Leaving the hospital for the first time or with a new condition can be a scary proposition. In fact a decent percentage of readmissions are caused by inadequate preparation for discharge. http://blog.aarp.org/2013/02/14/leaving-hospital-heed-care-tips-or-you-may-be-back/
THE INFORMATION FLOOD
The information flood presented to patients near discharge only compounds this problem. Technology allows healthcare providers to print off discharge instructions on a wide variety of topics and send them home with patients. The simplest sets are twenty to thirty pages long and if you have several chronic conditions they can easily get well above a hundred pages of technical verbiage – most of it at your best may not be understandable.
I went through this with my mom. When my mother had open heart surgery to replace her aortic valve I had not yet been through nursing school. The scariest day was when she was having surgery.
Without a doubt, the second scariest was the day my mom was discharged and we went home. Of course, after only a few minutes of being at home, I realized I had no idea what to expect the first night. I was sent home with a pillow (for her to hold when she coughs), about a hundred pages of discharge instructions, and an oxygen tank (with who knows how much oxygen).
The only thing I distinctly remember being taught in the hospital was how to help her stand up without using her arms. If she puts weight on her arms it can cause the healing sternum to split apart, a complication that can also occur if she coughs without holding the pillow.
After about thirty minutes I was able to find her new medication list in the 100+ pages of discharge instructions and make sure she got all of her pills. After six hours of worrying, a home health nurse, a physical therapist, and a home oxygen delivery technician all came by. My primary concerns were all taken care of.
What bothered me was that while I generally knew that people were going to come by I had no idea who they were, or when, or what would be important until they showed up. It took another three days of me going out and getting things before I finally felt like I had all of the care items that I needed. The sad part is that all of the information I needed was in the instructions, I simply did not have the attention span to sort through all of them while I was also taking care of my mother.
In addition to the stress of the situation, mistakes in home care can often force people to go back to the hospital. These problems delay healing and lead to complications that range from inconvenience to life threatening.
TIPS AND TOOLS TO REDUCE READMISSION RISKS
To help reduce the risk of readmission and complications, do the following:
- Start asking questions early: Nurses are taught to start thinking about discharge when the patient is admitted and patients should as well. The earlier you start asking questions the more people you will be able to ask and the more information you will have.
- Always ask two key questions: The two key questions to ask whenever you are doing exercises or having a procedure are 1. Will I be doing this at home? and 2. Can you explain what you are doing and why? You can learn a lot from these questions and if you are going to need to do it at home you should start learning about it early.
- Don’t wait: If you think something will be a problem when you get home, ask your providers as soon as you think of it. Do not assume you can just deal with it later or muscle through, the best time to problem solve is before you leave the hospital. Do you think you might not be able to afford something? Do you have stairs? The central point is that frequently alternatives exist and your providers can help you find them only if they know you are concerned.
- Take notes on the discharge instructions sheet. Frequently providers will verbally reinforce the most important points. You should have the things they thought were important enough to actually mention written down at the top instead of buried.
- Program phone numbers: Program important numbers into your phone before you leave. Somewhere in your instructions should be a list of who you should call for specific things. Usually this includes your doctor, pharmacy, home health nurse, or other people who will provide services. When going through the instructions ask the provider what number you should call if there is a problem. Also several insurance companies provide toll free health support; if yours does you should have the number in your phone.
- Know your medications: Generally you need to at least know three things: 1. When to take them? 2. How long you will need to take them? and 3. When you should call your doctor? You should be given some sort of list before you leave the hospital, go over the medications with your provider, especially any new ones. Write down any side effects mentioned by the provider and what you should do about them.
Your Health Shield: Reach out for help and information before you are sent home from a a hospital. Your recovery and life may depend on it.
Bio:
Thomas Lilley graduated Magna Cum Laude from the UNLV School of Nursing Bachelors of Science program. He also achieved Magna Cum Laude recognition during his J.D. work at Drexel University and his biology degree from UNLV. His unique experience includes clerical experience sorting thousands of reports on various patients, clinical experience as a student nurse, observation of mock trials of medical malpractice and other cases, and lay experience providing care for his parents and grandparents. His ability to examine problems from both provider and patient perspectives and recognize systemic breakdowns is informed by these experiences and provides the basis for https://insights.cermacademy.com/category/yourhealthrisk-thomas-lilley/.
Disclaimer:
Opinions and views shared in Your Health @ Risk are solely those of the author. These articles are intended for informational purposes only and should not be construed as individual health advice. You should see your primary care provider for specific information pertaining to your healthcare.