• Reference Number: HEY-417/2020
• Departments: Breast Services
• Last Updated: 31 January 2020

Introduction

This leaflet has been produced to give you general information about your pre-operative assessment appointment.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your nurse, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the Breast Care Team caring for you.

What is a pre-operative assessment?

The purpose of your pre-operative assessment is to ensure that you are prepared fully for your planned operation and the assessment is usually carried out a week or two before your operation, but the timing can vary.

Nasal, axilla (armpit) and groin swabs are routinely taken from all patients to test for the bacteria MRSA (Methicillin Resistant Staphylococcus Aureus).

In addition there are more specific tests that may be carried out because of your particular operation, or because you have a particular health problem. These may include blood tests or an electrocardiogram (ECG – monitoring of your heart).

Why do I need a pre-operative assessment?

A number of health checks will be carried out to make sure you are well enough to have an anaesthetic and to have your planned operation. It will help identify any possible health problems, which you may not be aware of. These can then be treated or stabilised before your surgery. Your planned surgery cannot go ahead without a completed Pre-operative Assessment.

Can there be any complications or risks?

We can foresee no complications or risks associated with attending your pre-operative assessment appointment; however, as with all surgery there can be complications or risks. These risks will be specific to your surgery and will be discussed fully with you by your consultant. If you need clarification please feel free to ask questions.

How do I prepare for the pre-operative assessment?

There is no preparation required for pre-operative assessment and you will not be staying in hospital at this visit. You may be required to remove some items of clothing to have swabs taken or if you require an ECG.

Medication

Please bring along to the appointment a list of current medication you are taking.

Additional information for your visit

Parking

Pay and display machines are situated in the visitors car parks, please ensure you have sufficient change.

Please note that our car parks are managed by OCS. Patrollers pay particular attention to vehicles parked in disabled spaces. Please ensure that you display your blue badge if you are parked in a disabled driver space.

The Trust cannot guarantee that you will find a car parking space within easy walking distance of the area you are visiting, and we strongly recommend that you consider alternative travel choices, such as public transport.

Please allow plenty of time for parking before your appointment.

Smoking

The Trust operates a no smoking policy. For help and advice on giving up, try the NHS Stop Smoking Service on 0800 022 4332 or visit www.smokefree.nhs.uk. Patients and visitors are permitted to use e-cigarettes within the Trust grounds.

Valuables

Please avoid bringing valuables, such as jewellery, and large amounts of money into hospital with you.

The Trust cannot accept responsibility or liability for property or money brought onto hospital premises, unless they are handed to a member of the nursing team for safe custody and an official receipt is issued.

Limited mobility

We endeavour to make your visit as comfortable as possible. If you have any mobility or sitting difficulties, please inform a member of staff so we can assist in ensuring that you will be comfortable during your visit.

What will happen?

Pre-operative assessment for your breast surgery is carried out in the Breast Care Unit at Castle Hill Hospital. Your visit may be between one and two hours. This is to allow for all the tests to be performed.

What tests will I have?

The number and type of pre-operative tests you may be recommended to have depends on a number of things, including:

• Your health – the nurse will look at factors such as your blood pressure, pulse, body mass index (a measure that expresses the relationship of your weight to your height), illnesses you have or have had, any history of health problems in your family and medications you are taking.
• Your age (the need for tests may increase as you get older).
• The type of surgery you are going to have (more tests may be needed if you are going to have major surgery).

What happens afterwards?

The results of pre-operative tests are available usually within a few days and must be available before your operation. If any abnormalities are identified we will contact you so that any necessary treatment can be given prior to your surgery.

You should then attend the ward on the date and time stated on your letter. Please follow the fasting information on your letter or your surgery could be delayed.

Your planned operation

When all the relevant information has been obtained and the necessary tests have been carried out, the nurse will ensure you have been informed fully about your planned operation and will answer any questions you may have. You will be informed of your expected length of stay in hospital, fasting procedures, any follow up care you may require and what items you may need to bring into hospital. We will then start planning your discharge from hospital to ensure that any problems are highlighted early. Please inform us if you have any concerns for discharge so that we can endeavour to help. It is no longer necessary for patients to stay in hospital for a long period of time. Early discharge means you can recover in your own home, in a familiar environment.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Breast Care Unit on telephone number (01482) 622679. E-mail: hyp-tr.breastcareunit.nurses@nhs.net

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.