NIKISA Geriatric & Recovery Hospital ensures the proper recovery of Post operation cases after discharge from acute care hospital. NIKISA is clear that the type of post-operation care required by a patient depends on the type of surgery that has been performed, age of the patient and also on pre-existing comorbidities like diabetes, hypertension etc.
NIKISA’s approach to post operation rehabilitation
NIKISA post operation rehabilitation plan will depend on the part of the body or type of ability affected by the Operation. Post operation recovering patients are divided into one of the following two categories right at the time of admission to NIKISA Hospital.
1. Patients who require Critical care: These patients are the ones who require high degree of care. Following is the criteria used to recognise Post operation patients who require critical care;
a. Completely immobile and are in Supine position.
b. Discharged from acute care hospital with cannula, Riels tube, and catheters.
c. The acute care hospital has done Tracheostomy.
d. Patients requiring Medical Oxygen, either continuous or on intermittent basis.
e. Post operation patients who require suctioning on account of Phlegm build-up
f. Post operation patients who are weak and completely bed ridden and therefore cannot communicate in an understandable manner with service providers.
2. Patients who do not require critical care.
a. Patients who do not come under any of the above criteria.
b. Patients who can be mobilised on wheel chair or on foot with or without support.
c. Patients who are normal except for post operation related mobility.They are able to eat normal food and do not require high degree of medical supervision.
Treatment of Post operation patients who require Critical care:
1. These patients are admitted to Critical care section till they attain a non-critical stage.
2. Critical care section is almost like an intensive care unit and has the following facilities.
a. Patients are provided with Fowlers bed.
b. Continues Medical oxygen supply facility is available in this section.
c. There are duty doctors at this section on 24 X 7 basis.
d. Patient monitors, suction facility is also available.
e. There is a minor OT in the Critical care section to do procedures on emergency basis.
f. Required activities like Chest physiotherapy, Suction etc are performed on bed side.
g. Visitor entry is also restricted.
h. Emergency cart is readily available. Emergency medicines provided by the hospital are to be replenished by the patient’s caretakers.
i. Medicines and other consumables can be bought from the Hospital Pharmacy or from any other pharmacy and provided to the treating doctors and nurses.
j. The Nutritionist guides the patients and their families on dietary requirement of the patients. Patients can get their diet from their homes. External catering services are also available.
3. Once, the patients recover from critical condition, they are shifted to wards, specially created for rehabilitation of Post operation patients. In case the patient turns out to be more critical, the family members will be requested to shift the patient to an acute care hospital for further acute care.
Treatment of Post operation patients who do not require Critical care
1. Post operation patients who do not require Critical Care in the judgement of NIKISA are moved to wards created for post operation recovering patients.
2. Physical facilities at the Post operation rehabilitation wards:
a. All the wards are provided on Single Occupancy basis.
b. These wards are fully equipped and have been designed keeping in mind the requirement of Post operation patients.
c. Corridors have been provided with rails for holding while walking.
d. Toilets are at floor level for easy mobilization of patients both on foot and also on wheel chairs.
e. Grab bars have been provided in bathroom and toilets.
f. Bed required for the convenience of patient will be provided. Option of utilising Fowler beds with air bed or luxury single bed or luxury double bed is provided to the patient.
g. Every ward is provided with attached bath rooms with hot and cold-water supply, western commode, Meals table, T V, Fridge, Nurse call facility, newspaper and Drinking water.
h. Services of Nurses and ward boys is available on 24 X & basis.
i. The wards are centrally air conditioned. (on account of Covid 19 restrictions AC is not being used for the present). Every ward is provided with pedestal fan.
j. Some rehabilitation equipment are provided at ward itself depending on the requirement of the recovering patient.
3. Medical and Diet care:
a. The patients are examined and treated by a team of NIKISA doctors on a daily basis. In addition, whenever required our Specialists provide consultation to the patients. Every surgeon gives instructions regarding post operation care. We ensure proper implementation of doctor’s instructions. In fact, feedback is provided to the surgeon on a daily basis regarding the recovery of the patient. In case any complication the surgeon will be consulted.
b. Proper nutrition and taking medication as per the prescription of nutritionist and the treating doctor respectively is of paramount importance in post operation recovery. Our Nutritionist will guide the patients and their families on dietary requirement of the patients. Patients can get their diet from their homes. External catering services are also available.
c. Some Post operation patients suffer from disorders like diabetes and hypertension. We monitor the vital parameters and take corrective action.
d. Most post operation patients get into a sedentary status, especially in-home settings and many develop secondary complications arising out of poor hygiene. Bed sores, urine and incontinence are very common in recovering post operation patients; therefore, we monitor the patients for these secondary complications and take remedial actions.
e. Secondary Injuries arising out of unexpected fall is very common in post operation patients. When untrained personnel handle post operation patients some might suffer from limb and girdle fractures. As trained personnel handle the patients, possibility of fall at NIKISA Hospital is very remote.
f. Medicines and other consumables can be bought by patient’s caretakers from the Hospital Pharmacy or from any other pharmacy and provided to the treating doctors and nurses.
4. Physiotherapy:
a. A separate Physiotherapy section has been created to aid speedy recovery of the operated patients, be it orthopaedic or any other type of surgery.
b. Rehabilitating after surgery starts with a complete physical therapy evaluation, looking at things like range of motion, strength and the surgeon’s recovery protocol. After examining each patient, the Physiotherapist will craft a plan based on the goals to be achieved. Using their knowledge of healing, the Physiotherapist will make sure that the recovering patient progresses safely and quickly through the four stages of rehabilitation so that the rehabilitation goals are met;
a. Restoring motion; A typical protocol following an orthopaedic procedure starts with gentle or passive therapy. The physical therapist assists the patient with range of motion for the particular joint.
b. Active range of motion: After follow up the surgeon or when the protocol indicates, the patient will gradually progress through assisted and active range of motion exercises. During this phase, the physical therapist will also provide guidance regarding resuming activity.
c. Strengthening: Once active range of motion is restored, strengthening phase of physiotherapy is initiated. That will involve a variety of exercises and many different equipment.
d. Restoring optimal movement: The last phase of recovery puts all the pieces together to help the patient to move efficiently and effectively through all of the daily tasks that the patient needs to perform.