QUESTIONNAIRE ON USE OF HEALTH SERVICES BETWEEN 3 and 12 MONTHS AFTER ANEURYSM REPAIR
|
|
- Kelly Shepherd
- 6 years ago
- Views:
Transcription
1 Date of questionnaire completion: Trial ID Immediate Management of the Patient with Ruptured aneurysm: Open Versus Endovascular repair QUESTIONNAIRE ON USE OF HEALTH SERVICES BETWEEN 3 and 12 MONTHS AFTER ANEURYSM REPAIR We would be grateful if you would take a few minutes to answer the following questions about services you may have used since * This date is either that of your previous follow up appointment or if you did not attend for your 3 month follow up, it is 3 months after your operation. Section A (Questions 1-5) is about services you may have used because of your aneurysm. Section B (Questions 6) is about services you may have used for other health reasons. *local trial co-ordinator to date this page, the top of page 3 and questions 2.1, 3.1, 4.1, 4.3 and of 7
2 Trial ID HOW TO FILL IN THE QUESTIONNAIRE Most questions can be answered by ticking the box next to the answer that applies to you. Please tick one box only for each question. Example: Since you left hospital after your aneurysm repair have you had further hospital treatment of your aneurysm, by either a doctor or nurse? If yes, where was this? Name of Hospital: e.g. West Middlesex If yes, did you have another operation? Example: How many more operations have you had? of operations OR if you can t remember the exact number of operations ops 1 or 2 3 or more Example: How many appointments have you had with the doctor or nurse at an outpatient s department because of your aneurysm? Who? How many times? OR if you can t remember the exact number of times tick one of the following boxes 1 A doctor 1 or 2 3 or 4 5 or more 2 A nurse none 1 or 2 3 or 4 5 or more Examples for filling in the questionnaire 2 of 7
3 Trial ID Services used since <please insert relevant date above and at 3.1, 4.1, 4.3 and 6.1> Section A: Service use for reasons related to your aneurysm 1.1 Have you had further hospital treatment of your aneurysm? 1.2 If yes, where was this? Name of Hospital: 1.3 If yes, did you have another operation? 1.4 How many more operations have you had? of operations OR if you can t remember the exact number of operations op(s) 1 or 2 3 or more 1.5 How many appointments have you had with the doctor, nurse or radiographer at an outpatients department because of your aneurysm? Who? How many times? OR if you can t remember the exact number of times tick one of the following boxes 1 A doctor 1 or 2 3 or 4 5 or more 2 A nurse 1 or 2 3 or 4 5 or more 3 A radiographer 1 or 2 3 or 4 5 or more 1.6 Have you seen your GP because of your aneurysm? 1.7 If yes, how many times have you seen the GP? of times OR if you can t remember the exact number of times time(s) 1 or 2 3 or 4 5 or more Services following discharge 3 of 7
4 Trial ID 2 District nurse visits 2.1 Has a district nurse been to visit you at home since 2.2 If yes, how often has the district nurse been to see you? Several times a week Once a week Once a fortnight Once a month Other (please specify) 2.3 For how many weeks has the district nurse been to see you? of weeks OR if you can t remember exactly how many weeks weeks 1 to 3 weeks 4 to 7 weeks 8 to 12 weeks 3 Stay in a convalescent home or nursing home 3.1 Have you stayed in either a convalescent home or nursing home since 3.2 If yes, how many weeks you have stayed there? of weeks OR if you can t remember exactly how many weeks weeks 1 week or less 1 to 4 weeks District nurse visits & Stay in a convalescent or nursing home 4 of 7
5 4 Use of social services 4.1 Have you seen a social worker for reasons related to your aneurysm since? 4.2 If yes, how many times? of times OR if you can t remember the exact number of times time(s) 1 or 2 3 or 4 5 or more 4.3 Has a home carer (someone from social services who comes to assist with cleaning and feeding) visited you since 4.4 If yes, how often have has the home carer visited you? Once a day Once a month 1 2 times a week Other (please specify) 4.5 For how many weeks have you had a home carer? of weeks OR if you can t remember exactly how many weeks weeks 1-3 weeks 4-7 weeks 8-12 weeks 4.6 Did you have a home carer before your aneurysm repair? Use of social services 5 of 7
6 5 Input from patients and carers 5.1 Have you had to leave paid employment because of your aneurysm? 5.2 Have you had to take time off work because of your aneurysm? 5.3 If yes, how many days? of days OR if you can t remember the exact number of days days 1-5 days 6-10 days more than 10 days 5.4 Have any of your friends or relatives had to have time off work for reasons relating to your aneurysm? 5.5 If yes, how many days? of days OR if you can t remember the exact number of days days 1-5 days 5-10 days more than 10 days 5.6 Do any of your family or friends help you with feeding, washing or dressing? 5.7 If yes, on average for how many hours a day? of hours OR if you can t remember the exact number of hours hours 2 hours or less 3 to 5 hours More than 5 hours Input from patients and carers 6 of 7
7 Section B: Service use for reasons not related to your aneurysm 6.1 Have you had hospital treatment by either a doctor or nurse for anything other than your aneurysm (examples might include breathing problems, skin rashes, constipation etc) since? 6.2 If yes, where was this? Name of Hospital: 6.3 If yes, what was the treatment for? 6.4 How many appointments have you had with the doctor or nurse at an outpatients department for reasons unrelated to your aneurysm? Who? How many times? OR if you can t remember the exact number of times tick one of the following boxes A doctor 1 or 2 3 or 4 5 or more A nurse 1 or 2 3 or 4 5 or more 6.5 Have you seen your GP for reasons unrelated to your aneurysm? 6.6 If yes, how many times have you seen the GP for reasons unrelated to your aneurysm? of times OR if you can t remember the exact number of times times 1 or 2 3 or 4 5 or more Many thanks for your help. Services at 12m 7 of 7
IMPROVE Case Report Form Completion Guidelines
2012 IMPROVE Case Report Form Completion Guidelines Suggested Check List for Data Capture For IMPROVE Trial ID no: Requirement Date Comments Initials Randomised patient data retrieved and checked for completion.
More informationPREPARED CARER QUESTIONNAIRE SECTION 1 : QUESTIONS ABOUT YOU, THE CARER. 1 Home post code. 2 Today s Date / / 20
PREPARED 1998 & Adelaide Research & Innovation office use only Patient ID. Hospital CARER QUESTIONNAIRE SECTION 1 : QUESTIONS ABOUT YOU, THE CARER 1 Home post code 2 Today s Date / / 20 Please circle 3
More informationDown s Syndrome Association
Trim 650.0 x 479.0 mm www.downs-syndrome.org.uk www.facebook.com/downssyndromeassociation twitter.com/dsainfo Down s Syndrome Association Down s Syndrome Association www.downs-syndrome.org.uk www.facebook.com/downssyndromeassociation
More informationPlease take it with you if you have to go into hospital. Make sure that all the staff who need to know about the information read it
HOSPITAL PASSPORT When you come into hospital we want to make sure that we care for you really well. This passport gives hospital staff important information about YOU and a brief account of any additional
More informationAssessments for NHS-funded nursing care
Assessments for NHS-funded nursing care People with dementia living in nursing homes should have their nursing care provided free of charge by the NHS; this is known as the registered nursing care contribution
More informationHOSPITAL DISCHARGE FOLLOW UP REPORT: NOVEMBER 2016
HOSPITAL DISCHARGE FOLLOW UP REPORT: NOVEMBER 2016 Following on from the Healthwatch Special Inquiry into hospital discharge which took place during July and August 2014 and the subsequent Healthwatch
More informationMaidstone Home Care Limited
Maidstone Home Care Limited Maidstone Home Care Limited Inspection report Home Care House 61-63 Rochester Road Aylesford Kent ME20 7BS Date of inspection visit: 19 July 2016 Date of publication: 15 August
More informationRecovering from a hip fracture following an accident
South Tyneside NHS Foundation Trust Recovering from a hip fracture following an accident Providing a range of NHS services in Gateshead, South Tyneside and Sunderland. What is a hip fracture? The hip joint
More informationGP online services for carers, including young carers Patient Guide
GP online services for carers, including young carers Patient Guide easy read Reading this booklet This booklet uses easy words and pictures to help you understand more about GP online services. You might
More informationTo Approve To Note To Assure. N/A Overall Income: N/A N/A N/A. Link to Business Plan:
Patient Story Community Nursing/ Pressure Ulcers Agenda Item: 1 Reference: WCT14/15-096 Meeting Name: Trust Board Meeting Date: 4 August 2014 Lead Director: Sandra Christie Job Title: Director of Quality
More informationWhat is TB? Prevention is better than cure. You can get latent or active TB even if you have had a BCG vaccination
What is TB? Tuberculosis (TB) is an illness caused by bacteria. When someone with TB in their lungs coughs or sneezes, they send TB bacteria into the air. If you breathe in these bacteria, one of three
More informationSingle Assessment Process (SAP) Single Assessment Process (SAP) Contact Form. NHS No Agency No
Appendix 1 Single Assessment Process (SAP) Single Assessment Process (SAP) Contact Form Date Title Family Name First Name Preferred Name Gender M F NHS No Agency No DOB Religion Marital status S M W Practising
More informationAre You Getting Ready For Surgery? Ask Questions & Speak Up!
Are You Getting Ready For Surgery? Ask Questions & Speak Up! Getting ready for surgery? Ask Questions & Speak Up! Everyone has a part in making health care safe doctors, health care leaders, nurses, and
More informationInformation for Patients Central Venous Catheter (Haemodialysis Catheter)
Information for Patients Central Venous Catheter (Haemodialysis Catheter) Going Home with a Haemodialysis Catheter? Important facts you must know. Haemodialysis Treatment 29/07/2018 Page 1 In order to
More informationAn introduction to the multi-disciplinary team for bowel and anal cancer
An introduction to the multi-disciplinary team for bowel and anal cancer Providing support for patients and their families at the Royal Sussex County Hospital An introduction to the Multidisciplinary team
More informationDepartment of Colorectal Surgery Pilonidal Sinus Operation
What is a pilonidal sinus? Department of Colorectal Surgery Pilonidal Sinus Operation A pilonidal sinus is an inflamed sinus tract (or tracts, as there can be more than one) which leads to a cavity under
More informationNATIONAL PATIENT SURVEY, 2004
NATIONAL PATIENT SURVEY, 2004 This survey is about your experience of the services provided by the National Health Service. What condition were you treated for when visiting the NHS Hospital Trust on the
More informationPATIENT QUESTIONNAIRE Please help us make hospital care better.
What is the survey about? PATIENT QUESTIONNAIRE Please help us make hospital care better. The National Patient Experience Survey is a new nationwide survey. It asks you for feedback about your most recent
More informationWelcome to the Neonatal Unit at the Royal Oldham Hospital. An information guide
TO PROVIDE THE VERY BEST CARE FOR EACH PATIENT ON EVERY OCCASION Welcome to the Neonatal Unit at the Royal Oldham Hospital An information guide Welcome to the Neonatal Unit at the Royal Oldham Hospital
More informationTaking Control, Shaping Our Future. Have Your Say. Cornwall and the Isles of Scilly Health and Social Care Plan
Taking Control, Shaping Our Future Have Your Say Cornwall and the Isles of Scilly Health and Social Care Plan 2016-2021 Easy Read 1e Have your say We want to what you think about our plans for health and
More informationYou and your gastrostomy feeding tube
The Clatterbridge Cancer Centre NHS Foundation Trust You and your gastrostomy feeding tube Rehabilitation and Support A guide for patients and carers Contents Skin care...1 Daily tube care...2 Feeding
More informationPatient Self Administration of Intravenous (IV) Antibiotics at Home
Trust Policy Document Ref. No: PP(16)319 Patient Self Administration of Intravenous (IV) Antibiotics at Home For use in: For use by: For use for: Document owner: Status: Clinical Areas Clinical Staff Patient
More informationThoracic Surgery Unit Information for Patients Having an Examination of the Lymph Glands Inside the Chest
Thoracic Surgery Unit Information for Patients Having an Examination of the Lymph Glands Inside the Chest Cervical Mediastinoscopy (often simply Mediastinoscopy ) The following information has been prepared
More informationFirst Line Manager Registered Nurse
First Line Manager Registered Nurse Responsible to: Manager Main Purposes of Role 1. To act as a first line Manager in assisting the Manager and Deputy/Head of Care/Senior Nurse in providing a home for
More informationRespiratory and Home Oxygen Service
Respiratory and Home Oxygen Service Who are the Respiratory and Home Oxygen Assessment Service? We are a team of nurses, physiotherapists and support staff with specialist training and experience of supporting
More informationPATIENT ONLINE SAFE ACCESS TO ONLINE RECORDS CASE STUDY SAFE ACCESS TO ONLINE RECORDS A PRACTICE S POINT OF VIEW
SAFE ACCESS TO ONLINE RECORDS CASE STUDY SAFE ACCESS TO ONLINE RECORDS A PRACTICE S POINT OF VIEW CASE STUDY Page 1 of 3 Since December last year, Hulme Hall Medical Group in south Manchester has been
More informationGeneral information about radiotherapy
General information about radiotherapy This information sheet is a general guide to radiotherapy. The treatment and side effects you have from radiotherapy will vary depending on which part of your body
More informationRenal cancer surgery patient experience February 2014-February 2015
Renal cancer surgery patient experience February 2014-February 2015 The specialist renal cancer team have set high patient experience as one of the key objectives of the specialist renal cancer centre.
More informationMaking a complaint about the NHS. The NHS and You. What you can expect from us What we expect from you NHS SCOTLAND
Making a complaint about the NHS The NHS and You What you can expect from us What we expect from you NHS SCOTLAND Who is this leaflet for? This leaflet is for anyone who uses the NHS in any part of Scotland.
More informationGeneral Information about radiotherapy
Department Radiotherapy General Information about radiotherapy Information for patients Introduction This information sheet is a general guide to radiotherapy. The treatment and side-effects you have from
More informationParticipant Information Sheet Adults
Participant Information Sheet Adults Prediction of Lupus TreAtment response Study (PLANS) Finding factors to help us treat lupus patients better and smarter. We would like to invite you
More informationThe Role of The Consultant, The Doctor and The Nurse Mr Gary Kitching Consultant in Emergency Medicine Foundation Training Programme Director
The Role of The Consultant, The Doctor and The Nurse Mr Gary Kitching Consultant in Emergency Medicine Foundation Training Programme Director Objective To provide an overview of your role as a junior doctor
More informationPatient survey report Survey of adult inpatients in the NHS 2009 Airedale NHS Trust
Patient survey report 2009 Survey of adult inpatients in the NHS 2009 The national survey of adult inpatients in the NHS 2009 was designed, developed and co-ordinated by the Acute Surveys Co-ordination
More informationTracheostomy ward decannulation. Information for families. Great Ormond Street Hospital for Children NHS Trust
Tracheostomy ward decannulation Information for families Great Ormond Street Hospital for Children NHS Trust This leaflet explains about the methods of decannulation used at Great Ormond Street Hospital
More informationElective Colorectal Surgery Enhanced Recovery Patient Diary
How can I help reduce healthcare associated infections? Infection control is important to the well-being of our patients and for that reason we have infection control procedures in place. Keeping your
More informationHaving an Oesophageal Manometry and 24-hour ph Test (a guide to the test)
South Tyneside NHS Foundation Trust Having an Oesophageal Manometry and 24-hour ph Test (a guide to the test) GI Services Endoscopy Day Ward Outpatients Department Providing a range of NHS services in
More informationNasogastric tube feeding
What is nasogastric tube feeding? Nasogastric (NG) feeding is where a narrow feeding tube is placed through your nose down into your stomach. The tube can be used to give you fluids, medications and liquid
More informationPERSONAL PORTRAIT. Attach photo here. This document is designed to provide important and relevant information. This Portrait was created on..
PERSONAL PORTRAIT OF.. Attach photo here This document is designed to provide important and relevant information about... This Portrait was created on.. I consent to the information in my Portrait being
More informationNew Patients Are Always Welcome
Page 1 of 5 New Patients Are Always Welcome Thank you for registering at Church Street Medical Centre For compliance with current governance regulations and to ensure we have all the necessary information
More informationCalendar Year 2014 Medicare Physician Fee Schedule Final Rule
Calendar Year 2014 Medicare Physician Fee Schedule Final Rule Non-Facility Cap After receiving many negative comments on this issue from physician groups, along with the House GOP Doctors Caucus letter
More informationAdmission Transfer and Discharge Protocol Community Hospitals. 1 Patient Categories and Clinical Criteria for Patient Admission
Admission Transfer and Discharge Protocol Community Hospitals Purpose Scope To ensure that patients are correctly assessed and managed during admission or transfer to, and transfer or discharge from Rural
More informationDischarge from hospital
Page 1 of 9 Discharge from hospital for patients, carers and relative Introduction Welcome to our Trust. This leaflet is about planning to leave hospital (also known as discharge from hospital). Please
More informationCoronary angiogram - Outpatients
Information for patients This leaflet can be made available in other formats including large print, CD and Braille and in languages other than English, upon request. Your doctor has advised you to have
More informationA Guide to Our Services
A Guide to Our Services Welcome to Saint Francis Hospice At Saint Francis Hospice, we are dedicated to providing people with a life-limiting illness the high quality and expert care and support they deserve,
More informationHickman line insertion and caring for your line
Hickman line insertion and caring for your line Information for patients This booklet explains how a Hickman line is put in, the benefits, the risks and the alternatives, as well as how to care for your
More informationWA Spinal Cord Injury Services (WASCIS)
WA Spinal Cord Injury Services (WASCIS) 1 Background: Existing service status in WA Fragmented services for people with SCI: Gaps in continuity of specialist clinical services after discharge from hospital,
More informationNHS standard contract letter templates for practice use
1 Use the hyperlinks to quickly reach each appendix. Appendix 1 Template response for missed appointment Letter to Trust requesting that the hospital liaises directly with a patient who has missed an outpatient
More informationSheffield. Juventa 4 Care Ltd. Overall rating for this service. Inspection report. Ratings. Good
Juventa 4 Care Ltd Sheffield Inspection report 26 Halsall Drive Sheffield South Yorkshire S9 4JD Tel: 07908635025 Date of inspection visit: 15 September 2017 18 September 2017 Date of publication: 11 October
More informationPatient Diary. Enhanced Recovery After Surgery (ERAS) Total Knee Replacement. Helping patients get better sooner after surgery.
Contact numbers If you need any support or advice before or after surgery please do not hesitate to call us. Claire Ward enhanced recovery nurse (Monday Friday 8-4) 07816448518 Ward 12B 01494426398 How
More informationCare Instructions AMT G-JET
Care Instructions AMT G-JET Patient name Date of Insertion Conversion Primary Placement The device size is: FR G CM J CM Balloon Fill Volume: ml Safe to gastric feed Y N Useful numbers Professional Name
More informationAn introduction to the multi-disciplinary team for breast cancer
An introduction to the multi-disciplinary team for breast cancer Providing support for patients and their families at the Royal Sussex County Hospital We would like to introduce you to the multi-disciplinary
More informationWorking together for better health The NHS is your NHS, use it well and it will serve you better.
Working together for better health The NHS is your NHS, use it well and it will serve you better. The NHS belongs to all of us. It is a limited resource and there are things that we can all do for ourselves
More informationCalifornia Advance Health Care Directive
California Advance Health Care Directive This form lets you have a say about how you want to be cared for if you get very sick. This form has 3 parts. It lets you: Part 1: Choose a medical decision maker,
More informationOxford Orthoptic Service, Oxford Eye Hospital Children s Day Care Ward, The Children s Hospital. Squint surgery for children
Oxford Orthoptic Service, Oxford Eye Hospital Children s Day Care Ward, The Children s Hospital Squint surgery for children This leaflet has been written to give you information about surgical correction
More informationDischarge Advice Following Breast Reconstructive Surgery
Oxford University Hospitals NHS Trust Discharge Advice Following Breast Reconstructive Surgery Information for patients This leaflet contains answers to some of the questions people most often ask when
More informationLaparoscopic cholecystectomy
Laparoscopic cholecystectomy Information for day surgery patients at King s College Hospital only This leaflet answers some of the questions you may have about having a laparoscopic cholecystectomy. It
More informationNHMC. Homecare Medicines Services: National Homecare Medicines Committee. History
NHMC National Homecare Medicines Committee Homecare Medicines Services: History Version Date Reason for change Person responsible for change V1 12/06/2018 New NHMC RPS Handbook for Homecare Services -
More informationGeneral Professional Services Questionnaire Instructions
Instructions The General Professional Services Questionnaire shall be used for all professional services except outside legal services and architecture, engineering, or survey projects. The General Professional
More informationThe Role of the Neurology Specialist Pharmacist In the management of Parkinson's Disease. Janine Barnes PhD
The Role of the Neurology Specialist Pharmacist In the management of Parkinson's Disease Janine Barnes PhD Medicines Management Innovation Ageing population with complex medication needs 2 specialist pharmacist
More informationDevelopment of a Regional Clinical Pathway for Total Hip Replacement in a Rural Health Network
Healthcare Quarterly ONLINE CASE STUDY Development of a Regional Clinical Pathway for Total Hip Replacement in a Rural Health Network Jessica Meleskie and Katrina Wilson 1 Abstract The Grey Bruce Health
More informationInfliximab Infusion for Patients with Crohns Disease Patient Information Leaflet
Infliximab Infusion for Patients with Crohns Disease Patient Information Leaflet Originator: Lindsey Wood Date: March 2011 Version: 2 Date for Review: March 2014 DGOH Ref No: DGOH/PIL/00303 2 Contact Numbers
More informationPharmacy Medicine Use Review What s it all about?
Pharmacy Medicine Use Review What s it all about? 1. What is it? 1.1 Medicine use Review has been introduced under the Advanced Services tier of the New Pharmacy Contract in England & Wales. The aim of
More informationHeart Homecare Ltd. Heart Homecare Ltd. Overall rating for this service. Inspection report. Ratings. Good
Heart Homecare Ltd Heart Homecare Ltd Inspection report Unit G2 Wises Oast Business Centre Wises Lane Sittingbourne Kent ME9 8LR Date of inspection visit: 07 March 2017 Date of publication: 30 March 2017
More informationMaking the Most of Your Florida Medicaid and ibudget Services
Making the Most of Your Florida Medicaid and ibudget Services Information for Individuals, Families, and Service Providers Created by the Florida Developmental Disabilities Council, Inc. Table of Contents
More informationPlan of Care in the Last Days and Hours of Life
Fylde and Wyre Clinical Commissioning Group Blackpool Clinical Commissioning Group Plan of Care in the Last Days and Hours of Life An information leaflet around understanding the changes as the end of
More informationANTERIOR RESECTION WHAT ARE THE BENEFITS OF HAVING AN ANTERIOR RESECTION?
WHAT IS AN ANTERIOR RESECTION? ANTERIOR RESECTION This is an operation that is designed to remove part of your lower large bowel and then join the bowel ends back together again. This is called an anastamosis.
More informationYou can complete this survey online at Patient Feedback Fill in this survey and help us improve hospital services
Patient Feedback Fill in this survey and help us improve hospital services Patient Survey Help us improve hospital services What is the survey about? This survey is about your most recent stay as an inpatient
More informationHernia. Information for patients General Surgery
Hernia Information for patients General Surgery page 2 of 8 What is a hernia? A hernia is a bulge or weakness in the muscles which form the front of the body wall. They are very common and easily treated,
More informationInfliximab Infusion for Patients with Ulcerative Colitis Patient Information Leaflet
Infliximab Infusion for Patients with Ulcerative Colitis Patient Information Leaflet Originator: Lindsey Wood Date: March 2011 Version: 2 Date for Review: March 2014 DGOH Ref No: DGOH/PIL/00304 Contact
More informationBowel Screening Wales Information booklet for care homes and associated health professionals. Available in other formats on request. October.14.v.2.
Bowel Screening Wales Information booklet for care homes and associated health professionals Available in other formats on request October.14.v.2.0 Contents Section 1 Page 3 Who are Bowel Screening Wales
More informationAssessment criteria for obtaining a venous blood sample
Core blood competencies assessment framework Assessment criteria for obtaining a venous blood sample This framework is for assessing the candidates ability in obtaining a venous blood sample for transfusion.
More informationBonnington Nursing Home Care Home Service Adults 205 / 207 Ferry Road Edinburgh EH6 4NN
Bonnington Nursing Home Care Home Service Adults 205 / 207 Ferry Road Edinburgh EH6 4NN Inspected by: Averil Blair Linda Paterson Type of inspection: Unannounced Inspection completed on: 9 June 2011 Contents
More informationFamily doctor services registration Postcode:... To be completed by your doctor
Family doctor services registration GMS1 GSM1 Patient s details Please complete in BLOCK CAPITALS and tick as appropriate Mr Mrs Miss Ms Date of Birth NHS No. Surname Male Female Town and country of birth
More informationPlanning for Your Future Advance Care Planning
Planning for Your Future Advance Care Planning Name: Date of discussion: We would like to invite you to a discussion about your future care. Advance care planning is an opportunity for you to talk about
More informationCaring for Carers. Includes Caregiver Health Checklists
Caring for Carers Includes Caregiver Health Checklists The role of carer can provide great satisfaction, but being a caregiver can also be very emotionally stressful between a third and a half of carers
More informationNHS non-urgent Patient Transport Service (PTS) Engagement Report
NHS non-urgent Patient Transport Service (PTS) Engagement Report September 2015 Introduction The Sussex PTS is currently provided by the South East Coast Ambulance Service (SECAmb). Around 280,000 PTS
More informationAPPENDIX 1: THE 5 MOMENTS FOR HAND HYGIENE
APPENDIX 1: THE 5 MOMENTS FOR HAND HYGIENE (WHO 2009) Page 1 APPENDIX 2 - HAND WASHING TECHNIQUE WITH SOAP AND WATER Page 2 Page 3 APPENDIX 3: SKIN CONDITIONS Page 4 APPENDIX 4 - GUIDE TO GLOVE SELECTION
More informationHealth and Social Care Protocol Pocket Book
Leicester, Leicestershire and Rutland Health and Social Care Protocol Pocket Book Leicestershire Partnership NHS Trust CONTENTS Introduction 2 Guiding Principles 4 Definition of Delegation 6 Lines of Communication
More informationMethicillin Resistant Staphylococcus aureus (MRSA) screening and decolonisation
Information for patients and carers This leaflet can be made available in other formats including large print, CD and Braille and in languages other than English, upon request. Contents Page What is MRSA?
More informationProfessionalism and Professional Accountability in Clinical Skills Practice. Guidance Notes for Assessors
Professionalism and Professional Accountability in Clinical Skills Practice Guidance Notes for Assessors Guidance Notes for Assessors Professionalism and Professional Accountability in Clinical Skills
More informationImplantable Loop Recorder (ILR)
Information for patients This leaflet can be made available in other formats including large print, CD and Braille and in languages other than English, upon request. Your doctor has advised you have an
More informationPatient Diary. Vascular Surgery Enhanced Recovery Programme
2-3 days following discharge, someone from the vascular team will contact you at home. If you have any problems please do not hesitate to contact the ward. We are here to help. Please contact us on the
More informationGeneral Professional Services Questionnaire Instructions
Instructions The General Professional Services Questionnaire shall be used for all professional services except outside legal services and architecture, engineering, or survey projects. The General Professional
More informationSection 7: Core clinical headings
Section 7: Core clinical headings Core clinical heading standards: the core clinical headings are those that are the priority for inclusion in EHRs, as they are generally items that are the priority for
More informationHaving a general anaesthetic
Easy Read Information Having a general anaesthetic If you are ill, your doctor may say you need some tests or an operation to help you get better. Because some people find tests frightening or because
More informationPart 3: Confirmation of eligibility and coverage for provincial home care - to be completed by the provincial home care case coordinator / manager.
Great-West Life Centre 100 Osborne Street N Winnipeg MB R3C 1V3 Dear Plan Member, To establish the amount of coverage available for nursing care under your group benefit plan, Great-West Life requires
More informationHOMECARE WORKERS FORUM
HOMECARE WORKERS FORUM Homecare Workers Forum We held a Homecare Workers Forum on 19th October 2015 at our centre in collaboration with Southwark Council which 20 Homecare workers attended. Southwark
More informationUser Guide for Prostate Care Questionnaire
User Guide for Prostate Care Questionnaire Contents 1. Using this guide 2. The purpose of the questionnaires 3. How the questionnaires have been developed 4. How to use the questionnaires a. Deciding which
More informationBladder Instillation Therapy (Mitomycin) Department of Urology Information for patients
Bladder Instillation Therapy (Mitomycin) Department of Urology Information for patients i Introduction Your consultant has prescribed a course of treatment for you called bladder instillation therapy.
More informationSkin Cancer Multi Disciplinary Team Patient Information
Skin Cancer Multi Disciplinary Team Patient Information Introduction This booklet is for people who have been diagnosed with skin cancer. It tells you about the skin cancer multidisciplinary team (MDT)
More informationOlder Person's Assessment Form. Name: Contact details: Provide detail: Detail: Detail: Detail: Detail:
BASELINE: COGNITION REVIEW: COGNITION Residents details Resident name: Gender: NHS No: Age: Religion, Spirituality: Older Person's Assessment Form Care Home details Phone number: Address: Date of admission:
More informationPatient survey report Outpatient Department Survey 2009 Airedale NHS Trust
Patient survey report 2009 Outpatient Department Survey 2009 The national Outpatient Department Survey 2009 was designed, developed and co-ordinated by the Acute Surveys Co-ordination Centre for the NHS
More informationPeople with a Learning Disability. Don t Miss Out! Your Annual Health Check
People with a Learning Disability Don t Miss Out! Your Annual Health Check Contents Why are health checks important? 2 What is a health check? 3 Preparing for your health check 4 While at the health check
More informationAranesp (Darbepoetin) for Renal Anaemia
Aranesp (Darbepoetin) for Renal Anaemia Information for patients, relatives and carers Renal Department York and Scarborough Hospitals Tel: 01904 725370 For more information, please contact: Renal Anaemia
More informationAbout Your Colectomy
UW MEDICINE PATIENT EDUCATION About Your Colectomy How to prepare and what to expect This handout explains a colectomy operation, including how to prepare for surgery, what to expect afterward, recovering
More informationBlack Country ESF Community Grants Application Form
Black Country ESF Community Grants Application Form ESF Community Grants are part of the European Social Fund (ESF) Programme which is distributing 900,000 in small grants in the Black Country region between
More informationNational Patient Experience Survey UL Hospitals, Nenagh.
National Patient Experience Survey 2017 UL Hospitals, Nenagh /NPESurvey @NPESurvey Thank you! Thank you to the people who participated in the National Patient Experience Survey 2017, and to their families
More informationThese tool box talks have been prepared by Constructing Better Health to raise awareness of the work related health issues you face on site
These tool box talks have been prepared by Constructing Better Health to raise awareness of the work related health issues you face on site So what is work related ill health? It is something that you
More informationECONOMIC EVALUATION OF PALLIATIVE CARE IN IRELAND
ECONOMIC EVALUATION OF PALLIATIVE CARE IN IRELAND 2015 AUTHORS Aoife Brick, Charles Normand, Sinéad O Hara, Samantha Smith Evidence from this study shows that more developed palliative care reduces the
More informationASDA Carrier Bag Community Grants Application Form Guidelines
ASDA Carrier Bag Community Grants Application Form Guidelines Please read the following criteria and guidance notes before deciding whether to apply or not and please keep them to hand when completing
More information