Patient Safety and Quality

Health care providers encounter many germs. This is why they should clean their hands with soap and water or use a special cleansing gel before treating you - even if they use gloves. Their hands should be cleaned before putting on new gloves, and gloves should be discarded after a single use. They should also wear clean gloves when they perform tasks like taking blood, touching wounds or body fluids, and examining you. Don't be afraid to ask your caregivers, your visitors and family members if they cleaned their hands or if they should wear gloves before touching you. You help everyone by speaking up. Also, don't forget to wash your own hands!

Another way to help prevent the spread of infections is through respiratory hygiene. Tell your caregivers immediately if you have flu symptoms, such as a cough or sneeze. Please cover your mouth and nose with a tissue when you cough or sneeze, and put used tissues in a waste basket. If you don't have a tissue, cough or sneeze into your upper sleeve or elbow, not your hands. You may also be asked to wear a mask if you are coughing or sneezing. Always remember to clean your hands after coughing, sneezing, and using tissues.

Here's what you can expect staff to do prior to any surgery or procedure to help prevent errors:

• Each doctor or nurse will ask you the same questions about your identity, procedure, and the site of the procedure. Don't be alarmed by these questions - this is how they make sure they have everything right.
• Your doctor may also mark the spot on your body to be operated on before you go into the procedure room.
• You may be given an antibiotic medication to help prevent a surgical infection.
• Just before the procedure begins, everyone in the room will conduct a "time out" and check for the last time that they are doing the right procedure on the right body part and on the right person.

The staff is taking these important steps to make sure that everything goes as planned for your surgery or procedure.

If something doesn't seem right, or you feel that your condition is worsening, alert your nurse, who will assess your situation. In cases where a patient is experiencing a fast decline in their condition, the nurse may call the Rapid Response Team.

The Rapid Response Team is a group of nurses, doctors, and respiratory therapists trained to help in such situations. They are here to provide help before there is a medical emergency, such as a heart attack. If a noticeable medical change in the patient occurs and you feel the health care team is not recognizing or addressing the concern, you or your family member can call the Rapid Response Team from the hospital telephone.

Recovering from an illness or injury can be challenging, and you and your family may be concerned about how you are going to manage your care after you are home. Your physician, nurses, Case Management team, and the hospital discharge team will give you written discharge instructions and review them with you so that you understand how to care for yourself after you leave the hospital. It's important to follow these instructions for the best possible recovery. Staying healthy and safe once you get home is up to you. The more you know, the more in control of your health you will be.

The hospitals of Hackensack Meridian Health offer services for patients to assist with recovery after their return home.

Blood thinners are used to thin the blood so clots will not form. Harmful blood clots can cause a stroke, heart attack, or other serious problems. If you have an irregular heart rate, blood thinner therapy can decrease your risk for stroke 60 - 80 percent. Aspirin cannot lower your risk to that degree.

What are the common medications used to thin blood?

• Warfarin (Coumadin)
• Heparin; Enoxaparin (Lovenox)
• Fondaparinux (Arixtra)

What will your health care team monitor?

We will monitor signs or symptoms of bleeding and blood work. A blood test called a "protime" is done to determine if your therapy is correct and is reported as an "INR" value. Changes in your dose are determined by your INR value.

Possible side effects and other things to tell your health care team about includes wheezing, chest tightness, fever, itching, bad cough, blue skin color, fits, or swelling of face, lips, tongue, or throat; severe dizziness or passing out; severe headache, back or belly pain; black, tarry, or bloody stools; blood in the urine; nosebleeds; coughing up blood or vomiting blood; significant change in thinking clearly and logically; and change in skin color to black or purple.

What are the common medications used to treat/control high blood sugar?

Insulins such as:

• Novolin/Novolog/Lantus/Levemir
• Regular/Aspart/Glargine/Detimer
• Oral Medications such Masetaformin/Diabeta/Glucotrol/Januvia/Avandia/Prandin, Metfromin/Glyburide/Glipizide/Sitagliptin/Rosiglitazone/Repaglinide

What will your health care team monitor?

We will monitor glucose levels in your blood or through a finger-stick test, as well as other blood work like liver function.

Possible side effects and other things to tell your health care team about: wheezing, chest tightness, fever, itching, bad cough, blue skin color, fits, or swelling of face, lips, tongue, or throat; Low blood sugar. The signs include anger, shaking, fast heartbeat, confusion, or sweating.; Nausea or vomiting; Irritation where the shot is given; Any rash.

What are the common medications used at Hackensack Meridian Health?

• IV Drugs including:
• Morphine/Hydromorphone/Meperidine Fentanyl
• Oral Medications including Morphine/Oxycodone/Propoxyphene/Tramadol and Percocet/Oxycodone/Darvocet/Ultram.

What will your health care team monitor?

We will monitor your pain as measured on a scale, and other blood work like liver function. Possible side effects and other things to tell your health care team about include wheezing, chest tightness, fever, itching, bad cough, blue skin color, fits, difficulty breathing, or swelling of face, lips, tongue, or throat; feeling lightheaded, sleepy, having blurred vision, or a change in thinking clearly; feeling dizzy (rise slowly over several minutes from sitting or lying position); severe dizziness or passing out; nausea or vomiting; severe nausea or vomiting; constipation; poor pain control; any rash.

Antibiotics are used to fight infection and to prevent possible infections (before surgery)

What are the common medications used at Hackensack Meridian Health?

• Ampicillin/Sulbactam (Unasyn)
• Azithromycin (Zithromax)
• Cefazolin; Ceftriaxone
• Ciprofloxacin (Lipro)
• Gentamycin
• Moxifloxacin (Avelox)
• Metronidazole (Flagyl)
• Trimethoprim/Sulfamethoxazole (Bactrim)
• Vancomycin

What will your health care team monitor?

We will monitor your drug levels for some medications and other blood work like renal or liver function. Possible side effects and other things to tell your health care team about: wheezing, chest tightness, fever, itching, bad cough, blue skin color, fits, difficulty breathing, or swelling of face, lips, tongue, or throat; severe dizziness or passing out; nausea or vomiting; diarrhea or constipation; stomach upset; and any rash.

Blood clots (deep vein thrombosis or DVT) most often occur in people who can't move around well or who have had recent surgery or an injury. They can form in any deep veins of the body, but most often they form in the legs, arms, or groin. These clots can break loose and move to other parts of your body, including your lungs. A blood clot in your lungs is called a pulmonary embolism and can be life threatening.

During your stay, you will be assessed to find out if you are at risk for blood clots. If you are found to be at risk, your health care team may ask you to get out of bed and walk. They may also have special sleeves or boots applied to your lower legs to help blood flow better in your veins. Except for bathing, these boots should be kept on at all times until you can walk on a routine basis. Your doctor may also give you a blood thinner, or anticoagulant, to treat the clots.

Your Role in Preventing Blood Clots

• Let your health care team know if you have had blood clots in the past
• Get up and walk when you are able to do so and directed by your doctor
• Keep your special boots on until you are back to walking
• Keep as active as possible when you get home