Todays Coaches

1
(No Transcript)
2
Doris Hamm, RNOrthopaedic and Neurology
NurseBenefis Healthcare
Todays Coaches
3
Your Other Coaches

• Pain Service Pharmacist
• Physical Therapist
• Occupational Therapist
• Unit Case Manager
• Welcome to our winning team.

4
Pre-Game Schedule

• Spine Surgery Background and Statistics
• Benefits and Goals of Spine Surgery
• Before Surgery and Day of Your Surgery
• Your Surgery
• Your Hospital Stay
• Going Home
• Questions Answers
• Class Evaluation

5
Today youve received your Folderpacked with
education and other information you will need
throughout your stay, discharge and home
care.Remember to bring your folder with you on
your surgery day
Education Folder
6
Spine Surgery Facts

• Reasons for spine surgery
• Provide substantial improvement in pain,
  functional status and overall health-related
  quality of life in most patients
• Over 500,000 spine surgeries performed in the
  United States in 2004

7
Spine Surgery at Benefis

• 2004 391 spine surgeries
• 2005 591 spine surgeries
• 2006 600 spine surgeries
• 2007 600 spine surgeries

8
The Playing FieldThe Ortho/Neuro Unit

• 8th Floor of East Campus
• 26 beds for backs, bones, and brains
• Mix of private and semi-private rooms
• All staff wear name badges
• Dry Erase Boards Special Needs Card in all
  rooms
• Pastoral Care staff available

9
Located in your room. A tool to track your
progress, goals, and discharge needs.
White Board
10
Benefits and Goals of Spine Surgery

• Reduces or eliminates pain
• Resuming many of your normal activities
• Getting back to work/play

11
Youve decided spine surgery is the ticket to a
more active future.Heres YOUR gameplan
PRE GAME JITTERS
12

Before Surgery

• Diet and Fluids
• Increase protein (chicken, fish, egg whites,
  turkey,beans)
• Increase fluids by 4-8 glasses per day during the
  week prior to surgery
• Stop Smoking
• Smoking is the 1 reason for non-union of fusion
• Donation of blood
• Pre-Operative lab work

13

Before Surgery

• Diabetics
• Surgical scrub(s)

14
Your Surgery Day
GAME DAY
15
Day of Surgery

• NPO Nothing by mouth
• Includes mints and gum
• No smoking or tobacco products of any kind

16
Day of Surgery

• What to bring to the hospital
• Loose fitting clothes
• Non-Slip shoes/slippers
• Personal toiletries
• Razor (men)
• Button-Up-the-front shirt (cervical procedures)
• BiPAP/CPAP
• Chargers for cell phones

17
Specific Spine Surgery Information
TLSO
CORSET
18
Specific Spine Surgery Information
Miami J Collar
19
Day of Surgery

• Arrive in AM Admit area
• 2nd Floor across from Lab
• Inform anesthesiologist of any previous problems
• Family can remain with you until you go to the
  operating room
• Family can wait in OR waiting area or lobby.

20
Anesthesia Reaction

• Todays anesthesia is safer than ever before
• It is very important to tell both the surgeon and
  the anesthesiologist if you have ever had a
  reaction to anesthesia or pain medication in the
  past

21
More About Your Surgery..
GAME DAY
22
Spine Anatomy

23
Spine Cross-Section

24
Spine Surgery Animations.
GAME DAY
25
After Surgery

• Remain in Recovery Room for approximately
• one hour
• Then transferred to Ortho/Neuro (8th) Floor
• Visiting Hours 8am 8pm
• Access to the hospital after 930pm is through
  the ER entrance

26

Potential Complications of Spine Surgery

• As with all major surgical procedures,
  complications can occur
• Some possible complications include
• Pain
• Side Effects
• Blood clots
• Infection

27
PAIN SERVICE

• Pain Management Specialist Pharmacist Lead
• Becky Allen, PharmD, RPh
• Provides specialized focus on pain control and
• side effect management for patients

28
PAIN SERVICE

• Goals
• Increased Comfort
• Decreased Side Effects
• i.e. nausea/vomiting
• Fewer Complications
• Enhanced Patient Satisfaction

29
PAIN SERVICE

• Patient Responsibilities
• Discussing pain relief options
• Asking for pain relief when pain first begins
• Helping the healthcare team to assess pain
• Talking to your healthcare team about any
  worries/concerns regarding medications

30
PAIN ASSESSMENT SCALE
31
PAIN SERVICE

• Medication and Surgery
• What medications do I take prior to surgery?
• What medications do I stop taking 7 to 10 days
  prior to surgery?
• Blood thinners (Coumadin, Aspirin,
• NSAIDS, Herbals, Vitamin E)
• Decreasing pain medications prior to surgery
• Home medication list, herbals and OTC

32
Controlling Pain

• Some temporary pain after surgery is common
• PCA (patient-controlled analgesia) places you in
  control of your pain relief
• Medications and repositioning will help keep you
  comfortable
• Converting to oral pain medication

33
Using Your PCA/CADD Pump

• The doctor will order the medication and will
  decide how often and how much of it can be given
• You should push the button when you start to feel
  pain
• Do not wait until the pain is severe
• It is very important that only you push the
  button

34
ORAL PAIN PILLS
PRESCRIBED BY PHYSICIAN FREQUENCY AND DOSE
WHITE BOARD PRESCRIPTION FOR DISCHARGE
35
Blood Clots

• After surgery, it is possible to develop a blood
  clot
• Deep Vein Thrombosis (DVT)
• Commonly in the veins of the leg

36
Preventing Blood Clots

• To help reduce the risk of blood clots, your
  surgeon may recommend
• Getting back on your feet as soon as possible
• Take blood-thinning medication

37
Preventing Blood Clots

• Wearing elastic stockings (TED
  Hose)
• Wearing inflatable foot/leg wraps that use air to
  enhance circulation
• Sequential Compression Devices (SCDs)
• A-V Impulse System (AVI)

38
TED HOSE

• For your safety Do Not walk with just TED hose
  on

39
SEQUENTIAL COMPRESSION DEVICES (SCD)

• For your safety Do Not walk with SCDs On

40
A-V IMPULSE
For your safety Do Not walk with AVIs On
41
Infection

• Antibiotics are given
• Before surgery
• 1 to 3 days after surgery

42
Infection Control

• Hand washing by staff
• Use of Antiseptic Hand Gel by staff

43
Your Hospital Stay
Post Game Program
44
Your Hospital Stay

• Diet
• Repositioning in bed
• Neurological checks
• Activity
• Importance of being out of bed
• Physical Therapy 1st day after surgery
• Occupational Therapy 1st day after surgery

45
Length of Stay

• Lumbar Decompression
• Expected hospital stay 1-2 days
• Cervical Fusion
• Expected hospital stay 1-2 days
• Lumbar Fusion
• Expected hospital stay 3-4 days
• Artificial Disk Replacement
• Expected hospital stay 3-4 days

46
Your Hospital Stay

• Turn, Cough and Deep Breath
• Abdominal splinting
• Using your Incentive Spirometer (IS)
• Oxygen

47
Other Activities During Your Hospital Stay

• Elimination
• Lab work
• Bathing/showering
• Incision/drain care
• IV

48
Incision Care

• Your surgeon will direct the nursing staff to
• Keep the incision clean and dry
• Cover the incision with a small dressing or
  bandage if it is draining
• Change the bandage daily or when drainage makes
  it wet

49
Physical Therapy

• Begins the day after your surgery
• Continues throughout your hospital stay
• Getting moving again

50
OccupationalTherapy

• Shower or bathtub needs
• A secure bench
• A long handled sponge
• A shower hose for bathing
• Have an elevated toilet seat
• For dressing have
• A dressing stick
• Sock Aide
• Long-handled shoehorn
• Have a reacher/grabber to pick up objects

51
Home Planning Checklist

• Temporary living area on ground floor if
  difficult to climb stairs
• Have a 2-armed chair with secure cushion and back
• Remove all loose rugs and electrical cords from
  living area
• Secure handrails (safety bars) on
• Stairs
• In shower or bath

52
Discharge Planning

• Dena Sterling, RN Unit Case Manager
• Insurance
• Home equipment
• Nursing Home/Rehab/Home Care

53
Remember to bring your folder with you on your
surgery day
Education Folder
54
Questions?
55
Spine Surgery Animations
Can also be found on our website www.benefis.org