Table 1.

VSS Presentations: a brief overview

VSS presentations (in this order);	Key Messages
1. Welcome and evidence for the session	• Introduction to prehabilitation team • Story of previous patient with successful outcome • Encouragement to participate in Surgery School
2. Respiratory care bundle (aCOUGH) including	• Risks of post-operative chest infection: lung collapse, body’s lung cleaning mechanism physiology
Active cycle of breathing technique instructions	• Airway clearance technique including controlled breathing, deep breathing, huff and cough
Oral care	• Attend the dentist/hygienist • Use an alcohol-free antiseptic mouthwash daily • Brushing teeth twice daily
Get out of bed	• Sit up straight in bed and sit out of bed to promote early post-operative mobilisation • Gradual return to activity after surgery
3. Exercise prehabilitation	• Smoking cessation • Benefits of exercise • Recommendations: avoid inactivity, physical activity to meet recommended guidelines, breathing exercises 5–10 min daily. • Monitoring intensity • Early post operative mobilisation. • Tips for safe exercise and starting an exercise program prior to surgery
4. Nutrition before surgery	• Effect of surgery on nutrition • Nutrition to increase muscle stores: exercise + eat/drink protein + eat/drink enough energy • Maintain weight • Follow Healthy Eating Guidelines • Post operative nutrition
5. Pain management after surgery	• Causes of pain after surgery • Daily pain assessment • Commonly used pain relief: PCA, epidural, spinal injections, tablets, wafers, liquids. • Common Side Effects incl: nausea, vomiting, rash/itch
6. Psychological preparedness and relaxation	• Why focus on psychological wellbeing? Prepare for surgery, cope with surgery, recover from surgery • Strategies to manage worry e.g. relaxation strategies • Staying motivated and goal setting • Using family and friend supports