Patient Safety

Handbook
You and your family member are an important and
equal member of the healthcare team at NWTHS.
Your participation in the care we render is essential to
providing a safe environment. We are committed to
listening to you and acting upon your request.

Healthcare research has clearly shown that when you

and your family member are active participants in the
care we give medical errors are prevented. In this
booklet you will find key information to guide you in
how you can help us provide the best care that you
deserve.

We welcome your questions and ask that you

continually challenge us as you feel the need.

Sincerely,

Frank Lopez
Chief Executive Officer, NWTHS

Mission Statement:
Northwest Texas Healthcare System will provide high
quality, efficient health services that:
• Patients and their families recommend
• Physicians prefer
• Employees, volunteers and board members are proud of
• Students and faculty excel in
• Purchasers select
• The community values

Vision Statement:
Amarillo’s health choice and the preferred health partner
for the region
TABLE OF CONTENTS
Page #
Partnering for Your Safety 4
National Patient Safety Goals 5
SPEAK UP 6-7
Medication Safety 8-10
Rapid Response Team 11
Fall Prevention 12-14
Patient Rights and Responsibilities 15-18
Your Hospital Wrist Bands 19
Advance Directives 20-21
When you have Surgery 22-25
Pain Management 26-31
Nutritional Services 32
Suicide Hotlines 33
Community Resources 33
Patient Accommodations 34
Safety and Security 36
Hand Hygiene 38
Tobacco Cessation 39
 r your S afety
g fo
Par tnerin
Your Safety is Important to Us
At Northwest Texas Healthcare System we desire to meet or exceed
your expectations for providing safe care and overall excellence during
your stay.

As we “Partner” for your safety, we ask that you review this information
to become part of your healthcare team. We invite you to designate a
“Care Partner” to help be your “eyes and ears” as well as promote a
safe environment for you. There are a number of ways you and your
Care Partner can actively participate in your safe care.

If you or your Care Partner have concerns or do not understand any

part of your care please SPEAK UP. Do not allow a treatment or proce-
dure to proceed unless you feel comfortable and understand the risks
and benefits.

Infection Control:
Infections may occur after many types of medical procedures, this is
particularly true if you have surgery. There are several steps you can
take to prevent infections from developing during your hospital stay:
Wash your hands carefully after handling any type of soiled mate-
rial. This is especially important after you have gone to the bath-
room.
Since you are part of the healthcare team, do not be afraid to re-
mind doctors and nurses about washing their hands before working
with you.
If you have a dressing, keep the skin around the dressing clean and
dry. Tell your nurse promptly if the dressing becomes loose or gets
wet.
If you have any type of catheter or drainage tube, let your nurse
know promptly if it becomes loose or falls out.
If you have diabetes, be sure that you and your doctor discuss the
best way to control your blood sugar before, during and after your
hospital stay. High blood sugar increases your risk of infection
If possible, ask your friends and relatives not to visit if they feel ill.
Cover your mouth and nose when coughing or sneezing.
Take antibiotics exactly as instructed. DO NOT stop taking them
without checking with your physician.
Follow isolation guidelines. Ask your doctor or nurse to explain why
isolation precautions are necessary.

4
 NATIONAL
PATIENT S
AFETY GO
ALS

The purpose of the National Patient Safety Goals is to improve pa-

tient safety. The Goals focus on problems
in health care safety and how to solve them.

Identify patients correctly:

Staff should use at least two ways (Name and Date of Birth) to identify
you when providing medicine and treatment. This also applies when
getting a blood transfusion.
Improve Staff Communication:
Orders must be read back to ensure accuracy.
A list of abbreviations and symbols that are not to be used has been
developed.
Critical results from tests are communicated to the right staff person.
Steps have been developed for staff to follow when sending you to the
next caregiver. These steps will help staff communicate details about
your care.
Use medicines safely:
Medications will be labeled to ensure accuracy. For example, medicines
in syringes, cups and basins.
Extra care is taken with patients who take medicines to thin their blood.
Prevent infection:
Hand hygiene practices are enforced utilizing guidelines from the Cen-
ters for Disease Control and Prevention (CDC).
Check patient medicines:
You should provide us with a list of the medicines that you take.
We will provide you or your next caregiver with a list of the your medi-
cines before you go home and the list will be explained.
Prevent patients from falling:
We will take action to prevent falls for you if you are at risk
Help patients to be involved in their care:
You may report any complaints about safety.
Identify patient safety risks:
If you feel like harming yourself, please notify your caregiver.
Watch patients closely for changes in their health and respond
quickly if they need help:
Contact the Rapid Response Team at 8999 if you need help emer-
gently.
Prevent errors in surgery:
Staff will utilize documents and your input before taking you to surgery.
A physician will mark the part of the body where the surgery will be
done. We will involve you in doing this.

5
Northwest Texas Healthcare System will treat all
customers with Service Excellence
Standard One
Treat Everyone As A Guest
Standard Two
Demonstrate Professionalism and Excellence
in the things I do.
Standard Three
Practice Teamwork

6
S peak up if you have questions or concerns, and if you
don’t understand, ask again. It’s your body and you have
the right to know.

P ay attention to the care you are receiving. Make sure

you are getting the right treatments and medications by the
right health care professionals. Do Not assume anything.

E ducate yourself about your diagnosis, the medical

tests you are undergoing, and your treatment plan.

A sk a trusted family member or friend to be your

advocate.

K now the medications you take and why you take

them. Medication errors are the most common health care
mistakes.

U se a hospital clinic, surgery center, or other type of

health care organization that has undergone a rigorous on-
site evaluation against established state-of-the-art quality
and safety standards such as that provided by The Joint
Commission.

P articipate in all decisions about your treatment. You

are the center of the health care team.
retrieved from www.jointcommission.org

7
 at io n S afety
Medic
Who is responsible for your
medicines?
A lot of people—including you!
• Doctors check all of your
medicines to make sure they
are OK to take together.
They will also check your vi-
tamins, herbs, diet supple-
ments or natural remedies.
• Pharmacists will check your
new medicines to see if there
are other medicines, foods or
drinks you should not take
with your new medicines.
This helps to avoid a bad re-
action.
• Nurses and other caregivers
may prepare medicines or
give them to you.
• You need to give your doc-
tors, pharmacists and other
caregivers a list of your
medicines. This list should
have your
prescription medicines
over-the-counter medi-
cines
vitamins
herbs
diet supplements
natural remedies
amount of alcohol you
drink each day/week
recreational drugs
8
What should you know
about your medicines?
Make sure you can read
the handwriting on the pre-
scription. If you can't read
it, the pharmacist may not
be able to read it either.
You can ask to have the
prescription printed.
Read the label. Make sure
it has your name on it and
the right medicine name.
Make sure that you under-
stand all of the instructions
for your medicines.
If you have doubts about a
medicine, ask your doctor,
pharmacist or caregiver
about it.
What if you forget the in-
structions for taking a
medicine or are not sure
about taking it?
Call your doctor or pharma-
cist. Don't be afraid to ask
questions about any of your
medicines.
 Medication
Safety
What can you do at the
hospital or clinic to help avoid
mistakes with your
medicines?
• Make sure your doctors,
nurses and other caregivers
check your wristband and ask
your name and date of birth
before giving you medicine. Some patients get a
medicine that was supposed to go to another
patient.
• Don't be afraid to tell a caregiver if you think you
are about to get the wrong medicine.
• Know what time you should get a medicine. If you
don't get it then, speak up.
• Tell your caregiver if you don't feel well after taking
a medicine. Ask for help immediately if you think
you are having a side effect or reaction.
• You may be given IV (intravenous) fluids. Read the
bag to find out what is in it. Ask the caregiver how
long it should take for the liquid to run out. Tell the
caregiver if it's dripping too fast or too slow.
• Get a list of your medicines—including your new
ones. Read the list carefully. Make sure it lists
everything you are taking. If you're not well enough
to do this, ask a friend or relative to help.

9
 e di c ati o n Safety
M

Questions to ask your doctor or pharmacist

• How will this new medicine help you?
• Are there other names for this medicine? For example, does it have
a brand or generic name?
• Is there any written information about the medicine?
• Can you take this medicine with your allergy? Remind your doctor
about your allergies and reactions you have had to medicines.
• Is it safe to take this medicine with your other medicines? Is it safe
to take it with your vitamins, herbs and supplements?
• Are there any side effects of the medicine? For example, upset
stomach. Who can you call if you have side effects or a bad reac-
tion? Can they be reached 24 hours a day, seven days a week?
• Are there specific instructions for your medicines? For example, are
there any foods or drinks you should avoid while taking it?
• Can you stop taking the medicine as soon as you feel better? Or do
you need to take it until it's gone?
• Do you need to swallow or chew the medicine? Can you cut or
crush it if you need to?
• Is it safe to drink alcohol with the medicine?

My Current Medicine List

Name:

Allergies:
Emergency
Contact:

Medication (include amount you take and how often or what time
of day)
Prescrip-
tion:

Over the Counter (for example, aspirin or vitamins):

10
11
 FALL PREVENTION
You will be evaluated to make sure you are safe from falls.
You can help prevent falls, by asking for help before getting
up.

The single most important way you can contribute to your

safety during your hospital stay is to be an active member
of your healthcare team. Patients who are more involved
with their care have better results.

Do not be afraid to ask questions about your care. It is im-

portant that you fully understand your treatment plan and
expected outcomes. You and your family/friends will be
able to better facilitate your recovery.

12
 Fall Preven
tion
Are you at risk for falls?
Falls are not just the result of getting older. Many falls can be
prevented. Falls are usually caused by a number of factors. By being
aware of these factors, and changing just a few things you can lower
your chances of falling.

You are at risk if any single or combination of the following

factors relate to you:
1) If you are age 65 or older
2) If you are unsteady on your feet
3) If you have periods when you are disoriented or confused
4) If you take medications such as sleeping pills, pain pills, heart
medications, laxatives, water pills, or high blood pressure
medications
5) If you have trouble controlling your bladder or bowel
6) If you have a history of falling
7) If you have vision or hearing problems

Prevention Steps:
Steps that may be taken while in the HOSPITAL
1) Familiarize yourself with your surroundings, examine where
furnishings are located
2) Plan a path to the bathroom or a bedside commode may be
provided
3) A specific yellow indicator will be placed on your nameplate outside
your door, and a yellow band placed on your arm to alert all
members of the healthcare team that you are at risk to fall
4) Keep your personal items within reach
5) Use your call light to ask for help when getting up
6) Your bed will be kept in a low position with your side rails up
7) A dim light may be left on at night
8) Leave floppy slippers and extra long bathrobes at home—wear well
fitting slippers with non-skid soles. Don’t wear clothing that drags
the floor; and keep the robe tied
9) Let the nursing staff know of anything you normally do at home that
keeps you from falling, such as wearing your glasses or hearing
aides
10) Your family’s support and involvement are welcomed and
encouraged

13
14
 Patient Rig
hts and Re
sponsibilit ies

Patient/Family Responsibilities:
The safety of health care delivery is enhanced when patients, as ap-
propriate to their condition, are partners in the health care process.
Hospitals are entitled to reasonable and responsible behavior on the
part of the patients and their families, within their capabilities.

1. Patients and families, as appropriate, are responsible to provide

accurate and complete information about present complaints, past
illnesses, hospitalizations, medications, and other matters relating
to their health. Patients and their families must report perceived
risks in their care and unexpected changes in their condition. They
can help the hospital understand their environment by providing
feedback about services needs and expectations, including but not
limited to any communication barriers and/or needs.
2. Patients and families, as appropriate, are responsible for participat-
ing in their health care plan and communicating questions about their
care to their health care providers if they do not understand their
care, treatment and service or what they are expected to do.
3. Patients and their families are responsible for following hospital
rules and regulations.
4. Patients and families, as appropriate, are responsible for following
the treatment plan recommended by the health care team. They
should express any concerns about their ability to follow the pro-
posed care plan. The hospital makes every effort to adapt the plan
to the specific needs and limitations of the patients. When such
adaptations to the care plan are not recommended, patients and
their families are informed of the consequences of the alternatives
and of not following the proposed plan.
5. Patients and their families are responsible for the outcomes if they
do not follow the care, treatment, and service plan.
6. Patients are responsible for assuring that the financial obligations of
their health care are promptly met as agreed to with the hospital. In
the case of minors or incompetent adult patients, the parents or le-
gal guardians shall be accountable for adhering to the responsibili-
ties listed.
7. Patients and their families must be considerate of hospital’s staff and
property as well as other patients and their property.
8. Patients and their families must inform their care provider of any spe-
cial communication needs.

15
 a nd R es ponsibilities
h ts
Patient Rig

1. NWTHS respects your rights as a patient including the right:

• To be treated in a dignified and respectful manner
• To effective communication
• To receive care that respects your cultural and
personal values, beliefs and preferences
• To privacy
• To pain management
• To religious and other spiritual services
• To have access, request amendment to, and obtain
information on disclosures of health information, in
accordance with law and regulation.

2. NWTHS respects your right to receive information in a

manner that you understand. This information will be
appropriate for your age, language, and ability to understand.
You have the right to receive interpreting and translation
services as necessary. NWTHS communicates with patients
who have vision, speech, hearing or cognitive impairments to
meet those needs.
3. NWTHS respects your right to participate in decisions about
your care, treatment and services. The hospital will involve
you in making decisions. You have the right to refuse care,
treatment and services in accordance with law and
regulation. If you are unable to make decisions about your
care, treatment and services, NWTHS will involve a surrogate
decision-maker in these decisions. NWTHS will provide you
or your surrogate decision-maker with information about
outcomes of care, treatment, and services that are needed to
participate in current and future health care decisions.
NWTHS and the physician will inform you or your surrogate
decision-maker about unanticipated outcomes of care,
treatment and services. You have the right to have a family
member or representative of your choice notified of your
admission to the hospital.
4. NWTHS honors your right to give or withhold informed
consent.

16
 Patient Rig
hts and Re
sponsibilit ies

5. NWTHS protects and respects your rights during research,

investigation, and clinical trials. When you decide you want to
be involved in a clinical trial, you will be provided with the fol-
lowing information:
• An explanation of the purpose of the research
• The expected duration of your participation
• A clear description of the procedures to be followed
• A statement of potential benefits, risks, discomforts,
and side effects
• Alternative care, treatment, and services available to
you that might prove advantageous to you
• Refusing to participate in research, investigation, or
clinical trials, or discontinuing participation at any
time, will not jeopardize your access to care, treat-
ment and services unrelated to the research.

6. NWTHS respects your right to receive information about the

individual(s) responsible for, as well as those providing, your
care, treatment, and services. You have the right to be in-
formed of the name of the physician or other individuals pro-
viding service to you as well as the practitioner who is primar-
ily responsible for your care, treatment and services.

7. You have the right to make decisions about your care, treat-
ment, and services received at the end of life.

8. You have the right to be free from neglect; exploitation; and

verbal, mental, physical, and sexual abuse.

9. You have the right to an environment that preserves dignity

and contributes to a positive self-image. You have the right to
telephone and mail services as appropriate to the setting and
population of the hospital. You may have access to private
telephone conversations in a private space based on the set-
ting and population of the hospital.

17
 ies
h t s a n d Responsibilit
Patient Rig
(continued)

10. You have the right to access protective services.

11. You have the right to have complaints and/or grievances re-
viewed by the hospital. You and/or your family can access
the Patient Advocate for resolution of complaints or to report
grievances. You are encouraged to contact the Charge
Nurse, Nursing Director of the unit that you are on. NWTHS
reviews and, when possible, resolved complaints and griev-
ances with you or your family. The Patient Advocate can be
reached at extension 1941. You have the right to voice com-
plaints and recommend changes without being subject to co-
ercion, discrimination, reprisal, or unreasonable interruption
of care. You have the right to file a complaint with the state
authority or Joint Commission:
Department of State Services The Joint Commission
Health Facility Compliance Division Office of Quality Monitoring
1100 West 49th Street One Renaissance Boulevard
Austin, Texas 78756 Oakbrook Terrace, IL 60181
(888) 973-0022 (630) 792-5636

Organ Donation
Organ Transplantation and Donation Facts at a Glance
• There is no national registry of organ donors. Even if you have indi-
cated your wishes on your drivers' license or a donor card, be sure
you have told your family as they will be consulted before donation
can take place.
• Please notify your healthcare provider of your wishes so that this
can be properly documented on your care record.
• People of all ages and medical histories should consider them-
selves potential donors. Your medical condition at the time of death
will determine what organs and tissue can be donated.
• Organs and tissues that can be donated include: heart, kidneys,
lungs, pancreas, liver, intestines, corneas, skin, tendons, bone, and
heart valves.
• All major religions approve of organ and tissue donation and con-
sider donation the greatest gift.
• An open-casket funeral is possible for organ and tissue donors.
Retrieved from unos.org

18
Northwest Texas Healthcare System is a voluntary
participant in a multi-state patient safety initiative that uses
standardized color-coded wristbands. Hospitals across
Texas and in more than 25 other states have adopted
standard colors to alert staff to specific conditions. RED
indicates an allergy; YELLOW signifies a fall risk; PURPLE
reflects a patient’s do-not-resuscitate status. If the nurse
assesses you need one or more of these wristbands –
either upon admission or at any time during your stay – you
will receive information about the type of alert and be asked
to wear the wristband. To avoid confusion, the hospital
requests that patients remove any “social cause”
wristbands. More information is available from your nurse.
Our goal is to make your care as safe as possible, and
these visual cues help alert all staff members to these
specific conditions. Thank you for your cooperation in this
important patient safety program

SOCIAL CAUSE WRISTBANDS:

“Social cause” (ex. LiveStrong) wristbands should not be worn

during your hospital stay due to the potential for confusion or
harm to you or your family member. Please remove any
colored wristbands that are not associated with your
hospitalization.

19
 nc e Di r e c tives
Adv a

T here is an important legal document

known as an Advance Directive
(Living Will). It is intended to help you communicate your wishes
about your medical treatment at some time in the future when you
are unable to make your wishes known because of illness or injury.
These wishes are usually based on personal values. You are
encouraged to discuss your values and wishes with your family or
chosen spokesperson, as well as your physician.

Your physician, other healthcare provider or medical institution may

provide you with various resources to assist you in completing your
advance directive.

Brief definitions of the three different advance directives are listed

below and may aid you in your discussions and advance planning.

Advance Directives Explanations

Directive to Physicians and Family: This document lets you

explain in writing which medical treatment you want or don’t want at
the end of your life. You may cancel or change the directive at any
time either in writing or verbally to your healthcare provider.

Medical Power of Attorney: This document lets you name another

person to make a medical decision for you. This person can speak
for you if – and only if – you cannot state your wishes yourself.

Out-of-Hospital DNR Order: This document communicates your

instructions to healthcare professionals acting in an out-of-hospital
setting, not to initiate life-sustaining treatment. Out-of-hospital
settings include: long-term care facilities, inpatient hospice services,
private homes, hospital outpatient or emergency departments,
physician offices, and vehicles during transport. If you have further
questions please contact your nurse. Advance Directive forms are
available on the nursing units and in the Admissions Office.

20
 Advance D
irectives
Treatment Decisions
You or your designated decision-maker will have different choices
to make about your treatment. We offer the following definitions to
help you when making your decisions.
• Cardiopulmonary Resuscitation (CPR)—attempts to restart your
heart beating and your breathing
• Do not resuscitate (DNR)—means that you do not want
someone to perform CPR on you should your heart stop
beating.
• Respirator or ventilator—machine that pumps air into your lungs
through a tube that is placed into your windpipe.
• Tube feeding—used when you cannot chew or swallow;
provides food and/or fluids through a tube placed in your
stomach or intestine.
• Kidney dialysis—procedure that cleans your blood by pumping it
through a machine.
• Pain medication—given to help control pain and keep you
comfortable; can be used at various stages of an illness.

Inserted in this section are forms that you can utilize to

complete your “Medical Power of Attorney” and/or
“Directive to Physicians and Family or
Surrogates forms”. If you have questions, please ask
your nurse to help you.

Ethics Committee
The committee has three primary functions:
1. To recommend institutional guidelines and policies concerning the
care of seriously ill patients
2. To offer a forum for the prospective and retrospective review of spe-
cific issues regarding critically ill patients
3. To serve as an educational and informational resource for patients
and families, healthcare providers and the community

Anyone can bring an issue to the committee at any time. If you have a
concern, please contact the Ethics Hotline at (806) 354-1000, Ext. 3600.
All inquiries are strictly confidential.

21
Things you should know if you are
having surgery:

As a patient, you should be involved and as informed as

possible about these protocols as well as your surgical
procedure. Never be afraid to ask questions and do your best to
ensure that your health care team has the information it needs to
make the best decisions about your care.

Patient safety is a priority at Northwest Texas Hospital and

many strategies are used to maintain that safety. Marking the
surgical site is one strategy we use to correctly identify the
intended site for your surgical procedure. Another strategy is
for you, the patient, and your family to participate with your
surgical site marking to help prevent wrong-site surgery.

What Can You Do?

Be Involved In Your
Health Care.
The single most important
way you can help to prevent
errors is to be an active
member of your health care
team. That means taking part
in every decision about your
health care.
Research shows that patients
who are more involved with
their care tend to get better
results.

22
 Please SPEAK UP if
you have any concerns or
questions that you would
like to discuss with a
member of the healthcare
team or your surgeon.

MARKING THE SURGICAL SITE

• Make sure that you and your surgeon agree on
exactly what will be done during the operation
• Make sure the surgical consent form specifies what
type of surgery you are having with your surgical site
area (for example, right total knee replacement)
• The surgical site will be marked with a skin pen/
marker by the surgeon. You will be asked to
participate.
• Marking the surgical site is required in surgeries of:
right versus left distinction (examples: right knee
versus left knee, right breast versus left breast, right
lung versus left lung)
• Multiple structures (fingers and toes)
• Multiple levels (of the spine/neck/ back)
• The surgical site will be marked by your physician
using a skin marker with the word “YES” over, or next
to the actual surgical site.
An “X” or the word “NO” should never be used to
either designate or eliminate a surgical site. You, as
a patient, or your family member will be asked to
initial the surgical site as well.

23
What You Need to Know about Infections after Surgery:
A Fact Sheet for Patients and Their Family Members
Most patients who have surgery do well. But sometimes
patients get infections. This happens to about 3 out of 100
patients who have surgery. Infections after surgery can lead
to other problems. Sometimes, patients have to stay longer
in the hospital. Rarely, patients die from infections. Patients
and their family members can help lower the risk of
infection after surgery. Here are some ways:

Days or weeks before surgery:

Meet with your surgeon.
• Bring an up-to-date list of all the medications you take.
Talk with your surgeon about why you take each
medication and how it helps.
• Let the surgeon know if you are allergic to any medication
and what happens when you take it.
• Tell the surgeon if you have diabetes or high blood sugar.
• Talk about ways to lower your risk of getting an infection.
This may include taking antibiotic medicines.

The day or night before surgery:

Take extra good care of your body.
• Do not shave near where you will have surgery. Shaving
can irritate your skin which may lead to infection. If you
are a man who shaves your face every day, ask your
surgeon if it is okay to do so.
• Keep warm. This means wearing warm clothes or
wrapping up in blankets when you go to the hospital. In
cold weather, it also means heating up the car before you
get in. Keeping warm before surgery lowers your chance
of getting an infection.

24
At the time of surgery:
• Tell the anesthesiologist (doctor or nurse who puts you to
sleep for surgery) about all the medications you take. A
good way to do this is with an up-to-date medication list.
• Let the anesthesiologist know if you have diabetes or
high blood sugar.
• People with high blood sugar have a greater chance of
getting infections after surgery.
• Speak up if someone tries to shave you before surgery.
Ask why you need to be shaved and talk with your
surgeon if you have any concerns.
• Ask for blankets or other ways to stay warm while you
wait for surgery. Find out how you will be kept warm
during and after surgery. Ask for extra blankets if you feel
cold.
• Ask if you will get antibiotic medicine. If so, find out how
much medicine you will get. Most people are on
antibiotics for just one day as taking too much can lead to
other problems.
You can learn more about Surgical Site Infection as it relates to the
5 Million Lives Campaign at www.ihi.org.

Information adapted from the Institute of Healthcare Improvement (IHI)

25
 ANAGE M E NT
PAIN M
There are many different causes and
kinds of pain. Pain can be caused by injury, illness, sickness,
disease or surgery. Treating pain is the responsibility of your
doctor, nurse and other caregivers. You can help them by asking
questions and finding out more about how to relieve your pain.

Questions To Ask Your Caregivers

• What pain medicine is being ordered or given to you?
• Can you explain the doses and times that the medicine needs to be
taken?
• How often should you take the medicine?
• How long will you need to take the pain medicine?
• Can you take the pain medicine with food?
• Can you take the pain medicine with your other medicines?
• Should you avoid drinking alcohol while taking the pain medicine?
• What are the side effects of the pain medicine?
• What should you do if the medicine makes you sick to your stomach?
• What can you do if the pain medicine is not working?
• What else can you do to help treat your pain?

Talking About Your Pain

Is it important for doctors and nurses to ask about your pain?
Yes. This is because pain changes over time or your pain medicine
may not be working. Doctors and nurses should ask about your pain
regularly.
What do you need to tell your doctor and nurse about your pain?
First, tell them that you have pain, even if they don’t ask. Your doctor or
nurse may ask you to describe how bad your pain is on a scale of 0
(zero) to 10 with 10 being the worst pain. They may use other pain
scales that use words, colors, faces or pictures. Tell them where and
when it hurts. Tell them if you can't sleep or do things like dressing or
climbing stairs because of pain. The more they know about your pain
the better they can treat it. The following words can be used to
describe your pain: Aching, Dull, Sharp, Bloating, Numbing, Shooting,
Burning, Pressing, Soreness, Cramping, Pressure, Stabbing, Comes
and goes, Pulling, Throbbing, Constant, Radiating, Tightness, Cutting,
or Searing

26
 PAIN MANA
GEMENT
What can you do when your pain gets worse?
Tell your doctor or nurse. Tell them how bad your pain is or if you’re in
pain most of the time. Tell the doctor if the pain medicine you're
taking is not helping.
Should you include pain medicine on your list of medicines or
medication card?
Yes! Even pain medicine that you will take for a short time should be
listed with all of your other medicines.
List all of your pain medicines — those prescribed by your doctor and
those you buy over-the-counter on your own.

Managing Your Pain

What can be done to treat pain?
There are many ways to manage your pain. There are medicines that
can be used to relieve pain. There are also other ways to treat pain
without taking medicine. Your doctor will work with you to find out
what works best for you.
What are some of the medicines used to treat pain?
Some pain medicines are acetaminophen, aspirin, ibuprofen,
naproxen and opioids. Opioids include morphine, oxycodone, and
hydromorphone. Many of these medicines come in pills, liquids,
suppositories, and skin patches. Some pain may be treated with
medicines that are not usually thought of as pain relievers. For
example, antidepressants.
Are there other ways to relieve pain?
That will depend on your illness or condition and how much pain you
have. Sometimes pain can be relieved in other ways. Some other
treatments for pain are listed here.
Acupuncture, which uses small needles to block pain
Taking your mind off the pain with movies, games, and conversation
Electrical nerve stimulation, which uses small jolts of electricity to block
pain
Physical therapy
Exercise
Hypnosis
Heat or cold
Massage
Relaxation

27
 GEMENT
PAIN MANA
Continued

What are the side effects of pain medicines?

It depends on the medicine. Side effects can include constipation,
nausea, vomiting, itching, and sleepiness.

What can you do if you have side effects or a bad reaction?

Call your doctor or nurse as soon as possible. Find out what can
be done to treat the side effect. Ask if there is another pain
medicine that may work better for you.

Are you afraid to take a pain medicine?

You may have had a bad experience taking pain medicine in the
past, such as a side effect or bad reaction. Or you may be taking a
lot of other medicines. Your doctor or nurse should be able to ease
your fears.

Are you afraid that you’ll become addicted to pain medicine?

This is a common concern of patients. Studies show that addiction
is unlikely. This is especially true if the patient has never been
addicted. Talk to your doctor or nurse about your fears.

Are you afraid that your pain medicine won’t work if you take
it for a long time?
This is called “tolerance.” It means that after awhile your body gets
used to the medicine and you need to make a change to get pain
relief. It's also possible that the condition causing your pain is
getting worse or you have a new type of pain. You may need more
medicine or a different kind of medicine to control your pain. Tell
your doctor or nurse about your fears.

Can you crush pills if you can’t swallow them?

Check with your doctor, nurse or pharmacist. Some medicines can
be crushed and some cannot. For example, time-release
medicines should not be crushed. Ask your doctor or nurse if the
medicine comes in a liquid or can be given another way.

28
 PAIN MANA
GEMENT
Continued

Methods of Pain Control

There are several medications available to help you control
your pain:
♦ Oral—These include pills or liquids, some of which may be
swallowed or placed under the tongue
♦ Shots—also called injections
♦ PCA—Patient Controlled Analgesia—you control the
amount and timing of the medication you receive through
your IV line.
♦ Epidural—Medication will be given by a small pump
through a catheter placed in the epidural space in your
back.
♦ IV—Intravenous delivery of medication
♦ Transdermal—Various methods of delivery through the
skin such as topical creams, patches or TENS units.
♦ Nerve Block—an injection into the nerves to decrease
pain.
Are PCA’s and Epidurals Safe:
You are the only person who will know when you are hurting
and when it is safe to have a dose of pain medication.
Therefore, you are the only person who should press the PCA
button. Your family, visitors, physicians, and hospital
personnel are not to press the PCA button. Any changes to
this rule requires written consent.
♦ The Epidural pump will be programmed to give you an
amount of pain medication that is typically safe for
someone of your sex, size, age, diagnosis or type of
surgery.
♦ The pumps will be programmed as ordered by your doctor.
♦ To achieve safe and effective pain control, you must
balance your pain and sedation. You may need to tolerate
some pain in order to be awake and participate in your
recovery.

29
 PAIN Diar y

Use this diary to document pain levels and

interventions.

Pain is assessed using a scale of 0-10 with 10

being the worst possible pain.

Document the pain level before an

intervention and 30 minutes after the
intervention.

An intervention could be pain medication,

repositioning, hot/cold compress or a
massage.

This diary is to assist with maintaining control

of pain.

Family members are encouraged to assist with

pain diaries when patients are unable to use
this tool themselves.

Please talk to your nurse if you have any

questions about your pain or this pain diary.

30
 Personal Pain Diary
For:_______________________________________

Date/ Pre Post Comments

Time Intervention Intervention

31
 IT IO N S E RVICES
N U TR
Patient Meals/Room Service
Wholesome, nourishing and well-balanced meals are
an important part of your treatment. Meals, snacks,
and nutrition support are provided for all patients by
physician order and under the direction of our staff of
registered dietitians.

Your meals are prepared fresh daily, ensuring the finest quality.
Patients in our Intensive Care Units are served breakfast generally
between 6:45 a.m. and 8:00 a.m., lunch between 11:15 a.m. and 12:00
p.m. and dinner between 5:00 p.m. and 5:30 p.m. Occasionally meals
may be delayed when you are scheduled for a special test or treatment,
and exact timing of meal delivery may vary by unit. Altered diet
schedules can be accommodated when required.
Patients who are in non-intensive care units may order meals via their
in-room telephone any time between 7:00 AM and 7:00 PM from a
“room service menu” which will be delivered to the patient’s room.
Once the “room service” order has been placed, the meal will be
delivered in approximately 45 minutes.

Accommodations will be made for special diet requirements.

If you wish to have a guest tray delivered to a patient’s room, guest

trays are available for purchase in the Blue Point Café.

Visitor Food Service

Visitors will find the Bluepoint Café located on the first floor of the
hospital. Breakfast is available from 6:30 a.m. to 10:00 a.m. daily; and a
variety of food choices are available from 11:00 a.m. to 1:00 a.m. seven
days a week. Cash and credit/debit cards are accepted. Please call
extension 3021 with any questions.

Also on the first floor is a full service coffee shop, Java City, with
espressos, cappuccinos, iced coffee drinks, teas, smoothies and fresh
pastries. Hours are 6:30 a.m. to 9:00 p.m. daily.

Vending Machines
Vending machines for snacks and beverages are located on the 1st
floor near the Cafe and in multiple other locations throughout the
hospital. They are available 24 hours a day. If you experience
problems with a vending machine, please notify a cashier in the
Bluepoint Cafe (see hours above).

32
 Suicide hotlines
In a crisis situation,
please contact
359-6699
1-800-692-4039
or
354-1810
We care about you!

Other Vital Community Resource Num-

bers

Child Protective Services

1-800-252-5400

Adult Protective Services

1-800-252-5400

Family Violence/Sexual Assault

Crisis Line
374-5433

United Way Social Service and

Referral Line
2-1-1

33
 c o mm o dations
Patient ac
Your room
Your room assignment at
NWTHS is based upon
your admitting diagnosis
and the bed availability on
the day of your
admission. Private (single
bed) and semi-private
(two bed) rooms are
available. Your doctor’s
office staff will call the
hospital’s admitting office
to schedule your
preference. We cannot
guarantee that your
preference can be met, as
rooms are assigned
based on patient need.
Security
In order to secure the
hospital premises all
doors are locked between
10:00 pm and 5:00 am,
except for the Emergency
Department entrance.
Television
Color television sets are
provided in each room.
Cable channels and
special maternal/child-
related educational
programs are available on
Channel 70 (English) and
Channel 72 (Spanish)
Your Hospital Bed
Hospital beds may be adjusted by
using the controls. The beds are
equipped with side rails that must
be raised while you are asleep or
sedated. Should you need
assistance, please call your nurse.
Room Temperature
All rooms in the hospital are
centrally heated and air-
c o n d i t i o ne d . I f y o u r r o o m
temperature is not comfortable,
please notify the nursing staff.
Calling your Nurse
All rooms are equipped with an
intercom/nurse call system. Patient
bathrooms are also equipped with
an emergency call system. You will
receive instructions on their use.
For assistance at any time, use
your call button.
Telephones
Telephones are provided in non-critical
care rooms. Local calls may be made
at any time from the room by dialing 9
and then the number. Long distance
calls cannot be charged to your room.
You may use a telephone calling card
or major credit card, or make a collect
call. Your room telephone has a num-
ber that family/friends may dial directly.
Incoming calls can only be received
between 7:00 am and 10:00 pm. If you
would prefer not to receive phone calls,
please call the hospital operator by
dialing 0.
34
 Lifting and Transfers
Northwest Texas Healthcare
System has a minimal lift policy,
which means that we may be
utilizing lift equipment to help move
you. This move could range from a
simple transfer to a total lift. To ensure that we
provide the safest transfer or lift possible, we
may ask for your help and
may require additional time
to retrieve the equipment.
Your patience and
cooperation is
appreciated.

New pajamas and slippers

for your hospital stay
$100

Dozen roses to lift your

spirits
$50

Safe, quality care during your

hospital stay….PRICELESS!

35
 TY AND SE CURITY
SAFE
Fire Drills
NWTHS is required to stage drills for
fire and other emergencies. During
drills, audible alarms will sound and all
doors will automatically close. During
these drills please remain in your room
unless directed otherwise by members
of the hospital staff.

Cellular Phones
In an effort to ensure the safety and well being
of all our patients, the Hospital Safety
Committee has determined that cellular
telephones and radio transmitters should not
be used near critical care areas. Cellular
telephones must be turned completely off
because the devices transmit even in standby
mode. Contact your nurse with any questions
regarding the use of cellular phones.

Valuables or Lost Items

When temporary storage of valuable items is necessary, a
safe is available in the Admissions Office. Items stored in the
safe may be obtained between 8:00 a.m. - 7:00 p.m., Monday
through Friday and on Saturday and
Sunday from 8:00 a.m. - 6:00 p.m. The
hospital’s liability is limited.

Any home medications that are brought

into the hospital should be taken home once your care pro-
vider has collected information from the bottles. If this is not
possible, these medication will be stored in Pharmacy until
you are discharged.

Contact the Admitting Department regarding lost and

found articles.

36
37
 Be an active participant in the hand hygiene
process. It only takes a few simple words to help
encourage this healthy habit:

“Excuse me, did you clean your hands?”

- or -
“I saw that you cleaned your hands, thank
you!”

HAND HYGIENE
Proper hand hygiene is vital to controlling infections.
This is especially important while you are hospitalized
because of your weakened condition. Also, there is an
increase in antibiotic-resistant organisms present in any
hospital. Whenever possible, wash your hands with the
product provided next to your sink. It is very important
to cleanse your hands before eating and after using the
restroom. For your convenience to cleanse before
meals, you will find a sanitizing hand wipe on your meal
tray. Thank you for assisting us in protecting you from
infections.

38
 Tobacco Free Environment
For your health and the health of our
patients, visitors, employees, volunteers
and medical staff, NWTHS is a tobacco-
free facility. Please refrain from using all
tobacco products.
This affects both indoor and outdoor property as of January 8, 2008.

If you smoke, you should quit.

For help, Contact our
Tobacco Cessation Program
at
351-LUNG (5864)

39
www.nwtexashealthcare.com