Nurses say patients don’t realize how bad they have it

You might already worry that hospitals aren’t as safe or sanitary as they should be, but nurses say you don’t know the half of it. That’s the startling conclusion of Consumer Reports’ first side-by-side surveys of hospital conditions from two very different perspectives: those of nurses and patients.
In the surveys, conducted by the Consumer Reports National Research Center, CR heard from subscribers who told them about their own or a loved one’s most recent hospital stay, and nurses reported on their most recent week at work.
Their responses show that hospitals look very different depending on your vantage point. About 4 percent of patients said they saw problems with hospital cleanliness, compared with 28 percent of nurses. Thirteen percent of patients said that their care wasn’t coordinated properly, but 38 percent of nurses said that was a problem. Five percent of patients, but 26 percent of nurses, said hospital staff sometimes did not wash their hands.
In spring 2009, CR surveyed a national sample of 731 nurses who cared directly for patients in emergency rooms, critical-care units, operating rooms and other areas of the hospital. For the patient’s viewpoint, in spring 2008, more than 13,540 readers told CR about their own or a family member’s hospital stay during the previous year.
CR also collected suggestions from dozens of interviews with hospital officials, doctors, registered nurses, social workers, dietitians and hospital pharmacists — and patients who were willing to share their experiences. Here’s their combined wisdom on how to get through a hospital stay safely and with minimal confusion.
1. Do your homework. Fifty-nine percent of patients in CR’s survey did not enter the hospital through the emergency room, so they might have had a choice of which hospital to go to. But 65 percent of patients in the survey simply went to the hospital their physician recommended or was affiliated with. Forty percent chose a hospital for its location, and 28 percent because it was in their health plan’s network.
Only 11 percent chose the hospital for its record in treating their condition, and only 2 percent on the basis of the hospital’s ratings in books or magazines or online. That’s unfortunate, because hospital quality differs. Looking up your local hospital will tell you what types of challenges other patients experienced there.
2. Plan for a smooth admission. Errors in medication are a leading cause of preventable injury to hospital patients in this country, and research suggests that mix-ups are especially likely during “care transitions,” when patients are admitted, transferred from one ward to another or discharged from the hospital. Keep an up-to-date list of your current medications and dosages, including over-the-counter drugs and dietary supplements, in your handbag or wallet at all times.
3. Avoid chaotic care. When care is not properly coordinated, a patient can be subjected to unnecessary or duplicate tests and treatments. If your admitting doctor or hospitalist isn’t doing a good job of coordinating care, you have options, such as working with a patient advocate, social worker or case manager to coordinate your care. But patients usually have to ask for such help.


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