Total Joint Replacement Class

Before Your Surgery

Pick up throw rugs

Count and measure stairs and tighten

handrails

Install a riser or handrails in the bathroom

Find the easiest way to enter with

a walker

Use an armchair when you return home

Pre-Surgery Clinic 1st Floor, Pavilion

Calls you 1-2 weeks before your surgery

Records your health history, including any allergies, and a list of

home medications

Provides Hibiclens

anti-bacterial wash

Performs nasal swab to screen for MRSA

Conducts lab work and testing based on personal history or physician orders

Packing

Comfy clean clothes

Toiletries Short robe Throat lozenges or hard candy

Cell phone, laptop, books,

magazines

Insurance card and medication list

CPAP Non-slip shoes/slippers

Night Before/ Morning Of Surgery

Refrain from eating and drinking after

midnight, including gum and mints

2 Hibiclens showers: 1. Night before surgery 2. Morning of surgery

Use clean clothes/clean sheets

after shower

DO NOT take any diuretics

Check with your doctor to see if you should take any medications the morning

of surgery

No creams, powders, deodorant, make-up,

etc. after showers

Arriving for Surgery

Report to Pre-Op (2nd Floor, Main

or 3rd Floor, Pavilion) Change into

hospital gown

Several people will ask, “What

are we doing today?”

The surgeon and anesthesiologist

will visit

Surgery time: 1.5-3 hours Designate a

spokesperson Provide Advance

Directive if available Start using Pain

Scale to rate pain

Infection Control

• Evening before surgery – Apply the anti-bacterial soap received from pre-surgery

testing. – Follow the directions on the packet/bottle. – Be careful, the soap may make the bottom of shower

slippery. – Do not apply soap to face or genitals.

• IV antibiotics – Receive your IV 30 min before incision and possibly for

24 hours after surgery. – Antibiotics reduce your risk for infections. – Make sure we know all of your allergy information.

Pharmacy

Anti-coagulation

• Blood clot prevention – Foot pumps – Activity – Medications

• Rivaroxaban (Xarelto), Warfarin (Coumadin), Enoxaparin (Lovenox), aspirin

• Medications are typically given for 3-6 weeks. • Missed doses may increase your risk for blood

clots.

Pharmacy

Pain Management

• You will be asked to rate your pain on a scale of 0-10 (10 is the worst pain imaginable) – Medications are given based on your pain level. – Oral medications take 30-40 minutes to work and last 3-4 hours. – IV medications take 5-15 minutes to work and last

1-2 hours. • Consider taking medication 30-40 minutes before

therapy sessions. • Take medication with food to avoid nausea. • Laxatives may be needed for constipation.

Pharmacy

Recovery Room

IV fluids for hydration

Oxygen tubing

Recovery Room time: 1 to 2 hours

Total Joint Replacement Class

Post-Surgery Equipment

Knee: Hip:

CPM

Polar Pack

Abductor Pillow Ice Bag

Drain Compression

Hose

Always call for assistance with getting out of bed.

Call. Don’t Fall.

Orthopedic Unit

All patient rooms are private with

private bathrooms

Each patient is assigned a nurse and a tech

Nurses will review your care in your room at each shift change

Nursing staff work 12-hour shifts

(7 a.m.-7 p.m. and 7 p.m.-7 a.m.)

Nurses will perform safety rounds every

1-2 hours

Diet

Start with a clear liquid or light diet

Order food from the Room Service Menu

between 7 a.m.-7 p.m. Dial 3663 (FOOD)

Include adequate fiber, protein and

fluid intake

Bowel routine of stool softeners

or laxatives

Your Care

Use your incentive

spirometer 5-10

times/hour to exercise your lungs

Sit on the side of your bed with assistance the

night of surgery

Bedside commode – 8 hours to

urinate after

surgery

Wear your gait belt every time

you are out of bed

Lovenox injections or other

blood thinners will be

started the day after surgery

Your Care

IV lines and drains will be

addressed daily as necessary

Take a sponge bath at the sink

Get out of bed for all meals. Breakfast in bed is overrated.

Your Care

Surgical bandages are changed to light dressing

Dress in your own clothes for comfort

Your discharge day will be based on your progress

Physical Therapy (PT)

Begins the day of or

morning after surgery

Scheduled for each day and

individualized to the patient

You will use a two-wheeled

walker for safety and

proper walking pattern

Request pain pills 45 minutes before

scheduled PT time

Order breakfast items each night for morning delivery so you can eat

before therapy

Physical Therapy (PT)

Goal of therapy: Work on mobility, strength and range of motion

Your doctor may order weight bearing restrictions

or other precautions

Always use your assistive device when standing or walking

Occupational Therapy (OT)

Teaches you how to safely move to the toilet,

shower and tub

Teaches you dressing and bathing techniques and offers suggestions on adaptive equipment you may

want to use at home

Social Worker

Determines your needs for home

and checks insurance coverage

Orders and schedules delivery of necessary

equipment

Arranges for home health

…or a rehab facility

Patient Partner Program

We encourage you to take part in our Patient Care Partner Program. Please let your nurse know when you arrive to the unit if you are interested in participating (available on 9HSP only).

Designated Care Partners encourage and comfort their loved ones during their hospital stay. They help their loved ones remember care instructions and remind them to perform breathing and ankle pump exercises throughout the day.

Care Partners also learn how to assist their loved ones with daily care and mobility for a safer transition at home. A staff member must always assist patients out of bed during their hospital stay.

Discharge Day

Discharge by 2 p.m. You can ...

Avoid rush hour traffic

Fill prescriptions Settle in before dinner time

Contact your doctor with questions (weekdays)

What Goes Home? Please keep:

You will take the items below if your surgeon ordered them for home use and they were delivered by an outside company:

Home Health (if needed)

Begins the day after you go home

Reviews all your medications

Performs a home safety assessment

Begins physical therapy

Outpatient Physical Therapy • We will give you a prescription for your

preferred outpatient therapy clinic. • You can make your own therapy appointment,

or ask your social worker for help while you are in the hospital.

• Keep in mind that scheduling depends on the clinic’s availability.

• If you and your surgeon make a plan for outpatient therapy before your surgery, call your preferred clinic ahead of your procedure to schedule your first post-surgical appointment.

Odds and Ends

You will not need a card to show TSA

at airports

Ask your doctor about the need to take antibiotics

before dental procedures

You should not need a handicap parking permit

Questions?

Ask your surgeon or primary care physician about specific medications. They are the experts in your individual health history and will know what is best for you.

Call one of the following departments if you have other questions. (Identify yourself as an upcoming Total Joint Replacement patient):

Pharmacy 816.691.5215 Physical and Occupational Therapy 816.691.1795 Social Work 816.691.8300 Pre-Admission Testing 816.691.1344 Orthopedic Nursing Unit (9HSP) 816.691.1997