Transcript Preparing for Your Surgery - High Desert Orthopedics & Sports

Preparing for your Surgical Experience
at Castleview Hospital
Presented by:
High Desert Orthopedics
Kelly D. Jensen D.O.
The Castleview Experience
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Patient First
– Safety is our first priority
– Quality of Care
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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
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Goals and Objectives
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Our goal as a Healthcare System is to give you
proper education and preparation before your
surgery
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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
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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
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Combination of
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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
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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
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Castleview Hospital and 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
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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!
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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
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Blood work
X-rays
CT results
Cardiac workup
Pulmonary work up
Preparing for your surgical procedure
Lets Get Ready!
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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!
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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
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Preoperative visit to the surgeon
– Usually one week prior to surgery
Preparing for your surgical procedure
Lets Get Ready!
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Family members or friends need to be available to
help you at home after your procedure
Make those arrangements now!
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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
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Keep items that you use frequently within
easy reach
Keep floor free from small objects
– Pets?
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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
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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!
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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
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Equipment for your home
Home Health
Help at home
Questions?
– Call Castleview Hospital Pre-Services/Advance Registration
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435-637-4120
A day or two before surgery
What to Expect
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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
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– Please arrive on time to the hospital
– Do not eat or drink anything after midnight
Special Instructions
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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
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Do not wear any make-up
Remove artificial nails
– Acrylics, wraps and tips
Day of Surgery
What should I bring?
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Personal hygiene items
Snug-fitted slippers and/or flat shoes
or tennis shoes
– Consider velcro straps
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Do NOT bring valuables!
A copy of advance directives
Day of Surgery
What should I bring?
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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?
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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?
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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
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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?
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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?
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Outpatients – going home the same day
– When you are awake and able, you will move to
our Phase II Recovery area
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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
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When the room is available, you will be transported
by 2 staff members
Safety First
– Hourly Rounding
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You can expect to see your nursing staff
– every hour until 10 pm
– every 2 hours during the night
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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
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Expect to sit on the edge of the bed on the evening
of surgery unless contraindicated by your physician
After surgery
What next?
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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?
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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
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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
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Bodily changes may occur
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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
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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
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Blood tests 2 times a week
When you go home
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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
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When you go home
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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?
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POSSIBLE COMPLICATIONS
– 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
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POSSIBLE COMPLICATIONS
What should I watch for?
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POSSIBLE COMPLICATIONS
– BLOOD CLOTS - Call the doctor if any of the
following occur :
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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?
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POSSIBLE COMPLICATIONS
– PULMONARY EMBOLUS
– ( Blood clot in your lung)
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Requires immediate medical attention
Check for the following
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Sudden chest pain/pressure
Difficulty breathing
Sudden shortness of breath
Sweating
Confusion
THANK YOU VERY MUCH!
ANY QUESTIONS