Total Joint Camp - Genesis Medical Center, Davenport

The team who will help you during your stay includes:

• Physician & Anesthesiologist
• Surgery Scheduling
• Pre-Admission Services
• Nursing
• Dietitian
• Social Worker
• Physical Therapy
• Occupational Therapy
• Home Medical Equipment representative

We want to help you to:

• Have a POSITIVE surgical experience
• Achieve YOUR goals with the best results

This class will:

• Properly prepare you for the day of surgery.
• Help you better understand typical procedures and equipment.
• Enhance your physical recovery.
• Allow you to return to your usual “Activities of Daily Living” (ADL’s) as quickly as possible.

You will be contacted by a Pre-Admission Nurse to:

• Schedule pre-surgical testing
• Obtain medical history
• Verify medications
• Discuss equipment needs and discharge plan
• Discuss safety issues at home after surgery

Before Surgery:

• Home Safety Checklist
• Day Before Surgery Checklist
• Checklists are included in your packet Please review and implement changes prior to surgery.

Day Before Surgery:

• DO NOT eat solid food for 6 hours prior to procedure. Meal should be light, no fried or fatty foods. Water, black coffee or clear tea (no cream or milk) may be taken up to 2 hours prior to procedure.
• DO NOT drink alcohol for 24 hours prior to your surgery.
• DO NOT smoke after 8 p.m. the night before your surgery. (Remember, Genesis is a “Tobacco Free” campus)
• DO NOT bring valuables, money, or jewelry. All jewelry and body piercings must be removed.
• CALL your doctor if you are ill or have a fever.
• Bring CPAP or BiPAP machine to hospital.
• Bring Blood Band with you to the hospital.

Plan to be hospitalized for 1-3 days.

How long you are hospitalized will depend upon:

• How well you have met your goals
• General health, physical strength
• Available assistance (spouse, family, friends)
• Structural barriers (stairs, 1st floor bathroom, bedroom, etc.)

• Facilitate discharge by 11:00 a.m.
• Equipment needs for home, in-home therapy.
• Outpatient therapy
• Explore facilities for short stay after hospitalization for therapy.
• Advanced Directives
• Identify who is available to help you 24 hours a day for several days if needed.
• Contact Social Worker for questions or concerns at 563-421-1083.

Potential Purchases:

• Walker
• Toilet riser
• Bath bench
• Reacher
• Grab bar
• Night light

Genesis Home Medical Equipment telephone number is 563-421-2896.

Nutrition Before Surgery

A well balanced diet with lots of variety is important.

• Review nutrition information in packet.

Meal Prior to Surgery:

• Avoid eating a heavy meal prior to your surgery.
• Instead, eat a light, low fat meal to minimize nausea & vomiting
• Stay hydrated.

Nutrition For Diabetes:

It is important to have your glucose in good control.

If you take medication that lowers your blood sugar, have items ready for when you get home:

• Regular soda
• Hard candy
• Carbohydrate choice
• Keep the above items easily accessible at all times

Nutrition In The Hospital:

There is no specific diet for joint repair patients. Depending upon your recovery, your diet may advance as follows:

• Clear Liquids – broth, tea, gelatin, & juices
• General Diet – well balanced diet to maintain good health
• Alert staff to special dietary needs

Nutrition At Home:

Needs can generally be met by eating a well balanced diet. If extra nourishment is needed, you may try:

• Carnation Instant Breakfast
• Boost
• Ensure

Report to Outpatient Care Center in Pavilion 1:

• Identification bracelet
• Check of history, allergies, review medications
• Sign consent forms
• Prep surgical site
• Start IV & receive antibiotic
• Empty bladder
• The Anesthesiologist will meet with you to discuss your anesthesia options.
• Surgical Site Marking (done by surgeon)

Ask Me:

• To wash my hands before & after I care for you.
• To check your name and birth date before performing any tests or treatments.
• To verify the name of any medication & confirm that it is for you.
• To check if you believe you are about to receive the wrong medication or test.
• To help you with your pain.
• If there is anything you do not understand.
• If you have any concerns about your care or treatment.

Pain Management Protocol:

• Pain medications will be given orally or through an IV before and after surgery.
• Your pain level is an extreme concern to our medical team.
• Pain management reduces the need for narcotics and injections.

Spinal Analgesia:

• Spinal Analgesia eliminates pain from a specific region of the body.
• The patient may remain awake or be sedated during the procedure.
• Complications are very uncommon
• Increased level of pain control
• Decreased nausea and vomiting
• Fewer breathing problems
• Lower level of heart problems
• Decreased drowsiness

Positions for Spinal Anesthesia:

• Your family will be shown where to wait while you are in surgery.
• There will be a nurse with you at all times.
• For your safety – “Time Out” process in the operating room

Transport To The Operating Room:

In The Operating Room:

• The OR will feel cold and is full of “unusual” looking people and equipment.
• All the strange things you see in the OR are for your safety and to ensure your procedure goes as smoothly as possible.

Anesthesia Equipment Used In The Operating Room:

Anesthesia machine is equipped with monitoring devices and supplies used to keep you safe and comfortable during your procedure.

Operating Room Environment:

• The operating room will be cool, we have plenty of warm blankets.
• The room may be a little noisy as the staff are busy getting the supplies ready for you.
• You will notice bright lights.
• Your surgeon and the staff assisting during your procedure will be wearing a helmet with a face shield to help protect you from infection.

• Your family will be notified when surgery is completed.
• You will be transferred to the Post Anesthesia Care Unit – (Recovery Room or may be called PACU).
• When you wake up you will feel oxygen blowing softly under your nose.
• A nurse will be at your bedside monitoring your status and pain level.

Recuperation:

• You will stay 1-3 days in a private room. Each room has Wi-Fi, and cable TV.
• Therapy and nursing care will take place in your room on the Orthopedic unit.

Post Operative Nursing Care:

• You will learn to use an Acapella Airway Clearance Device (pickle) to expand your lungs & clear airway secretions.
• Turning, sitting at the bedside.
• Dressing, Drain, Abductor pillow, and CPM.
• IV and blood transfusion(s).
• Special precautions will be taken to prevent blood clots.
• You will be asked to rate your pain on a scale from 0-10.

Medications and Pain Management:

• Home medications after surgery
• Pain control post-operatively
• Medications for nausea
• Antibiotics

Hospitalist Care:

• Cogent Physician – 24 hour care while in the hospital
• Communication with Primary Care Provider

Occupational Therapy:

• Occupational Therapy focuses on self-cares: bathing, dressing, toilet transfers and tub/shower transfers.
• These activities will be reviewed with you during your stay to ensure safety with these activities prior to your return home.
• OT sessions will be 1x/day until goals are met.

Occupational Therapy- Activities of Daily Living (ADL’s):

Bathing/Showering Shower

• Chair
• Long handled sponge
• Shower grab bars
• Hand held shower nozzle

Dressing

• Reacher
• Dressing stick
• Shoe horn
• Sock aid
• Elastic laces
  

Physical Therapy:

• Initial visit- same day OR day after surgery depending on doctor.
• Discuss home setup, equipment needs & goals to return home.
• Treatment is individualized based on goals & daily progress.
• PT sessions: twice a day during the week.
  

Treatment Focus

• Bed mobility
• Transfers: chair, toilet Walking with walker or crutches (100-150 ft)
• Home exercise program
• Total knee range of motion
• Stair negotiation
• Car transfer - total hip patient
• Family training
• Education: hip precautions & weight bearing restrictions
  

Physical Therapy Related Equipment

• CPM (Continuous Passive Motion Machine)
• Gait Belt
• Goniometer
• Pain Management
• Proper footwear/loose clothing
  

Discharge from Hospital 

When Physical Therapy goals are met (1-3 days).

Next Phase

Outpatient therapy, In-home therapy skilled nursing care with continued therapy.

Genesis At Home:

Physical Therapist

• Assess safety of home environment, progress exercises for joint strength and range of motion, advance mobility to return to prior activity level.

Occupational Therapist

• Assess ability to complete basic activities of daily living and assist in achieving independence. Recommend and provide adaptive equipment.

Skilled Nurse

• Assess surgical site, assist in medicine and pain management, complete home blood draws.

Home Health Aide

• Assist with bathing and personal care

Genesis Outpatient Physical Therapy Options:

• Bettendorf Genesis Medical Park, Maplecrest
• Davenport Outpatient Rehabilitation, Lombard
• Davenport Outpatient Rehabilitation, Valley Fair
• DeWitt Genesis Medical Center, DeWitt
• Eldridge Outpatient Rehabilitation, Eldridge
• LeClaire Outpatient Rehabilitation, LeClaire
• Moline Outpatient Rehabilitation, King Plaza
• Moline Outpatient Rehabilitation, Two Rivers YMCA
• Physical Therapy and Sports Medicine
• Silvis Genesis Medical Center, Illini Campus
  

Outpatient Rehab:

• Wide variety of equipment
• Wear appropriate clothing
• Have a Support System
• Take your pain medication
• Time frame for optimal outcome

Things to Contemplate Before Therapy

• Goals for therapy
• Functional activities
• Compliance