- Hi, my name is Megan Laframboise.

I'm the orthopedic neuroscience navigator

here at St. David's Medical Center.

Thank you for trusting us with your care.

We have an exceptional program here

at St. David's Medical Center.

It is important that you complete this online program

because we will teach you all you need to know

about the joint replacement process.

The class will discuss what to expect

while in the hospital after surgery

with the focus on pain management, mobility,

and preventing complications.

This class will increase your knowledge

to reduce anxiety, decrease the length of hospital stay,

and help establish realistic expectations

to improve surgical outcome.

We hope you'll enjoy this educational video

and thank you for choosing St. David's Medical Center.

(Light music)

(gentle music)

- Welcome to our Joint Replacement Pre-Op Education class.

Over the next 25 minutes, we will discuss a general overview

of the joint replacement process and hospital stay

at St. David's Medical Center.

Any specifics to your procedure

should be discussed directly with your surgeon.

This class will provide education and empowerment

about the joint replacement process,

and can help you to identify techniques

to decrease risk factors of complications after surgery.

It will also help prepare you

for your joint replacement surgery and help reduce anxiety

about the surgical process.

Our goal is to create expectations

of what you will experience here

at St. David's Medical Center and to assist

with beginning the process for your transition

back home after surgery.

Our mission at St. David's Medical Center

is to provide exceptional care to every patient every day

with a spirit of warmth, friendliness and personal pride.

Our vision is to be the finest care

and service organization in the world.

Our St. David's staff follows what we call the ICARE values,

which include integrity, compassion, accountability,

respect and excellence.

The goals of our facility are exceptional care,

customer loyalty and financial strength.

We function under a patient centered team approach

when providing care at our facility.

You can see here that you and your family members

are at the center of our care team.

Your surgeon and their physician's assistant are at the top;

they are the individuals performing your surgery

and they will see you every day while you're here

at the hospital with us.

A hospitalist is an internal medicine doctor

that is consulted by your surgeon to assist

with your medical care after your surgery.

A pharmacist is heavily involved in our care team

and manages all of your medications that you will take

while in the hospital.

The nursing team, both registered nurses

and patient care technicians, will be with you

24 hours a day.

We have a day shift and night shift team

that works 12-hour shifts.

Our physical and occupational therapists will see you

for therapy sessions twice a day and our nurse case manager

will assist with discharge planning

and durable medical equipment.

Once you have made the decision for surgery,

we recommend improving your nutrition

through healthy eating.

We encourage iron and protein rich foods, lean meats,

fruits, vegetables and grains.

Notify your dentist of your upcoming

joint replacement surgery.

Your orthopedic surgeon does not want you

to have any dental procedures for three months

following your joint replacement surgery.

Dental procedures can introduce bacteria

into your bloodstream,

which can increase your risk for infection.

After this three month period,

you will require oral antibiotics

prior to any dental procedure for at least one year

following your joint replacement.

If you wish to obtain a handicap placard for your vehicle,

contact your surgeon's office to get a prescription

to bring to the DMV.

Pre-Surgical Testing is ordered by your surgeon

to be completed prior to your surgery,

to ensure that you are well enough

to have your joint replacement procedure.

Here are a few examples of tests that may be ordered.

The tests that are ordered depend

on your medical and surgical history.

An EKG is a heart function test.

Stickers are applied to your chest to determine

if your heart is well enough for surgery.

A chest x-ray is an x-ray of your lungs and heart,

and a urinalysis is a sample of your urine.

Blood tests are lab tests run on blood samples,

and a MRSA swab is a swab of the inside of your nose.

You will complete your testing seven to 10 days

prior to your surgery.

However, this testing can be done up to 60 days

prior to surgery.

You will complete your testing here

at St. David's Medical Center

or at your Primary Care Physician's office,

if your surgeon has instructed you to do so.

Our Pre-Surgical Testing nurses will call you

and obtain a list of your home medications

and medical and surgical history.

They then will assist you in making an appointment

to come in, in order to have your testing done.

If your surgery is coming up and you have not heard

from one of our Pre-Surgical Testing nurses,

please call the Pre-Surgical Testing department

at 512-544-3333 to make an appointment.

Please bring your driver's license and insurance cards

with you to your appointment.

If you have an Advanced Directive

or Medical Power Of Attorney document

and would like us to have this on file

in your medical record, you may bring it with you

to your appointment and we will make a copy.

If you have been seen by a specialist to have testing done

prior to your surgery, the Pre-Surgical Testing nurses

will instruct you to bring any copies of these medical tests

in with you to your appointment.

We do also ask that you bring in a list

of your home medications.

Though we go over this list with you on the phone,

we would also like to have a written-out copy to ensure

that our list is complete and accurate.

Please allow two to three hours for this appointment

to complete the ordered testing.

The Enhanced Surgical Recovery program

at St. David's Medical Center was developed to help you

have an improved surgical outcome by recovering

more quickly and safely after surgery.

The benefits of the ESR program include faster recovery,

eating sooner after surgery, better pain control

with fewer side effects, reduction of nausea

or upset stomach after surgery,

increased early movement and walking,

shorten hospital stay, and returning to your normal life

at a quicker rate.

Get specific instructions from your surgeon

regarding when to stop taking blood thinning medications

prior to surgery.

We typically ask that you stop taking these medications

seven to 10 days prior to surgery.

These medications include Non-Steroidal

Anti-inflammatory Drugs, or NSAIDS, such as Motrin,

Ibuprofen, and Aleve. Celebrex and Meloxicam;

certain herbal supplements like fish oil, vitamin E

and glucosamine, and prescription blood thinners

like Coumadin, Aspirin, Plavix and Xarelto.

Please ask your doctor about taking your medications

before surgery.

The pre-operative nurses will instruct you

only on what medications to take on the day of your surgery.

Before surgery we recommend performing

a safety check of your home.

This includes removing throw rugs

and tacking down loose carpeting.

If you are able, remove electrical cords

and other obstructions from your path,

so you will not have to lift your assistive device

over these items when walking.

Having adequate lighting during the nighttime