WELCOME Introduction Pre-admission Your role in a successful outcome Hospital course Physical Therapy Physician Assistants Discharge Planning Discharge concerns Holistic Care

PRE-ADMISSION TESTING Surgeon has fully explained your surgery Complete any medical follow-up as directed by your surgeon Blood work: A “Type and Cross” needs to be drawn within 5-7 days of your surgery at White Plains Hospital

STOP taking blood thinners, anti-inflammatory, and aspirin products generally 7 days prior to surgery Discuss with your medical doctor which, if any, regular medications you should take the morning of surgery. DO NOT shave or use depilatories on the operative leg for one week prior to surgery

YOUR ROLE IN HAVING A SUCCESSFUL OUTCOME Smoking cessation Exercise Good oral hygiene Good hand hygiene Good nutrition Home accessibility and resources.

HOME SAFETY TIPS Have a clear path from your bedroom to your bathroom. If you have a commode, raised toilet seat, or tub bench at home, check that the equipment is in good condition. If you have crutches or a walker at home, check that the equipment is in good condition.

PREPARE HOME FOR YOUR RETURN

PRE-SURGICAL WASH HIBICLENS (antiseptic antimicrobial solution) Shower the night before and morning of surgery as directed Avoid contact with the eyes, inside ears, or other mucus membranes DO NOT perform the pre-surgical wash if Allergic to Hibiclens (Chlorhexidine) or any soap preparation If you have a history of any skin condition (eczema, psoriasis, contact dermatitis)

WHAT TO BRING TO THE HOSPITAL Complete your Medical History and the Medical Reconciliation forms Under shorts/underpants, and if desired, loose fitted clothes, robe, or pajamas Eyeglasses, hearing aides, dentures if used Loose fitting clothes and shoes for discharge Brace or orthotics Personal toiletries Leave all valuables home

DAY OF YOUR SURGERY Do not eat or drink as directed Arrive 2 hours prior to the time of your surgery. You’ll check in at the Admitting Department for registration You will be escorted to Ambulatory Surgery, where you will be introduced to your pre-op team Your surgeon and surgical team and go through a process of site verification

INCENTIVE SPIROMETER

ANESTHESIA Westchester Anesthesiology (914) Various forms of anesthesia: Spinal anesthesia General anesthesia Regional/Localized blocks to your joint Peripheral nerve block (knee surgery only)

OPERATION Your actual surgery will take hours The surgical team needs additional time for: Application of monitors Anesthesia Proper positioning Your surgeon will speak to your family after the surgery is completed.

POST-OPERATIVE COURSE You will go to the PACU/Recovery room immediately after the surgery. Your incision will be closed with either staples or glue. You will be transferred to your room after you have regained sensation in your legs. A drain may be placed to the surgical area. The drainage will be filtered and transfused back to you. This drain is removed on the first day after surgery.

WELCOME TO 4I – ORTHOPEDIC UNIT Phone/TV available at a small charge. A trapeze will be placed over your bed. Raised commode Orthopedic chair Visiting hours are 10:00am- 9:00pm. (We ask that family/friends that are ill to not visit). Visitors should not sit on your bed or use your bathroom.

INFECTION PREVENTION Hand sanitizers available for patients All employees must “wash-in and wash-out” during each patient encounter Your sheets will be changed daily and as needed Keep your hands away from your surgical incision Proper nutrition and glucose control (for Diabetic patients)

PAIN CONTROL The nursing staff utilize a Pain Assessment Tool to evaluate your level of pain or discomfort. Together a “pain goal” will be discussed. Adjustments of medications/treatments will be made in order to get you to the goal.

Antibiotics administered for 24hrs Anti-coagulants administered as per your surgeons recommendations (up to 6 weeks). SCD (Sequential Compression Device) Knee Immobilizer (Total Knee Replacement) Pain management and anti-nausea management Bowel regimen Incentive Spirometer

FALL PREVENTION Patient Safety is a priority! Fall prevention tools: Bed alarms Chair alarms Fall risk assessed every 12 hours “call before you fall.” Review contract

PHYSICAL THERAPY Role of the Therapist - Physical Therapy plays a critical role in every stage of the process - The goals of physical therapy is to prevent tightness/stiffness, improve patient education, and strengthen muscles around the joint through controlled exercises - Educate/ Improve functional mobility

PRE-SURGERY EXERCISE Starting exercises prior to surgery help prepare the patient for surgery and ease the postoperative process Only do exercises that you are able to do without increasing your pain

THERAPY Therapy may start as early as the day of your surgery Therapy will continue twice daily for the 3 days and then once daily till your discharge Group exercise class are offered Monday-Friday Physical Therapy session last about minutes

Continuous Passive Range of Motion (CPM) A CPM machine may be used after surgery based on your physician’s recommendation

POST OPERATIVE DAY #1 Out of bed transfer to chair Tolerate sitting upright for 1-2 hours Exercising will help stimulate blood circulation and keep your muscle strong Begin walking with physical therapist using assistive device Studies have shown that people who exercise heal faster and better than individuals that do not exercise

POST-OPERATIVE DAY 2 & 3 Pain Management Physical Therapy Increase exercise and range of motion Stair training

Post Operative Day #3 Progress stair training Progress walking distance Enhance exercise program Activities of daily living training Practice car transfers Practice tub transfers

HOME SAFETY TIPS

If you have any further questions about therapy, call the White Plains Hospital Physical Medicine Department at: (914)

Outpatient Physical Therapy before or after your surgery, consider one of our expertly staffed White Plains Hospital Physical and Occupational Therapy Centers 222 Westchester Avenue White Plains, NY (914)

Role of the Physician Assistants A Physician Assistant is a healthcare professional who works as part of your team with your surgeon to address your post surgical needs Pain management Dressing changes Other medical related issues Discharge Planning

CARE MANAGERS and your DISCHARGE PLAN A nurse Care Manager will visit with you to establish the most appropriate discharge plan. An individualized discharge care plan will be established by the multidisciplinary team. Your discharge plan is based on your needs and covered benefits. Your hospital stay should be 2-3 days Our discharge time is 11 :00 A.M.

DISCHARGE PLAN The discharge plan is formulated based on the following factors: Your post-operative medical status Your mobility Your home environment and support systems You insurance and financial considerations The discharge plan is heavily dependent on what arrangements your insurance company agrees to cover.

POST DISCHARGE CONCERNS Fever Redness, swelling to surgical site Drainage from your incision Calf pain Trouble breathing Constipation Pain management Avoid driving until cleared by your surgeon (generally 6-8 weeks)

Our goal is to provide exceptional care everyday! We are continually trying to improve our program and would very much appreciate your input on how we can make it better. Please speak to us regarding your concerns or suggestions before you leave.