Need Surgery? Do Your Hospital Homework!

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Actor Dennis Quaid has played a variety of roles of film. His new, real-life role as crusader for patient safety stems from the day his twin babies nearly died from a medication overdose due to hospital error.

"[The day] was spent caring for our infants who were still bleeding profusely, and severely bruised from internal bleeding," he recalled. "They were both screaming in pain and God only knows what they were feeling"

Click the player to watch the report from CBN News Medical Reporter Lorie Johnson followed by comments from Pat Robertson.

The children had accidentally been given the adult dosage for the medicine they were taking.  The youngsters are fine now, but it was enough to frighten Quaid and his wife into action.  They created a foundation that raises awareness about hospital errors and pushes greater safety changes in hospitals.

Speaking to a conference of medical professionals in Chicago, Quaid advocated the practice of hospitals putting a barcode on all medications and switching from handwritten charts to computerized ones, among other safety measures.

Being a Knowledgeable Patient

Hospital errors such as infections, surgical slip-ups and medication mistakes claim the lives of thousands each year.

"Hospitals do fabulous things to improve patients health, but there [is] also a huge opportunity for mistakes," said Dr. Carolyn Clancy, director of the Agency for Healthcare Research and Quality. "So to that end, they should be worried, because the risk is real and it's serious."

The good news is there are lots of things patients themselves can do to drastically minimize the chance of becoming the victim of hospital error. The most important thing is knowledge.

Learn as much as you can about the reason you're being hospitalized and learn as much as possible about your treatment plan. Ask questions and if you don't understand the answer continue asking until you do.

Since two heads are better than one, also get yourself a support system. It's best to have a friend or family member by your side as much as possible, particularly at discharge when patients are given lots of instructions about what to do when they get home.

Be sure that you understand exactly how much of which medications you need to take, and when. Also, discuss other medications, vitamins and herbal remedies.

The Importance of Communication

Good communication is essential in the prevention of hospital errors.

"I need the patient to be invested also, which means tell me about the medicines you're taking, tell me about the medicines you're allergic to and know what operation you're planning to have," explained Dr. Leonard Weireter, Jr., of the Eastern Virginia Medical School Department.

If a patient has blood work, cultures or an X-ray, he or she should ask about the results.

To reduce the chance of medication error, patients should ask their nurse to double-check their medication with their wristband nametag. Many medication mix-ups occur between patients with similar names or when drugs that sound or look alike are accidentally switched.

Patients should be aware of what medications they're taking, the dose and the frequency.

Avoiding Infections

Many hospital-acquired infections are the result of bacteria on catheters, particularly urinary catheters. Patients can reduce their risk of getting an infection from a catheier if they ask their nurse to remove the catheter as soon as possible. In some cases, patients can negotiate with their doctor pre-operatively to avoid using a catheter altogether. Sometimes if a patient promises not to eat or drink several hours before a procedure the doctor will deem it unnecessary to use a urinary catheter.

Sometimes infections are the result of poor hygiene, so before anyone touches you, make sure you see them clean their hands--and it's okay to ask.

One Leading Example

Reducing hospital error isn't just the responsibility of the patient, many hospitals are stepping up to the plate. Leading the way is Virginia's Sentara Norfolk General Hospital.

Hospital administrators actually consulted safety experts from nuclear power plants and the aviation industry-- two high-risk fields that have good safety procedures in place.

Sentara improved patient safety so dramatically they received national recognition. Now Sentara has become the model for hundreds of other hospitals across the U.S.

"We began to create a culture around safety here," said Dr. Gene H. Burke, Vice President of Clinical Effectiveness at Sentara Healthcare. "We started educating our employees around some basic habits that if these activities are executed on a regular basis the chance of creating a medical error and the chance of that error reaching the patient and creating harm would be significantly reduced."

Those safety habits center around paying attention to detail, have a questioning attitude, clear communication, good handoffs and "the idea of being a wingman," Burke added.

Sentara's Safety Measures

"Each patient has a unique bar code and each medication has a unique barcode," Burke explained. "So when a physician orders a medication for that patient, the nurse makes sure by scanning the bar code on the patient... And by scanning the barcode on the medicine."

"The opportunity to get the wrong medication, the wrong dose, the wrong time, is significantly reduced by barcoding," he added.

Medication errors are further reduced because of a "safety zone" which you'll find in every nurse station.

"We painted a red zone around those (medication dispensing) machines and it's a safety zone. The rule is, when someone's in that zone getting their medications for their patients you do not interrupt them. So we create a visual reminder to leave that person alone so they don't make a mistake," Burke said.

Communication errors are also minimized thanks to "E-CARE" -- a computer program used throughout the Sentara Healthcare system that allows everyone caring for a patient to be on the same page.

Doctors, nurses, pharmacists, lab technicians and others enter their information about the patient into the computer as opposed to writing records out by hand.

Changing Hygiene Standards

Infections at Sentara are way down since new standards reducing catheter use have been enacted. Ventilators, which were another source of infection, have been updated to include greater safety measures. Ventilators are removed as soon as it's safely possible, and while ventilators are in, patients' heads are elevated so secretions don't drain into the ventilator.

At Sentara, healthcare workers are instructed to sing the "happy birthday" song to themselves while washing their hands to ensure the proper cleansing time.

"It's not the soap, but the friction that counts," Burke explained. He adds that sanitizing foam is spread above the wrists, nails are trimmed and artificial nails are prohibited. He said contests and rewards further encourage employees to practice proper hand hygiene.

A 'Pause' Before Surgery

Surgical procedures at Sentara have also been re-vamped. The increased focus on safety centers around communication.

First, the surgeon meets with the patient pre-operatively to make sure both the surgeon and the patient agree on what is about to take place.

Then inside the operating room, there is a similar discussion between the surgeon and the entire operating team. This "pause" before the surgery begins is to confirm all parties have all the information and the tools they need.

Another communication aid is the process of the surgeon marking the exact spot on the body where the surgery is to take place. The prevents the surgeon from accidentally operating on the wrong site.

"It is simple," Weireter said, "but it is the simple things, across any industry, that get you the big benefits."

Holding Hospitals Accountable

Unfortunately, there is no national "scorecard" that rates hospital patient safety scores.

The reporting of adverse events varies from state to state, and so far there is nothing nationally mandated. But there are some things you can do to get an idea of a hospital's level of patient safety.

The most basic indicator is what's known as the "mortality ratio." It's the actual death rate compared with the expected death rate within a hospital.

If the actual death rate is higher than the expected death rate, there are some problems at that hospital. However, if the actual death rate is lower than the expected death rate, that means the hospital has been putting extra effort into improving safety.

*Originally aired April 22, 2009

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Lorie  Johnson

Lorie Johnson

CBN News Medical Reporter

Lorie Johnson reports on the latest information about health and wellness. Since medicine is constantly changing, she makes sure CBN News viewers are up-to-date on what they need to know in order to live a healthy life.  Follow Lorie on Twitter @LorieCBN and "like" her at Facebook.com/LorieJohnsonCBN.