Transcript Surgical Specialty Hospital of Arizona

THE Surgical Hospital of Phoenix
Orthopedic Program
PRE-HOSPITALIZATION
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Pre-op testing, if your MD orders testing
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Labs will need to be done within 10 days of
surgery
CXR
EKG
Medical and Cardiac clearance may be ordered
by your physician depending upon your medical
history.
PRE-HOSPITALIZATION
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Home Preparations
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Remove any safety hazards, an example would
be a tripping hazard such as a loose rug or cords
on the floor.
Obtain necessary equipment and supplies.
PRE-HOSPITALIZATION
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MEALS
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Light meal the night before surgery.
Nothing to eat after midnight or 8 hours prior to
surgery if you surgery is scheduled late in the
afternoon
No water in AM, except a sip with medications
instructed to take.
No gum, mints or cigarettes
PRE-HOSPITALIZATION
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Shower the morning of surgery.
Do not shave any body parts.
No make-up should be worn morning of
surgery.
You can brush your teeth, but do not drink.
We prefer no finger nail polish.
DAY OF SURGERY
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Bring any braces, walkers, or special
equipment with you to the hospital.
Hearing aids, dentures and glasses can be
worn to the hospital, but bring a case labeled
with your name to the hospital.
Comfortable clothing, enclosed heel footwear
for getting up with physical therapy and your
comfort.
DAY OF SURGERY
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You may want to bring your own Hygiene
Products such as toothbrush, comb/brush,
deodorant, and feminine products.
WHEN YOU ARRIVE AT THE HOSPITAL
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Patient parking is on the north side of the hospital.
You will come in the front door and immediately to your
right is the admitting desk.
In admitting you will sign in and receive your ID band which
you will be asked to verify that the information is correct.
PRE-OP
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A nurse will come to the admitting area and take you
to pre-op.
You will change into a hospital gown at this time.
Vital Signs, Height and Weight will be obtained
Consents will be reviewed and signed.
Your IV will be started.
The surgeon, anesthesiologist, and OR nurse will
meet with you prior to surgery.
Two family members at a time will be allowed in the
pre-op area.
SURGERY
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You will be taken back to the OR on your
pre-op bed.
The OR nurse and Anesthesiologist will
remain with you throughout surgery.
PACU/RECOVERY ROOM
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Average stay in recovery is 1 to 3 hours.
X-rays/labs may be taken while you are in the
recovery room.
Nurses in the recovery room will work with you
on your pain management.
Visitors will not be allowed in the recovery area
due to need to maintain privacy.
If family member needs to leave the hospital,
please leave the pre-op nurse your cell phone
number or a number in which you can be
reached.
SURGICAL UNIT-DAY OF
SURGERY
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You will be taken to your room in your bed.
You will have you own room.
You may be seen by Physical Therapy depending upon time
of your surgery.
Blood Clot Prevention, TED hose, Pneumatic stocking may
be ordered. An injection will be given once or twice daily
beginning post-op day #1.
What to Expect:
– IV fluids
--Oxygen
– Frequent vital signs --Nursing assessments
– Pain control plan --Comfort and positioning
– Possible drains --Possible Foley catheter
– First meal may be clear liquids.
OUTPATIENT PROCEDURES
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Shoulder Scope
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Discharged day of surgery from PACU.
Sling will be applied prior to discharge.
Wear a button up shirt.
Knee Scope
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Discharged day of surgery from PACU.
Ace wrapped knee dressing will be in place.
Usually no crutches are required.
Wear something that you can get over a large knee
dressing. (Shorts, dress, or loose fitting slacks)
POST-OP DAY ONE
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Morning blood draw.
Out of bed with Physical Therapy and nursing.
Physical Therapy twice a day.
IV fluids and oxygen may be discontinued.
Diet advance as tolerated and up in chair for meals.
Removal of Foley catheter.
Pain control with oral/IV medications.
Hospitalist consult for medical management.
Case Management will be in to assess discharge
needs.
POST-OP DAY TWO
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Morning blood draw.
Out of bed with PT or nursing.
PT twice a day.
Drain removed and dressing changed.
Pain control oral medications-Let your nurse
know if you are in pain!
Case management to continue with
discharge arrangements.
POST-OP DAY THREE
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Morning blood draw.
Blood clot prevention: anti-coagulation therapy
Teaching.
Pain control with oral medications
Discharge to home, Acute rehab., or Skilled Nursing
Facility.
Your discharge is occur when pain is
controlled with oral pain medications
and when it is safe to be discharged.
PHYSICAL THERAPY
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Focused on safety
Transferring
– Exercises
– Ambulation
– Precautions
Patients are seen twice a day.
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THERAPY GOALS
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Understand home exercise program.
Ability to walk with a wheeled walker.
Stair safety if applicable.
Getting in and out of bed with family assistance.
Knees
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Using CPM and increasing bend per physicians
orders.
Hips
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Ability to verbalize hip precautions
Ability to follow hip precautions
RECOMMENDED EQUIPMENT AT
HOME
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All Surgeries
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Shower chair
Front-wheeled walker
Hip Replacements
– Elevated toilet seat
DISCHARGE OPTIONS
HOME, with or without home health services.
 HOME, with outpatient services.
 SKILLED Nursing Facility.
 ACUTE inpatient rehabilitation facility (Must
qualify).
Depending upon your medical progress, your
therapy, and your home situation the
appropriate discharge option will be planned
for your safety.
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DISCHARGE INFORMATION
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A folder will be provide in order to keep your
discharge instructions, educational information, PT
exercises, and any additional information that might
be given.
You will be instructed in self
administration of a “low molecular
weight heparin” prior to discharge
and will typically continue this
medication at home for 10-21
days after surgery.
Travel After Surgery
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No flying for 2-4 weeks after surgery.
When riding in a vehicle, you need to stop
every ½ hour to get out and walk around.