Preparing For Your Surgery

Transcription

1 Preparing For Your Surgery

2 Centra Lynchburg General Hospital On the day of your procedure check in at the Registration Department located at the Terrace Entrance of Centra Lynchburg General Hospital on Thomson Drive. Surgicare is located adjacent to Registration. Bring photo ID and Insurance cards. Free valet parking is available for patients and visitors. Centra Virginia Baptist Hospital On the day of your procedure, check in at the Registration Department located at the Oak Lane Entrance of Centra Virginia Baptist Hospital. Bring photo ID and Insurance cards. Free valet parking is available for patients and visitors.

3 We are here to serve you Thank you for choosing Centra for your surgery. This is an important time for you and your family. Understanding what to expect can make your hospital experience more positive and improve your recovery. The information in this booklet is intended to prepare you for a smooth and successful surgery and recovery. Table of contents Preregistration...2 Details of your scheduled surgery...2 What to do if you become ill or need to cancel before your surgery...2 Preparing to come to the hospital...3 Preparing skin night before surgery...4 Information for family & visitors...5 Admission to The Surgery Center...6 The operating room...6 Post anesthesia care unit (recovery room)...7 Returning to your room after surgery...7 Managing your pain...8 Exercises for your recovery...9 Home care instructions...10 Questions to ask your doctors and nurses before surgery...11 Resources...12 Centra is comprised of Centra Lynchburg General Hospital, Centra Virginia Baptist Hospital, Centra Bedford Memorial Hospital, Centra Southside Community Hospital and numerous other facilities and programs throughout Virginia.

4 Preregistration If you have not already spoken to one of our representatives, please call or toll free between the hours of 7:30 a.m. and 6 p.m. It is important this be completed prior to the day of your surgery to facilitate events the day of your procedure. Details of your scheduled surgery Centra provides high quality, patient-focused care. You are scheduled for ambulatory surgery (also called same-day or outpatient surgery). Our highly skilled, caring staff will support you throughout your surgical experience. Day of arrival: Your ARRIVAL time is NOT your procedure time. Please arrive early as instructed to allow hospital personnel appropriate time to prepare you for your surgery. Failure to arrive on time may result in your procedure being moved to a later time or cancellation. ALL patients MUST STOP at registration. Bring a photo ID and insurance cards. (Even if you have been pre-registered by phone). IMPORTANT: You will receive final CONFIRMATION OF YOUR ARRIVAL TIME the evening prior to your procedure by an automated phone message. Be SURE to provide the hospital with the contact number with which you wish to receive the confirmation call. Your time may change due to scheduling events in the operating room. DATE OF SURGERY: Please arrive at the Registration Department at: a.m./p.m. Allow adequate time to park. Please be aware that your procedure may not start exactly on time due to unforeseen events in the operating room. If you have any questions or concerns prior to your procedure, please call the Preoperative Nurse Educator at: between 8 a.m. and 6 p.m., Monday through Friday Or, you may call your surgeon s office directly. What to do if you become ill or need to cancel before surgery If you become ill, such as with a cold, cough or fever before surgery, OR need to cancel, please call: Centra Lynchburg General Hospital at and notify your surgeon s office. Centra Virginia Baptist Hospital at and notify your surgeon s office. If your surgery date or time needs to be changed for any reason, it is the responsibility of your surgeon s office to notify you. 2

5 Preparing to come to the hospital If you were provided a BLOOD BRACELET, you MUST bring it to the hospital the day of your surgery. Failure to do so will result in a repeat blood draw and delay in your procedure. Please be advised that it is Centra policy not to perform elective medical procedures on women who are or may be pregnant. As part of your pre-operative procedures and tests, a pregnancy test may be ordered. Diet DO NOT eat or drink anything after midnight the night before surgery. This includes water, gum, candy and/ or mints. NO food or milk products after midnight the night before surgery. Clear liquids are allowed up to a.m./p.m. the day of surgery. NOTHING by mouth after this time. CLEAR LIQUIDS INCLUDE: Fruit juice without pulp, carbonated beverages, apple juice, white grape juice, tea without milk, black coffee, Gatorade, Kool-Aid, Hawaiian Punch, non-pulp popsicle. NO ORANGE OR GRAPEFRUIT JUICE. Medications Take medications as instructed by your surgeon or the preoperative nurse educator. DO bring all medications (include insulins, inhalers, nebulizers, CPAP machines, herbs and supplements, etc.) Tylenol/Acetaminophen is the ONLY over-thecounter pain medicine that will not thin your blood. Ask your surgeon or nurse educator about your prescription pain medicines. Additional preparations Do NOT use powder, hairspray, lotion or perfume prior to your surgery. Do NOT wear contact lenses to the hospital. If you must have them, be sure to bring a case to 3 store them in during surgery. Glasses are preferred. Brush your teeth; be careful NOT to swallow any toothpaste and/or water. Wear comfortable street clothes to the hospital that you can wear home after surgery. Do NOT smoke before your surgery. SMOKING IS NOT PERMITTED AT ANY CENTRA FACILITY. Do NOT consume alcohol prior to your surgery. Leave valuables at home if at all possible. Do NOT bring valuables, such as jewelry, pocketbooks and wallet. If you will be admitted after surgery, pack only essential items such as toilet articles, nightwear, slippers and eyeglasses. Leave your belongings in the car, and ask one of your family members to bring them to your room after your surgery. DO bring a warm pair of socks. Depending on your procedure, you may be permitted to wear them in the operating room. It is advised that you bring an extra pair of underwear to have if the need arises. Bring a pillow and leave in your car for support and positioning at discharge. VERY IMPORTANT: At the time of discharge, you MUST have a driver that will assume responsibility for you when leaving the hospital. If an appropriate driver is not pre-arranged, your procedure will be canceled. NOTE: The hospital is NOT responsible for the loss or theft of any personal item(s). It is recommended you have a family member responsible for your personal items, including dentures and glasses. Books, magazines, electronic devices, etc. are permitted. We encourage their use as they can help with diversion and comfort techniques. However, the hospital will not assume responsibility, and it is recommended your name and address be affixed to any such item.

6 Preparing skin night before surgery bathe and shower only as directed SHOWER (or bathe) before surgery. DO NOT use lotions, powders, perfumes or hairspray after your shower for surgery. Skin prep applies to you if checked. To assist in preparing the skin and decreasing the risk of infection Centra has chosen disposable pre-moistened cloths. You will receive a package from the Pre-Surgery Center to use the night before your surgery. Night before your surgery Take a shower if you are able to do so. Wait two hours after shower before using the Sage 2 percent Chlorhexidine cloths. Ladies, please DO NOT SHAVE your legs or underarms during this shower or until after your surgery. Do NOT apply lotions, moisturizers or make-up to your body. To open the package Hold top of package in one hand, lift flap on back of package with other hand. Grasp the notch at the top and pull straight across to expose cloths. Instructions DO NOT allow this product to come into contact with your eyes, ears, mouth or mucous membranes. Remove first cloth. Gently pat/wipe body from neck down. (Do not scrub.) Dispose of first cloth. Discard in trash can. Do not flush. Remove second cloth. Gently pat/wipe surgical site area (area circled on diagram). Dispose of second cloth. Front Back Do Not Rinse. Allow area to air dry for one minute. Skin may feel ''tacky'' for several minutes. DO NOT SHOWER, CLEANSE OR RINSE YOUR SKIN AFTER PREPARATION. MUST REMAIN ON SKIN UNTIL YOUR SURGERY. 4

7 Additional instructions Information for family and visitors A parent and/or legal guardian of a minor is required to remain in the hospital during surgical procedures. It is your responsibility to be available in the surgical waiting area to speak with the surgeon and or anesthesiologist. Only two family members or friends may be with you in your room on the day of your surgery. Children under 12 years of age are NOT permitted to visit in the Surgery Center. Your surgeon will come to the designated waiting area to speak with your family following your surgery. Note: Please remind family members to be available to speak with your surgeon in the waiting area. If you DO NOT wish for information to be given out about your procedure, you should discuss this with your surgeon in advance. During your surgery, your family will be instructed to wait in the surgical waiting area or in your assigned room. 5

8 Admission to The Surgery Center You will be assigned a room, given a hospital gown to wear and asked to remove all necessary clothing. The gown ties in the back and you will wear it into the operating room. A nurse will complete your admission, which includes assessment of your vital signs and listening to your heart and lungs. You will be asked to go to the bathroom to empty your bladder. You may receive a medication to help you relax. The medicine may make you drowsy, so please ask for help before getting out of bed. You will be asked to remove dentures. Cups are provided for dentures. Eyeglasses should be removed and stored in the bedside table or given to a friend or relative. The operating room You will be transported from The Surgery Center to the operating room on a stretcher by one of our operating room staff. An anesthesiologist (a physician who will administer the anesthetic) will talk with you about the type of anesthesia you will receive. Anesthesia is medication that keeps you from feeling pain during surgery. For minor surgery, you may need only local anesthesia to numb the surgical site. For other surgeries, your anesthesia may include: Regional anesthesia, to numb a single region of your body Monitored anesthesia care (MAC), to make you drowsy or lightly asleep General anesthesia, to put you completely asleep About one hour before your surgery, surgical personnel will start an intravenous solution (IV) to give you fluids and medications. As you are moved into the operating room, you may notice bright overhead lights and equipment. Our operating rooms are temperature controlled, and you may feel cold. Please request a blanket if you need it. You will be asked to move from the stretcher onto the operating room bed. A safety belt will be placed across your legs. Then the nurse or anesthesiologist will put a blood pressure cuff around one of your arms (or legs). They will also place three or four small stickers on your chest or back. These stickers will connect you to an EKG heart monitor. A monitor also will be placed on your finger to check your oxygen level. 6

9 Post anesthesia care unit (recovery room) After your surgery, you may be taken to the PACU (the recovery room) where you will be closely watched until you are fully awake. The amount of time you spend in the recovery room depends on your surgery and anesthetic. In PACU (Recovery Room): You may awaken with an oxygen mask on your face to help you breathe. You may have an automatic blood pressure cuff on your arm. You may have a sore throat, feel tired, groggy and sick to your stomach or have pain as your anesthesia wears off. This is not uncommon. If you have pain or nausea, please let your nurse know. You will be asked to take deep breaths, cough and turn with help. You will feel cold because the temperature in the PACU is cool. Let the nurse know if you need a blanket. You may hear beeping and noises from the monitors and equipment. Returning to your room after surgery For outpatient surgery Following your recovery in the PACU, you will be transported back to The Surgery Center. Your family can visit once you are settled back into your room. The nursing staff will monitor your status and you will be provided pain medication and comfort measures as needed. You will be encouraged to drink fluids as appropriate. Once you meet the necessary discharge criteria, home care instructions will be reviewed and provided. For admission following surgery Following your recovery in the PACU, you will be transported to an inpatient room in the hospital. Your family will be provided your room number. Once your family has spoken to your surgeon following your procedure they can take your overnight bag/suitcase to your assigned room. Your family can visit once you are settled back into your room. The nursing staff will monitor your status and you will be provided pain medication and comfort measures as needed. You will be encouraged to drink fluids, as appropriate and postoperative orders written by your physician will be carried out. Once your physician determines you are ready for discharge, home care instructions will be reviewed and provided. 7

10 Managing your pain Management of your pain is an important part of your healthcare and recovery process. Before your surgery, we encourage you to ask your doctor what to expect regarding pain and plans for pain management. How long and how much pain can be expected? Discuss pain control options with your doctor. Available methods of pain control administration (oral, intravenous, patient controlled analgesia, epidural and intramuscular). Discuss with your doctor any concerns you have about taking pain medication. Everyone feels and reacts to pain in different ways. Pain can interfere with healing and recovery. It is important for you to share your level of comfort or discomfort with the nursing staff. You are the only one who really knows how much pain you feel and what makes it better. Throughout your hospital stay, the nurses and your doctor will ask you about pain. The pain scale references below are tools used to help assess your level of comfort. Numeric No Pain Facial Moderate Pain Worst Possible Pain Reference: Wong, D. and Whaley, L. (1986). Clinical handbook of pediatric nursing, ed., 2, p St. Louis: C.V. Mosby Company Following your surgery, your comfort level will be assessed. Your description of pain will help enable us to determine how to help you become more comfortable. Here are some words that may help to describe your pain: Dull Prick Throb Sharp Ache Burn Pull Cramping Please notify your nurse if your pain worsens or increases in intensity above your comfort goal. Your surgeon will be notified for additional orders if needed. We may change the medication, dose or timing, if necessary. Following discharge, contact your surgeon s office if your pain worsens or increases in intensity. 8

11 Tips for taking your pain medication It is easier to remember to take medication if you take it on a schedule. (Try to time your medication by taking it before beginning an activity, such as dressing, walking or sitting at the table for a meal.) Take pain medications with a little food to help avoid an upset stomach. A common side effect of pain medications is constipation. Drinking fluids and eating fruits and vegetables may help. Avoid laxatives unless your surgeon has prescribed them. Don t drink alcohol while taking pain medication. The combination can cause dizziness, slow your respiratory system and can even be fatal. Pain medication can slow your reflexes. Do not drive or operate machinery while taking pain medication. Exercises for your recovery It is recommended you practice the following exercises at home prior to your procedure. To improve your recovery process, you should start the exercises as soon as you can after your surgery. Do them about every hour while awake until you are up and about. How to do deep breathing exercises Breathe in slowly and deeply through your nose. Hold the air for a count of three. Breathe out slowly through your mouth as if blowing out a candle. Repeat the deep breathing exercises approximately four times. Note: Breathing in and out using a harmonica is an excellent way to perform this exercise. How to do controlled coughing exercises Breathe in through your nose slowly and deeply. Hold the air for a count of three. Cough two or three consecutive times without inhaling between coughs. Several short coughs will loosen and remove secretions more effectively and completely. Leg exercises and changing positions Turn from left side to right side, using the side rails to assist moving. Diaphragm Windpipe Airways (Bronchial Tubes) Air Sacs If you have surgery on your chest or abdomen, you may want to splint the incision by holding your hands, a pillow or a folded blanket over the incision to ease the strain and discomfort. Repeat the controlled coughing exercises one more time. Push your toes forward, pull them back and then relax. Move each foot in a circular motion. One at a time, bend each leg at the knee, and then stretch your leg out completely. Repeat this exercise twice. 9

12 Home care instructions Before being discharged, you will be provided information on home care and what you can expect. Follow instructions for the care of your surgical site as directed by your physician. The postoperative nursing staff will help to direct you in your postoperative care. Call your surgeon if you notice any of the following symptoms: Excessive bleeding Unusual swelling, redness or smelly discharge around your wound, if applicable Pain unrelieved by your pain medicine Excessive vomiting, lasting longer than four hours Shortness of breath No bowel movement within three days Fever of 101 degrees or higher Questions to ask your doctors and nurses before surgery One way you can help lower your risk for problems from your surgery is to talk with a member of your surgical care team before surgery about the type of care you should receive. Your care team includes your surgeon, your anesthesiologist and your nurses. The information on this page is provided courtesy of the Surgical Care Improvement Project Partnership, a large national partnership dedicated to reducing the number of preventable surgical complications. What will you do to prevent blood clots? When you have surgery, you are at risk of getting blood clots because you do not move while under anesthesia. The more complicated your surgery, the higher your risk. Your doctor will know your risk for blood clots and steps that will help prevent them, such as giving you the right medicine before surgery. If I take medicine for heart disease, should I keep taking it? Taking certain medicines together can cause problems. Tell your doctor about all the medicines you are taking, including over-the-counter things like aspirin and herbal remedies. Your doctor or nurse will tell you which medicines you should continue to take and which medicines you should stop taking before surgery. What is a Surgical Site Infection (SSI)? A surgical site infection is an infection that occurs after surgery in the part of the body where the surgery took place. Most patients who have surgery do not develop an infection. However, infections develop in about 1 to 3 out of every 100 patients who have surgery. Some of the common symptoms of a surgical site infection are: Redness and pain around the area where you had surgery Drainage of cloudy fluid from your surgical wound Fever Can SSIs be treated? Yes. Most surgical site infections can be treated with antibiotics. The antibiotic given to you depends on the bacteria (germs) causing the infection. Sometimes patients with SSIs also need another surgery to treat the infection. What are some of the things that hospitals are doing to prevent SSIs? To prevent SSIs, doctors, nurses, and other healthcare providers: Clean their hands and arms up to their elbows with an antiseptic agent just before the surgery. 10

13 Clean their hands with soap and water or an alcohol-based hand rub before and after caring for each patient. May remove some of your hair immediately before your surgery using electric clippers if the hair is in the same area where the procedure will occur. They should not shave you with a razor. Wear special hair covers, masks, gowns, and gloves during surgery to keep the surgery area clean. Give you antibiotics before your surgery starts. In most cases, you should get antibiotics within 60 minutes before the surgery starts and the antibiotics should be stopped within 24 hours after surgery. Clean the skin at the site of your surgery with a special soap that kills germs. What can I do to help prevent SSIs? Before your surgery: Tell your doctor about other medical problems you may have. Health problems such as allergies, diabetes, and obesity could affect your surgery and your treatment. Quit smoking. Patients who smoke get more infections. Talk to your doctor about how you can quit before your surgery. Do not shave near where you will have surgery. Shaving with a razor can irritate your skin and make it easier to develop an infection. At the time of your surgery: Speak up if someone tries to shave you with a razor before surgery. Ask why you need to be shaved and talk with your surgeon if you have any concerns. Ask if you will get antibiotics before surgery. After your surgery: Make sure that your healthcare providers clean their hands before examining you, either with soap and water or an alcoholbased hand rub. Family and friends who visit you should not touch the surgical wound or dressings. Family and friends should clean their hands with soap and water or an alcohol-based hand rub before and after visiting you. If you do not see them clean their hands, ask them to clean their hands. What do I need to do when I go home from the hospital? Before you go home, your doctor or nurse should explain everything you need to know about taking care of your wound. Make sure you understand how to care for your wound before you leave the hospital. Always clean your hands before and after caring for your wound. Before you go home, make sure you know who to contact if you have questions or problems after you get home. If you have any symptoms of an infection, such as redness and pain at the surgery site, drainage, or fever, call your doctor immediately. If you have additional questions, please ask your doctor or nurse. 11

14 Resources For information on preparing for surgery, please visit which offers additional questions to ask your physician and surgeon about your surgery. For information on quality of hospital care, visit Hospital Compare at It includes information on how often hospitals provide some of the recommended care to get the best results for most patients. For information on the Joint Commission s Speak Up program, which includes safety tips for surgical patients and infection prevention, visit For patient information concerning anesthesia, please visit For more information concerning surgery, visit the American College of Surgeons at If you have any questions prior to your surgery after review of this material, please call the Presurgery Center at Thank you for allowing us to serve you. 12

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