Having Inpatient Surgery at Toronto Western Hospital

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1 Having Inpatient Surgery at Toronto Western Hospital TWH Name of surgeon: Phone: Preadmission appointment date: Time: Check-in: Preadmission Unit Toronto Western Hospital, 399 Bathurst St. Main Pavilion 1 st floor (Room 406) Phone: Surgery date: Time to arrive at the hospital: Time of my surgery: Check-in: Preoperative Care Unit (POCU) Toronto Western Hospital, 399 Bathurst Street Fell Pavilion 2 nd floor (Room 116) Phone: , extension 2111 For more information, call our recorded help line: Please visit the UHN Patient Education website for more health information: University Health Network. All rights reserved. This information is to be used for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider for advice about a specific medical condition. A single copy of these materials may be reprinted for non-commercial personal use only. Authors: Josephine Tung, RN, Beth Twigg-Damato RN and Bruna Curti RN, BScN-MSDU Revised: 10/2016 Form: 2345

2 Important: We will do our best to keep your surgery on time. But, we may need to delay or reschedule your surgery in case of an emergency. If we need to reschedule your surgery, we will let you know and give you the new date and time. Preadmission What is a Preadmission appointment? The Preadmission clinic will review your medical history and help prepare you for surgery. Your surgeon will decide if you need to have a Preadmission appointment. Before the Preadmission appointment: You must let your surgeon s office know as soon as possible if you have diabetes and take insulin. This is very important. Your family doctor must complete the Preadmission program Pre-Operative History and Physical Examination Form. You must bring this form with you to your Preadmission appointment. Your family doctor should also include any recent tests you had (for example, stress test, echocardiogram or sleep study test). You must also complete the Pre-Operative Patient Questionnaire and bring it with you to your Preadmission appointment. Your appointment may take 3 to 6 hours. Drink and eat as you would normally before this visit. Your surgeon may schedule you for this depending on your medical history. 2

3 During this appointment: Different health care professionals (such as a nurse, pharmacist, researcher, endocrinologist or anesthesiologist) may check your health and review your medical history with you. You may have a blood test. You may have an x-ray or an ECG. You may need to go to a class to learn more about your health problem. You may have other tests (such as eye ultrasound). If you are having orthopedic surgery you may need to attend physiotherapy classes. If you need to go to a Preadmission appointment, you must bring: Your health card (OHIP card) Your completed Preadmission package which includes the Pre-operative History and Physical Examination Form and the Pre-Operative Patient Questionnaire. All the medicines you take in their original bottles or a list of all the medicines you take. Make sure the list includes the name of the medicine, how much you take and how often you take it. 3

4 Preparing for my surgery How do I prepare for my surgery? The day before your surgery: Do not drink any alcohol for at least 24 hours before your surgery. Eat a light meal the evening before your surgery. Avoid eating fried food. Do not eat any solid food after midnight. This includes chewing gum or candy. You can drink clear fluids like water, apple juice, ginger ale, 7 Up, clear broth, clear tea or coffee with no milk or cream up to 5 hours before your surgery. For example if your surgery is scheduled for 11:00 am you may drink clear fluids up until 6:00 am. Don t drink anything after this time. Do not have any dairy the morning before surgery (this includes no milk or cream after midnight). You must be able to see through the liquids you're drinking. You may shower or bathe, rinse your mouth and brush your teeth before your surgery. Do not smoke for 5 hours before your surgery. 4

5 Follow any other special instructions your surgeon or nurse asked you to do at home. Remove all: nail polish, shellac, gel, or fake nails from fingers and toes makeup contact lenses (wear your glasses to the hospital) jewelry and body piercings must be removed If you can t remove your jewelry, have a jeweler remove or cut it off. Remove your Medic Alert chain if you have one. You can write the information on the chain on a piece of paper and give it to your nurse the day of your surgery. If all your jewelry isn t removed, your surgery may be cancelled. Before you come to the hospital, please bring: Your health card (OHIP card) All the medicines you take in their original bottles A small amount of toiletries (toothbrush, toothpaste, comb, bath soap) Loose fitting pajamas and a change of clothes in an overnight bag A book or magazine in case there is some extra time before your surgery hearing aids, dentures and glasses if you need them (they are removed before your surgery) only a small amount of cash Your family or friends can bring anything else you need to your room after your surgery. 5

6 Important: Leave all your jewelry and valuables at home. The hospital is not responsible for lost or stolen items. What if my health changes before surgery? If you don t feel well or if there are any changes in your health (for example, you have a cold, flu or other illness), please call your surgeon as soon as possible. The morning of your surgery: Don t take your medicines or insulin the morning of your surgery, unless your doctor or nurse said it s ok. You can take the medicines below with a little sip of water. Medicines I can take: 6

7 The day of my surgery What is the Preoperative Care Unit (POCU)? The POCU is where you go just before your surgery. Here, your nurse, anesthesiologist and surgeon talk to you and prepare you for your surgery. Once you re ready, we take you to the operating room. Come to the hospital and check-in at the POCU 2 to 3 hours before your surgery. Check the front of this booklet. If you are late, your surgery may be cancelled or your surgery time may be given to another patient. What can I expect when I arrive to the POCU? 1. A receptionist checks you in. 2. They will ask for your health card (OHIP card) to make sure they have the right information. 3. We put a hospital identification band on your wrist. We will double check the information on your band with you. 4. They will give you a hospital gown, pajama bottoms, a robe, hair cover, and slippers to change into. A family member or nurse can help you if you need assistance. 5. Your nurse checks your blood pressure, pulse, temperature, and breathing. They review your chart to make sure all the important information is ready. 6. Your nurse checks to see that you removed your jewelry, nail polish, underwear, dentures, hearing aids, and eyeglasses. Friends or family members can be with you while you wait to go to the operating room. In some cases you may have time to relax before surgery. You may want to bring a book or magazine to help you relax. 7

8 What can I expect in the patient holding area? When the operating room is ready, a staff member takes you to the patient holding area. Here, your operating room nurse, anesthetist, and surgeon have a short talk with you before we take you to the operating room. Depending on the type of anesthesia or block you receive (such as a spinal or regional block), you may have to start in the block room and then move to the operating room. Once you go into the operating room, we ask your family and friends to wait for you in the surgical waiting room on the 2nd floor. What can I expect in the operating room? We help you onto the operating table and put a cuff on your arm that will check your blood pressure. We also put an oxygen monitor on your finger and attach you to a machine that will check your heart rate. We then give you the anesthesia. We give you this medicine so you are relaxed or asleep during your surgery. What can I expect after my surgery? Post-Anesthetic Care Unit (PACU) When your surgery is over, we take you to the PACU to recover from the affects of the surgery, anesthesia and pain medicine. This is a large room with many other patients. You may be here for 30 minutes to 3 hours. The time will depend on the kind of surgery you had. 8

9 In the PACU: Your nurse checks you often as you recover from the anesthesia. You may have an oxygen mask over your mouth and nose. Your may get medicine for any pain or nausea. Your family will not be able to come visit you. But if you would like to speak with your family, you may ask your PACU nurse or volunteer to use a telephone service that we have available to you. When you are ready, we take you to the Inpatient unit where a bed has been saved for you. The surgical nursing unit or Inpatient unit: You will complete your recovery from your surgery in the Inpatient unit. The nurses here will continue to check how you are recovering and give you pain medicine when you need it. Other members of your health care team will help look after your needs. Depending on the type of surgery you have, you may have to do physiotherapy and occupational therapy exercises. When you are ready to go home, the nurses will give you an information booklet about how to care for yourself at home. You may be given a prescription that you will need to take to a pharmacy. There is a Shoppers Drug Mart in the hospital where you can fill the prescription. If you have insurance, bring the insurance card you need to cover the cost. If you need home care or physiotherapy, your surgeon or health team will arrange this before you go home. Phones and TVs are available in the Inpatient unit. You can order them once you are settled in your room. 9

10 Visiting policy: Please keep in mind that you need to rest after your surgery. We encourage only 2 visitors at a time. UHN has an open visiting policy on all units. Notes and special instructions for me: For more information visit our website at 10

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