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Cardiff Centre of Excellence for Spinal Care

Clinical Excellence | Education | Research

What to expect from your stay

  • It is very important to us that you are as prepared as possible for your hospital stay.

    This information will help you to prepare, assist in your recovery and reduce anxiety levels.

    Before your stay in hospital

    Prior to coming into hospital you will receive a pre-operative questionnaire in the post. Please take your time to consider your response and complete as accurately and as completely as you can. If we have any queries, we will contact you to discuss your answers.  

    Once we have received your questionnaire we will arrange for you to attend our pre- assessment clinic. Our pre-assessment nurse will review your completed questionnaire and discuss your medical history. They will also review your current medication and give advice as to whether you need to omit or continue with this pre-operatively. You may also be measured for anti-embolic stockings. 

    We will take some baseline recording of your temperature, pulse, blood pressure, respirations and oxygen saturations. Our ward nurses will use this information as a reference for your post-operative observations.  

    Your surgeon may have requested a blood test prior to your surgery. If so, one of our nurses will undertake this blood sampling during your pre-assessment.

    Depending on your clinical need you may also have an ECG, urine test and MRSA screening.  

    Your pre-assessment nurse will take this opportunity to discuss your pending surgery with you and provide you with relevant information and reassurance; including details of our pain scoring system so that you can be reassured we will monitor your pain and deal with it swiftly. 

    Most patients are keen to know when they will be able to return to their own home, therefore, we will discuss your planned length of stay, time of discharge and whether you require any social/home support in order for you to return home. If you require a referral to social services, this can be arranged prior to your admission.  

    Nutrition is very important during your hospital stay, so we will also talk through any specific dietary requirements and inform the catering department to ensure we can meet your dietary needs.

    During your pre-assessment the physiotherapist will talk through the operation and you will have the opportunity to ask any questions you may have about this. The physiotherapist will give you advice on what you will be able to do after your surgery and what limitations you may have, for example movements to be avoided and limitations to activities of daily living for example housework and recreational hobbies. The physiotherapist will advise you on the way to get in and out of bed and the physiotherapy you will receive on the ward after your operation and when you go home.

    Any pre-existing conditions for example, arthritic knee or asthma, which may affect your recovery, will also be assessed so your treatment plan can be individually tailored to suit your needs.

    The physiotherapists will also advise you on the exercises you will need to practice after your operation, for example core stability.

    Core stability relates to the bodily region bounded by the abdominal wall, the pelvis, the lower back and the diaphragm and its ability to stabilise the body during movement. The main muscles involved include the transversus abdominis, the internal and external obliques, the quadratus lumborum and the diaphragm. The diaphragm is the main muscle of breathing in the body and so breathing is important in providing the necessary core stability for moving and lifting. It is the action of these muscles contracting together upon the incompressible contents of the abdominal cavity (i.e. the internal organs or viscera) that provides support to the spine and pelvis during movement.

    You may also meet a physiotherapist during your pre assessment (see Physiotherapy section).

    Before your stay in hospital
  • Admission day

    When you arrive, please come to our main reception desk where our friendly reception staff will re-check your details and help you to complete a registration form. You will then be escorted to your room where our reception staff will make you familiar with your room; location of bathroom, safe and nurse call bell system.

    Your admitting nurse will then introduce herself/himself to you and ensure you ready for theatre. Although some details of this process will be repetitive, your safety and wellbeing is our priority, therefore we do re-check your details, such as date of birth, address and GP name. 

    We understand that patients may be anxious on the day of admission; therefore, your nurse will talk you through the process and answer any questions you may have. We will remind you of our pain scoring process and you will be encouraged to describe any pain as you experience it. We will record a routine set of observations and may undertake an ECG and further blood tests depending on your clinical requirements. 

    For female patients of child bearing age, it is our policy to offer a pregnancy test pre-operatively as there are risks to a foetus when having an anaesthetic. If you feel that there may be a chance that you could be pregnant, then we advise you to have the test performed. It is necessary to establish pregnancy status prior to your surgery and this information will be passed to your consultant. 

    Your expected length of stay will be discussed, including time of discharge and your means of transport home. Depending on your recovery, you may stay for your fully allotted time or be able to go home earlier, if your medical team agrees. Spire Cardiff Hospital implements a multi-disciplinary team approach, therefore, you can be reassured that all factors are taken into consideration so you are discharged in a safe manner. 

    Your consultant will see you in your room prior to surgery. He/she will discuss your surgery and ask you to sign your consent form. Please feel free to ask any questions you may have. Your anaesthetist will also visit you to check your medical history, your current medication, review your ECG, blood results and baseline observations. He/she will discuss the anaesthetic you are about to have and will give you the opportunity to ask questions. 

    You will be given an approximate time of surgery, morning or afternoon; however it is hard to provide completely accurate timing owing to the fluidity of our schedules. We will keep you informed regularly and your admitting nurse will advise you when to get changed in preparation for theatre. Once ready for theatre, a member of our Theatre Team will escort you. It is usual practice that you walk into theatre, although we do provide a wheelchair if your mobility is poor or may transport you on the bed if you have had some sedation prior to your surgery.

    Admission day
  • Post operation

    Following your surgery you will probably become “awake” in the recovery department. A recovery nurse will ensure that your pain is managed appropriately and will continuously monitor you until return to your room. Monitoring may include:

    • Blood pressure via a cuff on your arm.
    • Oxygen saturation probe on your finger.
    • Electrodes on your chest to monitor your heart rate.
    • Oxygen administered either by face mask or nasal cannula.
    • An intravenous infusion will be in place to keep you hydrated. 

    In order to reduce the potential of any complications such as deep vein thrombosis, we may place “foot pumps” onto your feet to promote venous return in your legs. These are not painful but can be noisy. 

    You may also find that your surgeon has inserted a wound drain to remove any excess blood and promote healing. This drain will be removed the following day or when advised by your consultant.

    Depending on your surgery, you may have a urinary catheter. This is for your comfort for the immediate post-operative period and will only remain in place until you are mobile.

    When your recovery nurse is confident that your condition is satisfactory and safe, he/she will call for your nurse to collect you. A full handover from recovery nurse to your ward nurse will be carried out which will include details of your surgery and current condition.

    On return to your room, you will continue to have observations recorded regularly as per protocol and as your condition dictates.

    Your comfort and recovery is our priority therefore you will be asked regularly to describe your pain using our pain scoring system which will have been explained to you earlier. We will administer medication regularly as prescribed. In addition to that for the immediate post-operative period you may have a patient controlled analgesia (PCA). You will be instructed how to use it effectively by the nursing staff. Our aim is to make you comfortable enough to be able to move, exercise and rehabilitate effectively.

    Depending upon your surgery, you will be allowed to drink when you return to the ward. We do not recommend fizzy drinks or juices initially. You can increase your intake gradually to include free fluids and a light diet. It is important that you maintain a good fluid intake (two litres per day) and a well-balanced diet. 

    We encourage all our patients to carry out their deep breathing exercises and move their limbs as instructed whilst in bed. Our nursing staff will assist you in changing your position regularly or whenever you wish to. This is in order to assist in the prevention of deep vein thrombosis or pulmonary embolism.  

    The hospital operates a minimal manual handling policy; the purpose being for you to try and move yourself as much as you can as early mobilisation is the key to your rehabilitation. If your condition is satisfactory on day 0 (operation day) you may stand out of bed for a short period of time. By day one, you should be able to have your oxygen, intravenous fluids and PCA discontinued. This will enable the physiotherapist and nursing staff to assist you to mobilise around your bed area, sit out of bed or perch on the side of the bed for short periods. Gradually you will be able to walk out into the ward corridor. It is usual for all patients to have a full physiotherapy assessment in order to promote a safe discharge home.

    Regular observations will continue throughout your stay.

    Your wound drain (if present) will usually be removed at 24-48 hours post-operatively, or when instructed by your consultant. The wound site will have a dressing covering it. Research has shown that minimal dressing changes are more beneficial to wound healing, therefore, the dressing will only be changed as and when necessary.

    Post operation
  • Going home

    Preparation for your discharge began at pre-assessment and we will continue this throughout your stay with us. When your consultant and the multidisciplinary team agree that your condition is satisfactory, you have been assessed as safe and your home/social circumstances dictate, then you will be given your date of discharge. 

    Pre-arranged discharges are by 9.30am on the morning of discharge. If you are unable to be collected by that time, please vacate your room and feel free to use our patient discharge lounge. 

    Your discharge nurse will provide you with a discharge pack. This will be discussed fully with you and will include:

    • Any appointments made for you (eg, consultant, physiotherapist, removal of sutures)
    • Wound care advice
    • General post-operative advice or specific instructions
    • A copy of a letter to your GP
    • A contact number for the ward which will enable you to contact us (day or night) if you have any queries or concerns

    You will usually be provided with a supply of medication to take home which your discharge nurse will discuss thoroughly with you before you leave. In order to ensure a smooth transition of your care, we will send a copy of your discharge summary to your GP. You will then be ready for discharge home and to continue with further rehabilitation.

    Going home

© Spire Healthcare Group plc (2018)