PATIENT GUIDE Key Information For Your Stay
FACTS FOR YOUR STAY
Plus! What Your Visitors Need to Know
KNOW YOUR RIGHTS RESOURCE GUIDE
For Services After Your Stay
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Brought to you by:
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Dr. Perry J. Argires, MD, FACS
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When It’s Comes To Your Brain, We’ve Got Your Back. When it comes to your brain and spine, you want to be sure you’ve selected a physician with the expertise, tools, and team to back you up. Dr. Perry Argires and Dr. Louis Marotti, distinguished neurosurgeons with Brain Orthopedic Spine Specialists, provide the most comprehensive brain and spine care in Central Pennsylvania. Advanced Specialists for Advanced Care. LANCASTER Main Office 2150 Harrisburg Pike | Suite 200 EPHRATA 1261 Division Highway, 2nd Floor (Nolt Dental Building) CONTACT US (717) 358-0800 • WWW.BRAINSANDBONES.COM
CO N T E N TS WELCOME. . . . . . . . . . . . . . . . . . . . . . . 2 ABOUT US. . . . . . . . . . . . . . . . . . . . . . . 3 PHONE DIRECTORY.. . . . . . . . . . . . . . 4 OUR COMMITMENT TO CARE.. . . . 5 RAPID RESPONSE TEAM. . . . . . . . . . 7 FAST FACTS ABOUT YOUR STAY.. . 8 Plus TV Channel Guide SPECIAL SECTION . . . . . . . . . . . . . . . 12 ADULT VACCINES. . . . . . . . . . . . . . . . 20 RIGHTS & RESPONSIBILITIES. . . . . . 21 ADVANCE DIRECTIVES. . . . . . . . . . . 23 HOSPITAL INFECTIONS. . . . . . . . . . . 24 LEAVING THE HOSPITAL. . . . . . . . . . 26 AFTER-HOSPITAL CARE. . . . . . . . . . . 28 UNDERSTANDING YOUR BILL. . . . . 29 HOSPITAL RESOURCES.. . . . . . . . . . . 31 STAFF DEFINITIONS. . . . . . . . . . . . . . 34 FOODS & MEDICATIONS 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 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 Manage Your Meds n
On Our Cover Facts for Your Stay Plus! What Your Visitors Need to Know. . . . . . . . . . . . . . . . 8 Know Your Rights. . . . . . . . . . . 21 Resource Guide For Services After Your Stay.. . . . . . . . . . . . . . 31
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. ©2016 PatientPoint ®
Welcome Thank You for Trusting Us Thank you for choosing Lancaster Regional Medical Center (LRMC) for your healthcare needs. It is our goal to provide you with quality, compassionate care without compromise. We have developed this guide to ensure you are well-informed about our hospital and capabilities. Our dedicated and professional staff stands ready to make certain that your stay is as pleasant as possible. More information about Lancaster Regional Medical Center is available at www.LancasterMedical Centers.com.
MISSION STATEMENT
If we can answer any questions while you are here or after you return home, please do not hesitate to ask. If you have any comments or suggestions you would like to share, we welcome the opportunity to learn from you.
Compassionate, personalized care‌ every patient, every time.
We Care About Your Care Please speak up and tell us if we can do more. In fact, after your stay, we’ll be reaching out to you to find out how we did. Please be honest and take a few moments to tell us what you think. Your responses to this patient satisfaction survey will help improve our services.
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Lancaster Regional Medical Center is not, in any way, responsible for the advertisements in this booklet. Lancaster Regional Medical Center makes no representation or endorsement of any kind related to the advertised services, entities, or businesses. Lancaster Regional Medical Center receives no remuneration in exchange for any advertisement. 022016
About Us Why We Are the Right Choice for Your Care As a full-service medical facility with community hospital values, Lancaster Regional Medical Center (LRMC) recognizes that health is the combination of body, mind and spirit, and holds sacred the lives entrusted to our care. At LRMC, you are a person first and a patient second. And you are never, ever just a number. That’s the LRMC difference. Everyone will have healthcare needs at some point in life. And with 214 licensed beds and more than 400 highly experienced physicians, we offer a high level of patient safety, medical expertise and technology, and a fully comprehensive range of inpatient and outpatient medical and surgical services. Often healthcare concerns affect not just individuals, but families and communities. We can work together to ensure your care is top notch. That’s why we’re the place for comprehensive care—from routine physicals to open heart surgery. As one of the first hospitals in the county, LRMC has been dedicated to providing patients with personal and compassionate care for more than 122 years. Multiple surveys illustrate that LRMC routinely scores high in Lancaster County in overall patient satisfaction. Lancaster County residents have choices for their healthcare needs. And those that choose LRMC say they would choose us again and again.
CONTACT US 250 College Avenue Lancaster, PA 17603 717-291-8211
To learn more, visit us at
www.LancasterMedicalCenters.com. 3
Phone Directory Key Numbers Main: 717-291-8211 Information Desk: 717-291-8221 | Cafeteria: 717-358-7777
Calling from INSIDE the hospital? Dial the last four digits only.
OTHER HOSPITAL SERVICES Administration 717-291-8123 Business Office 717-291-8075 Central “One Call� Scheduling 717-291-8133 Environmental Services 717-291-8216 Health Information Management 717-291 8234 Patient Advocate 717-291-8054 Spiritual Care 717-291-8414 Volunteer Services 717-291-8126
For more information on the resources available at Lancaster Regional Medical Center, visit www.LancasterMedicalCenters.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
n
ontact the Patient Safety Hotline at ext. 8552 or C the Patient Advocate at ext. 8123. ile a complaint with your state or Quality F Improvement Organization (QIO). See Rights and Responsibilities p. 22 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 your pain 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. 23). Our Ethics Committee can help your team of support people make difficult decisions. For help, contact Case Management at ext. 8251.
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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 the HCAHPS survey. The telephone survey asks multiple choice questions on key care topics, such as:
n
doctor and nurse communication
n
medicine and discharge information
n
pain management and staff responsiveness
n
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
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 Rapid Response Step 1: Please dial 122 on the 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 Bedside Assistance and Safety
Side rails on your bed may be raised for your protection. They are used for patients who are given sedatives or are recovering from anesthesia. Do not try to lower the rails or climb over them. Unless you have your doctor’s permission, please ask for assistance when getting out of bed. Your new surroundings or medication could make getting up more difficult. Please press the call button on the bedside control when you need assistance.
Cafeteria VISITING THE HOSPITAL? Thanks for taking the time to support your loved one’s care and recovery. See p. 10 for important visitor information.
Location: First floor Hours: Daily from 6:30 a.m. to 6:30 p.m.
College Ave. Cafe
Location: Ground floor Hours: Monday through Friday from 6:30 a.m. to 4:00 p.m.
Fire Safety
While you are staying with us, the hospital staff may conduct fire or disaster drills. These routine, mandatory drills ensure maximum safety for all patients.
Hearing Impaired
If your hearing is impaired, please ask your nurse for a volume control handset or TDD for your phone. The hospital provides closed-caption television, TDD with phone flasher, interpreters and written communication tools for your use.
Identification Bracelet
Each patient is required to wear an identification bracelet for safety. Please do not remove your ID bracelet while you are in the hospital.
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Interpreters
Contact your nurse to make arrangements for foreign language video interpretation. Call 0 for the operator to contact the nursing supervisor.
Lost and Found
For lost and found assistance, contact security at ext. 8390.
Mail and Flowers
We will deliver all mail and flowers directly to your room. Any mail you receive after your discharge will be forwarded to your home address. Flowers are not permitted in ICU.
Medicines
Make a list of currently prescribed home medications or bring the actual medications and supplements. After a pharmacist reviews them, we will return the medications to your family or store on the nursing unit until your discharge.
Parking
Visitor parking is directly across the street from LRMC, in the parking lot adjacent to the Medical Arts Building on College Avenue.
Patient Meals
We believe that patients should be able to eat the food they want, when they want it. Patients can order from a restaurant-style menu by dialing ext. 7777. All patients are invited to place a food order at any time
between 7:00 a.m. and 6:30 p.m. You can order any item on the menu as long as it falls within your prescribed diet. Specific guidelines are provided in the menu in your room. Family members can call in meals from home by dialing 717-358-7777. Guest meals also are available. After purchasing a voucher in the cafeteria, dial ext. 7777. Please provide the voucher number and order the meal. When the tray is delivered, hand the voucher to the delivery person. Cost: Breakfast, Lunch and Dinner, $5.
Personal Belongings
Personal care items such as contact lenses, eyeglasses, hearing aids and dentures can be stored in your bedside stand when not in use. Please do not put them on your bed or food tray to help avoid them being lost or damaged. Leave valuables like jewelry or cash at home, or give them to a trusted relative or friend to watch over. LRMC cannot be responsible for replacing personal belongings.
Regional Pharmacy
Registered pharmacists staff the Regional Pharmacy on the ground floor. Your physician will order all medications for you. Your physician, a hospital pharmacist and our nurses work together to oversee your drug therapy program. The Regional Pharmacy is open to the public Monday through Friday from 8:30 a.m. to 6:00 p.m., Saturday 9:00 a.m. to 2:00 p.m. and is closed on Sundays. It offers free home delivery, medical review and counseling, vitamin and nutritional supplements, and a range of OTC products. 9
Facts About Your Stay continued Smoking
LRMC promotes good health for all patients, visitors and associates. Smoking is prohibited anywhere inside the hospital or on hospital grounds.
Telephone
All rooms have a telephone for local and long-distance calls. Local (Lancaster city) calls are free and may be made by dialing 9 to get an outside line. You will be charged for calls outside Lancaster city limits. Longdistance calls cannot be billed to your room. Place collect, third party and credit card calls through the hospital operator by dialing 0.
n Second floor, adjacent to the
Cardiac Catheterization Lab
Visitor Guidelines
We ask that you and your visitors observe the following guidelines: n Visits should be brief. n Children are welcome visitors, but
do not leave them unattended.
n When the physician is consulting or
care is in progress, visitors may be asked to leave the room.
n Anyone with a cold, sore throat or
other contagious illness should not visit.
n If the patient is on isolation
precautions, wearing protective equipment may be needed. Please check with the nurse before entering.
TV
Each patient room has a television. Please be considerate of others by keeping the volume down and turning off your TV at bedtime. See p. 11 for Channel Listing.
Vending Machines
Here you can find beverages and snacks 24 hours a day. Vending area locations: n Emergency Department waiting
room
n Please do not bring food to patients
without physician approval.
n Please be courteous of others
and keep talking and noise to a minimum.
n In general, no more than three
people should visit at once.
n Social visits are discouraged during
n Delp Pavilion Day Hospital
Visiting Hours
To promote healing and safety and limit infection, some units may limit the number of visitors you can receive at one time. n
eneral Visiting Hours: 11:00 a.m. G to 9:00 p.m.
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scheduled therapy sessions.
TV CHANNELS 2 WLYH-15 (CW)
30 MTV
3 WCAU-10 (NBC)
31
4 WPMT-43 (FOX)
32 TBS
5 WGAL-8 (NBC)
33
6 WPVI-6 (ABC)
34 TNT
7 WHTM-27 (ABC)
35
8 CN8
36 AMC
61 Cartoon Channel
9 WHP-21 (CBS)
37 Disney Channel
62 Hallmark Channel
10 WGCB-49 (IND)
38 SPIKE TV
63 Style
11 WPHL-17 (MY)
39 CNBC
64 GSN
12 WITF-33 (PBS)
40 Headline News
65
13 HSN
41 ABC Family
66 Info & Access
16 Patient Information
42 Lifetime
67 CMT
18 PCN
43 VH1
71 TCM
20 WGN
44 Univision
72 Animal Planet
21 C-SPAN
45 BET
73 Golf Channel
22 QVC
46 TLC
74 Discovery Health
23 WTXF-29 (FOX)
47 MASN
75 truTV
24
WWSI-62 (Telemundo)
48
The Weather Channel Discovery Channel Comcast SportsNet Philadelphia
Fox News Channel
54 Travel Channel 55 Bravo 56 History Channel 57 HGTV 59 Syfy 60 Versus
C-SPAN 2/Comcast/ SportsNet Plus
76 TV Land
25 ESPN
49 Comedy Central
77 Speed Channel
26 ESPN2
50 Nickelodeon
78 Food Network
27 CNN
51 FX
95 Leased Access
28 A&E
52 E!
96 Educational Access
29 USA Network
53 MSNBC
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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 IDs
While you are here, many people will care for you (doctors, nurses, aides), 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 can also 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?
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 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
n
the type of surgery you are having
n
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.
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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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.
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8/28/15 1:28 PM
300 Harrisburg Ave. Lancaster, PA 17603 717.299.3000
www.lancasterartshotel.com
Rights & Responsibilities You Have the Right To:
B e treated in a dignified and respectful manner and to receive reasonable responses to reasonable requests for service E ffective 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 R espect for your cultural and personal values, beliefs and preferences P ersonal privacy, privacy of your health information and to receive a notice of the hospital’s privacy practices P ain management A ccommodation for your religious and other spiritual services A ccess, request amendment to and obtain information on disclosures of your health information in accordance with law and regulation within a reasonable time frame H ave 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 C are 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 P articipate 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 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 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
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Rights & Responsibilities cont. 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
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You Also Have the Right To:
Lodge a concern with the state, whether you have used the hospital’s grievance process or not. If you have concerns regarding the quality of your care, coverage decisions or want to appeal a premature discharge, contact the State Quality Improvement Organization (QIO). Contact information for the state and our QIO is located on the insert at the back of this booklet.
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: The Pennsylvania Department of Health also is available to assist you with questions or concerns about your hospital. You can reach the Department of Health by calling 800-254-5164 or writing: Pennsylvania Department of Health Room 526 Health and Welfare Bldg. 625 Forster St. Harrisburg, PA 17120 Livanta BFCC - QIO Program 9090 Junction Dr., Suite 10 Annapolis Junction, MD 20701 Phone: 866-815-5440 • TTY: 866-868-2289 Fax (Appeals): 855-236-2423 Fax (All Other Reviews): 844-420-6671 Acute and Ambulatory Care Services Pennsylvania Department of Health Room 532 Health and Welfare Bldg. 625 Forster St. Harrisburg, PA 17120 800-254-5164 Office of Quality and Patient Safety The Joint Commission One Renaissance Blvd. Oakbrook Terrace, IL 60181 You also may contact The Joint Commission by calling 800-994-6610. You also can email The Joint Commission at patientsafetyreport@jointcommission.org.
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
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 nursing supervisor or resource manager.
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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.
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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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
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 an MSP (Medicare secondary payer) 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 MSNs (Medicare summary notices) 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. Need Help? Self-Pay Patients and If you don’t understand Payment Arrangements something on your bill, If you’re planning to pay your bills you’re having trouble paying your bills, or you want to without help from Medicare or a know if you are eligible commercial insurance provider, for government-support then you’ll get bills directly from insurance programs, we the hospital. When the first bill arrives, can help. Just tell your call the hospital’s financial services nurse that you would like department to set up a payment plan. to speak to an application Communicate with the financial services coordinator. department as soon as possible. If you don’t set up a payment plan, or if you stop making payments, then 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 partners and spouses are 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 The Endoscopy Suite and Pain Management Center
The Endoscopy Unit provides 24-hour service for all GI and Pulmonary Endoscopy procedures. Procedures in the Pain Unit include epidural steroid injection, facet block, medical branch block, radiofrequency and more.
Laboratory Services
Most patients have laboratory tests as a routine part of their stay. Ordered by your physician, the information obtained from tests is important in helping you receive the best possible care. The laboratory staff performs routine tests seven days a week, 24 hours a day.
Regional Center for Cancer Care: 877-517-5008
The highly skilled and compassionate specialists affiliated with our Regional Center for Cancer Care (RCCC) provide all
the resources cancer patients and families need to face and fight the disease with confidence. As an affiliate of the Penn State Hershey Cancer Institute, our cancer patients benefit from access to the latest medical advances in cancer prevention and treatment, clinical research study programs, and the medical and surgical specialists and subspecialists of Penn State Hershey. RCCC partners with the American Cancer Society to offer educational and support services to help our patients and their families thoroughly understand cancer, and manage their lives through treatment and recovery.
Cardiac Care Services Network LRMC provides the highest quality of cardiac care from state-ofthe-art diagnostics and cuttingedge procedures to complete rehabilitation.
Diagnostic Imaging Services We are dedicated to providing consistent, quality and comprehensive imaging in a caring, compassionate environment that exceeds the needs of our patients, physicians and our community. Our board-certified physicians provide a wide spectrum of accredited diagnostic radiology services. We offer six convenient locations for imaging services, each offering different imaging services such as interventional radiology, DEXA scans, fluoroscopy, nuclear medicine and more.
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Hospital Resources continued We can provide cardiac education and early stage treatment and support to prevent, detect and address issues related to heart disease. You can depend on our world-class, compassionate physicians and associates to walk with you and your family through the latest technological advancements to explain procedures, answer questions and calm concerns. We’ll also help ensure that you have all the educational and support programs and services you and your loved ones need to understand your heart condition and manage your lives through treatment and recovery.
Inpatient & Outpatient Rehabilitation Services
Our Rehabilitation Services provide comprehensive inpatient and outpatient services including speech and language therapy, occupational therapy, hand therapy and physical therapy. You will receive an individual evaluation and goal-directed program. For inpatient services, call 717-291-8383, and for outpatient services, call 717-291-8573.
Adult Behavioral Health Services
Our 29-bed adult unit provides a safe environment to deliver short-term mental health stabilization for individuals with acute psychiatric disorders and cognitive impairment. We also have a 10-bed unit for older adults.
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For both units, we perform comprehensive assessments, psychiatric evaluations and medication stabilization. Our patients’ average length of stay is about one week, and our goal is to help alleviate the suffering of individuals afflicted with acute mental illness.
Diabetes Education
Living with diabetes can often seem like a daunting task filled with many questions. Our licensed registered dietitians can provide expert nutrition counseling to help you create a personalized meal plan and meets with you as needed to help you maintain your diet and lifestyle changes.
The Asthma Center of Lancaster The Asthma Center of Lancaster is a unique multidisciplinary program combining the treatment and education of the asthmatic patient. A Certified Asthma Educator will work with your physician to create an individualized program of education and exercise for you, whether you’re recently diagnosed or had asthma for years. Don’t let your asthma run your life—contact the Asthma Center of Lancaster at 717-291-8377.
Sleep Laboratory Services
We offer in-lab and at-home sleep studies to evaluate and diagnose sleep disorders such as sleep apnea, snoring, narcolepsy, insomnia, sleepwalking, sleep terrors and movement disorders.
Community Health and Education
We are committed to helping you recover when you are ill, as well as helping you stay healthy by preventing illness. Check our website for the various classes and seminars we offer.
Caregiver Resources American Cancer Society, Lancaster County Chapter 800-227-2345 Help with cancer support services such as support and survivor groups, transportation to treatment appointments, lodging, mastectomy supplies, wigs, children’s camps, etc. American Heart Association, Lancaster County Chapter 717-393-0725 Help with support options, educational resources, healthy living guides, etc. www.aoa.gov Caregiver resources from the Administration on Aging
Hospice of Lancaster 717-295-3900 Help with home hospice care, inpatient hospice care and bereavement services, as well as comfort and support resources 800-MEDICARE www.medicare.gov Official U.S. government site for people with Medicare National Family Caregivers Association 800-896-3650 www.nfcacares.org Support for caregivers of chronically ill, aged or disabled loved ones.
www.caregiving.com Online support groups and articles on caregiving Eldercare Locator 800-677-1116 www.eldercare.gov Help with locating aging services throughout the U.S.
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Staff Definitions Physicians
Your doctor is responsible for managing the course of your treatment. Your doctor will make the necessary arrangements for all medical procedures, medications, dietary needs, special treatments or services.
Nurses
Our staff of registered nurses, licensed practical nurses and clinical associates strives to provide you with the highest quality of nursing care. Your doctor works with your nurses to advise them of the care you require. Our Department of Nursing Mission Statement: LRMC is dedicated to providing exceptional and caring treatment for every patient’s body, mind and spirit in a safe, professional, comforting environment.
Pharmacists Ext. 8266
While you are in the hospital, all of your medications are dispensed by our hospital pharmacists. They can answer any questions you have regarding your medications.
Registered Dietitians Ext. 8399 A registered dietitian will review your medical record and work with your healthcare team to develop a nutrition care plan for you. Registered dietitians also are available to educate you about any diets you may need to follow after you are discharged.
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Technicians and Technologists
Skilled health professionals perform and assist with laboratory and other procedures, including X-rays, mammograms, ultrasound, CT scans, MRIs, cardiac catheterization, radiation therapy and other procedures that help in diagnosing and treating your illness or injury.
Case Managers and Social Workers Ext. 8251
Resource managers will review your medical record and discuss your discharge planning. They also are available to assist you with arrangement for home care, admission to a long-term care facility or rehabilitation care. Social workers offer emotional support, counseling and guidance to help patients and their families deal with financial, social and emotional problems related to illness or hospitalization.
Patient Advocate Ext. 8054
Our patient advocate is available to meet with any patient admitted to LRMC. They talk with you and your family members about your hospital stay. Their role is to ensure LRMC’s standards for superior customer service are met at all times.
Spiritual Services Ext. 8414
No matter your faith, the Lancaster Regional Spiritual Care Department can provide spiritual support and guidance during your time of need. Ask a nurse to arrange
a chaplain’s visit or dial ext. 8414 to leave a message. Each room contains a Bible. If you want other spiritual material, dial ext. 8414 and leave a message. The meditation chapel, located on the ground floor, is available for reflection and prayer. Mass is celebrated in the main chapel on the ground floor on Tuesday, Wednesday and Thursday at 12:05 p.m. and on Sunday at 9:00 a.m. Mass also is televised on Channel 17.
Volunteers Our dedicated volunteers help in 50 different areas of the hospital. They support our high standards of patient care, bring comfort and cheer to patients and families, perform tasks that help professional staff members and enable the hospital to provide additional services. Hunter green uniforms, navy aprons and white jackets identify our volunteers. Services performed by our volunteer staff include: • t ransport patients to in-house appointments • mail delivery to patients and hospital departments and run errands throughout the hospital • serve as hosts or hostesses in waiting rooms • provide spiritual care • active teen volunteer program and mentoring programs for teens who are considering healthcare careers • wheelchair transportation
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Staff Definitions continued Other Associates
During your stay, you may meet staff members from many of our different services. Here are some of the abbreviations you might see on employee badges: • CA clinical associate • CCRN certified critical care nurse • CDE certified diabetes educator • CEN certified emergency nurse • CRNA certified registered nurse anesthetist • CRNP certified registered nurse practitioner • CRTT certified respiratory therapy technician • LPN licensed practical nurse • MT medical technologist • MLT medical laboratory technologist
• NMT nuclear medicine technologist • PT physical therapist • RD registered dietitian • RT radiology technologist • RCP respiratory care practitioner • RRT registered respiratory therapist • RCVT registered cardiovascular technician • RN registered nurse • RNC medical surgical certified nurse • SLP speech and language pathologist • OCN oncology certified nurse • OTR occupational therapist Please ask if you have any questions about an employee’s title or role in your care.
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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. Class DRUGDrug CLASS
Prescription Medication RX MEDICATION
COMMENTS Comments
Analgesics (pain relievers)
Percocet (acetaminophen/ oxycodone) Tylenol #3 (acetaminophen/ codeine) Norco, Vicodin (acetaminophen/ hydrocodone)
Avoid drinking alcohol. Take with food COMMENTS 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.
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 Levaquin (levofloxacin)
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.
Coumadin, Jantoven (warfarin)
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.
Anti-coagulants (blood thinners)
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Foods & Medication Safety continued DRUG CLASS
RX MEDICATION
COMMENTS
Antidepressants
Paxil (paroxetine) Prozac (fluoxetine) Zoloft (sertraline) Lexapro (escitalopram) Celexa (citalopram)
Avoid drinking alcohol; avoid use of nicotine or tobacco products.
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 (carbamazepine)
Avoid eating grapefruit and drinking grapefruit juice.
Depakote (divalproex) Lamictal (lamotrigine) Lyrica (pregabalin) Topamax (topiramate) Zarontin (ethosuximide)
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 (metformin) DiaBeta (glyburide) Glucotrol (glipizide) Amaryl (glimepiride)
Avoid drinking alcohol. If diabetes is well controlled, limit alcohol to 1–2 drinks per day consumed with a meal.
Anti-seizure
Gastrointestinal Drugs Reglan (metoclopramide)
Gout Medications*
Avoid drinking or limit alcohol. Take 30 minutes before meals.
Nexium (esomeprazole) Prilosec (omeprazole) Protonix (pantoprazole)
Take at least 1 hour before meals.
Tagamet (cimetidine) Zantac (rantidine)
Avoid drinking alcohol, caffeine and nicotine.
Colcrys (colchicine)
Avoid eating grapefruit and drinking grapefruit juice.
Zyloprim (allopurinol)
Take after meals.
*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.
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DRUG CLASS
RX MEDICATION
COMMENTS
High Blood Pressure
ACE Inhibitors Monopril (fosinopril) Prinvil, Zestril (lisinopril) Vasotec (enalapril)
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).
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 (metoprolol tartrate)
Take with or immediately after meals. Do not take calcium products within 2 hours of taking medicine.
Diuretics Aldactone (spironolactone) Dyrenium (triamterene) Midamor (amiloride)
Avoid potassium-based salt substitutes and eating large amounts of foods high in potassium (bananas, cantaloupe, kidney beans, potatoes with skin, tomato juice, spinach).
Immunosuppressant Drugs
Neoral, Sandimmune (cyclosporine) Prograf (tacrolimus) Rapamune (sirolimus)
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 (isocarboxazid) Nardil (phenelzine) Parnate (tranylcypromine)
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).
Osteoporosis
Bisphosphonates Fosamax (alendronate) Boniva (ibandronate) Atelvia, Actonel (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 (levothyroxine)
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.
Continued on next page.
Limit caffeine when taking Calan.
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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 Lancaster Regional Medical Center to help you become a healthier, more informed patient.
GET AN ACCOUNT TODAY.
Ask us! And learn more at www. LancasterMedical Centers.com. For help using the Portal, call our toll-free Help Line at 877-456-9617, 24 hours a day, seven days a week.
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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. For extra security, each time you log in, you will enter your username (email address) and password, and answer your security question.
Service
AT YOUR
Wiley’s Offers: • Health and Beauty Aids • Vaccines, Consultations, and Free Blood Pressure Screenings • Gifts, Greeting Cards, and Gift Cards • Free delivery ($20 Minimum) • 24-Hour EMERGENCY Prescription Service Prescription Services: • Wiley’s accepts most insurance plans – Private insurance and Medicare Part D/Medicaid. • MEDISET – Drug dispensing program for patients taking multiple medications. • OnePAC – 7-day supply of medication packaged into individual perforated pouches for each day’s medication.
MILLERSVILLE (717) 871-1100 QUARRYVILLE (717) 786-1191 LANCASTER (717) 898-8804
Wiley’s Pharmacy Health. Wellness. Happiness.
STRASBURG (717) 687-6058
www.wileyspharmacy.com STORE HOURS (All Stores) Monday-Friday: 9:00 am to 7:00 pm • Saturday: 9:00 am to 2:00 pm
Thank You, Lancaster County
for voting us your favorite GI practice
8 years in a row!
Four Convenient Locations
Lancaster Health Campus • Oregon Pike-Brownstown Women’s Digestive Health Center • Elizabethtown www.RGAL.com • 717.544.3400