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

Preparing for your Surgical Preparing for your Surgical Experience at Memorial Hospital Experience at Memorial Hospital

WestWest

Presented by:Presented by:

Memorial Hospital West Surgical ServicesMemorial Hospital West Surgical Services

The Memorial Experience The Memorial Experience

Patient First Patient First – SafetySafety is our first priority is our first priority – Quality of CareQuality of Care

Patient Family Centered CarePatient Family Centered Care You and your family / loved ones are at You and your family / loved ones are at

the center of your carethe center of your care We want you / them involvedWe want you / them involved Visitation – Whatever is right for the Visitation – Whatever is right for the

patientpatient

Goals and ObjectivesGoals and Objectives

Our goal as a Healthcare System is to give Our goal as a Healthcare System is to give you proper education and preparation before you proper education and preparation before your surgeryyour surgery – Improve lines of communicationImprove lines of communication– Reduce anxietyReduce anxiety– Provide clear explanationsProvide clear explanations– Decrease the potential for complicationsDecrease the potential for complications

At the end of this session, you should know At the end of this session, you should know the following:the following:– What to expect at each step of your careWhat to expect at each step of your care– Things you will need to doThings you will need to do

Patient Safety InitiativesPatient Safety Initiatives

Crew Resource ManagementCrew Resource Management HELP ALERTHELP ALERT Safety FirstSafety First

– Introduction of the health care Introduction of the health care providersproviders

– Checking of your name bandChecking of your name band– Hand washingHand washing– Site markingSite marking

Crew Resource ManagementCrew Resource Management

Combination of Combination of TeamworkTeamwork Communication BehaviorsCommunication Behaviors Safety ToolsSafety Tools Procedures, protocols, checklistsProcedures, protocols, checklists

Purpose:Purpose:– Create culture of open communication Create culture of open communication

among team membersamong team members– Standardize processesStandardize processes– Promote an optimally safe environment for Promote an optimally safe environment for

patient carepatient care

Crew Resource Crew Resource ManagementManagement

ComponentsComponents– Pre Procedure Time Out or Pre-briefPre Procedure Time Out or Pre-brief– Post Procedure DebriefPost Procedure Debrief– Assertive Communication to escalate Assertive Communication to escalate

concerns and time critical informationconcerns and time critical information– Guidelines to “See it, Say it, Fix it!”Guidelines to “See it, Say it, Fix it!”– Standardized “Hand off” tools for Standardized “Hand off” tools for

health care providershealth care providers

HELP ALERTHELP ALERT An Additional Safety InitiativeAn Additional Safety Initiative Memorial Healthcare System is Memorial Healthcare System is

partnering with patients and families for partnering with patients and families for safe healthcaresafe healthcare

HELP ALERTHELP ALERT – Created to address needs of patient in case Created to address needs of patient in case

of an emergency or when the patient is of an emergency or when the patient is unable to get the attention of the Health unable to get the attention of the Health Care ProviderCare Provider

– Calling a Calling a HELP ALERTHELP ALERT provides our provides our patients/families a resource for immediate patients/families a resource for immediate help when they feel they are not receiving help when they feel they are not receiving adequate medical attentionadequate medical attention

HELP ALERTHELP ALERTDIAL 88DIAL 88

When to call 88When to call 88– A noticeable medical change occurs A noticeable medical change occurs

and the healthcare team is not and the healthcare team is not recognizing the concernrecognizing the concern

– If there is a breakdown in how care If there is a breakdown in how care is being given and/or confusion over is being given and/or confusion over what needs to be done what needs to be done

Preparing for your surgical Preparing for your surgical procedureprocedure Lets Get Ready!Lets Get Ready!

7-10 DAYS BEFORE SURGERY7-10 DAYS BEFORE SURGERY– Preoperative visit to the Medical doctor Preoperative visit to the Medical doctor (This (This

may not be requires for all patients)may not be requires for all patients) It is important to be in your best physical It is important to be in your best physical

conditioncondition The hospital will need a history, physical, and The hospital will need a history, physical, and

clearance from your medical doctor / specialists clearance from your medical doctor / specialists and a copy of all of your most recent testsand a copy of all of your most recent tests

– Blood workBlood work– X-raysX-rays– CT resultsCT results– Cardiac workupCardiac workup– Pulmonary work upPulmonary work up


Avoid infectionsAvoid infections Good hand washing practices! Good hand washing practices! AllAll the the

time!time! Wash the area with antibacterial soapWash the area with antibacterial soap Do Do notnot shave anywhere close to the shave anywhere close to the

operative siteoperative site Notify your surgeon if there are any Notify your surgeon if there are any

breaks in the skinbreaks in the skin– Scratches, insect bitesScratches, insect bites


Discuss with your surgeon/physician which Discuss with your surgeon/physician which medications can be taken the morning of medications can be taken the morning of surgerysurgery

Ask your physician and/or cardiologist Ask your physician and/or cardiologist about stopping medications that may about stopping medications that may cause bleedingcause bleeding– Some patients may need to continue those Some patients may need to continue those

medications medications

Preoperative visit to the surgeonPreoperative visit to the surgeon– Usually one week prior to surgeryUsually one week prior to surgery


Family members or friends need to be Family members or friends need to be available to help you at home after your available to help you at home after your procedure procedure

Make those arrangements now!Make those arrangements now!– Help with laundryHelp with laundry– Cleaning the houseCleaning the house– Changing linens on the bedChanging linens on the bed– Preparing your mealsPreparing your meals– Going to the drug store, grocery storeGoing to the drug store, grocery store– Getting to appointmentsGetting to appointments– Going to the doctorGoing to the doctor– Care for your petsCare for your pets

Preparing for your surgical procedurePreparing for your surgical procedure Make your home safeMake your home safe

Keep items that you use frequently Keep items that you use frequently within easy reachwithin easy reach

Keep floor free from small objectsKeep floor free from small objects– Pets?Pets?

Remove throw rugs Remove throw rugs Add a firm pillow to low chairsAdd a firm pillow to low chairs Move electrical cords out of the wayMove electrical cords out of the way

Preparing for your surgical procedurePreparing for your surgical procedure Make your home safeMake your home safe

Install a hand held shower head for Install a hand held shower head for easier bathingeasier bathing

Be sure to have a rubber backed Be sure to have a rubber backed bath matbath mat

Use a long handled sponge to wash Use a long handled sponge to wash hard to reach areashard to reach areas

Preparing for your surgical Preparing for your surgical

procedureprocedure Be prepared!Be prepared!

Check with your insurance company Check with your insurance company nownow– Is a deductible, co-payment and/or co-insurance Is a deductible, co-payment and/or co-insurance

amount required amount required before or whenbefore or when you receive you receive services?services?

– Check your benefit booklet/certificate of coverageCheck your benefit booklet/certificate of coverage– Do you need pre-authorization or a referral for your Do you need pre-authorization or a referral for your

tests or surgerytests or surgery– Coverage varies with each insurance companyCoverage varies with each insurance company– Ask what services are coveredAsk what services are covered

Equipment for your homeEquipment for your home Home HealthHome Health Help at homeHelp at home

Questions?Questions?– Call Memorial Healthcare System Call Memorial Healthcare System

Pre-Services/Advance RegistrationPre-Services/Advance Registration 954-276-5500, prompt #3954-276-5500, prompt #3

A day or two before surgeryA day or two before surgery What to ExpectWhat to Expect Confirmation of your arrival time at Confirmation of your arrival time at

the hospitalthe hospital– You will receive two phone calls from You will receive two phone calls from

the hospitalthe hospital One from Pre-Services/Advance RegistrationOne from Pre-Services/Advance Registration One from Pre Admission Testing NurseOne from Pre Admission Testing Nurse

– Please arrive on time to the hospitalPlease arrive on time to the hospital– Do not eat or drink anything after Do not eat or drink anything after

midnightmidnight

Special InstructionsSpecial Instructions

The nurse from the Pre Admission The nurse from the Pre Admission Testing area and/or the Anesthesiologist Testing area and/or the Anesthesiologist will review with you any medications you will review with you any medications you should take on the morning of surgery should take on the morning of surgery

Remember! Remember! – Leave Leave ALLALL VALUABLES at home VALUABLES at home

Do not wear any make-upDo not wear any make-up Remove artificial nails Remove artificial nails

– Acrylics, wraps and tipsAcrylics, wraps and tips

Day of SurgeryDay of SurgeryWhat should I bring?What should I bring?

Personal hygiene itemsPersonal hygiene items Snug-fitted slippers and/or flat Snug-fitted slippers and/or flat

shoes or tennis shoesshoes or tennis shoes– Consider velcro strapsConsider velcro straps

Do Do NOTNOT bring valuables! bring valuables! A copy of advance directivesA copy of advance directives

Day of SurgeryDay of Surgery What should I bring?What should I bring?

Insurance card, driver’s license or Insurance card, driver’s license or photo ID photo ID

Any co-payment that is requiredAny co-payment that is required Printed list of all medications Printed list of all medications

including dosages, names, including dosages, names, frequencyfrequency– Include Include ALLALL over-the-counter over-the-counter

medications, herbal supplements and medications, herbal supplements and other health related medications you other health related medications you are takingare taking

Day of SurgeryDay of Surgery What will happen?What will happen?

Arrive to the Hospital 2 hours prior to Arrive to the Hospital 2 hours prior to scheduled start timescheduled start time

A complete nursing assessment will be A complete nursing assessment will be donedone

Lab work will be repeated if necessary Lab work will be repeated if necessary An intravenous (IV) will be startedAn intravenous (IV) will be started Visit with the Anesthesiologist and OR Visit with the Anesthesiologist and OR

nursenurse


Safety FirstSafety First – Prevention of Wrong Site – Prevention of Wrong Site surgerysurgery– Nurse will confirm site & type of surgery with Nurse will confirm site & type of surgery with

youyou– If laterality is involved, the site will be marked If laterality is involved, the site will be marked

with a “yes”with a “yes”– Surgeon will initial the site near the “yes”Surgeon will initial the site near the “yes”

– Final “time out” or “prebrief” will be done in Final “time out” or “prebrief” will be done in the ORthe OR

Safety FirstSafety First

SafetySafety is our highest priority is our highest priority– All Health Care providers should All Health Care providers should

introduce themselves introduce themselves – Explain their roleExplain their role– Explain what they will be doingExplain what they will be doing– Check your name band each and every Check your name band each and every

time time – Wash their hands!Wash their hands!– Don’t be afraid to Don’t be afraid to askask questions questions


You will be in the PACU ( Post You will be in the PACU ( Post Anesthesia Care Unit or Recovery Anesthesia Care Unit or Recovery Room) for approximately 1 ½ hours Room) for approximately 1 ½ hours following completion of the surgery following completion of the surgery

Begin your breathing exercisesBegin your breathing exercises Begin ankle pump exercises 10 times Begin ankle pump exercises 10 times

each houreach hour Pain medication as neededPain medication as needed


Outpatients – going home the same Outpatients – going home the same dayday– When you are awake and able, you will When you are awake and able, you will

move to our Phase II Recovery areamove to our Phase II Recovery area Sit in a recliner chairSit in a recliner chair Be able to tolerate fluids and light foodBe able to tolerate fluids and light food Be able to urinateBe able to urinate Be able to ambulate Be able to ambulate Receive verbal and written discharge Receive verbal and written discharge

instructionsinstructions

– You will receive a phone call the following You will receive a phone call the following day from our staffday from our staff

Inpatient or staying Inpatient or staying overnightovernight When the room is available, you will be When the room is available, you will be

transported by 2 staff memberstransported by 2 staff members Safety FirstSafety First

– Hourly RoundingHourly Rounding You can expect to see your nursing staff You can expect to see your nursing staff

– every hour until 10 pm every hour until 10 pm – every 2 hours during the nightevery 2 hours during the night

They will checkThey will check– to ensure your pain is adequately managedto ensure your pain is adequately managed– if you need to use the bathroom/bedpanif you need to use the bathroom/bedpan– If you need to be repositionedIf you need to be repositioned

– Your call bell should always be within your reach and Your call bell should always be within your reach and answered promptlyanswered promptly

Expect to sit on the edge of the bed on the Expect to sit on the edge of the bed on the evening of surgery unless contraindicated by evening of surgery unless contraindicated by your physicianyour physician

After surgeryAfter surgeryWhat next?What next? Blood work, if ordered, will be drawn Blood work, if ordered, will be drawn

early in the morning early in the morning Intravenous pain meds may be Intravenous pain meds may be

stopped and oral pain meds stopped and oral pain meds (pills/liquid) may be started(pills/liquid) may be started

Expect to be out of bed into a chair for Expect to be out of bed into a chair for all mealsall meals

Case Manager will talk with you about Case Manager will talk with you about your discharge planyour discharge plan

After surgeryAfter surgeryWhat next?What next?

You may experience a decrease in You may experience a decrease in appetite appetite – It is important to try to eat as much of It is important to try to eat as much of

the meal as possible to assist with the meal as possible to assist with proper healingproper healing

– A nutritional consult with a dietitian can A nutritional consult with a dietitian can be provided if necessarybe provided if necessary

– A sample menu can be provided for you A sample menu can be provided for you at dischargeat discharge

Going Home - Going Home - DischargeDischarge Your length of stay is dependent Your length of stay is dependent

on your progresson your progress Going home:Going home:

– Make arrangements for pick-upMake arrangements for pick-up– Written discharge instructions for Written discharge instructions for

medications, activity level, diet, medications, activity level, diet, special precautions and exercisesspecial precautions and exercises

When you go homeWhen you go home

Bodily changes may occurBodily changes may occur– Poor appetitePoor appetite– Difficulty sleepingDifficulty sleeping– Decreased energy levelDecreased energy level– ConstipationConstipation– DrowsinessDrowsiness

It is important to eat properly, to breathe It is important to eat properly, to breathe deeply and to move!deeply and to move!


Blood Thinners may be ordered Blood Thinners may be ordered by your physician to avoid by your physician to avoid complications from blood clotscomplications from blood clots– May be required to take them for May be required to take them for

three to six weeks three to six weeks Blood tests 2 times a weekBlood tests 2 times a week


Compression stockings (support Compression stockings (support hose) may be orderedhose) may be ordered– Reduces the chance for blood clotsReduces the chance for blood clots– Keeps swelling downKeeps swelling down

If swelling persists, elevate the leg for short If swelling persists, elevate the leg for short periods throughout the dayperiods throughout the day

Wear stocking continuously, removing one Wear stocking continuously, removing one to two hours 2x/dayto two hours 2x/day

Notify the doctor if increased swellingNotify the doctor if increased swelling Ask when you can discontinue wearing of Ask when you can discontinue wearing of

the stockingsthe stockings


Incision careIncision care– Keep incision dryKeep incision dry– Cover with light dry dressing Cover with light dry dressing – Your physician will inform you when Your physician will inform you when

it is ok to showerit is ok to shower– After showering, apply dry dressingAfter showering, apply dry dressing

POSSIBLE POSSIBLE COMPLICATIONS COMPLICATIONS What should I watch for?What should I watch for?

POSSIBLE COMPLICATIONSPOSSIBLE COMPLICATIONS – INFECTIONINFECTION- Call the doctor if any of the - Call the doctor if any of the

following occur following occur An increase in the amount of drainage, An increase in the amount of drainage,

bleeding or change in color and/or odor of the bleeding or change in color and/or odor of the drainagedrainage

A significant increase in the amount of A significant increase in the amount of swelling accompanied by redness at the swelling accompanied by redness at the incision siteincision site

Temperature of more than 100.5 degreesTemperature of more than 100.5 degrees Significant increase in pain levelSignificant increase in pain level

POSSIBLE POSSIBLE COMPLICATIONS COMPLICATIONS What should I watch for?What should I watch for?

POSSIBLE COMPLICATIONSPOSSIBLE COMPLICATIONS – BLOOD CLOTSBLOOD CLOTS - Call the doctor if any of the - Call the doctor if any of the

following occur :following occur : Pain, warmth and tenderness in the calf, behind the Pain, warmth and tenderness in the calf, behind the

knee or the groin areaknee or the groin area Localized swelling in the thigh, calf or ankleLocalized swelling in the thigh, calf or ankle

– PREVENTION OF BLOOD CLOTSPREVENTION OF BLOOD CLOTS– ExerciseExercise– Use of compression stockings (support hose)Use of compression stockings (support hose)– Leg elevationLeg elevation

POSSIBLE POSSIBLE COMPLICATIONS COMPLICATIONS What should I watch for?What should I watch for? POSSIBLE COMPLICATIONS POSSIBLE COMPLICATIONS

– PULMONARY EMBOLUS PULMONARY EMBOLUS – ( Blood clot in your lung) ( Blood clot in your lung)

Requires Requires immediateimmediate medical attention medical attention Check for the followingCheck for the following

– Sudden chest pain/pressureSudden chest pain/pressure– Difficulty breathingDifficulty breathing– Sudden shortness of breathSudden shortness of breath– SweatingSweating– ConfusionConfusion

THANK YOU VERY MUCH!THANK YOU VERY MUCH!

ANY QUESTIONSANY QUESTIONS

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

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