Wolfson Children’s Hospital Outpatient Surgery Guidebook 800 Prudential Drive Jacksonville, Florida 32207

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