St Mark's HospitalLondon North West Healthcare

Day-to-Day Patient Stay

A brief summary of a typical patient stay in hospital while on the Enhanced Recovery Programme.

The Day Before Surgery 

• Most people can eat a normal diet – unless they are having ‘bowel preparation’
• Bowel preparation (to empty the bowel) may be needed – if so follow the dietary instructions provided
• Patients may need an injection of heparin (a blood thinning agent) to reduce the risk of blood clots causing problems after surgery

The Morning of the Operation

• Patients can eat up until six hours before the surgery (unless taking oral bowel preparation)
• Patients can carry on drinking clear fluids (water, weak black tea, weak black coffee or weak fruit squash) until 2 hours before the operation
• Patients should have 2 (400ml in total) of preOp© three hours before surgery and these must be finished by 2 hours before the operation
• No fluids are allowed from 2 hours before surgery 
• An enema (to empty the bowel) may be needed in some patients

The Afternoon or Evening on the Day of Surgery

• Once patients are fully awake they are encouraged to drink, from the time they are in the recovery area
• Patients are encouraged to eat as soon as they return to the ward, once they feel able to do so
• Patients are encouraged to get out of bed and sit in the chair for 2 hours, if they feel able to do so

The Day After Surgery

• After the doctors and nurses review patients, they may take down the drip (intravenous fluids) and urinary catheter and start patients on pain killers by mouth (analgesia), as well as continuing the epidural or PCA (patient controlled analgesia) type of pain relief
• Patients are encouraged to wash and dress in normal clothes (if unconnected from medical equipment)
• Patients will be reviewed by one of the team regarding mobility. Provided they are well enough we would aim for patients to walk up and down the ward 4 times during the day
• Patients are encouraged to remain out of bed (with breaks if needed) for 6 hours
• Whenever possible we encourage patients to take their meals in the dining room on the ward
• Patients are encouraged to take two protein, high calorie drinks

Days 2 and 3 After Surgery

• Patients should continue walking, eating, drinking, taking supplement drinks and start wearing their normal clothes
• After the doctors and nurses review patients, they may take down the epidural or PCA (patient controlled analgesia)
• Patients should plan for their discharge home from day 3 onwards