Preparing for admission to hospital
Preparing for admission to hospital
Prior to admission
We do our utmost to prevent the spread of bacteria in our hospital.
Please get in touch with the ward to which you are to be admitted if you have answered YES to one or more of the following questions. It could be that you are carrying a bacterium undetected, and we need to take precautionary measures.
- Have you been found to carry a hospital bacterium (such as MRSA, VRE, Acinetobacter, MRGNS or ESBL)?
- Were you admitted to another Dutch hospital in the past two months and was there an outbreak of a hospital bacterium on the relevant ward?
- Were you admitted to, treated or examined at a foreign hospital or healthcare institution in the past two months?
- Do you live or work somewhere where there are pigs, veal calves or poultry?
- Do you live with or care for someone who has been found to be carrying the MRSA bacterium?
- Have you lived in a shelter or institute for asylum seekers in the past two months?
The admission schedule
As far as possible, we will set the date and time of admission in consultation with you. You will be provided with a definitive notification closer to that date. Nevertheless, it could be that a scheduled admission cannot go ahead due to forces beyond our control. We do realize how annoying this is for you. We will let you know as soon as possible and make a new appointment for you.
If you are undergoing surgery or an examination under anesthetic, then we will first check whether you will be able to undergo the procedure safely and without particular risks. This screening will usually be carried out by nursing staff at the outpatient clinic. Furthermore, you will often be sent to the Preoperative Screening clinic ("POS-poli") for medical screening performed by the physician. Preparation for an operation starts at home.
Day admissions, multi-day admissions
Some treatments or examinations require that the patient spend one or more nights in the hospital as a medical necessity. We refer to these as "multi-day admissions." For other treatments or examinations you will be able to return home the same day. This is referred to as a day admission or day treatment.
Going to be admitted to hospital soon? If so, it is important for you to keep as physically fit as your condition will allow. After all, research shows that patients coming into hospital in better shape are able to return home sooner and recover to their previous level more rapidly.
Do you spend a lot of time sat at a desk or on the sofa? Long periods spent sitting down are not good for your body. Sitting is the new smoking, it is often said. For that reason, please try to exercise as much as your condition will allow in the period leading up to your admission. A bit of walking or climbing the stairs a bit more often could already help.
Mixed-sex nursing wards
Most nursing wards hold both men and women. This enables us to minimize waiting times for admissions. Any objections to mixed-sex nursing wards? If so, please inform the nursing ward staff prior to admission. We will take this into consideration if it is possible to do so.
Seeing to the period after admission
We generally know prior to your admission whether you will be requiring any extra help upon your return home. The nursing staff will discuss this with you. Will family members or other relatives be able to support you? Take care of as many things as possible prior to your admission. You can get information on domestic help from the social support (WMO) counter at your local authority. You can always discuss this with your family doctor too.
The day of admission
Reporting to Central Admissions
On the day of your admission, please report to Central Admissions near the main entrance. A member of staff will check your personal and insurance details in a computer file. You can pass on any changes here.
If you need to be at the hospital before 8 a.m., then the day of admission will start differently for you: If there is no one available yet at Central Admissions, please head straight to the nursing ward. Of course, the day of admission will also run differently if you are admitted urgently.
If you are admitted on the day of the treatment, then you will often need to have fasted. If this is the case, then your physician will indicate in advance the latest time at which you are allowed to eat and drink.
In the nursing ward
After registration, a host or hostess will accompany you to the nursing ward. You will be given a tour of the ward and be introduced to a few members of staff. An identity band will be put round your wrist. This is to ensure that you can be identified at all times.
One of the ward's nurses will hold a nursing admissions consultation with you. They will ask such things as the name and telephone number of a family member or contact person whom we can get in touch with if need be. If you need to arrive at the hospital before 8 a.m., then the admissions consultation will usually be done at your last outpatient clinic visit. In that case you will only need to state whether anything has changed since that visit.
Wherever possible, we will take the nature of your illness, your personal circumstances and your wishes into consideration for the purposes of room selection.
Hypersensitive or allergic to certain substances, foods or medicines? If so, please be sure to let us know during the admissions consultation. Please also inform the physician treating you.
Are you on a specific diet? Please inform the nurse during the admissions consultation. They will inform the ward's dietician to enable you to continue with your diet during your spell in hospital. If a particular diet or dietary change is necessary on the grounds of your treatment, then the dietician will discuss this with you. You will subsequently be given a diet tailored to your wishes and preferences. The dietician will explain how the diet works.
Are you taking any medication? If so, please bring it to the hospital, preferably in its original packaging. It is important for physicians and nursing staff to know what medication you are currently taking and what medication you have been using recently. Therefore, please ask for a current overview of medication at your pharmacy. The pharmacist’s assistant will run through this overview with you. During your stay you will be given medication from the hospital. Please only use your own medication in consultation with the physician, as certain combinations of medication can be harmful.
Staying in the hospital
The nursing wards encompass several one-person, two-person and four-person rooms. Each room has its own bathroom with toilet. You will be allocated your own locker. Next to your bed is a screen enabling you to watch television, use the telephone, surf the Internet and listen to the radio.
The nursing ward
The nursing desk is in the middle of the ward. Each nursing ward has a day room where you can watch television, play games or receive visitors.
Your stay in the hospital is all about examining and treating your condition. This will result in regularly recurring activities, of which we will provide you with an impression. Precise times could vary from ward to ward.
- The day on the ward begins at 7.30 a.m. The day team will read the patients’ care files until 7.45 a.m. The night team will hand over to the day team.
- You will be given breakfast between 8 a.m. and 8.15 a.m. In the course of the morning, the nursing staff will help you with your care and treatment, as required. The nursing staff will perform various physical checks (such as taking your temperature, your pulse and your blood pressure). Examinations might also be scheduled for you over the course of the day.
- You can expect lunch between 12 p.m. and 1 p.m.
- Further care will be given during the course of the afternoon and evening, if need be. Naturally there will be ample opportunity to welcome visitors in the afternoon. In principle, visiting hours are between 3 p.m. and 8 p.m. Other visiting times can be arranged in consultation with the nursing staff.
- You will be served dinner on the ward between 5 p.m. and 6 p.m.
- We try to ensure peace and quiet on the ward from 10 p.m. For that reason, we request that you no longer use any bright light, radio without earphones, television and suchlike to give your fellow patients a chance to sleep.
The physician treating you could be a different physician to the one who was treating you at the outpatient clinic. It goes without saying that the physician treating you will be aware of your situation and will have all information at their disposal.
Once admitted to hospital, try to keep moving as much as possible. For every day that you do not exercise, you could lose between 1% and 5% of your fitness and muscle strength, will slow down your recovery. It also increases the risk of complications, such as thrombosis or a lung infection.
Exercising is easily combined with day-to-day activities on the ward, such as washing, getting dressed, watching television or receiving visitors.
A few tips are presented below:
- Try to take a walk every morning, afternoon and evening at a minimum. Depending on your level of fitness, this could be in your room, on the ward or even outside of the ward. If you leave the ward, please tell the nursing staff.
- As far as possible, please wear your normal clothing and comfortable shoes instead of pajamas and slippers during your stay in the hospital.
- Try to wash and dress yourself as much as you can, preferably in the bathroom (and not in bed).
- Try to keep out of bed as much as possible, unless you are told to stay in bed.
- If you have difficulty getting out of bed yourself, please ask the nursing staff or a physiotherapist for help.
- As far as possible, please eat and drink at the table and not in bed.
- Coffee can be obtained from the vending machine and then drunk at the table.
- Take a walk round the ward regularly
- Escort your visitors to the lifts to say goodbye to them.
Whilst you are in our hospital, you will often see several doctors, sometimes of different specializations. The practitioner is often a physician training to be a medical specialist (i.e. a resident physician). They will be your point of contact and will come by to discuss the treatment with you (physician visit). A medical specialist will always bear final responsibility for your medical treatment. This will be your primary practitioner. The nurse or ward physician will inform you who your primary practitioner is. Sometimes this is specified on a board by your bed. It goes without saying that you can also ask them.
Every day (except on weekends) the ward physician will come by, along with an intern and a nurse. We refer to this as the physician visit. Occasionally the medical specialist will accompany them. They will then discuss the continuation of the treatment with you.
Please do consider beforehand what questions you would like to ask the physician and write these down if need be. Ensure that you remain close to your room until after the visit to prevent you missing the physician. Visits are at set times on every ward.
In addition to the daily physician visits there is a "big visit" from a large group of physicians and nurses each week. They will be evaluating your care and treatment. This also serves as an opportunity to educate interns and resident physicians. If you wish to speak with the ward physician or medical specialist outside of the physician visit, please say so during the visit or inform the nursing staff.
Your name and date of birth
During your stay at the hospital you will frequently be asked your name and date of birth by staff. This is not because we do not know who you are, but rather to prevent them from making a mistake.
It is important for the physicians and nursing staff to know whether or not you are in pain. Pain is not only unpleasant, it can also cause problems. During your stay at the hospital, the nursing staff will regularly ask you to rate your pain on a scale from 0 to 10, with 0 meaning no pain and 10 being the worst pain imaginable. Medication can be administered if you are in pain.
Measures to prevent infections
A hospital contains patients and people who are carrying bacteria or viruses. These bacteria or viruses could cause infections. We do our utmost to prevent the spread of bacteria and viruses to other patients. Hygiene measures are in place (such as the use of hand sanitizer), which all hospital staff are required to adhere to.
Sometimes these general measures prove inadequate. In such cases, special isolation measures are required. These include hanging a colored card (isolation card) on the door to your room or by your bed. This will alert hospital staff and those visiting you to the requisite measures.
The ward staff take your privacy into account. As far as possible, we will ensure that other people do not witness any of your treatment. Discussions with a healthcare provider can be held in a separate room on the ward.
Use of cell phones
The use of cell phones is permitted within the UMC Utrecht, except in those zones where it would interfere with medical equipment or disturb other people. There are prohibition signs at the entrance to these areas. You are not allowed to use your cell phone on the nursing wards. Consequently, we would ask you to switch off your cell phone on a nursing ward.
Mail is received through the ward secretary or a member of the nursing staff. Address your mail as follows:
Ward (for example) C4 West - room 14
c/o UMC Utrecht
3508 GA Utrecht, The Netherlands
The majority of wards allow you to receive visitors between 3 p.m. and 8 p.m. each day. If you do not feel up to receiving visitors, then the nursing staff will inform your contact person of this situation. In order to ensure peace and quiet for patients:
- Visits are preferably restricted to two people at a time. We would appreciate it if your contact person could see to it that visits from different people are staggered.
- Visits should preferably not exceed one hour.
Due to these generous visiting times, it is possible that a physician or nurse comes by during the visiting period. In such cases, we would ask that your visitor(s) wait outside the room for a short while. Alternative visiting hours may apply on some wards for practical reasons. The nursing staff will tell you about this.
Smoking is not permitted in the hospital. There are specific smoking areas outside, which are clearly indicated.
Leaving the ward
If you are not required to remain in bed, then you can also go to other parts of the hospital. Interesting places for you include the central lobby, the indoor patios, the sanctuary, the piazza or the magazine service (all on level 1). You can also take a walk past all the art in our hospital. It may also be possible to take a short stroll outside in the garden, in consultation with your physician. Please always inform the nursing staff if you are leaving the department. Please also let them know where you think you will be going and at what time you will be back. This is with a view to scheduled examinations or visits from the physician, family or friends. Be sure not to leave your valuables unattended. Take them with you or place them in your locker.
If your situation permits, it is possible to leave the hospital for the weekend and on public holidays, after consulting with the ward doctor. In principle, weekend leave runs from Saturday morning 9 a.m. to Sunday evening 8 p.m.
It is possible that you may have to move to another room on the ward during your stay at the hospital. If this is required, then you will be informed as soon as possible. We thank you for your understanding.
Good information on what is to be done is important before, during and after your admission to hospital. Accordingly, the healthcare providers will explain to you what the problem is and what is to be done about it. Usually, you will be supplied with some reading material to provide further clarification, which you can read through at your leisure. It can help you to actively contribute to thinking and decision-making on your healthcare and treatment. Any questions? Please ask the physician or nursing staff. Need help understanding information or making decisions? Then let us know. There will always be a healthcare provider who can help you to think things through.
Discharge and aftercare
Returning home (discharge)
It is often difficult to say when you will be allowed to return home. Usually you will be told one or two days in advance. You will have a discharge consultation with your physician and a nurse. The time of discharge is around 10 a.m. on most wards. Your physician will discuss with you any follow-up treatment you may require after being discharged from the hospital. If you need to take any medication at home, you will be given a prescription. You can take this to your own pharmacy or use the pharmacy in the hospital. Your family doctor will be informed of your discharge and of the agreed aftercare.
Spending less time in hospital is a win-win situation
The shorter the time a patient has to spend lying in a hospital bed, the quicker their recovery will be. However, it is not just good for the patient if the time spent lying down is no longer than is strictly necessary. It also frees up more places more quickly for other patients. The UMC Utrecht therefore actively seeks to reduce the time patients occupy beds in the hospital.
Projected discharge date
Obviously we prefer our patients to make a swift recovery and return home as soon as they are fit to do so. However, as long as they are with us we want them to feel as comfortable as possible. This calls for perfect organization: The wards have to harmonize their schedules unerringly. One thing that can help in this regard is to work toward a projected discharge date. Based on this date, an overall plan can be drawn up.
Several successful "projected discharge date" projects have now been completed at the UMC Utrecht, which have resulted in the time patients spend in hospital beds being reduced by at least 10-30%.
Website for informal caregivers
Once you return home, you may occasionally require help from family or friends for a while, with shopping or getting dressed and undressed, for instance. This is referred to as informal care. There is a free website to assist in making this care easy to organize: WeHelpen.nl (Dutch language only). Here you will find such things as an electronic diary. Using this diary will mean that everyone in your network knows what tasks need to be tackled, thus ensuring that you do not have to call or email everyone. This website is also useful for coordinating visits.
Usually, the ward secretary will make an appointment for your next visit to the outpatient clinic. The transfer nurse or medical social worker will look at what help you require in your home. If you need nursing assistance at home, they will arrange this domestic care for you. You might be referred to a physiotherapist, a dietician or other healthcare provider. If you need home help after your stay at the hospital, you will need to arrange this yourself. Please ask about the procedure at the social support (WMO) counter at your local authority.
Occasionally it is not possible to return home straight away. The physician could, for example, recommend a temporary stay in a nursing or convalescent home. You will be able to discuss the options with the transfer nurse or medical social worker. They will arrange the admission to the other facility.
Recovering your strength after your stay at the hospital
Back home after your stay at the hospital? Then the time has come to keep working on your recovery. It is crucial at this stage to start building up your exercise again. This can aid swifter recovery.
As soon as you have returned home, you can set yourself goals. Walking a little further each day, for instance. In the beginning, stick to walking in and around the house before moving on to getting a little further down the street or around your neighborhood. You may be able to start cycling again or return to a gym after a few weeks and push things further.
Unsure as to what is and is not possible in your situation? Then please discuss this with your physician or physiotherapist.