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Preparing for your Surgical Experience at Memorial Hospital West

Preparing for your Surgical Experience at Memorial Hospital West. Presented by: Memorial Hospital West Surgical Services. The Memorial Experience . Patient First Safety is our first priority Quality of Care Patient Family Centered Care

Mercy
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Preparing for your Surgical Experience at Memorial Hospital West

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

  2. The Memorial Experience • Patient First • Safety is our first priority • Quality of Care • 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

  3. Goals and Objectives • 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: • What to expect at each step of your care • Things you will need to do

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

  5. Crew Resource Management • Combination of • 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

  6. Crew Resource Management • 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 ALERTAn Additional Safety Initiative • Memorial Healthcare System 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

  8. HELP ALERTDIAL 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 procedureLets Get Ready! • 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 • Blood work • X-rays • CT results • Cardiac workup • Pulmonary work up

  10. Preparing for your surgical procedureLets Get Ready! • 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

  11. Preparing for your surgical procedureLets Get Ready! • 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 • Preoperative visit to the surgeon • Usually one week prior to surgery

  12. Preparing for your surgical procedureLets Get Ready! • Family members or friends need to be available to help you at home after your procedure • 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 procedureMake your home safe • Keep items that you use frequently within easy reach • Keep floor free from small objects • Pets? • Remove throw rugs • Add a firm pillow to low chairs • Move electrical cords out of the way

  14. Preparing for your surgical procedureMake your home safe • 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

  15. Preparing for your surgical procedureBe prepared! • 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 • Home Health • Help at home • Questions? • Call Memorial Healthcare System Pre-Services/Advance Registration • 954-276-5500, prompt #3

  16. A day or two before surgeryWhat to Expect • 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 • 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 • Remember! • Leave ALL VALUABLES at home • Do not wear any make-up • Remove artificial nails • Acrylics, wraps and tips

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

  19. Day of SurgeryWhat should I bring? • 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

  20. Day of SurgeryWhat will happen? • 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

  21. Day of SurgeryWhat will happen? • 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 • 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

  23. Day of SurgeryWhat 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 • Begin your breathing exercises • Begin ankle pump exercises 10 times each hour • Pain medication as needed

  24. Day of SurgeryWhat will happen? • 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 • 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

  25. Inpatient or staying overnight • When the room is available, you will be transported by 2 staff members • Safety First • Hourly Rounding • You can expect to see your nursing staff • every hour until 10 pm • every 2 hours during the night • 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

  26. After surgeryWhat next? • 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

  27. After surgeryWhat next? • 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 • 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 • Poor appetite • Difficulty sleeping • Decreased energy level • Constipation • Drowsiness • 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 • May be required to take them for three to six weeks • Blood tests 2 times a week

  31. When you go home • 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

  32. When you go home • 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 • 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

  34. POSSIBLE COMPLICATIONS What should I watch for? • 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 • 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 • PULMONARY EMBOLUS • ( Blood clot in your lung) • Requires immediate medical attention • 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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