• Reference Number: HEY417-2024
• Departments: Breast Services
• Last Updated: 31 January 2024

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. 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.

Please give the pre-assessment nurse as much information as possible about your past medical history. This will help determine which tests and investigations need to be performed prior to surgery. Without this information the anaesthetist may not be happy to proceed with an anaesthetic.

What will happen?

Pre-operative assessment for your breast surgery is carried out in the Breast Care Unit at Castle Hill Hospital. Your visit will take approximately one hour, depending on the tests that are required.

This is an appointment with a nurse. You will be asked questions about your health, medical history, home circumstances and some tests may be carried out.

Why do I need a pre-operative assessment?

This appointment is to check if you have any medical problems that might need to be treated before your operation, or if you will need special care during or after the surgery.

Can there be any complications or risks?

We can foresee no complications or risks associated with attending your pre-operative assessment appointment. The complications and risks specific to your surgery will be discussed fully with you by your surgeon. If you need clarification please feel free to ask questions.

How do I prepare for the pre-operative assessment?

There is no specific preparation required for pre-operative assessment, other than having your medical history and a list of medication you take ready to share with us at the appointment. We also recommend you have non caffeinated drinks before your appointment – at least 500ml to 1 litre. Being well hydrated enables us to take blood samples from your arm, should blood tests be needed as part of the pre-operative assessment.  You may be required to remove some items of clothing to have swabs taken or if you require an ECG. You will not be staying in hospital at this visit.

If you have any questions about your hospital admission, you may wish to bring a list of questions with you.

Medication

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

What tests will I have?

The tests you have will depend on what operation you are having and your health and medical history.

You may have blood tests so it is important that you are well hydrated when you attend.

You may have an ECG.

You may have swabs for MRSA.

MRSA stands for Methicillin Resistant Staphylococcus aureus, which is a bacteria (germ) which is found in 40% of the population. MRSA can live quite harmlessly on the body but it has the potential to cause serious infections if it is allowed to enter the body. MRSA is identified by taking swabs from the nose, axilla (armpit) and groin. MRSA is treated with antiseptic body wash and antibiotic nose ointment.

If the MRSA swabs detect that you carry MRSA, we will contact you and request your GP to start the body wash and nose treatment. If this treatment is required, the date for your operation may be changed.

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.

Your planned operation

When all the relevant information has been obtained and the necessary tests have been carried out, you will be ready for your planned operation. The pre-operative assessment nurse will answer any questions about your admission, any questions specific to the surgical technique should be directed to your surgeon.

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.

The nurse will clarify your next appointment, which is usually the day of your operation. Please check with the nurse, if there any other appointments for you to attend before your operation date.

You should attend Ward 16 or Day Surgery Centre at Castle Hill Hospital as stated on the letter sent to you. Please follow the fasting information on your letter or your surgery could be delayed.

Additional information for your visit

Parking

All of our patient and visitor car parks at Castle Hill Hospital now use Automatic Number Plate Recognition (ANPR).

• A camera will read your number plate as you drive into our car park.
• You will need to “pay on exit” before returning to your car.
• When you reach the exit, the barrier will lift as long as you have paid.

Further information can be found at www.hull.nhs.uk

Blue Badge holders

• Parking is free for Blue Badge holders.
• You must display a valid Blue Badge in your vehicle.
• You must register your Blue Badge on the APCOA Blue Badge Permit Portal ideally before you come to hospital. You can add multiple vehicle registrations via the app if necessary.
• If you arrive at hospital before registering your Blue Badge, you can validate your free parking using the tablets at the security offices or the Queen’s Centre.

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

Your valuables are usually held in a central location in the hospital called the General Office. These are located on the second floor of the Tower Block at Hull Royal Infirmary and at the main reception at Castle Hill Hospital.  They are open weekdays between 9:00 am and 4:30 pm.

If you are discharged over the weekend, you may have to return to the hospital to collect valuables or money left with the General Office.

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.

If you require transport to attend your appointment, please contact your GP surgery.

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.