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

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Presentation on theme: "Preparing for your Surgical Experience at Memorial Hospital West Presented by: Memorial Hospital West Surgical Services."— Presentation transcript:

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

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

3 Goals and Objectives Our goal as a Healthcare System is to give you proper education and preparation before your surgery 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: 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

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

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

6 Crew Resource Management Components 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

7 HELP ALERT An Additional Safety Initiative Memorial Healthcare System is partnering with patients and families for safe healthcare Memorial Healthcare System is partnering with patients and families for safe healthcare HELP ALERT 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

8 HELP ALERT DIAL 88 When to call 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

9 Preparing for your surgical procedure Lets Get Ready! 7-10 DAYS BEFORE SURGERY 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 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 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

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

11 Preparing for your surgical procedure Lets Get Ready! Discuss with your surgeon/physician which medications can be taken the morning of surgery 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 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 Preoperative visit to the surgeon –Usually one week prior to surgery

12 Preparing for your surgical procedure Lets Get Ready! Family members or friends need to be available to help you at home after your procedure Family members or friends need to be available to help you at home after your procedure Make those arrangements now! 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

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

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

15 Preparing for your surgical procedure Be prepared! Check with your insurance company now 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 Equipment for your home Home Health Home Health Help at home Help at home Questions? Questions? –Call Memorial Healthcare System Pre-Services/Advance Registration 954-276-5500, prompt #3 954-276-5500, prompt #3

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

17 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 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! Remember! –Leave ALL VALUABLES at home Do not wear any make-up Do not wear any make-up Remove artificial nails Remove artificial nails –Acrylics, wraps and tips

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

19 Day of Surgery What should I bring? Insurance card, drivers license or photo ID Insurance card, drivers license or photo ID Any co-payment that is required Any co-payment that is required Printed list of all medications including dosages, names, frequency 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

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

21 Day of Surgery What will happen? Safety First – Prevention of Wrong Site surgery 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

22 Safety First Safety is our highest priority 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! –Dont be afraid to ask questions

23 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 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 your breathing exercises Begin ankle pump exercises 10 times each hour Begin ankle pump exercises 10 times each hour Pain medication as needed Pain medication as needed

24 Day of Surgery What will happen? Outpatients – going home the same day 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 Sit in a recliner chair Be able to tolerate fluids and light food Be able to tolerate fluids and light food Be able to urinate Be able to urinate Be able to ambulate Be able to ambulate Receive verbal and written discharge instructions Receive verbal and written discharge instructions –You will receive a phone call the following day from our staff

25 Inpatient or staying overnight When the room is available, you will be transported by 2 staff members When the room is available, you will be transported by 2 staff members Safety First Safety First –Hourly Rounding You can expect to see your nursing staff You can expect to see your nursing staff –every hour until 10 pm –every 2 hours during the night They will check 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 Expect to sit on the edge of the bed on the evening of surgery unless contraindicated by your physician

26 After surgery What next? Blood work, if ordered, will be drawn early in the morning 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 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 Expect to be out of bed into a chair for all meals Case Manager will talk with you about your discharge plan Case Manager will talk with you about your discharge plan

27 After surgery What next? You may experience a decrease in appetite 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

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

29 When you go home Bodily changes may occur 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! It is important to eat properly, to breathe deeply and to move!

30 When you go home Blood Thinners may be ordered by your physician to avoid complications from blood clots 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 Blood tests 2 times a week

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

32 When you go home Incision care 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

33 POSSIBLE COMPLICATIONS What should I watch for? POSSIBLE COMPLICATIONS 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 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 A significant increase in the amount of swelling accompanied by redness at the incision site Temperature of more than 100.5 degrees Temperature of more than 100.5 degrees Significant increase in pain level Significant increase in pain level

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

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

36 THANK YOU VERY MUCH!

37 ANY QUESTIONS


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