SURGERY DETAILS:

________________________________________Date:

________________________________________Physician:

________________________________________Surgeon’s Phone Number:

The safety and comfort of our

patients is our priority.

You play an important role in partnering with us to ensure a safe,

efficient, and exceptional experience.

If you have any remaining questions after reading these instructions, please call your surgeon’s office.

It’s the Way WeCARE

Physicians referral line: 1-877-377-27621 Medical Center Boulevard • Cookeville, TN 38501931.528.2541crmchealth.org

Preparing for Surgery

Arrival Time:If you have not received a call from Surgical Services BY 5:00 pm on the day before your surgery, please call the Same Day Surgery Unit at (931) 783-2190.

PATIENTGUIDE

Do not apply hair products, make-up, nail polish, and piercings.

Remove contact lenses, and wear your glasses or bring your

contact lens case with you.

Remove jewelry (including rings and all body piercings). Jewelry,

including body piercings, presents a potential safety risk.

Leave jewelry and other valuables at home. We do not have a locked area in which to keep them.

1 WEEK BEFORE SURGERY:

STEP 1: In the shower, wash your face and body with antibacterial soap (such as Dial) using a clean washcloth. Shampoo hair as you normally do.

***Note*** You will be given a bottle of special cleanser called Chlorhexidine. It is very important that you use Chlorhexidine cleanser in addition to antibacterial soap. Begin bathig daily with Chlorhexidine 2 days before your surgery. Also use it the morning of surgery before coming to the hospital. Chlorhexidine should NOT be used near eyes, nose, ears, and mouth or in the vagina. If the solution gets in your eyes, rinse them out with water immediately. Chlorhexidine is absorbed by cotton washcloths and may cause discoloration. KEEP out of reach of children. Chlorhexidine should not be used on children less than 2 months old.

STEP 2: Wash body thoroughly from the neck down (avoiding the vagina and rectal area) with Chlorhexidine. Pay special attention to the area where you will have surgery as well as the stomach, belly button, hands, between finger/toe nails, elbows, ankles, knees (front and back), under skin folds (stomach and breasts) and under arms.

STEP 3: Ask for help if you are unable to wash certain areas of your body.

STEP 4: Rinse very well and dry with a clean towel.

PLEASE REMEMBER 1. SHOWER DAILY beginning 2 days

before surgery with antibacterial soap and Chlorhexidine, then AGAIN the morning of your surgery, before coming to the hospital, following above instructions.

Use a clean towel and washcloth. 2. DO NOT SHAVE ANY BODY PARTS

from the neck down. Shaving increases your risk of infection

when you have surgery. 3. AFTER YOU SHOWER, the morning of surgery, do not use

powder, deodorant, perfumes or lotions. Please remove nail polish from fingers and toes.

4. WEAR FRESHLY LAUNDERED clothes after your shower and

to the hospital.

TAKING CARE OF YOUR TEETH Brush your teeth and tongue with a soft bristle toothbrush with any brand of toothpaste. If you have dentures, do your routine cleaning. Don’t forget to rinse your mouth with mouthwash.

CHANGES TO YOUR MEDICATION SCHEDULE

PRIOR TO SURGERY:It is extremely important that you are aware of the changes that will need to

be made to your normal medication schedule 7 days before your surgery.

BEFORE COMING TO THE HOSPITAL CHECKLISTNOTHING TO EAT OR DRINK AFTER MIDNIGHT EXCEPTMEDICATION AS DIRECTED BY THE NURSE, WITH A SIP OF WATER.

***Note*** You will be given a bottle of special cleanser called Chlorhexidine. It is very important that you use Chlorhexidine cleanser in addition to antibacterial soap. Begin bathing daily with Chlorhexidine 2 days before your surgery. Also use it the morning of surgery before coming to the hospital. Chlorhexidine should NOT be used near eyes, nose, ears, and mouth or in the vagina. If the solution gets in your eyes, rinse them out with water immediately. Chlorhexidine is absorbed by cotton washcloths and may cause discoloration. KEEP out of reach of children. Chlorhexidine should not be used on children less than 2 months old.

Stop taking Ibuprofen, Motrin, Advil, Aleve, Naprosyn, Relafen, Daypro, Nuprin and Celebrex.

Stop taking all herbal medication/dietary supplements, such as garlic pills, vitamin E,

St. John’s Wort, fish oil, diet pills and multivitamins.

Please discontinue taking Aspirin unless otherwise instructed by your physician.

____________________________________________________________________

Follow instructions given to you by your nurse practitioner or physician

concerning your Coumadin therapy.

Tylenol (Acetaminophen) is acceptable.

Please take the following medication with a sip of water the morning of surgery.

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BEFORE SURGERY

Arrive promptly at your scheduled time.

Bring your identification and insurance card/prescription card.

CRMC's Outpatient Pharmacy is available for your convenience

to fill your prescriptions before you go home.

Leave all medication at home, except asthma inhalers and

C-PAP machines.

Wear clean comfortable clothes.

INSU

RANC

ECA

RD

PREOPERATIVE SURGERY HYGIENE INSTRUCTIONS To keep your skin as clean as possible and to help prevent infection, follow the instructions below: DAILY BEGINNING 2 DAYS BEFORE YOUR SURGERY AND AM OF SURGERYSTART DATE:______________________________

WHAT TO EXPECT

ONCE YOU ARRIVEGo to the surgical waiting reception desk. A staff member will escort you to an area to prepare for your surgery.

Use of the Incentive Spirometer 10 times per hour

Coughing and Deep Breathing when possible

Oral Care - Brush your teeth and rinse with mouth wash 3 times per day.

Understanding - Ask if you have questions about the reasons for these guidelines.

Getting Out of Bed and Walk through the Hallways

Head of Bed at30 degrees elevation

DISCHARGED HOME:As a service to our patients, prior to leaving the hospital,

CRMC Outpatient Pharmacy can fill your discharge medication(s).

You (or family member or caregiver) may pick up your medication(s) at the CRMC Outpatient Pharmacy.

This program is optional and is offered for your convenience. Please note that you have the right to select any pharmacy you

wish to provide medication(s) prescribed by your physician.

If you need any more information before making a decision, please feel free to contact a pharmacist at 931-783-2552.

IN THE SAME DAY OR HOLDING AREA:• Meet your surgeon, anesthesia provider, and nurse care team.

• Proper Safety Checks which include a list of regulations is undergone before every surgery.

• Possible additional blood tests.

IN THE OPERATING ROOM (OR):Family may wait for you in the waiting room during this time.

IN THE POST-ANESTHESIA CARE UNIT (PACU):You will be monitored by a nurse until you wake up from anesthesia.

IF ADMITTED TO HOSPITAL:You will be transported to an inpatient floor, where you will be cared for by a team of caregivers until you have recovered sufficiently.

IN THE SAME-DAY SURGERY UNIT:After your surgery you will receive care by a team of caregivers until you have recovered sufficiently.

If going home the same day as your surgery, you MUST have a ride from a family member or a friend.

You will not be able to operate a vehicle, leave in a taxi or take public transportation by yourself.

SURGICAL PROCESS

If you are running late on the day of your surgery or have any questions or concerns about anything regarding your surgery, please call the Same Day Surgery Unit at 931-783-2190.

Professional Building

Cancer Center

Outpatient

Inpatient

7th St

O n e M e d i c a l C e n t e r B l v d . + C o o k e v i l l e , T N 3 8 5 0 1 9 3 1 - 5 2 8 - 2 5 4 1 + P h y s i c i a n R e f e r r a l : 9 3 1 - 7 8 3 - 2 5 7 1 + c r m c h e a l t h . o r g

MainEntrance

ER Entrance

Cancer Center Entrance

W 5th St

N Willow Ave

N Whitney Ave

N Peachtree AveN Walnut Ave

N Oak Ave

N Cedar Ave

Medical Center Blvd

W 3rd St

W 4th St

W 3rd St

W 4th St

W 6th St

W 7th St

N Hickory Ave

Employee/Visitor

Parking

Visitor ParkingVisitor

Parking

Visitor Parking

One Medical Center Blvd

It’s the Way WeCARE

you will enter here the morning

of surgery

EastEntrance

Glass Elevator (to Second Floor Only)

Med Records

Dining

Gift Shop

Elevator To All Floors

To Second Floor

CustomerService

Reception

Administration

Co�ee/Newsstand

SurgeryWaiting

1-5

Registration/CashierIncluding Outpatient Lab

COOKEVILLECAFE

MAIN ENTRANCE

WEST ENTRANCE

GROUND LEVEL - 1ST FLOOR

DEPARTMENTAdministrationCookeville CafeCustomer ServiceGift ShopMedical RecordsOutpatient LabRegistration/CashierThe Surgery Center Waiting Room

FLOORGround LevelGround LevelGround LevelGround LevelGround LevelGround LevelGround LevelGround Level

O n e M e d i c a l C e n t e r B l v d .C o o k e v i l l e , T N 3 8 5 0 19 3 1 - 5 2 8 - 2 5 4 1P h y s i c i a n R e f e r r a l : 9 3 1 - 7 8 3 - 2 5 7 1c r m c h e a l t h . o r g

It’s the Way WeCARE

ENTER HERE

Form OR-46 (Rev. 5/16)