PATIENT GUIDE TO MOUNT NITTANY MEDICAL CENTER SURGERY

PATIENT GUIDE TO MOUNT NITTANY MEDICAL CENTER SURGERY

Our Mission We are here to make people healthier. Our Vision To become the most trusted source of healthcare for Central Pennsylvanians. Table of Contents Welcome / Mission 1 Patient Rights 2 Understanding Surgery 3 General Information 9 Safety 11 Pain Control 12 Notes 13 PLEASE READ We ask that you carefully read and follow these instructions in order to ensure a successful surgery and positive operative experience. Your cooperation is greatly appreciated. Please bring this booklet with you when you are going to your pre-admission testing appointment. The staff will refer to it often. SURGERY 1800 E. Park Avenue State College, PA 16803 814.231.7000 mountnittany.org Services provided by Mount Nittany Medical Center

Welcome to Mount Nittany Medical Center Thank you for choosing Mount Nittany Medical Center for your healthcare needs. We realize that hospitals can sometimes seem overwhelming, especially when you are ill. This guide was developed to help prepare you for your visit, to inform you of all the services we offer and to make your stay with us as smooth and comfortable as possible. We strive to provide the best individualized patient- and family-centered care and service that reflects the compassion, value and respect that you deserve and have come to expect from us. As we continue to grow advancing your health and well being by providing progressive, compassionate healthcare services and innovative care we aim to be the region s trusted healthcare provider and your medical center of choice. We realize that in today s healthcare environment, you have many choices for your medical needs. Our exceptional doctors, nurses and other healthcare professionals work together to give you a positive Mount Nittany Health Experience. It is our goal to meet your needs with a level of customer service that matches the top rate medical care you receive at Mount Nittany Medical Center. Our staff wants to exceed your expectations of care, so please tell us about any special needs or concerns you have that may affect your stay here, or what we can do to make your stay with us as pleasant and as positive as possible. We want to know the ways we have exceeded your expectations so we can continue these efforts. Feedback is received through patient surveys. If you receive a survey, please take the time to complete it and return it with your honest review. This is extremely valuable information that we take very seriously in our efforts to continually enhance our care and serve you to best of our ability. WELCOME / MISSION We also want to know if we have not met your needs or expectations. The Service Excellence Department is available to answer your questions and discuss any concerns you may have, either during your stay or after discharge. You may call Service Excellence at any time by dialing 6706, from a Mount Nittany Medical Center phone. From home, please call 814.234.6706. 1 Thank you for choosing Mount Nittany Medical Center. It is an honor to serve you and we wish you all the best for a successful and complete recovery. Sincerely, Kathleen L. Rhine President and CEO, Mount Nittany Health

PATIENT RIGHTS 2 A Message from your Healthcare Team Welcome! We look forward to partnering with you to meet your healthcare needs. Our goal is to provide you with high-quality, safe care in a quiet, comfortable environment. We also want you and your family to understand what to expect before, during and after your surgery, which can lead to a quicker recovery. If at any time during your stay we can assist with anything that promotes your health, please ask any member of our team. Patient Rights and Responsibilities As a patient at Mount Nittany Medical Center, you have certain rights and responsibilities to ensure you receive the best possible care. The brochure Patient Rights and Responsibilities will be provided upon your request. If you feel your issue requires more attention or is not resolved to your satisfaction, please call the service excellence department at 814.234.6706. Staff is available Monday through Friday, from 8:00 am to 4:30 pm. If you are calling after hours, please leave a message and a representative will get back to you as soon as possible. If you prefer to speak with someone not employed by the Medical Center to discuss your concerns or questions, please contact: Pennsylvania Department of Health Acute and Ambulatory Care Services PO Box 90 Harrisburg, PA 17108-0090 1.800.254.5164 Office of Quality Monitoring The Joint Commission One Renaissance Boulevard Oakbrook Terrace, IL 60181 1.800.994.6610 Interpreter Services Interpreters for foreign languages and the hearing impaired are available free of charge. Please let your nurse know if you need communication assistance.

Before Surgery PAT Appointment Pre-Admission Testing and Evaluation Your physician will schedule you for a pre-anesthesia testing appointment to prepare for your procedure. This appointment will help you to have the best outcome for your surgery. It includes: Meeting with a nurse and anesthesia staff to review your medical history and medicines. Instructions on which medication you should and should not take before surgery. Information and questions answered about your surgery. Complete pre-op testing: Blood/urine testing, electrocardiogram (EKG) and X-rays. On the day of your appointment, you will arrive at the hospital. Please bring the following items with you: Any forms/papers such as consents or orders you may have from your doctor. A current medication list with the name, dose and how often you take your medications. Photo ID and insurance cards. If you have any questions or concerns, please call the pre-admission testing clinic at 814.231.7050 between the hours of 9:00 am and 4:00 pm, Monday through Friday. If you are unable to reach staff with urgent calls, please use 814.234.6193. UNDERSTANDING SURGERY Planning for Surgery Complete pre-op testing such as: Blood and urine testing, electrocardiogram (EKG), and X-rays. 3 If crutches are needed, please get them prior to day of surgery. Ask your doctor/pre-admission testing nurse what medicines you should and should not take before and after your surgery. If you take Aspirin, Coumadin or other blood thinners for your heart condition, please contact your doctor for instructions. Please check at least 10 days before your surgery for these instructions. Your spouse, relative, or friend may accompany you to the Medical Center. During your surgery and recovery room time, they may wait in the first floor surgical waiting room, located by the visitor elevators. A volunteer will share information with your family as it becomes available. Complimentary hot beverages, such as coffee and tea, are available. Please ask the receptionist.

All minors (under 18 years of age) must have one parent or legal guardian with them at all times. If you are bringing a small child, we encourage you to bring a special toy or blanket with them. We will make every attempt to keep you and your child together as much as possible on the day of surgery. DO NOT DRIVE AFTER SURGERY for 24 hours! UNDERSTANDING SURGERY Have a responsible adult with you the day of surgery. This person should stay in the waiting room area. They are responsible for your transportation. A taxicab/ bus is not permitted for transportation following surgery unless a responsible adult is with you (NOT the taxi driver or bus driver). Evening before Surgery Confirm your surgery time by calling 814.234.6108 between 2:00 pm 7:00 pm the day before your surgery. Please call on Sunday for Monday surgery times. You may use the Medical Center toll-free number at 1.866.757.2317 for long distance calls and ask for the admission office. Bathe or shower the night before or morning of your surgery. Do not shave operative site, use depilatory agents or do anything that might damage the skin at or around the incision site within the 24 hours before your operation. The anesthesiologist may give special instructions for men to trim their facial hair. 4 If given instructions for CHG Antiseptic Skin Preparation, please complete as directed. After midnight before the day of your surgery: o Do not eat (including gum/mints) o Do not drink (including water) o Do not smoke or use chewing tobacco Note: If you were instructed by your doctor to bowel prep, you may prep as instructed with only the amount of fluids required for the prep. If there is any change in your physical condition, such as a cough, cold, fever, infection or rash, please notify your doctor before coming to the same day surgery unit. If you are unable to reach your doctor, please call 814.234.6121.

Day of Surgery You will need to be available by phone in case of schedule changes. Bring insurance cards and photo ID the day of surgery. Arrive on time per your instructions. Wear comfortable, loose-fitting clothing. Do not wear makeup and remove nail polish. Leave jewelry and valuables at home. Remove your piercings and rings. Do not use fragrance or perfumes. Do not eat or drink anything today before your surgery, including chewing gum, hard candy and any kind of tobacco products (cigarettes, cigars, pipes or chewing tobacco). You should take any scheduled prescribed medicines (such as heart and blood pressure) with a sip of water the morning of surgery unless otherwise told by your surgeon or anesthesiologist. If you are a female between the ages of 12-55, you may be asked to give a urine sample when you arrive. If you have diabetes: o Please take ½ of your morning insulin (Lantus, NPH). o Do not take any of your diabetic oral medication that morning. Note: NO Metformin for 48 hours before surgery. UNDERSTANDING SURGERY 5 o If you experience low blood sugar, you may drink 3 oz of apple juice. o Please call if you have questions or concerns.

UNDERSTANDING SURGERY 6 Check-in and Patient Registration Enter the Medical Center at the main entrance and stop at the front desk. Your insurance and demographic information will be reviewed and then you will go to the same day surgery unit (SDS) where you will be met by a nurse to prepare for surgery. Pre-operative Room You will be asked to change into a patient gown and will be given an ID band. A nurse will review your health history, allergies and medicines with you. The anesthesiologist will see you and talk with you about which type of anesthesia is best for your surgery. An intravenous line (IV) is placed in your vein for fluids. Medicine may be given to prepare for your surgery. Dentures, contact lenses, eyeglasses are removed at this time. Instructions will be given by your nurse.

Anesthesia There are several types of anesthesia. The type used for your surgery will depend on many factors. In most cases, the surgery you are having will determine what kind of anesthesia will be used. Types of anesthesia: General: Patient is unconscious, meaning they cannot see, hear or feel anything during surgery. General anesthesia can be given as a gas (patient is given a breathing mask or tube) or through a vein (patient is given an intravenous line). It is used in major surgery. Regional: The general area of the body that needs surgery is numb. Patients are awake but may be given medicines that make them drowsy. Regional anesthesia is given as an injection. Spinal: The patient is given an injection into the spinal fluid that makes the body numb from the chest to the toes. Epidural: The patient is given an injection into the spine that makes the surgery less painful. A tiny tube (catheter) is also inserted so a constant flow of medicine may be given. This tube can be left in for a few days to give pain medication and then removed. Monitored Anesthesia Care (Deep Sedation): You will receive medicine through your vein. You will be sleepy and most patients do not remember anything from the procedure. This type of anesthesia is not as deep as general anesthesia (If you had your gall bladder removed, for example). Local: The specific area on the body that needs surgery is numb. Local anesthesia is given as an injection and is used for minor surgery. When you meet with your anesthesiologist, he or she will explain the risks and benefits of each type of anesthesia, along with possible side effects. You will be monitored carefully to avoid side effects. UNDERSTANDING SURGERY 7 Operating Room You will be taken to the operating room by your nurse and/or anesthesia team. The operating room is cold and brightly lit. Warm blankets are available for your comfort. You will be helped onto a bed and a safety strap will be secured. A monitor for blood pressure will be placed on your arm. Heart monitor stickers will be placed on your chest. A clip will be placed on your finger.

Recovery Room Depending on your surgery/anesthesia, you will be in the recovery area until you are fully awake. Monitors for heart rate, blood pressure and blood oxygen level are used in the recovery room for patient s assessment. Oxygen will be given to help you until you wake easily. You may experience a scratchy or dry throat. You will be asked frequently to breathe deep and cough. If needed, pain medicine will be given. UNDERSTANDING SURGERY 8 Medicine for nausea (upset stomach) may be given. When you are awake, you will be moved to the discharge area or your hospital room. Post-op Room Preparing to Go Home You will be moved on your bed to your room. Family may visit at this time. You will be having your blood pressure, heart rate and breathing monitored. Your pain and nausea will be monitored and you will receive medications as ordered by your doctor. You may have something to drink and crackers to eat here. You may be asked to go to the bathroom (pass urine) before you are discharged home. If you had spinal anesthesia, nurses will be checking with you until your legs return to normal feeling. Your intravenous fluids will be taken out before you leave. You will be helped to dress for going home. Some pain and drowsiness and nausea may continue when you leave to go home. We will try to make you as comfortable as possible. Your discharge instructions will be reviewed with you and your responsible adult. You will be given a copy. Any prescriptions for medicines and other needed items may be given at this time. You will need to get your prescriptions filled at the pharmacy of your choice. A pharmacy is not available at Mount Nittany Medical Center.

Privacy and Confidentiality Your health is a very personal matter. As your healthcare provider, we recognize that and work hard to ensure your privacy. To protect your health information, we maintain physical, electronic and procedural safeguards. We ask that you share medical information with your family and friends as you believe to be appropriate. One safe guard you will be asked to help with is to give a code word to the staff and your family/friends. This code word will be used to keep your information protected when we are speaking with your family/friends. You may contact our privacy officer at 814.234.6160 or privacyofficer@mountnittany.org. Advance Directive An Advance Directive allows you to express your wishes about medical treatment when you are unable to make or express them yourself. If you have an existing advance directive, living will or healthcare power of attorney, please provide a copy to your provider for your medical record. Blank Advance Directive forms are available at your request. Your Medical Record The complete confidentiality of your medical information is of vital importance to Mount Nittany Medical Center staff. The health information management department is responsible for maintaining patient records. A properly signed consent form is necessary for the release of your information. If you would like assistance in this area, please contact the correspondence secretary at extension 6167 (or 814.234.6167). GENERAL INFORMATION 9 Patient Accounts Patient accounts associates can answer questions about your Medical Center bill and help you understand our financial policies and billing procedures. Please call patient accounts at extension 6171 (or 814.234.6171), Monday through Friday, from 8:00 am to 4:30 pm. Residents who live out of the 814 area code may dial 866.686.6171 or use the Internet for payment and questions at mountnittany.org.

Visiting Guidelines Visiting hours In the interest of the patient s well-being, Mount Nittany Medical Center recommends no more than two visitors per patient at a time. Upon arrival to the nursing unit, you and your family will be given specific instructions on the surgical waiting process. Preferred visitation hours are between 11:30 am and 8:00 pm to optimize patient rest. Quiet time begins at 8:00 pm and ends at 6:00 am. During quiet time, visitors are asked to keep noise to a minimum to allow patients to rest. Additional quiet periods may be determined by the patient care units. Visitation by children under age 10 is not encouraged. ATM Machine An ATM (automated teller machine) is located near the main lobby for withdrawal of funds only. VISITING 10 Lost and Found Items If you lose something, please tell your nurse immediately. The Medical Center is not responsible for lost items, but we make every effort to help find them. The security office keeps unclaimed articles for a limited time. To inquire about lost articles, call security at extension 7191 (or 814.231.7191). Café (Cafeteria) The Café, located on the ground floor of the Medical Center, is open from 6:00 am - 7:00 pm and 2:30 am - 4:15 am. The Café is open to all employees and the general public. Visa, MasterCard, and Discover are accepted. Patients must have permission from the nursing staff to eat in the Café and need to show their identification bracelets to be served. The Café offers hot entrees, seasonal soups, a deli counter and a fresh salad bar, as well as an assortment of fruits, breakfast items, hot sandwiches, pizza, chips, pretzels, and beverages. We also have ice cream novelties, sugar-free and lactose free ice cream, fresh baked cookies, gourmet desserts and cakes, and gluten free offerings. Café - Ground Floor The Nittany Grill The Nittany Grill, located on the first floor in the main hallway of the Medical Center, serves meals and snacks all day. It is open to all employees and the general public Monday through Friday, from 7:00 am - 7:00 pm, and weekends, from 11:00 am - 5:00 pm. Visa, MasterCard, and Discover are accepted. Breakfast is served all day. Other food items offered include daily specials, soups, sandwiches, salads, fruit, espresso beverages, and snacks. The Nittany Grill - First Floor Main Entrance The Nittany Grill

For Your Safety Be a Part of Your Healthcare Team You can help make our health system safer by being an active member of your healthcare team. That means taking part in every decision about your healthcare. Personal Items Personal items kept at the bedside or family (including, but not limited to dentures, eyeglasses, hearing aids, and walkers) are the responsibility of the patient. Please be sure to label personal items with your name and keep them in an appropriate container when not in use. Your nurse can provide a denture cup case upon request. If you lose something, please tell your nurse immediately. The Medical Center is not responsible for lost items, but we make every effort to help find them. Your Room and Accommodations Your comfort and safety are important to us. Bedside rails are used for your protection and may be raised if you are resting, recovering from surgery or taking certain medications. Our staff will show you how to work your bed. Preventing Falls If you need help, please ring using the bedside call bell button. We will respond as quickly as possible. This is especially important if: This is the first time you get out of bed after surgery and/ or you were given medicine for pain or sleeping or your side rails are up. You feel weak or dizzy. SAFETY Follow instructions given by your doctor or nurse about whether you may get out of bed, use the bathroom or walk in the hallways, etc. Wear non-skid slippers or appropriate shoes while walking and use any ambulatoryassist devices that you need, such as a cane, walker, wheelchair or crutches. Smoking and Tobacco Free Zone All Mount Nittany Health facilitates and properties are tobacco free to ensure a clean, safe and healthy environment for our patients, visitors and staff. 11 Infection Prevention Standard precautions will be taken with all patients in the handling of body substances, which means staff members must wash or disinfect their hands between patients and wear gloves when in contact with body secretions or fluids. Hand washing is the most important way to prevent the spread of infection. Ask anyone who might touch you to wash his or her hands with soap and water for at least 20 seconds, or to use the alcohol hand sanitizer, rubbing hands until dry. You also need to wash your hands often, especially after going to the bathroom and after touching anything that is soiled. If you have any questions, please ask your nurse or call the infection prevention and control coordinator at extension 6164 (or 814.234.6164).

Pain Prevention and Control What is Pain Pain is an uncomfortable feeling that tells you something may be wrong in your body. Pain is your body s way of sending a warning to your brain. Your spinal cord and nerves provide the pathway for messages to travel to and from your brain and the other parts of your body. Pain medicine blocks these messages or reduces their effect on your brain. Your doctors and nurses will ask you about your pain because they want you to be comfortable. You, your doctor and your nurse will decide which pain control methods are right for you. Pain Scale PAIN CONTROL 0 2 4 6 8 10 Hurts Hurts Hurts Even Hurts Little Bit Little More More Whole Lot No Hurt Pain Control Can Help You: Maintain greater comfort. Hurts Worst 0 1 2 3 4 5 6 7 8 9 10 Get well faster after surgery. With less pain, you can start walking, do your breathing exercises, and get your strength back more quickly. You may even leave the hospital sooner. Improve your results. People whose pain is well controlled seem to do better. 12 Some patients have shared their concern about not wanting to take pain medicine because they fear becoming addicted. Most studies show that short-term pain medicine does not cause a problem. What You Can Do To Help Yourself Ask the doctor or nurse what to expect - being prepared helps put you in control. Tell your nurses and doctors what pain control methods have worked well, or not so well, for you in the past. Tell them about any reaction you have had to pain medicines. Side effects such as nausea and vomiting are generally not considered an allergy, and can be treated effectively. Try other measures to help manage your pain, including position change, relaxation, positive thinking, music, TV Care Channel 14, or other pastimes to distract you.

Special Instructions and Notes for Your Procedure

Thank you for choosing Mount Nittany Medical Center s surgical services to meet your surgical needs. Your comments and suggestions help us to know what we do well and how we can make your experience better. Pre-Admission Testing Appointment Date/Time: If you have any questions or concerns, please call the pre-admission testing clinic at 814.231.7050 between the hours of 9:00 am and 4:00 pm, Monday through Friday. Provider Information Search for medical provider information at Mount Nittany Medical Center by going to mountnittany.org/physicianfinder. Local Healthcare News and Information Stay up to date on all the latest news and events at Mount Nittany Health by signing up for one of our e-newsletters at mountnittany.org/newsletters. SURGERY 1800 E. Park Avenue State College, PA 16803 814.231.7000 mountnittany.org AN-026 07/18/2017