OSPIDÉAL NAOIMH SÉAMAS ST. JAMES S HOSPITAL

Transcription

1 OSPIDÉAL NAOIMH SÉAMAS ST. JAMES S HOSPITAL Ospidéal Naomh Séamus, Sráid Shéamais, Baile Átha Cliath 8. St. James s Hospital, James s Street, Dublin xxx.stjames.ie Endoscopy Unit Route 2 Phase 1H (Main Hospital) Tel: endoscopy@stjames.ie MRN: Dear Patient, An appointment has been made for you to have a(n) on in the Endoscopy Unit, Route 2. Please note that this time is your registration time; do not arrive before this time. You will be called in order of your scheduled time and not in the order of your arrival. Due to unavoidable circumstances delays may occur. Expect to be in the Unit for between 4-6 hours. If you cannot attend this appointment or wish to reschedule please contact or endoscopy@stjames.ie as soon as possible. Please bring this letter and a list of your current medications to your appointment. Yours Sincerely, Endoscopy Secretary For details of clinic location and other relevant information

2 Information for patients attending the Endoscopy Unit Location: The Endoscopy Unit is located on Route 2 on the ground floor of the Main Hospital. Opening times: The unit is open Monday Friday from 08:00 17:00 hours. To cancel your appointment To reschedule your appointment If you require an interpreter for your procedure Please contact: or or endoscopy@stjames.ie If you have a medical query regarding your colonoscopy appointment Please contact the colonoscopy nurse: or colonoscopynurse@stjames.ie If you have a medical query regarding any other Endoscopy procedure Please contact the Endoscopy nurse: or endoscopynurses@stjames.ie If you have been an in-patient in Tallaght Hospital anytime from September 2015 please let us know by phoning or endoscopynurses@stjames.ie as you may need to be tested for CRE carriage. Hospital Charges: Please bring your medical card or medical insurance details with you to your appointment. For non-medical card holders there is a Statutory Hospital Charge of (payment will not be taken on the day, an invoice will be sent to you by post). Car Parking: Access to the hospital by car is via the St. James s Street entrance only. Patients and visitors should use the underground car park off Junction 2. This car park provides internal access, by lift or stairs, to the Main Hospital Concourse. Bus: The Dublin Bus Route 123 passes through the hospital grounds and stops near the main hospital entrance. From the city centre, buses 40 and 13 stop at the James s Street entrance. The 68 stops on the South Circular Road close to the Rialto Gate entrance. For more information see: Luas: The Red Line between Tallaght and Connolly Station has three stops adjacent to the hospital. The James s stop is at the James s Street entrance. The Rialto and Fatima stops are nearby. This line also serves Heuston and Connolly Stations. For more information visit Train Services: Heuston station is located in close proximity to St. James s Hospital, servicing the following routes: Cork, Tralee, Limerick, Waterford, Ballina/Westport, Galway and intermediary stations. For more information visit

3 CONSENT You will find a Transmissible Spongiform Encephalopathy (TSE/CJD) Exposure Assessment Form as part of the information which has been sent out to you. Please ensure you read this form carefully, fill it in, sign and date it and bring the form with you for your appointment. The Doctor will sign the consent form for the procedure with you prior to your procedure once you understand and agree to the procedure. WHAT HAPPENS DURING THE PROCEDURE? A nurse will stay with you throughout the examination. You will receive sedation for your examination through a needle in your arm. You will lie on your left side. An examination of your rectum will be carried out. The tube will be passed from the rectum into the colon. During the test, air will be put into your colon which enables a better view. Because of this you may feel some cramps and pressure. This is normal and will pass within a couple of hours. Biopsies (small pieces of tissue) may be taken during your procedure for further examination in the laboratory. Polypectomies may be carried out to remove polyps which are growths in the lining of the colon by using biopsy instruments. A repeat procedure may be required if polyps are found depending on the laboratory results. The examination usually takes between minutes. Following your procedure you will be brought to the recovery area. FOLLOWING THE EXAMINATION If you have not received sedation you may go home unescorted as soon as follow up instructions have been given by the nurse. If you have received sedation you will be observed in the recovery area for at least one hour until the effects of the sedation have worn off. The nurse looking after you will call your escort home at this point and inform them of the exact time you will be ready to be collected. You are NOT allowed to drive or travel home unaccompanied for you own safety. When you have sufficiently recovered you will receive a light snack. A nurse will speak with you prior to discharging you and go through your procedure results. Urgent follow up appointments will be arranged before you leave the unit otherwise an appointment will be posted out to you if needed. You will be provided with a follow-up care information leaflet. PRE ASSESSMENT NURSE If you have a medical query prior to your procedure please call (01) and you will be able to speak with a nurse. Patient Information Leaflet Colonoscopy/Lower Endoscopy A Colonoscopy is an examination that enables the doctor to examine the lining of your colon (large intestine) for abnormalities by inserting a thin flexible tube into your anus (back passage) and slowly advancing into the rectum and the colon. Please note: the time on your appointment letter is the time to register at the reception desk; not your procedure time. Medical procedures can vary greatly in time therefore delays may occur. Other delays may occur due to circumstances beyond our control.

4 PREPARATION REQUIRED FOR THE EXAMINATION To prepare for this procedure you need to take a strong laxative which cleanses your bowel, there is a prescription for this medication attached and you should plan to stay at home for the day you are taking this preparation. It is very important to follow the instructions exactly as specified on the attached leaflet as the success of your procedure will depend on your bowel being as clean as possible. You will be provided with a gown to change into for your procedure, if you wish you can bring a dressing gown and slippers. If you have a known Bleeding Disorder and attend the NCHCD in St. James Hospital please ensure you contact the Centre on (01) This is to make them aware of the date of your procedure to organise any pre procedure treatment if necessary. If you are under 16 years of age you must be accompanied by your parent or guardian. They will be required to give written consent to the procedure being carried out on you. If you are having sedation for your procedure it is essential that you can provide a telephone number and name of a friend /relative who we may contact to collect you following your procedure, otherwise your procedure may be cancelled. Going home by Taxi on your own is not allowed following sedation. Please do not bring valuables with you on the day of the examination i.e. jewellery or money. Please remove all nail polish/shellac/ two-week manicure from your finger nails prior to attending for your procedure. WILL YOU BE SEDATED? The procedure will be performed under conscious sedation and will be administrated through a needle in your arm. WHAT IS CONSCIOUS SEDATION? Conscious sedation is a combination of medicines to help you relax and block pain. An injection is given into a vein to make you feel relaxed and sleepy, but not unconscious. This means you may or may not be aware of the procedure. Patients who receive conscious sedation are usually able to speak and respond to verbal cues throughout the procedure. This allows patients to communicate any discomfort they experience to the endoscopist. Generally no or mild discomfort should be experienced. You will be monitored for signs of discomfort and your level of sedation will be adjusted if necessary. A brief period of amnesia may cause you to completely forget the procedure. You must have a responsible adult to stay with you for 24 hours following sedation. MEDICATIONS (TABLETS) Please bring a list of your medication with you on the day of your procedure. Stop taking IRON tablets 7 days prior to your procedure. Take essential medication (including inhalers and nebulisers) with a small amount of water on the day of your procedure. If you are allergic to any medication please ensure you have the name of the medicine you are allergic to. Please inform nurse on the day of your procedure of any allergies you may have. If you are taking iron tablets or supplements please ensure you stop taking them 7 days prior to your procedure. If you take Aspirin please ensure you do not take it on the morning of your procedure. If you take any other blood thinning tablets i.e. Plavix/ Clopidogrel/ Effient/ Brilique/ Warfarin/ Dabigatran/ Xarelto/ Eliquis please contact the pre assessment nurse on (01) at least 10 days prior to your procedure for advice. If you are a Diabetic please contact the Diabetic centre you attend or your GP/ practice nurse. They will give you advice re taking your diabetes medication whilst preparing/fasting for your procedure. RISKS The risks associated with this test are rare but can include complications such as perforation, bleeding and reactions to medications. These complications may require urgent treatment and even surgical intervention (an operation). The Doctor performing your procedure will explain the risks associated with the procedure as part of the consent process.

5 ST. JAMES S HOSPITAL ENDOSCOPY UNIT HOW TO PREPARE YOUR BOWEL FOR COLONOSCOPY WITH MOVIPREP Please observe the following instructions carefully if you have a Morning Appointment You must begin a modified diet three days before your test (e.g. Friday if your test is on Monday) A modified diet is a Low Residue diet - only eat foods from the following list: Boiled /steamed / grilled fish or chicken Eggs, cheese, white bread /white bread toasted, butter / margarine, plain biscuits Potatoes (no skins) Do not eat any high fibre foods example: fruit, vegetables, nuts, pulses, rice, wholemeal breads or cereals ***Drink at least 2 litres of clear fluid each day e.g. Water, soda/tonic water, 7-up, squash, Bovril, tea or coffee with a little milk added The day before your test Have a breakfast of foods taken from the list allowed from the previous two days list at 9am. After breakfast do not eat any solid foods but drink as much clear fluid as possible Clear fluids include water, soft drinks, black tea and coffee (without milk), Bovril No milk or milk based drinks should be taken. Do not eat solid food from now until the examination is complete Begin taking the bowel clearing medicine as outlined below The more clear fluids you drink, the better your bowel preparation will be INSTRUCTIONS FOR TAKING MOVIPREP MORNING APPOINTMENT 1. A box of Moviprep contains two sealed bags with an A and B sachet in each bag 2. Measure out 1 Litre (1¾ pints) of water into a jug or other suitable container 3. Pour the contents of pack A & B into the water and stir until dissolved 4. To improve the taste, chill the solution in the refrigerator before drinking 5. You can add cordial (NOT Blackcurrant) to the solution if you wish to improve the taste 6. At 5pm start to drink the Moviprep solution, drink it over 1-2 hours 7. You will have lots of watery bowel movements, so stay near a toilet because you may need to use it urgently. If you get a bloated or uncomfortable feeling drink the solution more slowly. 8. Once the litre of Moviprep is finished, drink an additional 500mls of water. 9. At 8pm repeat steps 2-5 to make up the second bag which contains sachet A& B of Moviprep 10. You can continue to drink clear fluids up to 12 midnight no solid food should be taken Remember do not eat anything, Do not drink any fluids after 12 midnight Failure to follow these instructions may result in the requirement for your procedure to be repeated

6 YOU DO NOT NEED TO COMPLETE THIS SECTION NOW; IT WILL BE COMPLETED BY YOUR DOCTOR/HEALTH PROFESSIONAL ON THE DAY OF YOUR PROCEDURE (Who has the appropriate knowledge of the proposed procedure) ST. JAMES S HOSPITAL CONSENT FOR ENDOSCOPY 1 An information sheet about the proposed investigation and/or treatment has been provided and understood? Yes Name: MRN: DOB: Consultant: COMPLETE OR ATTACH AN ADDRESSOGRAPH LABEL 2 I confirm that I have explained the following terms, which in my judgement are suited to the understanding of the patient and/or to parent(s) or guardians of the patient: The type of procedure or proposed investigation and/or treatment Benefits of the proposed investigation and/or treatment; Risks associated with the proposed investigation and/or treatment Potential for blood transfusion/other intervention as deemed medically necessary Requirement for sedation and associated risks Alternative treatment options, including no treatment Utilisation of imaging in diagnosis and/or treatment and possible storage of images for research and teaching Reason for TSE exposure questionnaire (must be completed) DOCTOR S/HEALTH PROFESSIONAL S SIGNATURE Dr/PROF/Mr/Ms Date:. SIGNATURE OF PATIENT or PARENT/GUARDIAN. Date:. SIGNATURE OF INTERPRETER/OTHER. Date:

7 ST. JAMES S HOSPITAL TSE FORM Name: MRN: DOB: Endoscopy Unit TRANSMISSIBLE SPONGIFORM ENCEPHALOPATHIES (TSE) / CJD* *Creutzfeldt Jacob Disease Human Form of Mad Cow Disease EXPOSURE ASSESSMENT FORM (Please circle appropriate answer)- if you are uncertain of any answer, leave the question unanswered and speak in confidence to your GP, doctor or nurse). 1) Have you ever been told that you may be at risk of CJD*? Yes No 2) Has anyone in your family had CJD*? Yes No 3) Did you have brain surgery or an operation on your spine # before 1994? Yes No 4) If yes to question 3: were you told donor graft material was used for your surgery? Yes No 5) Did you receive growth hormone before 1985? Yes No 6) Have you ever received UK sourced plasma factor concentrate from 1980 to 2001 (as used for bleeding disorders)? #Doctor to assess if dura mater graft was used Yes No If you answer yes to any question please contact the clinical nurse manager in the Endoscopy Unit (01) or the Sterivigilance nurse (01) /or (01) & bleep 497 prior to your appointment Patient Signature: Date:

8 Medication Advice If you have stopped Warfarin for this procedure your Endoscopist advises that you restart your Warfarin on: Follow Up Process A copy of your report/results of your Colonoscopy today will be sent to your GP or referring Doctor tomorrow by our clerical staff. If you had a biopsy or biopsies taken today they will be sent to the laboratory here in the hospital to be processed. It usually takes about 3 weeks for the results to be ready. The Endoscopist who performed your procedure today will review these biopsy results once they are available and will then arrange the appropriate follow up for you. This may mean: You will need to attend for an Out-Patient Appointment You may need to have a repeat procedure Your biopsy results will be sent to your GP or the Doctor that referred you to us for your procedure This follow up will be arranged by us in the Endoscopy Unit and you will be informed of the follow up that you require. Important Information For Patients Following Colonoscopy/Lower Endoscopy and/or Polypectomy You may contact the Staff in the Endoscopy Unit weekdays 09:00-17:00 if you require any further advice/assistance: Medical queries: (01) colonoscopynurse@stjames.ie Clerical queries: (01) endoscopy@stjames.ie Please note is the best way to contact us Sigmoidoscopy Discharge Endoscopy Version 1 (2016)

9 Instructions Following your Procedure Today 1. You have received sedation for your procedure; one of the side effects of this sedation is that you may not remember having had the procedure today, this is normal 2. It can take 24 hours for the effects of sedation to wear off completely so it is important you go home and rest for the remainder of the day and adhere strictly to the following advice: DO NOT DRIVE DO NOT OPERATE MACHINERY DO NOT DRINK ALCOHOL DO NOT SIGN IMPORTANT/LEGAL PAPERS DO NOT LOOK AFTER CHILDREN OR DEPENDANTS ALONE 3. You may drink at: 4. You may eat at: 5. You may feel a little bloated with wind type pains. Mild cramps are common for 12 hours after your procedure due to trapped wind. These usually settle without any problems 6. You may notice streaks of blood in your stool/spotting of blood from the back passage; this is normal following a colonoscopy. However, large amounts of bleeding from the back passage is NOT normal. 7. Please be aware that the laxative (bowel preparation) you took before your procedure may continue to work for some hours after your colonoscopy. 8. You may not have a bowel movement for 1-3 days following you colonoscopy; this is normal. It may take a few days for your bowel to fill enough to have the urge to have a movement. 9. Due to the bowel preparation you have taken you may experience some symptoms of dehydration. It is important to drink plenty of fluid to rehydrate yourself. If you Experience Problems Please contact your GP or Emergency Department if you experience any of the following symptoms and bring this leaflet with you: Persistent chest or abdominal pain Difficulty breathing Persistent nausea and vomiting Vomiting of blood Passing of dark stools or blood Persistent weakness or clammy feeling Follow Up Arrangements The Endoscopist who performed your procedure will review your biopsy results once available and schedule the appropriate follow up which may mean: You will require a repeat procedure on: Further investigations will be arranged: An appointment will be posted to you to attend the Out Patients Department/Private Rooms: You have been discharged back to the care of your GP