Logan Reid
Hospitals are committed to providing a safe and secure environment for patients, staff, and visitors. However, there are still risks associated with being in a hospital, including infections, medication errors, blood clots, falls, and violence. To ensure your safety, it is important to be involved in your care, ask questions, and take extra precautions to prevent infections and other complications. This includes advocating for yourself by confirming your identity and the treatment plan with nurses and healthcare providers, asking about medications and their side effects, and being vigilant about hand hygiene for yourself and those around you. Additionally, be mindful of your surroundings to prevent falls, and only bring essential items to reduce the risk of theft.
| Characteristics | Values |
|---|---|
| Preventing infections | Wash hands frequently, ask visitors to do the same, use hand sanitiser, and keep up to date with vaccines |
| Preventing medication errors | Speak up and take charge of your care, ask for a printout of medications and dosages, ensure staff check your ID bracelet, and ask about side effects |
| Preventing falls | Wear properly fitting clothing and footwear, use a walking aid if necessary, and call a nurse before getting out of bed for the first time |
| Preventing blood clots | Get out of bed as soon as possible, exercise lower leg muscles, and ask about compression stockages |
| Preventing pressure injuries | Change position in bed frequently, move around when possible, and wear slippers over pressure stockings |
| Preventing Covid | Use air purifiers, UV lights, mouthwashes, nasal sprays, and saline rinses |
| Preventing theft | Do not bring valuables to the hospital, only bring essential items, and clearly label belongings |
| Food safety | Do not bring outside food, as it may cause food contamination and food poisoning |
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What You'll Learn
Preventing infections
Hand Hygiene:
Handwashing with soap and water or using an alcohol-based hand sanitiser is critical. Cleanse your hands before entering and after leaving the hospital, and always clean them before and after caring for wounds or incisions. Insist that all healthcare workers and visitors do the same before touching you or any medical devices. Hand hygiene is a simple yet highly effective way to prevent the spread of various infections, including the common cold, influenza, and challenging-to-treat infections like Methicillin-resistant Staph Aureus (MRSA).
Respiratory Etiquette:
Cover your mouth and nose with a tissue or your upper arm when coughing or sneezing, then dispose of the tissue properly and cleanse your hands. This simple act helps prevent the spread of respiratory droplets, a common route of infection transmission in healthcare settings.
Catheter and Drain Care:
If you have a catheter or drain, understand the reason for its use and how to care for it properly. Ask your healthcare team about the necessary precautions to avoid infections. Keep the tubing secured to your leg, below the level of your bladder or hips, and ensure the urine drain bag stays off the floor. The longer a catheter remains in place, the higher the risk of infection, so ask daily if you still need it.
Surgery Precautions:
Before surgery, ask your surgeon about infection prevention measures and whether it is safe to proceed. Ensure your healthcare provider marks the area to be operated on to avoid confusion. After surgery, follow all instructions on wound care, medications, and activities to avoid. Understand how to care for your surgical site, and be vigilant for signs of infection, such as increased redness, pain, or drainage.
Patient Advocacy:
Be proactive in your care decisions and speak up about any concerns. Ask a family member or friend to be your advocate, especially if you are heavily medicated or sedated. Ensure that nurses confirm your identity and explain the medications they are administering. Understanding your treatment plan and staying informed can help prevent medical errors and keep you safe.
Additional Measures:
To prevent pneumonia, follow breathing instructions from your healthcare team and inquire about relevant vaccines. Take antibiotics as directed for bacterial infections, but remember that they are ineffective against viral infections. If you are visiting a hospital, do not go if you feel unwell, and always follow the directions and advice given by the healthcare team.
While in the hospital, it is important to be vigilant and proactive in preventing infections. Following these guidelines and staying informed can significantly reduce the risk of infection and contribute to a safer hospital stay.
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Preventing medication errors
While hospitals are generally safe, medication errors are a leading cause of injury and avoidable harm in healthcare systems worldwide. Here are some strategies to prevent medication errors and enhance patient safety:
Firstly, patients should be proactive and involved in their care. Before checking into a hospital, discuss with your surgeon about infection prevention and ask questions about your procedure, including whether it can be safely delayed or performed in an outpatient setting. During your hospital stay, ensure that your identity is confirmed via a wristband check before any medication is administered. It is also advisable to have a family member or friend assist in tracking your care, especially if you are heavily medicated or sedated. Ask the nurses to explain the medicines being given and why.
Secondly, hospitals should foster a culture of safety that prioritises patient wellbeing. Hospital administrators should emphasise the importance of reporting errors and near misses without fear of retribution, treating mistakes as opportunities for improvement. Strategies to minimise distractions, such as limiting alerts and alarms, creating quiet zones, and establishing checklists for complex tasks, can reduce interruptions during the medication administration process.
Additionally, utilising systems and technologies specifically designed to prevent medication errors is crucial. Electronic prescribing systems, for example, are being introduced across NHS hospitals to reduce medication errors and improve transparency. Hospitals should also conduct regular medication safety audits to proactively identify vulnerabilities and rectify issues before they lead to adverse events.
By combining patient engagement, a culture of safety, and the effective use of preventive systems and technologies, hospitals can significantly reduce medication errors and enhance patient safety.
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Preventing falls
Falls are the most frequently reported safety incident in hospitals, with more than 250,000 recorded annually in England and Wales. They are particularly prevalent among older adults due to age-related factors such as mobility impairments and cognitive issues. Advanced age (over 85 years), male sex, a recent fall, gait instability, agitation, confusion, new urinary incontinence, adverse drug reactions, and neurocardiovascular instability are all risk factors for falls in hospitalised patients.
To prevent falls, hospitals should implement a coordinated multidisciplinary clinical team approach that identifies underlying risk factors and intervenes to reduce these risks. Encouraging a culture of vigilant safety consciousness through continuous feedback and learning from adverse events is crucial. Doctors of all grades and disciplines play a vital role in preventing falls and their consequences.
While single interventions such as 'high-risk' wristbands, bed signage, medication reviews, urinalysis, and routine prescription of vitamin D have not been successful in reducing fall rates, a comprehensive approach that incorporates patient education, tailored interventions, and advanced technologies is essential for effective fall prevention. Video monitoring systems and sensor technologies provide continuous surveillance with minimal disruption, enhancing real-time monitoring and patient safety.
Additionally, emerging technologies like virtual reality training and robots show potential in improving balance and gait control, although further research is needed. Implementing these strategies can significantly enhance patient care, shorten hospital stays, and reduce associated costs, as well as foster better communication and collaboration among hospital staff.
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Preventing blood clots
Blood clots are a serious medical condition that can lead to long-term health issues and, in some cases, death. Hospital-associated blood clots are a well-known issue, with patients at increased risk of developing a blood clot during their hospital stay and up to 90 days after discharge. This is due to a variety of factors, including reduced mobility and recent surgery.
Deep Vein Thrombosis (DVT) is a type of blood clot that forms in the deep veins, most commonly in the legs, pelvis, arms, or groin. It may cause no symptoms, or it can lead to swelling, redness, or pain in the affected area. A more serious complication is Pulmonary Embolism (PE), which occurs when the blood clot breaks free and travels to the lungs, causing symptoms such as coughing, chest pain, and difficulty breathing.
To prevent hospital-associated blood clots, doctors may prescribe a small dose of an anticoagulant, commonly known as a blood thinner, to reduce the chances of blood clots forming. The most frequently used blood thinner is heparin, which is administered via injection. Patients should be aware that some blood thinners are derived from animal products, and alternative options are available if this is a concern. Additionally, blood-thinning tablets are increasingly being used after orthopedic surgery.
Patients may also be fitted with anti-embolism stockings to help prevent blood clots. These stockings are worn on the legs and must be worn correctly to be effective. Patients should report any new pain or discomfort in their legs or feet while wearing these stockings. Calf or foot pumps, which are special inflatable sleeves, may also be recommended to improve circulation and reduce the risk of blood clots.
It is important to be vigilant for any signs or symptoms of a blood clot, both during and after a hospital stay. These include swelling, redness, soreness, or pain in the arms or legs, as well as breathing difficulties, chest pain, or coughing, especially with blood-stained phlegm. If any of these symptoms develop, it is crucial to seek immediate medical advice.
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Preventing pressure injuries
Pressure injuries, or pressure ulcers, are a significant health issue faced by hospitals. They are skin lesions that can cause pain and lead to serious infection, prolonging hospital stays and interfering with a patient's recovery. Critical care patients are at high risk of developing pressure injuries due to the use of various devices, instability, and restricted movement.
To prevent pressure injuries, it is important to regularly change a patient's lying or sitting position. This is because pressure ulcers are often caused by remaining in the same position for extended periods, which puts constant pressure on certain areas of the body. Patients who are weak, ill, paralysed, or unconscious are particularly vulnerable as they are less likely to change their position. Therefore, they may benefit from pressure-relieving mattresses and support surfaces, such as special foam mattresses, gel-filled support surfaces, and air cushions. These products provide soft surfaces or alternating pressure to reduce the risk of pressure ulcers.
In addition to using pressure-relieving products, patients can be advised to use soft cushions when sitting, and to move as much as possible. This could include sitting up, leaving the bed, or walking with assistance. While there is no universal recommendation, some individuals benefit from repositioning every two hours.
Skin care is another important aspect of pressure injury prevention. This includes inspecting the skin for pressure points, temperature changes, and skin condition upon admission and daily thereafter. pH-balanced skin cleansers and moisturisers can be used to maintain skin health, and it is important to avoid excessive dryness or constant moisture, both of which can damage the skin.
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Frequently asked questions
Ask everyone who comes into your room, including doctors, nurses, staffers, and visitors, to wash their hands or use an antibacterial hand rub before touching you. Keep a bottle of hand sanitiser near your bed and wash your hands often.
Ask a nurse for a printout of all the medications ordered for you and their dosages. Ask doctors, nurses, or staffers to tell you exactly what they are giving you before administering any medication. Make sure that they check your ID bracelet and confirm your identity before giving you any medication.
Get out of bed as soon as you safely can. If you can't get out of bed, exercise your lower leg muscles by stretching your calves, pointing and flexing your toes, or drawing circles with your feet. Ask your doctor about wearing special compression stockings to help blood flow in your legs and feet.
Wear socks, slippers, or shoes that won't slip. Ask for help when getting out of bed for the first time. Be vigilant for trip hazards, such as electrical cords and equipment in the hallway. Use a walking aid if necessary.
Do not bring jewellery, large amounts of money, or other valuable personal items to the hospital. Bring only the essential items that you need for your stay. Label all your belongings with your full name and keep them in marked cases or bags.
