• Home

  • Documents

  • My Hospital Passport · My Hospital Passport Any relevant care plans Lifetime Yes No Wishes...
4

Click here to load reader

My Hospital Passport · My Hospital Passport Any relevant care plans Lifetime Yes No Wishes Document Yes No Other (please state) Yes No Name

  • Upload
    ngoanh

  • View
    213

  • Download
    1

Embed Size (px)

Citation preview

Page 1: My Hospital Passport · My Hospital Passport Any relevant care plans Lifetime Yes No Wishes Document Yes No Other (please state) Yes No Name

My Hospital Passport

Any relevant care plans

Lifetime Yes No

Wishes Document Yes No

Other (please state) Yes No

Name

Address

Parent / Carer Names

Telephone Number

Date of Birth

Hospital Number

Preferred Language

Religion

Who else is involved with me? (please give details) Education / Health / Social Services

Completed by Date Signed (on admission)

(by parent/carer)

REDESSENTIAL

INFORMATIONVery important

information you must know

about me.

AMBERIMPORTANT

INFORMATIONImportant

information about my general

daily living.

GREENPREFERABLE

INFORMATIONInformation

about my likes, dislikes and

comfort issues.

Page 2: My Hospital Passport · My Hospital Passport Any relevant care plans Lifetime Yes No Wishes Document Yes No Other (please state) Yes No Name

2

Diagnosis and medical conditions

Relevant medical history

Allergies

Current medication and method of taking medication

Challenging behaviours that may cause a risk

Triggers that may lead to challenging behaviours

Communication

Pain indicators and making medical interventions easier

Keeping safe and specific support needs

Equipment, settings and sizes (trachy/ng size, ventilation settings, pad size, etc.)

Important routines

Previous admissions and procedures (if relevant)

Any concerns and/or problems at previous admission?

ESSENTIAL INFORMATION Very important information you must know about meRED

RED

Page 3: My Hospital Passport · My Hospital Passport Any relevant care plans Lifetime Yes No Wishes Document Yes No Other (please state) Yes No Name

3

IMPORTANT INFORMATION Important information about my general daily livingAM

BERAM

BER

Going to the toilet and personal hygiene needs (inc: pad size, support needs)

Washing and dressing (inc: mouth care, abilities / support needs)

Moving around (inc: positioning, equipment, support required, safety)

Breathing (inc: ventilation settings)

Sleeping

Eating and drinking (inc: Nil by mouth, support required, temperature, texture, equipment, likes, dislikes, frequency, feed type, etc.)

Expressing emotion

PREFERABLE INFORMATION Information about my likes, dislikes and comfort issuesGREE

N GREEN

3 things that will make my stay in hospital better

Things that make me feel safe and comfortable

Things I like

Things I don’t like

Page 4: My Hospital Passport · My Hospital Passport Any relevant care plans Lifetime Yes No Wishes Document Yes No Other (please state) Yes No Name

This hospital passport has been adapted by Bristol Royal Hospital for Children and is based on the original Hospital Passport by Gloucestershire NHS Trust.

The aim of the hospital passport is to provide our staff with all the necessary information about your child when you use our hospital services. This information will help us work in partnership with you in meeting your child’s needs. We have deliberately restricted the size of this document so that staff can have access to important information quickly.

Please let a member of staff know if your child has a hospital passport.

Please try to make sure the information in the hospital passport is kept up-to-date. As a guide we recommend:

Children under 5 years of age - review every 6 months.•

Children over 5 years of age - annual review.•

A traffic light system is used as follows:

‘My Hospital Passport’ is available at the following web address: www.uhbristol.nhs.uk/hospital-passport

If you have difficulty completing this form or require a paper copy please contact Liaise at BRHC on: 0117 342 8065 or the Disability Nurse on: 0117 342 8653

Images © Copyright Boardmaker. All rights reserved.

XXXXXXX/XXXXXXXXXXXX/XXX11© University Hospitals Bristol Xxxxxxxxx 2011

Hospital Switchboard: 0117 923 0000Minicom: 0117 934 9869www.uhbristol.nhs.uk

For an Interpreter or Signer please contact the telephone number on your appointment letter.

For this leaflet in Large Print, Braille, Audio, or Email, please call the Patient Information Service:

0117 342 3728 / 3725

@

w w w

For access to other patient leaflets and information please go to the following address:

www.uhbristol.nhs.uk/patients-visitors-and-carers/ patient-information.html

Please recycle after use

October 2011 CHILDRENS/MYPASSPORT/OCT11

REDESSENTIAL

INFORMATIONVery important

information you must know

about me.

AMBERIMPORTANT

INFORMATIONImportant

information about my general

daily living.

GREENPREFERABLE

INFORMATIONInformation

about my likes, dislikes and

comfort issues.

This section is to highlight the extremely important information we need to know about your child.

For example: allergies, communication needs, medical •equipment sizes or challenging behaviours which may cause a risk. Think of this section as a ‘red alert’ to identify your child’s high risk needs.

Finally, please give us a brief description of things your child likes such as favourite toys, music and DVDs. Also, things that might calm your child if they become distressed.

There is space to tell us about things which might make a hospital visit better and also a section for you to tell us about things your child does not like.

Please use this section to tell us about your child’s important day to day living activities.

For example: tell us about your child’s level of understanding, •how they express themselves or any particular signs or symbols they use. It would be useful to know how to support your child with their personal hygiene needs or if your child has specific dietary needs.


Investor presentation - Medigus Relations/Investorsppt2014.pdf · Esophyx . Linx . yes . yes . yes . yes yes . yes yes . yes . yes . 1 GI/Surgeon. Stretta . no . yes . no . 1 . no

Investor presentation - Medigus Relations/Investorsppt2014.pdf · Esophyx . Linx . yes . yes . yes . yes yes . yes yes . yes . yes . 1 GI/Surgeon. Stretta . no . yes . no . 1 . no

Documents
 · GZ curve with heeling moment plot shown INTACT Yes No No No No No No 3D 3D 3D Yes No Yes Yes Yes YesGZ No No Yes No Yes No No Yes YesGZ Yes

 · GZ curve with heeling moment plot shown INTACT Yes No No No No No No 3D 3D 3D Yes No Yes Yes Yes YesGZ No No Yes No Yes No No Yes YesGZ Yes

Documents
Theory manual ENG 2011 - DeepEx · Caquot-Kerisel Tabulated No - - - Yes Yes Yes No Caquot-Kerisel Tabulated No - - - Yes Yes Yes No Lancellota No - - - Yes Yes Yes Yes Notes: 1

Theory manual ENG 2011 - DeepEx · Caquot-Kerisel Tabulated No - - - Yes Yes Yes No Caquot-Kerisel Tabulated No - - - Yes Yes Yes No Lancellota No - - - Yes Yes Yes Yes Notes: 1

Documents
Mail & Guardian · Kwa Dabeka CHC 13.1nanda CHC Providing Yes Yes Yes Yes Yes No No No No No Yes Yes Yes No No No No No Yes No No No No Yes Yes No No No Yes Yes Yes Yes No No No No

Mail & Guardian · Kwa Dabeka CHC 13.1nanda CHC Providing Yes Yes Yes Yes Yes No No No No No Yes Yes Yes No No No No No Yes No No No No Yes Yes No No No Yes Yes Yes Yes No No No No

Documents
Drawing, Revision 1, 'Cover Sheet Sediment Control and … · 2012. 12. 4. · MnC2 RdD2 ReD SaB2 saC2 ShB2 ShC3 ShD3 SrE WoA Yes No No No Yes No No No No No Yes Yes Yes Yes Yes Yes

Drawing, Revision 1, 'Cover Sheet Sediment Control and … · 2012. 12. 4. · MnC2 RdD2 ReD SaB2 saC2 ShB2 ShC3 ShD3 SrE WoA Yes No No No Yes No No No No No Yes Yes Yes Yes Yes Yes

Documents
(M) 30320 31366 21666 29236 32124 No No No No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Detailed Project Report is placed before the DRC , the abstract of the report is as under :-

(M) 30320 31366 21666 29236 32124 No No No No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Detailed Project Report is placed before the DRC , the abstract of the report is as under :-

Documents
Planning an Enterprise GeodatabaseNetezza Data Warehouse Appliance No No Yes Oracle Yes Yes Yes PostgreSQL Yes Yes Yes SAP HANA No Yes Yes SQLite No No No Teradata Data Warehouse Appliance

Planning an Enterprise GeodatabaseNetezza Data Warehouse Appliance No No Yes Oracle Yes Yes Yes PostgreSQL Yes Yes Yes SAP HANA No Yes Yes SQLite No No No Teradata Data Warehouse Appliance

Documents
Section 3 – General Liability and Excess Complete Sections 3 thru … · 1 day ago · Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No . Section 4 B. - Property

Section 3 – General Liability and Excess Complete Sections 3 thru … · 1 day ago · Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No . Section 4 B. - Property

Documents
dentistryknoxvilletn.comdentistryknoxvilletn.com/download/i/mark_dl/u/1774949/...Taking oral contraceptives? Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No No No No no No No No blo

dentistryknoxvilletn.comdentistryknoxvilletn.com/download/i/mark_dl/u/1774949/...Taking oral contraceptives? Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No No No No no No No No blo

Documents
Table of Contents - download.ivanti.com · Mantis 2.1.0+ SOAP Yes Yes Yes Yes VSTS / TFS 2017+ Basic Yes Yes Yes Yes SalesForce OAuth Yes Yes No No HP Quality Center Cookies No No

Table of Contents - download.ivanti.com · Mantis 2.1.0+ SOAP Yes Yes Yes Yes VSTS / TFS 2017+ Basic Yes Yes Yes Yes SalesForce OAuth Yes Yes No No HP Quality Center Cookies No No

Documents
EDIC@ Specifications - medicacorp.com · Yes Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No CALIBRATE NOW? ANALYZE BLOOD? DAILY CLEANER?/ STANDBY MODE? SECOND

EDIC@ Specifications - medicacorp.com · Yes Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No CALIBRATE NOW? ANALYZE BLOOD? DAILY CLEANER?/ STANDBY MODE? SECOND

Documents
Wrecker/Salvage Processor Monthly Report · 2019-09-16 · X Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Wrecker/ Salvage Processor

Wrecker/Salvage Processor Monthly Report · 2019-09-16 · X Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Wrecker/ Salvage Processor

Documents
Evaluation of Speech Recognizers for Use in Advanced Combat … · ITT Yes Yes No No Yes Yes No No 500 > i00 1500 Yes Yes Yes No MARCONI Yes Yes No Yes Yes Yes No No 640 > I00 400

Evaluation of Speech Recognizers for Use in Advanced Combat … · ITT Yes Yes No No Yes Yes No No 500 > i00 1500 Yes Yes Yes No MARCONI Yes Yes No Yes Yes Yes No No 640 > I00 400

Documents
PASSPORT - Wild Honey St James · GBR Passport No./Passeport No 02077472238 Authority/Autorité UNITED KINGDOM PASSPORT AGENCY PASSPORT PASSEPORT The ‘Passport’ menu at St James

PASSPORT - Wild Honey St James · GBR Passport No./Passeport No 02077472238 Authority/Autorité UNITED KINGDOM PASSPORT AGENCY PASSPORT PASSEPORT The ‘Passport’ menu at St James

Documents
 · M. Irfan No No no Yes agreed Yes Yes No no 15000 Yes Ashraf Ali Yes yes yes yes yes yes Yes Yes yes 32786 yes Feed Well Yes Yes Yes Yes agreed Yes Yes Yes Yes 26000 Yes Al-Wahid

 · M. Irfan No No no Yes agreed Yes Yes No no 15000 Yes Ashraf Ali Yes yes yes yes yes yes Yes Yes yes 32786 yes Feed Well Yes Yes Yes Yes agreed Yes Yes Yes Yes 26000 Yes Al-Wahid

Documents
TransformaTion - Wilmar InternationalJV Plantations Africa NO YES YES FFB Suppliers NO YES YES CPO Suppliers NO YES YES Downstream operations NO NO YES The performance data disclosed

TransformaTion - Wilmar InternationalJV Plantations Africa NO YES YES FFB Suppliers NO YES YES CPO Suppliers NO YES YES Downstream operations NO NO YES The performance data disclosed

Documents
YES or NO: PRODUCTS CONTAIN THE FOLLOWING … · Calcium Lactate Crust: Original crust No Yes No No No Yes No No No Yes No No No No Pan crust No Yes No No No No No No Yes Yes No Yes

YES or NO: PRODUCTS CONTAIN THE FOLLOWING … · Calcium Lactate Crust: Original crust No Yes No No No Yes No No No Yes No No No No Pan crust No Yes No No No No No No Yes Yes No Yes

Documents
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No No No No No No No No No No No No No No No No 9. Have you ever become ill, dizzy, or passed out while exercising in the heat? If

Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No No No No No No No No No No No No No No No No 9. Have you ever become ill, dizzy, or passed out while exercising in the heat? If

Documents
Best Engineering College of Rajasthan | Top Engineering College.Bhamashah Card Aadhar Card For Office Use (Document Received) Yes No Yes / NO Yes No Yes / No Yes I No Yes / No Yes

Best Engineering College of Rajasthan | Top Engineering College.Bhamashah Card Aadhar Card For Office Use (Document Received) Yes No Yes / NO Yes No Yes / No Yes I No Yes / No Yes

Documents
Tranquility Vertical Stack (TSL) Series...A = ADA B A YES NO NO NO NO NO PSC PSC STANDARD LOW STATIC YES YES NO YES YES NO NO YES YES YES YES YES NO NO NO NO ECM CONSTANT VOLUME (DXM2

Tranquility Vertical Stack (TSL) Series...A = ADA B A YES NO NO NO NO NO PSC PSC STANDARD LOW STATIC YES YES NO YES YES NO NO YES YES YES YES YES NO NO NO NO ECM CONSTANT VOLUME (DXM2

Documents
· PDF filefor Saudi Aramco in 2012 (Valentine ... Blasting NO YES NO YES NO YES NO YES NO YES NO YES NO YES ... known to Raychem as tackifiers for

· PDF filefor Saudi Aramco in 2012 (Valentine ... Blasting NO YES NO YES NO YES NO YES NO YES NO YES NO YES ... known to Raychem as tackifiers for

Documents
FOOD WORKER ILLNESS FLOWCHART - … NO YES YES YES NO YES NO YES NO YES NO NO YES NO YES FOOD WORKER ILLNESS FLOWCHART Use this diagram to help you determine whether a food worker

FOOD WORKER ILLNESS FLOWCHART - … NO YES YES YES NO YES NO YES NO YES NO NO YES NO YES FOOD WORKER ILLNESS FLOWCHART Use this diagram to help you determine whether a food worker

Documents
SCHOOL INSURANCE APPLICATION · Employees Volunteers Yes No Yes No Yes No Yes No Yes No Yes No Yes No years years Yes No. Page 5 of 12 Sexual Misconduct Liability If coverage is desired,

SCHOOL INSURANCE APPLICATION · Employees Volunteers Yes No Yes No Yes No Yes No Yes No Yes No Yes No years years Yes No. Page 5 of 12 Sexual Misconduct Liability If coverage is desired,

Documents
Suggested ADULT PIF Changes · Web viewACLS ATLS PALS FCCS YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO ACLS ATLS PALS FCCS YES NO YES NO YES NO YES NO YES NO YES NO YES

Suggested ADULT PIF Changes · Web viewACLS ATLS PALS FCCS YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO ACLS ATLS PALS FCCS YES NO YES NO YES NO YES NO YES NO YES NO YES

Documents
Office Policy - lpwellness.com · Tonsillitis Yes No Bleeding Disorders Yes No Gout Yes No Pacemaker Yes No Tuberculosis Yes No Breast Lump/Cyst Yes No Headaches Yes No Parkinson’s

Office Policy - lpwellness.com · Tonsillitis Yes No Bleeding Disorders Yes No Gout Yes No Pacemaker Yes No Tuberculosis Yes No Breast Lump/Cyst Yes No Headaches Yes No Parkinson’s

Documents
MDGS.TASE MDGS.Nasdaq February 2016 - … · Stomach acid rises ... MUSE™ EGS Torax yes yes yes yes yes yes 1 Mederi no no yes GI/Surgeon no no no no no no no 1 Surgeon ... Chris

MDGS.TASE MDGS.Nasdaq February 2016 - … · Stomach acid rises ... MUSE™ EGS Torax yes yes yes yes yes yes 1 Mederi no no yes GI/Surgeon no no no no no no no 1 Surgeon ... Chris

Documents
Decision Making Flow Chart - NASA Aircraft Icing … · Decision Making Flow Chart Yes Yes Yes Yes No No No No No No Yes Yes No No Yes Yes No No No No Yes Yes No No Yes Yes Yes Yes

Decision Making Flow Chart - NASA Aircraft Icing … · Decision Making Flow Chart Yes Yes Yes Yes No No No No No No Yes Yes No No Yes Yes No No No No Yes Yes No No Yes Yes Yes Yes

Documents
TAV Service Note Review Summation MH Care Coordination ... · 10) MH Oral Health Survey yes no yes no yes no yes no yes no 1) County of service yes no 2) yes no 7) 8) 3) yes no 4)

TAV Service Note Review Summation MH Care Coordination ... · 10) MH Oral Health Survey yes no yes no yes no yes no yes no 1) County of service yes no 2) yes no 7) 8) 3) yes no 4)

Documents
ASSURED NRIC / PASSPORT NO. ASSURED NRIC / PASSPORT NO. · 2019-01-27 · assured nric / passport no. assured nric / passport no. bilal azam piperdi agxxx195 michael riley xxx0001430

ASSURED NRIC / PASSPORT NO. ASSURED NRIC / PASSPORT NO. · 2019-01-27 · assured nric / passport no. assured nric / passport no. bilal azam piperdi agxxx195 michael riley xxx0001430

Documents
Central/Intermediate Administrative Level … · Web viewRPR antigen Yes No Yes No Immersion oil Yes No Yes No Uristix Yes No Yes No Methanol Yes No Yes No

Central/Intermediate Administrative Level … · Web viewRPR antigen Yes No Yes No Immersion oil Yes No Yes No Uristix Yes No Yes No Methanol Yes No Yes No

Documents