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Before Surgery: Your Top 6 Hospital Risks

By R. Morgan Griffin
WebMD Feature

It's a fact of life: people checking into the hospital face risks. Expecting to get better, some actually wind up getting worse.

We've all heard the horror stories about hospital risks after surgery. There's the danger of medical complications, like bleeding or infection. Then there are the human errors, like getting the wrong drug or dosage. "Even though you've got a lot of well-trained people in a hospital working very hard, they're still people," says Fran Griffin, RRT, MPA, a director at the Institute for Healthcare Improvement in Cambridge, Mass. "And people sometimes make mistakes."

All these hospital risks can seem far beyond your control. It can leave you feeling pretty helpless.

But experts say that's not the case. "Patients are just too passive when they check into the hospital," says Peter B. Angood, MD, vice president and chief patient safety officer of the Joint Commission in Oakbridge Terrace, Ill. According to Angood and other experts, taking an active role in your health care can reduce many of these hospital risks. While you might feel out of control when you go into the hospital, you're really not.

So what can you do to cut your risks? Here's a list of the six top hospital risks and -- more importantly -- what you can do to avoid them.

Hospital Risk No. 1: Medication Errors

"Far and away, the most serious hospital risk is a medication error," says Carolyn Clancy, MD, director of the Agency for Healthcare Research and Quality (AHRQ) in Rockville, Md. "All it takes is for someone to miss a decimal point and you could have a life-threatening mistake."

A 2006 report from the Institute of Medicine estimated that every year, there are 450,000 injuries resulting from medication errors in hospitals, and perhaps many more that are unreported. What's especially frightening about these hospital risks is they "seem" completely beyond your control. How would you even know what medicines you need, or how much, or how often? How can you stop a doctor's poor handwriting on a prescription from being misread by a pharmacist or nurse?

But there are things you can do to reduce this hospital risk. Before surgery, you need to make sure that your doctor, your surgeon, and everyone else involved in your care know about every single medicine -- whether prescription, over-the-counter, or herbal supplement -- that you use. To make it easier, you can just stick all of your medicines in a bag and bring them to the hospital.

Then, after surgery, ask questions. When a nurse comes to give you medicine, ask what it is and why you need it, says Dale Bratzler, DO, MPH, medical director at the Oklahoma Foundation for Medical Quality in Oklahoma City. Make sure the nurse checks your ID bracelet against the name on the prescription.

"If you ever feel like something's wrong, you have to speak up," says Griffin. She's talked to nurses who said that they were about to administer the wrong medication or dose and were only stopped because the patient asked them to double-check." Just by saying something, they averted what could have been very serious medication errors," Griffin says.

Important Safety Information

LOVENOX® Full Prescribing Information

Certain procedures, called "epidural/spinal anesthesia" and "spinal puncture," may be used as a normal part of hospitalization. Patients requiring these procedures while being treated with LOVENOX® (enoxaparin sodium injection) or other low-molecular-weight heparins are at risk of developing a blood clot in or around the spine. This condition may result in long-term or permanent paralysis.

LOVENOX® is not the same as "unfractionated heparin" or other drugs called "low-molecular-weight heparins." Therefore, these drugs cannot be used interchangeably with LOVENOX®.

LOVENOX® can alter the blood's ability to clot. Patients treated with LOVENOX®, who also have conditions affecting the clotting system, must be carefully monitored by their physician. Adjusting the dose of LOVENOX® may be necessary for patients who have certain forms of kidney disease. All patients receiving LOVENOX®, as well as other anticoagulants, should be carefully monitored for bleeding by their physician. Bleeding can occur at any site with LOVENOX® use.

Platelet drops, known as "thrombocytopenia," can occur with LOVENOX® use. Cases of a related condition called "heparin-induced thrombocytopenia" have been observed in clinical practice. If you have had this condition, you must notify your healthcare professional. Your physician may perform blood tests to monitor for the occurrence of any drop in platelet count.

The use of LOVENOX® has not been adequately studied in pregnant women with artificial (mechanical) heart valves.

LOVENOX® should not be used in patients with an allergy or sensitivity reaction to the active ingredient called enoxaparin sodium, heparin, or pork products, and in patients with active major bleeding.

Common side effects include mild local reactions or irritation at the site of injection, pain, bruising, and redness of skin.

For specific questions about your health, you should always consult your physician or a qualified healthcare professional who is responsible for your care.

Please see Full Prescribing Information including boxed WARNING, for additional important information.

Which hospital risk concerns you most?

  • Anesthesia complications
  • Bleeding after surgery
  • MRSA - A hospital infection
  • DVT - A deadly blood clot
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