University of Florida Surgery Internship Survival Guide

Size: px
Start display at page:

Download "University of Florida Surgery Internship Survival Guide"

Transcription

1 University of Florida Surgery Internship Survival Guide GENERAL PRINCIPLES: 1. Have a positive attitude. Always. 2. Communicate up the ladder. Always. If we do not communicate well within our teams and to the night team, our patients will get hurt. 3. Form your own system or routine that will allow you to optimize your efficiency. 4. Know your patients. 5. Remember that you are the first person to be called if a patient doesn t look right. Go see your patients when you are called! Then refer to #2. 6. Always perform a thorough sign-out with the on-call residents. The completeness of our sign-out is the ONLY continuity of our patient care. 7. Only consent patients for a procedure if you can explain the procedure and complications thoroughly. Alternatively, you can do the paperwork if you have witnessed an attending, chief, or junior resident discuss the procedure, risks, & benefits with the patient. 8. Dictate discharge summaries either the night before or the day a patient is discharged. At the end of your dictation, ask the transcription to send a copy of your dictation to the patient s referring physician (if one is listed on the chart). 9. Our nurse practitioners and physician assistants are great resources and very helpful. Do not abuse them. 10. Before you start a new service, contact the intern on that service for sign-out and call your chief. DAILY PRIORITIES: 1. Arrive minutes before morning rounds and update The List. You can access your service s list by logging in at: If you are at the VA, each service keeps their lists on one computer in their team room (Microsoft Access program). Correct patient room numbers since your patients may be moved to different rooms overnight Make sure the antibiotics are correct Print out a short list for the chief and junior residents. Print out a long list for yourself. 2. During morning rounds, write every task down on your list with an empty check box next to it. You will be amazed at how many tasks you will forget if it is not written on your list. 3. After morning rounds, your top two priorities should be calling consults & calling to schedule radiology studies/procedures. Be considerate to our consultants. When they return your page, ask for a consult, and provide them with the patient s name, medical record number, and room number. Give them a concise patient history and specific question

2 that we would like them to answer. Write the order for radiology studies/procedures in your patient s chart AND call to make sure that your patient is on the schedule. Do not assume that if the order is written that it will automatically get done. Monday-Friday 8am-5pm: you need to call for fluoroscopy, interventional radiology, angiography, MRI, and nuclear medicine studies. For the most part, you will not need to call for routine x-rays, EKGs, CT scans, duplex scans and ultrasounds. On nights and weekends, you will need to call for everything except for x- rays and EKGs. After you have ordered a test, do not wait for the report to come up in the computer system. Call radiology and try to talk to a resident or attending to find out the results ASAP. As a general rule, remember that if your patient needs a test sooner than routine, a phone call never hurts. Everything is more efficient with a little love (i.e. person-to-person contact, follow-up phone call). 4. Discharge your patients that are going home. Patient discharges are MUCH more efficient if you complete them the night before. Check your patient s MAR (medical administration record) so that you can write prescriptions for their medications. With the exception of pain medications, your patient does not need to go home with PRN medications (or heparin SQ). Complete the 2 discharge sheets in front of the chart. Make sure that your patient has a follow-up appointment with your service and any other appropriate consulting services. Ask your chief resident when you should schedule your patient s follow-up appointment, then call for an appointment time. Dictate your discharge summaries the same day. Otherwise, you can count on a large pile of charts in medical records with your name on it. Remember that your discharge summary will be helpful to the next person who sees your patient at their follow-up appointment (another reason to complete your DC summaries in a timely fashion). 5. Check your patients morning labs. Alert your chief of any significant abnormal lab values so that they may be addressed early in the day. Replete electrolytes PRN. Order AM labs PRN. Remember that not every patient on your service will need morning labs, while others will. Ask your junior or chief resident. 6. At 11am, microbiology data will be updated. Check your patients cultures and sensitivities on a daily basis. 7. TPN orders are due at 1pm. If you have any questions regarding TPN, call Paula Johns (cell ). 8. Write your note and orders on one patient before moving on to the next patient. This routine will maximize your efficiency and prevent you from missing or forgetting anything. 2

3 9. Run the list multiple times throughout the day to make sure you do not miss anything. Update The List frequently. Check room numbers for patients that are transferred to SICU, IMC, or the floor. Add patients that are post-op admissions, and delete your discharged patients (after you have seen them physically leave Shands). 10. Prepare the pre-op notes and orders for the next day. Obtain the OR weekly schedule from each service secretary or the junior/chief residents. 11. Master the art of multi-tasking and efficiency. Find a computer with a phone next to it, and page your consults. As you are waiting for them to call you back, call radiology to schedule tests. At the same time, write down your patients labs on your list, write orders in the chart, and discharge patients. You will get used to it. 12. Make time to go the OR. Remember why you re here PREOPS: 1. All patients (inpatient and outpatient) need a pre-op note. This note is the only way to be sure that any abnormal tests are recognized the night before the operation. Alert your chief if you identify anything abnormal! Your chief and junior residents will not check these tests. They are depending on you to notify them. 2. Your pre-op orders will not be reviewed by your chief or junior resident. If you have a question regarding antibiotics or blood products, ask them. 3. Pre-op notes should include the following: Pre-operative diagnosis Planned Procedure Attending Anesthesia preferred Laboratory Data EKG (age > 40yrs or else indicated by history) CXR (age > 60yrs or else indicated by history) Blood products (if needed) Antibiotics Consent (Procedure consent AND blood consent) Verify H&P on chart 4. Antibiotics For skin operations (hernias, thyroids, parathyroids, breast, etc) use Kefzol one gram IV OCTOR. Kefzol has a short half-life so it must be given within 30 minutes prior to incision (usually given when pt is already in the OR). If your patient is allergic to penicillin, then use Clindamycin 900mg IV or Vancomycin one gram IV. Vancomycin needs to be infused over one hour, so if it is written for an inpatient, then the infusion needs to be started before the patient leaves the floor to go to pre-op holding. For GI operations, use Cefoxitin one gram IV or Cefotan one gram IV. Do not give Cefotan if the patient has any liver disease or liver metastases. If your patient is allergic to penicillin, then use Ciprofloxacin 400mg IV AND Flagyl 500mg IV. 3

4 For biliary operations (Whipple procedure, hepaticojejunostomy, liver resections) use Timentin 3.1 grams IV or if your patient is allergic to penicillin, then use Ciprofloxacin 400mg IV AND Flagyl 500mg IV 5. Write for SCD to BLE before pt goes into the OR 6. Peri-op beta-blockade (refer to additional print-out on this) In general, except for kids, healthy young adults w/o cardiac risk factors, and AV block or sick sinus syndrome, we should beta-block everyone before the OR. Metoprolol 5-10mg IV in pre-op, or Atenolol mg PO before the OR(unless pt has taken this already as part of home medications) 7. After your pre-operative paperwork is complete, drop them off at the OR front desk the day before the operations. 8. Bowel preps One gallon of Go-Lytely OR two bottles of Mag Citrate OR two bottles of Fleets Phospho-soda (Pt to drink all between 10am and 12pm) Neomycin one gram PO at 1pm, 2pm, and 8pm Erythromycin one gram PO at 1pm, 2pm, and 8pm Normal saline enema if patient s stool is not clear by 8pm History & Physicals/Consults 1. Always do a complete Review of Systems. Remember to specifically ask about weight loss, TIA symptoms, chest pain, shortness of breath, bleeding or clotting disorders, bloody stools, nausea, vomiting, buttock or calf claudication. 2. When you are meeting a new patient and performing an H&P, actively look for PMH reasons to cancel the patient s operation until a more complete pre-operative workup (cardiology or pulmonary clearance) can be completed. 3. Remember that your H&P will be the most detailed evaluation on the team. Your chief resident and attending are depending on you to pick up anything abnormal! 4. Dictate your H&Ps! 5. On some services, you will be the consult resident. As soon as you receive a consult, go and see your patient. Remember that you have been called because a patient might need to have an emergent operation, so evaluate them ASAP. After you have seen them, tell your chief or attending. The worst thing that you can do after you see a consult is to wait for hours before letting somebody know that the team got a new consult. Admission Orders: Admit: (Floor) / (Service) / (Attending Surgeon) ex: 64 / Surgical Oncology / Cance Contacts: (Intern or 1 st call s name) / (Service pager or 1 st call pager) & Night float pager Diagnosis: Condition: Vitals: Fresh post-ops or sick floor patients should be Q4h, others are routine Allergies: Activity: With a few exceptions, all post-ops are OOB on POD#1, ambulate on POD#2 Nursing: Call House Officer if temperature greater than 38.5 C, heart rate greater than 110 or less than 60, systolic BP greater than 160 or less than 90, diastolic blood pressure greater than 90 or less than 60 or urine output less than 30cc/hr. 4

5 Bilateral SCDs to lower extremities Strict I/O Chemsticks q6hr for diabetics and any patient on TPN or Tubefeeds. When pt is tolerating regular diet, change chemsticks to QAC&HS. NGT to LIWS, Foley to gravity, JP to bulb suction (if applicable) Orders for dressing changes (if applicable wet to dry BID, dry dressing QD and PRN, etc.) Respiratory: Incentive spirometer 10x/hr while awake If pt has epidural or a basal rate on PCA, then order continuous pulse oximetry Aggressive pulmonary toilet if needed Albuterol 2.5mg/Atrovent 0.5mg nebulizer treatments Q4h (if applicable) Chest physiotherapy Q4h or Q6h (if applicable) Diet: IVF: Meds: We usually use D5 ½ NS with KCl 20 meq Be cautious about fluids. If you have a patient whose rate of TPN or tube feeds is increasing, remember to decrease the rate of IVF so that the total fluids will equal maintenance. Be especially careful in patients with heart failure (don t fluid overload) or dialysis (don t fluid overload & leave the potassium out of their fluids). Ask your chief or junior if you are not sure. Pain meds (Morphine PCA 1/6/10 or Dilaudid PCA 0.1/6/1. If tolerating PO, use oxycodone 5-10mg PO q4-6hr PRN or percocet 1-2 tabs PO q4-6hr PRN) Morphine PCA 1/6/10 (Patients will receive 1mg every 6 mins for a maximum of 10mg an hr). Patients on regular floor should have pulse oximeter especially when you have a basal or continuous infusion as part of the PCA order. 1/1/6/11 (basal of 1 mg an hr infusion, 1 mg on demand every six minutes, for a max of 11mg an hr). Dilaudid PCA 0.1/6/1 (0.2 mg on demand every 6 minutes for a max 2mg hr). Try to avoid using continuous or basal rate morphine for floor patients. Do not use basal/continuous PCA for VA 5 th floor Surgery patients. If your patient has an epidural, write Page Acute Pain Service (APS) for pain control issues) Bowel regimen (Colace 100mg PO twice a day, Dulcolax suppository PRN) Tylenol 650mg PO q6hr PRN (not to exceed greater than 4 grams of acetaminophen per day from all sources) Benadryl 25-50mg IV/PO q6hr PRN pruritus or insomnia Zofran 4mg IV/PO q4hr PRN OR Promethazine 12.5mg IV q4hr PRN for nausea Insulin sliding scale & chemsticks (include how often to check chemsticks) Regular insulin SQ sliding scale: 0-75 one amp of D50 and call House Officer, do nothing, units, units, units, units, greater than units and call House Officer 5

6 You can also write a tighter sliding scale, above is only a guideline Check your patient s home medications too! Labs: Radiology: Consults: Prophylactic/Peri-operative agents Stress ulcer prophylaxis: Ranitidine 50mg IV q8hr or 150mg PO bid OR PPI (Lansoprazole 30mg dissolvable tab qd or bid). If pt has documented GI bleed, use Pantoprazole 40mg IV bid. Thromboprophylaxis: Lovenox 30mg SQ bid or Heparin 5000 Units SQ q8hr Beta-blockade/cardioprotection: Metoprolol 5mg IV q6hr scheduled AND 5-10mg IV q6hr prn HR > 90. Hold if SBP < 100. Anti-hypertensives: Labetalol 5-40mg IV q2hr prn SBP > 160. Hold if HR < 60 Hydralazine 10-20mg IV q2hr prn SBP > 160. AM BMP, Mg, Phos, CBC (and any other applicable labs) Order studies if appropriate Physical Therapy (reason: post-op deconditioning) 6

Surgical Oncology Manual: Patient Protocols: Daily Rounds:

Surgical Oncology Manual: Patient Protocols: Daily Rounds: Surgical Oncology Manual: Patient Protocols: Daily Rounds: All inpatients must be seen by the chief resident or fellow prior to that day s OR cases. Multidisciplinary notes are to be completed for every

More information

Surgical H&P and Consultations Daily Progress Notes and Presentations Post-Operative Notes What should I be doing throughout the day?

Surgical H&P and Consultations Daily Progress Notes and Presentations Post-Operative Notes What should I be doing throughout the day? Surgical H&P and Consultations Daily Progress Notes and Presentations Post-Operative Notes What should I be doing throughout the day? Surgical H&P s and Consultations For this and all other clerkships,

More information

Post-operative "Fast-Track" pathways for lung resection. Dennis A. Wigle Division of Thoracic Surgery Mayo Clinic

Post-operative Fast-Track pathways for lung resection. Dennis A. Wigle Division of Thoracic Surgery Mayo Clinic Post-operative "Fast-Track" pathways for lung resection Dennis A. Wigle Division of Thoracic Surgery Mayo Clinic Post-operative "Fast-Track" pathways for lung resection Dennis A. Wigle Division of Thoracic

More information

Clinical Pathway: TICKER Short Stay (Expected LOS 5 days) For Patients not eligible for other TICKER Clinical Pathways

Clinical Pathway: TICKER Short Stay (Expected LOS 5 days) For Patients not eligible for other TICKER Clinical Pathways Project TICKER Teamwork to Improve Cardiac Kids End Results Clinical Pathway: TICKER Short Stay (Expected LOS 5 days) For Patients not eligible for other TICKER Clinical Pathways Notes: (1) This pathway

More information

PATIENT MOVEMENT RECORD DATA PROTECTED BY PRIVACY ACT OF 1974

PATIENT MOVEMENT RECORD DATA PROTECTED BY PRIVACY ACT OF 1974 SECTION I PATIENT MOVEMENT RECORD DATA PROTECTED BY PRIVACY ACT OF 1974 PERMANENT MEDICAL RECORD (S) - Information needed to submit patient movement record PATIENT IDENTIFICATION (s) NAME (Last, First,

More information

Protocol: Name of supervising ED provider: Name of RDTC Faculty: Disposition: Date: / / Time: : (military)

Protocol: Name of supervising ED provider: Name of RDTC Faculty: Disposition: Date: / / Time: : (military) RDTC TRACKING SHEET Record patient information in top right corner When completed, place in RDTC binder at A-pod Faculty desk Name: MR# Stamp OR write patient information above ED provider (i.e. faculty/pa/resident

More information

Clinical Pathway: Ventricular Septal Defect (VSD) or Atrial Septal Defect (ASD) Repair

Clinical Pathway: Ventricular Septal Defect (VSD) or Atrial Septal Defect (ASD) Repair Project TICKER Teamwork to Improve Cardiac Kids End Results Clinical Pathway: Ventricular Septal Defect (VSD) or Atrial Septal Defect (ASD) Repair Notes: (1) This pathway is a general guideline and does

More information

TOTAL HIP REPLACEMENT FLOW SHEET

TOTAL HIP REPLACEMENT FLOW SHEET TOTAL HIP REPLACEMENT FLOW SHEET Before Surgery: Nothing to eat or drink after midnight the night before surgery. Make sure you have a bowel movement the day before surgery. Be sure to attend your pre-op

More information

Surgical Weight Loss at Eastern Maine Medical Center Your Inpatient Nursing Stay

Surgical Weight Loss at Eastern Maine Medical Center Your Inpatient Nursing Stay Surgical Weight Loss at Eastern Maine Medical Center Your Inpatient Nursing Stay Dear Prospective Patient: I have recently been informed that you are considering weight loss surgery at EMMC. As you know

More information

Enhanced Recovery After Surgery in OB/GYN

Enhanced Recovery After Surgery in OB/GYN Enhanced Recovery After Surgery in OB/GYN Audra Williams, MD Ashley Wright, MD University of Alabama at Birmingham Department of OB/GYN Women s Reproductive Healthcare Division Outline Brief background

More information

INCLUSION CRITERIA. REMINDER: Please ensure all stroke and TIA patients admitted to hospital are designated as "Stroke Service" in Cerner.

INCLUSION CRITERIA. REMINDER: Please ensure all stroke and TIA patients admitted to hospital are designated as Stroke Service in Cerner. ACUTE STROKE CLINICAL PATHWAY The clinical pathway is based on evidence informed practice and is designed to promote timely treatment, enhance quality of care, optimize patient outcomes and support effective

More information

UW MEDICINE PATIENT EDUCATION. Angiography: Radiofrequency Ablation to Treat Solid Tumor. What to expect. What is radiofrequency ablation?

UW MEDICINE PATIENT EDUCATION. Angiography: Radiofrequency Ablation to Treat Solid Tumor. What to expect. What is radiofrequency ablation? UW MEDICINE PATIENT EDUCATION Angiography: Radiofrequency Ablation to Treat Solid Tumor What to expect This handout explains radiofrequency ablation and what to expect when you have this treatment for

More information

Clinical Pathway: Tetralogy of Fallot (TOF) Repair

Clinical Pathway: Tetralogy of Fallot (TOF) Repair Project TICKER Teamwork to Improve Cardiac Kids End Results Clinical Pathway: Tetralogy of Fallot (TOF) Repair Notes: (1) This pathway is a general guideline and variations can occur based on professional

More information

Whipple Procedure (Pancreaticoduodenectomy)

Whipple Procedure (Pancreaticoduodenectomy) Enhanced Recovery After Whipple Procedure (Pancreaticoduodenectomy) Your Path to Healing Your Pancreatic Surgical Oncology Team This expert team is an important part of the Pancreatic Surgery Program at

More information

2. Unlicensed assistive personnel: any personnel to whom nursing tasks are delegated and who work in settings with structured nursing organizations.

2. Unlicensed assistive personnel: any personnel to whom nursing tasks are delegated and who work in settings with structured nursing organizations. XVIII. A. General Information: The judgments that you make in about coordinating and facilitating client care situations have to be based on knowledge. You MUST know your content, and then you can move

More information

Radiofrequency Ablation to Treat Solid Tumors

Radiofrequency Ablation to Treat Solid Tumors Patient Education Radiofrequency Ablation to Treat Solid Tumors This handout explains what radiofrequency ablation is and what to expect when you have it done to treat solid tumors. Why do I need this

More information

Creating Clinical Pathways

Creating Clinical Pathways Creating Clinical Pathways Michael Stifelman, MD Professor and Chairman of Urology Director, Urologic Oncology & Courtney DiBona, MSN, RN-BC Nurse Manager: Urology Why create clinical pathways? Institute

More information

University of South Dakota Vermillion, South Dakota Department of Nursing. Simulation Scenario Infection: Post Anesthesia Care Unit (Part 1) Overview

University of South Dakota Vermillion, South Dakota Department of Nursing. Simulation Scenario Infection: Post Anesthesia Care Unit (Part 1) Overview Title: To cite this reference: University of South Dakota Simulation Scenario Infection: Post Anesthesia Care Unit (Part 1) Overview Post Anesthesia Care Target Group: First Year Concept: Infection Unit

More information

North Cypress Medical Center Patient Portal is a secure, private web portal that allows you to access health information online.

North Cypress Medical Center Patient Portal is a secure, private web portal that allows you to access health information online. North Cypress Medical Center Patient Portal is a secure, private web portal that allows you to access health information online. WHY USE THE PATIENT PORTAL? Manage and maintain your personal health information,

More information

Preparing for Thoracic Surgery and Recovery

Preparing for Thoracic Surgery and Recovery Division of Thoracic Surgery Preparing for Thoracic Surgery and Recovery A Guide for Patients and Families Brigham And Women s/faulkner Hospitals Important Phone Numbers Important Phone Numbers BWH NUMBERS

More information

Beth Israel Deaconess Medical Center Department of Anesthesia, Critical Care, and Pain Medicine Rotation: Post Anesthesia Care Unit (CA-1, CA-2, CA-3)

Beth Israel Deaconess Medical Center Department of Anesthesia, Critical Care, and Pain Medicine Rotation: Post Anesthesia Care Unit (CA-1, CA-2, CA-3) Beth Israel Deaconess Medical Center Department of Anesthesia, Critical Care, and Pain Medicine Rotation: Post Anesthesia Care Unit (CA-1, CA-2, CA-3) Goals GOALS AND OBJECTIVES To analyze and interpret

More information

Going home after breast surgery with drains

Going home after breast surgery with drains Going home after breast surgery with drains Information for patients and families Princess Margaret Read this resource to learn: How to care for yourself when you go home What activities you can do while

More information

Neighborhood Hospital

Neighborhood Hospital Physician Progress Notes Time Mon S/P HoLEP Procedure without complications; estimated blood loss < 100 ml; stable condition to recovery room. 1530 To be admitted to Urology following PACU. Dan Stein,

More information

UW MEDICINE PATIENT EDUCATION. Angiography: Percutaneous or Transjugular Liver Biopsy. How to prepare and what to expect. What is a liver biopsy?

UW MEDICINE PATIENT EDUCATION. Angiography: Percutaneous or Transjugular Liver Biopsy. How to prepare and what to expect. What is a liver biopsy? UW MEDICINE PATIENT EDUCATION Angiography: Percutaneous or Transjugular Liver Biopsy How to prepare and what to expect This handout explains how to prepare and what to expect when having a percutaneous

More information

Radical Prostatectomy Care Guide: A checklist of what to expect

Radical Prostatectomy Care Guide: A checklist of what to expect Radical Prostatectomy Care Guide: A checklist of what to expect Form: D-5473 How to prepare for your operation as an outpatient 1. Pre- Admission Visit Where to find us: Toronto General Hospital (TGH),

More information

University of South Dakota Vermillion, South Dakota Department of Nursing. Simulation Scenario Safety: Patient Safety. Overview

University of South Dakota Vermillion, South Dakota Department of Nursing. Simulation Scenario Safety: Patient Safety. Overview Simulation Scenario Safety: Patient Safety Overview Title: Patient Safety Concept: Safety Target Course: First Year Nursing Students To cite this reference Dreke, C. (2012). Simulation scenario; Safety:

More information

Your Anesthesiologist, Anesthesia and Pain Control

Your Anesthesiologist, Anesthesia and Pain Control You should avoid having pain after surgery by planning ahead. For example, if you know that you are going to be getting up to do your exercises with the therapist, ask for pain control medication in advance.

More information

WELCOME TO THE PEDIATRIC SURGERY SERVICE

WELCOME TO THE PEDIATRIC SURGERY SERVICE We re happy to welcome you to the Pediatric Surgery team. If you haven t done much pediatrics, sick children can be a bit intimidating but you will quickly discover a few things: it s easy to recognize

More information

You will be having surgery to remove a the distal or tail part of your pancreas.

You will be having surgery to remove a the distal or tail part of your pancreas. Distal pancreatectomy You will be having surgery to remove a the distal or tail part of your pancreas. This handout will help you learn about the surgery, how to prepare for surgery and your care after

More information

Protocol: Name of supervising ED provider: Name of RDTC Faculty: Disposition: Date: / / Time: : (military)

Protocol: Name of supervising ED provider: Name of RDTC Faculty: Disposition: Date: / / Time: : (military) RDTC TRACKING SHEET Record patient information in top right corner When completed, place in RDTC binder at A-pod Faculty desk Name: MR# Stamp OR write patient information above ED provider (i.e. faculty/pa/resident

More information

Next Gen Training. Why is Next Gen So Important? Step-by-Step Vitals Entry Scenarios and Mock Work-ups

Next Gen Training. Why is Next Gen So Important? Step-by-Step Vitals Entry Scenarios and Mock Work-ups Next Gen Training Why is Next Gen So Important? Step-by-Step Vitals Entry Scenarios and Mock Work-ups Why is Next Gen So Important? Better for the VFC: All the necessary info can be accessed from any VFC

More information

Guidelines for Kuakini Medical Center General Surgery Rotation (Formulated by a previous Chief Surgical Resident)

Guidelines for Kuakini Medical Center General Surgery Rotation (Formulated by a previous Chief Surgical Resident) Guidelines for Kuakini Medical Center General Surgery Rotation (Formulated by a previous Chief Surgical Resident) Welcome to Kuakini Medical Center! The typical patient is in the Geriatric age group. As

More information

St. Vincent s Health System Page 1 of 8. Nursing Administration HOSPITAL SHARED POLICY?

St. Vincent s Health System Page 1 of 8. Nursing Administration HOSPITAL SHARED POLICY? St. Vincent s Health System Page 1 of 8 TITLE: Rapid Response Team FACILITY: St. Vincent s East FUNCTION: ORIGINATING DEPT: Nursing Administration HOSPITAL SHARED POLICY? EFFECTIVE DATE: _X_ Yes No DOCUMENT

More information

Your Anesthesiologist, Anesthesia and Pain Control

Your Anesthesiologist, Anesthesia and Pain Control You can reduce your pain level after surgery by planning ahead. For example, if you know that you are going to be getting up to do your exercises with the therapist, ask for pain control medication in

More information

Open Hysterectomy Enhanced Recovery (HER) (For elective benign hysterectomy, myomectomy and ovarian/adnexal surgery)

Open Hysterectomy Enhanced Recovery (HER) (For elective benign hysterectomy, myomectomy and ovarian/adnexal surgery) CLINICAL PATHWAY Open Hysterectomy Enhanced Recovery (HER) (For elective benign hysterectomy, myomectomy and ovarian/adnexal surgery) Pre-Admission Unit (PAU) Day of Surgery Pre-op Same Day Admission (SDA)

More information

Surgical Technology Patient Care Skills Preop Routine Objectives:

Surgical Technology Patient Care Skills Preop Routine Objectives: Surgical Technology 8-Jul-09 Patient Care Skills Preop Routine Objectives: 1) Discuss why preop preparation of the patient is important a) Preparing the patient decreases impact and potential risks of

More information

Lowe Plastic Surgery (LPS) Dr Lowe s: Breast Reconstruction Instruction Summary Pre-operative: Hospital Stay: Day of Discharge: , (405)

Lowe Plastic Surgery (LPS) Dr Lowe s: Breast Reconstruction Instruction Summary Pre-operative: Hospital Stay: Day of Discharge: , (405) Lowe Plastic Surgery (LPS) Dr Lowe s: Breast Reconstruction Instruction Summary Pre-operative: 1) Patient should not eat anything after midnight, and hold medicines if instructed 2) Avoid aspirin, blood

More information

About Your Colectomy

About Your Colectomy UW MEDICINE PATIENT EDUCATION About Your Colectomy How to prepare and what to expect This handout explains a colectomy operation, including how to prepare for surgery, what to expect afterward, recovering

More information

Transjugular Liver Biopsy About your procedure

Transjugular Liver Biopsy About your procedure Patient Education Transjugular Liver Biopsy About your procedure This handout explains what a transjugular liver biopsy is and what to expect when you have this procedure. What is a liver biopsy? In a

More information

Percutaneous Transhepatic Biliary Drainage Interventional Radiology

Percutaneous Transhepatic Biliary Drainage Interventional Radiology Percutaneous Transhepatic Biliary Drainage Interventional Radiology Your doctor has scheduled a percutaneous transhepatic biliary drainage to be done in the Interventional Radiology (IR) Department on

More information

Bedside Shift Reporting

Bedside Shift Reporting INCHES 1 2 3 4 5 6 Bedside Shift Reporting Pre-Bedside Checklist: 1. Notify PT/Family 30-60 minutes Before Report Starts 2. Check Pain Score/Adm. Meds if Needed Bedside Report Guide: 1. Introduce Oncoming

More information

Unfolding Clinical Reasoning Case Study: STUDENT Sepsis I. Data Collection History of Present Problem: Jean Kelly is an 82 year old woman who has been feeling more fatigued for the last three days and

More information

Patient Timeline to Surgery and Recovery Ventricular Assist Device

Patient Timeline to Surgery and Recovery Ventricular Assist Device Patient Timeline to Surgery and Recovery Ventricular Assist Device Pre-Ventricular Assist Device Implantation First Visit: Heart Failure Team Assess history and physical exam Complete additional tests

More information

The STEMI ALERT Packet

The STEMI ALERT Packet The STEMI ALERT Packet (At a PCI-capable institution) Use of a STEMI ALERT Packet is a key step in optimizing treatment of the STEMI patient. Opening a STEMI ALERT Packet upon first recognition of STEMI

More information

Services That Require Prior Authorization

Services That Require Prior Authorization Services That Require Prior Authorization Some of the services listed in the Medical Benefits Chart are covered only if your doctor or other network provider gets approval in advance (sometimes called

More information

Columbia Gorge Heart Clinic 1108 June St. Appointment date/time Hood River, OR fax Physician

Columbia Gorge Heart Clinic 1108 June St. Appointment date/time Hood River, OR fax Physician Columbia Gorge Heart Clinic 1108 June St. Appointment date/time Hood River, OR 97031 541-387-6125 fax 541-387-6315 Physician Welcome to the Columbia Gorge Heart Clinic. We welcome you as a patient and

More information

UW MEDICINE PATIENT EDUCATION. What is Yttrium-90 radiotherapy? DRAFT. Why do I need this treatment? How does Y-90 radiotherapy work?

UW MEDICINE PATIENT EDUCATION. What is Yttrium-90 radiotherapy? DRAFT. Why do I need this treatment? How does Y-90 radiotherapy work? UW MEDICINE PATIENT EDUCATION Angiography: Yttrium-90 Radiotherapy Treatment for liver tumors This handout explains what Yttrium-90 radiotherapy is and what to expect when you have it done. What is Yttrium-90

More information

A PARENT S GUIDE TO PEDIATRIC DAY SURGERY PROVIDENCE MEDICAL CENTER ALASKA PEDIATRIC SURGERY 4100 LAKE OTIS PARKWAY SUITE

A PARENT S GUIDE TO PEDIATRIC DAY SURGERY PROVIDENCE MEDICAL CENTER ALASKA PEDIATRIC SURGERY 4100 LAKE OTIS PARKWAY SUITE ALASKA PEDIATRIC SURGERY 4100 LAKE OTIS PARKWAY SUITE 206 929-7337 A PARENT S GUIDE TO PEDIATRIC DAY SURGERY AT PROVIDENCE MEDICAL CENTER Pre- Admission Appointment, Tours and Pre- Registration If pre-

More information

Case Presentation. Cindy Felty MSN, RN, CNP, FCCWS Assistant Professor of Medicine Mayo Clinic March 27, 2008

Case Presentation. Cindy Felty MSN, RN, CNP, FCCWS Assistant Professor of Medicine Mayo Clinic March 27, 2008 Case Presentation Cindy Felty MSN, RN, CNP, FCCWS Assistant Professor of Medicine Mayo Clinic March 27, 2008 Acute DVT Case 1- Day 1 68 year old male admitted overnight to hospital for painful acute DVT

More information

Pre-Procedure/Surgical Instructions for Adults

Pre-Procedure/Surgical Instructions for Adults Pre-Procedure/Surgical Instructions for Adults Thank you for choosing Edward Hospital for your health care needs. Our goal is to be your partner to ensure that you will have a very good experience. Preparing

More information

MIS/Bariatric/Endoscopy Service

MIS/Bariatric/Endoscopy Service MIS/Bariatric/Endoscopy Service Here is an introductory document about your upcoming rotation on our team. First of all, we would like to state our general expectations, which are that you come ready and

More information

UW MEDICINE PATIENT EDUCATION. How to prepare and what to expect DRAFT. What is an IVC filter?

UW MEDICINE PATIENT EDUCATION. How to prepare and what to expect DRAFT. What is an IVC filter? UW MEDICINE PATIENT EDUCATION Angiography: Inferior Vena Cava (IVC) Filter How to prepare and what to expect This handout explains what an inferior vena cava filter is and what to expect when you have

More information

Laparoscopic Radical Nephrectomy

Laparoscopic Radical Nephrectomy Urology Department Laparoscopic Radical Nephrectomy Information Aims of this leaflet To give information on the intended benefits and potential risks of kidney surgery To guide you in the decisions you

More information

Carotid Endarterectomy

Carotid Endarterectomy P A T IENT INFORMAT ION Carotid Endarterectomy Please bring this book to the hospital on the day of your surgery. CP 16 B (REV 06/2012) THE OTTAWA HOSPITAL Disclaimer This is general information developed

More information

See One, Do One, Take it Home! Root Cause Analysis 2 Simulations

See One, Do One, Take it Home! Root Cause Analysis 2 Simulations Role Description: Emergency Department Physician s Assistant You are the Physician s Assistant (ED PA) who evaluates the patient in the Emergency Department. You are the first provider to interview the

More information

Physician Access. Your User name is your Doctor number. * It is always 6 characters; add zeroes to the beginning if needed.

Physician Access. Your User name is your Doctor number. * It is always 6 characters; add zeroes to the beginning if needed. Bethesda Memorial Hospital proudly introduces Siemens' new Clinical Information System that we have named ecos (electronic Clinical Online System). You can access ecos through the Bethesda Intranet by

More information

Pre-Operative Patient Education Class

Pre-Operative Patient Education Class Pre-Operative Patient Education Class Provide you with valuable information on what you may expect after surgery An opportunity to familiarize yourself with Grandview Medical Center and the staff who will

More information

Surgical Preadmission Information. Joint Replacement Hip. Knee

Surgical Preadmission Information. Joint Replacement Hip. Knee Surgical Preadmission Information Joint Replacement Hip Joint Replacement Knee Spine Surgery Planning for Surgery Preoperative Assessments and Tests An appointment for Preoperative Assessments and Tests

More information

About your peritoneal dialysis catheter. Information for patients Sheffield Kidney Institute (Renal Unit)

About your peritoneal dialysis catheter. Information for patients Sheffield Kidney Institute (Renal Unit) About your peritoneal dialysis catheter Information for patients Sheffield Kidney Institute (Renal Unit) Introduction You will have discussed with your doctor that your kidney condition means that you

More information

Enhanced Recovery After. Colorectal Surgery. Your Path to Healing

Enhanced Recovery After. Colorectal Surgery. Your Path to Healing Enhanced Recovery After Colorectal Surgery Your Path to Healing Your Colorectal Surgical Oncology Team This expert team works together to give you the best care available. Based on your situation, you

More information

University of South Dakota Vermillion, South Dakota Department of Nursing

University of South Dakota Vermillion, South Dakota Department of Nursing Title: To cite this reference: Simulation Scenario Complex Patient: Multi-System Organ Failure Part 2 (Sepsis) Multi-System Organ Failure (MSOF) Sepsis (Part 2 of 2) Overview Concept: Complex Patient Target

More information

Pancreaticoduodenectomy enhanced recovery programme (PD ERP) Information for patients

Pancreaticoduodenectomy enhanced recovery programme (PD ERP) Information for patients Pancreaticoduodenectomy enhanced recovery programme (PD ERP) Information for patients Welcome to the pancreaticoduodenectomy enhanced recovery programme (PD ERP). The aim of the programme is for you to

More information

RADIATION ONCOLOGY RESIDENCY SUPERVISION POLICY

RADIATION ONCOLOGY RESIDENCY SUPERVISION POLICY RADIATION ONCOLOGY RESIDENCY SUPERVISION POLICY This policy is intended to guide the activities of radiation oncology residents in insuring that patient care activities in which residents participate are

More information

Total Knee Replacement

Total Knee Replacement Total Knee Replacement Pre-operative Joint Class Updated: November 2017 Where to Begin Thank you for attending the UNC REX Joint Replacement Class today This presentation is designed to prepare you for

More information

PowerChart Review Guide

PowerChart Review Guide PowerChart Review Guide How do I find: Administered Medications MAR Summary Admission History Nursing Charges IV Team, Respiratory Clinical Discharge Summary Content appropriate for next care provider

More information

UW MEDICINE PATIENT EDUCATION. Angiography: Kidney Exam. How to prepare and what to expect. What is angiography? DRAFT. Why do I need this exam?

UW MEDICINE PATIENT EDUCATION. Angiography: Kidney Exam. How to prepare and what to expect. What is angiography? DRAFT. Why do I need this exam? UW MEDICINE PATIENT EDUCATION Angiography: Kidney Exam How to prepare and what to expect This handout explains how to prepare and what to expect when having a kidney exam using angiography. What is angiography?

More information

Think proactively = prevent codes Elective intubation better than PEA arrest

Think proactively = prevent codes Elective intubation better than PEA arrest Kyla Terhune, MD Treat all the same Think proactively = prevent codes Elective intubation better than PEA arrest Floor patient going to ICU? Treat if you are waiting! Rapid Response if Needed Does this

More information

HEALTH SERVICES POLICY & PROCEDURE MANUAL

HEALTH SERVICES POLICY & PROCEDURE MANUAL PAGE 1 of 8 PURPOSE To provide guidelines on: 1. rating offenders using patient acuity, 2. how to properly handle offenders who are housed in facilities with conflicting acuity levels, 3. how to properly

More information

Cardiac catheterisation. Cardiology Department Patient Information Leaflet

Cardiac catheterisation. Cardiology Department Patient Information Leaflet Cardiac catheterisation Cardiology Department Patient Information Leaflet Introduction The purpose of this leaflet is to address some of the questions you might have including: What is cardiac catheterisation?

More information

Tips & Tricks COMPASS Improvements

Tips & Tricks COMPASS Improvements SEBD, SHL, SMCH, SMCW, UMCB Tips & Tricks COMPASS Improvements January 22, 2014 Information for All Medical Practitioners Regardless of Specialty... 1 Discontinued order set on Feb 3... 1 Summary of the

More information

INTERN BOOT CAMP 2017

INTERN BOOT CAMP 2017 Sign Out INTERN BOOT CAMP 2017 Objectives Review importance of sign outs Touch on less than ideal examples of verbal and written sign outs Review the IPASS system of sign outs Review disease-specific details

More information

DO NOT DISCARD. Colonoscopy Prep Instructions. Pre-Procedure Hospital Admission

DO NOT DISCARD. Colonoscopy Prep Instructions. Pre-Procedure Hospital Admission DO NOT DISCARD Colonoscopy Prep Instructions Pre-Procedure Hospital Admission 1 Welcome to the GI Diagnostic Lab at Froedtert & the Medical College of Wisconsin. The information in this packet will guide

More information

Pre-Operative Surgical Packet

Pre-Operative Surgical Packet Pre-Operative Surgical Packet We know that you have many questions about your surgery and what to expect. The following pages contain answers to the questions most commonly asked by our patients and their

More information

YOUR SURGERY MADE EASY

YOUR SURGERY MADE EASY BASCOM PALMER EYE INSTITUTE ANNE BATES LEACH EYE CENTER YOUR SURGERY MADE EASY Welcome Anne Bates Leach Eye Center 900 NW 17 Street, Miami, FL 33136 305-326-6000 800-329-7000 (toll-free) Frequently Called

More information

Welcome to Orientation!

Welcome to Orientation! Welcome to Orientation! Wards Rounding Consults Pagers/ASCOM Labs/Phlebotomy Radiology Discharges Topics to be Covered Inpatient Wards 5 Intern Ward Teams: Academic Team 1 Silver: Hospitalist + Kaiser

More information

A Patient s Guide to Surgery

A Patient s Guide to Surgery A Patient s Guide to Surgery Welcome Welcome to Carolinas Medical Center-NorthEast. Our staff of skilled professionals look forward to providing the care you need. We want your stay to be pleasant and

More information

Bar Code Medication Administration and MAR Resource Manual

Bar Code Medication Administration and MAR Resource Manual Bar Code Medication Administration and MAR Resource Manual Creating Orders Creating an Order in CareMobile (Ad Hoc Order Entry)...2 Creating an Order for med that is already ordered with a different dose/frequency....4

More information

Enhanced Recovery Programme for Nephrectomy (Kidney Removal)

Enhanced Recovery Programme for Nephrectomy (Kidney Removal) Enhanced Recovery Programme for Nephrectomy (Kidney Removal) This information leaflet will explain what will happen when you come to the hospital for your operation. The enhanced Recovery Programme is

More information

Using Clinical Criteria for Evaluating Short Stays and Beyond. Georgeann Edford, RN, MBA, CCS-P. The Clinical Face of Medical Necessity

Using Clinical Criteria for Evaluating Short Stays and Beyond. Georgeann Edford, RN, MBA, CCS-P. The Clinical Face of Medical Necessity Using Clinical Criteria for Evaluating Short Stays and Beyond Georgeann Edford, RN, MBA, CCS-P The Clinical Face of Medical Necessity 1 The Documentation Faces of Medical Necessity ç3 Setting the Stage

More information

Laparoscopic partial nephrectomy

Laparoscopic partial nephrectomy Laparoscopic partial nephrectomy This leaflet is written to give you information and answer questions you may have about your surgery. If you have any further questions, please speak to your doctor or

More information

Patient Education Guide. Inpatient Team. Following Surgery. You Should Know

Patient Education Guide. Inpatient Team. Following Surgery. You Should Know Patient Education Guide All kidney and/or pancreas transplant recipients must bring their Patient Education Guide to the hospital with them when they come to be admitted. The Patient Education Guide contains

More information

Endometrial Cancer. Information for patients. Gynaecology Department. Feedback

Endometrial Cancer. Information for patients. Gynaecology Department. Feedback Feedback We appreciate and encourage feedback. If you need advice or are concerned about any aspect of care or treatment please speak to a member of staff or contact the Patient Advice and Liaison Service

More information

Bowel Surgery Hartmann s Procedure Your operation explained

Bowel Surgery Hartmann s Procedure Your operation explained Bowel Surgery Hartmann s Procedure Your operation explained Introduction This information is for people considering having a Hartmann s Procedure operation. It explains what is involved and some possible

More information

LGH Trauma Surgery Scheduling not Basics

LGH Trauma Surgery Scheduling not Basics LGH Trauma Surgery Be sure to contact your classmate who is on service before you about a week before you come on service. This will be your most updated resource. Scheduling Contact Eve Gorski, the Trauma

More information

Endoscopic Ultrasound (EUS) or Endosonography

Endoscopic Ultrasound (EUS) or Endosonography Endoscopic Ultrasound (EUS) or Endosonography This booklet contains details of your appointment, information about the examination and the consent form. Please bring this booklet with you to your appointment

More information

*Your Name *Nursing Facility. radiation therapy. SECTION 2: Acute Change in Condition and Factors that Contributed to the Transfer

*Your Name *Nursing Facility. radiation therapy. SECTION 2: Acute Change in Condition and Factors that Contributed to the Transfer Gaining information about resident transfers is an important goal of the OPTIMISTC project. CMS also requires us to report these data. This form is where data relating to long stay transfers are to be

More information

CNA SEPSIS EDUCATION 2017

CNA SEPSIS EDUCATION 2017 CNA SEPSIS EDUCATION 2017 WHAT CAUSES SEPSIS? Sepsis occurs when the body has a severe immune response to an infection Anyone who has an infection is at risk for developing sepsis Sepsis occurs when the

More information

Insertion of a Hickman Line Information for parents and carers

Insertion of a Hickman Line Information for parents and carers Oxford University Hospitals NHS Trust Children s Hospital, Kamran s Ward Insertion of a Hickman Line Information for parents and carers This leaflet explains: what a Hickman line is why one is necessary

More information

SPINAL CORD STIMULATOR (SCS) SURGERY INFORMATION Dr. Joshua Rosenow

SPINAL CORD STIMULATOR (SCS) SURGERY INFORMATION Dr. Joshua Rosenow Pre-Operative Checklist SPINAL CORD STIMULATOR (SCS) SURGERY INFORMATION Dr. Joshua Rosenow General Confirm surgery dates: STAGE 1 (Electrodes): STAGE 2 (Battery):. Obtain blood tests/ x-rays/ekg and medical

More information

Preparing your Patient for Surgery at The Valley Hospital

Preparing your Patient for Surgery at The Valley Hospital Preparing your Patient for Surgery at The Valley Hospital Ensuring a smooth preoperative course to provide safe and efficient care Cristina Smith, RN, BSN, CPAN HOUSEKEEPING Bathroom location Cell Phone

More information

Care Transition Strategies: The 2013 Transition Care Management Codes

Care Transition Strategies: The 2013 Transition Care Management Codes Care Transition Strategies: The 203 Transition Care Management Codes Sponsored by The Carolinas Center for Medical Excellence (CCME) and The South Carolina Partnership for Health (SC PfH) E. G. Nick Ulmer,

More information

Blood and Blood Products Administration

Blood and Blood Products Administration NCAL Patient Care Services 2016 Blood and Blood Products Administration Objectives: On completing this module, you will be able to: Identify blood group systems Describe compatibility requirements List

More information

Brachytherapy: High Dose Rate (HDR) Radiation Interstitial Implant

Brachytherapy: High Dose Rate (HDR) Radiation Interstitial Implant Brachytherapy: High Dose Rate (HDR) Radiation Interstitial Implant What are the goals of this procedure? Brachytherapy, or internal radiation therapy, is a way of giving a higher dose of radiation to a

More information

STANDARDIZED PROCEDURE INTRAVENTRICULAR CHEMOTHERAPY VIA OMMAYA RESERVOIR (Adult, Peds)

STANDARDIZED PROCEDURE INTRAVENTRICULAR CHEMOTHERAPY VIA OMMAYA RESERVOIR (Adult, Peds) I. Definition The administration of chemotherapy via Ommaya Reservoir into cerebrospinal fluid (CSF) for treatment of previously diagnosed central nervous system (CNS) involvement by leukemia and lymphoma

More information

Last Name First Middle. Mailing Address. City State Zip Phone. Date of Birth Age Soc. Sec# Cell. Employer Work Phone

Last Name First Middle. Mailing Address. City State Zip Phone. Date of Birth Age Soc. Sec# Cell. Employer Work Phone Last Name First Middle Mailing Address City State Zip Phone Date of Birth Age Soc. Sec# Cell Employer Work Phone Email Address Emergency contact Phone # Relation: Name of Primary Insurance Policy # -----

More information

Admission Record IVF/Gynae

Admission Record IVF/Gynae Admission Record IVF/Gynae Surgeon: Operation : of Admission: Please state your full name and date of birth - correct Nurse Checklist Yes No Please tell me your full address - correct Consent form signed,

More information

Percutaneous Transhepatic Cholangiogram (PTC) and Biliary Stent

Percutaneous Transhepatic Cholangiogram (PTC) and Biliary Stent Percutaneous Transhepatic Cholangiogram (PTC) and Biliary Stent Radiology Department Patient information leaflet This leaflet informs you about the procedure known as a Percutaneous Transhepatic Cholangiogram

More information

Initial Pool Process: Resident Interview

Initial Pool Process: Resident Interview Initial Pool Process: Resident Interview Care Area Probes Response Options Choices Are you able to make choices about your daily life that are important to you? I d like to talk to you about your choices.

More information

2. Unlicensed assistive personnel: any personnel to whom nursing tasks are delegated and who work in settings with structured nursing organizations.

2. Unlicensed assistive personnel: any personnel to whom nursing tasks are delegated and who work in settings with structured nursing organizations. XVII. MANAGEMENT AND DELEGATION A. General Information: The judgments that you make in management and delegation situations have to be based on knowledge. You MUST know your content, and then you can move

More information

A Guide to the Emergency Department

A Guide to the Emergency Department A Guide to the Emergency Department Welcome to UPMC Mercy Emergency Department The staff at UPMC Mercy would like to make your visit with us as easy and comfortable as possible. Please read through this

More information