My post-op admit order notes

 

Thyroid

Hemithyroidectomy

.cdldrainteach

Total or completion thyroid:

Outpatient labs

.cdldrainteach

Tracheostomy

“Consult RT”:

  1. Prior to discharge, have patient demonstrate understanding of what to do and practical proficiency of skills in case of obstruction of the tracheostomy tube

    1. Include trachea suctioning

    2. Include removal and replacement of the inner cannula

  2. Send pt home with 3 weeks of trach care supplies (extra tracheostomy tube, replacement inner cannulas, replacement soft velcro trach ties, suction tubings)

Consult SLP:

  1. Prior to discharge, have patient demonstrate understanding of how and when to use the Passe-Muir valve.

  2. Prior to discharge, have patient physically demonstrate practical proficiency in removal and replacement of the Passe-Muir valve.

Discharge coordinator

  1. Home health nursing, RT, and SLP is needed.

  2. A list of trach supplies needed should be communicated to home health (backup trach, many disposable inner cannulas, suction tubing, flexible suction tips, Yankauer suction tips, trach cleaning kits.

“Nursing communication”

  1. Home health readiness: Hold discharge until you have verified

    1. the availability and readiness of home health (including respiratory therapy) within 12 hours of the patient arriving home.

    2. plans for availability of a home suction machine within 12 hours of the patient arriving home.

    3. The home health nurse (or agency) has my phone number (309-363-0275) and I have theirs

  2. SLP readiness: Hold discharge until

    1. inpatient speech pathology has signed off that the patient meets knowledge and practical skill proficiency in self trach care.

    2. Home health speech pathology is set up, that they have my number (309-363-0275) and I have theirs

  3. RT readiness: Hold discharge until:

    1. RT has signed off that the patient meets knowledge and practical skill proficiency in self trach care

    2. The patient is going home with 3 weeks of trach care supplies (backup trach same as indwelling trach, many (about 21) disposable inner cannulas, suction tubing, flexible suction tips, Yankauer suction tips, trach cleaning kits).