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Other people may be there to help us, teach us, guide us along our path, but the lesson to be learned is always ours.

In This Guide Welcome to Decatur Morgan Hospital About Us Telephone Directory Your Satisfaction During Your Stay

Communication Fire Safety Smoking ATM Visitation Isolation Electrical Appliances Gift Shop Mail and Other Deliveries Environmental Services Valuables Hourly Rounding Food Services

2 3 4 5 6-8 6 6 6 6 6 6 7 7 7 7 7 8 8

Your Rights & Responsibilities 9-11 Treating Pain 12 Speak Up 13 Stay Safe 14-20 What are Advance Directives? 21 Your Privacy & Health Information 22-23

Decatur Campus Parkway Campus West Campus Danville Road Campus

Don’t Leave Until...

Preparing for Discharge When You Are Discharged Going Home What a Hospital Bill Covers Coordination of Benefits Medicare Medicaid Commercial Insurance Post-Discharge Follow up Uninsured?

For Self-Pay Patients Giving Back Be Prepared Watch What You Eat

24-25 26-28 26 26 26 26 27 27 27 27 28 28 28 29-30 31-33

North Alabama Health Information Exchange TV Channel Listings

34-35 36

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Welcome to Decatur Morgan Hospital Mission Statement Decatur Morgan Hospital is committed to meeting the health and wellness needs of those we serve through compassionate care, innovation and medical excellence.

This commitment is supported by service, technology and a dedication to continuous quality improvement.

Wireless Internet Decatur Morgan Hospital is pleased to offer wireless service (Wi-Fi). Patients, guests, and visitors can use this service to access the Internet at any time free of charge.

On behalf of our entire care team, welcome to Decatur Morgan Hospital, where we have a long-standing tradition of community healthcare.

You are our guest, and your health and safety is our first priority.

This handbook is designed to acquaint you with our hospital. It provides information about our services, how we strive to meet your needs, and the people and the procedures we adhere to while caring for you. Our dedicated team of professionals is prepared to meet your physical and emotional needs and treat you with dignity, compassion and respect.

We encourage you and your family to be active participants in your care. Ask questions. Let us know if you need anything or if there is a problem or concern.

Should you have a need that you feel is not being resolved, please contact our patient representative at extension 32124.

Because we continually look for suggestions as to how we might better serve you, we have retained an independent survey company to gather patient feedback.

Should you receive a call from HealthStream Research™ after your discharge, please take a moment to give them your honest feedback.

Caring for you is a privilege we take very seriously.

Thank you for choosing Decatur Morgan Hospital as your healthcare provider.

Sincerely, Nathaniel Richardson, Jr. President

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About Us In 2012, Decatur General joined the Huntsville Hospital Health System and combined with Parkway Medical Center to become Decatur Morgan Hospital.

We are now one unified system with four locations to better serve Morgan County.

Our award-winning, innovative, personal care is now available at the Decatur Campus, Parkway Campus, West Campus, and Danville Road Campus. We are keeping all of the valuable services you have depended on in the past, and will continue to invest in key services to benefit our patients and community. Plus, our focus on building more effective and efficient systems will ensure quality healthcare for you and your family for generations to come.

OUR LOCATIONS Decatur Campus 1201 7th St. SE Parkway Campus 1874 Beltline Rd. West Campus 2205 Beltline Rd. Danville Road Campus 2349 Danville Rd.

Your Opinion Counts

Decatur Morgan Hospital has partnered Specialties/Services with HealthStream n Emergency Services at two convenient locations Research™ to conduct n General and acute inpatient care Patient Satisfaction surveys n Numerous surgical specialties for Hospital Consumer n Behavioral Medicine including inpatient programs for Assessment of Healthcare adults, adolescents and senior adults providers and systems n Sleep Disorders Center including pediatric sleep studies (HCAHPS), Outpatient and n Breast Health Services including digital mammography, Emergency Department stereotactic breast biopsy, and ultrasound surveys. Following your stay n Outpatient Services including lab, radiology/imaging with us, you may receive a telephone call from services, nuclear medicine and CT HealthStream Research™. n Inpatient and outpatient physical therapy, occupational This call will only take a therapy and speech therapy few minutes, and your n Women’s Services including urogynecology feedback will be used by n Gastroenterology the hospital to continually n Labor and Delivery provide excellent patient n Orthopedics care. Patients are randomly n Respiratory Therapy selected, and if you are n Wound Care chosen, please complete n Urology the survey. If you have any n New Vision – medical stabilization for adults with drug, questions about the survey alcohol and related health issues process or your stay with n Senior Services, Lifeline and Volunteer Services us, please contact the n Community outreach and education patient representative n Health and Wellness Center at 973-2124.

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Telephone Directory MAIN NUMBERS Decatur Campus 256-973-2000 Danville Road Campus 256-973-4900 Parkway Campus 256-973-2000 West Campus 256-973-2000

Administration Decatur Campus 256-973-2152 Parkway Campus 256-973-6411

Gift Shop Decatur Campus 256-973-2217

Cafeteria Decatur Campus 256-973-2854 Parkway Campus 256-973-6302

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General hours of operation are weekdays, 8:00 a.m. to 4:30 p.m.

Registration Decatur Campus 256-973-2551 Parkway Campus 256-973-6705 Behavioral Medicine Center Decatur 256-973-2000 Huntsville 256-551-2710 Cashier Decatur Campus 256-973-2179 Parkway Campus 256-973-6466 Chaplain Services 256-973-3288 Community Outreach 256-973-2444 Financial Counselor 256-973-2898/2528 Foundation 256-973-2187 Medical Records Decatur Campus 256-973-2691 Parkway Campus 256-973-6123 Lifeline and Lifestyle 256-973-2184 New Vision 256-973-6780 Patient Representative 256-973-2124 Physician Referral 256-973-2111 Radiology Decatur Campus 256-973-2540 Parkway Campus 256-973-6161 Rehab Access 256-973-4900 Security (from an internal line) 36660 Sleep Disorders Center 256-973-6333 Volunteer Services 256-973-2184

ALBERT EINSTEIN 1879-1955

Truth is what stands the test of experience.

Your Satisfaction We encourage your feedback to improve care.

Your healthcare is our priority. To determine where

improvements are needed, Decatur Morgan Hospital takes part in the Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) survey.

The HCAHPS survey measures your satisfaction with the quality of your care. It is designed to be a standardized tool for measuring and reporting patient 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 survey asks multiple-choice questions about your hospital stay. Please take the time to answer the HCAHPS survey; your feedback is important!

Hospital Compare

is a government website that allows users to compare the quality of care provided by hospitals. The information provided on this website is based on HCAHPS survey results. www.medicare.gov/ hospitalcompare

What is HCAHPS?

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.

You are Part of the Team COMMUNICATE It’s your health; don’t be afraid to ask your doctors and nurses questions.

PARTICIPATE You are the center of your healthcare team so ask questions, understand your treatment plan and medications, and communicate with your doctors and nurses.

APPRECIATE There are hundreds of people in the hospital who need help; please be patient as doctors and nurses attend to everyone.

The Joint Commission

has created quality and safety standards for healthcare organizations.

The Joint Commission reviews, accredits, and certifies healthcare organizations that meet its high standards.

Quality reports for all accredited organizations are available on its website. www.qualitycheck.org

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During Your Stay Communication As a patient at Decatur Morgan Hospital, you have the right to receive information in a way that you understand. This includes interpretation and translation, free of charge, in the language you prefer for discussing your healthcare. This also includes providing you with needed help if you have vision, speech, hearing or cognitive impairments.

Fire Safety We periodically conduct fire drills. If you hear an alarm, stay where you are. In the event of an actual emergency, you will be notified by hospital staff.

Smoking Smoking is not permitted anywhere in the hospital or on hospital grounds.

ATM At the Decatur Campus, an automated teller machine (ATM) is located at the main entrance­— on the ground floor by the gift shop.

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We have policies and procedures in place to help you and your family work with our doctors, nurses and staff to get the most from your hospital stay. Please take a few minutes to review these guidelines with your loved ones.

Visitation

Decatur Morgan Hospital advocates open and flexible visitation that welcomes and encourages the involvement of family/significant others in the patient’s care. You may decide whether you want visitors while you are here and designate those people who can visit you during your stay. Due to the nature of care given in some units, the hospital may need to limit visitors to better care for you or other patients when based on clinical restrictions or limitations: Critical Care Unit Due to the critical nature of the care given in the ICU, visiting hours are limited to the following: n 8:00 a.m. to 6:00 p.m. n 8:00 p.m. to 6:00 a.m.

Please limit visitors to two (2) per patient at one time.

After 10:00 p.m., only one (1) visitor is allowed to stay overnight until 6:00 a.m. No children under age twelve (12) are permitted in the ICU. Labor and Delivery: n The patient may request two specific people present during the delivery. Any greater number must be approved by the physician. n Visitation may be canceled or limited based on critical situations or events.

Isolation

Isolation refers to the precautions that are taken in the hospital to prevent the spread of an infectious agent from an infected or colonized patient to susceptible people.

The decision to isolate a patient is carried out by the medical team caring for the patient, in consultation with the nursing staff and Infection Control Team.

It is the responsibility of ALL members of staff to comply with Isolation and Infection Control procedures.

Electrical Appliances

Electrical appliances including hairdryers, curling irons, razors, radios, DVDs, computers and other devices must have an equipment safety inspection prior to use. Notify your nurse if you have any electrical items with you.

Gift Shop at Decatur Campus

The hospital’s gift shop is located on ground floor in the main lobby. The proceeds from the gift shop are reinvested into the hospital for the needs of our patients.

Cash, debit and credit cards are accepted.

Hours of Operation: Monday/Thursday: 8:00 a.m. to 6:00 p.m.

Friday: 8:00 a.m. to 5:00 p.m.

Saturday: 10:00 a.m. to 3:00 p.m.

Mail and Other Deliveries

Mail and packages will be delivered to you by a hospital volunteer. Patient mail received after discharge will be returned to the sender if there is a return address on the envelope. Volunteers or staff also will deliver purchases of flowers and gifts when requested. The gift shop gladly accepts phone orders.

Individual florists deliver flower orders to your room.

Environmental Services

Decatur Morgan Hospital is committed to providing you and your loved ones a safe environment and excellent service. If your room has not been cleaned to your satisfaction or if you have additional cleaning needs, please let your nurse know and he or she will contact our Environmental Services staff.

Leave Your Valuables At Home If you have valuables, such as jewelry and cash, please give them to a relative or friend to take care of during your stay. Contact lenses, eyeglasses, hearing aids and dentures should be stored in your bedside stand when not in use.

Please don’t put them on your bed or food tray— they may be damaged or lost. Upon your request, your valuables can be placed in our safe.

Talk with your nurse for more information.

The hospital cannot be responsible for replacement of personal belongings.

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During Your Stay Hourly Rounds

It is our goal to actively monitor your well-being and meet your personal needs so you can focus on your recovery and your loved ones can stay up-to-date on your progress. To meet this goal, we take an efficient and proactive approach by providing hourly rounds. During hourly rounds, you can expect your caregiver to: n Check on you and your well-being n Monitor your comfort and pain n Help you move and change positions n Assist you to the bathroom I n addition, we will make sure you have easy access to: n Telephone n Bedside table n Call light n Water or other beverages n Urinal and/or bedpan

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Food Services

Decatur Campus Cafeteria: Location: Ground floor Monday through Friday Breakfast: 7:00 a.m. to 9:00 a.m.

Lunch: 11:00 a.m. to 1:30 p.m.

Code Brew Location: Ground floor Offering coffee, snacks and sundries Monday through Friday: 6:00 a.m. to 8:00 p.m.

Weekends: 7:00 a.m. to 6:00 p.m.

Hot sandwiches and soup: 2:00 p.m. to 6:00 p.m.

Breakfast biscuits: Weekends, 7:00 a.m. to 9:00 a.m.

Parkway Campus CafĂŠ Location: Ground floor Breakfast: 7:00 a.m. to 9:00 a.m.

Lunch: 11:00 a.m. to 1:30 p.m.

The CafĂŠ is open Monday through Friday, 7:00 a.m. to 2:30 p.m., offering Starbucks coffee, snacks and beverages.

Patient Room Service, Parkway Campus Only Daily: 7:00 a.m. to 5:30 p.m.

From your in-room phone, dial 3-3663.

Rights & Responsibilities As a patient of Decatur Morgan Hospital, we want you to know your rights and responsibilities, and to know that by taking an active role in your healthcare, you can help your hospital caregivers meet your needs. Patient Rights are posted throughout our facility and detailed handouts are provided to all patients.

n Expect emergency procedures to be

implemented without unnecessary delay.

n Know the names of doctors, nurses and

staff providing care to you.

n Request a consultation by another

healthcare provider.

n Receive proper assessment and

management of pain, including the right to request or reject any options to relieve pain. n Be involved in all aspects of your Your Rights As a patient, you or your legally care and take part in decisions about responsible party have the right to: your care based on your spiritual and n Receive care without discrimination. personal values. n Safe, respectful, and dignified care. n Request care. This right does not mean Your cultural, psychosocial and you can demand care or services that spiritual values will be respected. are not medically needed. n Have a family member, another person, n Refuse any care, therapy, drug, or or your doctor notified when you are procedure against the medical advice admitted to the hospital. of a doctor. n Receive information in a way that n Receive care free from restraints or you understand, including free seclusion unless necessary to provide interpretation and translation services medical, surgical, or behavioral and assistance with vision, speech, healthcare. n Expect the hospital to get your hearing or cognitive impairments. n Designate a support person to act on permission before taking photos, your behalf. recording, or filming you if the purpose n Decide if you want visitors and designate is for something other than patient who can visit you during your stay. identification, care, diagnosis, or n Be told of hospital rules, which include therapy. n Be informed of protective and no smoking. n Receive information about your community services. n Limit who knows about your being current health, plan of care, and any ongoing healthcare needs in the hospital. n Be informed about proposed care n Be interviewed, examined, and discuss options including risks and benefits, your care in places designed to protect other care options, and what could your privacy. n Be advised why certain people are happen without care. n Receive medical screenings to present, and to ask others to leave determine treatment during sensitive talks or procedures.

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Rights & Responsibilities n Expect all communications and records

related to care to be treated as private.

n Report any condition that puts you

at risk (for example, allergies or hearing problems). n Report unexpected changes in how your personal health information will be used and shared with other your condition to the healthcare healthcare professionals involved professionals taking care of you. n

in your care.

Provide a copy of your advance n Review, request copies and amend your directive, living will, durable power of attorney, and any organ/tissue medical record unless restricted for medical or legal reasons. donation permissions to the healthcare n Create advance directives. professionals taking care of you. n Ask about and discuss the ethics of n Tell us who, if any, visitors you want your care, including resolving any during your stay. n

conflicts that might arise such as Recognize and respect the rights of forgoing or withdrawal of treatment. other patients, families, and staff, n Receive instructions on follow-up care including treating hospital property with respect. and participate in decisions about n Follow hospital rules and regulations your plan of care after you are out of the hospital. affecting patient care and conduct. n Receive a prompt and safe transfer to n Refrain from conducting any illegal the care of others when this hospital is activity on hospital property. n Promote your own safety by following not able to meet your request or need for care or service. You have the right instructions, including your plan of to know why a transfer to another care and becoming an active, involved, healthcare facility might be required. and informed member of your The hospital cannot transfer you to healthcare team. n

another hospital unless that hospital Ask questions if you are concerned about your health or safety. has agreed to accept you. n Request a detailed explanation of n Make sure your doctor knows the site/ your hospital charges and receive side of the body that will be operated counseling on ways to help pay for on before a procedure. n Remind staff to check your the hospital charges. n Request information about business identification before medications or financial arrangements that may are given, blood/blood products are impact your care. administered, blood samples are taken, or before any procedure. n Remind caregivers to wash their hands It Is Your Responsibility To n Provide accurate and complete before taking care of you. n Be informed about which medications you information about current healthcare problems, and complete medical history. are taking and why you are taking them. n Receive written notice that explains

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n Ask all hospital staff to

identify themselves. n You are responsible for your actions if you refuse care or do not follow care instructions. n You are responsible for paying for the healthcare that you received as promptly as possible. This includes giving the hospital correct information about your insurance or your way for paying your bill.

Complaints & Questions

Our goal is to provide excellent care.

If at any time you have questions or concerns about the quality of care that you or a family member are receiving or have received at our hospital, do not hesitate to speak with your nurse or the nursing supervisor. If you feel that your issue wasn’t resolved, please contact the Service Excellence Department at 256-341-2124 (Monday through Friday, 8:00 a.m. to 4:30 p.m.) or in writing at PO Box 2239, Decatur, AL 35609 with

your questions or concerns. You may call at any time during or after your stay.

After normal business hours, call 256-341-2000 and ask to speak with the clinical supervisor. If we are unable to resolve your issue, you may contact the following agencies: n The Alabama Department of Public Health 800-356-9596 or Complaint Department, Suite 600 RSA Tower, 201 Monroe St., Montgomery, AL 36104 n The Joint Commission–Office of Quality and Patient Safety, One Renaissance Blvd., Oakbrook Terrace, IL 60181, 800-994-6610 or patientsafetyreport @jointcommission.org n Alabama Quality Assurance Foundation at 800-760-4550 or Two Perimeter Parkway S., Suite 200, Birmingham, AL 35243 n Center for Medicaid and Medicare Services, 800-633-4227

Notes _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ 11

Treating Pain Treating pain is an important part of good patient care, and we realize pain is subjective to every individual. Our doctors and nurses strive to help ease that pain.

The nurse may ask you to rate your pain on a 10-point scale with 10 being the worst pain ever, or the nurse may use the scale you see at the bottom of the page to assess your pain.

Your nurse also will write down the last time you had pain medicine on the whiteboard in your room, as well as the time the next dose is available.

This is just to remind you of the earliest time you can have more pain medicine.

The nurse might have other suggestions for pain relief if it is too early for your next dose of pain medicine: for example, a heat pack, a hot shower, breathing techniques or relaxation techniques.

USE THE PAIN RATING SCALE BELOW TO TELL YOUR DOCTOR OR NURSE HOW YOUR PAIN IS AFFECTING YOU.

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FRANCIS BACON

Who questions much, shall learn much, and retain much.

Speak Up! Take charge of your care.

During your stay, the doctors, nurses and staff

of Decatur Morgan Hospital will treat you and your family as partners in your own 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—how to stay safe, get the information you need, ask the right questions and interact effectively with your doctors, nurses and hospital staff.

STEP UP & SPEAK UP SPEAK UP: Ask questions and voice concerns.

It’s your body, and you have a right to know. As you think of questions, write them down so you remember to ask.

PAY ATTENTION: Make sure you’re getting the right treatments and medicines.

EDUCATE YOURSELF: Learn about the medical tests you get and your treatment plan.

FIND AN ADVOCATE: Pick a trusted family member or friend to be your advocate or support person.

Have them communicate and ask questions for you.

WHAT MEDS & WHY: Know what medicines you take and why you take them. Make a list.

CHECK BEFORE YOU GO: Use a hospital, clinic, surgery center or other type of healthcare organization that meets The Joint Commission’s quality standards.

PARTICIPATE IN YOUR CARE: You are the center of the healthcare team. As nurses make hourly rounds or conduct shift change reports at your bedside, ask for additional information on your plan of care.

Remember: rite down any questions W you have n Choose a support person to communicate with the doctors and staff n K eep a list of doctors you see and the meds they prescribe n

Don’t Get Overwhelmed, Write It Down!

Courtesy of The Joint Commission.

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HENRY H. TWEEDY 1868-1953

Fear is the father of courage and the mother of safety.

Stay Safe You can contribute to healthcare safety.

In the event of an emergency, such as a serious change in the patients condition, call the Critical Assist Team.

Dial 2200 from your in-room phone (at the Decatur Campus) or 23456 (at the Parkway Campus) and give the operator your: Name Location n Brief description of what is wrong n n

The team will arrive within minutes to assist you.

Don’t Be Afraid to Ask… A number of people may enter your hospital room.

Be sure to: n Ask for the ID of everyone who comes into your room. n Speak up if hospital staff doesn’t ask to check your ID. n Ask if the person has washed his or her hands before he or she touches you. n If you are told you need certain tests or procedures, ask why you need them, when they will happen and how long it will be before you get the results.

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PATIENT IDENTIFICATION Any time staff members enter your room to administer medications, transport you or perform procedures and treatments, they must check your name and date of birth before they proceed. At times, you may be asked the same questions repeatedly.

We are aware that this may be annoying. Please understand, however, that this verification process is a critical component in our patient safety program in order to guarantee that all of our patients receive the correct medications and treatments.

Check ID

STAY SAFE

Fighting Infections While you’re in the hospital to get well, there is the possibility of developing an infection. The single most important thing you can do to help prevent infections is to wash your hands and make sure that everyone who touches you—including your doctors and nurses—washes his or her hands, too.

You, your family and friends should wash hands: 1. after touching objects or surfaces in the hospital room 2. before eating 3. after using the restroom

It also is important that your healthcare providers wash their hands with either soap and water or an alcohol-based hand cleaner every time, before and after they touch you. Healthcare providers know to practice hand hygiene, but sometimes they forget. You and your family should not be afraid or embarrassed to speak up and ask them to wash their hands.

Happy Birthday to You! Wash your hands with soap and warm water for 15 to 20 seconds.

That’s about the same amount of time that it takes to sing the “Happy Birthday” song twice.

No Soap? No Problem.

Doctors, nurses and other healthcare providers come into contact with a lot of bacteria and viruses.

So before they treat you, ask them if they’ve cleaned their hands.

Alcohol-based hand cleaners are as effective as soap and water in killing germs. To use, apply the cleaner to the palm of your hand and rub your hands together. Keep rubbing over all the surfaces of your fingers and hands until they are dry.

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STAY SAFE

Know Your Meds While you are hospitalized, your doctor may prescribe medications for you. Be sure that you understand exactly what they are and why they are being prescribed. Use this checklist to help you get the information you need from your doctor: What is the name of the medicine?

What is its generic name?

Why am I taking this medicine?

What dose will I be taking? How often, and for how long?

When will the medicine begin to work?

What are the possible side effects?

Can I take this medicine while taking my other medications or dietary supplements?

Are there any foods, drinks or activities that I should avoid while taking this medicine?

Should I take my medicine at meals or between meals?

Do I need to take the medicine on an empty stomach or with food or a whole glass of water?

What should I do if I forget to take the medicine and miss a dose?

KEEP A WALLET-SIZED NOTEBOOK OF ALL MEDICATIONS YOU ARE TAKING.

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Preventing Medication Errors By taking part in your own care, you can help the members of your healthcare team avoid medication errors. Here’s how: Be sure that all of your doctors know what medications you have been taking, including prescription drugs, over-thecounter medications, herbal and vitamin supplements, natural remedies and recreational drugs.

Be sure that all of your doctors know of any allergies you may have— to medications, anesthesia, foods, latex products, etc.

When you are brought medications or IV fluids, ask the person to check to be sure you are the patient who is supposed to receive the medications. Show that person your ID bracelet to double-check.

Remember—you play an important role in helping to reduce medication errors.

STAY SAFE

Prevent the Spread of

Multi-Drug Resistant Organisms When you are admitted into the hospital, you may have a nasal swab done to determine if you have MRSA (methicillinresistant Staphylococcus aureus). This is a multi-drug-resistant organism (MDRO) that is frequently found in patients.

MDROs are bacteria that are resistant to antimicrobial drugs (antibiotics), so precautions must be taken to ensure that MDROs aren’t spread.

If your culture is positive, you will be placed on isolation. This means staff will wear gowns, gloves or masks when they treat you. Your family and visitors are expected to do the same to help prevent the spread of bacteria. These are the most common types of MDROs:

MRSA: Methicillin-Resistant Staphylococcus Aureus

MRSA is a bacterium that is carried on the skin or in the noses of healthy people and is a common cause of minor skin infections.

It also can cause surgical wound infections, bloodstream infections and pneumonia.

To prevent the spread of MRSA: n Cover your wound: Keep areas of affected skin covered with clean, dry bandages. n Clean your hands: Anyone in close contact should clean hands with soap and warm water or an alcohol-based sanitizer. n Do not share personal items: Avoid sharing clothing, towels or razors. n Talk to your doctor: Tell any of your healthcare providers that you have a MRSA infection. If you have a wound that does not heal or a boil or “spider bite” that looks infected, see your doctor.

E. coli: Escherichia coli E. coli is a type of bacteria found in your intestines and is usually harmless. This bacteria, highly resistant to antibiotics, can spread outside of your gut and cause an infection. In hospitals, E. coli infections spread through contact with wounds or stool.

To help prevent E. coli infections: n Tell your medical team if you were treated in another hospital or country recently. n Make sure that all healthcare providers clean their hands before and after caring for you. n Be sure to clean your hands often. n Take antibiotics only as prescribed.

VRE: VancomycinResistant Enterococci Enterococci are bacteria that are normally present in the intestines and female genital tract.

Vancomycin is an antibiotic that is often used to treat infections cause by enterococci. When enterococci become resistant to vancomycin (not killed by it), it is called VRE. VRE can cause infections of the urinary tract, bloodstream, or of wounds. Most VRE infections can be treated with antibiotics other than vancomycin. If you develop VRE while on a urinary catheter, removal of the catheter can help get rid of the infection.

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STAY SAFE

Adult Vaccines 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 over age 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 up. 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).

Your 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.

Talk to your doctor about other vaccines you may need, including a booster for Td (tetanus diphtheria).

18

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but very much worth the effort.

With every step, you lower your risk for type 2 diabetes and heart disease.

It’s not easy. But it is worth it.

Learn how you can help stop diabetes by losing weight, eating healthy and staying active.

Visit checkupamerica.org or call 1-800-DIABETES.

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MY MOM H AD A S TRO K E Learn the signs of a stroke F.A.S.T.

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MY MOM H AD A S TRO K E

Sleep deprivation deprives you

of more than just sleep.

Sleep deprivation deprives you of more than just sleep.

Lack of sleep causes crankiness, fatigue, frustration, depression and illness. But the Lack of sleep causes crankiness, fatigue, specially trained physicians and staff at frustration, depression and illness.

But the our Sleep Disorders Center can help. specially trained physicians and staff at Don’t suffer throughCenter another sleepless our Sleep Disorders can help. night.

256.973.2000

Don’t suffer through another sleepless night.

www.decaturmorganhospital.net

3 LOCATIONS TO SERVE YOU Decatur Decatur General Campus 256.341.2298 256.973.2226 Parkway Campus Campus 256.973.6375 256.350.2211 Parkway Medical Plaza I Laboratory 256.341.2954 256.973.2954

REFERENCE LAB

Accredited by the College of American Pathologists and The Joint Commission and backed by the resources of the Mayo Clinic.

Do you or someone you know

have a problem with

drugs or alcohol?

Call 800.939.2273 Medicaid, Medicare and most insurances accepted

24 HOURS A DAY, 7 DAYS A WEEK, WE ARE HERE.

The American Cancer Society is there for you to help answer your questions, connect you to the resources you need, and just listen.

24 /7

Information We can answer your questions about cancer, including prevention, diagnosis, treatment options, and clinical trials.

Day-to-day Help HOPE

We can help you with everyday needs like transportation and lodging during treatment.

Emotional Support We can connect you to local and online support groups for both patients and caregivers.

We’re here to help you through every step of your cancer experience. Visit www.cancer.org or call 1-800-227-2345 anytime, day or night.

STAY SAFE

Preventing Falls Hospital patients often fall because they are weak or unsteady due to illness or medical procedures, their medications make them dizzy, or they’ve been sitting or lying down for too long. We care about our patients’ safety. Please help us keep you safe by following these guidelines during your hospital stay: n Do not get out of bed by yourself. Your hospital bed is probably higher and narrower than your bed at home, and you can easily fall while trying to get in or out of it. Please use your nurse call button and ask for assistance. n Keep often-used items—call button, tissues, water, eyeglasses, telephone, TV remote—within easy reach. n Do not walk in bare feet. Wear nonskid socks or slippers. n Make sure your robe or pajamas don’t drag on the floor; they can cause you to trip. n Use the handrails in your bathroom and throughout the hospital at all times. n Ask your nurse to show you how to properly walk with your IV pole, drainage bags or any other equipment. n Be sure your wheelchair is locked when getting in or out of it. Never step on the footrest. n If you see a spill on the floor, report it at once.

DVT: Lower Your Risk Deep-vein thrombosis (DVT) occurs when blood clots form in the legs and block circulation. The clots can lodge in your brain, heart or lungs, causing damage or even death.

When you’re hospitalized and in bed with limited physical activity, your risk of DVT increases.

Ask your doctor about using compression boots or stockings and/or blood thinners to prevent DVT during your stay. And be sure to tell your doctor or nurse if you have any of the following warning signs: A leg cramp or charley horse that gets worse Swelling and discoloration in your leg, upper arm or neck Unexplained shortness of breath Chest discomfort that gets worse when you breathe deeply or cough Light-headedness or blacking out

PATIENTS OF ALL AGES ARE AT RISK OF FALLS BECAUSE OF MEDICATIONS THAT MAY MAKE THEM DIZZY, WEAK OR UNSTEADY

19

STAY SAFE

Questions for My Doctor Be Informed

You and your caregiver need to stay informed about your medical condition and treatments while you are hospitalized. Once you are released from the hospital, it is important to have this information available so you can share it with your primary care physician during your next visit. These checklists will help you ask questions while in the hospital and keep track of vital health and medication information.

About My Medicines

See “Know Your Meds� on page 16. Once you are discharged from the hospital, your pharmacist can help answer your questions about medications, including what the label on the medicine bottle means. Ask your pharmacist to put your medicines in easy-to-open containers, and ask for large-print labels.

About My Medical Tests

4 Why do I need this test?

4 What will this test show about my health?

4 What will the test cost? Will my health insurance cover the costs?

4 What do I need to do to get ready for the test?

4 How is the test done? What steps does the test involve?

4 Are there any dangers or side effects?

4 How will I find out the results of my test? How long will it take to get the results?

4 What will we know after the test?

4 Will I get a written copy of the test results?

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About My Condition

4 What effect did my hospitalization have on my condition? Is it cured or just under control for now?

4 How can my condition be treated, managed or made better?

4 How will this condition affect me? Will I need to change some of my activities?

4 Are there long-term effects of my condition?

4 How can I learn more about my condition?

What are Your Advance Directives?

You have the right to make decisions about your own medical treatment. These decisions become more difficult if, due to illness or a change in mental condition, you are unable to tell your doctor and loved ones what kind of healthcare treatments you want. That is why it is important for you to make your wishes known in advance.

Here is a brief description of each kind of directive:

Living Will

A set of instructions documenting your wishes about life-sustaining medical care. It is used if you become terminally ill, incapacitated or unable to communicate or make decisions. A living will protects your rights to accept or refuse medical care and removes the burden for making decisions from your family, friends and medical professionals.

Healthcare Proxy

A person (agent) you appoint to make your medical decisions if you are unable to do so. 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. Remember that an agent may have to use his or her judgment in the event of a medical decision for which your wishes aren’t known.

Durable Power of Attorney

What are Advance Directives?

A living will, healthcare proxy and durable power of attorney are the legal documents that allow you to give direction to medical personnel, family and friends concerning your future care when you cannot speak for yourself. You do not need a lawyer in order to complete advance directives.

Your advance directive will become part of the medical record and can be referenced on subsequent admissions.

For more information about advance directives or to obtain forms, please speak with your nurse.

For healthcare: A legal document that names your healthcare proxy. Once written, it should be signed, dated, witnessed, notarized, copied and put into your medical record.

For finances: You also may want to appoint someone to manage your financial affairs when you cannot. A durable power of attorney for finances is a separate legal document from the durable power of attorney for healthcare. You may choose the same person for both, or choose different people to represent you.

21

Your Privacy & Health Information If you believe your health information was used or shared in a way that is not allowed under the privacy law, or if you weren’t able to exercise your rights, you can file a complaint with your provider or health insurer. You also can file a complaint with the U.S. government.

Go online to www.hhs. gov/ocr/privacy for more information. A separate law provides additional privacy protections to patients of alcohol and drug treatment programs. For more information, go online to www.samhsa.gov.

You have privacy rights under a federal law that protects your health information. These rights are important for you to know. Federal law sets rules and limits on who can look at and receive your health information.

Who must follow this law?

n Doctors, nurses, pharmacies, hospitals, clinics,

nursing homes and many other healthcare providers and their vendors n Health insurance companies, HMOs and most employer group health plans n Certain government programs that pay for healthcare, such as Medicare and Medicaid

What information is protected?

n Information your doctors, nurses and other healthcare

providers put in your medical records

n Conversations your doctor has with nurses and others

regarding your care or treatment

n Information about you in your health insurer’s

computer system

n Billing information about you at your clinic

n Most other health information about you held by

those who must follow this law

You have rights over your health information.

Providers and health insurers who are required to follow this law must comply with your right to: n Ask to see and get a copy of your health records n Request an amendment to your health record n Receive a notice that tells you how your health information may be used and shared n Decide if you want to give your permission before your health information can be used or shared for certain purposes, such as for marketing n Get a report on when and why your health information was shared for certain purposes n File a complaint 22

To make sure that your health information is protected in a way that doesn’t interfere with your healthcare, your information may be used and shared: n For your treatment and care coordination n To pay doctors and hospitals for your healthcare n With your family, friends or others you identify who are involved with your healthcare or your healthcare bills, unless you object n To protect the public’s health, such as by reporting when the flu is in your area n To make required reports to the police, such as reporting gunshot wounds n When required by law

Without your written permission, your provider cannot:

n Give your health information to your employer

(except in Worker’s Comp cases)

n Use or share your health information for marketing

or advertising purposes

n Share private notes about your mental health

counseling sessions

Adapted from U.S. Department of Health & Human Services Office for Civil Rights

How do I get copies of my medical records?

Patients can request a copy of their medical records from the nurse at any time during their stay. If you are not currently in the hospital and need to obtain your medical records, call 256-341-2691 Decatur Campus) or 256-9736123 (Parkway Campus).

Pass Code

In order to safeguard patient privacy, employees will need to verify that individuals requesting health information have the patient’s pass code number prior to disclosing any information about the patient. Patients will be assigned a pass code number at the time of registration. Any individual seeking information will need to provide this pass code number to the nurse or other hospital employee in order to receive any information. Patients are encouraged to safeguard this pass code number, distributing only to those they desire to have their protected health information.

23

LOUIS PASTEUR 1822 - 1895

In the field of observation, chance favors only the prepared mind.

Don’t Leave Until…

5 things to know before you walk out that hospital door.

Be sure to meet with the hospital’s case manager early in your stay to ensure a smooth discharge process later on.

When it’s time to be released from the

hospital, your physician will authorize a hospital discharge. This doesn’t necessarily mean that you are completely well—it only means that you no longer need hospital services. If you disagree, you or your caregiver can appeal the decision (see If You Disagree, right).

On the other hand, you may be pleased to learn that your doctor has approved your discharge. But before you can leave the hospital, there are several things that you or your caregiver must attend to.

The first step is to know who will be involved in your discharge process. This starts with the hospital’s case manager 24

and social worker. You and your caregiver should meet this person relatively early in your hospital stay; if not, find out who this person is and be sure to meet with him or her well before your expected discharge date.

If You Disagree You or your support person can appeal your doctor’s discharge decision. If you are a Medicare patient, be sure you are given “An Important Message from Medicare” from the hospital’s case manager. This details your rights to remain in the hospital for care and provides information on who to contact to appeal a discharge decision.

Make sure you have the following information before you leave the hospital: 1. Medications list. This is a listing of what medications you are taking.

Having a list prepared by the hospital is a good way to double-check the information you have.

n what follow-up tests you may need

2. Rx. A prescription for any medications you need. Be sure to fill your prescriptions promptly so you don’t run out of needed medications.

As an added service to our patients, Decatur Morgan Hospital (Decatur Campus) has partnered with Payless Pharmacy on the First Fill program. If a doctor prescribes new medications for a patient to take when he or she gets home from the hospital, Payless Pharmacy will fill that prescription and deliver it to the patient in the hospital on the day of discharge. Let your nurse know if you are interested in participating.

your caregiver, such as how to get you in and out of bed, how to use and monitor any equipment, and what signs and symptoms to watch out for n telephone numbers to call if you or your caregiver has any questions pertaining to your after-hospital care.

and when you need to schedule them

n what medicines you must take, why,

and for how long

n when you need to see your physician

n any other home-care instructions for

4. Other services. When you leave the hospital, you may need to spend time in a rehabilitation facility, nursing home, or other institution. Or you may need to schedule tests at an imaging center, have treatments at a cancer center, have in-home therapy, or need social services. Be sure to speak with your nurse or physician to get all the details you need before you leave.

5. Community resources. You and 3. Follow-up care instructions. Make your caregiver may feel unprepared sure you have paperwork that tells you:

n what, if any, dietary restrictions you

need to follow and for how long

n what kinds of activities you can and

can’t do, and for how long

n how to properly care for any injury

or incisions you may have

for what will happen after your discharge. Make sure your social worker provides you with information about local resources, such as agencies that can provide services like transportation, equipment, home care, and respite care.

Be sure to ask what foods to stay away from while on your medications.

25

Preparing for Discharge When You Are Discharged Your physician determines when you are ready to be discharged.

Your physician and nurse will give you discharge instructions and answer any questions you have about managing your treatment and medications once you are home. If you are confused or unsure about what you need to do, what medications you must take or if you have to restrict your diet or activities, don’t be afraid to ask and take notes.

Be sure you understand any instructions you have been given before you leave the hospital.

Going Home

When your doctor feels that you are ready to leave the hospital, he or she will authorize a hospital discharge. Please speak with your nurse about our discharge procedures.

Here are a few tips to make the discharge process run smoothly: n Be sure you and/or your caregiver has spoken with a case manager or social worker and you understand what services you may need after leaving the hospital. (See “Don’t Leave Until…” on page 24 for more discharge advice.) n Verify your discharge date and time with your nurse or doctor. n Have someone available to pick you up. n Check your room, bathroom, closet and bedside table carefully for any personal items. n Retrieve any valuables you have stored in the hospital safe. n Make sure you or your caregiver has all necessary paperwork for billing, referrals, prescriptions, etc. n You may be required to settle your hospital bill in the Business Office prior to leaving the hospital.

What a Hospital Bill Covers

The hospital bill covers the cost of your room, meals, 24-hour nursing care, laboratory work, tests, medication, therapy and the services of hospital employees. You will receive a separate bill from your physicians for their professional services. If you have questions about these separate bills, please call the number printed on each statement.

The hospital is responsible for submitting bills to your insurance company and will do everything possible to expedite your claim. You should remember that your policy is a contract between you and your insurance company, and you have the final responsibility for payment of your hospital bill.

Coordination of Benefits (COB)

Coordination of Benefits, referred to as COB, is a term used by insurance companies when you are covered 26

under two or more insurance policies. This usually happens when partners and spouses are listed on each other’s insurance policies, when both parents carry their children on their individual policies, or when there is eligibility under two federal programs. This also can occur when you are involved in a motor vehicle accident and have medical insurance and automobile insurance.

Most insurance companies have COB provisions that determine who is the primary payer when medical expenses are incurred. This prevents duplicate payments.

COB priority must be identified at admission in order to comply with insurance guidelines. Your insurance may request a completed COB form before paying a claim, and every attempt will be made to notify you if this occurs. The hospital cannot provide this information to your insurance company. You must resolve this issue with your insurance carrier in order for the claim to be paid.

Medicare

We will need a copy of your Medicare card to verify eligibility and process your claim. You should be aware that the Medicare program specifically excludes payment for certain items and services, such as cosmetic surgery, some oral surgery procedures, personal comfort items, hearing evaluations and others. Deductibles and co-payments are the patient’s responsibility.

Medicaid

We will need a copy of your Medicaid card. Medicaid has payment limitations on a number of services and items.

Medicaid does not pay for the cost of a private room unless medically necessary.

Commercial Insurance

As a service to our customers, we will forward a claim to your commercial insurance carrier based on the information you provide at the time of registration. It is very important for you to provide all related information such as policy number, group number and the correct mailing address for your insurance company.

Post-Discharge Follow Up Over the Phone Our concern about your health does not end when you leave the hospital!

You will be enrolled in a post-discharge follow up program to help us better care for you at home.

How It Works You will receive a phone call from our automated system to ask you a few important questions about your health and progress. Your answers will be reviewed by staff from Decatur Morgan Hospital and we will provide help as necessary.

How You Participate Expect a call from 1-256-392-XXXX. 1. You will get an automated call within 48 hours of leaving the hospital.

2. The automated call will ask you a few questions.

Please answer the questions using the phone keypad.

3. B ased on your answers, a representative from Decatur Morgan Hospital may call you to offer help and instructions.

Thank you for your participation.

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Preparing for Discharge Uninsured?

If you are in need of assistance with your hospital billing, you can contact Hospital Financial Counseling (Decatur Campus) at 256-341-2551.

For Self-Pay Patients

Patient Financial Services Department will send statements for payment of self-pay accounts. You will receive billing statements and telephone calls to obtain a payment or to make payment arrangements. If payment arrangements are not established and no payment is made, the account will be placed with a collection agency. If you need an itemized statement, you can obtain one by calling our Customer Service Department at the number listed below. You also can pay your bill online at www.decaturmorganhospital.net. If you have any questions regarding your billing statement, you can contact the patient Financial Services Department at 877-615-6364 or 256-341-2898.

Giving Back Volunteer Volunteers are a vital part of Decatur Morgan Hospital. The more than 120 volunteers ranging from teen to retired adults assist with a range of tasks including transporting patients, working in the gift shop, and providing assistance at specials events.

For more information on volunteering, call 256-341-2444.

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There are many ways to help your community...

Helping Us Help Others

We are committed to providing quality healthcare regardless of the patient’s ability to pay. You can help us help others by making a contribution to Decatur Morgan Hospital Foundation. Your gift also will help enhance our services, programs and facilities to better care for our patients and the community.

Tax-deductible gifts can be made in the form of cash, check, credit card or stocks. You also may remember the Decatur Morgan Hospital Foundation in your will and through life insurance, among other gift options.

For more information, contact 256-341-2187 or make a gift online at www.decaturmorganhospital.net.

FRAN DRESCHER 1957-

Surgery is half the race, but you have to go for the follow-up or do yourself a major disservice.

Be Prepared

Rx

X marks the spot— be sure any mistaken markings on your body are completely cleaned off.

How you can make your surgical procedure and follow-up care as safe as possible.

Mistakes can happen during surgery.

As an active member of your healthcare team, you can make your surgical procedure and follow-up care as safe as possible. Here’s what you need to know.

Before Your Surgery

n Arrange for transportation to and

from the hospital or surgical center.

n Ask a relative or friend to go to the

hospital or surgical center with you, stay during your procedure, and accompany you home afterward.

n Bring a list of any questions you have

about your surgery to your pre-surgical doctor’s visit. Also bring a list of all the prescription, over-the-counter, and herbal medications that you are currently taking or that you took until very recently. Review the list with your surgeon and ask if there are any you should stop taking prior to your procedure. n Be sure your surgeon knows about any allergies you have to medications and foods. n Ask your surgeon whether you can eat or drink before your procedure, and if so, what kinds of food or drink, and within how many hours of your surgery. n Ask your surgeon whether you should remove nail polish or temporary dental appliances (such as a bridge), if you can wear deodorant or body lotion, and if there are other preparations you need to make prior to surgery. n Find out if you will need therapy after your surgery, who will arrange for it, and whether you can have therapy at home.

It’s hard to remember everything yourself.

When you meet with your doctor, bring your questions and a friend. Your friend can help listen, take notes and ask questions, too!

29

A Team Effort

Here’s how to work with your surgical team to get the best outcome: n Know the preparations you must make before your surgery. n Get to the hospital or surgical center early on the day of your surgery. n Review paperwork carefully before signing. n Make sure the proper part of your body is marked for surgery. n Get your post-surgical care instructions in writing before you leave.

On the Day of Your Surgery

nS hower or bathe and wash your hair.

Don’t wear makeup or perfume. Be sure to follow any other pre-surgery instructions you were given. nL eave your jewelry, money, credit cards, and other valuables at home. nA llow yourself plenty of time for travel. nO nce you arrive at the hospital or surgical center, you will be given an Informed Consent form to sign. Read it carefully. Make sure everything on the form is correct. If you don’t understand something, ask questions before you sign the form.

Before Your Procedure Begins n Staff at the hospital or surgical

center should ask you the following questions more than once before your surgery: Your name What kind of surgery you’re having The part of your body that is being operated on nA healthcare professional will mark

the spot on your body that is going to be operated on. Make sure he or she marks only the correct part. If he or she makes a mistake and has to make a new mark, be sure the old mark is completely cleaned off.

30

n I f you won’t be awake for the

marking, be sure your relative or friend watches the marking. nA sk your surgeon if the team will take a “time out” just before your procedure. This is done to make sure the team is doing the right surgery on the right body part of the right person.

After Your Surgery

nS peak up about any pain you are

having and ask for relief. Be specific about the intensity and location. n I f you are given medications right after surgery, ask what they are and what they are for. Ask about side effects. If you are given a prescription for medications you must take while recovering, be sure you understand the instructions for the dosage, how frequently you need to take the medications, and for how long. n I f you are given IV (intravenous) fluids right after surgery, ask what they are and what they are for. Be sure someone monitors the fluid level. nA sk your surgeon if your activities need to be limited, and if so, for how long. Ask when you will be able to resume work, exercise, and travel. nB e sure to get instructions for post-surgical care in writing before you leave.

ROBERT B. SHERMAN 1925–2012

A spoonful of sugar helps the medicine go down.

Watch What You Eat

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

RX MEDICINE

TIPS

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 overthe-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) Doxycycline Tetracycline Levaquin (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.

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.

Anti-coagulants (blood thinners)

31

Watch What You Eat continued DRUG CLASS

RX MEDICINE

TIPS

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.

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.

Colcrys (colchicine)

Avoid eating grapefruit and drinking grapefruit juice.

Zyloprim (allopurinol)

Take after meals.

Anti-seizure

Gout Medications*

*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.

32

DRUG CLASS

RX MEDICINE

TIPS

ACE Inhibitors Monopril (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 Blockers Calan (verapamil) Cardizem (diltiazem) Plendil (felodipine) Procardia (nifedipine)

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

Beta Blockers Tenormin (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.

Diuretics Aldactone (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

Bisphosphonates Fosamax (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.

High Blood Pressure

Limit caffeine when taking Calan.

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North Alabama Health Information Exchange Providing the right information for the right care.

Exchange (NAHIE). NAHIE was created in response to today’s demand Physicians who use NAHIE will be to make sharing health information able to share information with other easier and more secure, while improving participating healthcare providers who healthcare quality, better managing care for you. For example, specialists will costs and protecting patient’s privacy. be able to obtain your health records from This participation ensures your health your primary care physician. information is available to the doctors and North Alabama Health Information staff involved in your care.

Exchange provides answers to important NAHIE provides a patient portal, questions about patients quickly. allowing you to access your clinical information online. When you register Benefits for patients: with a participating healthcare provider, nG ives healthcare providers the he or she will ask you for an email address right answers to important health and offer to send you an invitation to questions, which is critical in receiving participate in the portal. If you accept this the right care. invitation, you will receive an email with nP rovides important emergency instructions on how to register for the information to healthcare providers. portal, and begin to monitor your own nG ives healthcare providers a more clinical information. complete picture of your overall health.

NAHIE is a partnership among North nC are can be more easily coordinated Alabama physicians, hospitals, clinics across different providers and facilities. and other healthcare facilities. Currently, nY ou can easily view your own health physicians are exchanging information information. through fax and hard copies. This process nY our personal health information is will make the exchange electronic. It protected in ways that traditional health offers participating healthcare providers records are not. a more complete picture of your health nM ay help reduce your costs by so they can deliver the best care. preventing duplication of tests and procedures.

Privacy and security NAHIE uses the latest technology to Making health information more protect your personal health information accessible and more secure and has safeguards that protect your Your physician is currently participating in information in ways that traditional the North Alabama Health Information health records cannot.

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NAHIE provides answers to important questions about patients quickly, securely and accurately, but only to those professionals who need to know.

Providers using NAHIE can only see and use your health information if they need to: n t reat you nc oordinate care with other providers n s ecurely communicate with you, as well as your caregivers Healthcare providers need your health information to accurately diagnose and treat you. While each of your healthcare providers may have different portions of your medical record, if they can access each other’s records and see a more complete picture of your health information, they can provide you with better care.

you may follow the instructions on the portal to opt out.

2. Alternatively, you may: nD ownload and print the Opt Out form at www.nahie.org. nF ill out the form completely, sign and mail the original to: North Alabama Health Information Exchange 101 Sivley Rd. Huntsville, AL 35801

You will NOT be denied medical care if you decide not to share your health information through NAHIE. However, it does mean that your complete health record will not be available in an emergency situation.

If you change your mind and want your providers to have access to your complete medical information, an Opt Out Opt out process Revocation form is located at www.nahie.

Although you are automatically enrolled org. Complete the revocation, sign and mail to the address listed on the form, and in NAHIE, your participation is voluntary. If you wish to opt out, there are your data will once again be available to your healthcare provider. several methods available to you.

Find out more by visiting www.nahie.org or calling 256-265-4443.

1. After registering through the NAHIE patient portal (in response to the email invitation from your healthcare provider),

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