Welcome to Underwood-Memorial Hospital. Although we recognize that a surgical experience may be an anxious time for both you and your loved ones, we are committed to making your experience as positive as possible. We are pleased you have chosen our hospital for your surgery. Our staff will provide you with the highest quality care.
Our entire staff follows the highest care standards to assist your recovery. Our goal is patient satisfaction in a friendly, quiet, and comfortable setting.
We encourage your questions and feedback on how we can improve your stay. Please ask if there is anything we can do to assist you or your loved ones during this experience. You are our priority.
These instructions are for your comfort and safety. It is very important to follow them carefully so that your surgery will not be cancelled or delayed.
Before Your Surgery
The day before your surgery, your surgeon's office will give you the time to report for surgery.
All patients undergoing surgery at Underwood are required to have a responsible adult drive them to and from the hospital. Also, please make arrangements to have someone stay with you for the first 24 hours at home.
Important Items to Remember:
* If you are taking blood thinners, aspirin, diet pills, vitamin E, fish oil, or herbal supplements, call your surgeon and/or physician for further instructions
* Stop diet pills or herbal supplements two weeks prior to your surgery and/or procedure.
* Please be sure to tell the surgeon and the Pre-Admission Testing nurse ALL of the names of your pills.
* Do not drink or eat anything after midnight the night before your surgery--this includes gum, candy, and water. The only exception may be if the nurse tells you to take your regularly prescribed medications with a small amount of water.
* If you smoke, try to avoid smoking for at least 24 hours before surgery.
Not following these instructions may cause your surgery to be cancelled or postponed. If you have any questions about these guidelines, please don't hesitate to call your Pre-Admission Testing nurse, 856.845.0100, ext. 2317, or your surgeon's office.
The Day of Your Surgery
On the day of your surgery, dress in light, loose clothing. Button- down shirts are preferable to pullovers, especially if you are having shoulder surgery. Loose, pull-up pants are ideal. Do not wear makeup, nail polish, jewelry, hair spray, perfumes, body piercing, or contact lenses.
Please Bring:
* Identification such as a driver's license or photo ID
* A list of all of your current medications including prescriptions, non prescriptions, over-the-counter, vitamins and herbal supplements
* An eyeglass case if you wear your glasses to the hospital
* Your crutches, if you have already been fitted for them
Please Do NOT Bring:
Valuables of any sort. Please leave your wallet, cash, credit cards and jewelry at home.
When arriving at the hospital on the day of your surgery, enter through the main lobby entrance on Red Bank Avenue. The Information Desk staff will direct you to the Admissions Office where you will check in. At this time, the admission paperwork will be done and you will receive an identification band for your wrist.
If Your Child is the Patient
All children, 18 years of age and under, must be accompanied by their parent or legal guardian on the day of surgery. Please bring two forms of identification. If you are a legal guardian, you will need to bring your legal papers.
The guardian must remain with the patient for the entire hospital stay. Because you will need to be able to give your full attention to your child who is undergoing the surgery, please do not bring other small children with you.
Children often take their cues from adults they trust. You can help your child feel safe by staying calm. The staff will also help you and your child feel at ease by showing and explaining things, answering questions, addressing any concerns, and doing their best to put all of you at ease.
You will be able to stay with your child until he or she enters the operating room. When your child's surgery is complete, you will be notified and taken to your child's bedside in the recovery room. This is very comforting to the child-- and to most parents.
You may also want to follow these other guidelines:
* Explain what to expect
* Encourage questions
* Discuss the reason for the surgery
* Bring a favorite toy or book
* If your child uses a "sippy cup" or bottle, please bring one
What to Expect on the Day of Your Surgery
Holding Area
In the holding area, the hospital staff will check your ID band and chart and start an intravenous (IV) line. All staff members will check your name, procedure, physician, and allergies. This will happen many times during your hospital stay.
The anesthesiologist will review your medical history with you and explain what anesthesia will be used. You will be asked to sign a consent form for anesthesia. If you have any questions regarding your anesthesia, the anesthesiologist will be glad to answer them. You may be given some light sedation to relax you at this time.
Enclosed is a copy of the consent form that you will be asked to sign. Please review it and if you have any questions, call the anesthesia office, 856.845.0100, ext. 2353 or ext. 2357.
Operating Room
A nurse from the operating room will greet you in the holding area and escort you to the operating room. This nurse will remain with you during the entire surgery.
Post Surgery - Stage 1
After your surgery, you will be moved to the Post Anesthesia Care Unit (PACU). The usual stay in Stage 1 is one to two hours. In Stage 1, the hospital staff will monitor your blood pressure, pulse, and breathing. They will also check your incision area and intravenous fluids.
It is common to be confused, have blurred vision, a dry mouth, and a chilly feeling when you first awake up. Your comfort is important to us so if you need anything, please let the staff know. You will be asked to rate your level of pain on a scale of 0 - 10. Your pain will be managed as needed.
You will remain in Stage 1 until you are awake and your condition is stable. Your family will be kept informed of your progress. A minor must have a parent or guardian with them in the PACU.
Patients to be Admitted after Surgery
When you are transferred to a hospital room, the nurse caring for you will make sure you are comfortable and continue to monitor your condition.
Post Surgery - Stage 2
Outpatients Only
The second phase of your post operative care will occur in the ASU (Ambulatory Service Unit). You will be given something to drink, be assisted into a chair, and get dressed to go home.
Before discharge, you and your family will receive verbal and written instructions. If the physician leaves a prescription for you, you will receive it at this time.
To assure that you get home safely, you must have a responsible adult drive you home. Taxis and buses are not acceptable. It is strongly recommended that someone stay with you for the first 24 hours. You may have to limit activities such as heavy lifting, bending, straining, or driving until your surgeon allows you to resume full activity. Let your responsible adult caregiver take care of you.
Contact your surgeon at any time if you have any problems or questions following your surgery
When You Get Home
Medicines
You may have pain or nausea during the first few days after your surgery. These symptoms are not unusual and your surgeon will prescribe medicine to relieve your discomfort. Please take the medicine as directed-- do not wait to let the pain or nausea become too severe.
If you are staying at Underwood, be sure to report your symptoms to your nurse promptly. Pain after surgery is normal and will diminish as healing occurs, but the medicines are very helpful initially. Good pain control will allow you to recover more quickly. Remember to request your pain medicine as soon as your pain begins to recur.
Breathing Exercises
After your surgery, you will be asked to do breathing exercises to help prevent lung problems. Exercises may include deep breathing and coughing.
These may be performed as follows:
* Exhale normally and then take a deep breath in through your nose
* Purse your lips and exhale completely through your mouth
* Rest and repeat
* Follow with coughing. If you have had abdominal surgery, hold your incision with a pillow, blanket, or your hand and cough
Activity
Anesthesia can remain in your body for a day or more. You may feel fine but you may not have complete control of your abilities. It is very important that you:
* Do not drive or operate heavy machinery
* Do not take any medicine without your surgeon's approval
* Do not drink any alcoholic beverages
* Do not sign any legal documents
Your surgeon will determine what activities you can do following your surgery. If you have any questions about what you should avoid, your surgeon will be glad to answer them.
Diet
After surgery, patients generally start with clear liquids and progress to regular foods. Your normal diet will gradually be resumed as ordered by your surgeon.
Important Things to Remember
* Carefully follow the printed instructions given to you by your surgeon
* Make a follow-up appointment with your surgeon-and keep it
* Have your prescriptions filled immediately
* Take your medicine as instructed by your surgeon
* Keep your bandages clean and dry and change them as instructed by your surgeon
* Carefully perform any treatments as instructed by your surgeon
When to Contact Your Surgeon
After leaving the hospital, call your surgeon immediately if you have any of the following symptoms:
* Any signs of bleeding
* Fever greater than 100°F
* Changes in your incision such as increased pain, excessive swelling, redness, discoloration, or any unusual drainage
Do not hesitate to call your surgeon if you have any concerns or questions.
Surgical Site Infections
Frequently Asked Questions about Surgical Site Infections
What is a surgical site infection (SSI)?
An SSI is an infection that occurs after surgery in the part of the body where the surgery took place. Most patients who have surgery do not develop an infection.
What are the signs of an SSI?
* Redness and pain around the area where you had surgery
* Drainage of cloudy fluid and /or foul odor from your surgical wound
* Fever greater than 100°F
Can SSIs be treated?
Yes. Most surgical site infections can be treated with antibiotics. The antibiotic given to you depends on the bacteria (germs) causing the infection. Sometimes patients with SSIs may need wound care or another surgery to treat the infection.
What does the hospital do to prevent SSIs?
* Staff clean and sterilize all equipment used for surgery.
* Surgeons clean their hands and arms up to their elbows with a special soap to kill germs just before surgery.
* Staff clean your skin at the surgical site with a special soap to kill germs just before surgery.
* Staff clean their hands with soap and water or an alcohol based hand rub before and after caring for each patient.
* Staff may remove some of your hair from the surgical area immediately before your surgery using electric clippers.
* Staff may wear special hair covers, masks, gowns, and gloves.
* You may be given antibiotics, 60 minutes before your surgery and these should be stopped within 24 hours after your surgery.
What can I do to help prevent SSIs?
Before Surgery:
* Be sure to tell your doctor about other medical problems you may have. Other health problems such as allergies and diabetes could affect your surgery and your treatment.
* Quit Smoking. Patients who smoke get more infections. Talk to your doctor about how you can quit before your surgery.
* Do not shave near the area where you will have surgery. Shaving with a razor can irritate your skin and make it easier to develop an infection.
* Ask if you will get antibiotics before surgery.
After Surgery
* Make sure that your doctors and nurses clean their hands with soap and water or an alcohol based hand rub before and after examining you.
* Visitors should also clean their hands with soap and water or an alcohol based hand rub before and after visiting. Visitors should not touch the surgical wound or dressings.
If you do not see someone clean their hands, please ask them to do so.
What do I need to do when I go home from the hospital?
* Make sure you understand how to care for your surgical wound. Your doctor or nurse will explain what you need to know and allow you time to ask questions.
* Always clean your hands before and after caring for your wound.
* Call your doctor immediately if you have any signs of a surgical site infection such as:
* Redness and pain around the area where you had surgery
* Drainage of cloudy fluid and /or foul odor from your surgical wound
* Fever greater that 100°F