Going to the hospital can be frightening, even if you have scheduled surgery and looked forward to a new pain-free joint for months or years. That’s because the place we go for healing holds its own set of dangers – infections, medication mistakes and even mix-ups.
Tempted to call off your surgery? Don’t! Fortunately, planning and vigilance can help ensure your hospital safety, says Peter Pronovost, MD, PhD, director of adult critical-care medicine and a patient-safety researcher at the Johns Hopkins University School of Medicine in Baltimore and author of Safe Patients, Smart Hospitals: How One Doctor's Checklist Can Help Us Change Health Care from the Inside Out (Hudson Street Press, 2010).
Here are three things that can go wrong and what you can do to greatly improve your chance that they won’t.
1. Wrong site surgery. Imagine going into surgery to have your painful left knee replaced and waking up to a sutured incision over your right knee. Incidents like that are rare, but not unheard of. As of June 2007, 592 cases of wrong-site surgery had been reported to the Joint Commission on Accreditation of Healthcare Organizations, a nonprofit organization that evaluates and accredits hospitals nationwide. Orthopaedic surgeries were among the most common.
What you can do: Remind your doctor and other professionals who see you before surgery what procedure you’re having and where on your body. Before going into the operating room use a marker to mark your surgical site and have your surgeon initial the site in a location that can been seen when you are fully prepped and draped for surgery and ideally where the surgeon will have to operate through or at least adjacent to his or her initials. Also request that your medical records be available in the operating room. Your surgeon should be doing all of these things – and more – to comply with Joint Commission’s Universal Protocol to prevent such surgical errors. But accidents can happen. Best to play it safe.
2. Infection. As many as 1 in 20 patients contract some type of infection while in the hospital, according to the Centers for Disease Control and Prevention. Infections acquired in the hospital kill more people each year than breast cancer, says Dr. Pronovost.
What you can do: Before checking into the hospital, ask about their infection rates, especially for bloodstream infections in intensive care units, advises Dr. Provonost. Once in the hospital, observe whether doctors or nurses who have direct contact with you wash their hands before doing so. If you don’t see them wash their hands, ask. Ask if doctors and other health professionals if they use a checklist to ensure best practices. If you need catheter after surgery, ask each day if you still need it, he says. “Catheters help patients, but they also have their risks.”
3. Medication Errors. Medication errors are among the most common mistakes occurring in U.S. hospitals. Each year at least 1.5 million people are harmed by medication errors, according to a report from the Institute of Medicine of the National Academies. That translates to roughly one error per hospitalized patient per day. Medication errors may involve prescription or over-the-counter drugs, or OTC drugs, and include mistakes in prescribing, administering and monitoring the response to those medications.
What you can do: Before being admitted to the hospital for surgery, speak with your doctor about all of the medications – including OTC drugs and nutritional supplements – you take and find out if there are any you need to start – or stop – before your hospital stay. Make a list of all your medications and their dosages and take it to the hospital with you so your doctor can check for duplication or drug interactions. Before taking any medication in the hospital, ask the person administering it the name of the medication and the reason for giving it. If anything doesn’t seem right, speak up. If possible, have a friend or family member stay with you in the 24 hours or so after surgery, to ask questions and be your patient advocate when you may still be groggy from anesthesia.