Patient Consent Form for Selling of Personal Creations - PDF

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Patient Consent Form for Selling of Personal Creations - PDF Powered By Docstoc                                                                                              (816) 348-1458

H2U news                                                ®

                                                              health happiness you
H2U at Research Belton Hospital                                                                                              April 2006

Donate Life Today
and Help 50 People!
Life is precious, a fact that is always “top of   and tissue typing, organ size, medical
mind” to more than 90,000 Americans who           urgency, length of time on the list and
are waiting for an organ, marrow or tissue        geographic location.
transplant. With April being such a big
                                                  Myth: Donors must be within a specific
month for health observances, including
                                                  age range.
National Donate Life Month, it’s important
                                                  Fact: People of all ages may be organ and
to understand the facts about organ and
                                                  tissue donors. Physical condition, not age,
tissue donation.
                                                  is important. Please sign a donor card; at
Each day, about 74 people receive an organ        the appropriate time physicians will decide
transplant. However, 17 people die each           whether your organs and tissues can be
day waiting for transplants that can’t take       transplanted.                                              Health Bite
place because of the shortage of donated
                                                  Myth: My family will be charged for
organs. The following are a number of
myths and facts about organ donation.
                                                  donating my organs.
                                                  Fact: Donation costs are not the
                                                                                                      Reaching Out
Myth: The rich and famous on the National         responsibility of the donor’s family or estate.     to Our Neighbors
Organ and Tissue Donor Registry get
                                                  Myth: Organ donation will disfigure my              The Research Foundation,
preferential treatment.
                                                  body.                                               physicians and staff of Research
Fact: The computerized matching system
                                                  Fact: Organs and tissues are removed in             Medical Center will join together on
does not select recipients based on fame
                                                                                                      Saturday, April 22 to provide a health
or wealth. Organs are matched by blood            Continued on next page
                                                                                                      care event for the community
C22                                                                                                   focusing on fitness, wellness and
                                                                                                      prevention. There will be a 2-mile
                                                                                                      walk, cooking and exercise
                                                                                                      demonstrations, kids’ area, live
                                                                                                      band, and more. A free health fair,
                                                                                                      with tips for leading a healthy lifestyle
                                                                                                      will be the centerpiece of the event.
                                                                                                      There will be food, fun and prizes!
                                                                    Belton, MO 64012                  See page 4 for details.
                                                                    17065 South 71 Highway
                                                                    H2U at Research Belton Hospital
Research Belton Hospital

Donate Life
From front page
                                                   Watch Out, Weekend
procedures similar to surgery, and all
incisions are closed at the conclusion of
the surgery. An open casket funeral is
possible after donation.                           It’s great that you are all pumped up and
                                                   ready to exercise. But if you don’t take
Myth: Organs are sold, with enormous               precautions, your “season” could be over
profits going to the medical community.            before the first game.
Fact: Federal law prohibits the buying and
selling of organs in the U.S. Violations are       As you know, our bodies change with age.
punishable by prison sentences and fines.          Tendons and ligaments lose some of their
                                                   elasticity which leads to reduced range of
Myth: Marrow donation is painful.                  motion in the joints, making these areas
Fact: Marrow donors do not feel pain               more prone to injuries. And when injuries
when the marrow is removed because                 strike aging bodies, recovery usually takes
anesthesia is used. Soreness and/or                longer.
stiffness may be felt for a week or so post-
donation.                                          To prevent injury, follow these tips from the
                                                   American Academy of Orthopedic
Myth: If I sign a donor card, it will affect the
                                                   Surgeons (AAOS) and the American
quality of care I receive at the hospital.                                                         day with activities such as jogging,
                                                   Orthopedic Society for Sports Medicine
Fact: No! Every effort is made to save                                                             walking, swimming, cycling and strength
your life before donation is considered.                                                           training.
                                                   > Get a basic medical screening if you’re
What can be donated?                                                                               > Get the right equipment for your sport.
                                                   over 35 and haven’t been involved in a
Organs: heart, kidneys, pancreas, lungs,                                                           If, for example, the tread on the bottom of
                                                   regular exercise program. Find out if you
liver and intestines                                                                               your shoes is worn, replace the shoes. If
                                                   have any conditions that would put you in
Tissue: cornea, skin, bone marrow, heart                                                           you’re a cyclist, wear a properly fitted
                                                   jeopardy while exercising.
valves and connective tissue                                                                       helmet.

Make today the day you:                            > Warm up and stretch before physical
                                                   activity. Cold muscles are more prone to        > Follow the 10 percent rule. Increase
> Download, print, sign and carry a donor
                                                   injury, which is why you’re asking for          your level of activity in 10 percent
                                                   trouble if you skip the warm-up. Wake up        increments. If you currently walk two miles,
> Say yes to donation on your driver’s
                                                   those muscles with light jogging or             don’t expect to walk four miles tomorrow.
                                                   walking. Then stretch the major muscles         Instead, build your activity level gradually.
> Sign up with your state’s donor registry
                                                   you’ll be using; hold each stretch 30           This rule applies to working with weights,
(if your state has one).
                                                   seconds without bouncing.                       too.
> Discuss your decision with your family;
they may be asked to give consent.
                                                   > Stick with a balanced exercise program.       > Listen to your body. Every day your
Even if you sign a donor card, it is essential     Follow a program that includes                  body sends you messages about how it’s
that your family knows your wishes. Your           cardiovascular activity, strength training      feeling. Pay attention to those messages.
family may be asked to sign a consent form         and stretching.                                 Don’t ever stretch or exercise if it is painful.
in order for your donation to occur.
                                                   > Ditch the “weekend warrior” attitude.         > Seek professional help if you injure
For more information and to print a donor          You can’t possibly make gains in fitness by     yourself. Consult an orthopedic surgeon
card, visit the “National Resources” page          cramming your activity into two days. Aim       for injuries such as tendonitis, arthritis,
at                                    for 30 minutes of physical activity every       stress fractures or low back pain.                                                                                             (816) 348-1458

                                                this very important program about the risk   Thursday, April 13

                                                of falls and what you can do to prevent      2:00 p.m.
                                                them. Professional staff from the Rehab      Meeting Rooms 3 & 4,
                                                Department of Research Belton will           Lobby Level, RMC
                                                provide information about home safety        Free
                                                and fall prevention. Refreshments will be    Dr. Tapan K. Chaudhuri, M.D. will present

  health and                                    served. RSVP to (816) 348-1458.

                                                Let’s Hang on to What We’ve Got:
                                                                                             the Art and Science of Acupuncture. If
                                                                                             you have questions about Alternative
                                                                                             Medicine or Acupuncture, specifically, Dr.

  community                                     Looking Terrific During Menopause
                                                Thursday, April 13
                                                6:30 p.m.
                                                                                             Chaudhuri, a physician of Internal
                                                                                             Medicine will provide up to date and
                                                                                             practical information about this ancient

  events                                        Research Belton Hospital Cafeteria
                                                                                             practice. A free blood pressure screening
                                                                                             will be offered following the program.
                                                Red Hot Mamas offers a fun, supportive,      RSVP to (816) 823-0508.
                                                and educational forum to obtain the most
Research Belton Events                          current and reliable information on           Sponsoring Hospital
                                                menopause issues from local medical
Joint Venture
                                                specialists. Invite a friend and join Red
Tuesday, April 11
                                                Hot Mamas! This program is free to the
and Tuesday, April 25
                                                public. Please register in advance by
Second and fourth Tuesday
                                                calling Hannah at (816) 348-1458.
9:00 a.m. - 12:00 p.m.
Research Belton Hospital
2nd Floor, Activity Room                        Sister Hospital Events
“Joint Venture” is a program that has been
created at Research Belton Hospital to          Reading Labels and Shopping
assist patients that will be experiencing       Wednesday, April 5
total hip or knee surgery. It has been set-     8:30 - 9:30 a.m.                             membership
up as a time for the patient to pre-register,
have their lab work completed, visit with
                                                Cardiac Rehab, 7th Floor, RMC
                                                Free                                         information
the operating room nurse, receive               Now is the time to learn the basics for
instructions from the physical therapy          heart healthy shopping. RSVP to              To contact the H2U national office:
department and have the opportunity to          (816) 276-3970.                              H2U Membership Center
ask questions they may have. Bring your                                                       .O.
                                                                                             P Box 1300
Medicare and Insurance Cards. A family          Healthy Eating & Portions                    Nashville, TN 37202-1300
member is welcome to participate with           Wednesday, April 12                          (800) 771-0428
you. “Joint Venture” concludes with a           2:00 - 3:00 p.m.
complimentary lunch. RSVP to                    and Wednesday, April 19                      To contact your local H2U office:
(816) 248-1203.                                 8:30 - 9:30 a.m.                             H2U at Research Belton Hospital
                                                Cardiac Rehab, 7th Floor, RMC                17065 South 71 Highway
Don’t Let a Fall Be Your Last Trip!             Free                                         Belton, MO 64012
Wednesday, April 19                             Learn how to protect your health,            (816) 348-1458
2:00 p.m.                                       manage your weight, and reduce your          Affiliate Director:
Research Belton Hospital Cafeteria              risk of heart disease, by paying careful     Jacqueline Talman
Free                                            attention to food choices and portion
More than one-third of adults ages 65           size. RSVP to 276-3970.                      or go to
and older fall each year. Among older
                                                                                             This newsletter is not intended to provide
adults, the majority of fractures are           Dessert with the Doctor — The Art            advice on personal medical matters, nor is it a
caused by falls. You won’t want to miss         and Science of Acupuncture                   substitute for consultation with a physician.
Research Belton Hospital

    special events
Community Block Party
and Health Fair
“Reaching Out to Our Neighbors”
Saturday, April 22
10 a.m. - 2 p.m.
RMC, Parking Lot, Meyer Blvd.
Enjoy an old fashioned block
party, complete with face
                                                                   For health information, options and support, join the Red Hot
painting, music, dancing,
                                                                   Mamas. Refreshments, fun and prizes are a part of every
refreshments, prizes and
                                                                   meeting. To register for the Red Hot Mamas or for additional
more! The Research Foundation is hosting this event which will
                                                                   information, call (816) 348-1458.
also include a health fair with a variety of free screenings and
health information provided by Research Medical Center
physicians and staff. In addition, cooking and exercise            High Tea & Fashion Show
demonstrations will be offered, as well as a supervised walk,      Saturday, April 29
led by an exercise expert. You won’t want to miss this             11:30 a.m.
opportunity to take control of your health and to enjoy            Milburn Country Club, 7501 W. 69th St., Shawnee, KS
springtime in Kansas City.                                         $15
                                                                   Bring your sister, daughter, granddaughter or friend to this
Red Hot Mamas                                                      delightful afternoon of friendship and High Tea. Enjoy a spring
                                                                   fashion show modeled by our own H2U members and featuring
Topic: Let’s Hang on to What We’ve Got:                            the latest creations from Dillard’s. You will feast on assorted
Looking Terrific During Menopause                                  finger sandwiches. Delicious scones and assorted mini fruit
Thursday, April 13                                                 muffins will be served with a variety of condiments. Satisfy your
6:30 p.m.                                                          sweet tooth with mini cream puffs, tart bars, lemon shortbread,
Research Belton Hospital Cafeteria                                 apple tarts, chocolate dipped strawberries and much more.
Menopause is an extremely “hot” topic these days and women         Everyone attending will receive a discount coupon to be used at
everywhere are looking for answers. With 6,000 American            Dillard’s and you will also be able to do a little shopping
woman a day entering menopause, it is no surprise that the Red     immediately following the tea. Make check payable to H2U and
Hot Mamas program has become the nation’s largest                  mail to 12200 W. 106th St. Suite 20, Overland Park, KS. For
menopause education program. We recognize that many                additional information call (913) 541-5364.
women lack the necessary information they need to confront the
range of changes that may occur at menopause.

The menopause management education programs of PRIME
PLUS/Red Hot Mamas are designed to help women acquire
medically accurate information about menopause and to help
them maximize their quality of life. Each month, meetings are
held at which a physician or healthcare professional addresses
a specific topic on the wide range of physical and emotional
changes related to menopause, providing up-to-date, medically
sound information.                                                                                       (816) 348-1458
           calendar of events                                                                                  april 2006
  S U N D AY        M O N D AY         T U E S D AY        W E D N E S D AY      T H U R S D AY   F R I D AY         S AT U R D AY

  Research Belton Hospital (RBH)
  17065 South 71 Highway
  Belton, MO 64012
  Baptist-Lutheran Medical Center (BLMC)
  6601 Rockhill Rd. (Holmes and Rockhill Road)
  Kansas City, MO 64131
  Research Medical Center (RMC)
  2316 Meyer Blvd. (71 Highway and Meyer Blvd.)
  Kansas City, MO 64132

               2                 3                    4    8:30 a.m.
                                                                         5                    6                7                 8
                                                           Labels and
                                                           Cardiac Rehab,
                                                           7th fl, RMC

               9              10     9:00 a.m. -
                                     12:00 p.m.
                                                   11      2:00 p.m.
                                                                       12      2:00 p.m.
                                                                                            13             14                  15
                                     Joint Venture,        Eating and          with the Doctor,
                                     2nd floor, Activity   Portions, Cardiac   Meeting Rooms
                                     Room,                 Rehab, 7th fl,      3 & 4, Lobby
                                     Research              RMC                 Level, RMC
                                     Belton Hospital
                                                                               6:30 p.m.
                                                                               Red Hot Mamas,
                                                                               Belton Hospital

            16                17                   18      8:30 a.m.
                                                                       19                   20             21      10:00 a.m.
                                                           Eating and                                              out to our
                                                           Portions, Cardiac                                       Neighbors”
                                                           Rehab, 7th fl,                                          Community
                                                           RMC                                                     Block Party and
                                                           2:00 p.m.                                               Health Fair, RMC
                                                           Don’t Let a Fall                                        parking lot
                                                           Be Your Last
                                                           Trip!, Research
                                                           Belton Hospital

            23               24                    25      2:00 p.m.
                                                           Eating Out
                                                                       26                   27             28      11:30 a.m.
                                                                                                                   High Tea &
                                                           & Cooking                                               Fashion Show,
                                                           Healthy, Cardiac                                        Milburn Country
                                                           Rehab, 7th fl,                                          Club

Research Belton Hospital

    travel information
                                                                         Sac-n-Fox Casino
                                                                         July 6
                                                                         Depart Research Belton Hospital at 8:00 a.m.; return at
                                                                         6:00 p.m.
                                                                         $29 per person
                                                                         You’re off to Powhattan, Kansas for some exhilarating Vegas-
                                                                         style gambling at the Sac-n-Fox Casino. This casino feature 470
                                                                         slot machines with the new games on the market. Sac N Fox
                                                                         also offers a variety of table games including Craps, Blackjack,
                                                                         Roulette, and Texas Hold ‘Em. You receive a $10 gaming
                                                                         coupon upon arrival, and a lunch buffet is included. Please
Springtime in Topeka plus                                                include your full date of birth on your registration form (the

the Bob Dole Institute                                                   Casino requires it).

May 30
Depart Research Belton Hospital at 7:30 a.m.; return at
                                                                         Local H2U Partners with
6:15 p.m.
$47 per person
                                                                         McKinzie Tours, Inc.
What a way to Welcome Spring! Travel to Topeka for a private             You will notice several opportunities for day trips in this
home tour in the historic Potwin district of Topeka. Lunch is            newsletter and in the future. Please note the contact
included at a local restaurant. We will then visit Cedar Crest, the      information for registrations and information is with McKinzie
Governor’s Mansion. Cedar Crest is one of our nation’s most              Tours listed below:
beautiful Governor’s homes, uniquely located in a wildlife refuge        Pat McKinzie or Pam Hedlund
and park. Next, visit the Robert J. Dole Institute of Politics located   Cruise Specialist and Tour Planner
on the University of Kansas Campus in Lawrence. The exhibit              McKinzie Tours, Inc.
introduces you to the senator’s life and career.                         phone: (913) 681-2202; fax: (913) 681-2685
Flavors of the Flint Hills                                               P.O.Box 23559, Overland Park, KS 66283-0559
                                                                         Cancellations must be received at least 48 hours prior to
June 1                                                                   departure. Enjoy!
Depart Research Belton Hospital at 5:30 a.m., return at
8:15 p.m.
$83 per person
Get a bite to eat and a taste of history at our stops on this
unusual tour through the beautiful Flint Hills of Kansas. Our
morning begins with breakfast at Terwilliger House, built in 1861
alongside the Santa Fe Trail. Rose Bacon, a true cowgirl joins us
on the coach to the R&K Ranch for a cutting horse and cattle
dog demonstration. Taking the Flint Hills Scenic Byway, expect
the hills to be alive with the brilliant colors of wildflowers.
Next it’s lunchtime in Cottonwood Falls at the Emma Chase
Café. We’ll continue taking the scenic byway thru the Flint Hills
stopping for an ice cream treat at Sunflower & Sodas and in
Alma, we’ll stop at the Alma Creamery, before returning home.                                                                                              (816) 348-1458


from the H2U desk
Those of us who work in hospitals know firsthand the innumerable contributions
volunteers make. Without their time, talent and commitment our organization would
never achieve all that must be done to best serve our patients and their families.
                                                                                                Discover Drug
Volunteers enrich every area, allowing us to do more, aim higher and achieve the best
possible results. Volunteers are the ultimate “budget stretcher.” Their dedication allows       You pick up a new medicine that your
every dollar we spend to go further, accomplishing more than we’d ever achieve without          doctor prescribed for you but you can’t
them. The productivity they add to our organization is undeniably beneficial.                   remember what the pharmacist said. Is it
                                                                                                okay to take this medicine with juice? Will
But it is not the monetary value derived from volunteers that is most important. Think of       it affect the other medications? Are there
all the kind words, engaging smiles and empathetic understanding they provide.                  any potential side effects? Get your
Although only one week annually is dedicated in their honor, they are with us every             answers at
week. It is with great pleasure and thankfulness we honor these wonderful individuals
                                                                                                For instance, if you take Allegra for
during National Volunteer Week, April 23-29.
                                                                                                allergies, you should only drink water with
                                                                                                the medicine. Allegra is comprised of
Jacqueline Talman
                                                                                                fexofenadine hydrochloride, which can be
H2U Affiliate Director
                                                                                                neutralized if you drink grapefruit, orange
Research Belton Hospital
                                                                                                or apple juice when taking the medicine.
                                                                                                The juices will essentially turn off the
                                                                                                active ingredient in the medication.
                                               give out patient information unless the

                                               caller has a specific passcode. When             You can evaluate your current medications
                                               patients enter our hospital, they are            by visiting the H2U website. Under the
                                               given a passcode. It is up to the patient        heading “H2U Health Map” in the left
                                               to give this passcode to friends and             navigation bar, click on the link “Drug
                                               family members with whom the patient             Interactions.” A new Web browser will
                                               wants to share personal health                   appear, titled “My Drug-Reax, your
                                               information. If a caller has the correct         comprehensive medication interaction
Cynthia Princ, Chief Nursing Officer
                                               passcode, the nurse is authorized to             source.” The next step is to find all your
at Research Belton Hospital,
                                               give out limited information about the           medications and add them to “My Med
discusses the hospital’s privacy
                                               patient.                                         Cabinet.” You can scroll through the list of
                                                                                                common medications or you can search
                                               Patients are automatically listed in a daily     for a specific medication. Once you find
Q. I am aware that the hospital has
                                               register of hospital patients, but you can       each medicine, click on the link “Add to My
certain privacy rules. Can my friends
                                               decide not to be included on this list. If       Med Cabinet.”
and family call me when I’m in the
hospital?                                      you opt out of this list, you will not receive
                                                                                                After all your medications have been
                                               any visitors, floral deliveries, etc.
                                                                                                added, click on the “Check My Meds”
A. Absolutely. Support from family and
                                                                                                link to evaluate your medications in light
friends is important to your recovery. But     Many of our patients use the passcode
                                                                                                of any interactions with other over-the-
our hospital does have certain rules that      but keep their names on the register so
                                                                                                counter drugs (like aspirin) or certain
follow the requirements of the HIPAA           that they can have visitors. Should it be
                                                                                                foods and drinks (such as juices,
(Health Information Portability and            necessary for you to stay in our hospital,
                                                                                                caffeinated beverages or alcohol).
Accountability Act) Privacy Rule.              we hope the information we have
                                               provided on these privacy regulations will       Visit today and check your
In the case of our hospital, we do not         enhance your stay.                               medications. It can impact your health.
   Empowering people to manage their health and enjoy a healthy lifestyle

A Salute to our Volunteer Staff
What would a hospital be without                                                           an opportunity to just get out of the house
volunteers? Obviously, just not the same!                                                  for awhile in the evenings. She started her
We at Research Belton Hospital are                                                         volunteer services from 3:00 - 8:00 p.m. in
honoring our many volunteers in April. We                                                  our ED. Dorothy wanted to become a
currently have 37 volunteers on staff here                                                 nurse and started classes at the University
who dedicate their time and resources to                                                   of Pittsburgh however, that career path did
help make our hospital warm and friendly                                                   not happen as she found herself busy
for our patients. In 2005 volunteers                                                       raising her five children with her husband.
contributed 11,571 hours of service to our
hospital!                                                                                  When not volunteering at the hospital
                                                                                           Dorothy can be found enjoying her 9
When you enter the hospital you will be                                                    grandchildren and one great grandchild
greeted by one of our many volunteers.                                                     or playing the piano or organ. Dorothy’s
As you pass the gift shop you will notice                                                  volunteer services have been a great gift
that it is staffed daily by one of our many                                                to our hospital of over 15,500 hours.
volunteers. Linda Landers, one of our
volunteers oversees our gift shop from                                                     Dorothy is just one of our many dedicated
purchasing to displaying to scheduling                                                     volunteers who are a great asset at
her staff of volunteers.                      volunteering in our emergency                Research Belton Hospital. If you are
                                              department. Dorothy started volunteering     interested in becoming a volunteer please
One of our longest serving volunteers,        at Research Belton in l984 when the          contact Christine Meyer, our volunteer
Dorothy Moccia, may be found                  hospital first opened. She was looking for   coordinator at (816) 348-1201.

The Life You Save Could Be a Friend’s
Cher, former President Ronald Reagan,         Surgeon General C. Everett Koop              celebrates the human lives saved while
Elizabeth Taylor, Goldie Hawn, Walter         endorsed the Heimlich maneuver as the        recognizing their rescuers’ efforts.
Matthau, Carrie Fisher and Jack Lemmon        only safe method for saving a choking
all have something in common. According       victim. The life-saving procedure was        The Heimlich maneuver is easy to learn,
to the Heimlich Institute, all of them were   developed by Henry J. Heimlich, MD, a        and anyone, including children, can use it to
saved from choking to death by the            thoracic surgeon, for use on choking         save themselves or another person.
Heimlich maneuver.                            victims.                                     For detailed information on the maneuver,
                                                                                           visit or you
Since the Heimlich maneuver was               National Heimlich Maneuver Week, April       may write to them at The Heimlich Institute
introduced in 1974, it has saved the lives    16-22, is designed to remind the public of   Foundation, Inc., 311 Straight Street,
of more than 50,000 people. In 1985, U.S.     the usage of the maneuver for choking. It    Cincinnati OH 45219 or call (513) 559-2391.

                at Research Belton

Description: Patient Consent Form for Selling of Personal Creations document sample