)? 5. What kinds of activities and foods are limited? For how long? 6. Do the doctors caring for me after my stay have access to my test results and medicines? Do I need follow-up tests? 7. Are my new medicines safe to take with my other medicines, vitamins or supplements? 8. D o I know how and when to take my medicines and how I will get prescriptions filled? 9. Who will provide the extra personal, home or healthcare services I may need? 10. Who can help me if I have concerns about medical costs? 11. If I am enrolled in the Patient Portal, can I access my medical records from home?
Need Medical Equipment or Supplies? If you need durable medical equipment (walker, wheelchair, hospital bed, oxygen, etc.), Medicare will only cover the cost if you use an approved supplier. To find one in your area, visit www.medicare.gov and select “Find suppliers of medical equipment and supplies� or call 1-800-MEDICARE (800-633-4227).
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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. Be sure to contact your case manager with any questions.
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. 32
Understanding Your Bill Take Charge of Your Payments The hospital billing process may seem complicated, but you can feel more in control by knowing exactly what your bill covers. For example, if you stay overnight, you can expect to see charges for your room, meals, 24-hour nursing care and medicines. The bill also will show charges for any special services, such as X-rays and lab tests. You’ll receive bills for doctors, surgeons and specialists separately from the hospital.
Medicare
If you have Medicare, you’ll have to fill out a Medicare Secondary Payer (MSP) form. This ensures that Medicare only pays for services not covered by other insurance you may have. If you have secondary insurance, this usually covers Medicare deductibles. If you don’t have secondary insurance, you need to pay these amounts yourself. Also, be sure to read your quarterly Medicare Summary Notices (MSNs) to review: the amount your doctor(s) charged the amount Medicare approved and paid n the amount you owe n your current deductible status If you have questions, call the customer service number listed on your statement.
n
n
Commonly Confused Terms
KEEPING TRACK
One of the key ways to feel wellinformed and less overwhelmed about the hospital billing process is to stay organized. Keep all of your statements and bills together and review each one as it arrives.
• D eductible: The amount you owe each year before your insurance begins making payments. • C o-payment: A flat fee you pay for a specific service, usually due at the time of service. • C o-insurance: The portion of your medical expenses that you’re personally responsible for paying. For example, your insurance may cover 80 percent of a bill, while you have to pay the remaining 20 percent.
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Understanding Your Bill continued Commercial Insurance Providers
If you use a commercial insurance provider, then the hospital forwards your claim based on the information you provide at registration. But remember, you still are ultimately responsible for payment of your bill. About a month after you leave the hospital, you’ll get an Explanation of Benefits (EOB) statement from your insurance provider. This isn’t a bill. EOBs show:
n
the amount billed by your doctor or hospital
n
how much of that cost is covered by your insurance
n
how much you owe
Review this and all other bill-related documents carefully. If you have questions, contact your doctor or the customer service number listed on the statement.
Self-Pay Patients and Payment Arrangements
If you’re planning to pay your bills without help from Medicare or a commercial insurance provider, you’ll get bills directly from the hospital. When the first bill arrives, call the hospital’s financial services department to set up a payment plan.
Need Help? If you don’t understand something on your bill, have trouble paying your bills, or want to know if you are eligible for governmentsupport insurance programs, we can help. Just tell your nurse that you would like to speak to an application coordinator.
Communicate with the financial services department as soon as possible. If you don’t set up a payment plan, or if you stop making payments, your account may be placed with a collection agency. The hospital wants to work with you, so reach out with any questions or concerns you have.
Understanding Coordination of Benefits (COB) COBs happen when you’re covered under two or more insurance companies. This may occur when a husband and wife are both listed on each other’s insurance policies, or when both parents carry their children on their individual policies. To prevent duplicate payments, COBs determine the primary payer. You choose who this is when you’re admitted. Insurance companies usually request completed COBs from you before paying a claim, so make sure you address these requests quickly.
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Hospital Resources Diabetic Support Group
Join us at our next Diabetes Support Group on the last Thursday of each month from 4:00 p.m. to 5:00 p.m. in the BCH conference room. The free program provides information on various resources to assist diabetic patients in their rehabilitation. This group shares ideas, coping tips, experiences and, most importantly, exchanges emotional support to minimize the condition’s affect on their lives. For more information, contact Terri Jackson at 760-957-3259.
Stroke Support Group
This group gives the survivors/ caregivers/family members the opportunity to socialize with other patients experiencing a similar situation. For more information, contact Bonnie Lou Schneider at 760-792-2733.
Volunteer
We are recruiting new volunteers for our hospital Auxiliary. We offer a free year membership in our Senior Circle program if you volunteer a minimum number of hours per month. Call 760-9573124 for more information.
Join us at our next Stroke Support group on the second Tuesday of each month from 4:30 p.m. to 5:30 p.m. in the BCH conference room. The free program provides information on various resources to assist stroke patients rehabilitate and cope with the adjustment after suffering a stroke.
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Staff Definitions Case Managers
Ext. 3266
Dietitians
Ext. 3335
Case managers will review your medical record and discuss your discharge plan. They are available to assist you with arrangements for home care, admission to a long-term care facility or rehabilitation care.
A registered dietitian will review your medical record and work with your healthcare team to develop a nutrition care plan for you. Registered dietitians are also available to educate you about any diets you may need to follow after you are discharged.
Hospitalists (Physician)
A hospitalist’s only focus is to take care of patients when they are in the hospital. Hospitalists work in close consultation with the patient’s primary care physician and specialists. They manage a patient’s entire hospital experience, from admission until discharge.
Nurses
In each patient unit, a registered nurse is responsible for the coordination of your care. Nursing staff is available around the clock.
Pharmacists
Ext. 3127
While you’re in the hospital, hospital pharmacists review all your medications. They can answer any questions you have regarding your medications.
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Physicians
Your primary care physician or a hospitalist will supervise your care while you’re in the hospital. If you have not been seen by a doctor in the previous 24 hours, please notify your nurse.
Rehabilitation Therapists
Physical therapists and speech pathologists will work with you, your family and your medical team to help meet goals of recovery. Therapy may range from brief consultation to long-term intervention, based on the extent of your injuries or illness.
Technicians and Technologists
Skilled health professionals perform and assist with laboratory and other procedures, including X-rays, mammograms, ultrasound, CT scans, MRIs and other procedures that help in diagnosing and treating your illness or injury.
Volunteers
Volunteers give thousands of hours each year to our hospital to enhance the care of our patients and their families. They provide support throughout the hospital, including staffing the information desk, delivering newspapers, mail and flowers and operating the gift shop.
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 Barstow Community 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 see or gain access to the information in your Portal. We will not share, sell or lease your personal information with any outside party not affiliated with our organization.
Ask us! And learn more at BarstowHospital. MyHealthHome. com. For help using the Portal, call our For extra security, each time you log in, you will enter toll-free Help Line your username (email address) and password, and at 877-456-9617, answer your security question. 24 hours a day, seven days a week.
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Only those who care for others know what it’s really like to care for others. That’s why AARP created a community with experts and other caregivers to help us better care for ourselves and for the ones we love.
aarp.org/caregiving or call 1-877-333-5885 ®
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Right Choice.