Wolfson Children’s Hospital Outpatient Surgery Guidebook 800 Prudential Drive Jacksonville, Florida 32207 904.202.8000 POPS Pediatric Outpatient Services (POPS) wants to make your child’s surgical care safe, comfortable and as convenient as possible. The information provided in this booklet will help you and your child prepare for the upcoming procedure. About Our Facilities We offer two locations for your child’s surgery: SAN MARCO BLVD 1 Wolfson Children’s Hospital 800 Prudential Drive Jacksonville, Florida 32207 904.202.8838 1 BA P T IST D O WN TO W N A ND W OLF SO N C HI LD R EN’ S HO SP IT A L 2 Children’s Ambulatory Center Baptist Outpatient Center 1235 San Marco Boulevard Jacksonville, Florida 32207 904.202.7280 GARY ST CHILDREN’S WAY BAP T IST O UT PAT IE NT CEN T ER PALM AVE DANTE PL 2 NIRA ST Free Parking • Garage A on Palm Avenue serves Wolfson Children’s Hospital. • A surface lot for the Children’s Ambulatory Center is located in front of the Baptist Outpatient Center. Internet Access • Free Wi-Fi is available throughout Baptist Health. • Free Internet access and computers are available in the Library for Healing, located on the first floor of the main hospital. Baptist is Smoke- and Tobacco-Free Smoking and tobacco product use is prohibited at all Baptist Health properties, including all buildings, parking lots, garages and grounds. Wolfson Children’s Hospital Outpatient Surgery Guidebook 1 PREPARING FOR SURGERY Preparing for Your Child’s Procedure Please call the pre-registration office at 904.202.2280 two weeks before your child’s scheduled procedure. The pre-registration office is open from 8:30 a.m. until 5 p.m., Monday through Thursday and 8 a.m. until 4:30 p.m. on Friday. You will be asked to provide the following: insurance information, your child’s Social Security number, your phone number, the guarantor name, and the name of your child’s primary care physician. If guardianship is with anyone other than the biological or adoptive parent, proof of guardianship will be required. Surgery/procedure may be cancelled if paperwork is not brought to the hospital. Between Now and the Procedure PRE-SURGERY CHECKLIST o Call 904.202.2280 to pre-register 2 weeks before procedure and provide the best phone number to reach me. o Contact my child’s surgeon and provide the best phone number to reach me. o Also inform the surgeon’s office of illness, rash, abrasions. o Make a list of questions for the physician. o Follow eating instructions from staff. o Bring proof of Guardianship, if necessary. You may be called before your child’s surgery to discuss your child’s medical history. If you do not receive a call and are concerned about your child’s past history, please call us at 904.202.8838. If your child develops a cold, fever, sore throat, rash, other signs of illness, or if he or she has been exposed to any type of communicable disease (chicken pox, any type of flu or stomach virus), please call the surgeon’s office immediately because this may increase the risk of infection and surgery may need to be postponed. If you need to cancel the procedure, please call your surgeon/physician as soon as possible. Speak Up If you have questions or concerns it is important to share them with us. Write your questions down and bring them with you so that they can be answered when you meet with the physician/surgeon and/or staff. There is a page in the back of this booklet for “questions to remember.” If you still have questions or concerns, ask again! We don’t mind. It is your right to know! Most importantly, make sure that the surgeon/physician’s office has the best phone number for reaching you before your child’s procedure. Wolfson Children’s Hospital Outpatient Surgery Guidebook 3 PREPARING FOR SURGERY Registration PREPARING FOR SURGERY The Day Before Your Child’s Procedure The surgery schedule is available after 3 p.m. the day before the scheduled procedures. The staff will call you that afternoon with instructions and the time your child’s surgery is scheduled. You can reach us at 904.202.8838 (if the procedure is scheduled at the Children’s Ambulatory Center, please call 904.202.7280). It is very important that we have the correct phone number where you can be reached before this time. There are times when the surgery schedule may change. If this occurs, we will call to inform you of the change and give you new instructions. If your child has just been added the day before to the surgery schedule, we ask that you call 904.202.8838, and give us your contact information. If your child takes medication on a daily basis, please inform the nurse during the pre-op phone call. If possible, make other arrangements for siblings so you can provide the best care for your child. Eating Instructions You will receive eating instructions during the phone call. Generally, your child can eat anything until midnight the day before the scheduled surgery, unless your surgeon/physician has given you different instructions. After midnight, your child may ONLY have these clear liquids: WATER, APPLE JUICE, GATORADE or PEDIALYTE. Any liquids that are consumed other than the ones listed or instructed could mean a delay or cancellation of your child’s procedure. Do not allow your child to have candy, gum, mints or ice chips, which could also delay your child’s procedure. Reducing the Risk for Surgical Site Infection The hospital will: • Give your child an antibiotic prior to the procedure, if ordered by your child’s surgeon/physician. 4 To prevent infection, you will need to: • Do not shave in the area of your child’s procedure within 48 hours of surgery. If needed, your surgeon will clip the hair. • If your child is a diabetic, monitor blood glucose as directed. • Inform your surgeon if your child develops a rash, has a cut/abrasion, bug bite or pimple in the surgical site area. Wolfson Children’s Hospital Outpatient Surgery Guidebook 5 PREPARING FOR SURGERY • Give your child a bath with antibacterial soap (such as Dial) the night before and the morning of your child’s procedure (unless your surgeon/physician has instructed you to use a certain solution or soap). DAY OF SURGERY The Day of Surgery The day before your child’s procedure, you will be provided with a time to arrive at Wolfson for your child’s surgery. If you are not at the hospital at the instructed time, your child’s procedure could be delayed or cancelled. Please consider delays in traffic or unexpected circumstances when you are making arrangements to come to the facility. Please call us at 904.202.8838 (for the Children’s Ambulatory Center, 904.202.7280) if you are running late or delayed for any reason. SURGERY DAY CHECKLIST o Arrive on time. o Bring list of items (see left). o Bring list of my child’s medications for the past 2 weeks. o Let staff know if I am leaving the waiting area and provide a cell phone number. What to Bring DAY OF SURGERY • Non-skid socks or slippers (clean) • Empty bottle or cup • Special feeding equipment • Special suction equipment • Favorite toy or security item • Loose-fitting clothes • Medical history and physical (if requested by your surgeon) • Documentation of guardianship or custody Please Remove From Your Child • All jewelry and piercings • Fingernail polish/artificial nails • Metal hair accessories • Retainers • Contact lens (must be removed before the child is taken back to the operating room) • Any other valuables Wolfson Children’s Hospital Outpatient Surgery Guidebook 7 What to Expect the Day of Surgery When you arrive at our facility, stop by the information desk for directions to register. At the registration desk you will need to sign the admission paperwork before you check-in with the surgical unit. Please check all information on the admission paperwork before signing it (this will help prevent delays after arrival to the surgical unit). Check for the correct spelling of your child’s name, date of birth, address and phone number. DAY OF SURGERY After signing the required documents, you will be directed to the surgical check-in desk. Here, we will collect your admission packet and take you to the dressing rooms. We ask that all children change into a hospital gown before their procedure, unless otherwise instructed. They will be allowed to keep their pajama bottoms and clean socks on until time to go to the operating room, at which time we will ask for them to be removed. The dressing rooms have plastic bags for your child’s clothing items. The check-in process includes: • Weight • Height • Blood pressure • Pulse • Respirations • Temperature • We will ask when and what your child last ate or drank. We will ask specific questions about what was consumed (beverages, time and amount). 8 It is very important that you have a list of all medications your child currently takes or has taken in the past two weeks. While your child is in our facility, you may be asked the same questions over and over again. This is to verify information we received upon your arrival and is for enhanced patient safety. Just before your child goes to the operating room, you will talk to your child’s surgeon and the anesthesiologist. They will verify current information about your child and make sure he or she is ready for the surgery. If the surgical consent has not been signed in the surgeon’s office, the surgeon will talk to you about the procedure and ask you to sign the consent. Please listen to the surgeon carefully regarding the type of surgery, and the risks and benefits of the procedure being performed. Please also read the consent and if you are not sure or do not understand something on the consent or have questions about the consent process, please speak up. Our staff will: • Check your child’s name band several times through his or her stay and anytime your child is to receive medication. • Ask if your child has any allergies numerous times throughout your stay. • Clean their hands with soap and water after each patient contact and before and after placing gloves on their hands. If you are not sure if they have cleansed their hands, ask them. • Make every effort to keep your child warm. Wolfson Children’s Hospital Outpatient Surgery Guidebook 9 DAY OF SURGERY Your Child’s Safety and Comfort are Important to Us Preparing for Surgery If the surgery your child is having is on one side versus the other, the surgeon will mark the site. Make sure he or she marks the correct site/area. The surgical team will complete a surgical checklist and call a “timeout” just prior to beginning your child’s surgery. This assures they are performing the correct procedure on the correct side and on the correct patient. If there are any concerns that your child is not well enough to have the procedure, the procedure may be delayed or cancelled. Remember, your child’s health and safety is the most important thing to us. DAY OF SURGERY After we are sure that everything is ready, the operating room nurse will do a final check, ask you to remove any unnecessary clothing items and take your child to the operating room. 10 While You’re Waiting You will be directed to the surgical waiting area. • Eating is allowed in designated areas, but not in the waiting area or playroom. • If you have to leave the surgical waiting area for any reason, please let the staff know. If you have a cell phone, notify the staff so we can reach you if the physician needs to talk to you or give you an update. • Your child’s surgeon will update you on your child’s condition. Your child will be taken to the post anesthesia care unit (PACU) for recovery. We will inform you where to meet your child after he or she has recovered from anesthesia. If you have any questions about anything regarding your child’s care, please do not hesitate to ask. We will be glad to assist you in any way that we can. Our goal is to keep you informed and make this visit as pleasant as possible. Wolfson Children’s Hospital Outpatient Surgery Guidebook 11 DAY OF SURGERY While your child continues to recover, we will be checking blood pressure, pulse and respirations frequently. We will also teach you how to care for your child at home. AFTER SURGERY After Surgery Managing your Child’s Pain POST-SURGERY CHECKLIST o Monitor my child’s pain level. o Provide pain medications Pain management has many benefits, including as directed. a quicker recovery. Managing pain will allow your child to have greater comfort while healing. o Follow guidelines to prevent falls. Unrelieved pain can cause anxiety, irritability and o Read and follow the problems with eating and sleeping, which can discharge instructions. slow healing and disrupt treatment. However, total absence of pain is often not realistic or always achievable. Keeping your child comfortable allows his or her energy to be used for healing and recovery instead of dealing with pain. Measuring Pain Never assume doctors or nurses know your child is in pain. No one knows your child as well as you do. It is important to help your child communicate to the staff how he or she feels before the pain becomes too severe. You can expect your health professionals to respond quickly to reports of pain. • If your child is an infant or non-verbal, the nurse will look at behaviors like crying, movement, agitation, body language and vital signs to gauge the level of pain. • Wong-Baker Faces Scale. If your child is able to understand a scale system, he or she may be asked to rate pain using the six “Faces Scale.” Each face shows a different level of discomfort and your child points to the face that best shows how he or she feels. AFTER SURGERY Wolfson Children’s Hospital Outpatient Surgery Guidebook 13 • If your child is old enough to understand a rating system, he or she may be asked to rate the level of pain on a scale of 0-10. Zero means there is no pain at all. Ten means it is the worst pain imaginable. NO PAIN WORST PAIN Your child’s anesthesiologist and physician will discuss with you options for pain control. Going Home with Pain Medications You will be given information on how to care for your child’s pain at home. Medications used appropriately are very safe and effective, and addiction is not a concern with short-term use. Ask your doctor or nurse if you have any questions about your child’s medication. Fall Prevention Wolfson Children’s Hospital is committed to Patient Safety. For your child’s protection, we ask that these guidelines be followed: • Children ages 3 and younger should be placed in cribs. • Crib rails should be kept up at all times when a child is in a crib. • Children should wear non-skid footwear when walking. AFTER SURGERY • Children with IVs should have adult assistance when walking. • Children in wagons or wheelchairs should not be left unattended. • Ask your healthcare providers about any medication your child is taking. Some medications can cause a child to be light-headed or dizzy. • For the 24 hours after anesthesia, your child needs close adult supervision. 14 Transmission-Based (Isolation) Precautions In addition to our usual practices, transmission-based (isolation) precautions are meant to stop the spread of infectious germs among patients, staff and visitors. Children on isolation precautions are not allowed in the playroom and must remain in a patient room. There will be a sign posted outside their room to identify what type of isolation precautions are needed. If brothers or sisters are visiting, they, too, must remain in their sibling’s room and cannot visit the playroom or other common areas. We discourage visitation if your child is on isolation precautions. This will help reduce the spread of contagious bacteria to others. The number-one way to help stop the spread of germs is good hand cleaning practices, especially after coughing, sneezing and using the bathroom, and before eating. Going Home Once your child has met discharge requirements, your child’s nurse will provide handouts and discharge instructions. If your child has a prescription, you may have it filled onsite at Baptist Pharmacy Pavilion. As a courtesy, a member of the RxExpress team can deliver the medication to your room before your child is discharged. Please request the RxExpress service as soon as you know there are discharge prescriptions to be filled. Simply ask any nursing staff in Surgical Services how to obtain prescriptions while your child is recovering. Your child should rest as much as possible at home. Temporary nausea and/or vomiting are quite common after discharge. A nurse will call you within three days after your child’s surgery to make sure your child is recovering normally. We would also appreciate any comments/concerns about your child’s experience. Feedback from parents helps us to plan and improve our service in the future. We want to hear from you! Wolfson Children’s Hospital Outpatient Surgery Guidebook 15 AFTER SURGERY Baptist Pharmacy accepts most insurance and any co-pays may be applied to your charge card or debit card. If you have questions about your child’s medication after receiving prescriptions by RxExpress, you may call the pharmacist at 904.202.5230. Notes 16 We would like to thank you for allowing us to care for your child. We hope to make this a positive and pleasant experience for you and your child. For additional information about Wolfson Children’s Hospital, visit wolfsonchildrens.org. Wolfson Children’s Hospital Outpatient Surgery Guidebook 17
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