Our knowledge of orthopaedics. Your best health.

When you visit your orthopaedic surgeon, use the following checklist — or make one of your own — to provide your surgeon and surgical team with necessary information about you and your orthopaedic problem.

• Orthopaedic Problem. Describe when it began, how it bothers you, and which treatments you have tried for it.
• Medical History. List all of your past and current medical problems and how they have been treated.
• Family History. List diseases or health conditions that affect your family, including any problems that arose during surgery or with anesthesia.
• Current Medications. List the medications you are taking and their dosages. Be sure to include any over-the-counter medications or dietary supplements you take on a regular basis. If you are on a lot of medications, bring a printed list of your current regimen to your appointment.
• Allergies and Sensitivities. List all medication, food and environmental allergies (such as pollen or bee stings) that you have. Tell your surgeon if you have ever had an allergic reaction such as a rash, swelling, or difficulty breathing. There are some medications and foods that you may be sensitive to, even though you are not truly allergic to them. Include these medications and foods on your list and describe the side effects that you have experienced.
• X-rays, Images, Operative Notes and Lab Tests. Bring copies of medical records, operative notes, X-rays, CT scans, MRI scans, and lab test results — especially those that relate to your orthopaedic problem.
• Questions or Concerns. List any specific questions that you have about your health and your planned surgery. Discuss these with your surgeon and surgical team. It is important that you understand the goals of your surgery, how the surgery will be done, any possible risks or complications, and the plan for your recovery.

• Bring to the hospital:
  • A list of all medications, over-the-counter drugs, herbs and vitamins that you take.
  • A list of your drug and food allergies and sensitivities.
  • Your insurance card.
  • Copies of any legal documents, including medical proxy, medical power of attorney, and/or a living will.
  • The name and phone number of your primary contact while you are in surgery or, if you are having same-day surgery, the name and phone number of the person who will be picking you up.
  • A small amount of cash, but no valuables or jewelry.
  • Little else. Most hospitals provide everything you need, even toothbrushes, bed clothes, and slippers. You may prefer your own razor, and you may bring some cosmetics, but you should not bring perfume, cologne, or body spray.
  • If you wear glasses, a case to put them in to protect them.
  • If you wear contact lenses, either leave them at home or, if you want to put them in after the procedure, bring a case and solution to store them while you are in surgery.
• An I.D. band will be given to you. Hospitals may have two patients with the same name, but your patient number is unique to you. If the band comes off, be sure to tell a member of your care team so it can be replaced.
• Before surgery your doctor and healthcare team will ask you many questions. You may be asked some questions — such as your drug allergies and identification of the surgical site —several times. This repetition is planned, and you should expect these questions from your team. Some questions that you may be asked include:
  • Do you have diabetes and take diabetic medications?
  • Do you take any blood thinners?
  • Do you or any member of your family have a history of problems with surgery — such as adverse (bad) reactions to anesthesia — or problems with medications?
• Your doctor will review, discuss and then ask you to sign a consent form that clearly outlines the planned surgical procedure.
• Your doctor will confirm the surgical site with you and then mark the correct area on your skin with a magic marker.
• Give your cell phone, reading glasses, hearing aids and other personal items to a friend or family member before you go into the operating room. If you wear contact lenses to the hospital or surgical center, remove them and give the case to your friend or family member. These items can be returned to you when you are awake and recovering.

Pay attention to the health care you receive. If something does not seem right — such as the type of medication you are receiving — tell your doctor, nurse, or another healthcare professional right away.

• Expect healthcare workers to introduce themselves to you. Look for their identification badges.
• Notice whether your caregivers have washed their hands. Hand washing is the most important way to prevent the spread of infection.
• Help to avoid medication errors:
  • Make sure health care professionals confirm your identity by checking your wristband or asking your name before giving you any medications or treatments.
  • Know what time of day you usually take each medication. Tell your nurse or doctor if a regular medication is missed.
  • Be able to identify your pills before swallowing them. Your regular medications may have a different color or shape in the hospital.
  • Do not bring pills from home to the hospital or surgical center. They may duplicate or conflict with the medications you are getting in the hospital. Tell your physician if you are not getting your regular pills while you are in the hospital.
• Prevent falls.
  • Surgery and postoperative medicines can make even the strongest person feel weak and unsteady.
  • Some medicines and extra intravenous fluids may cause a need to empty your bladder frequently. Do not be embarrassed to ask for help. Do it early, before your need to go is urgent. Allow time for busy staff to get there.
  • Serious falls occur when patients try to be independent and do not ask for help.
  • At night, many people need more help than they do during the day. To ensure your safety, turn on lights, wear glasses, and use non-skid shoes, slippers, or hospital socks if getting out of bed.
  • Wheelchairs should be securely locked before getting in and out.
  • Hot water in a shower can lower your blood pressure and cause you to faint.
• Know your treatment plans.
  • Ask questions to make sure you understand the next steps in your treatment.
• Encourage visitors to wash their hands before and after visits.
• Discourage visits from friends and family members who are not feeling well. Children are frequent cold carriers.
• If staff moves your bedside table or rolling stand, ask them to put it back before leaving. Otherwise, your water, personal items, phone, or even the call button may be out of reach.
• Food servers should not just leave your tray; they should set it up so you can easily reach it. This may also mean adjusting the height of the rolling stand or of your bed.
• If equipment in your room starts to ding or buzz, do not be alarmed.  It is usually something simple like your IV indicating to the nurse that it is time for a refill.

You usually receive a lot of instructions just before leaving the hospital or surgical center. The nurse will give you the highlights in writing, including a list of the medications you will need to take. It is hard to remember everything. As always, ask questions if you do not understand the instructions.

• Have a family member or friend present to help remember what was said.
• Take notes (or have your family member or friend take them for you) and, specifically, find out:
  • When to see the doctor again
  • Dates and times if home nurses or therapists are coming to you
  • When to change your bandages
  • When bathing is permitted
  • When it is OK to be alone in the house
  • When you can drive
  • Instructions about elevation (raising up) of an operated extremity (arm or leg), and weight bearing on a leg after surgery
• Understand all of the medicines you need, including the names, why you are taking them, and any specific instructions about how or when to take them. Someone will have to get prescriptions filled for you.
• Make sure you understand any signs of complications, such as infections or blood clots. Know how to quickly contact your doctor or healthcare team if you notice signs of complication
• Even at home, getting up to go the bathroom at night can be dangerous. Sleeping pills and pain medications can cause unexpected balance problems, and blood loss from surgery can make you feel dizzy when you first stand up.
  • Stand still at the bedside for a moment before walking
  • Use eyeglasses and turn on a light
  • Be sure slippery scatter rugs have been removed and that there aren't any objects on the floor (boxes, electrical cords, etc.) that you may trip over
  • Be aware that standing up quickly and/or emptying your bladder can drop blood pressure and cause fainting. Even if you typically urinate standing up, you are much safer sitting down to urinate while you recover from your surgery.

Patients who ask questions, understand their treatment, and follow their doctor's instructions are more likely to achieve better results from orthopaedic surgery and be more satisfied with their care. Using safety checklists — the above examples, or lists you create on your own — can help ensure a smoother, safer road to recovery.