What to Look Out For to Avoid Hospital Mistakes

WRONG MEDICATIONS

In a hospital with 100 patients who take four different drugs four times a day, with 10 possible places in the system where things can go wrong, there are 480,000 opportunities each month for an error to occur somewhere in the medication chain. Doctors can prescribe the wrong drug. Pharmacists can misinterpret a doctor’s handwriting, supply the wrong drug, mislabel it or mix it under unsanitary conditions. A nurse can give the drug to the wrong patient.

*What you can do:*

• Give hospital personnel a list of all the medicines you take, including dietary supplements and over-the-counter drugs.
• Get a copy of your medication administration record, which lists the drugs you are supposed to take in the hospital. Protest if it’s not accurate. Take it with you if you are transferred to another part of the hospital or a nursing home.
• If possible, go to a hospital with a computerized drug-ordering or bar-coding system, which matches the drugs patients receive with a bar code on their ID bracelet.
• Whenever you get a new prescription, tell the doctor if you are taking a similar drug for the same condition and what other medications and supplements you take. Read the prescription back to the doctor—if you can’t read it, your pharmacist probably can’t either.
• Added by HARP: Ask what medication you are being given every time you are offered a pill or a shot. If you don't recognize it, ask who ordered it, when, and for what purpose.

HOSPITAL INFECTIONS

Infections are usually caused by the failure of doctors and nurses to wash their hands, the failure to give antibiotics before surgery and the improper handling of tubes and other invasive devices.

*What you can do:*

• Have a family member make sure you’ve received antibiotics before you go in for surgery.
• If you have a catheter in place, ask every doctor who examines you how long you will need it. Catheters can cause blood and urinary tract infections if kept in too long.
• Note whether hospital workers wash their hands or change gloves when examining you, inserting tubes or changing dressings. Raising the subject may prompt them to practice good hygiene.

INADEQUATE CARE

In 2003 the RAND Corp., a national research firm, found the chances of getting appropriate, adequate care that follows accepted medical guidelines are at best 50-50.

*What you can do:*

• Follow up on test results. Don’t wait for the doctor to call you.
• Understand the treatment guidelines for your condition, which you can find on the National Guideline Clearinghouse’s website www.guideline.gov/resources/guideline_index.aspx. Although the material may be technical, showing it to your doctor may prompt him or her to prescribe appropriate treatment.
• Added by HARP: Be sure you have a member of your family with you at all times while you are in the hospital, to get nurses when they don't answer call buttons, to check on the identity of every medication given, to find out the identity of every person who gives care, to question who ordered every procedure given, etc.

*USEFUL WEBSITES*

• For more on the safe use of medications, go to AARP’s website www.aarp.org/wiseuse/
• Find your state’s Quality Improvement Organization www.medqic.org/content/qio/qio.jsp?pageID=4
• To find hospitals with computerized drug-ordering systems, go to the Leapfrog survey results www.leapfroggroup.org/cp.
• Bruised and Broken Health Care System(March 2003) www.aarp.org/bulletin/yourhealth/Articles/a2003-07-02-bruised.html
• 7 Health Care Safety Practices That Could Save Your Life(January 2002) www.aarp.org/bulletin/yourhealth/Articles/a2003-08-07-safetypractices.html
• Quiz: Life-Saving Health Care Practices(January 2002) www.aarp.org/bulletin/yourhealth/Articles/a2003-08-07-safetypractices_quiz.html