Welcome to our second Newsletter designed to keep our renal people informed via handy hints and suggestions plus current policies being implemented by Oxford Radcliffe Hospitals NHS Trust.
NHS FUNDED TRANSPORT Please can all patients who currently make use of hospital funded transport use the service in an appropriate way. It is NOT a personal taxi service and is provided for the benefit of all our eligible renal patients. Patients should be aware that they may have to wait for other patients to finish their dialysis treatment before hospital transport will take them home. The renal unit also shares hospital transport provision with The Great Western so there may be other non- renal patients making use of the same car service. It is NOT appropriate for patients to send drivers to collect items or to perform other chores including being dropped off at various non-home addresses on an individual basis. POLITE REQUESTS:
ARTERIO-VENOUS FISTULAS & GRAFTS
Please could all patients with this type of access regularly check their fistulas to make sure there is a pulse (should feel like a buzzing sensation on touch). Grafts are slightly harder to feel but the unit or access team can provide patients with stethoscopes so you can “hear” the fistula/graft. Staff will instruct you on how to do this. It is vitally important that you check your access as once a fistula has failed there is only a very short time in which to salvage it and it does mean an admission to Oxford for de- clotting/surgery. Check AV Fistula/Graft twice a day ideally morning and evening. If you are worried that the access has failed or seems weaker please ring the Swindon Renal unit within their operating hours or if out of hours ring the renal ward at The Churchill Hospital. (See end of Newsletter for contact numbers). CHRISTMAS AND NEW YEAR DIALYSIS SESSION SCHEDULING Please find attached sheets at the back of this newsletter. Individual letters will be sent out during the first week of December and there is a schedule list on the notice-board in the patient waiting/reception area. PATIENT-LINE -REVISITED
Would all patients who utilise the Patient-line service please ensure that they SIGN OFF at the end of their treatment sessions. (Ring customer services and listen to automated message then press 4 this will discontinue the service). The TV sets should then be turned OFF before patients leave their bed/chair. This will help the renal unit conserve energy and also help to preserve our current free patient-line service. Please could all patients who wish to use patient line bring in their own set of headphones this will help with infection control issues and short supplies of replacement head sets. Once our existing stock is used up these will not be replaced. BLANKETS
The renal unit is an out-patient facility and our consumption of laundry is now becoming a prohibitive cost for The Great Western and we have been asked to cut back on consumption if possible. From January 2008 can patients bring in their own blankets – these only need to be light-weight. We will not be providing blankets from that date unless there is a clinical/nursing indication to do so. If lockers are not available then the blankets can be stored in bags or brought in for each session. The renal unit staff will endeavour to find some space for blankets that cannot be brought in each time by certain patients. SWINDON KIDNEY PATIENTS ASSOCIATION (SKPA) New patients attending the Swindon Renal Unit can find out more about SKPA fundraising and membership via their website: www.skpa.org.uk HANDY HINTS
PHOSPHATE BINDERS: CALCICHEW/RENAGEL/PHOSEX This perennial patient favourite is still top of the list as the most likely medication patients do not take correctly or if at all. It is appreciated that they are rather like horse pills but if they are not taken or taken in a way that renders them in-active this has long term implications for the management of your renal care. So please – take your binders especially now the festive season is approaching. Please ask a member of staff or Jane the dietician if you need any information or advice on diet and phosphate/calcium medication. THE FLUID GAME
This is still the number-one favourite with renal patients. It is also very difficult to maintain the correct fluid restriction with so many tempting drinks and tasty morsels at ones’ fingertips, particularly now Christmas and New Year are on the horizon. All the dialysis staff do their very best to remove fluid via the haemodialysis session but would like to remind all patients that what goes through the lips marches to feet, ankles, legs and lower back and can cause breathlessness as the lungs fill with excess fluid. As with all aspects of dialysis treatment we try to be realistic when monitoring fluid intake for renal patients. However it is the responsibility of each one of you to try and make a conscious effort to restrict fluids to the required allowance set by the medical and nursing staff. Excess fluid can make people feel very unwell and in the long term will cause damage to the heart. In some cases fluid overload can be fatal. Fluid allowance is over a 24hr period and is inclusive of any form of liquid ranging from water to soups and yoghourts. If you are a beer/lager fan then think about changing to “shorts”. Most fruit and vegetables contain fluid in some form so this must be taken into consideration within your allowance. You need to watch out for the Christmas Puds and cakes as these are very high in potassium so be sensible and moderate intake. If you are unsure as to what fluid restriction you should be on or need advice about which foods contain fluid (most do) then please ask a member of staff or arrange to see Jane our Dietician. We hope you find this newsletter useful and would appreciate any comments. SWINDON RENAL UNIT OPENING TIMES
Monday to Saturday 0700 – 1900hrs Telephone Number Haemodialysis Unit : 01793 - 605286 Telephone Number for Clinic enquiries: 01793 605291 Telephone Number for CAPD: 01793 605288 Patients who need to contact the renal unit outside these hours should ring The Churchill Hospital on 01865 741841 and ask for the Renal Ward.
Recent Declines in ß-Lactam and MLSB Resistances Among S. pneumoniae and Age-Related Effects: Report from the SENTRY Antimicrobial Surveillance Program (North America, 1997 - 2002) RN JONES, DM JOHNSON, HS SADER, TR FRITSCHE The JONES Group/JMI Laboratories, North Liberty, IA A M E N D E D A B S T R A C T M A T E R I A L S A C D S ( C o n t i n u e d ) Background: The
“Apelo aos representantes da comunidade internacional ao mais alto nível. para que adoptem um objectivo que vise diminuir para metade o número de pessoas que vivem na pobreza absoluta, até 2015.” Kofi Annan, Relatório do Milénio Estatísticas Fundamentais • Mais de 2800 milhões pessoas, perto de metade da população mundial, vivem com menos do equivalente a 2 dólare