1. THE Surgical Hospital of Phoenix Orthopedic Program

2. PRE-HOSPITALIZATION Pre-op testing, if your MD orders testing – 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.

3. PRE-HOSPITALIZATION Home Preparations – 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.

4. PRE-HOSPITALIZATION MEALS – 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

5. PRE-HOSPITALIZATION 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.

6. DAY OF SURGERY 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.

7. DAY OF SURGERY You may want to bring your own Hygiene Products such as toothbrush, comb/brush, deodorant, and feminine products.

8. WHEN YOU ARRIVE AT THE HOSPITAL 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.

9. PRE-OP 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.

10. SURGERY You will be taken back to the OR on your pre-op bed. The OR nurse and Anesthesiologist will remain with you throughout surgery.

11. PACU/RECOVERY ROOM 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.

12. SURGICAL UNIT-DAY OF SURGERY 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.

13. OUTPATIENT PROCEDURES Shoulder Scope – Discharged day of surgery from PACU. – Sling will be applied prior to discharge. – Wear a button up shirt. Knee Scope – 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)

14. POST-OP DAY ONE 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.

15. POST-OP DAY TWO 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.

16. POST-OP DAY THREE 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.

17. PHYSICAL THERAPY Focused on safety – Transferring – Exercises – Ambulation – Precautions Patients are seen twice a day.

18. THERAPY GOALS 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 – Using CPM and increasing bend per physicians orders. Hips – Ability to verbalize hip precautions – Ability to follow hip precautions

19. RECOMMENDED EQUIPMENT AT HOME All Surgeries – Shower chair – Front-wheeled walker Hip Replacements – Elevated toilet seat

20. 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.

21. DISCHARGE INFORMATION 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.

22. Travel After Surgery 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.