HOSPITAL STAY AND INSURANCE PLAN 2
Category: Internal Medicine
Abstract : Hospital caregivers Sometimes, the patients personal or family physician is not the attending physician who is in charge of the patients overall care and treatment in the hospital. The attending physician may be a doctor on the hospital staff or a specialist. Fellows, residents, or interns may also provide care. Fellows are doctors who receive training in a special area of medicine after their
Hospital caregivers
Sometimes, the patients personal or family physician is not the attending physician who is in charge of the patients overall care and treatment in the hospital. The attending physician may be a doctor on the hospital staff or a specialist. Fellows, residents, or interns may also provide care.
Fellows are doctors who receive training in a special area of medicine after their residency training; residents are doctors who have recently graduated from medical school and are training in a medical specialty; and interns are first-year residents.
Nurses work closely with doctors to supervise the care provided in the hospital. Nurses take the patients vital signs, administer medications, provide treatments, and teach patients how to care for themselves. The head nurse, also called the clinical nurse manager, coordinates care for each patient on the nursing unit.
Other health care providers include medical technologists, radiographers, and nuclear medicine technicians who perform diagnostic tests; therapists such as physical therapists, occupational therapists, and speech therapists who provide specialized care as needed; and dietitians to provide nutrition counseling and nutrition assessments. There are several other health care providers who may assist patients during their hospital stay; patients should ask for more information about the types of providers they may be in contact with during their hospital stay.
Information for visitors and family members
It may be helpful for the patient to select a spokesperson from the family to communicate with the health care providers. This may improve communication with the health care providers as well as to other family members. The patient should also communicate his or her wishes regarding the spokespersons telephone communications to other family members.
Educational classes may be available for family members to learn more about the patients condition and what to expect during the patients recovery at home. If a family member needs to contact the patient or the patients other family members, the family member should call the hospital and ask for the nursing unit where the patient is staying. The nursing unit staff can connect the caller to the patients room, take a message, or connect the caller to the patients family members who are present. Since every hospital has patient confidentiality rules, some information may not be able to be disclosed over the telephone.
Most hospitals prohibit the use of cellular phones in patient care areas, as they interfere with the operation of medical equipment. Most hospitals are smoke-free environments. There are usually designated outside areas where visitors can smoke.
Most hospitals have designated visiting hours that should be adhered to by family members and friends. Most hospitals have on-site pharmacies where family members can fill the patients prescriptions; gift shops; and a cafeteria. Usually a list of on-site and offsite dining options can be obtained from the hospitals information desk or social work department.
Preadmission testing
Preadmission testing includes a review of the patients medical history, a complete physical examination, a variety of tests, patient education, and meetings with the health care team. The review of the patients medical history includes an evaluation of the patients previous and current medical conditions, surgeries and procedures, medications, and any other health conditions such as allergies that may impact the patients hospital stay. Preadmission testing is generally scheduled a few days before the hospital admission.
The patient may find it helpful to bring along a family member or friend to the preadmission testing appointments. This caregiver can help the patient remember important details to prepare for the hospital stay.
Preadmission instructions
Preadmission instructions include information about reserving blood products if necessary, taking or discontinuing medications, eating and drinking, smoking cessation, limiting activities, and preparing items to bring to the hospital.
Blood transfusions and blood donation
Blood transfusions may be necessary during surgery. A blood transfusion is the delivery of whole blood or blood components to replace blood lost through trauma, surgery, or disease. About one in three hospitalized patients will require a blood transfusion. The surgeon can provide an estimate of how much blood the patients procedure may require.
To decrease the risk of infection and immunologic complications, some hospitals offer a blood donation program if surgery is scheduled or if it is known that blood products will be needed by the patient during his or her hospital stay. Autologous blood (from the patient) is the safest blood available for transfusion, since there is no risk of disease transmission.
Methods of autologous donation or collection include:
• Intraoperative blood collection: The blood lost during surgery is processed, and the red blood cells are re-infused during or immediately after surgery.
• Preoperative donation: The patient donates blood once a week for about one to three weeks before surgery. The blood is separated and the blood components needed are re-infused during surgery.
• Immediate preoperative hemodilution: The patient donates blood immediately before surgery to decrease the loss of red blood cells during surgery. Immediately after donating, the patient receives fluids to compensate for the amount of blood removed. Since the blood is diluted, fewer red blood cells are lost from bleeding during surgery.
• Postoperative blood collection: Blood lost from the surgical site right after surgery is collected and re-infused after the surgical site has been closed.
The physician determines what type of blood collection process, if any, is appropriate.
Medication guidelines
Depending on the reason for the hospital stay, certain medications may be prescribed or restricted. The health care team will provide specific guidelines. If certain medications need to be restricted before the hospital stay, the patient will receive a complete list of the medications (including prescription, over-the-counter, and herbal medications) to avoid taking. The patient should not bring any medications to the hospital; all necessary medications, as ordered by the doctor, will be provided in the hospital.
Eating and drinking guidelines
Before most procedures, the patient is advised not to eat or drink anything after midnight the evening before the surgery. This includes no smoking and no gum chewing. The patient should not drink any alcoholic beverages for at least 24 hours before being hospitalized, unless instructed otherwise.
Smoking cessation
Patients are encouraged to quit smoking and stop using tobacco products prior to their hospital admission and to make a commitment to be a nonsmoker. Quitting smoking will help the patient recover more quickly. There are several smoking cessation programs available in the community. The patient should ask a health care provider for more information if he or she needs help quitting smoking.
Activity
The patient should eat healthy foods, rest, and exercise as normal before a hospitalization, unless given other instructions. The patient should try to get enough sleep to build up energy for the surgery. The patient should make arrangements ahead of time for someone to care for children and take care of any other necessary activities at home such as getting the mail or newspapers. The patient should inform family members about the scheduled hospital stay, so they can provide help and support.
Items to bring to the hospital
The patient should bring a list of current medications, allergies, and appropriate medical records upon admission to the hospital. The patient should also bring a prepared list of questions to ask.
The patient should not bring valuables such as jewelry, credit cards, checkbook, or other such items. A small amount of cash (no more than $20) may be packed to purchase items such as newspapers or magazines. If necessary, patients can secure their personal belongings in the hospital cashiers office, safe, or vault for safekeeping until discharge. Most hospitals state in their policies that they are not responsible for lost or stolen personal items. The patient should only pack what is needed. Some essential items include a toothbrush, toothpaste, comb or brush, deodorant, razor (not electric), slippers, robe, pajamas, and one change of comfortable clothes to wear when going home. The patient should also pack eyeglasses, hearing aids, and dentures, including their carrying cases, if applicable. These items should be labeled with the patients name when not in use, should be stored in their carrying cases, and put in the bedside stand so they are not lost.
The patient should bring a list of family members names and phone numbers to contact in an emergency. The patient may also want to pack a book or other personal item such as a family picture.
Personal electronic devices such as hair dryers, curling irons, electric razors, personal televisions, computers, and other electronic devices are not permitted in the hospital, since these devices may interfere with the hospitals medical equipment.
Transportation
The patient should arrange for transportation home, since the effects of certain medications given in the hospital make it unsafe to drive.
Hospital registration and admission
Upon arriving at the hospital, the patient first reports to the hospital registration or admitting area. The patient will be required to complete paperwork and show an insurance identification card, if insured. Often, a pre-registration process performed prior to the date of hospital admission helps make the registration process run smoothly. An identification bracelet that includes the patients name and doctors name will be placed on the patients wrist.
If the patient is not feeling well upon arrival to the hospital, a family member or caregiver can help the patient complete the admitting process. Sometimes, a patients illness may require that the hospital stay be rescheduled.
Informed consent
The health care provider will review the informed consent form and ask the patient to sign it. Informed consent is an educational process between health care providers and patients. Before any procedure is performed or any form of medical care is provided, the patient is asked to sign a consent form. Before signing the form, the patient should understand the nature and purpose of the procedure or treatment, the risks and benefits of the procedure, and alternatives, including the option of not proceeding with the procedure. Signing the informed consent form indicates that the patient permits the surgery or procedure to be performed. During the discussion about the procedure, the health care providers are available to answer the patients questions about the consent form or procedure.
Advance directives
As part of the admissions evaluation, the patient will be asked about advance directives. Advance directives are legal documents that increase a patients control over medical decisions. A patient may decide medical treatment in advance, in the event that he or she becomes physically or mentally unable to communicate his or her wishes. Advance directives either state what kind of treatment the patient wants to receive (living will), or authorize another person to make medical decisions for the patient when he or she is unable to do so (durable power of attorney).
Advance directives are not required and may be changed or canceled at any time. Any change should be written, signed, and dated in accordance with state law, and copies should be given to the physician and to others who received original copies. Advance directives can be revoked either in writing or by destroying the document. Advance directives are not do-not-resuscitate (DNR) orders. A DNR order indicates that a person - usually with a terminal illness or other serious medical condition - has decided not to have cardiopulmonary resuscitation (CPR) performed in the event that his or her heart or breathing stops.
Admission tests
Some routine tests will be performed, including blood pressure, temperature, pulse, and weight checks; blood tests; urinalysis; chest x ray; and electrocardiogram (ECG). A brief physical exam will be performed. The health care team will ask several questions to evaluate the patients condition. The patient should inform the health care team if he or she drinks alcohol on a daily basis so precautions can be taken to avoid complications.
Results
Patients who receive proper preparation for their hospital experience, including physical and psychological preparation, are less anxious and are more likely to make a quicker recovery at home, with fewer complications.
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