Hospital Care Checklists

The key to preventing blood stream infections — which can lead to deadly sepsis — is a 100% germ-free central line (also called an IV)  installation and 100% germ-free maintenance.

The central line is a good “tool of the trade” to use when patients need several liquid medications and/or fluid.

A hub, placed under the patient’s skin near a large vein, allows fluids to get into the patient’s blood stream for fast, efficient delivery. Unfortunately, this super-highway for good meds can also be used by very bad germs.

Help make sure that tools of the trade include super attention to super clean practices.

HOW to Help Prevent Sepsis:

Watch to make sure nurses and doctors follow these safety steps:

• • Wash their hands thoroughly before touching your loved one and wear a mask
  • Choose the safest spot – if groin is chosen, ask, “Why?”
  • Use a clean sheet to drape your loved one’s body
  • Clean the skin with an alcohol wipe
  • Cover the area with a sterile pad
  • Use sterile instruments and supplies
  • Make sure any openings in the skin are kept covered at all times.

NOBODY WANTS TO BE THIS GUY!

“Guy” went into the hospital for a simple torn rotator cuff repair — too much tennis! Being such an active person, he decided to ignore the nurses’ instructions to ask for help when he needed to get out of bed. Woozy from the anesthesia, and unfamiliar with the room, Guy tripped on his IV pole trying to get to the bathroom on his own.

Falls are a risk for all patients, from the young and athletic to the older and infirm. 

As your loved one’s Care Partner, don’t fall down on the job! Use our quick checklist to help your loved one go home fracture-free.

• Tell the nurses if you are concerned about your loved one taking a fall, or falling out of bed.
• ​Ask for a bed alarm and a room close to the nurses’ station.
• Look for things in your loved one’s room that might cause a trip and fall.
• Point out all furniture and equipment on wheels. Discuss ways to move around the room without leaning on wheeled items for support.
• Ask the nurses for non-skid socks for your loved one to wear when out of bed.
• Ask about getting a cane or walker, and using bed rails.

Medication mix-ups are more common than you might think — despite all the checks and balances in hospital systems.

The Institute of Medicine estimates preventable medication errors cause upwards of 9,000^[4] deaths every year in hospitals. Not all medication mix-ups are fatal, but they can cause harm.

How do they happen?

• • Sound alike names (e.g. Celebrex and Cerebyx)
  • Unknown patient allergies
  • Taking medications at the wrong time
  • Taking medications (or eating foods) that “don’t get along”

Imagine you are supposed to receive 1.0 milligrams of a drug and a clerical or math error causes the pharmacist to deliver 10 milligrams instead. Details matter — but they are easy to check. It just takes a bit of extra time and focus.

Follow this simple checklist to prevent medication mix-ups from harming your loved one in the hospital and at home.

HOW to Help Prevent Medication Mistakes

• Make sure your loved one’s allergies and any bad experiences with medicines in the past are included on the medical record—and highlighted in a bold way.
• Before a nurse ever gives a medicine, ask:

1. 1. What is the medicine you’re planning to give? (If an IV bag is used, read the label to double-check it’s the right medicine.)
   2. What is it for?
   3. What is the dose?
   4. Who prescribed it?
   5. Say: “Let’s confirm that it’s for (your loved one’s name).”

• Don’t talk to nurses when they give medicines—or distract them.
• However, speak up immediately if you sense a mistake is being made. (For example, wrong patient, wrong medicine, wrong time, wrong dose, wrong way.)
• If you have any concerns, bring them up immediately with the attending doctor.
• Record every time your loved one gets a medicine.
• For medicines in an IV bag, ask: “What time do you think this bag will run out?” If the bag empties completely, get a nurse, especially if you see blood creeping up the IV tube.

• Diarrhea
• Stomach cramps
• Coughing
• Wheezing
• Difficulty breathing
• Difficulty swallowing

• Swelling face
• Swelling/itchy eyes
• Rash or hives
• Confusion, anxiety, restlessness
• Light-headedness, dizziness

Urinary Tract Infections (UTIs) are the most common hospital-acquired bacterial infection among patients.

According to the latest research, many hospitals still do not monitor catheter duration despite the fact that every day a patient is fitted with a urinary catheter, the likelihood of acquiring an infection significantly increases.

Studies also reveal that 25% of patients receive a urinary catheter at some point during their hospital stay and up to 50% of these are placed unnecessarily.^[5]

Help make sure your loved one doesn’t suffer a urinary tract infection in the hospital — share and follow this simple checklist!

Get a nurse if you see or your loved one tells you about:

• • Chills, shivering
  • Confusion
  • Pain or a burning feeling in the lower stomach area
  • Headache
  • Lower back pain
  • Body aches
  • Blood in urine bag
    

A staggering 60,000^[6] patients die from complications from bed sores each and every year — yet 95% of them are preventable.

These are caused by constant pressure or friction on skin, especially in bony areas that normally have limited circulation — or in folds of fat where moisture can accumulate. The open wounds can erupt from bed rest or sitting in one place and can be a “highway” for bacteria and infection. Actor Christopher Reeves, who was wheelchair-bound after a riding accident, was an unfortate victim who died from an infected pressure wound.

You can make a difference! Thousands of lives could be saved every year just by following these simple prevention steps.

Bed sores are much easier to prevent than to heal.

HOW to Help Prevent Painful Bed Sores/Wounds:

• Help make sure your loved one changes positions every two hours—even more often if your loved one can manage it. (It helps to set a timer.)
• Ask for an alternating air pressure mattress and some type of pad to absorb moisture.
• Make sure your loved one has foam cushions between ankles and knees, for elbows, and back of head.
• If the hospital gown or sheets become wet, get help to change them as soon as possible. If you are able-bodied, help change the sheets.
• Help make sure that nothing rubs or scratches your loved one’s skin—ask nurses about barrier cream for fragile skin areas.
• When your loved one gets out of bed, either alone or with help, make sure it’s done very gently to avoid scraping any skin.
• Ask the attending doctor about “upping” the protein in your loved one’s diet. Ask if it’s OK for you to bring high-protein snacks, drinks or food.
• It’s OK to ask for the hospital wound care specialist if you have any concerns.

WHAT TO LOOK FOR:

• Any skin breaks or scrapes 
• Abnormally white patches of skin (especially on bony areas)
• Pinkness, redness, or swelling of the skin that doesn’t go away in minutes
• Areas of skin that are extra-warm

• Chills, shivering
• Confusion
• Extreme pain
• Fast heartbeat

• Headache
• Diarrhea
• Nausea
• Fast breathing