Total Preop Hip Surgery - Enhanced Recovery After Surgery Hip class... · Your hip is most prone to...
Transcript of Total Preop Hip Surgery - Enhanced Recovery After Surgery Hip class... · Your hip is most prone to...
Total Hip Replacement: Enhanced Recovery After Surgery
© 2015 Kaiser Permanente. All Rights Reserved.
What to expect at home
2 © 2015 Kaiser Permanente. All Rights Reserved.
Today’s session
Enhanced Recovery: What’s it all about?
Get ready for surgery and recovery
Questions?
Fifth Agenda
Physician Assistant
Enhanced Recovery After Surgery (ERAS)
3 © 2015 Kaiser Permanente. All Rights Reserved.
ERAS Video
▪ Introduction to ERAS Video
4 © 2015 Kaiser Permanente. All Rights Reserved.
Enhanced Recovery After SurgerySpeed healing and reduce risk of infection
5 © 2015 Kaiser Permanente. All Rights Reserved.
Drink clear liquids &
carb drink until 2 hours
before arrival.
Eat soon after surgery.
Control pain Move sooner Eat & drink
Mixture of medications with less narcotics.
Stay ahead of the pain.
Get up soon after surgery.
We will help you sit, then stand and walk.
Prepare physically and mentally Be your healthiest
▪ Quit tobacco
▪ Be active
▪ Prevent illness, cuts, scrapes, and infections
▪ Sleep well, eat healthy, drink water
▪ Relax kp.org/surgerypodcast
▪ Control blood sugar, if you have diabetes
6 © 2015 Kaiser Permanente. All Rights Reserved.
https://kp.org/mydoctor/hipreplacement
7 © 2015 Kaiser Permanente. All Rights Reserved.
Emmi: Prepare for your surgerySearch knee surgery or hip surgery on kp.org/mydoctor
8 © 2015 Kaiser Permanente. All Rights Reserved.
Enhanced Recovery Prevent infections before surgery
9 © 2015 Kaiser Permanente. All Rights Reserved.
Mouth care Skin care
Going home
▪ When?
– Patients are able to go home on the day of surgery, unless there is a medical need
–Prepare now for transportation and help at home
10 © 2015 Kaiser Permanente. All Rights Reserved.
What’s common at home?
▪ Pain will increase at times
– Take medications on time
– Rest, ice, and elevate leg
– Move your joint, but don’t overdo it
▪ Swelling can be present for months after surgery
▪ Bruising or color changes anywhere on your leg or foot
▪ Not sleeping well for first 2 - 3 months
- Get up and stretch
- Take naps
- Don’t use sleep medications
11 © 2015 Kaiser Permanente. All Rights Reserved.
12 © 2015 Kaiser Permanente. All Rights Reserved.
Care after discharge
You will get a call from orthopedics the day after surgery. Please read your discharge instructions for details.
▪ Call if you have these symptoms
– Fever over 101.5
– Excessive bleeding at incision
– Vomiting or diarrhea
– Uncontrolled pain
– Any Concerns
KP Preventive Carehelps you remember
Try a video visit with your doctor or physical
therapistDownload our app. Talk with your doctor or physical therapist
on your smartphone.
13 © 2015 Kaiser Permanente. All Rights Reserved.
My Doctor Online
PHYSICAL THERAPY
Preparing for and recovering after your surgery
14 © 2015 Kaiser Permanente. All Rights Reserved.
Physical Therapy
▪ In the Hospital right after surgery.
▪ Physical therapy in your home (Home Health Physical Therapy): 24-48 hours after discharge from the hospital.
▪ Outpatient Physical Therapy (at your home facility) begins after you have met your goals with home health physical therapy for further strengthening and return to activities.
15 © 2015 Kaiser Permanente. All Rights Reserved.
Physical Therapy: Hospital Goals
▪ Before you are discharged from the hospital, we will show you how to:
– Get in and out of bed.
– Sit, stand, and walk.
– Climb stairs, if you have them at home.
16 © 2015 Kaiser Permanente. All Rights Reserved.
Positions to avoid
▪ The chances of dislocation is very low.
▪ Your hip is most prone to dislocating the first 4-6 weeks after surgery.
▪ It is OK to bend your hips beyond 90 degrees as long as your knees
are apart and not together.
17 © 2015 Kaiser Permanente. All Rights Reserved.
Positions to Avoid
18 © 2015 Kaiser Permanente. All Rights Reserved.
Acceptable positions
19 © 2015 Kaiser Permanente. All Rights Reserved.
Heel slides
20 © 2015 Kaiser Permanente. All Rights Reserved.
Quad thigh squeezes
21 © 2015 Kaiser Permanente. All Rights Reserved.
Gluteal (buttocks) squeezes
22 © 2015 Kaiser Permanente. All Rights Reserved.
Moving at home
▪ Limit walking to around your home and to appointments until your home health physical therapist sees you
▪ Do your exercises
– At least 3 times a day
▪ Prevent swelling
– Ice and elevate your leg.
– Slowly increase activities
23 © 2015 Kaiser Permanente. All Rights Reserved.
OCCUPATIONAL THERAPY
Preparing your home and equipment to assist with activities of daily living
24 © 2015 Kaiser Permanente. All Rights Reserved.
Think about your home ?
25 © 2015 Kaiser Permanente. All Rights Reserved.
Clear, wide
pathways?
Where will
I sleep?
Where will
I sit?
Good
lighting?
26 © 2015 Kaiser Permanente. All Rights Reserved.
Is your home ready?
√ Wide, clear pathways for walker
√ Remove clutter and things on the floor
√ Bed or recovery area on 1st floor
√ Firm chair with armrests and high back
√ Good lighting between bed and bathroom
√ Grab bars in shower
√ How will you confine pets?
√ Will you have meals prepared or frozen?
Recovering from Total Joint Surgery
27 © 2015 Kaiser Permanente. All Rights Reserved.
Toilet seat frame
- Provides arm rests only to give
you support when seated and
allow you to use your arm
strength to assist in transfers
on and off the toilet
Raised Toilet Seat w/ arms
- Also available without arms
- Decreases the distance your
body has to travel from a
standing to a sitting position,
saving you energy
3-in-1 Commode
- Available with drop arms, with
and without backrest
- Allows for use in a wide open
room
- Can be placed for convenience
to limit the distance you have
to walk to the bathroom
- Bucket can be removed for
placement over bathroom
toilet
http://www.ableforlife.com/Bathroomsafety.html
Recovering from Total Joint Surgery
28 © 2015 Kaiser Permanente. All Rights Reserved.
Bath Bench for tub showers
-eliminates the need for balance and
strength to step over the tub side
- makes transferring into the shower
easy and safe
Shower Chair for walk-in shower
stalls
- Provides a safe place to sit
while washing hard to reach
areas of the body
- Decreases the energy it
requires to take a shower
Handheld shower head
- Makes sitting while showering
easier as you are able to
control the direction and
pressure of the water
http://www.ableforlife.com/Bathroomsafety.html
Total Joint Kit
▪ Sock aide
▪ Reacher
▪ Elastic shoe laces
▪ Long handled shoe horn
▪ Long handled bath sponge
29 © 2015 Kaiser Permanente. All Rights Reserved.
30 © 2015 Kaiser Permanente. All Rights Reserved.
Is your helper ready?Plan to have help for 2 weeks consistently
▪ Prepare meals.
▪ Help keep your spirits up.
▪ Do laundry and chores.
▪ Take care of family and pets.
▪ Run errands. Drive you to and from appointments.
▪ Help with medications, icing, and elevating.
▪ Help with mobility and daily activities.
PATIENT CARE COORDINATOR
Equipment, coverage and assistance at home
31 © 2015 Kaiser Permanente. All Rights Reserved.
32 © 2015 Kaiser Permanente. All Rights Reserved.
Discharge planning
▪ What’s my coverage for medical equipment?
▪ Where can I get a walker? Discharge planning department will be calling to order the week before surgery
▪ Skilled nursing care is rarely necessary because patients do better at home.
▪ Resources
33 © 2015 Kaiser Permanente. All Rights Reserved.
To Summarize: Be Prepared
▪ Prepare your body, mind, and home.
▪ Prepare to go home on the day of surgery. Have transportation and help at home ready.
▪ Follow Enhanced Recovery instructions.
▪ Actively participate in rehab to return to your usual activities.
▪ Good luck with your recovery and please remember to read your discharge instructions!