Preparing for your Surgical Experience at Memorial Hospital West Presented by: Memorial Hospital West Surgical Services

The Memorial Experience Patient First Safety is our first priority Quality of Care Patient Family Centered Care You and your family / loved ones are at the center of your care We want you / them involved Visitation – Whatever is right for the patient

Goals and Objectives Our goal as a Healthcare System is to give you proper education and preparation before your surgery Improve lines of communication Reduce anxiety Provide clear explanations Decrease the potential for complications At the end of this session, you should know the following: What to expect at each step of your care Things you will need to do

Patient Safety Initiatives Crew Resource Management HELP ALERT Safety First Introduction of the health care providers Checking of your name band Hand washing Site marking

Crew Resource Management Combination of Teamwork Communication Behaviors Safety Tools Procedures, protocols, checklists Purpose: Create culture of open communication among team members Standardize processes Promote an optimally safe environment for patient care

Crew Resource Management Components Pre Procedure Time Out or Pre-brief Post Procedure Debrief Assertive Communication to escalate concerns and time critical information Guidelines to “See it, Say it, Fix it!” Standardized “Hand off” tools for health care providers

HELP ALERT An Additional Safety Initiative Memorial Healthcare System is partnering with patients and families for safe healthcare HELP ALERT Created to address needs of patient in case of an emergency or when the patient is unable to get the attention of the Health Care Provider Calling a HELP ALERT provides our patients/families a resource for immediate help when they feel they are not receiving adequate medical attention

HELP ALERT DIAL 88 When to call 88 A noticeable medical change occurs and the healthcare team is not recognizing the concern If there is a breakdown in how care is being given and/or confusion over what needs to be done

Preparing for your surgical procedure Lets Get Ready! 7-10 DAYS BEFORE SURGERY Preoperative visit to the Medical doctor (This may not be requires for all patients) It is important to be in your best physical condition The hospital will need a history, physical, and clearance from your medical doctor / specialists and a copy of all of your most recent tests Blood work X-rays CT results Cardiac workup Pulmonary work up

Preparing for your surgical procedure Lets Get Ready! Avoid infections Good hand washing practices! All the time! Wash the area with antibacterial soap Do not shave anywhere close to the operative site Notify your surgeon if there are any breaks in the skin Scratches, insect bites

Preparing for your surgical procedure Lets Get Ready! Discuss with your surgeon/physician which medications can be taken the morning of surgery Ask your physician and/or cardiologist about stopping medications that may cause bleeding Some patients may need to continue those medications Preoperative visit to the surgeon Usually one week prior to surgery

Preparing for your surgical procedure Lets Get Ready! Family members or friends need to be available to help you at home after your procedure Make those arrangements now! Help with laundry Cleaning the house Changing linens on the bed Preparing your meals Going to the drug store, grocery store Getting to appointments Going to the doctor Care for your pets

Preparing for your surgical procedure Make your home safe Keep items that you use frequently within easy reach Keep floor free from small objects Pets? Remove throw rugs Add a firm pillow to low chairs Move electrical cords out of the way

Preparing for your surgical procedure Make your home safe Install a hand held shower head for easier bathing Be sure to have a rubber backed bath mat Use a long handled sponge to wash hard to reach areas

Preparing for your surgical procedure Be prepared! Check with your insurance company now Is a deductible, co-payment and/or co-insurance amount required before or when you receive services? Check your benefit booklet/certificate of coverage Do you need pre-authorization or a referral for your tests or surgery Coverage varies with each insurance company Ask what services are covered Equipment for your home Home Health Help at home Questions? Call Memorial Healthcare System Pre-Services/Advance Registration 954-276-5500, prompt #3

A day or two before surgery What to Expect Confirmation of your arrival time at the hospital You will receive two phone calls from the hospital One from Pre-Services/Advance Registration One from Pre Admission Testing Nurse Please arrive on time to the hospital Do not eat or drink anything after midnight

Special Instructions The nurse from the Pre Admission Testing area and/or the Anesthesiologist will review with you any medications you should take on the morning of surgery Remember! Leave ALL VALUABLES at home Do not wear any make-up Remove artificial nails Acrylics, wraps and tips

Day of Surgery What should I bring? Personal hygiene items Snug-fitted slippers and/or flat shoes or tennis shoes Consider velcro straps Do NOT bring valuables! A copy of advance directives

Day of Surgery What should I bring? Insurance card, driver’s license or photo ID Any co-payment that is required Printed list of all medications including dosages, names, frequency Include ALL over-the-counter medications, herbal supplements and other health related medications you are taking

Day of Surgery What will happen? Arrive to the Hospital 2 hours prior to scheduled start time A complete nursing assessment will be done Lab work will be repeated if necessary An intravenous (IV) will be started Visit with the Anesthesiologist and OR nurse

Day of Surgery What will happen? Safety First – Prevention of Wrong Site surgery Nurse will confirm site & type of surgery with you If laterality is involved, the site will be marked with a “yes” Surgeon will initial the site near the “yes” Final “time out” or “prebrief” will be done in the OR

Safety First Safety is our highest priority All Health Care providers should introduce themselves Explain their role Explain what they will be doing Check your name band each and every time Wash their hands! Don’t be afraid to ask questions

Day of Surgery What will happen? You will be in the PACU ( Post Anesthesia Care Unit or Recovery Room) for approximately 1 ½ hours following completion of the surgery Begin your breathing exercises Begin ankle pump exercises 10 times each hour Pain medication as needed

Day of Surgery What will happen? Outpatients – going home the same day When you are awake and able, you will move to our Phase II Recovery area Sit in a recliner chair Be able to tolerate fluids and light food Be able to urinate Be able to ambulate Receive verbal and written discharge instructions You will receive a phone call the following day from our staff

Inpatient or staying overnight When the room is available, you will be transported by 2 staff members Safety First Hourly Rounding You can expect to see your nursing staff every hour until 10 pm every 2 hours during the night They will check to ensure your pain is adequately managed if you need to use the bathroom/bedpan If you need to be repositioned Your call bell should always be within your reach and answered promptly Expect to sit on the edge of the bed on the evening of surgery unless contraindicated by your physician

After surgery What next? Blood work, if ordered, will be drawn early in the morning Intravenous pain meds may be stopped and oral pain meds (pills/liquid) may be started Expect to be out of bed into a chair for all meals Case Manager will talk with you about your discharge plan

After surgery What next? You may experience a decrease in appetite It is important to try to eat as much of the meal as possible to assist with proper healing A nutritional consult with a dietitian can be provided if necessary A sample menu can be provided for you at discharge

Going Home - Discharge Your length of stay is dependent on your progress Going home: Make arrangements for pick-up Written discharge instructions for medications, activity level, diet, special precautions and exercises

When you go home Bodily changes may occur Poor appetite Difficulty sleeping Decreased energy level Constipation Drowsiness It is important to eat properly, to breathe deeply and to move!

When you go home Blood Thinners may be ordered by your physician to avoid complications from blood clots May be required to take them for three to six weeks Blood tests 2 times a week

When you go home Compression stockings (support hose) may be ordered Reduces the chance for blood clots Keeps swelling down If swelling persists, elevate the leg for short periods throughout the day Wear stocking continuously, removing one to two hours 2x/day Notify the doctor if increased swelling Ask when you can discontinue wearing of the stockings

When you go home Incision care Keep incision dry Cover with light dry dressing Your physician will inform you when it is ok to shower After showering, apply dry dressing

POSSIBLE COMPLICATIONS What should I watch for? INFECTION- Call the doctor if any of the following occur An increase in the amount of drainage, bleeding or change in color and/or odor of the drainage A significant increase in the amount of swelling accompanied by redness at the incision site Temperature of more than 100.5 degrees Significant increase in pain level

POSSIBLE COMPLICATIONS What should I watch for? BLOOD CLOTS - Call the doctor if any of the following occur : Pain, warmth and tenderness in the calf, behind the knee or the groin area Localized swelling in the thigh, calf or ankle PREVENTION OF BLOOD CLOTS Exercise Use of compression stockings (support hose) Leg elevation

POSSIBLE COMPLICATIONS What should I watch for? PULMONARY EMBOLUS ( Blood clot in your lung) Requires immediate medical attention Check for the following Sudden chest pain/pressure Difficulty breathing Sudden shortness of breath Sweating Confusion

THANK YOU VERY MUCH!

ANY QUESTIONS