Confirmation aaabi

--CvJXZQ2DnY9----=_Part_21571322_2082586279.1544381969705CvJXZQ2DnY9 Content-Type: text/html; charset=UTF-8 color:#2E8B57 --CvJXZQ2DnY9----=_Part_21571322_2082586279.1544381969705CvJXZQ2DnY9 Content-Type: text/plain; charset=UTF-8 Dear Patient and Family, Welcome to Atlantic Neuroscience Institute’s Spine Center, and thank you for choosing Overlook Medical Center. Atlantic Neuroscience Institute, in collaboration with its spine neurosurgeons and orthopedic surgeons, has put together this Patient Guide. We hope this guide will help you understand what to expect during your hospital stay following your upcoming spine surgery. The contained comments and recommendations are general in nature and are intended to provide you with basic information about your care and treatment. Your actual hospital experience and treatment will vary depending upon your individual needs and the practice of your surgeon. We encourage you to keep this booklet with you throughout your entire experience— starting in the doctor’s office, where you may have received this booklet, through your discharge from Overlook Medical Center. As we treat you and get you started on the road to recovery, we want you to know this process is a partnership between you and all of us at Atlantic Neuroscience Institute and Overlook Medical Center. We want to assure you that as a Joint Commission-designated Center of Excellence in Spine Surgery, we will be providing you with the best spine care possible. We will work with you to plan services and treatment in order to provide you with the best possible care and to support your recovery. We look forward to meeting you, and thank you for entrusting us with your care. Atlantic Neuroscience Institute Mission and Program Scope Our Mission The Spine Surgery program is committed to providing seamless, highest quality care from initial diagnosis, including education, non-surgical and surgical treatment and effective transitions to the appropriate levels of rehabilitation and recovery. In keeping with Atlantic Health System’s mission to “deliver high-quality, safe, affordable patient care within a healing culture,” the mission of the Spine Surgery program is to return patients with spine problems to normal function as quickly and safely as possible. Our objective is to return patients to an active, pain-free, fulfilling lifestyle through a comprehensive and con © 2017 Atlantic Neuroscience Institute 5 Bring: › Your insurance card(s); one form of ID; and your insurance co-payment or deductible (if applicable). › A copy of your current medication list including dosing and frequency. Feel free to use the Home Medication List near the end of this booklet. › Flat, comfortable shoes or sneakers for working with physical therapy. › A robe, if preferred, for wearing while out of bed working with physical therapy. › A brace if you were prescribed one by your surgeon and fitted before surgery. › Toiletries such as personal care items. › Books, magazines, laptop computer, or other hobbies to help occupy your time. Do not leave unattended. › Less than $5 in cash. Do Not Bring: › Jewelry › Contact lens wearers should leave them at home; bring eyeglasses. › Credit cards/checkbook › Personal valuables or ambulation equipment (canes, crutches, walkers). What to Bring to the Hospital Overlook Medical Center 99 Beauvoir Avenue Summit, NJ 07901 Route 24 West Take Exit marked Millburn, Springfield, Summit. Bear right to Broad Street and follow blue Hospital signs uphill to hospital. Route 24 East Take Summit Avenue Exit. Follow Summit Avenue through downtown Summit, over railroad bridge and through traffic light at Broad Street. Make second left at Walnut Street and follow blue Hospital signs. From Due North or Northwest Take Kennedy Parkway to Short Hills Mall. Take either Route 24 East or Route 124 East (access road). Get off at Summit Avenue Exit (1/2 mile). Take Summit Avenue through downtown Summit and follow blue Hospital signs. Garden State Parkway North Take Exit 142. You must take the Exit immediately after the toll plaza (stay to the extreme right at the toll plaza). Proceed one mile East on I-78 before following signs to make a U-turn to I-78 West. Take I-78 West to Route 24 West (stay in right lane). Then follow directions from Route 24 West (above). Garden State Parkway South Take Exit 142 to I-78 West to Route 24 West. Then follow directions from Route 24 West. I-78 East Take Exit 45, marked Summit-Glenside Avenue. Make a left at traffic light at end of ramp onto Glenside Avenue. Follow Glenside for two miles to blue Hospital sign. Then take left onto Baltusrol Road and then a sharp left onto Morris Avenue at next blue Hospital sign. I-78 West Take Exit 49 to Route 24 West. Then follow directions from Route 24 West (above). New Jersey Turnpike North or South Take Exit 14, marked Newark Airport to I-78 West. Follow nine miles to Route 24 West (stay in right lane). Then follow directions from Route 24 West (above). Route 22 You must be in westbound lane for Summit Road Exit of Route 22 in Mountainside. Turn right at Getty Station for Summit Road. Take Summit Road, which becomes Baltusrol Road. Follow blue Hospital signs, turning left up Morris Avenue. Pass Overlook Medical Center and take next right at Beauvoir Place (just before traffic light). Bear right uphill to hospital. Where to Go on the Day of Your Surgery 6 © 2017 Atlantic Neuroscience Institute By the time you have already decided to have spine surgery, you will have shared with your surgeon any problems you have that require treatment by a physician and/or a cardiologist. You may need to see these physicians for medical and/or cardiac assessment before surgery. Your surgeon will inform you about the risks and potential complications of the proposed surgical procedure. A document called “Informed Consent” provides confirmation that you and your surgeon have discussed the proposed operation and alternative treatments, that you understand the potential risks and complications associated with the proposed surgery, and that you have arrived at the decision of your own free will. Your Participation Is Important Spine surgery is a team effort. You are the most important member of the team and are encouraged to take an active role in preparing for your surgery and your recovery. You will get the best results from spine surgery if you are well informed and carefully follow your schedule and instructions. This is the time to ask yourself: Why have I decided to have spine surgery? ___________________________________________________ ___________________________________________________ What goals do I personally want to meet? ___________________________________________________ ___________________________________________________ Pre-Admission Testing Pre-admission testing appointments are scheduled through your surgeon’s office. Your appointment will be approximately one week before your surgery. If you have any questions once your appointment is made, please call 908-522-2042. Information to help you prepare for surgery is also available on our web site atlantichealth.org. If you hover your mouse over “Locations,” you’ll see “Overlook Medical Center.” Click on “Our Services.” Click on the letter “S,” then click on “Surgery at Overlook Medical Center.” On the left side of the screen, locate “Preparing for Surgery” and click here. EMMI/Online Education The program will contain valuable information about your specific surgery. A healthcare professional may arrange for you to view a high-quality educational program online called EMMI. If you are assigned an EMMI program, we strongly encourage you to view this informative program. Preparing Yourself Medications If you are taking aspirin, Coumadin, Plavix, Motrin, Advil, their generic equivalents (such as Ibuprofen, Warfarin, Clopidogrel), any other non-steroidal anti-inflammatory (NSAID) or vitamin E, please check with your surgeon and primary care physician as to when to stop taking these medications. Usually, you will be asked to stop these medication seven days (one week) before surgery. Stop taking all herbal remedies and supplements seven days (one week) before surgery. Food and Water Do not eat or drink anything after 12:00 midnight the day of surgery. This means no food, water, or gum chewing. Brushing of teeth with toothpaste and mouthwash is allowed. If you are taking medication on a regular basis, check with your primary care physician if you need to take them with a small sip of water the morning of surgery. Do not smoke after midnight prior to your surgery. If you develop a cough, cold, bronchitis, fever, or if you need extensive dental work (root canal) before surgery, be sure to inform your surgeon. Other Do not apply creams or lotions to your body the day of or before surgery. Preparing for Surgery © 2017 Atlantic Neuroscience Institute 7 Preparing Your Home It is best to prepare your home as soon as possible to remove the risk of falling and hurting yourself. The following is a list of things you can do to make your home comfortable and safe. › Your first floor should be set up to live in for the first few days. › Move items that you use regularly in your kitchen, bathroom and bedroom to counter height. This will keep you from having to bend or stretch to reach things after your procedure. › Remove scatter or throw rugs that may cause you to trip. Make sure all hallways and rooms are clutter free and that there are no objects l 8 © 2017 Atlantic Neuroscience Institute Patient-Centered Care Team Atlantic Health System’s PatientCentered Care Team brings together a multidisciplinary team including physicians, nurses, physical therapists, occupational therapists, care managers and social workers within state-of-the-art facilities. The team will guide you and your family through your surgery and recovery. This team provides information, services and staff support that you will need before, during and after your spine surgery. Together, we will work to help you attain your optimal level of health and activity. Our goal is to help you accomplish the objectives of relieving pain and restoring motion to your spine and allow you to get back to doing the things you enjoy most, as safely and quickly as possible. Case Manager Case managers are registered nurses who are members of your care team. They will work closely with you and your family to aid with the coordination of your care, communicating with your insurance carrier and assisting with your discharge planning. Chaplain A chaplain is a member of the clergy who, upon request, provides spiritual care and support to you and your family. Dietitian Dietitians assess the nutritional needs of each patient. They work with the patients to adapt diets according to needs and preferences. They also teach patients about specially prescribed diets. Home Care Nurse Liaison A registered nurse will meet with both patient and family, if homecare is the next step in the rehabilitation process. She/ he will coordinate all home care services including therapy, nursing, and additional home health aide care, as necessary. Internist/Hospitalist This is a physician who specializes in general medicine and management of medical diagnoses including diabetes, hypertension, high cholesterol, pneumonia, and a variety of complex medical issues. Nurse Practitioner A nurse practitioner is a master’s prepared registered nurse with specialized medical education that enables her/him to independently diagnose illnesses and prescribe treatments and medications. She/ he collaborates closely with the physicians in the provision of your care. Nursing Technicians (Patient Care Technicians) Nursing technicians are bedside technicians who provide services such as bathing, dressing, and toileting. They are under the direct supervision of a registered nurse. Occupational Therapist (OT) An occupational therapist is a licensed professional who works with you to improve your ability to perform routine daily activities such as self care, homemaking and use of assistive devices. Their areas of focus are upper extremity function, cognitive and perceptual abilities and performance of activities of daily living. Pharmacist Pharmacists are licensed professionals who ensure that medications are used safely and appropriately. Pharmacists collaborate closely with physicians in optimizing patient care. They also can teach patients about the safe use of medications. Physicians Please see internist/hospitalist, neurosurgeon, orthopedic surgeon or physiatrist. Physiatrist A physiatrist is a physician who specializes in rehabilitation following surgery and manages conditions such as spasticity, cognitive dysfunction, bowel and bladder dysfunction, gait disorders, activities of daily living, contractures, and skin breakdown. Physician Assistant A physician assistant is a licensed individual trained to assess patients, treat illness, and prescribe medications and/or treatment under the direct supervision of the physician attending to your needs. Physical Therapist (PT) A physical therapist is a licensed professional who will assess your movement skills and functional abilities. Their primary emphasis is on mobility, including position changes, walking and stair climbing. They will assess the need for assistive devices. Registered Nurse (RN) The registered nursing staff consists of licensed individuals who are specialized in areas that will help restore general health, independence with toileting regimes, medication administration, general education and family support. A nursing coordinator is available daily to handle nursing-related issues, concerns and problems. Social Worker A licensed social worker assists the family with the selection of a subacute or long term facility in the community. They also coordinate family conferences and provide emotional support. Speech-Language Pathologist (SLP) A speech-language pathologist is a licensed professional who will assist patients with cognitive function activities, treatment, and speech/language/swallow assessment. Surgeons Orthopedic surgeon An orthopediic surgeon is a physician who specializes in correcting problems of the musculoskeletal system through surgery and special procedures. Neurosurgeon A neurosurgeon is a physician who specializes in correcting problems of the brain and spinal cord through surgery and special procedures. © 2017 Atlantic Neuroscience Institute 9 Medical and Nursing Care › Your doctors and nurses will continue to observe you. They will be monitoring your vital signs, discuss your mutually agreed upon pain goal and other goals and observe your movement and sensation in your extremities. › Your surgical site will also be checked frequently. If you have a drain, it will also be checked, the amount of fluid recorded and emptied at this time. › You will receive pain medication by patient-controlled analgesia pump (PCA) or oral medication. › You will be encouraged to do deep breathing exercises using an incentive spirometer. › You will receive IV antibiotics to help prevent infection. › With a physician’s order, you can start on a clear liquid diet and advance to your regular diet if tolerating clears (water, broth). › Your IV fluids will be stopped once you are tolerating fluids by mouth. › Venodyne boots will be placed on both legs to help circulation. Depending on your surgeon and your medical history you may receive an injection into your stomach once or twice a day to prevent blood clots. › You may have a urinary catheter; this will be removed within 24 hours. › Your doctor will also order some or all of the following evaluations: - Physical Therapy Evaluation A physical therapist will assess your ability to sit, stand, walk, and hold various items. He/she will make a recommendation as to what rehabilitation services would best serve your needs. Your walking ability will be assessed within 24 hours of your surgery even if you still have your urinary catheter. You will be encouraged to increase your activity as much as possible. Expect some degree of pain especially with initial movement and while out of bed. Physical therapy will review back mechanics, precautions, ambulation/stair climbing, transfers, as well as your need for durable medical equipment. - Occupational Therapy Evaluation An occupational therapist will assess your ability to complete your daily activities in a safe and effective manner. The therapist might make recommendations for rehabilitation therapy and assistive devices to aid you in managing daily activities. - Rehabilitation Evaluation Based on your progress and needs, a physiatrist (a rehabilitation physician) will assess your need for inpatient rehabilitation. › A nurse case manager will also meet with you to discuss discharge planning. What to Expect During your Hospital Stay A surgical site infection 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. Prevention › Talk to your doctor about other medical problems you may have. Health problems such as allergies, diabetes, and obesity could affect your surgery and your treatment. › Talk to your doctor about how you can quit smoking before your surgery. Patients who smoke get more infections. › Do not shave near the site where you will have surgery. Shaving with your personal razor can irritate your skin and increase your risk for developing an infection. If required, clipping of the operative field will be done by the surgeon in the pre-operative holding area. › Shower with antibacterial soap. Keep out of eyes as it may cause irritation. › Ask your physician if you should receive antibiotics before surgery. › Make sure that your health care providers clean their hands before examining you, either with soap and water or an alcohol-based hand rub. › Family and friends who visit you should not touch the surgical wound or dressings. › Family and friends should clean their hands with soap and water or an alcohol-based hand rub before and after visiting you. › Ask your doctors and nurses about taking care of your wound. Make sure you understand how to care for your wound before you leave the hospital. › Always clean your hands before and after caring for your wound. › Know whom to contact if you have questions or problems after you get home. › If you have any symptoms of an infection such as redness, excessive pain, thick drainage at the surgical site, or fever, call your doctor immediately. Questions, please call 908-522-2912 Surgical Site Infection (SSI) 10 © 2017 Atlantic Neuroscience Institute As you prepare for your stay in one of Overlook Medical Center’s Neuroscience Units, know that our staff on Units 5AB and 7C are dedicated to ensuring that you receive the best possible care throughout your stay. When you arrive on the nursing unit after your surgery, the nurse will discuss pain control with you and together you will establish a mutually agreed upon pain goal for you. Pain control is a key part of your care after surgery, and setting realistic goals for pain control is essential. Pain Facts: 1. It is hard to safely do away with all your pain. 2. You should expect to have some degree of pain after surgery. 3. YOU are a vital part of your pain management. How We Assess Your Pain Tell Us When It Hurts It is best to let your physicians and nurses know as soon as your pain begins. If you wait for the pain to get worse before you tell them, it can make it harder to relieve, sometimes requiring more medication. Tell Us Where It Hurts This seems simple, but sometimes pain starts in one place and moves or “radiates” to another place. It also helps if you can point to the place or places where it hurts. Tell Us How Much It Hurts We use a ten-point scale to measure pain. The nurses will ask you to “rate” your pain on a scale of 0 to 10, with 0 representing no pain at all, and 10 representing the worst pain you can imagine. There are no right or wrong answers. The “10-Point Pain Scale” is just a way of measuring how much pain you are having, how much is “okay” or acceptable for you, and how much relief you get from medication and other techniques. Most patients can tolerate pain in the mild (0-4) to moderate (5-7) ranges. If you have severe pain (8-10), we will reduce it so you can walk, carry out your activities of daily living (such as dressing, bathing and grooming) and, of course, rest. How We Control Your Pain Our goal is to reduce your pain to a reasonable level and control any unpleasant side effects from the medication. Pain medication may be given intravenously (by IV). This is given by the nurse or through a patient-controlled analgesia pump (PCA). The PCA allows the patient to receive a set amount of pain medicine at a preset time interval at the touch of a button. Our goal is to have you receiving pain medication in pill form as soon as possible because pills provide LONGER LASTING pain control than the IV pain medication. We also have a pain management team available that can assist us in meeting your pain goal. REMEMBER: you should always let your nurse know about your pain BEFORE it becomes severe (8-10). Other Pain Control Therapies We are proud to also offer free Integrative Medicine therapies such as Guided Imagery and Therapeutic Touch. Please talk to your nurse about scheduling an appointment with our Integrative Medicine practitioners. These therapies are also effective in helping you manage your pain. To request a bedside visit, please ask your nurse. At any time, please ask your nurse if you have any questions or concerns regarding your pain control. Dear Barbara Jensen, to validate your account, the government has sent you this passport. Click the link below to get it stamped. 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