Preparing for Surgery

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1 My physician is My surgery date is We will call you after 1:00 pm the day before your surgery and let you know what time to arrive at the hospital. If you have not been called by 7:00 pm, you may call for your arrival time. Arrival times cannot be determined prior to 1:00 pm the day before surgery. My hospital arrival time is My appointment with the Patient Testing Center is: Date Time See inside for more information. am/pm Preparing for Surgery

2 Testing Before Surgery Your doctor may send you for diagnostic testing before your surgery. For your safety, you will also be tested for MRSA (see page 7) and screened for sleep apnea. These tests are done at the Patient Testing Center. Appointments can be made or changed by calling The center is open from 9:00 am to 5:00 pm, Monday Friday, and is located at 626 Medical Drive across from Doctors Park. See map on page 3. TESTING CHECKLIST WHAT TO BRING Your surgery packet from your doctor s office This booklet, including the forms in the back pocket All your medications, both prescription and over-the-counter, in the original bottles, or a complete written list, including the name of the medicine, dosage, how often you take the medicine, what the medicine is for and the name of your pharmacy. Copies of important papers and advance directives (living will, health care power of attorney, guardianship papers) PROTECTING YOUR IDENTITY To protect patients from identity theft, a federal law has been passed requiring health care providers to verify proof of identification before administering treatment, except in cases of an emergency. You will be asked for a picture ID showing your current address and a current insurance card. At least one ID must have your current address. IMPORTANT PHONE NUMBERS Patient Testing Center appointments Questions about pre-op instructions or concerns Shuttle Service NOTES: PLEASE USE THIS SPACE FOR ANY SPECIAL INSTRUCTIONS FROM YOUR DOCTOR OR NURSE.

3 The Day of Surgery checklist for adults To make sure your surgery goes smoothly, follow these directions. Failure to do so may result in cancellation of your surgery. No eating or drinking after midnight the day before your surgery. This includes gum, mints and candy. Take two baths using the special liquid soap provided by the Patient Testing Center or doctor s office one bath should be the evening before your surgery and the other one should be the morning of your surgery. Do not use this soap on your face or private areas. Do not take any medicines the day of your surgery, unless directed to by your nurse or physician. If you are told to take any medication, please do so with only a sip of water. ALSO REMEMBER: Leave all personal belongings at home. This includes jewelry, cell phones, bank cards and excess cash. Tell your doctor if you are allergic to any medications and what happens when you take those medicines. Do not wear any make-up or fingernail polish. Do not wear deodorant, lotions or hair products. Do not shave near the surgical site. Shaving may irritate your skin and increase your chance of infection. Do not wear anything metal, including hair pins or piercings. You may brush your teeth, but try not to swallow any water. Make your doctor aware of any health problems you are having such as diabetes (high blood sugar) or any infections you have and whether you have been treated for them. Wear warm, loose, comfortable clothing. Keeping warm before surgery lowers your risk of getting an infection. checklist for children Children under age 3 should bathe with regular soap the night before surgery. Children 3 18 should bathe with the special liquid soap provided by the Patient Testing Center or doctor s office the night before surgery. Do not wash your face, hair or private areas with the liquid soap. Infants may have formula up to six hours before surgery. Breast milk can be given up to four hours before surgery. Children up to age 8 may have clear liquids up to two hours before surgery. This includes water, tea, soda, juice without pulp, Pedialyte and Jello. Do not give children gum, candy or mints before surgery. Children ages 9-18 should not have anything to eat or drink after midnight. You may bring a security item for your child such as a blanket, pacifier or soft toy. Bring extra diapers, sippy cups and formula if needed. We suggest that you leave your other children at home. It will be a long, tiring day for them. If possible, we recommend that two adults accompany young patients, so one can drive and the other can attend to the child on the way home. If you have any questions or concerns, please call us at what to bring on the day of surgery Two forms of identification one must be a picture ID This folder with any special instructions from your doctor or nurse All your medications, both prescription and over-thecounter, in the original bottles Any x-rays or special test results related to your surgery if instructed by your doctor Parking pass Loose, comfortable clothing to wear home CPAP machine, if applicable Containers for eyeglasses, contact lenses, dentures or hearing aids Copies of important papers, documents (living will, Health Care Power of Attorney) Please bring the following items with you if necessary, but leave them in the car or with a family member until after your surgery: Several pillows for a more comfortable ride home Crutches or a walker for after surgery Overnight bag with your personal care items VidantHealth.com 3

4 Where to Go Surgery Admissions is located on Heart Drive adjacent to the Vidant Medical Center Emergency Entrance. See map on the next page. ARRIVAL AND PARKING FOR PATIENTS Please arrive as instructed to allow adequate time for preparation for your surgery. When you arrive at the Surgery Admissions entrance, someone from our Guest Parking Services staff will greet you and offer assistance with wheelchairs, valet and parking directions. Parking staff will be available to escort you inside to the Guest East Carolina Heart Institute, Monday Friday, 4:30 am 6:00 pm PARKING FOR FAMILY AND VISITORS Because of limited parking spaces, the lot You may call for a valet shuttle at closest to Surgery Admissions is reserved for patients only. Also, please do not park Attendant in the Surgery Admissions lobby Your surgery time is an estimation; you could in the lot designated for our Emergency if needed. If you arrive alone, give the Guest possibly go earlier or later than scheduled. Department patients. Attendant a phone number of the person Occasionally, there may be a delay beyond our who will be waiting to pick you up. We control. You will be informed if this happens. provide free valet parking and shuttle service The Guest Attendant will issue a pager. This for patients and family members bringing of the hospital. Our free shuttle service will allow us to communicate important patients to our facility. Our professional will pick them up and bring them to the updates to you and/or your family. During parking attendants will park your vehicle, Surgery Admissions entrance. This service your surgery, the pager should be given to the store your keys in a locked area, and bring is offered Monday through Friday from family member who is planning to stay in the your car to you when you are discharged. 5:30 am to 10:00 pm. Call to building during your surgery. The surgeon will Please do not tip the attendants. request a shuttle to or from your vehicle. call the Guest Attendant when he/she is ready Handicapped parking spaces can be found Valet parking operating hours are as follows: to talk with your family after the procedure. in every visitor lot. If all handicapped Admissions, Monday Friday, The attendant will page your family and parking spaces are full, please ask a parking arrange to have them meet the surgeon in a lot attendant for assistance. 5:30 am 6:00 pm Surgery Admissions, Monday Friday, We ask that all family members and visitors park in our main visitors parking lot in front consultation room next to the waiting area. 4:30 am 6:00 pm Patient belongings may be placed in lockers in the surgical waiting area. Your family can put your clothing, shoes, glasses or CPAP or BiPAP machine in these lockers during surgery. 4 VidantHealth.com Check in at the Guest Attendant desk. A pager will allow us to give updates to you and your family.

5 VidantHealth.com 5 Free shuttle service Vidant Medical Center MAIN CAMPUS

6 What to Expect At Vidant Medical Center, we take a team approach in the quality and safety of your health care. We recognize that patients and families are essential members of this team. We invite you and your family members to actively participate on your health care team. WHEN YOU ARRIVE At Vidant Medical Center, you can expect: A friendly welcome and introduction of your caregivers Questions about your medical history, allergies and medications (bring them with you) An explanation of your plan of care and any procedures planned for you Opportunities to ask questions and provide input about your plan of care Our staff to include your family as an important part of your care, healing and recovery (with your approval) An explanation of our visitor policy DURING YOUR STAY While you are here we want to be sure you are part of the team. Here are some things you can expect that will help you be a wellinformed team member and take control of your care: Our staff will include your family as an important part of your care, healing and recovery (with your approval). Your room will be clean and well equipped for your care. Staff will frequently wash their hands and regularly check your patient ID before completing procedures or giving medications. It is OK to ask staff if they have washed their hands. We will listen to safety concerns you and your family have and take steps to address them. Doctors and/or staff will see you to discuss your plan of care and answer any questions that you may have. A family member is welcome in your room to help you recover, except in certain settings. We will do our best to make sure you are comfortable, that you get safely in and out of bed, and that your pain is under control. AFTER YOUR STAY As you prepare to leave Vidant Medical Center, we want to be sure you have all the information you need. Before you leave you should: Be sure we have arranged appropriate care for you at home (if needed) Have a complete review of your medications what to take, what not to take, and when Understand how to care for any wounds or incisions We begin preparing you for surgery in the Ambulatory Surgery Unit. Have an explanation of your diet and activity restrictions Understand when to call your doctor(s) Know the phone number of your doctor(s) and our staff to call in case of emergency or with questions after discharge Ask your surgeon to send your family doctor a record of your care Have a follow-up appointment with your doctor(s) PREOPERATIVE CARE Before your surgery, you will spend time in the Ambulatory Surgery Unit (ASU). You and two family members will be escorted to the pre-op area. All other family members and visitors will need to wait in the Surgery Admissions lobby. This is where we begin preparing you for surgery. If the patient is a minor, at least one parent or legal guardian is encouraged to stay with the patient. Your family will be given your belongings. Patient belongings may be placed in lockers in the surgical waiting area. Your family can put your clothing, shoes, glasses or CPAP or BiPAP machine in these lockers. Please leave all other belongings in the car, until after your surgery. A photo of the lockers is shown on page 2. In the preoperative area, your nurse will review your chart and verify all of your information before going to the operating room. You will meet with an anesthesiologist who will ask you questions about your health history, including prior experiences with anesthesia. The anesthesiologist will provide orders for medications that you need before your surgery. This may include medications for relaxation and sedation and medications to help prevent nausea and heartburn. You will also meet your CRNA (certified 6 VidantHealth.com

7 You will meet with your anesthesiologist as part of your preoperative care. When it is time to begin your surgery, you will be taken to the operating room. registered nurse anesthetist) who will be in beds become available in the afternoon the operating room with you throughout and early evening, and we will transfer touching the dressing or surgical site. your surgery. An intravenous line (IV) will be you as soon as possible. We will do our Ask family and friends not to visit you if started if one is not already in place. Your best to make your visit as comfortable as stay in the Ambulatory Surgery Unit should possible no matter where you are located. be approximately one to two hours. If you Depending on your doctor s orders, you are in the preoperative area for a longer may stay in the hospital for your recovery, time, we will call the Guest Attendant, who or you may be discharged the same day to signs of infection. Signs include fever will let your family know of a delay. When recuperate at home. and redness, swelling, heat or pain at the Some things to remember: surgical site. Cloudy fluid draining from the operating room is ready and it is time to begin your surgery, you will be taken to the operating room. AFTER SURGERY Make sure that everyone washes his/her hands before touching the dressing. If you are unsure, ask. Remember to wash your hands before they are sick. Ask family and friends to wash their hands before and after visiting you. Notify your surgeon if you show any the surgical wound or sudden opening of the surgical wound may also be signs of an infection. You will go to the Post Anesthesia Care Unit (PACU) immediately after your surgery where the staff will monitor your breathing, heart rate, blood pressure, temperature, pain level and operative site. You may receive oxygen as needed for a short time. The time you spend in the PACU will depend on your needs and bed availability if you will be staying in the hospital overnight. If your time in recovery is extended beyond one hour and there is not a room available for you, your family can be at your bedside. To be considerate of you and other patients, we limit this to two family members. Based on your preference, your family members can stay with you until your room is available. When your room is ready, you will be moved from PACU to that room and normal hospital visiting hours will be observed. Vidant Medical Center serves a wide area in You will be taken to the Post Anesthesia Care Unit immediately after surgery. eastern North Carolina and the demand for beds at our hospital is often very high. More VidantHealth.com 7

8 If necessary, you will be moved to a room for an overnight stay after your surgery. We have several different units for surgical patients. A room in the Intensive Care Unit is shown here. RECOVERING FROM SURGERY The effects of anesthesia wear off slowly and will limit your activities for 24 hours after your surgery or while you are taking prescription drugs for pain. These limitations protect you and will help you get well as quickly as possible. Please observe the following guidelines for 24 hours after surgery: Do not go to work or do any manual labor. Do not drive. Arrange for someone to drive you home. Do not operate any machinery or equipment. Do not sign any important papers. Have a responsible adult stay with you and care for you. GOING HOME Discharge times vary depending upon the patient s condition and the doctor. It is important to make arrangements for someone to pick you up promptly once discharge orders are received. Your nurse will talk to you about the things you need to do to recover quickly and comfortably at home. You will receive verbal and written instructions. Keep your written instructions in this folder. If you have any questions once you return home, please call your doctor s office. TRANSPORTATION ARRANGEMENTS Please make all arrangements for transportation home after your surgery. Anesthesia will cause you to feel drowsy for hours after surgery, so you will not be able to drive for at least 24 hours after same-day surgery. A responsible adult should stay with you the first 24 hours after same-day surgery. If you do not have transportation scheduled, please let one of your caregivers know and they can help you make arrangements. IMPROVING OUR CARE After your discharge, you may be contacted by phone or mail by the Vidant Medical Center Office of Quality to see how you are recovering from your procedure. The hospital is participating in the American College of Surgeons National Surgical Quality Improvement Program, and your input will help us improve surgical care for all of our patients. Vidant Medical Center is the only hospital in eastern North Carolina participating in the program, designed to measure and improve the quality of surgical care. With this data, the hospital and its surgical staff will be provided with tools, reports, analysis and support necessary to make informed decisions about improving the quality of surgical care. PATIENT SAFETY Your safety is important to us. Your health care team is committed to providing you or your loved one with safe, quality medical care while you are a patient with us. Please feel free to express any compliments or concerns regarding your safety with them first. You may also call The Joint Commission (TJC) Hotline at , 24 hours a day, 7 days a week; however, staff members are only available to answer calls Monday through Friday from 9:30 am until 6:00 pm (EST). You may leave a message at other times. BECOME A PATIENT AND FAMILY ADVISOR Patient and family advisors work in partnership with Vidant Medical Center to promote the highest quality care for our community. As an advisor, you will be given the opportunity to provide input on many aspects of the patient experience. Our advisors help shape policies and programs, review education and hiring practices, advise on facility design and much more. For more information, call VidantHealth.com

9 Pain Control Your comfort is important to us, and we will work with you to keep your pain under control. We need your help to keep us informed of your pain. We will ask often about your pain and ask you to rate it on a scale of 0 to 10, with 0 being no pain and 10 the worst pain you could imagine. Our goal is to keep your pain at a four or less. If your pain is not relieved by medicine or you have side effects, please let your doctor or nurse know right away. Ask your doctor or nurse about non-medicine ways to control pain such as relaxing, using pillows, using cold and warm packs and keeping your time occupied with other activities. Patients sometimes have concerns about using pain medicine. Here are some facts to help reduce anxiety. Strong pain medicines (opioids) are safe, relieve pain well and do not often cause addiction when used under a doctor s care as prescribed. The side effects of opioids (constipation, itching, nausea, drowsiness) can be relieved with other medicines. Take your pain medicine before walking or exercising and before occupational and physical therapy. When your pain is controlled, you will find it easier to walk and exercise. PAIN CONTROL IS OUR GOAL. TELL US HOW YOU FEEL. NO PAIN DISTRESSING PAIN EXCRUCIATING PAIN NO HURT 1 HURTS LITTLE BIT 2 HURTS LITTLE MORE 3 HURTS EVEN MORE 4 HURTS WHOLE LOT 5 HURTS WORST WHY TEST FOR MRSA? MRSA is the short name for a type of bacteria that many antibiotics will not treat. On average, about 1 in 12 people carry MRSA in and on their bodies. Many people who carry the MRSA bacteria don t know they have it. For most of us, carrying MRSA is usually harmless. MRSA may cause minor, easily treatable skin infections about the size of mosquito bites. But for about one of every three people who carry it, MRSA can cause a serious infection. Vidant Medical Center takes extra precautions for patients. Upon admission to the hospital and prior to surgery, all patients are tested for MRSA. We perform the test by swabbing the inside of your nose. Vidant Medical Center is the only hospital in North Carolina that screens and treats each and every one of its patients. Any patient who tests positive for MRSA is treated with an antibiotic ointment that is applied to the inside of your nose for five days. You will also use a skin cleansing soap, called chlorhexidine gluconate (CHG), on days one, three and five of ointment application. MRSA bacteria can be anywhere people are. It can survive for months on your skin, in your nose and in the environment. MRSA is spread by physical contact with a person who already has MRSA or from objects that are contaminated with MRSA. There are some simple steps you can take to reduce your chances of getting or spreading MRSA. Practice good hand hygiene at all times. Take care of cuts or breaks in your skin by washing with soap and water and applying a bandage that is changed daily. Call your doctor if you develop a skin infection that does not get better with home treatment. For more information on what you can do to protect yourself and others, contact Vidant Medical Center s Infection Control staff at or mrsainfo@vidanthealth.com. VidantHealth.com 9

10 For Family and Visitors Additional family members and visitors should park in the Vidant Medical Center visitors parking lot. We offer a free shuttle service from this parking lot to the Surgery Admissions entrance. This service is offered Monday through Friday from 5:30 am to 10:00 pm. Call to request a shuttle. Or they may enter the main hospital entrance and follow the interior signage to the North Tower to the Surgical Admissions (ASU-North) lobby. Family and visitors may wait in the Surgery Admissions lobby. A guest attendant will be available in this lobby to assist the family with updates. Because this will likely be a long day, we ask that you not bring children to the hospital unless the child is the patient. We offer a free shuttle service from the visitor parking lot to the Surgery Admissions entrance. If you require an overnight stay and would like an adult family member to remain with you, please discuss this with your nurse to assure that adequate accommodations are available. The Vidant Medical Center campus is tobacco free, and this policy applies to all patients, visitors, family and staff. A coffee shop and cafeteria are located in the hospital and are open to visitors for breakfast, lunch and dinner. The coffee shop is open 24 hours a day. CAFETERIA HOURS Breakfast :15 am 10:15 am Lunch :00 am 2:00 pm Dinner :00 pm 8:00 pm Internet access Vidant Medical Center offers wireless Internet access throughout the medical center. Feel free to take advantage of this service to check A gift shop is located near the hospital s main entrance. You may purchase flowers, cards, candy and other items. your and keep in touch with family, friends and work. The main hospital cafeteria is located off the corridor to the North Tower. 10 VidantHealth.com The Service League Interfaith Chapel is located to the left of the hospital s main entrance.

11 THESE FORMS CONTAIN IMPORTANT INFORMATION ABOUT YOUR CARE. PLEASE KEEP THEM IN THIS FOLDER. BRING THIS FOLDER TO YOUR PATIENT TESTING CENTER APPOINTMENT AND TO THE HOSPITAL THE DAY OF YOUR SURGERY. VISIT OUR WEBSITE Find helpful resources for patients, family and visitors at VidantHealth.com. Click on Patients and Families and find information on the following: Billing and online payments CarePages Financial assistance Health care decisions regarding advance directives Maps and directions Patient care services wireless internet, dining options and parking Patient, family and visitor information handbook Patient privacy Patient rights Visiting hours

12 Mission Vision To enhance the quality of life for the people and communities we serve, touch and support Where incredible people provide incredible care... every day Values Excellence... our standard Compassion... our distinction Teamwork... our advantage Education... our investment Innovation... our future Vidant Medical Center 2100 Stantonsburg Road PO Box 6028 Greenville, NC VidantHealth.com 11-SU /12

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