Your admission for day surgery

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1 Royal Berkshire NHS Foundation Trust London Road Reading Berkshire RG1 5AN (switchboard) West Berkshire Community Hospital London Road, Benham Hill Thatcham Berkshire RG18 3AS Your admission for day surgery Adult Day Surgery Unit (ADSU) Royal Berkshire Hospital (RBH) Reading ADSU_491 ADSU / Pre-operative Assessment, April 2014 Review due: April 2016 West Berkshire Community Hospital (WBCH) Thatcham Useful information for patients 12

2 This booklet contains useful information and advice for patients coming in for day surgery under general or local anaesthetic. If you have any queries or concerns, please speak to a member of staff. For your notes Who to contact If there is any change in your health between your pre-operative assessment and the date of your surgery, or if you are unsure whether to take any regular medication before you are admitted, please contact the hospital you are being admitted to and discuss with a nurse: Pre-op Assessment Clinic (RBH): or West Berkshire Community Hospital (WBCH) on /3/4. Please contact the Waiting List Office by telephone, if: - There is any change in your personal information (address, telephone number, change of GP); - You decide not to undergo your planned surgery; - You go for your surgery elsewhere; - You wish to change the date of your surgery. *WBCH Waiting List Office: / 5 *Orthopaedic Waiting List Office: /7379/7569/8432/8974 *General Surgery Waiting List Office: /8158 *Urology Waiting List Office: *Eye Surgery Waiting List office: *Maxillofacial Waiting List Office: * Nurse to indicate correct number 11

3 If for some reason this is not possible then you will be given the letter to convey to your GP at your earliest opportunity. Any medication which has been prescribed for you will be given along with verbal instructions on how to take it. The nurse will also give you information and advice regarding followup appointments, removal of stitches, care of your wound etc. Returning to work This depends on what your job involves and the type of surgery you have had; your doctor can advise you. If you need a medical certificate (sick note) for your employer, please ask the nurse before your operation. During the first 24 hours following your discharge If you have any further concerns about your surgery, please telephone: ADSU: Tel: / 8215 or Fax: WBCH: Tel: / 3 / 4 or Fax: If you need help or advice outside the opening hours (page 6) please telephone your community duty GP After 24 hours, please seek advice from your own GP. For more information about the Trust, visit our website 10 Blood tests and medication Please have your blood test within 1 week*/ 2 weeks* of your admission date. *(Pre-operative assessment nurse to delete as appropriate). Remember to take the request form given to you at preassessment. You can have your blood test done at the Pathology Department in the Royal Berkshire Hospital or West Berkshire Community Hospital. The Trust no longer provides basic pain relief medicines, such as Paracetamol or Ibuprofen for patients to take home. Please ensure that you have a supply of these painkillers at home to take following your discharge. If stronger pain relief is required, then it will be provided. If you have an allergy to these medications please discuss with your own doctor before your admission. You will also need to bring in any medicines that you take regularly in the original packaging. Before you come in It is important that you make arrangements for a reliable adult to: - To be available to come and collect you at the time requested by the day surgery staff on the day of your admission, and who must be available to look after you for 24-hours following your discharge from hospital. - Receive discharge advice and information about your care at home. - Take you home by private car or taxi, as you will not be able to drive yourself home, travel on public transport or unaccompanied in a taxi. Failure to ensure you have a designated reliable adult to act on your behalf and care for you as described above may mean that your surgery is cancelled. 3

4 If you wish, at ADSU, your relative or friend may stay with you during your admission; however, space is limited and other patients privacy has to be observed. At WBCH we do not allow relatives or visitors into the ward area as there is a serious shortage of space; however after admission, the patients are welcome to sit in the waiting area until they are called down to theatre. Please read your Coming into hospital booklet and surgery information. Please follow the instructions given to you by the preoperative assessment nurse. Anaesthetic Your operation will be carried out under general or local anaesthetic. For further information see the Coming into hospital booklet. You will be able to go home the same day unless there are any difficulties with the surgery or with your recovery. In these cases you will then be transferred to a ward until you are ready to go home. WBCH patients who require an overnight stay will have their surgery at RBH. There are no facilities for staying overnight at the community hospital. Patients who do not recover sufficiently, or have a problem, will be transported by ambulance to RBH. Length of stay You will normally be in hospital several hours post operatively but it will depend on which operation you have, the type of anaesthetic and the amount of time you take to recover. You will not normally see the surgeon after your operation unless he/she has a particular reason to visit you. After your operation Anaesthesia Please be aware that the drugs used in general anaesthesia can stay in your system for 24 hours and can cause tiredness and lack of concentration. Therefore, for 24-hours following your discharge you must not: Go to work; Drive a car or any other motor vehicle; Ride a bicycle; Operate any machinery or electrical equipment (including kettles and cookers); Make any important decisions or sign any documents; Drink alcohol; Make yourself inaccessible to the person who is looking after you. Please ensure that they have easy access to a telephone in case of an emergency. Discharge home The unit nursing staff will continue to assess your progress until they are assured of your fitness to go home. They will then discuss discharge information with you and your escort; please tell the nurse if you have any concerns or questions. If we have contact with your GP on our computers, a letter explaining your care will be ed to them. 4 9

5 Please tell the nurse if you have any special requirements or anxieties about your operation. You will then be seen by the surgeon or a member of their team, who will discuss the proposed operation with you. The anaesthetist who will be looking after you during your operation will also visit you to discuss your anaesthetic. Going into theatre You will walk with a nurse to the anaesthetic room where you will be asked to remove your dressing gown and slippers and to lie on a trolley. If you feel that you may have difficulty walking to the anaesthetic room, please discuss your concerns with your nurse. Recovering after your operation You will wake up in the recovery suite where you will be looked after by a recovery nurse. You may be given oxygen to breathe and regular recordings of your blood pressure and oxygen levels will be made. The nurse will also ask you about pain and monitor your wound if applicable. When the recovery nurse is satisfied with your progress they will report information about the operation, anaesthetic and observations to a day surgery nurse. You will then be transferred on the trolley back to the unit by a porter, accompanied by your day surgery nurse. When you are back on the unit, nursing staff will continue to monitor your progress. If you feel well enough, you may be offered fluids and light foods. You may also be seen by other healthcare staff, such as physiotherapists, depending on your operation. 8 Admission times and pre-operative nutrition information For directions please refer to the map provided in your pre-operative information booklet (ADSU) or additional leaflet for WBCH patients. *7.30 / *8 am admission: Please remember, you must not have anything to eat after 2.30am. However, you should continue to drink clear fluids until 6.30am on the morning of your admission. Please plan your travel into hospital so that you arrive at the day unit no later than *7.30 / *8am The operating list will commence at *8.30 /*9 am 11am admission: Please remember, you must not have anything to eat after 5.00am. However, you should continue to drink clear fluids until 9.00am on the morning of your admission. Please plan your travel into hospital so that you arrive at the day unit no later than 11.00am *12.30 / *1 pm admission: Please remember, you must not have anything to eat after 7.30am (this means you may have a light breakfast on the day of admission). However you may have clear fluids only to drink until 11.30am. Please plan your travel into hospital so that you arrive at the day unit no later than 12.30pm. The operating list will commence at *1.30 / *2pm. * (Pre-operative nurse to delete as appropriate) Clear fluids Clear fluids include: water, black tea and black coffee (a small teaspoon of sugar or sweetener is permitted), well diluted squash (but not fruit juice) you should be able to read newsprint through it. Please do not suck sweets or chew gum on the day of your operation. Failure to follow these instructions will cause a delay in your surgery or your surgery being cancelled. 5

6 What to bring with you Please have a bath or shower before your admission, and wear loosefitting clothes, and flat comfortable shoes. Small lockers are available for your clothing. Please bring with you: - A clean dressing gown and slippers; - Something to occupy your time, e.g. book, newspaper, The contact telephone numbers for your next of kin and your escort. Personal property: Please leave valuable items at home, i.e. large sums money, expensive jewellery etc. The Trust is not liable for and does not take responsibility for damage to, loss or theft of your private property. Where to go ADSU is situated on Level 3, South Block, Royal Berkshire Hospital and can be accessed by using the lifts or stairway leading from level 2; please refer to the map provided in your information pack for directions. WBCH Day Surgery Unit is situated on the first floor, and accessed via the main entrance; please refer to the map provided in your information pack for directions. About Day Surgery Units The Day Surgery Units are open as follows: RBH from 7.30am to 10.00pm (Mon-Fri), 7.30am to 4.00pm (Sat). WBCH from 8am to 6pm (Mon-Fri). Both units are for adult patients undergoing various types of surgery. The Adult Day Surgery Unit consists of five bays with a mixture for up to 33 trolleys and 2 chair spaces. The WBCH Day Surgery Unit consists of 12 trolley spaces and 6 reclining chairs as a step down area. There are 2 single wards. Patients stay for varying lengths of time, depending on the type of surgery and anaesthesia. There is only a small number of staff working on the unit. They work as a team to provide continuity of care. We all hope to make your stay with us as pleasant as possible. Accommodation The Day Surgery Units are mixed gender wards but we nurse male and female patients in separate bays. There are also separate toilet facilities. We rarely have to mix patients; if this is likely to happen, you will be told on admission. Patients at WBCH are told prior to admission regarding mixed gender facilities. The ward is split between male and female patients, but there is no wall dividing the areas. There are two side rooms available if necessary. Please speak to staff if you have any concerns. Getting ready for your operation You will be shown to your trolley or chair and asked to change into an operating gown and your hospital identification band will be applied. A member of the nursing staff will then ask you a few routine questions and record your blood pressure, temperature and any other observations that may be needed. 6 7

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