Frederick Memorial Hospital Preparing for Surgery Checklist

Frederick Memorial Hospital Preparing for Surgery Checklist

Name: _______________________________________

Date of Birth: _________________________________

Frederick Memorial Hospital Preparing for Surgery Checklist

MUST COMPLETE AND BRING ON DAY OF SURGERY

Presurgical Labwork Completed Date: ________________

Preregistration Completed Date: ________________

Prescreening with RN Completed Date: ________________

Presurgical MRSA Test Completed Date: ________________

Iodine Allergy ❒ Yes ❒ No

Latex Allergy ❒ Yes ❒ No

MRSA results received Date: ________________ ❒ MRSA Positive ❒ MRSA Negative

CHG SHOWER

(See page 3 for CHG Instructions)

Day Before Date: ________________

Day of Surgery Date: ________________

JOINT REPLACEMENT AND SURGICAL SPINE CHG SHOWER

MRSA Negative: MRSA Positive:

Day 3 Date: ________________

Day 2 Date: ________________

Day 5 Date: ________________

Day 4 Date: ________________

Day 1 Date: ________________

Day of Surgery Date: ________________

Day 3 Date: ________________

Day 2 Date: ________________

Day 1 Date: ________________

Day of Surgery Date: ________________

Continued on back

BRING WITH YOU

A list of your current medications, including dose and time taken

Photo ID

Insurance card and co-pay, if needed

Something to read or do while you are waiting

A copy of your Advance Directives and Living Will if you have them

CPAP or BiPAP Machine (sleep apnea)

Eye glasses case/contact lens container and solution

INSTRUCTIONS FOR THE DAY OF SURGERY

Wear clean comfortable, loose-fitting clothes that are easy to change and will not fit tightly over the area of your surgery

Remove all jewelry (including piercings), nail polish and makeup

Take your usual medications unless otherwise directed with only a sip of water

Do not eat or drink after midnight the night before your surgery

Do not smoke or use electronic cigarettes

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Getting Ready for Your Surgery

CheCklist for surgery – Complete the checklist in the front of this booklet and bring the entire booklet with you the day of your surgery.

important reminders

• Be sure to follow the instructions on page 3 for showering. Use CHG and clean towels.

• Do not use lotion or conditioner on your skin or hair.

• Remove all nail polish.

• Leave all jewelry and valuables at home.

• Do not wear makeup.

• Make arrangements for someone to drive you home and stay with you after your surgery.

Do not eat or drink anything after midnight before your surgery unless otherwise instructed by your physician. This includes gum or candy.

The only exception would be a sip of water if you are instructed to take your medications. Intake of solid foods or liquids could cause your operation to be postponed.

If you are taking any medications, ask your physician in advance if you should take them the morning of surgery.

Contact your doctor for advice if you are taking any blood thinners, aspirin, or anti-inflammatory medication.

Stop smoking or limit your smoking for a few days before surgery, and do not smoke after midnight the day before surgery.

Do not drink alcoholic beverages 24 hours before surgery.

• If you develop a cold, fever, or other health problem within 48 hours of your scheduled admission, please call and inform your physician.

• For children having surgery, at least one parent must be present at all times while the child is in the hospital.

FMH is not responsible for money or valuables you bring with you. We strongly recommend that you leave all money at home, unless you have a copay. If it is necessary to bring valuables with you, the Cashier’s office can store smaller items in the safe. When you arrive for admission, notify your nurse and arrangements will be made.

For patients being admitted after surgery:

Please leave your luggage in your vehicle until you have been brought to your post-op room. At that point a family member may bring it to your room.

If you have any questions, call your doctor’s office, Pre-Admission Screening at 240-566-3918, or

Perioperative Services at 240-566-3756.

Pain Management

Pain management starts immediately after surgery while you are in the recovery room. It is important for you to remain comfortable after surgery. Good pain management will help you recover faster and allow you to get out of bed more quickly. This is important to prevent complications, such as pneumonia and blood clots.

In order to know how much pain medication to give you, the nurses will often ask you to rate your pain on a scale of 0 to 10, with 0 being “no pain” and 10 being the “worst pain you can imagine.”

Be honest when you answer. Bearing the pain may limit your ability to move around and increase your risk of complications.

For the Best Pain Management During Your Hospital Stay:

• Rate your pain on a scale of 0 to 10 when asked about your pain level using the reference scale described above.

• Ask for pain medication as soon as the pain begins.

Different pain-control treatments will be used at different times during your hospital stay. Pain medication may be delivered by IV or by mouth.

Day After Surgery

If you are discharged directly from the PACU, you will receive a phone call from one of our

Perioperative Services nurses within a few days of going home. The nurse will ask how you are feeling and answer any questions you have about your discharge instructions. In the meantime, if you have any questions concerning your instructions, please call your doctor’s office or

Perioperative Services at 240-566-3435.

Avoiding Problems After Surgery

Speak Up

Let your doctor know if you are concerned about a medication, your IV fluids, or if you are experiencing pain.

Doing so may make all the difference in your care. Let your doctor know what is on your mind, whatever it is. Don’t be afraid to speak up. It can help save your life!

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Visitor guidelines

We want to reunite you with your family member or friend as quickly as it is safe to do so, and we understand that they are important to your recovery. Please share the following guidelines with the person accompanying you to the hospital.

• Outpatients can have one visitor in the PACU when the patient is approximately

20 minutes from being discharged. This person should be the individual who will be caring for you at home. Discharge instructions will be reviewed with him or her as well as with you.

• No children of visitors or patients will be allowed in the PACU.

• If the visitor is going to leave the surgical waiting area, he or she should inform the volunteer to ensure that he or she is present to speak with the surgeon after the procedure and available to go to the PACU when you are ready for discharge.

Standard Precautions

Standard precautions are measures that are followed to protect both you and our staff against the transmission of communicable disease. These measures involve the use of protective equipment such as gloves, gowns, or masks in conjunction with good hand washing practice and appropriate disposal of contaminated needles and waste.

Just for Children

When your little one is scheduled for surgery, you want everything to be as stress-free as possible—and so do we. As a general rule, children under five years of age may have their IV started in the operating room after they are asleep. Young children may be accompanied into the operating room by one parent, who will be allowed to remain with his or her child until he or she is asleep.

When your child is awake and stable, you will be called directly back to be with him or her in the PACU. If your child is to be discharged, you may carry him or her out of the hospital, or he or she can have a ride in a wheelchair—most children love this part!

You will be escorted to your waiting car by staff or volunteer.

Information for Visitors

The Coffee Bean

and FMH Gift Shop are open daily and located on the first floor.

The Cafeteri

a is located on the lower level of the hospital and offers a wide variety of meal choices. Hours - 6:30

A

.

M

.-11:00

P

.

M

.

Pastoral Care Services

are available on a 24 hour basis.

Free WiFi

is available throughout the hospital.

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What to Expect When You Arrive

Arriving at FMH

Patients admitted the morning of surgery should arrive at the hospital two hours before the scheduled procedure

(or as directed by your physician). This ensures that there is adequate time to prepare you for a safe surgical experience. A complimentary parking valet service is available for your convenience.

Admission

Upon arrival, a registrar will review your insurance documents, collect copay, obtain necessary signatures, and copy your ID and insurance cards. When your patient file is complete, you will be escorted to the Surgical Waiting Area. There you will be greeted by an FMH staff member or an

FMH Auxiliary volunteer. He or she will check you in on the computer and as soon as he or she receives your room number, you will be escorted back to the pre-operative area to meet the staff.

A Surgical Waiting Room staff member or volunteer will explain the computerized patient tracking system to the person who has accompanied you and provide him or her with your confidential ID number. He or she will be able to follow your progress on the large computer screen in the waiting area as you prepare for surgery, move to the operating room, recovery area and discharge, or transfer to your room.

In Pre-op

Once you are settled in pre-op, your nurse will again verify some basic information for your safety, perform a physical assessment, complete required documents, carry out any tasks ordered by your physician and start an IV. You will be visited by your surgeon, your anesthesiologist and your operating room nurse. They will answer any further questions you might have and will take very good care of you throughout your surgery.

Your family member or friend may stay with you until it’s time for your surgery and then will be directed to the waiting area.

Although our goal is to begin all of our surgeries on time, sometimes surgeries must be delayed due to unforeseen circumstances. If this happens, your nurse will keep you updated as to the status of a delay.

Marking of Surgical Site and Clipping of Hair

Your surgeon may mark your surgery site by writing directly on your skin the day of surgery. Don’t be afraid to ask for this; it will remind the surgeon of your correct surgical site. Do not mark the site yourself. Do not shave surgical site. Someone will clip the hair the day of surgery in Pre-op area.

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Preadmission Screening

Prior to surgery, you will need to speak to two

FMH representatives:

• The Scheduling Center to pre-register (240-566-3400 or

800-995-1438)

• The Preadmission Nurse (240-566-4970 or 866-790-3011)

One of our Preadmission Screening nurses will attempt to call you several days before your surgery. The call usually takes approximately 10-15 minutes. If you are not available we leave a message for you to return our call before a certain time and the phone number to reach us. If we are unavailable when you call, please leave your name and a number where we can reach you. Due to time limits, individual’s busy schedules and phone screen staff availability, we may not talk with everyone before the day of surgery. If we do not reach you, we will take your medical and surgical history on the day of your surgery/procedure.

The Preadmission Screening nurse will ask you to verify your name and date of birth. You will be asked for your medical and surgical history so we can document it in our computer system.

This includes height/weight, medication/any allergies and the reactions, current names, dosage and frequency of medications (prescribed, over-the-counter, vitamins/supplements and herbals).

The preadmission screening nurse will review with you what medications you should take the morning of your surgery, with a sip of water. Please bring a list of your medications and the last time/date you took them including the day of surgery.

There may be tests needed prior to your surgery. You must request that the results be faxed to the hospital at 240-566-3636.

The nurse will ask you to identify when/where you had preoperative testing or consultations with medical, cardiac, or lung specialists, so we can contact them to obtain the information if they have not been received.

It is important for you to know that you have patient rights, which include the right to ask questions, the right to participate in your care, the right to refuse treatment and the right to comfort, privacy and safety.

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Must-Knows Before Your Surgery

As you get ready for surgery, there are a number of things you must know. This tool will help you to be better prepared.

1. Control Your Blood Sugar (if you are diabetic)

Blood sugar range should be between 140 and 180 mg/ dL before meals, and less than 200 mg/dL two hours after starting a meal. The better your blood sugar is controlled in the days and weeks before and after surgery, the better you will heal and the less likely you will experience any complications.

2. Quit Smoking —Quitting Helps You Heal Faster

The longer you remain smoke-free before surgery, the better you will heal. Quitting smoking before your surgery is an important step for a successful recovery. Smoking increases your chance of complications like infection, pneumonia and heart attacks, both during and after surgery.

Most doctors recommend quitting smoking as soon as you decide to have surgery. This includes electronic cigarettes.

Consult the FMH Smoking Cessation program if you need help to quit. Call 240-566-3622 or email [email protected]

3. Know Your Medications

Know the names of your medications, the dose and how often you take it. Ask your doctor if you should take any of your medications before your surgery, even if you are told not to eat or drink anything.

4. Keep Warm

Use clean blankets and heat in the vehicle that transports you to the hospital.

5. Take Your Pre-Operative Shower or Bath

Note: Avoid shaving or the use of any topical hair removers in the armpit for 1 week prior to the surgery

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Instructions for a Chlorhexidine [CHG] Shower/Bath

CHG bathing is done to decrease the number of potentially harmful germs on the patient, which decreases the risk of getting a postoperative infection.

• Patients who are known to have MRSA, VRE or any other multi-drug resistant organisms should bathe daily for at least 2 days (or up to 5 days if advised by your surgeon) before surgery with CHG antiseptic solution.

• Patients who do not have a history of MRSA or VRE or other multi drug resistant organism or infection should receive a bath or shower the night before surgery, then the morning of surgery, with CHG soap.

Gather the supplies:

• Antiseptic solution—a 2%-4% chlorhexidine gluconate (CHG) solution (a brand name is

Hibiclens, which can be purchased at your local pharmacy)

• Clean wash cloths (2-3)

• Clean towels and clean sheets

• Clean (freshly washed) clothing to put on after bathing

Using CHG in the shower*:

1. With each shower, wash and rinse your hair first using your normal shampoo. Make sure you completely rinse the shampoo from your hair and body.

2. Apply the antiseptic solution (CHG) to a wet clean washcloth. Turn the water off in the shower or move away from the water spray to avoid rinsing the soap solution off, then lather your entire body, except your face. DO NOT USE CHG ON YOUR FACE.

3. Once you’ve completed the entire lather-down of your body, concentrate for 3 minutes gently washing and lathering your surgical site area.

• Do not shave any parts of your body.

• Pay particular attention to skin folds under the breast and the armpit area.

• Avoid scrubbing too hard—you don’t want to irritate or break the skin.

• Never use the antiseptic solution on your face or near your eyes.

4. Once you have completed the scrub, turn the water on and rinse the CHG solution off your body completely. CHG can be drying and irritating to the skin if left to dry.

5. Do not wash with regular soap after you have used the CHG solution.

6. Pat yourself dry with a clean freshly washed towel. DO NOT apply any powders, deodorants, or lotions. Dress with freshly washed clothes. Place clean, freshly laundered sheets on your bed to avoid re-contamination of your skin from cells shed on previous nights.

* If you do not have a shower, use the CHG solution when you bathe in place of your regular soap. Wash your entire body (except your face), concentrating on crevices or skin folds. Rinse off the CHG soap solution with warm tap water (placed in a basin or in the sink).

Do not attempt to do this bathing in the tub, as the bath water will wash off the CHG soap too quickly.

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Getting Ready for Your Surgery

CheCklist for surgery – Complete the checklist in the front of this booklet and bring the entire booklet with you the day of your surgery.

important reminders

• Be sure to follow the instructions on page 3 for showering. Use CHG and clean towels.

• Do not use lotion or conditioner on your skin or hair.

• Remove all nail polish.

• Leave all jewelry and valuables at home.

• Do not wear makeup.

• Make arrangements for someone to drive you home and stay with you after your surgery.

Do not eat or drink anything after midnight before your surgery unless otherwise instructed by your physician. This includes gum or candy.

The only exception would be a sip of water if you are instructed to take your medications. Intake of solid foods or liquids could cause your operation to be postponed.

If you are taking any medications, ask your physician in advance if you should take them the morning of surgery.

Contact your doctor for advice if you are taking any blood thinners, aspirin, or anti-inflammatory medication.

Stop smoking or limit your smoking for a few days before surgery, and do not smoke after midnight the day before surgery.

Do not drink alcoholic beverages 24 hours before surgery.

• If you develop a cold, fever, or other health problem within 48 hours of your scheduled admission, please call and inform your physician.

• For children having surgery, at least one parent must be present at all times while the child is in the hospital.

FMH is not responsible for money or valuables you bring with you. We strongly recommend that you leave all money at home, unless you have a copay. If it is necessary to bring valuables with you, the Cashier’s office can store smaller items in the safe. When you arrive for admission, notify your nurse and arrangements will be made.

For patients being admitted after surgery:

Please leave your luggage in your vehicle until you have been brought to your post-op room. At that point a family member may bring it to your room.

If you have any questions, call your doctor’s office, or Pre-Admission Screening at 240-566-4970.

4

Visitor guidelines

We want to reunite you with your family member or friend as quickly as it is safe to do so, and we understand that they are important to your recovery. Please share the following guidelines with the person accompanying you to the hospital.

• Outpatients can have one visitor in the PACU when the patient is approximately

20 minutes from being discharged. This person should be the individual who will be caring for you at home. Discharge instructions will be reviewed with him or her as well as with you.

• No children of visitors or patients will be allowed in the PACU.

• If the visitor is going to leave the surgical waiting area, he or she should inform the volunteer to ensure that he or she is present to speak with the surgeon after the procedure and available to go to the PACU when you are ready for discharge.

Standard Precautions

Standard precautions are measures that are followed to protect both you and our staff against the transmission of communicable disease. These measures involve the use of protective equipment such as gloves, gowns, or masks in conjunction with good hand washing practice and appropriate disposal of contaminated needles and waste.

Just for Children

When your little one is scheduled for surgery, you want everything to be as stress-free as possible—and so do we. As a general rule, children under five years of age may have their IV started in the operating room after they are asleep. Young children may be accompanied into the operating room by one parent, who will be allowed to remain with his or her child until he or she is asleep.

When your child is awake and stable, you will be called directly back to be with him or her in the PACU. If your child is to be discharged, you may carry him or her out of the hospital, or he or she can have a ride in a wheelchair—most children love this part!

You will be escorted to your waiting car by staff or volunteer.

Information for Visitors

The Coffee Bean

and FMH Gift Shop are open daily and located on the first floor.

The Cafeteri

a is located on the lower level of the hospital and offers a wide variety of meal choices. Hours - 6:30

A

.

M

.-11:00

P

.

M

.

Pastoral Care Services

are available on a 24 hour basis.

Free WiFi

is available throughout the hospital.

9

119917_text.indd 9

What to Expect When You Arrive

Arriving at fMH

Patients admitted the morning of surgery should arrive at the hospital two hours before the scheduled procedure

(or as directed by your physician). This ensures that there is adequate time to prepare you for a safe surgical experience. A complimentary parking valet service is available for your convenience.

Admission

Upon arrival, a registrar will review your insurance documents, collect copay, obtain necessary signatures, and copy your ID and insurance cards. When your patient file is complete, you will be escorted to the Surgical Waiting Area. There you will be greeted by an FMH staff member or an

FMH Auxiliary volunteer. He or she will check you in on the computer and as soon as he or she receives your room number, you will be escorted back to the pre-operative area to meet the staff.

A Surgical Waiting Room staff member or volunteer will explain the computerized patient tracking system to the person who has accompanied you and provide him or her with your confidential ID number. He or she will be able to follow your progress on the large computer screen in the waiting area as you prepare for surgery, move to the operating room, recovery area and discharge, or transfer to your room.

In Pre-op

Once you are settled in pre-op, your nurse will again verify some basic information for your safety, perform a physical assessment, complete required documents, carry out any tasks ordered by your physician and start an IV. You will be visited by your surgeon, your anesthesiologist and your operating room nurse. They will answer any further questions you might have and will take very good care of you throughout your surgery.

Your family member or friend may stay with you until it’s time for your surgery and then will be directed to the waiting area.

Although our goal is to begin all of our surgeries on time, sometimes surgeries must be delayed due to unforeseen circumstances. If this happens, your nurse will keep you updated as to the status of a delay.

Marking of Surgical Site and Clipping of Hair

Your surgeon may mark your surgery site by writing directly on your skin the day of surgery. Don’t be afraid to ask for this; it will remind the surgeon of your correct surgical site. Do not mark the site yourself. Do not shave surgical site. Someone will clip the hair the day of surgery in Pre-op area.

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Wound Care

In order to avoid wound infection after surgery, you need to be diligent about wound care and hand washing. By following these tips, you will be less likely to get a wound infection:

• Keep the dressing clean and dry.

• Wash your hands thoroughly before changing a dressing or emptying a drain.

• Do not remove the dressing and don’t let anybody touch the dressing or the wound unless otherwise instructed by your physician.

• Do not probe, pick at, or squeeze your wound.

• Follow your doctor’s instructions for wound care.

• Contact your doctor immediately if you experience any symptoms that may indicate an infection, such as unexpected pain, chills, fever, excessive wound drainage, increasing redness, or swelling of the surgical area.

Post-Discharge Care and Rehabilitation

Discharge planning starts when you are admitted to the hospital. A case manager will likely visit you during your hospital stay if you are not able to be discharged home to your own care.

Your insurance and your physical restrictions will also play a role in your discharge planning.

Depending on your surgery, rehabilitation may be recommended:

Nutrition

If you are discharged to recover at home, you should be aware of the food you should eat to aid your recovery. Eating well after surgery can affect how quickly you heal; increasing your water intake and eating more protein can aid the healing process. Foods rich in protein include:

• Meats, poultry, and fish

• Tofu

• Legumes (dry beans and peas)

• Eggs

• Nuts and seeds

• Grains, some vegetables, and some fruits (provide only small amounts of protein relative to other sources)

• Milk and milk products

• Yogurt, especially if you

have received antibiotics

For more information about nutrition, visit

http://www.cdc.gov/nutrition/everyone/basics/protein.html

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Preadmission Screening

Prior to surgery, you will need to speak to two

FMH representatives:

• The Scheduling Center to pre-register (240-566-3400 or

800-995-1438)

• The Preadmission Nurse (240-566-4970 or 866-790-3011)

One of our Preadmission Screening nurses will attempt to call you several days before your surgery. The call usually takes approximately 10-15 minutes. If you are not available we leave a message for you to return our call before a certain time and the phone number to reach us. If we are unavailable when you call, please leave your name and a number where we can reach you. Due to time limits, individual’s busy schedules and phone screen staff availability, we may not talk with everyone before the day of surgery. If we do not reach you, we will take your medical and surgical history on the day of your surgery/procedure.

The Preadmission Screening nurse will ask you to verify your name and date of birth. You will be asked for your medical and surgical history so we can document it in our computer system.

This includes height/weight, medication/any allergies and the reactions, current names, dosage and frequency of medications (prescribed, over-the-counter, vitamins/supplements and herbals).

The preadmission screening nurse will review with you what medications you should take the morning of your surgery, with a sip of water. Please bring a list of your medications and the last time/date you took them including the day of surgery.

There may be tests needed prior to your surgery. You must request that the results be faxed to the hospital at 240-566-3636.

The nurse will ask you to identify when/where you had preoperative testing or consultations with medical, cardiac, or lung specialists, so we can contact them to obtain the information if they have not been received.

It is important for you to know that you have patient rights, which include the right to ask questions, the right to participate in your care, the right to refuse treatment and the right to comfort, privacy and safety.

7/12/13 1:34 AM

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07/12/2013 01:23:46 119917_Printing_Services_In

Getting Ready for Your Surgery

CheCklist for surgery – Complete the checklist in the front of this booklet and bring the entire booklet with you the day of your surgery.

important reminders

• Be sure to follow the instructions on page 3 for showering. Use CHG and clean towels.

• Do not use lotion or conditioner on your skin or hair.

• Remove all nail polish.

• Leave all jewelry and valuables at home.

• Do not wear makeup.

• Make arrangements for someone to drive you home and stay with you after your surgery.

Do not eat or drink anything after midnight before your surgery unless otherwise instructed by your physician. This includes gum or candy.

The only exception would be a sip of water if you are instructed to take your medications. Intake of solid foods or liquids could cause your operation to be postponed.

If you are taking any medications, ask your physician in advance if you should take them the morning of surgery.

Contact your doctor for advice if you are taking any blood thinners, aspirin, or anti-inflammatory medication.

Stop smoking or limit your smoking for a few days before surgery, and do not smoke after midnight the day before surgery.

Do not drink alcoholic beverages 24 hours before surgery.

• If you develop a cold, fever, or other health problem within 48 hours of your scheduled admission, please call and inform your physician.

• For children having surgery, at least one parent must be present at all times while the child is in the hospital.

FMH is not responsible for money or valuables you bring with you. We strongly recommend that you leave all money at home, unless you have a copay. If it is necessary to bring valuables with you, the Cashier’s office can store smaller items in the safe. When you arrive for admission, notify your nurse and arrangements will be made.

For patients being admitted after surgery:

Please leave your luggage in your vehicle until you have been brought to your post-op room. At that point a family member may bring it to your room.

If you have any questions, call your doctor’s office, Pre-Admission Screening at 240-566-3918, or

Perioperative Services at 240-566-3756.

Pain Management

Pain management starts immediately after surgery while you are in the recovery room. It is important for you to remain comfortable after surgery. Good pain management will help you recover faster and allow you to get out of bed more quickly. This is important to prevent complications, such as pneumonia and blood clots.

In order to know how much pain medication to give you, the nurses will often ask you to rate your pain on a scale of 0 to 10, with 0 being “no pain” and 10 being the “worst pain you can imagine.”

Be honest when you answer. Bearing the pain may limit your ability to move around and increase your risk of complications.

For the Best Pain Management During Your Hospital Stay:

• Rate your pain on a scale of 0 to 10 when asked about your pain level using the reference scale described above.

• Ask for pain medication as soon as the pain begins.

Different pain-control treatments will be used at different times during your hospital stay. Pain medication may be delivered by IV or by mouth.

Day After Surgery

If you are discharged directly from the PACU, you will receive a phone call from one of our

Perioperative Services nurses within a few days of going home. The nurse will ask how you are feeling and answer any questions you have about your discharge instructions. In the meantime, if you have any questions concerning your instructions, please call your doctor’s office or

Perioperative Services at 240-566-3435.

Avoiding Problems After Surgery

Speak Up

Let your doctor know if you are concerned about a medication, your IV fluids, or if you are experiencing pain.

Doing so may make all the difference in your care. Let your doctor know what is on your mind, whatever it is. Don’t be afraid to speak up. It can help save your life!

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What to Expect When You Arrive

Arriving at FMH

Patients admitted the morning of surgery should arrive at the hospital two hours before the scheduled procedure

(or as directed by your physician). This ensures that there is adequate time to prepare you for a safe surgical experience. A complimentary parking valet service is available for your convenience.

Admission

Upon arrival, a registrar will review your insurance documents, collect copay, obtain necessary signatures, and copy your ID and insurance cards. When your patient file is complete, you will be escorted to the Surgical Waiting Area. There you will be greeted by an FMH staff member or an

FMH Auxiliary volunteer. He or she will check you in on the computer and as soon as he or she receives your room number, you will be escorted back to the pre-operative area to meet the staff.

A Surgical Waiting Room staff member or volunteer will explain the computerized patient tracking system to the person who has accompanied you and provide him or her with your confidential ID number. He or she will be able to follow your progress on the large computer screen in the waiting area as you prepare for surgery, move to the operating room, recovery area and discharge, or transfer to your room.

In Pre-op

Once you are settled in pre-op, your nurse will again verify some basic information for your safety, perform a physical assessment, complete required documents, carry out any tasks ordered by your physician and start an IV. You will be visited by your surgeon, your anesthesiologist and your operating room nurse. They will answer any further questions you might have and will take very good care of you throughout your surgery.

Your family member or friend may stay with you until it’s time for your surgery and then will be directed to the waiting area.

Although our goal is to begin all of our surgeries on time, sometimes surgeries must be delayed due to unforeseen circumstances. If this happens, your nurse will keep you updated as to the status of a delay.

Marking of Surgical Site and Clipping of Hair

Your surgeon may mark your surgery site by writing directly on your skin the day of surgery. Don’t be afraid to ask for this; it will remind the surgeon of your correct surgical site. Do not mark the site yourself. Do not shave surgical site. Someone will clip the hair the day of surgery in Pre-op area.

8

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Wound Care

In order to avoid wound infection after surgery, you need to be diligent about wound care and hand washing. By following these tips, you will be less likely to get a wound infection:

• Keep the dressing clean and dry.

• Wash your hands thoroughly before changing a dressing or emptying a drain.

• Do not remove the dressing and don’t let anybody touch the dressing or the wound unless otherwise instructed by your physician.

• Do not probe, pick at, or squeeze your wound.

• Follow your doctor’s instructions for wound care.

• Contact your doctor immediately if you experience any symptoms that may indicate an infection, such as unexpected pain, chills, fever, excessive wound drainage, increasing redness, or swelling of the surgical area.

Post-Discharge Care and Rehabilitation

Discharge planning starts when you are admitted to the hospital. A case manager will likely visit you during your hospital stay if you are not able to be discharged home to your own care.

Your insurance and your physical restrictions will also play a role in your discharge planning.

Depending on your surgery, rehabilitation may be recommended:

Nutrition

If you are discharged to recover at home, you should be aware of the food you should eat to aid your recovery. Eating well after surgery can affect how quickly you heal; increasing your water intake and eating more protein can aid the healing process. Foods rich in protein include:

• Meats, poultry, and fish

• Tofu

• Legumes (dry beans and peas)

• Eggs

• Nuts and seeds

• Grains, some vegetables, and some fruits (provide only small amounts of protein relative to other sources)

• Milk and milk products

• Yogurt, especially if you

have received antibiotics

For more information about nutrition, visit

http://www.cdc.gov/nutrition/everyone/basics/protein.html

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5

Preadmission Screening

Prior to surgery, you will need to speak to two

FMH representatives:

• The Scheduling Center to pre-register (240-566-3400 or

800-995-1438)

• The Preadmission Nurse (240-566-4970 or 866-790-3011)

One of our Preadmission Screening nurses will attempt to call you several days before your surgery. The call usually takes approximately 10-15 minutes. If you are not available we leave a message for you to return our call before a certain time and the phone number to reach us. If we are unavailable when you call, please leave your name and a number where we can reach you. Due to time limits, individual’s busy schedules and phone screen staff availability, we may not talk with everyone before the day of surgery. If we do not reach you, we will take your medical and surgical history on the day of your surgery/procedure.

The Preadmission Screening nurse will ask you to verify your name and date of birth. You will be asked for your medical and surgical history so we can document it in our computer system.

This includes height/weight, medication/any allergies and the reactions, current names, dosage and frequency of medications (prescribed, over-the-counter, vitamins/supplements and herbals).

The preadmission screening nurse will review with you what medications you should take the morning of your surgery, with a sip of water. Please bring a list of your medications and the last time/date you took them including the day of surgery.

There may be tests needed prior to your surgery. You must request that the results be faxed to the hospital at 240-566-3636.

The nurse will ask you to identify when/where you had preoperative testing or consultations with medical, cardiac, or lung specialists, so we can contact them to obtain the information if they have not been received.

It is important for you to know that you have patient rights, which include the right to ask questions, the right to participate in your care, the right to refuse treatment and the right to comfort, privacy and safety.

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Antibiotic Treatment

Ask your doctor if you will be receiving antibiotic medication before surgery to prevent infection.

Most people receive one dose of antibiotics at the time of the surgery and may remain on antibiotics for a day or two after surgery, depending on your surgical procedure.

Nasal Antiseptic

Thirty percent of people carry bacteria in their nose. You are at higher risk to develop infections from the bacteria. Your healthcare providers will provide you with an iodine nasal antiseptic one hour before surgery to reduce the bacteria in the nose and reduce the risk of you getting an infection after surgery. You will be given specific directions the day of your surgery.

Anesthesia

On the day of surgery, the anesthesiologist will discuss your anesthesia options. The type of anesthesia you receive will depend on the type of surgery you are having or any health conditions you have.

Regional anesthesia:

This is also called a “nerve block.” Numbing medication (local anesthesia) is injected near the nerve to prevent feeling in an arm or leg.

Spinal or Epidural anesthesia: Numbing medication is injected in your back to keep you from feeling anything in the lower body and legs during surgery.

General anesthesia: This type of anesthesia makes you unconscious and unable to feel anything.

The medication is usually inhaled through a breathing tube and injected through a vein in your forearm. Once the surgery is completed, the anesthesiologist will remove the breathing tube and wake you up. It is not unusual to have a sore throat for a day or two after the surgery if you had a breathing tube.

You need to arrange for a responsible adult to take you to and from the hospital, since you may be somewhat disoriented from the anesthesia. We suggest that you have a responsible person stay with you the first night following your procedure. Adult patients with children should consider making child care arrangements for children for 24 hours following surgery. You could feel drowsy.

Medications

During your hospital stay, you may be asked to confirm the medications you are currently taking.

This is meant to keep you safe and should occur during admission, transfers within the hospital, and when you are released from the hospital.

Some of your medications may be changed during your hospital stay and others may be added or eliminated. Be sure to ask your physician to explain these changes to you, and don’t be afraid to ask any questions you may have about a new medication.

Each time a physician or nurse reviews your medications with you is an opportunity to ask questions.

Source: U.S. Department of Health & Human Services. Agency for Healthcare Research and Quality.

Build Your Question List. http://www.ahrq.gov/questionsaretheanswer/questionBuilder.aspx. Accessed July 27, 2010.

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6

In the Operating Room

You will be wearing a special gown and covered in warm blankets and transferred to the OR table for your procedure. Monitoring equipment will be connected and your anesthesiologist will begin administering medication through your IV. At the completion of your surgery, you will be transferred to the Post Anesthesia Care Unit (PACU) for your recovery.

A registered nurse will accompany you through your surgical experience, beginning with preparing you for the procedure, remaining with you through the procedure and managing your care afterward.

Immediately After Surgery

Recovery Room

After your surgery, you will spend the next one to three hours in the Post-Anesthesia Care Unit, also called the PACU or the recovery room. In the PACU, a registered nurse will watch you closely until you are completely awake. Your vital signs —such as your blood pressure, heart rate and rhythm, breathing and temperature—will be monitored closely. You will receive oxygen through a small tube (called a cannula) in your nose. Pain medication is often given, based on your level of pain, and may be given through an intravenous tube in your forearm.

When You Are Awake, Stable and Comfortable:

Outpatients – You will be assisted to a recliner chair, to the restroom if needed, and be given something to drink. Shortly before your discharge, we will call your family to be with you and review your discharge instructions.

Inpatients – You will be transferred to your room from the Post Anesthesia Care Unit area when you are awake and comfortable and the room is ready. The nurse caring for you will contact the volunteer in the waiting area, who will inform your family of your room number and how to get there.

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Getting Ready for Your Surgery

CheCklist for surgery – Complete the checklist in the front of this booklet and bring the entire booklet with you the day of your surgery.

important reminders

• Be sure to follow the instructions on page 3 for showering. Use CHG and clean towels.

• Do not use lotion or conditioner on your skin or hair.

• Remove all nail polish.

• Leave all jewelry and valuables at home.

• Do not wear makeup.

• Make arrangements for someone to drive you home and stay with you after your surgery.

Do not eat or drink anything after midnight before your surgery unless otherwise instructed by your physician. This includes gum or candy.

The only exception would be a sip of water if you are instructed to take your medications. Intake of solid foods or liquids could cause your operation to be postponed.

If you are taking any medications, ask your physician in advance if you should take them the morning of surgery.

Contact your doctor for advice if you are taking any blood thinners, aspirin, or anti-inflammatory medication.

Stop smoking or limit your smoking for a few days before surgery, and do not smoke after midnight the day before surgery.

Do not drink alcoholic beverages 24 hours before surgery.

• If you develop a cold, fever, or other health problem within 48 hours of your scheduled admission, please call and inform your physician.

• For children having surgery, at least one parent must be present at all times while the child is in the hospital.

FMH is not responsible for money or valuables you bring with you. We strongly recommend that you leave all money at home, unless you have a copay. If it is necessary to bring valuables with you, the Cashier’s office can store smaller items in the safe. When you arrive for admission, notify your nurse and arrangements will be made.

For patients being admitted after surgery:

Please leave your luggage in your vehicle until you have been brought to your post-op room. At that point a family member may bring it to your room.

If you have any questions, call your doctor’s office, Pre-Admission Screening at 240-566-3918, or

Perioperative Services at 240-566-3756.

Pain Management

Pain management starts immediately after surgery while you are in the recovery room. It is important for you to remain comfortable after surgery. Good pain management will help you recover faster and allow you to get out of bed more quickly. This is important to prevent complications, such as pneumonia and blood clots.

In order to know how much pain medication to give you, the nurses will often ask you to rate your pain on a scale of 0 to 10, with 0 being “no pain” and 10 being the “worst pain you can imagine.”

Be honest when you answer. Bearing the pain may limit your ability to move around and increase your risk of complications.

For the Best Pain Management During Your Hospital Stay:

• Rate your pain on a scale of 0 to 10 when asked about your pain level using the reference scale described above.

• Ask for pain medication as soon as the pain begins.

Different pain-control treatments will be used at different times during your hospital stay. Pain medication may be delivered by IV or by mouth.

Day After Surgery

If you are discharged directly from the PACU, you will receive a phone call from one of our

Perioperative Services nurses within a few days of going home. The nurse will ask how you are feeling and answer any questions you have about your discharge instructions. In the meantime, if you have any questions concerning your instructions, please call your doctor’s office or

Perioperative Services at 240-566-3435.

Avoiding Problems After Surgery

Speak Up

Let your doctor know if you are concerned about a medication, your IV fluids, or if you are experiencing pain.

Doing so may make all the difference in your care. Let your doctor know what is on your mind, whatever it is. Don’t be afraid to speak up. It can help save your life!

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Visitor Guidelines

We want to reunite you with your family member or friend as quickly as it is safe to do so, and we understand that they are important to your recovery. Please share the following guidelines with the person accompanying you to the hospital.

• Outpatients can have one visitor in the PACU when the patient is approximately

20 minutes from being discharged. This person should be the individual who will be caring for you at home. Discharge instructions will be reviewed with him or her as well as with you.

• No children of visitors or patients will be allowed in the PACU.

• If the visitor is going to leave the surgical waiting area, he or she should inform the volunteer to ensure that he or she is present to speak with the surgeon after the procedure and available to go to the PACU when you are ready for discharge.

Standard Precautions

Standard precautions are measures that are followed to protect both you and our staff against the transmission of communicable disease. These measures involve the use of protective equipment such as gloves, gowns, or masks in conjunction with good hand washing practice and appropriate disposal of contaminated needles and waste.

Just for Children

When your little one is scheduled for surgery, you want everything to be as stress-free as possible—and so do we. As a general rule, children under five years of age may have their IV started in the operating room after they are asleep. Young children may be accompanied into the operating room by one parent, who will be allowed to remain with his or her child until he or she is asleep.

When your child is awake and stable, you will be called directly back to be with him or her in the PACU. If your child is to be discharged, you may carry him or her out of the hospital, or he or she can have a ride in a wheelchair—most children love this part!

You will be escorted to your waiting car by staff or volunteer.

Information for Visitors

The Coffee Bean

and FMH Gift Shop are open daily and located on the first floor.

The Cafeteri

a is located on the lower level of the hospital and offers a wide variety of meal choices and vending machines.

Pastoral Care Services

are available on a 24 hour basis.

Free WiFi

is available throughout the hospital.

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8

Wound Care

In order to avoid wound infection after surgery, you need to be diligent about wound care and hand washing. By following these tips, you will be less likely to get a wound infection:

• Keep the dressing clean and dry.

• Wash your hands thoroughly before changing a dressing or emptying a drain.

• Do not remove the dressing and don’t let anybody touch the dressing or the wound unless otherwise instructed by your physician.

• Do not probe, pick at, or squeeze your wound.

• Follow your doctor’s instructions for wound care.

• Contact your doctor immediately if you experience any symptoms that may indicate an infection, such as unexpected pain, chills, fever, excessive wound drainage, increasing redness, or swelling of the surgical area.

Post-Discharge Care and Rehabilitation

Discharge planning starts when you are admitted to the hospital. A case manager will likely visit you during your hospital stay if you are not able to be discharged home to your own care.

Your insurance and your physical restrictions will also play a role in your discharge planning.

Depending on your surgery, rehabilitation may be recommended:

Nutrition

If you are discharged to recover at home, you should be aware of the food you should eat to aid your recovery. Eating well after surgery can affect how quickly you heal; increasing your water intake and eating more protein can aid the healing process. Foods rich in protein include:

• Meats, poultry, and fish

• Tofu

• Legumes (dry beans and peas)

• Eggs

• Nuts and seeds

• Grains, some vegetables, and some fruits (provide only small amounts of protein relative to other sources)

• Milk and milk products

• Yogurt, especially if you

have received antibiotics

For more information about nutrition, visit

http://www.cdc.gov/nutrition/everyone/basics/protein.html

5

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Preadmission Screening

Prior to surgery, you will need to speak to two

FMH representatives:

• The Scheduling Center to pre-register (240-566-3400 or

800-995-1438)

• The Preadmission Nurse (240-566-4970 or 866-790-3011)

One of our Preadmission Screening nurses will attempt to call you several days before your surgery. The call usually takes approximately 10-15 minutes. If you are not available we leave a message for you to return our call before a certain time and the phone number to reach us. If we are unavailable when you call, please leave your name and a number where we can reach you. Due to time limits, individual’s busy schedules and phone screen staff availability, we may not talk with everyone before the day of surgery. If we do not reach you, we will take your medical and surgical history on the day of your surgery/procedure.

The Preadmission Screening nurse will ask you to verify your name and date of birth. You will be asked for your medical and surgical history so we can document it in our computer system.

This includes height/weight, medication/any allergies and the reactions, current names, dosage and frequency of medications (prescribed, over-the-counter, vitamins/supplements and herbals).

The preadmission screening nurse will review with you what medications you should take the morning of your surgery, with a sip of water. Please bring a list of your medications and the last time/date you took them including the day of surgery.

There may be tests needed prior to your surgery. You must request that the results be faxed to the hospital at 240-566-3636.

The nurse will ask you to identify when/where you had preoperative testing or consultations with medical, cardiac, or lung specialists, so we can contact them to obtain the information if they have not been received.

It is important for you to know that you have patient rights, which include the right to ask questions, the right to participate in your care, the right to refuse treatment and the right to comfort, privacy and safety.

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Pain Management

Pain management starts immediately after surgery while you are in the recovery room. It is important for you to remain comfortable after surgery. Good pain management will help you recover faster and allow you to get out of bed more quickly. This is important to prevent complications, such as pneumonia and blood clots.

In order to know how much pain medication to give you, the nurses will often ask you to rate your pain on a scale of 0 to 10, with 0 being “no pain” and 10 being the “worst pain you can imagine.”

Be honest when you answer. Bearing the pain may limit your ability to move around and increase your risk of complications.

For the Best Pain Management During Your Hospital Stay:

• Rate your pain on a scale of 0 to 10 when asked about your pain level using the reference scale described above.

• Ask for pain medication as soon as the pain begins.

Different pain-control treatments will be used at different times during your hospital stay. Pain medication may be delivered by IV or by mouth.

Day After Surgery

If you are discharged directly from the PACU, you will receive a phone call from one of our

Perioperative Services nurses within a few days of going home. The nurse will ask how you are feeling and answer any questions you have about your discharge instructions. In the meantime, if you have any questions concerning your instructions, please call your doctor’s office or PACU/Perioperative Services at 240-566-3435.

Avoiding Problems After Surgery

Speak Up

Let your doctor know if you are concerned about a medication, your IV fluids, or if you are experiencing pain.

Doing so may make all the difference in your care. Let your doctor know what is on your mind, whatever it is. Don’t be afraid to speak up. It can help save your life!

4

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Visitor guidelines

We want to reunite you with your family member or friend as quickly as it is safe to do so, and we understand that they are important to your recovery. Please share the following guidelines with the person accompanying you to the hospital.

• Outpatients can have one visitor in the PACU when the patient is approximately

20 minutes from being discharged. This person should be the individual who will be caring for you at home. Discharge instructions will be reviewed with him or her as well as with you.

• No children of visitors or patients will be allowed in the PACU.

• If the visitor is going to leave the surgical waiting area, he or she should inform the volunteer to ensure that he or she is present to speak with the surgeon after the procedure and available to go to the PACU when you are ready for discharge.

Standard Precautions

Standard precautions are measures that are followed to protect both you and our staff against the transmission of communicable disease. These measures involve the use of protective equipment such as gloves, gowns, or masks in conjunction with good hand washing practice and appropriate disposal of contaminated needles and waste.

Just for Children

When your little one is scheduled for surgery, you want everything to be as stress-free as possible—and so do we. As a general rule, children under five years of age may have their IV started in the operating room after they are asleep. Young children may be accompanied into the operating room by one parent, who will be allowed to remain with his or her child until he or she is asleep.

When your child is awake and stable, you will be called directly back to be with him or her in the PACU. If your child is to be discharged, you may carry him or her out of the hospital, or he or she can have a ride in a wheelchair—most children love this part!

You will be escorted to your waiting car by staff or volunteer.

Information for Visitors

The Coffee Bean

and FMH Gift Shop are open daily and located on the first floor.

The Cafeteri

a is located on the lower level of the hospital and offers a wide variety of meal choices. Hours - 6:30

A

.

M

.-11:00

P

.

M

.

Pastoral Care Services

are available on a 24 hour basis.

Free WiFi

is available throughout the hospital.

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9

What to Expect When You Arrive

Arriving at fMH

Patients admitted the morning of surgery should arrive at the hospital two hours before the scheduled procedure

(or as directed by your physician). This ensures that there is adequate time to prepare you for a safe surgical experience. A complimentary parking valet service is available for your convenience.

Admission

Upon arrival, a registrar will review your insurance documents, collect copay, obtain necessary signatures, and copy your ID and insurance cards. When your patient file is complete, you will be escorted to the Surgical Waiting Area. There you will be greeted by an FMH staff member or an

FMH Auxiliary volunteer. He or she will check you in on the computer and as soon as he or she receives your room number, you will be escorted back to the pre-operative area to meet the staff.

A Surgical Waiting Room staff member or volunteer will explain the computerized patient tracking system to the person who has accompanied you and provide him or her with your confidential ID number. He or she will be able to follow your progress on the large computer screen in the waiting area as you prepare for surgery, move to the operating room, recovery area and discharge, or transfer to your room.

In Pre-op

Once you are settled in pre-op, your nurse will again verify some basic information for your safety, perform a physical assessment, complete required documents, carry out any tasks ordered by your physician and start an IV. You will be visited by your surgeon, your anesthesiologist and your operating room nurse. They will answer any further questions you might have and will take very good care of you throughout your surgery.

Your family member or friend may stay with you until it’s time for your surgery and then will be directed to the waiting area.

Although our goal is to begin all of our surgeries on time, sometimes surgeries must be delayed due to unforeseen circumstances. If this happens, your nurse will keep you updated as to the status of a delay.

Marking of Surgical Site and Clipping of Hair

Your surgeon may mark your surgery site by writing directly on your skin the day of surgery. Don’t be afraid to ask for this; it will remind the surgeon of your correct surgical site. Do not mark the site yourself. Do not shave surgical site. Someone will clip the hair the day of surgery in Pre-op area.

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Wound Care

In order to avoid wound infection after surgery, you need to be diligent about wound care and hand washing. By following these tips, you will be less likely to get a wound infection:

• Keep the dressing clean and dry.

• Wash your hands thoroughly before changing a dressing or emptying a drain.

• Do not remove the dressing and don’t let anybody touch the dressing or the wound unless otherwise instructed by your physician.

• Do not probe, pick at, or squeeze your wound.

• Follow your doctor’s instructions for wound care.

• Contact your doctor immediately if you experience any symptoms that may indicate an infection, such as unexpected pain, chills, fever, excessive wound drainage, increasing redness, or swelling of the surgical area.

Post-Discharge Care and Rehabilitation

Discharge planning starts when you are admitted to the hospital. A case manager will likely visit you during your hospital stay if you are not able to be discharged home to your own care.

Your insurance and your physical restrictions will also play a role in your discharge planning.

Depending on your surgery, rehabilitation may be recommended:

Nutrition

If you are discharged to recover at home, you should be aware of the food you should eat to aid your recovery. Eating well after surgery can affect how quickly you heal; increasing your water intake and eating more protein can aid the healing process. Foods rich in protein include:

• Meats, poultry, and fish

• Tofu

• Legumes (dry beans and peas)

• Eggs

• Nuts and seeds

• Grains, some vegetables, and some fruits (provide only small amounts of protein relative to other sources)

• Milk and milk products

• Yogurt, especially if you

have received antibiotics

For more information about nutrition, visit

http://www.cdc.gov/nutrition/everyone/basics/protein.html

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Preadmission Screening

Prior to surgery, you will need to speak to two

FMH representatives:

• The Scheduling Center to pre-register (240-566-3400 or

800-995-1438)

• The Preadmission Nurse (240-566-4970 or 866-790-3011)

One of our Preadmission Screening nurses will attempt to call you several days before your surgery. The call usually takes approximately 10-15 minutes. If you are not available we leave a message for you to return our call before a certain time and the phone number to reach us. If we are unavailable when you call, please leave your name and a number where we can reach you. Due to time limits, individual’s busy schedules and phone screen staff availability, we may not talk with everyone before the day of surgery. If we do not reach you, we will take your medical and surgical history on the day of your surgery/procedure.

The Preadmission Screening nurse will ask you to verify your name and date of birth. You will be asked for your medical and surgical history so we can document it in our computer system.

This includes height/weight, medication/any allergies and the reactions, current names, dosage and frequency of medications (prescribed, over-the-counter, vitamins/supplements and herbals).

The preadmission screening nurse will review with you what medications you should take the morning of your surgery, with a sip of water. Please bring a list of your medications and the last time/date you took them including the day of surgery.

There may be tests needed prior to your surgery. You must request that the results be faxed to the hospital at 240-566-3636.

The nurse will ask you to identify when/where you had preoperative testing or consultations with medical, cardiac, or lung specialists, so we can contact them to obtain the information if they have not been received.

It is important for you to know that you have patient rights, which include the right to ask questions, the right to participate in your care, the right to refuse treatment and the right to comfort, privacy and safety.

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Medication Safety

It is important to keep an up-to-date list with you and share it with your doctor at each visit.

There are four main elements that should be included on your medication list:

1. What you are taking (name)

2. The strength (for example, number of milligrams) and how much you should take (dose)

3. When to take it (frequency)

4. What it is used for

Stoplight SySteM of infection prevention

Stop

Early warning signs that require medical evaluation include the following:

• Swelling, pain, tenderness, or warmth around the wound site

• Yellow or green discharge from the wound site or change in odor

• Change in the size or an opening of the incision

• Excessive bleeding through the wound dressing

• Severe pain that does not improve following surgery

• Painful urination or cloudy, strong-smelling urine

• Fever or low body temperature

• Low blood pressure

• Combination of foul-smelling diarrhea, abdominal pain and fever

• Other signs and symptoms of a post-surgical complication identified by your surgeon or primary care physician

If you are not able to reach your primary care physician or surgeon, go to the emergency room.

Please call FMH Infection Prevention & Control (240-566-3509) if you get an infection.

go ABoUt yoUr recovery

Monitor your condition closely at home.

Keep the wound dry: If you experience tenderness, tingling, numbness, itching, small amounts of discharge, bruising, or a small lump around the wound, these are signs of healing and no cause for concern. Continue to monitor the wound site for changes.

Proper hand washing is the best way to prevent infection Keep your hands clean in order to protect yourself, and encourage your family, friends, and other visitors to do the same. Speak up if you do not see the doctor or nurse wash their hands. Health care professionals come in contact with a lot of bacteria and viruses, so it is important to make sure they have clean hands and clean gloves before making contact with you.

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3

2

Blood clots – Clotting is important; it prevents excessive bleeding when an injury occurs. When you are inactive while recovering from surgery, blood moves more slowly through veins and sometimes pools, causing a blood clot to form. Pain in your calves and shortness of breath are signs of a clot. There are several ways to prevent blood clots, including special stockings, a device to promote blood flow, or medication. It is also helpful to begin to move, sit up from bed, or walk around as soon as you are able following surgery. By doing so, you’ll be doing your part to help prevent blood clots.

Pneumonia – Pneumonia is an infection that develops from a buildup of fluid in the lungs. It can result from lying in bed and not moving for too long. Fever, shortness of breath, cough, or chest pain after surgery could be signs of pneumonia. Patients who are older and undergo certain types of operations may be at higher risk of developing pneumonia after surgery.

To prevent fluid buildup in the lungs, you may be given an incentive spirometer to use for breathing exercises. Use this device for several days after surgery to exercise your lungs ten times an hour while awake. Pace yourself; repeating this exercise too quickly may cause you to become dizzy or lightheaded. If this occurs, stop the exercise and rest.

Because pneumonia is a serious complication that can interfere with your recovery and even become life threatening, it’s important to prevent it whenever possible. With that in mind, a vaccine is available to help prevent pneumonia in those people who are at greatest risk. (See the chart to follow.) If you fit into any of the categories listed in the chart, ask your doctor if the vaccine may be right for you.

Source: Annals—Summary for Patients

After Discharge from the Hospital

Set a Follow-Up Appointment with Your Doctor

Before you leave the hospital, you will be given instructions on when to follow up with your doctor. If possible, try to schedule the appointment before you leave the hospital.

Expected Activity —Do’s and Don’ts

Make sure you know how active you are allowed to be after discharge. Ask your doctor when you may:

• Lift anything (and if you are permitted to lift, how many pounds?)

• Drive a car

• Exercise

• Have sexual relations

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Getting Ready for Your Surgery

CheCklist for surgery – Complete the checklist in the front of this booklet and bring the entire booklet with you the day of your surgery.

important reminders

• Be sure to follow the instructions on page 3 for showering. Use CHG and clean towels.

• Do not use lotion or conditioner on your skin or hair.

• Remove all nail polish.

• Leave all jewelry and valuables at home.

• Do not wear makeup.

• Make arrangements for someone to drive you home and stay with you after your surgery.

Do not eat or drink anything after midnight before your surgery unless otherwise instructed by your physician. This includes gum or candy.

The only exception would be a sip of water if you are instructed to take your medications. Intake of solid foods or liquids could cause your operation to be postponed.

If you are taking any medications, ask your physician in advance if you should take them the morning of surgery.

Contact your doctor for advice if you are taking any blood thinners, aspirin, or anti-inflammatory medication.

Stop smoking or limit your smoking for a few days before surgery, and do not smoke after midnight the day before surgery.

Do not drink alcoholic beverages 24 hours before surgery.

• If you develop a cold, fever, or other health problem within 48 hours of your scheduled admission, please call and inform your physician.

• For children having surgery, at least one parent must be present at all times while the child is in the hospital.

FMH is not responsible for money or valuables you bring with you. We strongly recommend that you leave all money at home, unless you have a copay. If it is necessary to bring valuables with you, the Cashier’s office can store smaller items in the safe. When you arrive for admission, notify your nurse and arrangements will be made.

For patients being admitted after surgery:

Please leave your luggage in your vehicle until you have been brought to your post-op room. At that point a family member may bring it to your room.

If you have any questions, call your doctor’s office, Pre-Admission Screening at 240-566-3918, or

Perioperative Services at 240-566-3756.

Pain Management

Pain management starts immediately after surgery while you are in the recovery room. It is important for you to remain comfortable after surgery. Good pain management will help you recover faster and allow you to get out of bed more quickly. This is important to prevent complications, such as pneumonia and blood clots.

In order to know how much pain medication to give you, the nurses will often ask you to rate your pain on a scale of 0 to 10, with 0 being “no pain” and 10 being the “worst pain you can imagine.”

Be honest when you answer. Bearing the pain may limit your ability to move around and increase your risk of complications.

For the Best Pain Management During Your Hospital Stay:

• Rate your pain on a scale of 0 to 10 when asked about your pain level using the reference scale described above.

• Ask for pain medication as soon as the pain begins.

Different pain-control treatments will be used at different times during your hospital stay. Pain medication may be delivered by IV or by mouth.

Day After Surgery

If you are discharged directly from the PACU, you will receive a phone call from one of our

Perioperative Services nurses within a few days of going home. The nurse will ask how you are feeling and answer any questions you have about your discharge instructions. In the meantime, if you have any questions concerning your instructions, please call your doctor’s office or

Perioperative Services at 240-566-3435.

Avoiding Problems After Surgery

Speak Up

Let your doctor know if you are concerned about a medication, your IV fluids, or if you are experiencing pain.

Doing so may make all the difference in your care. Let your doctor know what is on your mind, whatever it is. Don’t be afraid to speak up. It can help save your life!

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Visitor guidelines

We want to reunite you with your family member or friend as quickly as it is safe to do so, and we understand that they are important to your recovery. Please share the following guidelines with the person accompanying you to the hospital.

• Outpatients can have one visitor in the PACU when the patient is approximately

20 minutes from being discharged. This person should be the individual who will be caring for you at home. Discharge instructions will be reviewed with him or her as well as with you.

• No children of visitors or patients will be allowed in the PACU.

• If the visitor is going to leave the surgical waiting area, he or she should inform the volunteer to ensure that he or she is present to speak with the surgeon after the procedure and available to go to the PACU when you are ready for discharge.

Standard Precautions

Standard precautions are measures that are followed to protect both you and our staff against the transmission of communicable disease. These measures involve the use of protective equipment such as gloves, gowns, or masks in conjunction with good hand washing practice and appropriate disposal of contaminated needles and waste.

Just for Children

When your little one is scheduled for surgery, you want everything to be as stress-free as possible—and so do we. As a general rule, children under five years of age may have their IV started in the operating room after they are asleep. Young children may be accompanied into the operating room by one parent, who will be allowed to remain with his or her child until he or she is asleep.

When your child is awake and stable, you will be called directly back to be with him or her in the PACU. If your child is to be discharged, you may carry him or her out of the hospital, or he or she can have a ride in a wheelchair—most children love this part!

You will be escorted to your waiting car by staff or volunteer.

Information for Visitors

The Coffee Bean

and FMH Gift Shop are open daily and located on the first floor.

The Cafeteri

a is located on the lower level of the hospital and offers a wide variety of meal choices. Hours - 6:30

A

.

M

.-11:00

P

.

M

.

Pastoral Care Services

are available on a 24 hour basis.

Free WiFi

is available throughout the hospital.

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What to Expect When You Arrive

Arriving at FMH

Patients admitted the morning of surgery should arrive at the hospital two hours before the scheduled procedure

(or as directed by your physician). This ensures that there is adequate time to prepare you for a safe surgical experience. A complimentary parking valet service is available for your convenience.

Admission

Upon arrival, a registrar will review your insurance documents, collect copay, obtain necessary signatures, and copy your ID and insurance cards. When your patient file is complete, you will be escorted to the Surgical Waiting Area. There you will be greeted by an FMH staff member or an

FMH Auxiliary volunteer. He or she will check you in on the computer and as soon as he or she receives your room number, you will be escorted back to the pre-operative area to meet the staff.

A Surgical Waiting Room staff member or volunteer will explain the computerized patient tracking system to the person who has accompanied you and provide him or her with your confidential ID number. He or she will be able to follow your progress on the large computer screen in the waiting area as you prepare for surgery, move to the operating room, recovery area and discharge, or transfer to your room.

In Pre-op

Once you are settled in pre-op, your nurse will again verify some basic information for your safety, perform a physical assessment, complete required documents, carry out any tasks ordered by your physician and start an IV. You will be visited by your surgeon, your anesthesiologist and your operating room nurse. They will answer any further questions you might have and will take very good care of you throughout your surgery.

Your family member or friend may stay with you until it’s time for your surgery and then will be directed to the waiting area.

Although our goal is to begin all of our surgeries on time, sometimes surgeries must be delayed due to unforeseen circumstances. If this happens, your nurse will keep you updated as to the status of a delay.

Marking of Surgical Site and Clipping of Hair

Your surgeon may mark your surgery site by writing directly on your skin the day of surgery. Don’t be afraid to ask for this; it will remind the surgeon of your correct surgical site. Do not mark the site yourself. Do not shave surgical site. Someone will clip the hair the day of surgery in Pre-op area.

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Wound Care

In order to avoid wound infection after surgery, you need to be diligent about wound care and hand washing. By following these tips, you will be less likely to get a wound infection:

• Keep the dressing clean and dry.

• Wash your hands thoroughly before changing a dressing or emptying a drain.

• Do not remove the dressing and don’t let anybody touch the dressing or the wound unless otherwise instructed by your physician.

• Do not probe, pick at, or squeeze your wound.

• Follow your doctor’s instructions for wound care.

• Contact your doctor immediately if you experience any symptoms that may indicate an infection, such as unexpected pain, chills, fever, excessive wound drainage, increasing redness, or swelling of the surgical area.

Post-Discharge Care and Rehabilitation

Discharge planning starts when you are admitted to the hospital. A case manager will visit you during your hospital stay if you are not able to be discharged home to your own care.

Your insurance and your physical restrictions will also play a role in your discharge planning.

Depending on your surgery, rehabilitation may be recommended.

Nutrition

If you are discharged to recover at home, you should be aware of the food you should eat to aid your recovery. Eating well after surgery can affect how quickly you heal; increasing your water intake and eating more protein can aid the healing process. Foods rich in protein include:

• Meats, poultry, and fish

• Tofu

• Nuts and seeds

• Grains, some vegetables, and some fruits (provide only small amounts of protein relative to other sources)

Legumes (dry beans and peas)

Eggs

Milk and milk products

• Yogurt, especially if you

have received antibiotics

For more information about nutrition, visit

http://www.cdc.gov/nutrition/everyone/basics/protein.html

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