Patient Overview

We want your surgery to go smoothly, and you can help by following these guidelines, which are essential to avoid having your surgery delayed or cancelled:

• Plan to arrive one hour to one hour and 15 minutes prior to your surgery time.
• Do NOT eat solid foods or drink anything – including water – after midnight unless you are instructed otherwise.
• Do NOT take any medications after this time unless you receive other instructions from a nurse or your healthcare provider.
• Do NOT wear makeup, fingernail or toenail polish.
• Do NOT bring jewelry or valuables to the center.
• Do NOT smoke the night before or the morning of surgery.
• Do NOT drink any alcohol for 24 hours before your surgery.
• Do NOT bring gowns, robes or slippers. These will be provided for you.
• We want your experience here to be positive. We suggest limiting your guests to two people and refrain from bringing small children.
• You will need to bring a list of all medications you are currently taking including vitamins, herbals, over-the-counter, and prescriptive medications. The medication name, dose, route, and frequency will be needed for each medication you are taking.
• If you wear contact lenses, bring your lens container and solution. You will not be allowed to wear contacts during surgery.
• If you have eyeglasses, we prefer that you wear them.
• If you have previously been fitted with assistive devices such as crutches, a walker, cam boots, etc., please bring it with you to the center.
• Please bring pillow(s) to use in your car for your trip home.
• You may brush your teeth, but do not swallow the water or toothpaste.
• Take a shower or bath the morning or night before surgery.
• Wear loose-fitting clothing. This makes it easier to dress and undress.
• A responsible family member or friend over the age of 18 MUST accompany you home. This adult also should be available to assist you in your recovery at home. Under no circumstances will a patient who has had a general anesthetic or sedation be allowed to drive home.
• If your condition changes prior to surgery – such as a cold, persistent cough, fever or rash, notify your physician. You may need to be evaluated again before your surgery can take place.
• A consent form MUST be signed before the procedure begins. For patients younger than 18 years of age, a guardian or parent must be present to sign the form and remain in the surgery center for the duration of the minor’s stay.
• HIPAA privacy laws prohibit our center from leaving detailed messages without proper authorization.
• Accurate phone numbers where we can reach you for arrival times are very helpful.
• Please remember to call the surgery center by 2 p.m. the day before surgery if you have not already talked to a member of the River Hills Surgery Center staff.
• We ask that you let us know where we can contact you the day before and the morning of surgery in case your surgery time changes.

Admissions

Your physician has scheduled your surgical procedure through our scheduling office. A staff member will contact you within a week of your surgery. However, if you have not received a call by 2 p.m. the day before your surgery, please call us at 515-323-6400. During our call we will confirm what time you should arrive for your procedure. In addition, we will gather pertinent medical information needed before your surgery and allow time to answer your questions.

You need to arrive at River Hills Surgery Center one hour and fifteen minutes prior to a surgery procedure, and one hour prior if having a pain procedure unless instructed otherwise. This gives our staff time to prepare and verify your medical records, perform necessary lab work, and prepare you for surgery or procedure. Arriving late may cause your surgery to be delayed or cancelled, so please be on time. We also ask that you bring a photo ID and insurance cards with you, so we can make copies for Patient Accounts. If you have an Advance Directive, Living Will or Durable Power of Attorney document, please bring them so we can make copies to keep with our records.

All patients who receive a general anesthetic or sedative must have a responsible adult (over the age of 18) present to drive them home. Any patient having a pain procedure also must have an adult driver. Please inform the surgery center staff if your driver chooses to leave the facility while you are in surgery. Parents/guardians of minor children (under the age of 18) must remain at the surgery center during their child’s entire stay.

Secured lockers are available to store your clothing.
Please bring with you:

• Advance Directive 
• Copay/Deductible Payments
• Photo ID
• Insurance Card(s)

Anesthesia

Anesthesia is an important part of any surgery, including outpatient surgeries performed at River Hills Surgery Center. We believe that there is no such thing as minor surgery, so we provide the same high levels of care, experience, equipment and patient monitoring that a hospital provides in its main surgery department.

The four types of anesthesia administered here are:

• General anesthesia, which puts you to sleep during the entire operation;
• IV conscious sedation, in which a registered nurse and your surgeon monitor your care and give you light sedative medications in conjunction with local anesthesia;
• Regional anesthesia, which anesthetizes the part of the body where the surgery will take place, such as a hand or arm;
• Local anesthesia, which is administered by injection by your surgeon.

A staff anesthesiologist and/or surgeon are responsible for all anesthesia care you receive. Your fitness for anesthesia and your safety are the anesthesiologist’s and surgeons primary concerns. It’s important for you to report if any changes have occurred in your physical condition since the day your surgery was scheduled.

Pain Management

River Hills Surgery Center has an ongoing commitment to pain management. The promotion of pain management is viewed as a priority in maintaining basic human dignity, as all patients have a right to pain relief.

There are many ways to control your pain. You will be much more comfortable if you know what to expect. It is very important that you ask your doctors or nurses questions.

Measuring Your Pain
You will frequently be asked to rate your pain. This tells the doctor and nurse whether the pain medicine is working or if it needs to be adjusted or changed. For example: if 0 means you are having no pain and 10 is the worst possible pain, how would you rate your pain?

Types of Pain Control
There are many types of pain medication and different ways to give them. You may have one type of medication or a combination of medications to best control your pain. It is very important that you tell your nurse if your medicine is not working. Sometimes the amount of medicine needs to be changed to give you better pain control.

Intravenous
During your stay with us you may be given pain medication directly into your IV. This type of pain relief works within minutes and can control even severe pain.

Pain Pills
Once you are able to eat and drink you may be started on pain pills. Pain pills take about 20-30 minutes to start working. They will work best if taken prior to activity that may increase pain. If possible, take them with food

After Surgery

To our patients and families, we request that at least one family member remains in the waiting room until your surgery is over. This is to ensure them the opportunity to visit with your physician after surgery.

After your surgery you may go directly to the Phase I Recovery Room or Phase II Discharge Area. If you have received a general anesthesia or heavy sedation you will be admitted to the Phase I Recovery Room. This is a critical stage of your recovery. In order to provide you with optimal care and privacy, family members are not allowed in Phase I Recovery Room. If an hour or more has passed, your family should feel free to ask the receptionist to call the Recovery Room staff for an update.

When you are awake and comfortable, your nurse will move you to a recliner in the Phase II Discharge Area. This allows time for some of the effects of anesthesia to wear off and enables our staff members to make sure you are feeling well enough to go home. Your family will be asked to join you once you are comfortably settled. They may remain with you until you are ready to go home. You will be discharged home according to your physician’s orders. Discharge usually occurs within one hour after your surgery is completed. However, each patient and procedure is different so your discharge time may vary.

You will not be allowed to leave River Hills Surgery Center alone if you have had a general anesthetic, regional anesthesia or a sedative. If it is necessary for you to leave by taxi, you must have a responsible adult over the age of 18 to accompany you.

For your comfort and safety do not drive, operate machinery, drink alcoholic beverages, make any important decisions or take any medication not prescribed by your physician for at least 24 hours after you are discharged.

A nurse from the River Hills Surgery Center will attempt to call you the next business day after your procedure to determine your health status and to answer any questions you have following your surgery. You may be given a patient satisfaction form to fill out and return to our center following your surgery. It is very important for you to return the postage paid form to allow us to provide the best care possible at our center. Your feedback is greatly appreciated.

Advance Directives

A growing number of people are stating their health care choices in writing while they are still able to make these decisions.

These legal documents are called Advance Directives, more commonly known as a Living Will and Durable Power of Attorney for Health Care. You should talk to your physician about the effects of withholding or withdrawing different treatments. It is also a good idea to discuss your decision with your family. While it is not necessary to consult an attorney for your Advance Directive to be a legally binding document, it is often helpful.

What is an Advance Directive?
An Advance Directive is a document stating your health care choices or naming someone to make the choices for you if you become unable to do so.

Iowa law provides two types of Advance Directives:

• The Declaration Relating to Use of Life-Sustaining Procedures (commonly known as a Living Will)
• The Durable Power of Attorney for Health Care

What is a Living Will?
A Living Will is a document directing your physician that certain life-sustaining procedures should be withheld or withdrawn if you are in a terminal condition and unable to decide for yourself.

What is a Durable Power of Attorney for Health Care?
A Durable Power of Attorney for Health Care is a document through which you name another person known as your “Attorney-in-fact” or “agent” to make health care decisions for you if you are unable to make them. This agent is required to make decisions according to directions you may provide in the document or otherwise. If your wishes are not known, your agent shall make decisions in your best interests.

Where Can I Get a Living Will or Durable Power of Attorney for Health Care Form?
The Iowa State Bar Association has prepared a form containing both types of Advance Directives. Single copies are available for free by writing to: Iowa State Bar Association, P.O. Box 4906, Des Moines, IA 50306. You can also access the form by visiting www.iowabar.org.

As a Patient at River Hills:
If you have an Advance Directive in place, please bring a copy with you to your surgery. Upon registration, our staff members will take a copy for your file. Should you need to be transferred to a hospital for additional treatment at any point during your visit, a copy will accompany you and your medical records. Upon admission to the hospital, your Advance Directives will be carried out according to your wishes. If you have any additional questions regarding Advance Directives, please do not hesitate to ask our staff members or your physician.

Interpreter Services

As part of our commitment to ensuring all patients have access to quality health care, interpretation services are provided free of charge to any patient upon request. It is very important to our center that each patient fully understands all aspects of their upcoming surgery and that your educational needs are met. The use of minor children and/or family members to interpret for patients is discouraged. Please contact us, in advance, if you need an interpreter.