n Speak Up, Plus 7 Key Ways to Take Charge of Your Care

n Choose a Support Personn Check IDsn Pay Attention to Your Caren 5 Ways to Fight Infectionsn Don’t Ignore Painn Prevent Fallsn Prepare for Surgery

Take Chargeof Your Care

Facts for Your Stay Plus! What Your Visitors Need to Know . . . . . . . . . . . . . . . 8Take Charge of Your Care 7 Easy Steps . . . . . . . . . . . . . . . . 13

On Our Cover

13

CONTENTSWELCOME . . . . . . . . . . . . . . . . . . . . . . 2

ABOUT US . . . . . . . . . . . . . . . . . . . . . . 3

PHONE DIRECTORY . . . . . . . . . . . . . . 4

OUR COMMITMENT TO CARE . . . . 5

RAPID RESPONSE TEAM . . . . . . . . . 7

FAST FACTS ABOUT YOUR STAY . . 8 Plus TV Channel Guide

SPECIAL SECTION . . . . . . . . . . . . . . . 13

ADULT VACCINES . . . . . . . . . . . . . . . 20

ADVANCE DIRECTIVES . . . . . . . . . . 21

HOSPITAL INFECTIONS . . . . . . . . . . 22

RIGHTS & RESPONSIBILITIES . . . . . 24

LEAVING THE HOSPITAL . . . . . . . . . 26

AFTER-HOSPITAL CARE . . . . . . . . . . 29

STAFF DEFINITIONS . . . . . . . . . . . . . 30

HOSPITAL RESOURCES . . . . . . . . . . . 32

SPOTLIGHT ON HEALTH . . . . . . . . . 33 Stop Smoking Heart Attack & Stroke Warning Signs Type 2 Diabetes

FOOD & MEDICATION SAFETY . . . 36

PATIENT PORTAL . . . . . . . . . . . . . . . . 39

GAMES . . . . . . . . . . . . . . . . . . . . . . . . . 40

The editorial content displayed here is the responsibility of PatientPoint. This material is for your educational use only. It does not contain, nor should it be construed as containing, medical advice. Talk to your doctor before making any lifestyle or treatment changes. Sponsors are responsible for the material provided, and your healthcare provider’s participation in the program does not represent an explicit or implied endorsement of any material presented. The people shown are models and are not known to have any health condition. Images are for illustrative purposes only. Image credits: Getty Images, iStockphoto. ©2016 PatientPoint®

2

Welcome

MISSION STATEMENTWe at Mary Black Health System – Spartanburg are dedicated to providing compassionate, high-quality health services to our community.

Thank You for Trusting UsThank you for choosing Mary Black Health System – Spartanburg to meet your healthcare needs. On behalf of our board, physicians, staff and volunteers, we welcome you to Mary Black. We are dedicated to providing you and your loved ones with quality, compassionate care.We recognize that being a patient in the hospital or visiting our outpatient services for diagnostic procedures can cause potential anxiety. Rest assured our experienced team is here to comfort and ease your fears. As part of that effort, we have created this Patient Guide to equip you with helpful information about what to expect during your stay or visit. If you have further questions, please do not hesitate to ask any member of our staff for assistance. Your satisfaction is important to us.Thank you for allowing us the privilege of serving you. Best wishes for your good health.Sincerely,Sean DardeauChief Executive Officer

Welcome

Mary Black Health System – Spartanburg is not responsible for the advertisements in this booklet. Mary Black Health System – Spartanburg makes no representation or endorsement of any kind related to the advertised services, entities, or businesses. Mary Black Health System – Spartanburg receives no remuneration in exchange for any advertisement. • Mary Black Health System – Spartanburg is directly or indirectly owned by a partnership that proudly includes physician owners, including certain members of the hospital’s medical staff. 082016

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About Us

Why We Are the Right Choice for Your CareMary Black Health System LLC is a healthcare delivery system comprised of Mary Black Health System – Spartanburg, Mary Black Health System - Gaffney, Mary Black Physicians Group, and Mary Black Health Network, Inc. The combined organization has 332 licensed beds, more than 1,400 employees and more than 400 physicians on medical staff. Providing healthcare services to Upstate residents for more than 90 years, Mary Black Health System – Spartanburg’s acute care hospital is accredited by The Joint Commission, The Society of Cardiovascular Patient Care (Chest Pain Accreditation), and is a certified Stroke Center. It features surgical suites, a warm and inviting Family Birthing Center, nationally credentialed (CARF) Inpatient Rehabilitation, a 24-bed Emergency Department, Intensive Care Unit, Geriatric Psychiatric Services, a Joint Care Program, Cardiology, and a Sleep Center. Outpatient services include Radiology, Endoscopy Center, a Wound Care and Hyperbaric Center, Rehabilitation Services and Women’s Breast Health Center featuring same-day digital mammography and bone density testing. We are a patient-centered, professional, highly skilled healthcare system that provides a continuum of care through the dedicated work of our nurses, staff, and volunteers. For more information, visit MaryBlackHealthSystem.com.

CONTACT US

1700 Skylyn Dr.

Spartanburg, SC 29307

864-573-3000

www.MaryBlackHealthSystem.com

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For more information on the resources available at Mary Black Health System – Spartanburg, visit MaryBlackHealthSystem.com.

Phone Directory

Key NumbersMain: 864-573-3000 | Patient Information/Lobby: 864-573-3000 Hospital Billing: 1-844-480-6688 | Physicians Group Billing: 864-253-8080 Gift Shop: 864-573-3182 |

Calling from INSIDE the hospital? Dial the last four digits only.

OTHER HOSPITAL SERVICESAdmitting 864-573-3814 Medical Records 864-573-3840

Birthing Center 864-573-3005 Patient Advocate 864-573-3237

Breastfeeding/ Lactation Consultant 864-573-3011

Patient Portal Help Line (Hospital

Records) 1-877-456-9617

Case Management 864-573-3062 Patient Rooms 573-3000 (switchboard)

Center for Rehabilitative

Medicine 864-573-3081 Senior Circle 864-573-3921

Environmental Services 864-573-3951 Sleep Center 864-573-3164

Geriatric Psychiatric Services 864-573-3725 Volunteer Services 864-573-3941

Healthy Woman 864-253-8114Women’s

Mammogram Scheduling

864-573-3245

Joint Care Program 864-216-4709 Wound Care & Hyberbaric Center 864-573-3633

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Our Commitment to Care

MAKING A DIFFICULT HEALTHCARE DECISION?Sometimes a healthcare choice can involve an ethical concern—such as a wish to refuse life-saving treatment or a disagreement over advance directives (see p. 21). Our Bioethics Committee can help your team of support people make difficult decisions. For help, call 864-573-3387.

How are we doing?

Explain things more clearly

Ease your pain

Help you understand your medicine plan

Respond quicker to your needs

We want you to be satisfied with your care. To help,

speak up if we can …

Help keep your room clean or quiet

How are we doing?

Patient Satisfaction Matters to UsHow’s your stay? Are you getting the care you need? Are your doctors and nurses listening and responding to your questions or requests? Our goal is to provide the best quality care. To do so, we ask for feedback from patients like you.

During Your Stay Please speak with your nurse or nursing supervisor if you have any questions or concerns about your care. If your issue is still not resolved, you may:

n Contact the Patient Advocate Line at 864-573-3237.

n File a complaint with your state or Quality Improvement Organization (QIO). See Rights and Responsibilities p. 25 for contact information.

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Our Commitment continued

After Your Stay Once you leave our care, we will continue to seek your feedback through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. This survey is designed to be a standardized tool for measuring and reporting satisfaction across all hospitals in the U.S.After you are released from the hospital, you may be selected to participate in the HCAHPS survey. The telephone survey asks multiple choice questions on key care topics, such as: n doctor and nurse communication n medicine and discharge information n pain management and staff responsiveness n overall quality of the hospital environment

The HCAHPS survey is backed by the U.S. Department of Health and Human Services. The survey is used to improve the quality of healthcare. HCAHPS makes survey results public so hospitals are aware of where changes are needed. The results also enable healthcare consumers to review and compare hospitals before choosing a healthcare provider.

Want to Know How We Score?You can review and compare the quality, care and safety ratings for different hospitals at:n Medicare Hospital Compare, uses HCAHPS results and

other data: www.medicare.gov/hospitalcompareYou also can find information on hospitals through these accrediting organizations:n Healthcare Facilities Accreditation

Program (HFAP): www.hfap.orgn The Joint Commission:

www.qualitycheck.org

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Rapid Response TeamSpecial Support to

Prevent Emergencies

WHEN to Call Rapid Response

Step 1: Dial 0 on bedside phone.Step 2: Tell the operator: your name, room number, patient’s name and your concern.Step 3: The Rapid Response Team will be sent to your room.

HOW to Call Rapid Response

Call for help if you notice: n changes in heart rate or drop

in blood pressuren change in respiratory

(breathing) rate or oxygen levels

n changes in urine output (much more or less urine)

n change in mental status or level of consciousness

n any time you are worried something might be wrong

n any change in the patient’s condition that needs immediate attention and the healthcare team is not responding, or if you continue to have serious concerns after speaking with the healthcare team

During your stay, you have access to a special service called the Rapid Response Team. You can call this service, and a critical-care team will check on you or your loved one and provide help before there is a life-threatening emergency.

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Fast Facts About Your Stay

VISITING THE HOSPITAL?Thanks for taking the time to support your loved one’s care and recovery. See p. 11 for important visitor information.

An A-Z Guide to the Most Frequently Asked QuestionsATMFor your convenience, an ATM is located in the dining room.

CafeteriaLocation: First floor near the main hospital Visitors are welcome to dine in the cafeteria.

Calling Your NurseA nurse call button is located at each bed. To call your nurse, simply push the button and it will notify the nurses’ station that you need help. The call can be answered through an intercom system that allows you to speak with someone at the nurses’ station.

All patient restrooms have either a nurse call cord or a nurse call button. Pulling the cord or pushing the button will automatically notify the nurses’ stations.

CellphonesWe ask you to please refrain from talking on your cellphone while your physician is in the room discussing treatment so we can provide the best care possible.

Guest MealsGuest trays may be purchased through the Admitting Office. Please call 864-573-3894. Discounts apply for Mary Black Senior Circle members. Call 864-573-3921 for details.

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Hearing Impaired and Interpreter ServicesMary Black offers the following services for patients with special communication needs. Please contact your nurse to request any of these services:n A telephone device for the hearing

impaired (TDD)n Closed caption for the hearing

impairedn Accessible rooms and elevators

for the disabledn Telephone amplification devices

for individual phonesn Access to sign language

interpretersn Access language translation

servicesAll phones are hearing aid compatible.

Housekeeping ServicesPatient satisfaction is the main focus of the housekeeping staff. We are dedicated to going the extra mile for our patients, visitors and staff. Please ask your nurse to contact the housekeeping member responsible for your room if you have any concerns or requests.

InternetWe offer free wireless service. To access, select “Guest Wireless Access” from your wireless network settings.

Mail and FlowersA volunteer will deliver mail and flowers to you. Please note that flowers are prohibited in intensive care units and there are restrictions, including no glass, for patients on Tower 7. You may take outgoing mail to the nursing station or give it to your attending nurse. Postage stamps are available in the gift shop.

Notary PublicIf you need a notary public while a patient at Mary Black, please contact the switchboard at 864-573-3000.

ParkingMaternity patients and visitors, please use the main parking lot and hospital entrance. Preregistration is located at the North Wing Entrance (Patient Access—11 Doctors Park Drive).

Patient MealsPatients on special diets should refrain from eating food from outside the hospital or from the hospital’s vending machines. Your physician will determine the diet most suitable for you. Within the limitations of this diet, you may use the selection sheet provided

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Facts About Your Stay continued

to you each day to select your own menu. You may ask your nurse or a dietitian to help. During your hospital stay, we want your meals to be enjoyable. If you have problems or requests with your meals or questions about your diet, please call the Food Services Office at 864-573-3894.

Personal Belongings and ValuablesIf you have valuables, such as jewelry and cash, please give them to a relative or friend to take care of during your stay. Store contact lenses, eyeglasses, hearing aids and dentures in your bedside stand when not in use. Please do not put them on your bed or food tray. They may be damaged or lost. Mary Black Hospital is not responsible for replacement of personal belongings.

Public RestroomsPlease do not use the bathrooms in patient rooms. They are reserved only for patients in order to protect their health. Public restrooms are located throughout the hospital.

SmokingSmoking and/or the use of any tobacco products is not permitted anywhere in the hospital or on hospital grounds. This includes the use of electronic cigarettes.

TelephoneTo place a local call, dial 90, wait for a dial tone and dial the desired number. There are two ways to place a long-distance call from your room. To make a collect call, dial 90, listen for a dial tone, dial 0, area code and the number you wish to call. To make a calling card call, dial 90, listen for a dial tone, and follow the instructions for placing a long-distance call. You cannot charge long-distance telephone calls to the hospital, and the hospital will not accept incoming collect calls for patients.

TVEach patient room has a TV. Labor and Delivery patients can enjoy the Newborn Channel on Channel 2.

Vending MachinesVending machines offering beverages and snacks are located next to the cafeteria. They are available 24 hours a day, seven days a week.

Visitor GuidelinesWe encourage visitors for emotional support and recovery. View specific patient rights and responsibilities regarding visitors on p. 24. To provide a restful and safe environment, we ask that all visitors comply with the following guidelines:n Be considerate of other patients

by keeping noise to a minimum.n Refrain from visiting if you

have a cold, sore throat or any contagious disease.

11

n Observe no visiting and precaution signs before entering the room.

n Do not smoke.n Leave the room during tests or

treatments if asked.n Limit visitors to two people at

one time.n Limit one visitor overnight.n Visitors are allowed based on

patient’s condition.

Waiting RoomsWaiting rooms are conveniently located throughout the hospital,

including the main lobby area and surgery areas.

Your RoomPlease ask your nurse for help in adjusting the thermostat that controls the temperature in your room. Bed rails are on each bed and will be used when your safety is involved (especially at night and after sedatives have been administered). Do not lean out of bed to reach for items on the bedside table or on the floor.

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2 Newborn Channel 23 CNBC 44 ABC Family

3 CBS 24 MSNBC 45 Travel Channel4 NBC 25 TNT 46 truTV5 CW 26 TBS 47 Comedy Central6 ABC 27 FX 48 E!7 FOX 28 USA 49 Disney Channel8 PBS 29 A&E 50 Nickelodeon9 MyTV 30 AMC 51 Cartoon Network

10 Weather Channel 31 Bravo 52 Animal Planet

11 ESPN 32 Oxygen 53 Discovery Channel12 ESPN2 33 TLC 54 MTV13 FS South 34 SPIKE TV 55 VH114 SportSouth 35 Syfy 56 CMT

15 Charter Sports SE 36 Food Network 57 BET

16 Fox Sports 1 37 History 58 OWN17 Golf Channel 38 Lifetime 59 Univision 18 MLB Network 39 Hallmark Channel 60 National Geographic

19 NBC Sports Network 40 HGTV 61 ION

20 Fox News Channel 41 GSN 62 Investigation Discovery

21 CNN 42 TCM22 HLN 43 TV Land

Facts About Your Stay continued

TV CHANNELS

Quick Quiz! By the age of 65, how many years of the average American’s life is spent in front of the TV?o 2 years o 5 years o 9 years o 12 years

Answer: With 4 hours of viewing each day or 28 hours a week, by age 65 TV-viewing time can equal roughly 9 years!

??

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Take Chargeof Your Care

Is there anything else the hospital should be aware of to improve my care experience?

Ask Yourself

During your stay, our doctors, nurses and staff will treat you and your family as partners in your care. One important way that you can be involved is to speak up. Ask questions, voice your concerns, and don’t be afraid to raise any issues relating not only to your care and treatment, but also to overall hospital services.In the pages that follow, you’ll find a step-by-step guide to making the most of your hospital stay—steps for taking charge of your care, getting the information you need, asking questions and interacting with hospital staff.

You are the center of your healthcare team. Let this special guide help you get the best results from your hospital stay.

Speak Up!

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7 Key WaysTO TAKE CHARGE OF YOUR CARE

Source: The content within the “Take Charge of Your Care” section reinforces the safety and quality care goals and standards issued by The Joint Commission and other hospital accreditation organizations.

TAKE CHARGE OF YOUR CARE continued

SPEAK UP. Ask questions and voice concerns. It’s your body, and you have the right to know.

PAY ATTENTION. Always double-check that you are getting the right treatments and medicines from the right hospital staff.

EDUCATE YOURSELF. Learn about your medical condition, tests and treatment options, so you know why following your care plan is so important.

FIND A SUPPORT PERSON. Pick someone to help speak up for your care and needs during your stay.

KNOW YOUR MEDS. Understand what your medicines treat, why you need them and how to take them for the best results.

CHECK BEFORE YOU GO. Make an informed decision when selecting additional healthcare services. Choose only accredited providers who meet patient safety and quality standards. Go to www.qualitycheck.org to learn more.

PARTICIPATE IN YOUR CARE. You are the center of your healthcare team. Make sure you know what’s happening every step of the way—from admission through discharge.

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Choose a Support PersonA trusted friend or family member can be a big help during your hospital stay. Select one key person to be your healthcare advocate. If you become stressed or your ability to communicate changes, this person can stand in for you—and stand up for your care.

A support person can:n ask questions you might not

think of and write down information

n double-check your medicines and treatments

n watch for signs your condition is getting worse and ask for help Don’t forget to tell the staff who

you’ve picked to be your support person.

Check IDsWhile you are here, many people will care for you (doctors, nurses, aides, attendants), and these same people will care for many patients. To prevent errors in your care: Ask to see the ID of everyone who comes into your room, so you

know the name and job of the person caring for you. If you do not see an ID badge, contact your nurse immediately.

Speak up if hospital staff does not check your ID. Any time staff enters your room to give you medicine, transport you, or perform procedures or treatments, state your name and birth date.

This may seem repetitive at times, but it helps ensure you receive the correct care.

Always double-check your name with staff to avoid errors.

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TAKE CHARGE OF YOUR CARE continued

Ask About Jargon: If you hear a medical term you don’t understand, ask what it means.

“Teach Back”: After you get instructions or an explanation, repeat back what you thought you heard so you can double-check that you understood.

Take Notes: Write down any key facts your doctor tells you so you won’t forget.

And Remember, Take Charge of Your Communication

Pay Attention To Your Caren Tell your nurse if

something doesn’t seem right.

n Know what time you normally get medicine, and tell your nurse if you don’t get it.

n Request drawings or illustrations to help you learn about your condition.

n Read and understand all medical forms before signing. Ask if you need information explained.

n If your treatment involves medical equipment, practice using it with your nurse before you leave the hospital.

n Don’t be afraid to ask for a second opinion. The more information you have, the better you will feel about making decisions.

n Talk to your doctor and family about whether you want life-saving actions taken.

You Are KeyYou are the most important member of your healthcare team.

Understand your treatment

Ask questions

Speak up about pain

Know your medicines

Plan early for a successful discharge

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Some infections can spread easily, so staff and visitors may be asked to wear isolation clothing like gowns and masks. Your doctors or nurses also may take extra precautions. This is the best way to reduce

the spread of these infections.

5 Ways to Fight InfectionsThe hospital is a place you come to get well, but you also can come in contact with germs that can make you feel worse. Ask friends and family not to visit if they are sick. You also can reduce your chances of infection by taking the following safety precautions:

1 Clean your hands. n after touching hospital

objects or surfaces n before and after eating n after using the restroom

2 Ask hospital staff members to clean their hands. We ask that all staff members clean their hands when entering and exiting your room. This should be standard practice, but don’t be afraid to remind them if they forget or to ask them to wear gloves when touching you. Ask visitors to clean their hands too!

3 Cover your cough if you are sick. If you are sick or have an infection, limit this spread of germs by sneezing and coughing into tissues, promptly throw them away and avoid touching others. Ask the staff if there is anything else you should do—like wear a surgical mask — to prevent the spread of germs.

4 Keep an eye on bandages or dressings. If a bandage or dressing covering a wound, incision or IV site becomes loose, wet or painful, notify your nurse. Also if you have a catheter or drainage tube, tell your nurse if it becomes loose or dislodged.

5 Keep your vaccinations up-to-date. Make sure you are as protected as possible from the spread of infection. Check with hospital staff about whether it’s safe for you to receive any vaccines you might need.

No Soap? No Problem.Alcohol-based hand cleaners are as effective as soap and water for killing most germs. To use, apply the cleaner to the palm of your hand, and run your hands together. Keep rubbing over all the surfaces of your fingers and hands until they are dry.

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TAKE CHARGE OF YOUR CARE continuedTAKE CHARGE OF YOUR CARE continued

Don’t Ignore PainNo one knows how much pain you are in but you. Tell your doctor or nurse when pain strikes or if it comes back again after it goes away. Talk about your pain level throughout the course of your stay.

Ask yourself, then share with your nurse.n Where does it hurt?n When does it hurt?n Does it keep you from doing things—like sleeping, dressing, eating?

How bad is it on this pain scale?

You’re the Expert on Your Pain

0No

Hurt

2Hurts

Little Bit

4Hurts

Little More

6Hurts

Even More

8Hurts

Whole Lot

10HurtsWorst

*Copyright 1983, Wong-Baker FACES® Foundation, www.WongBakerFACES.org. Used with permission.

Wong-Baker FACES® Pain Rating Scale

q aching q bloating q burning q comes and goesq constant

q cramping q cuttingq dull q numbing q pressing

q pressure q pulling q radiating q searingq sharp

q shootingq soreness q stabbing q throbbing q tightness

Which words describe your pain?

Starting to get uncomfortable? Pain medicine not working? Speak up. You may need to get more of the current pain medicine you are on or switch to a different kind of medicine to get relief. Don’t try to ignore painful symptoms. Managing your pain will help with your healing process. Talk to your doctor or nurse when pain strikes.

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TAKE CHARGE OF YOUR CARE continued

Prevent FallsWhile you are here, you may feel dizzy or weak. Illness, procedures, medicines or even just lying down for too long can make you less steady on your feet. To keep yourself safe:n Use the nurse call button for help getting out of bed.n Your nurse may give you a colored wristband that lets the staff know

you might need special assistance to keep you safe from falling. n Ask for help going to the bathroom or walking around. (And use

hospital handrails when they’re available.)n Wear nonslip socks or footwear.n Keep often-used items within easy reach (glasses, remote, tissues, etc.).n Make sure your wheelchair is locked when you get in or out of it. Never

step on the footrest.n Make sure your robe or pajamas don’t drag on the floor. They can cause

you to trip.n Ask your nurse to show you how to properly walk with your IV pole,

drainage bags or any other equipment. n If you see a spill on the floor, report it immediately. Patients of all ages are at risk for falls. It’s better to be extra careful than risk another medical problem.

Ask your surgeon to take a “time out” to check: you’re the right person, getting the right surgery, on the right body part.

TAKE CHARGE OF YOUR CARE continued

Prepare for SurgeryBefore your procedure, make sure you and your surgical staff confirm:n your namen the type of surgery you are havingn the body part to be operated on—In fact,

hospital staff will mark the correct spot on your body. Make sure you or your support person checks that it’s correct.

Take simple steps like these to help prevent medical mistakes.

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Adult Vaccines Which Vaccines You Need to Protect Your Health

Vaccines work with your immune system to help protect you from infections and disease. As you age, you’re more at risk of certain health conditions because your immune system isn’t as strong as it used to be. And if you do get sick, the symptoms can be more serious than when you were younger.

Three types of vaccines are especially important for older adults, including:

Influenza Vaccine—The flu vaccine is recommended for all ages every year, and there is a higher-dose vaccine for adults older than 65. You need the vaccine every year because the flu virus changes over time.

Zoster or Herpes Zoster Vaccine—This vaccine protects against shingles. It’s one dose and is recommended for all adults age 60 and older. Shingles causes rash, blisters and severe pain.

Pneumococcal Vaccines—Recommendations recently changed for pneumonia vaccines. Even if you already received one vaccine, you may still need another. Talk to your doctor about the vaccination schedule that’s right for you.

Pneumococcal conjugate or PCV13: You need one dose of this vaccine if you are age 65 or older and didn’t receive it at a younger age. It’s best to get this one before the PPSV23 vaccine (see below). Wait at least 12 months if you receive the PPSV23 first.

Pneumococcal polysaccharide or PPSV23: If you are age 65 or older, you need one dose of this vaccine, ideally 6 to 12 months after receiving the PCV13 vaccine (see above).

Talk to Your DoctorYour doctor is your best source for information about vaccines. Which vaccines are right for you depend on your age, other health conditions you have (including pregnancy) and where you travel.

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FILL OUT YOUR FORMSMake sure you submit advance directives each time you go to the hospital, so your most current information and wishes are on file. You do not need a lawyer to fill these out. For more information and to obtain the forms you need, contact your Case Manager at 864-573-3062.

Advance Directives

A Simple and Smart Way to Take Charge of Your Care

One of the most important decisions you can make about your care is to fill out advance directives in case you can no longer speak for yourself. Advance directives are documents that let others know your wishes about the type of care you want. And they will only be used if you become unconscious or too ill to communicate yourself.Different states have different laws about advance directives. Check with your Admissions department or nurse if you have any questions. Directives can include:

Living Will This set of instructions explains the type of life-prolonging medical care you wish to accept or refuse. It can include your wishes about the use of resuscitation (CPR) if your heart stops, a ventilator if you stop breathing, or feeding tubes or IVs if you cannot eat or drink.

Durable Power of Attorney for Healthcare This is a legal document that names your healthcare proxy—someone who can make medical decisions for you if you’re unable to do so. An official healthcare proxy can represent your wishes on emergency care but also on other medical issues like potential treatment options, blood transfusions, kidney dialysis, etc. Choose someone you trust, discuss your medical wishes, and make sure the person agrees to represent you in this role.

Healthcare Surrogate A person (agent) appointed to make medical decisions on your behalf if you are unable to do so. This person is sometimes chosen by patients themselves, or, depending on state regulations, may be chosen by the patient’s doctor in certain circumstances. If you are choosing your own healthcare surrogate, choose someone you know well and trust to represent your preferences. Be sure to discuss this with the person before naming him or her as your agent.

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Prevent Hospital InfectionsTake Steps to Reduce Your Risk During Your Stay

INFECTION HOW IT STARTS

Catheter-Associated Urinary Tract Infections (UTI)

Surgical Site Infections

Central Line-Associated Bloodstream Infections

Ventilator-Associated Pneumonia

Germs enter your urinary tract while using a tube to drain urine

Germs affect the site of your surgery—either on your skin or internally

Germs enter your bloodstream through a large tube that’s inserted in a vein near your neck, chest or groin

Germs enter your lungs through a tube in your mouth, nose or neck used to help you breathe

According to the U.S. Department of Health and Human Services, 1 in 25 patients gets a healthcare-associated infection while staying at the hospital. Often, these happen because hospital procedures and equipment can expose internal parts of your body to germs. The chart below lists common infections and steps you can take to prevent them.

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SYMPTOMS PREVENTION

n fevern burningn painn bloody or

frequent urination

n rednessn painn drainage of

cloudy fluidn fever

n red skin and soreness at site

n fevern chills

n coughn mucusn fevern chillsn shortness

of breath

n clean hands before touching arean keep urine bag below level of bladder to

prevent backflow n don’t tug, pull, twist or bend the tube n secure catheter to your leg and ask every day

if it’s still needed

n do not shave surgery site (irritation increases risk of infection)

n clean hands before touching arean don’t let visitors touch or dress your woundn ask your nurse to show you how to care for

your wound

n clean hands before touching arean make sure staff wear gloves, gown, cap, mask

and sterile drape when handling tuben speak up if your bandage comes off, looks wet

or dirty, or if your skin looks soren avoid touching tube or letting visitors

touch tuben ask that tube be removed as soon as possible

n clean hands before touching arean ask if it’s safe to raise the head of your bedn know how often the inside of your mouth

needs to be cleaned and speak up when it hasn’t happened

n ask that the tube be removed as soon as possible

SuperbugsSuperbugs are strains of bacteria that are resistant to several types of antibiotics. For many years, antibiotics have been prescribed to people around the world for unnecessary reasons. The overuse of antibiotics helped to create these resistant superbugs; examples include MRSA, VRE, ESBLs and C. diff. These superbugs can be spread from person to person by touch or from contaminated objects on surfaces. They also can survive for long periods of time on hands and other surfaces. Remember to only take antibiotics when prescribed by your doctor. Protect yourself by taking these steps below, and lastly, always remember to wash your hands and ask everyone you see during your stay to wash his or her hands, too.

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Rights & Responsibilities

You Have the Right To: Be treated in a dignified and respectful manner and to receive reasonable responses to reasonable requests for service

Effective communication that provides information in a manner you understand, in your preferred language with provisions of interpreting or translation services at no cost, and in a manner that meets your needs in the event of vision, speech, hearing or cognitive impairments; information should be provided in easy to understand terms that will allow you to formulate informed consent

Respect for your cultural and personal values, beliefs and preferences

Personal privacy, privacy of your health information and to receive a notice of the hospital’s privacy practices

Pain management Accommodation for your religious and other spiritual services

Access, request amendment to and obtain information on disclosures of your health information in accordance with law and regulation within a reasonable time frame

Have a family member, friend or other support individual to be present with you during the course of your stay, unless that person’s presence infringes on others’ rights, safety or is medically contraindicated

Care or services provided without discrimination based on age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, and gender identity or expression

Participate in decisions about your

care, including developing your treatment plan, discharge planning and having your family and personal physician promptly notified of your admission

Select providers of goods and services to be received after discharge

Refuse care, treatment or services in accordance with law and regulation and to leave the hospital against advice of the physician

Have a surrogate decision-maker participate in care, treatment and services decisions when you are unable to make your own decisions

Receive information about the outcomes of your care, treatment and services, including unanticipated outcomes

Give or withhold informed consent when making decisions about your care, treatment and services

Receive information about benefits, risks, side effects to proposed care, treatment and services; the likelihood of achieving your goals and any potential problems that might occur during recuperation from proposed care, treatment and service and any reasonable alternatives to the care, treatment and services proposed

Give or withhold informed consent to recordings, filming or obtaining images of you for any purpose other than your care

Participate in or refuse to participate in research, investigation or clinical trials without jeopardizing your access to care and services unrelated to the research

Know the names of the practitioner who has primary responsibility for your care, treatment or services and the names of other practitioners providing your care

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Formulate advance directives concerning care to be received at end-of-life and to have those advance directives honored to the extent of the hospital’s ability to do so in accordance with law and regulation; you also have the right to review or revise any advance directives

Be free from neglect; exploitation; and verbal, mental, physical and sexual abuse

An environment that is safe, preserves dignity and contributes to a positive self-image

Be free from any forms of restraint or seclusion used as a means of convenience, discipline, coercion or retaliation; and to have the least restrictive method of restraint or seclusion used only when necessary to ensure patient safety

Access protective and advocacy services and to receive a list of such groups upon your request

Receive the visitors whom you designate, including but not limited to a spouse, a domestic partner (including same sex domestic partner), another family member, or a friend. You may deny or withdraw your consent to receive any visitor at any time. To the extent this hospital places limitations or restrictions on visitation; you have the right to set any preference of order or priority for your visitors to satisfy those limitations or restrictions

Examine and receive an explanation of the bill for services, regardless of the source of payment

You Have the Responsibility To: Provide accurate and complete information concerning your present medical condition, past illnesses or hospitalization and any other matters concerning your health

Tell your caregivers if you do not completely understand your plan of care

Follow the caregivers’ instructions Follow all medical center policies and procedures while being considerate of the rights of other patients, medical center employees and medical center properties

Regarding Problem Resolution, You Have the Right To:Express your concerns about patient care and safety to hospital personnel and/or management without being subject to coercion, discrimination, reprisal or unreasonable interruption of care; and to be informed of the resolution process for your concerns. If your concerns and questions cannot be resolved at this level, contact the accrediting agency indicated below:South Carolina Department of Health and Environmental Control (DHEC)2600 Bull St.Columbia, SC 29201800-545-4370

Kepro5201 W. Kennedy Blvd., Suite 900Tampa, FL 33609844-455-8708 Fax: 844-834-7129

Office of Quality and Patient Safety The Joint Commission One Renaissance Blvd. Oakbrook Terrace, IL 60181 800-994-6610 Email: patientsafetyreport@jointcommission.org

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A successful recovery after your stay starts with a solid plan before you go.

A Reason To Plan Early If you need a rehabilitation facility, nursing home, skilled care or other service after your stay, you’ll need time to find and weigh your options. For help comparing services in your area, go to:

n www.medicare.gov/nursinghomecomparen www.medicare.gov/homehealthcomparen www.qualitycheck.org

Before You Leave the Hospital

Plan Early to reduce your chances of being readmitted and increase your chances for a healthy recovery. Take steps as soon as possible during your stay to plan for a successful transition from the hospital.To begin, ask your nurse to have your discharge planner contact you to review the following: n your discharge plan n your complete medicine list and instructions n your upcoming appointments n what to do if you don’t feel well

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Checklist for DischargeMake sure you have the following information before you leave the hospital.

p Discharge summary. This includes why you were in the hospital, who cared for you, your procedures and medicines.

p Medicine list. This includes all your new and former prescriptions, over-the-counter medicines, vitamins and supplements. Ask if there are any medicines you can stop taking or that are not good to take together. Also make sure you know why, how and when to take each one.

p Prescriptions. Check that your pharmacy has your new prescriptions and that you have a plan to get them filled.

p Follow-up care instructions. Beyond medicine, this can include: n foods or activities to avoid n tests or appointments n how to care for incisions or

use equipment

p After-hospital services. Know how much support you’ll need in these areas:

n Personal care: bathing, eating, dressing, toileting n Home care: cooking, cleaning, laundry, shopping n Healthcare: taking your medicines, doctor’s appointments,

physical therapy, wound care, injections, medical equipment

p Local Resources. Ask your discharge planner for help finding local after-care services or other support groups.

Try the teach back method. Repeat back what you hear the discharge planner say to make sure you understand the details correctly.

n warning signs to watch forn daily living adjustments

(like how to get into bed)n who to call with questions

A successful recovery after your stay starts with a solid plan before you go.

You have the right to appeal your discharge if you don’t agree with the decision that you are ready to leave the hospital. Speak with your discharge planner or physician and share your concerns. You also may need to reach out to Medicare, Medicaid or your insurance company.

Not Ready To Leave?

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Top 10 Questions to Ask Before Discharge

If you need durable medical equipment (walker, wheelchair, hospital bed, oxygen, etc.), Medicare will only cover the cost if you use an approved supplier. To find one in your area, visit www.medicare.gov and select “Find suppliers of medical equipment and supplies” or call 1-800-MEDICARE (800-633-4227).

Need Medical Equipment or Supplies?

Before You Leave continued

1. What number can I call 24 hours a day if I have questions or concerns? Who is my contact?

2. Has my follow-up appointment been scheduled? With whom? Do I have a ride there?

3. What are key warning signs I need to watch out for? Whom do I call if they happen?

4. What special equipment do I need? What special instructions do I need (wound care, injections, etc.)?

5. What kinds of activities and foods are limited? For how long?

6. Do the doctors caring for me after my stay have access to my test results and medicines? Do I need follow-up tests?

7. Are my new medicines safe to take with my other medicines, vitamins or supplements?

8. Do I know how and when to take my medicines and how I will get prescriptions filled?

9. Who will provide the extra personal, home or healthcare services I may need?

10. Who can help me if I have concerns about medical costs?

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After-Hospital Care Quick Guide to Recovery

Options for After Your Stay

Contact your health insurance, Medicare or Medicaid to find out what care and services are covered for you, and to obtain help with costs.

After-hospital care that fits your needs is important. Make sure you understand what your hospital staff recommends for you.

Home Healthcare—Care provided by professionals in your home to help maintain or restore health. Includes: home care services such as housekeeping and meal preparation; personal care services such as bathing, dressing or eating; and healthcare services such as physical therapy or skilled nursing.

Independent Living— Communities with individual, private apartments or homes. Includes: meals, housekeeping, maintenance, social activities and possibly transportation.

Assisted Living—Individual units or apartments, usually in a long-term care facility. Includes: home and personal care services, as well as help managing health conditions

and medicine routines—plus social activities and transportation. Medical staff is on-site 24 hours.

Nursing Home—Long-term care facility for individuals who don’t need a hospital, but can’t be cared for at home. Includes: all daily living and personal care services, 24-hour skilled nursing care, plus social activities and events. Special units often available for people with Alzheimer’s disease or memory loss.Some nursing homes also offer short-term rehabilitative stays for patients recovering from an injury or illness.

Hospice—Care program that provides support for terminally ill patients and families in hospitals, facilities or homes, depending on the patient’s condition. Includes: 24-hour help with pain control, symptom management and emotional or spiritual support.

To get started evaluating or finding after-hospital care resources in your area, visit: n Eldercare Locator www.eldercare.gov n National Respite Network and Resource Center www.archrespite.org

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Mary Black Health System (MBHS)supports the education and development of clinical trainees, such as resident physicians, medical students, nursing students or licensed professionals, whose training includes the personal care or medical treatment of patients. Clinical trainees perform their duties under the supervision of an instructor, preceptor, physician or other professional healthcare provider within the scope of their practice for their education and experience. All clinical trainees will be clearly identified by wearing badges that clearly state their name, school and title.

Your attending physician is the person responsible for your care while you are in the hospital. The attending physician may change during your hospital stay, depending upon the type of care or services required for your care. Medical students, interns or residents may be involved in making treatment decisions or participating in invasive procedures. Some attending physicians work closely with a physician assistant or nurse practitioner (allied health professional). In this instance, these professionals would be making treatment decisions and participating in your care. Allied health professionals are licensed and credentialed by the hospital.

It is your right at any time during your hospital stay to discuss your personal medical care with your attending physician. Upon request, a nurse will provide you with your attending physician’s phone number and assist in placing the call. If you are unable to make a personal call, upon request, a nurse will call your attending physician to inform him or her or a designee of your concern and your need for one-on-one communication. In addition, you may request at any time to speak with a MBHS department manager or supervisor to discuss concerns about your treatment plan or hospital care. If at any time you feel you need immediate assistance, dial 0 from your bedside phone. The hospital operator will ask for caller identification, room number, patient name and patient concern.

Staff Definitions

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We Are Here to Serve You. If at any time during your stay you have a question about who is caring for you, or you need help for any reason, please ask. A staff member will find the right person to provide you with the care you need.

Case Managers and Social WorkersCase managers will review your medical record and discuss your discharge planning, and can assist you with arranging after-hospital care. Social workers offer counseling and guidance to help you and your family deal with financial, social and emotional problems related to your illness or hospitalization.

ChaplainVolunteer chaplains are available to all patients and families. Please contact your nurse to request a chaplain. A chapel is located in front of the tower elevators on the first floor.

DietitiansA registered dietitian will develop a nutrition care plan for you. They also are available to educate you about diets you may need to follow after you are discharged. Ask your nurse to contact a dietitian if you would like more information.

HospitalistsHospitalists work in close consultation with your primary care physician and specialists. They manage your hospital experience from admission until discharge.

NursesA registered nurse is responsible for supervising patient care and directing the nursing and support staff of each unit. Registered nurses are assisted by nursing assistants and nurse technicians.

PharmacistsWhile you are in the hospital, all of your medications are dispensed by our hospital pharmacists. They can answer any questions you have regarding your medications.

PhysiciansYour primary care physician or a hospitalist will supervise your care while you are in the hospital.

Rehabilitation TherapistsPhysical therapists, occupational therapists and speech pathologists will work with you, your family and your medical team to help meet goals of recovery.

Technicians and TechnologistsSkilled health professionals perform and assist with laboratory and other procedures, including X-rays, mammograms, ultrasounds, CT scans, MRIs, cardiac catheterizations and other procedures that help in diagnosing and treating your illness or injury.

VolunteersVolunteers provide support throughout the hospital and give thousands of hours each year to enhance the care of patients and their families. If you are interested in becoming a volunteer, please call 864-573-3941.

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Hospital Resources

Quit SmokingMary Black Memorial Hospital offers one-on-one coaching (phone or web-based counseling and support) and development of a personalized quit plan.

For information on how to quit smoking:1-800-QUIT-NOW1-800-784-8669www.scdhec.gov/Health/ TobaccoCessation/ TobaccoQuitline/ CalltheQuitlineNow/

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SPOTLIGHT ON HEALTH

Stop SmokingReduce Your Chances of Returning to the Hospital

1. Fight the Urge Don’t let yourself think that you can have just one cigarette, but if you do slip, start again and make tomorrow your new first day to quit.

2. Get Moving Exercise is a good way to keep your mind off cigarettes. The longer you go without smoking, the better you can breathe and the easier it will be to exercise.

3. Keep Your Mouth Busy Try toothpicks, celery, sugarless gum or sugar-free lollipops.

3 Tips to Help You Quit

No matter how long you’ve been a smoker, it’s never too late to quit this unhealthy habit. The benefits start right away and last a lifetime:n 20 MINUTES after quitting, your

heart rate and blood pressure drop.n 2 WEEKS TO 3 MONTHS after

quitting, your circulation improves and your lungs work better.

n 1 YEAR after quitting, your risk of heart disease is half that of a smoker’s.

n 5 YEARS after quitting, your risk of mouth, throat, esophagus and bladder cancers is cut in half.

n 10 YEARS after quitting, your risk of lung cancer is half that of a smoker’s.

n 15 YEARS after quitting, your risk of heart disease is the same as a nonsmoker’s.

Ready, Set, Quit! Now that you’ve decided to quit, take it one day at a time. Remind yourself that you are in control—you can choose to smoke or not. Be prepared to have nicotine cravings. They usually pass soon, so wait it out. The good news is that they become weaker and less frequent the longer you go without smoking. When a craving hits, take a walk, call a friend or do something else you enjoy.If you need help quitting or coping with cravings while you’re here, contact your nurse to talk to your doctor to consider medications to help reduce cravings. Free nicotine patches, gum, or lozenges are available to eligible South Carolinians who enroll in Quitline services.

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SPOTLIGHT ON HEALTH

Heart Attack & Stroke Warning SignsRecognize the Signs and Get Help Quickly A heart attack or stroke is a medical emergency and every second counts. The faster you or a loved one recognizes the symptoms and gets help, the better your chances of surviving, with the least amount of damage to your heart or brain. Once you’ve had an event, you’re at greater risk of having one in the future, but the symptoms of a second event can be different from the first.

Heart Attack Warning Signs The main symptom of a heart attack is chest pain or discomfort. It also can feel like pressure, fullness or squeezing in your chest. These feelings may start gradually and get worse, or they may come and go. Women also may have unusual heartburn, shortness of breath, lightheadedness, nausea, or feel tired or anxious weeks before.

Stroke Warning Signs Think F.A.S.T. when it comes to recognizing a stroke:

F ACE DROOPING: Does one side of your face droop or is it numb? Try to smile.

A RM WEAKNESS: Is one arm weak or numb? Raise both arms. Does one arm drift downward?

S PEECH DIFFICULTY: Is your speech slurred? Are you unable to speak? Try to say a simple sentence like “The sky is blue.”

T IME TO CALL 911: If you notice any of these symptoms, even if they go away, call 911 right away.

Other sudden symptoms can include: n numbness or weakness in your leg n confusion or trouble understanding n trouble seeing in one or both eyes n trouble walking, dizziness, loss of balance and coordination n severe headache with no known causeIf you think you or a loved one is having heart attack or stroke symptoms, call 911 immediately.

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SPOTLIGHT ON HEALTH

Type 2 DiabetesManaging Diabetes During Your Hospital Stay Keeping your blood sugar under control takes careful attention. To help, make a diabetes care plan with your doctor or nurse. Include information like: n how often your blood sugar

needs to be checked n how often you need to take

your medicines and insulin n what to do if you can’t eat n how to handle your insulin

pump if you have one

You also may want to ask a friend or family member to be your diabetes advocate. Together you can work with hospital staff to follow your diabetes care plan.

Tracking Your Blood Sugar Tracking your blood sugar can give you valuable information about how your body’s working so you know if you need to make adjustments. Being sick and taking new medicines can cause your blood sugar numbers to go up or down. Ask your nurse if your blood sugar needs to be tested more often.

Taking Medicine or Insulin You’ll still need your medicines and insulin (if you take it) while in the hospital, but your nursing staff is responsible for giving them to you. If you have questions about your schedule, it’s okay to ask.

Planning for Meals Once you’re admitted to the hospital, ask if there’s a special meal plan for patients with diabetes. You also can ask to see the hospital’s dietitian if your blood sugar is too high or too low during your stay. If you need to take medicine or insulin before your meal, work out a schedule with your nurse.

Avoid Infections Having diabetes puts you at a higher risk of infection, so be extra careful during your hospital stay: n Ask everyone who comes in

your room to wash his or her hands.

n Wash your own hands when you can, or ask for hand sanitizer to be placed near your bed.

n Tell your nurse about any cuts, sores or bruises you have.

n Ask friends and family who aren’t feeling well not to visit.

If you have questions about managing your diabetes while you’re here, contact the diabetes education office at ext. 3872.

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Foods & Medication Safety

COMMENTS

This chart will help you steer clear of side effects that can be caused by pairing certain foods and medications.Did you know foods you eat could affect the medicine you take? Eating or drinking certain foods can cause your body to absorb medicine slower or faster. This can make medicine less effective or cause troubling side effects. The chart below lists some common drug-food interactions, but it does not include every medication or food interaction. Be sure to ask your doctor or pharmacist about possible interactions between food, vitamins, supplements, herbals or other drugs before taking any prescription or over-the-counter medications.

Drug Class Prescription Medication Comments

Analgesics (pain relievers)

Percocet (acetaminophen/oxycodone)Tylenol #3 (acetaminophen/codeine) Norco, Vicodin (acetaminophen/ hydrocodone)

Avoid drinking alcohol. Take with food to reduce upset stomach. Avoid over-the-counter Tylenol (acetaminophen)- containing products. It’s unsafe to take more than 4,000 mg of acetaminophen in 24 hours.

Anti-arrhythmics (irregular heart beat)

Cordarone, Pacerone (amiodarone)

Avoid eating grapefruit and drinking grapefruit juice. May take with or without food, but take the same time each day.

Antibiotics Ampicillin Penicillin

Take on an empty stomach for best absorption.

Cipro (ciprofloxacin)DoxycyclineTetracyclineLevaquin (levofloxacin)

To improve absorption, avoid antacids, iron-containing foods and calcium-rich dairy products.

Flagyl (metronidazole)Tindamax (tinidazole)

Avoid alcohol while taking and for 3 days after finishing the medication. Take with food to prevent upset stomach; take probiotics (yogurt or supplements) to prevent diarrhea.

Griseofulvin Take with fatty food (ice cream, whole milk or cheese) for better absorption.

Anti-coagulants (blood thinners)

Coumadin, Jantoven(warfarin)

Avoid sudden increase or decrease in foods rich in vitamin K (green leafy vegetables, avocados, soybeans, green tea, bacon, butter, cheese) and multivitamins with vitamin K. Check with your doctor or pharmacist for a complete list. Limit alcohol and cranberry juice.

DRUG CLASS RX MEDICATION COMMENTS

37Continued on next page.

DRUG CLASS RX MEDICATION COMMENTS

Antidepressants Paxil (paroxetine)Prozac (fluoxetine)Zoloft (sertraline)Lexapro (escitalopram)Celexa (citalopram)

Avoid drinking alcohol; avoid use of nicotine or tobacco products.

Antipsychotics Clozaril (clozapine) Avoid drinking alcohol and caffeine.

Abilify (aripiprazole)Seroquel (quetiapine)

Avoid drinking alcohol and grapefruit juice.

Anti-seizure Dilantin (phenytoin) Take on an empty stomach at the same time every day. Avoid calcium or antacids within 2 hours of taking medicine.

Carbatrol, Tegretol (carbamazepine)

Avoid eating grapefruit and drinking grapefruit juice.

Depakote (divalproex)Lamictal (lamotrigine)Lyrica (pregabalin)Topamax (topiramate)Zarontin (ethosuximide)

Avoid drinking alcohol.

Cholesterol Lipitor (atorvastatin)Mevacor (lovastatin)Zocor (simvastatin)

Avoid eating large amounts of grapefruit or grapefruit juice (greater than 1 quart per day). Do not eat oat bran within 2–4 hours of taking medicine.

Diabetes Drugs Glucophage (metformin)DiaBeta (glyburide)Glucotrol (glipizide)Amaryl (glimepiride)

Avoid drinking alcohol. If diabetes is well controlled, limit alcohol to 1–2 drinks per day consumed with a meal.

Gastrointestinal Drugs Reglan (metoclopramide)

Avoid drinking or limit alcohol. Take 30 minutes before meals.

Nexium (esomeprazole)Prilosec (omeprazole)Protonix (pantoprazole)

Take at least 1 hour before meals.

Tagamet (cimetidine)Zantac (rantidine)

Avoid drinking alcohol, caffeine and nicotine.

Gout Medications* Colcrys (colchicine) Avoid eating grapefruit and drinking grapefruit juice.

Zyloprim (allopurinol) Take after meals.

*If you have gout, avoid large amounts of purine-rich foods (anchovies, beef stock gravies, sardines, shellfish, asparagus, lentils and red meat—especially pork). Check with your doctor or pharmacist for a complete list.

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Foods & Medication Safety continued

High Blood Pressure ACE InhibitorsMonopril (fosinopril)Prinvil, Zestril (lisinopril)Vasotec (enalapril)

Avoid potassium-based salt substitutes and eating large amounts of foods high in potassium (almonds, bananas, cantaloupe, kidney beans, oranges/orange juice, potatoes with skin, tomato juice, spinach).

Calcium Channel BlockersCalan (verapamil)Cardizem (diltiazem)Plendil (felodipine)Procardia (nifedipine)

Avoid drinking Seville (sour) orange juice, eating grapefruit, and drinking grapefruit juice.

Limit caffeine when taking Calan.

Beta BlockersTenormin (atenolol)

Avoid drinking orange juice. Do not take calcium products within 2 hours of taking medicine.

Lopressor (metoprolol tartrate)

Take with or immediately after meals. Do not take calcium products within 2 hours of taking medicine.

DiureticsAldactone (spironolactone)Dyrenium (triamterene)Midamor (amiloride)

Avoid potassium-based salt substitutes and eating large amounts of foods high in potassium (bananas, cantaloupe, kidney beans, potatoes with skin, tomato juice, spinach).

Immunosuppressant Drugs

Neoral, Sandimmune (cyclosporine)Prograf (tacrolimus)Rapamune (sirolimus)

Avoid eating grapefruit and drinking grapefruit juice. Avoid potassium-based salt substitutes and eating large amounts of food high in potassium (almonds, avocados, bananas, cantaloupe, kidney beans, oranges /orange juice, potatoes with skin, spinach).

MAO Inhibitors Eldepryl, Zelapar, Emsam (selegiline)Marplan (isocarboxazid)Nardil (phenelzine)Parnate (tranylcypromine)

Avoid foods high in tyramine (aged cheese, avocado, banana, bologna, pepperoni, salami, pickled herring, liver, raisins, yeast extracts, red wine, sour cream). Avoid drinking large amounts of alcohol and caffeine (chocolate, coffee, tea).

Osteoporosis BisphosphonatesFosamax (alendronate)Boniva (ibandronate)Atelvia, Actonel (risedronate)

Take on an empty stomach with 8 oz. of water in the morning before breakfast. Do not take any other drugs, vitamins or food within 30 minutes (60 minutes for ibandronate) of taking medicine. Remain upright, not reclining or lying down, for 1 hour after taking.

Thyroid Hormones Levoxyl, Synthroid, Unithroid, Tirosint (levothyroxine)

Take on an empty stomach 30–60 minutes before breakfast with 8 oz. of water. Avoid eating walnuts, soybean flour, dietary fiber, and calcium products within 4 hours of taking medicine.

DRUG CLASS RX MEDICATION COMMENTS

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Patient Portal

A secure online home to access your hospital information. You can have online access to your hospital inpatient records—test results, medications, diagnoses and discharge instructions—through our secure Patient Portal, My Health Home. This information from your hospital stay usually is available to you or those you authorize by the second day of your inpatient stay (or soon after you leave the hospital after a one-day stay).

It’s quick and free to set up an account. Ask a staff member or stop by Registration to start the process for setting up your personal My Health Home Portal account. After providing your email address, you will receive an email with a link to the Portal so you can enter your secure password and finalize your account setup.If you did not provide an email address as a patient while at the hospital, you can call our toll-free Help Line at 877-456-9617 or the Hospital Health Information department to verify your identity and provide an email address to receive an email with instructions to set up your secure account.

It’s easy to use and convenient.The Portal has user-friendly navigation and can be accessed any time from any computer or smartphone with internet connection. That’s 24/7 access to your personal health information! Once you set up your account, bookmark the site to make it convenient to view, download and share your information. When new information is added to your Portal, you will receive a secure email notification directing you back to your Portal, where the new information will be highlighted. Keeping you informed is important to us.

Get Connected with My Health Home Patient Portal

It’s Confidential and SecureYour personal and medical information in your My Health Home Portal account is confidential, using a secure, encrypted connection that meets the highest industry standards. All health data is stored on a secure server and managed with the protection of your information in mind. We will not share, sell or lease your personal information with any outside party not affiliated with our organization. Only you—and those you authorize—will be able to see or gain access to the information in your Portal.

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Games

SudokuFill in the blank squares so that each row, each column and each 3-by-3 block contain all of the digits 1 through 9.

Answer Key

How did you do?Check your answers here.

Source: www.sudoku-puzzles.net