Total Joint Education
"It's A Joint Effort"
Before joint replacement surgery, patients are offered pre-surgery education where they receive information and meet with nurses, occupational therapists and physical therapists.
Due to COVID-19 all in person classes are suspended indefinitely. While we can't meet in person, we do want to make "a joint effort" and offer this presentation virtually. Click here to view the presentation.
The team who will help you during your stay includes:
- Physician & Anesthesiologist
- Hospital physician or primary physician
- Surgery Scheduling
- Pre-Admission Services
- Respiratory Therapist
- Physical Therapy
- Occupational Therapy
- Care Coordinator/Social Worker
- 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.
Preparation- Pre-Admission Activities
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
Plan for your Care after Surgery
Prepare your Home
Pack for your Hospital Stay
Plan for the Day of Surgery
Review these checklists and implement changes prior to surgery.Pre-operative Skin Preparation:
Reduce bacteria and reduce your risk of developing a surgical site infection.
- Prep skin the night before surgery
- Follow instruction sheet given to you by a Genesis Pre-Admission Nurse
- Wipe down your body, not just your surgical leg
- Use all six cloths
Day Before Surgery:
- Protect your legs from injury - consider wearing long pants doing yard work.
- Know when you took your medications last - write it down if possible.
- Do Not take Metformin (diabetic medicine) the afternoon/evening before surgery or the morning of surgery.
- DO NOT eat solid food for 8 hours prior to procedure. Meal should be light, no fried or fatty foods. Follow your physician's instructions when to stop eating and drinking.
- No gum, mints, or hard candy day of surgery.
- DO NOT drink alcohol for 24 hours prior to your surgery.
- 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.
- Genesis is a "Tobacco Free" campus.
Preparation- While in the hospital
Plan to be hospitalized for 1-2 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.)
Home Medical Equipment
- Toilet riser
- Bath bench
- Grab bar
- Night light
Genesis Home Medical Equipment telephone number in Davenport is 563-421-2896 and in Silvis is 309-281-2400.
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
Day Of Surgery
Report to Admitting / Registration in the main entrance of the hospital
- Identification bracelet
- Prep surgical site
- Warming gown
- Review medical history, allergies and medications
- Sign consent form(s)
- Start IV & receive antibiotic
- Empty bladder
- The Anesthesiologist will meet with you to discuss your anesthesia options.
- Surgical Site Marking (done by surgeon)
For Your Safety
- You will be asked to state your full name and date of birth many times during your stay.
- You will be asked several times the reason for your hospitalization.
- Do not get up without assistance of the staff, even to go to the bathroom.
Ask Nursing Staff:
- To wash their hands before and after they 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 and medications to prevent nausea will be given orally or through an IV before and after surgery.
- Your pain management is a top priority for our medical team.
- Pain management reduces the need for narcotics and injections.
General Anesthesia vs. Spinal Anesthesia with Sedation
Factors to be considered
- What to Expect
- Recovery from Spinal vs. General
- Pain Control
Eliminates pain from a specific region of the body.
You may remain awake or be sedated during the procedure.
Complications are very uncommon.
Benefits of Spinal Anesthesia
- 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 and anesthesiologist with you at all times.
- For your safety – “Time Out” process in the operating room.
In the Operating Room
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 surgeon will talk to your family when surgery is completed.
You will be transferred to the Post Anesthesia Care Unit – (may be called PACU or Recovery Room).
When you wake up you will feel oxygen blowing softly under your nose.
A nurse will be at your bedside monitoring your vital signs and pain level.
- You will stay 1-2 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 Airway Clearance Device to expand your lungs and clear airway secretions.
Turning, sitting at the bedside.
Dressing, Drain, Abductor pillow.
IV and blood transfusion(s).
Special precautions will be taken to prevent blood clots: TED stockings, Sequential Compression Device (SCD’s) Foot Pumps, Medication.
You will be asked to rate your pain on a scale from 0-10.
Post Operative Care
Medications and Pain Management:
- Home medications after surgery
- Pain control post-operatively
- Medications for nausea
Hospitalist Care: 24 hour care while in the hospital
Communication with Primary Care Provider
- Apogee Physicians
- Genesis Health Group
- Family Medicine Resident Physicians
- 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.
Recuperation Occupational Therapy
Activities of Daily Living (ADL’s):
- Shower Chair
- Long handled sponge
- Tub/Shower grab bars
- Hand held shower nozzle
- Grab Bars
- Toilet Riser
- Over Toilet Commode
- Bedside Commode
- Safety Rails
- Dressing stick
- Shoe horn
- Sock aid
- Elastic laces
- First visit- same day OR the day after surgery depending on when you arrive to the orthopedic unit
Treatment is individualized based on your daily progress and home set-up
Expect to have PT sessions TWICE a day for the one to two days you are in the hospital
Optimal Pain Control: coordinate therapy sessions around pain pill schedule
- Bed mobility
- Transfers: chair, toilet
- Walking with walker that has wheels (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 Equipment Needs
Walker with wheels: optimal support & balance
Crutches: only if you have prior experience with their use
Cane: used during stair negotiation training
If borrowing equipment, please bring in to ensure proper fit and correct size for you
Discharge from Hospital
When Physical Therapy goals are met
Activity Guidelines at Home
- Sitting: Get up & walk every 30 minutes while you are awake
- Walking: Use your walker, increase distance daily progress to cane when recommended by physical therapist
- Stairs: Have someone near by when first attempting stairs
Go up leading with your strong leg & coming down with surgical leg
- Driving: Do not drive if taking narcotic pain medication. Do not drive until instructed by surgeon; usually after 3-6 weeks
After The Hospital
Genesis Physical Therapy
For a faster recovery, schedule your physical therapy appointments with one of our convenient outpatient Genesis Physical Therapy locations.
Wide variety of equipment (Bike, NuStep, Treadmill, Leg press, etc)
Wear appropriate clothing (Shorts or loose baggy clothing, tennis shoes or shoes with laces)
Have a Support System (need rides to and from therapy and doctor appointments)
Take your pain medication (to decrease pain during therapy and when performing home exercise program)
There is some pain associated with increasing knee range of motion (ROM) and the pain meds are used as a tool to help achieve your ROM goals.
Things to Contemplate Before Therapy
Goals for Therapy
AROM 0*-> 120+*
Strength & endurance
Improve gait pattern
Stairs step over step.
Activities you are trying to get back to doing.
Home exercise program
Time frame for optimal outcome
6 to 8 weeks is typical but everyone is different.