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Pre-admission Clinic

You will be asked to attend this clinic before your operation. Try to make sure that you are as fit as possible at this stage otherwise your admission date may be postponed. If following the assessment, anything is found that would prevent you from having the surgery, the nurse who carried out your assessment will contact you and advise you on the next course of action and a referral letter will be faxed to your GP. You can expect to be at the pre-admission clinic for about half a day. You will need to see a number of people in order for a full assessment to be completed, and for us to start organising your care following your operation.

The following is a list of people you will see in the clinic:

Nurse: She or he will check your general medical fitness to ensure that you are fit for surgery.

Routine tests will also be carried out:

• Blood test

• ECG (heart trace)

• Urine sample

• X-rays may be taken if needed

Physiotherapist: He or she will look at how you walk, how your affected joint moves and any other joint problems you may have. This is done in order to help your rehabilitation after your operation.

Occupational Therapist: He or she will take the furniture measurement form, which you should have completed at home. They will ask you about your home environment, and any support you may have. They may arrange an appointment to see you at home (see pre-admission home assessment below) to organise any equipment you might need when you are discharged from hospital.

When you attend for your pre-admission assessment please bring your urine sample in the bottle provided (this will be sent with your appointment), any medication you are taking (including any bought from health food shops or chemists), your completed National Joint Registry (NJR) consent form and completed furniture height form. If for any reason you are unable to attend for your pre-operative appointment please contact the pre-operative assessment office on the number provided at the end of this booklet. Failure to do so may result in your operation being cancelled.

Pre-admission Home Assessment

The Occupational Therapist (OT) will carry out a home assessment if needed. The purpose of this visit is to prepare you and your home to help you manage following your operation.

During the assessment, the OT will advise you on the correct height of your furniture. This is to make sure you do not bend your hip more than 90° while sitting (see page 8). If necessary the OT will raise your own furniture with suitable adaptations. The Occupational Therapist will also show and practice techniques, for example, getting on and off the bed and kitchen tasks. The OT will offer advice/education in relation to your individual needs, in order to follow the precautions already explained on page 8. They will also answer any other questions relating to how you will manage after your operation. You will be given any equipment you need either by the hospital OT or OT in your community.

If you live out of the Liverpool Social Service area, it is not possible for the Occupational Therapist to carry out a pre-admission home assessment. The OT will liaise with Social Services in your local area to arrange equipment and any services you need. All other assessments will be carried out on the ward after your operation.

The week before your operation you may need to come to clinic. It is very important that you are available at this time, so please do not book any holidays.

Your stay in hospital is usually between five and ten days. The nurse will admit you onto the ward and will explain what is going to happen to you during your stay in hospital.

What do I need to bring into hospital with me?

• Nightclothes

• Underwear

• Day clothes - as you will be encouraged to get dressed a few days after your operation

• Supportive low-heeled slippers and shoes

• Any walking or dressing aids that you already use at home

• Toiletries

• Towels - large and small

• This booklet

• All medication you are taking (even those bought from health food or chemist shops)

• We advise you to only bring into hospital enough money to buy things you need while you are here
• e.g. newspapers, TV/phone card, toiletries etc.

The day of your operation

You will come into hospital either on the day of your operation or the day before. You will have been given a contact number to phone to check bed availability.

Please leave all cash and valuables at home. If you need to bring valuables into hospital, these can be sent to General Office for safekeeping. General Office is open between 08.30 and 4.30 Monday to Friday. If you are discharged outside these times we will not be able to return your property until General Office is open. The Trust does not accept responsibility for items not handed in for safekeeping. If you have house keys with you, either send them home or hand into staff for safekeeping.

Please bring any medicines that you take into hospital with you.

You will be asked to remove jewellery - plain bands can be worn but they will be taped. Please leave body piercings at home. False nails and nail polish will also need to be removed.

You will be asked to put on a gown and disposable underwear. A bracelet with your personal details will be attached to your wrist. If you are on regular medication you will be told to take this if necessary.

You may be prescribed some medication (called a pre-med) by the anaesthetist, to take before your operation. A member of the nursing staff will give this to you. One of the actions of the pre-med is to relax you. It may make you drowsy. Once you have had your pre-med you will be asked to stay in bed for your own safety.

A nurse and porter will take you to the operating theatre.

Your dentures, glasses or hearing aid can stay with you on your journey to the operating theatre. When you arrive in the theatre you will be asked to put on a disposable hat and a member of staff will check your details with you.

What should I expect after my operation?

After your operation you will be kept in the theatre recovery room before being transferred back to the ward.

When you wake up in the recovery area, you will have an oxygen mask on your face and a drip (intravenous infusion) in your arm, which is used to give you drugs, fluid or blood. You may also have up to three drainage tubes in your hip. These drainage tubes are normally removed 24 to 48 hours after the operation. This is not a painful procedure. After you have recovered from the anaesthetic, you will be taken back to your ward.

Usually you will be away from the ward for about three to four hours. You may arrive back from theatre with a wedge or leg troughs between your legs to keep your new hip in a good position. In some cases you may also be wearing surgical stockings.

A nurse will check your pulse, blood pressure and breathing regularly. The nursing staff will also advise you when you can start taking sips of water. Anaesthetics can make some people sick. If you feel sick we advise you not to drink until this feeling has passed. Please tell the nursing staff if you are feeling sick because they can offer you an injection or tablet to help this feeling go away.

Do not try to get out of bed without help.

Pain Relief

We aim to keep you comfortable at all times. Most patients are able to use Patient Controlled Analgesia (PCA), which is given through a drip. A full explanation of how to use this will be given by the nurse. You may feel sickly because of the painkillers. Please tell your nurse who can give you a tablet or injection to ease this. Once the drip is removed, painkillers will be given in tablet form. Please remember it is important that you are comfortable enough to relax, sleep and move freely. Nursing staff will offer you painkillers regularly, but please tell them if you are still in pain. The use of painkillers will help you to tolerate your exercises after your operation.

Your Wound

Your wound will be covered with a dressing that will only be changed or removed if it is loose or heavily bloodstained. Stitches (suture) or staples are removed 10 to 14 days after surgery. This is not a painful procedure.