March 2019


What's New at  

Guardian Nurses?

Just When You  

Thought It Was Safe  

To Go Home 







What's New at
 Guardian Nurses

  Out and About with our SHIF MCC Team 
This January, we introduced our Mobile Care Coordinator Program to the 14,000 members of the Schools Health Insurance Fund (SHIF) in New Jersey.  The three nurses-- Rachel, Colleen and Jeanette---photographed below, have been quite busy the last two months meeting and talking with patients and helping them through their healthcare journey.   
Rachel Fanslau, Colleen Pace, Betty Long and Jeanette Meredith pose with the Delsea Regional High School's Crusader mascot after a teachers' in-service. 

The SHIF MCC Team, all NJ based nurses, are clearly enjoying their work and based on early feedback from the patients and family members with whom they've helped, they are doing a wonderful job!!
March Madness Fun Facts 
1. First Game: March 27, 1939.  Among only eight teams, the University of Oregon defeats the Ohio State University 46-33 to win the first-ever NCAA men's basketball tournament.  
2. Most titles: UCLA holds the men's record for most titles---at 11.  University of Connecticut has the women's record, also at 11 titles.
3.  24 Million.  Last year, nearly 24 million people participated in March Madness bracket challenges, spending over $2.6 billion in entry fees.  
4.  $10 Billion:  The amount that will be wagered on this year's tournament, only $300 million of which will be done legally at sports books in Las Vegas, according to the American Gaming Association.  
5.  $8.8 billion. The amount of money CBS Sports and Turner will pay the NCAA to extend their March Madness broadcast rights through 2032.  
6.  $0.  The amount of money the NCAA pays the players participating in the tournament. 
Leaving the hospital after an admission, particularly if it's been a prolonged stay, can be cause for celebration.  But if the discharge instructions are not clear, or worse yet, incomplete, that celebration may result in a trip back to the ER.  And no one wants that!

A study of discharge instructions given to about 500 trauma patients leaving the hospital found that only 25% truly understood their instructions. Even if the patients understood what occurred during their hospitalization, they become confused after they leave.  And who can blame them?

Communication is the biggest hurdle in healthcare. We see it day in and day out with the patients with whom we are working. But one of the most important times to GET IT RIGHT is when someone is leaving the hospital. This issue of The Flame presents suggestions and questions for you to consider when either you or someone you love is being discharged.  

Enjoy 'March Madness'!  
Betty Long, RN, MHA
         Guardian Nurses Healthcare Advocates

Just When You Thought It Was Safe to Go Home...

The best time to start planning for discharge from the hospital or rehab facility is just after you (or your loved one) is admitted. While you may think this is too soon, planning gives you more time to prepare.  No one should be discharged until there is a safe and adequate discharge plan. This means that the plan meets your needs. If your stay has been complex, it may be in your best interest to ask for a "care team meeting" so you can fully understand the details of your discharge.

But, generally, here are some important considerations to keep in mind as you get ready to go home:

Equipment and Supplies--find out what the hospital or home care agency provides and what you must get.
  1.  What supplies do I need? (Skin care items, disposable gloves?)
  2. What equipment (like a shower chair, oxygen, or maybe a hospital bed) will I need?
  3. Where do I get these items and will my insurance pay for them?  Know that you CAN choose the company.
  4. Who is going to order them so that when I get home they're either already there or will be delivered soon?
Home Space--the space should be comfortable and safe and a good place for care. Ask the hospital team if you need to do anything special to get it ready. This might include: 
  1. Making room for a hospital bed or other large equipment.
  2. Move out items that can cause falls such as area rugs and cords.
  3. Arrange a safe place to store medications.
  4. Have a place for important information such as a bulletin board, notebook or drawer.
Medications--this is a very important component of a safe discharge plan:
  1. Review what medications you have been taking in the facility and what medications you are being sent home on.
  2. Make sure you have all the prescriptions for what you are supposed to take when you get home---especially painkillers.
  3. Make sure you understand how the medications are to be taken (with food, without food, at certain times of the day)
  4. Are there any side effects that I should be aware of?

Special Instructions--this includes wound care, activity level or special foods, etc.

  1. Ask if there are certain foods or liquids that you should or should not be eating.
  2. What types or kind of activities are safe for you to perform?  (Driving? Lifting? Running? etc)
  3. If a wound is involved, how do I take care of it at home? What supplies will I need to do that?
  4. Do I or my family member need special training to be able to manage care?
Follow Up Care--you may have one or more new healthcare providers as a result of your hospitalization. Even if no one new was introduced, at the very least, a post-discharge follow up visit should be scheduled with your primary care provider.   Before you leave the facility, make sure you know:
  1. Whom should I call with questions or changes in how I feel? 
  2. Whom do I need to see for follow up? What are the phone numbers for their offices?
  3. How soon do I need to make the appointment?
  4. Will a discharge summary be sent to my primary care provider?

In addition to all of the above, we encourage all of our patients to request from the facility a copy of their discharge summary. The discharge summary is a written document which summarizes the patient's admission.  Since it is completed after patients have gone home, the finalized version is available after discharge.   


If patients are in the hospital for surgery, we also encourage them to request a copy of the operative note. The operative note is a report written to document the details of a surgery.  


Bottom line, it is ALWAYS good to keep a record of any procedures, surgeries, tests, and admissions in your health care records. 

Click on "Your Discharge Planning Checklist" for a document you can print----courtesy of the Centers for Medicare and Medicaid Services.

Guardian Nurses Healthcare Advocates

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