Tom Sharon
Insider tips before getting ready to go home


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For a Safer Hospital Discharge

Open surgical wounds

  • Do not go home without registered nurse coverage from a licensed or certified home-care agency.
  • Do not leave the hospital until you have received all the surgical supplies you will need. One of the treating doctors should write a prescription.
  • You have the option to refuse to change the dressing and insist that the home-care agency provide a visiting nurse for daily dressing changes. Self-care is voluntary.
  • Make sure that dirty dressing materials are disposed of in plastic bags—do not touch with bare hands.
  • Maintain sterile technique with new dressing.
  • Be careful not to dislodge any surgical drains. If there is any problem or doubt, call the nurse and/or doctor.
  • Observe the wound for foul odor, redness of the surrounding skin, swelling, tenderness, or an increase in pain. Immediately call the nurse and/or doctor if you notice any of these symptoms.

Unhealed skin grafts

  • Same instructions apply as for open surgical wounds.
  • Be careful not to touch skin graft.
  • If you have to apply an ointment or a cream, do so very gently to avoid even the slightest trauma.
  • Note the color of the graft. If it gets darker, call the nurse and/or doctor.

Central intravenous lines inserted through the chest wall—single lumen (one tube) or double lumen (two tubes in one)

  • Same instructions apply as for open surgical wounds.
  • Make sure that the end of the catheter is capped and clamped at all times to prevent hemorrhage.
  • Remember that self-care is voluntary.
  • Observe the insertion site and immediately call the nurse and/or doctor if you notice any redness, swelling, tenderness, and/or pain.

Central venous lines inserted in the arm (single lumen only)

  • The same instructions apply as for central intravenous lines.
  • The insertion site must be sealed off with a clear plastic dressing.

Peripheral intravenous lines

  • Only a registered nurse with certification may insert a new IV into your vein. And remember that self-care for administration of medications is voluntary.
  • The vein catheter must be capped-off and clamped when not in use, with a small amount of anticoagulant inside to prevent clotting.
  • If the next intravenous medication is not flowing freely, clamp or close off the line and call the nurse.
  • Observe the insertion site and immediately call the nurse and/or doctor if you notice any redness, swelling, tenderness, and/or pain.

Limb fractures with external fixators (pins sticking out of the legs or arms)

  • Same instructions apply as for open surgical wounds.
  • Keep the pin insertion sites clean and dry with sterile cotton swabs and prescribed solution (doctors usually prefer a mixture of one-half part hydrogen peroxide to one-half part saline).
  • Do not allow scab formation at insertion site.
  • Observe for signs of infection at pin insertion sites, such as pain, tenderness, redness, swelling, and fever. If you notice any of these, immediately call the nurse and/or doctor.

Neck fractures with halo splints (multiple pins inserted in skull to immobilize the neck)

  • Same instructions apply as for open surgical wounds.

Unstable pelvic fractures requiring total bed rest

  • Do not go home unless there is a family member or home-care agency able to provide care twenty-four hours per day.
  • Do not attempt to get out of bed for any reason.
  • Make certain that there is an emergency evacuation plan in case of fire or another emergency.
  • You must have the following equipment: electric hospital bed with trapeze, reclining wheelchair, Hoyer lift, bedpan, and urinal (for men).

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SECTION : Hospital

· Hospital mishaps
· Bedsores
· At risk for bedsores
· Why bedsores occur
· Prevent bedsores
· Turning - positioning
· Healing wounds
· Nursing care plan
· Wound cleaning
· Increase blood flow
· Drawing off fluids
· Pressure on wounds
· Wound care experts
· Nutrition in healing
· Anemic people
· Bedsores and diabetes
· Skin integrity
· Treating bedsores
· Hospital-acquired infections
· Cleanliness first
· New gloves
· Ventilator maintenance
· Bladder infection
· Contamination
· Dressing change
· Vein catheter sterility
· Hazardous body waste
· Isolation of patients
· Isolation technique
· Effective isolation
· Treatment for infections
· Use of antibiotics
· Reducing infection risk
· Treatment denial
· History of managed care
· HMOs today
· The Diapulse machine
· Dealing with HMO denials
· Communicating with staff
· Communication
· Behavioral assessment
· Nurse burnout
· Nurse-patient relationship
· Nurse practice
· Renewing nursing plan
· Leaving hospital quicker
· Early discharge problems
· Wound care at home
· The discharge order
· Discharge planner
· Inappropriate discharge
· Discharge function
· Safe hospital discharge
· Treating chemical victims
· Anthrax types
· Anthrax treatment
· Foodborne botulism
· Botulism treatment
· Plague
· Plague treatment
· Smallpox
· Smallpox treatment
· Chemical attack victims
· Nuclear attack survivors
· Radiation sickness
· Radiation treatment
· Hospital managing
· JCAHO accreditation
· Hospital risk management
· Rights after an accident
· Daily log

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