Pre-Operative Care


 
POLICY:
 
The health status of the individual being considered for 
outpatient surgery is determined by the continuous collection 
of data.  Only patients who are Class I, Class II, or with 
special clearance from the Medical Director, Class III,  will 
be considered eligible for outpatient surgery procedures.  A 
patient having outpatient surgery is expected to be able to 
provide self-care upon discharge, with the assistance of a 
family member and to be able to achieve pain control via the 
use of oral analgesia.
 
The medical staff member will contact the patient's primary 
care physician regarding serious pre-existing medical 
conditions for clearance prior to surgery.  If the contact 
has been verbal, this will be documented in the History and 
Physical report or as a part of the pre-operative anesthesia 
evaluation.
 
The pre-operative diagnostic procedures for each patient is 
individualized according to the patient's condition, surgical 
procedure, and physician's preference.
 
All laboratory work must be drawn no earlier than 7 days 
prior to the surgical procedure.  The pre-admission 
laboratory tests are to be completed prior to patient's 
arriving for elective outpatient surgery.
 
Except when the surgical procedure is for the treatment of a 
specific infection, patients for outpatient surgery shall be 
free of infection at the time of surgery.
 
PROCEDURE:

1.  The pre-operative work-up, if any, shall include a 
    patient interview with appropriate history and physical 
    examination, and as indicated, consultation with primary 
    care physician, and diagnostic studies relative to the 
    planned intervention.  The following will be discussed 
    with the patient, as appropriate:
 
    A.  Current medical diagnosis and proposed treatment;
    B.  Presence of pre-existing medical conditions which 
        affect patient's fitness for the planned 
        intervention;
    C.  Understanding by patient of the expected results of 
        the planned procedure;
    D.  Historical response to anesthesia, illness, 
        hospitalizations, and/or procedures;
    E.  Family history of anesthesia complications
    F.  Results of diagnostic studies, if any;
    G.  Special needs assessment (i.e., vision, hearing, 
        speech, home/caregiver situation).
 
    Food restrictions including NPO, medications (if any) to
    be taken prior to surgery/procedure and any preparations 
    needed, such as skin prep scrubs, enemas will be 
    discussed and carefully explained to the patient.
 
2.  The following tests are guidelines for required 
    diagnostic procedures, with appropriate consideration of 
    the patient's age and/or co-morbidity:
 
    A.  Laboratory:  CBC, UA, PT, PTT, Electrolytes; urine
                     for pregnancy testing, if applicable
    B.  X-ray:       Chest film, if indicated; acceptable up 
 
                     to 90 days if patient is asymptomatic.
    C.  Other:       EKG 
 
3.  When contacted to confirm surgical arrangements, the 
    patient will be encouraged to ask questions.   
 
The patient should be informed that any outpatient procedure 
may require inpatient admission to the hospital, in the event 
of unforeseen circumstances.
 
Approved By Governing Board    
PO.5    
Control #57.0
GUPTA GASTRO