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Clinical Hub,Patient Education,Health and Nutrition Facts For You,Cardiology, Cardiovascular Surgery

Patient Timeline to Surgery and Recovery-VAD (7893)

Patient Timeline to Surgery and Recovery-VAD (7893) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Cardiology, Cardiovascular Surgery

7893


Patient Timeline to Surgery and Recovery – Ventricular
Assist Device

Pre-Ventricular Assist Device Implantation
First Visit: Heart Failure Team
ξ Assess history and physical exam
ξ Complete additional tests prescribed by the doctor
ξ Review medical records and test results
ξ Discuss treatment options
ξ Share review of findings with referring doctor
ξ Talk over case with cardiac surgeon
Second Visit:
Cardiac Surgeon
 Assess history and physical exam
 Review medical records, surgical history, medicine, and test results
 Discuss timeline for surgery
 Create timeline to discontinue medicines
 Schedule additional tests or exams needed
 Share review of findings with the heart failure team
 Talk over Ventricular Assist Device evaluation consent
Ventricular Assist Device Coordinator
 Review Ventricular Assist Device system
 Discuss plan for post-surgical education
 Share an average post-surgical recovery course
 Talk over post discharge instruction
 Learn of patient, community, doctor, and hospital coordination



2

Home instruction: Prepare for Admission
 Stop drinking alcohol
 Stop taking medicines as prescribed by the doctor
 Leave all jewelry, rings, large sums of money, and credit cards at home
 Take along pajamas, a robe, non-skid slippers, cell phone, and other personal items
 Bring labeled inhalers or CPAP equipment, glasses, hearing aids, dentures, and prosthesis
Admission for Ventricular Assist Device Implantation
Admission Instruction: Day of Admission
ξ Blood is drawn
ξ Complete admission paperwork
ξ Meet with a heart failure nurse practitioner
o Update medical history and physical exam
o Review medicines and discuss plan for taking medicines
o Order required tests, such as an echocardiogram or right heart catheterization
ξ Meet with a cardiac surgery nurse practitioner or physician’s assistant
o Discuss expected post-surgical course
o Complete surgical evaluation
o Sign consent for surgery
ξ Meet with a Ventricular Assist Device coordinator
o Review Ventricular Assist Device materials
o Discuss post-surgical education plan
o Complete quality of life survey and house preparation checklist
ξ Meet with an Anesthesiologist
o Discuss the time you will go down to operating room for surgery
ξ Meet with surgeon before surgery for questions
Admission Instruction: Night before Surgery
ξ Eat a light meal low in fat content
ξ Stop eating solid food at 7 PM
ξ Stop drinking milk, and juice with or without pulp at 7 PM
ξ Stop drinking clear liquids at midnight
ξ No eating or drinking after midnight unless discussed with a staff nurse
ξ Shower with an antimicrobial soap
o Scrub from the neck to the toes for 2 to 3 minutes
o Do not break the skin when scrubbing
o Do not apply lotions or powders to skin
ξ Remove all make makeup and fingernail polish

3

Admission Instruction: Morning of Surgery
ξ Brush teeth and rinse, do not swallow
ξ Shower with antimicrobial soap called Hibiclens®
o Follow instructions given the night before
ξ Take morning medicines as directed by the surgeon
Family instruction: Day of Surgery
ξ Two family members may accompany you to the operating room
ξ Family will be guided to the family waiting area by operating room staff
ξ Family will need to give a phone number to the operating room staff
ξ Family will need to pick up a pager from the operating room staff
ξ Family will be updated on your condition throughout the surgery
ξ Family will be taken to the to the post-operative unit after surgery
ξ Family will be updated by the surgeon after the surgery is done
Post Ventricular Assist Device Implantation
Day of Surgery: Cardiothoracic Surgery Unit (B4/5)
ξ Family may visit after a recovery period (1-2 hours).
ξ A breathing tube will be in place after surgery. You will not be able to talk. It is removed as
soon as you are awake enough to breathe on your own. After the tube is removed, you may
begin to talk.
ξ Several tubes and line will be placed during surgery. Please see the section in the binder called
“Common Tubes and Lines” for details.
ξ You and your family will hear several noises, such as the beep of the monitor and the bubbles
from the chest tubes. The noises you hear are normal.
ξ Wrist restraints may be in place after surgery. The restraints protect you from hurting yourself
while waking up from anesthesia.
ξ The nurse will start turning you the evening of surgery.
Day after Surgery: Post-op Day # 1-2
ξ The Cardiac team visits daily to assess progress, called rounding. The time of day may vary.
They first meet outside the room to discuss your progress. Then they go into the room to update
you and your family and answer any questions.
ξ See the section in the binder called “Your Health Care Team” for a list of health care workers
involved in your care while in the hospital. Specialized teams, not listed in this section of the
binder may also visit you, based on your needs.
ξ The Ventricular Assist Device team will visit daily to assess your recovery progress.
ξ Removal of tubes and lines is based on your progress. It is reviewed daily.

4

ξ Diet begins at clear liquid (e.g., water and ice chips) and advances as tolerated.
ξ Cough and deep breathe daily using an incentive spirometer (Breathing Device).
ξ Physical therapy will help your sit, stand, and walk. The nurse can also help.
o The goal is to get out of bed and sit in the chair at least 3 times a day.
o The goal is to walk in the hallway 4 times a day.
ξ Education about the Ventricular Assist Device is provided to you and your family.
Post-op Day 3 until discharge: The Hospital Stay
ξ The Cardiac team visits daily to assess progress, called rounding. The time of day may vary.
They first meet outside the room to discuss your progress. Then they go into the room to update
you and your family and answer any questions.
ξ See the section in the binder called “Your Health Care Team” for a list of health care workers
involved in your care while in the hospital. Specialized teams, not listed in this section of the
binder may also visit you, based on your needs.
ξ All tubes and lines are assessed daily for removal.
ξ Physical therapy will help you sit, stand, and walk. The nurse can also help.
o The goal is to get out of bed and sit in the chair at least 3 times a day.
o The goal is to walk in the hallway 4 times a day.
ξ Cough and deep breathe daily using an incentive spirometer (Breathing Device).
ξ Staff from Cardiac Rehab will meet with you on post-op day 4 or 5.
ξ Education is provided to you and your family every day while in the hospital.
ξ Discharge date will depend on your recovery, knowledge of the Ventricular Assist Device,
family’s ability to do dressing change, blood pressure control, and stable weight.
Day of Discharge: Last day at the Hospital
ξ A member of the heart failure team talks about discharge with you. Please see the section in the
binder called “Home Bound” for details.
ξ A pharmacist reviews medicines with you and your family.
ξ The nurse reviews discharge instruction with you and your family.
ξ Ventricular Assist Device coordinator reviews what is expected of you and your family post
discharge. They answer any questions.
ξ Other members of the health care team may meet with you and your family before leaving the
hospital.
ξ Pick medicines at your local pharmacy of choice before arriving home or our hospital’s
outpatient pharmacy.
ξ Other follow-up care is arranged as needed.



5

Recovery after leaving the hospital
After Discharge: Care at Home
ξ Daily, you must review the Ventricular Assist Device numbers and collect a weight. Bring
those to clinic for evaluation by the provider.
ξ Every patient is unique in how they recover and feel after Ventricular Assist Device
implantation. There are some common feelings each patient experiences after surgery.
ξ Please see the section in the binder called “Homeward Bound” for more details.
Follow-up Visit: 2-3 days from discharge
ξ Blood will be drawn in the lab before attending follow-up visit.
ξ You will meet a Ventricular Assist Device team member to discuss progress.
ξ Future follow-up visits will be scheduled.
Follow-up visit: 2-4 weeks from discharge
ξ You will meet a Ventricular Assist Device NP to discuss your progress
ξ Cardiac Rehab begins at this time
Follow-up visit: 4-6 weeks from Ventricular Assist Device implant
ξ Tests will be completed prior to appointment as ordered by the surgeon
ξ You will meet with a Ventricular Assist Device team member
ξ Surgeon will discuss ability to drive and approve driving privileges
ξ Surgeon will discuss changing daily dressing changes to every three day dressing changes
ξ Surgeon will discuss changing the lifting restriction




Your health care team may have given you this information as part of your care. If so, please use it and call if you have any
questions. If this information was not given to you as part of your care, please check with your doctor. This is not medical
advice. This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health needs are
different, you should talk with your doctor or others on your health care team when using this information. If you have an
emergency, please call 911. Copyright © 5/2016 University of Wisconsin Hospitals and Clinics Authority. All rights reserved.
Produced by the Department of Nursing. HF#7893