DOCSLIB.ORG

British Thoracic Society Guideline for Bronchiectasis in Adults

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
British Thoracic Society Guideline for Bronchiectasis in Adults BTS Guideline British Thoracic Society Guideline for bronchiectasis Thorax: first published as 10.1136/thoraxjnl-2018-212463 on 13 December 2018. Downloaded from in adults Adam T Hill,1 Anita L Sullivan,2 James D Chalmers,3 Anthony De Soyza,4 J Stuart Elborn,5 R Andres Floto,6,7 Lizzie Grillo,8 Kevin Gruffydd-Jones,9 Alex Harvey,10 Charles S Haworth,7 Edwin Hiscocks,11 John R Hurst,12 Christopher Johnson,7 W Peter Kelleher,13,14,15 Pallavi Bedi,16 Karen Payne,17 Hashem Saleh,8 Nicholas J Screaton,18 Maeve Smith,19 Michael Tunney,20 Deborah Whitters,21 Robert Wilson,14 Michael R Loebinger14 For numbered affiliations see SUMMARY OF RECOMMENDATIONS AND GOOD General end of article. PRACTICE POINTS ✓ CT scanning can also aid in identifying an aeti- How should the diagnosis of bronchiectasis be ology of bronchiectasis eg Allergic bronchopul- Correspondence to Professor Adam T Hill, determined? monary aspergillosis (ABPA), Non-tuberculous Respiratory Medicine, Royal Recommendations – Imaging mycobacteria (NTM), primary ciliary dyski- Infirmary of Edinburgh, ➢ Perform baseline chest X-ray in patients with nesia, alpha one antitrypsin deficiency, Williams Edinburgh and University of suspected bronchiectasis. (D) Campbell syndrome and a foreign body. Edinburgh, EH16 4SA, UK; ➢ adam. hill318@ nhs. net Perform a thin section computed tomography scan (CT) to confirm a diagnosis of bronchiec- In whom should the diagnosis of bronchiectasis tasis when clinically suspected. (C) be suspected? ➢ Perform baseline imaging during clinically Recommendations stable disease as this is optimal for diagnostic ➢ Consider investigation for bronchiectasis in and serial comparison purposes. (D) patients with persistent production of mucop- urulent or purulent sputum particularly with relevant associated risk factors. (D) Good practice points ➢ Consider investigation for bronchiectasis in CT imaging protocol patients with rheumatoid arthritis if they have The most appropriate imaging protocol will ✓ symptoms of chronic productive cough or vary according to scanner technology and recurrent chest infections. (C) patient factors. ➢ Consider investigation for bronchiectasis in ✓ When using volumetric CT, dose reduction patients with Chronic Obstructive Pulmonary http://thorax.bmj.com/ techniques including adaptive mA and kV Disease (COPD) with frequent exacerbations and iterative reconstruction should be utilised (two or more annually) and a previous positive where available. sputum culture for P. aeruginosa whilst stable. (B) ✓ Typical CT imaging parameters for the diag- ➢ nosis of bronchiectasis are: Consider investigation for bronchiectasis in º Slice thickness: ≤1mm patients with inflammatory bowel disease and º Reconstruction algorithm: – high spatial chronic productive cough. (C) frequency on October 2, 2021 by guest. Protected copyright. º kVp: 100-140 Good practice points º mAs (or effective mAs): 100 – 200 ✓ In at risk groups, if bronchiectasis is suspected, º Gantry rotation time: <0.5s bronchiectasis needs confirmation. ✓ In patients with COPD, investigation for bron- CT features of bronchiectasis chiectasis may be appropriate especially in the ✓ Bronchiectasis is defined by bronchial dilatation presence of chronic productive cough with posi- as suggested by one or more of the following: tive sputum cultures for potentially pathogenic ► http:// dx. doi. org/ thoraxjnl- 2018- 212468 º Bronchoarterial ratio >1 (internal airway microorganisms (PPM) whilst stable or 2 or more lumen vs adjacent pulmonary artery) exacerbations in the preceding 12 months. º Lack of tapering ✓ In patients with asthma, investigation for bron- º Airway visibility within 1cm of costal chiectasis may be appropriate with severe or © Author(s) (or their pleural surface or touching mediastinal poorly-controlled disease. employer(s)) 2018. No pleura. commercial re-use. See rights ✓ In patients with a history of HIV-1 infection, and permissions. Published ✓ The following indirect signs are commonly solid organ and bone marrow transplant, and by BMJ. associated with bronchiectasis: history of immunosuppressive therapy for º Bronchial wall thickening lymphoma and vasculitis, investigation for To cite: Hill AT, Sullivan AL, º Mucus impaction bronchiectasis may be appropriate with symp- Chalmers JD, et al. Thorax º Mosaic perfusion / air trapping on expir- toms of chronic productive cough or recurrent 2019;74 (Suppl 1):1–69. atory CT chest infections. Hill AT, et al. Thorax 2019;74(Suppl 1):1–69. doi:10.1136/thoraxjnl-2018-212463 1 BTS Guideline Thorax: first published as 10.1136/thoraxjnl-2018-212463 on 13 December 2018. Downloaded from ✓ In patients with chronic rhinosinusitis, investigation for in patients with coexisting clinical features of arthritis, bronchiectasis may be appropriate with symptoms of chronic connective tissue disease and/or systemic vasculitis. productive cough or recurrent chest infections. ✓ Consider testing for alpha 1 antitrypsin (A1AT) deficiency in ✓ In patients with other connective tissue disease or inflamma- patients with coexisting basal panacinar emphysema. tory bowel disease, investigation for bronchiectasis may be ✓ Investigations for reflux and aspiration should be under- appropriate if they have symptoms such as chronic produc- taken only in symptomatic patients, or where there are other tive cough or recurrent chest infections. suggestive clinical features. ✓ Investigation for bronchiectasis may be appropriate in other- ✓ Consider bronchoscopy for patients with localised disease to wise healthy individuals with a cough that persists for longer rule out an endobronchial lesion or foreign body as the cause than 8 weeks, especially with sputum production or a history of bronchiectasis. of an appropriate trigger (see BTS Recommendations for the ✓ A bronchial aspiration or bronchial wash targeting the areas management of cough in adults (61)). of bronchiectasis from CT scan of the chest should be consid- ered in patients who do not expectorate and can be particu- Investigations for causes of bronchiectasis larly helpful in the diagnosis of NTM pulmonary disease. Recommendations (see Table 1) ✓ Serum protein electrophoresis should be performed in all ➢ A panel of investigations should be performed to establish patients with bronchiectasis with raised immunoglobulins. the underlying cause of bronchiectasis. (B) ✓ Consider HIV-1 serology in patient with bronchiectasis a. Co-morbidities and past medical history should be depending on prevalence of HIV-1 and clinical features recorded in patients diagnosed with bronchiectasis to suggestive of increased risk of retroviral infection. identify relevant and possibly causative disease such as rheumatoid arthritis, COPD, asthma, gastro-oesophageal Research recommendations reflux disease and inflammatory bowel disease. (C) Consensus criteria for diagnosis of ABPA need to be validated in b. Measure full blood count, serum total IgE and assess- bronchiectasis cohorts. ment of sensitisation (specific IgE or skin prick test) to Consensus criteria for definition of abnormal post pneumococcal Aspergillus fumigatus in all patients with bronchiectasis. test immunisation antibody responses need to be validated in (D) bronchiectasis cohorts. c. Serum Immunoglobulin G (IgG), Immunoglobulin A (IgA) and Immunoglobulin M (IgM) should be performed Severity scoring in all patients with bronchiectasis. (C) Good practice point d. Consider measuring baseline specific antibody levels ✓ Consider using the bronchiectasis severity index which may against capsular polysaccharides of Streptococcus pneu- help guide management. moniae in all patients to investigate for specific antibody deficiency. If pneumococcal antibodies are low, immunise Stable state treatment with 23 valent polysaccharide pneumococcal vaccine, Which patients should be taught airway clearance techniques? followed by measurement of specific antibody levels 4–8 Recommendation weeks later. (D) ➢ Teach individuals with bronchiectasis to perform airway http://thorax.bmj.com/ e. Test for cystic fibrosis (according to NICE Guidelines for clearance. (D) Cystic Fibrosis (CF)) in patients with supporting clinical features, for example, early onset, male infertility, malab- Good practice points sorption, pancreatitis. (B) Airway clearance techniques should be taught by a respira- f. Test for Primary Ciliary Dyskinesia (PCD) (according ✓ tory physiotherapist. to ERS Guidelines for PCD Diagnosis) in patients with At initial assessment, a respiratory physiotherapist should supporting clinical features, including a history of ✓ neonatal distress, symptoms from childhood, recurrent educate the patient about their condition and if appropriate on October 2, 2021 by guest. Protected copyright. otitis media, rhinosinusitis, or infertility. (A) give advice on adjuncts (inhaled/oral therapy or exercise) g. Sputum cultures should be performed in all patients that may enhance effectiveness of their chosen airway clear- with bronchiectasis for routine and mycobacterial ance technique. culture. (D) ✓ Patients admitted with an exacerbation of bronchiectasis should be seen daily by a respiratory physiotherapist until their airway clearance is optimised. Good practice points ✓ A previous diagnosis of idiopathic bronchiectasis should prompt careful reinvestigation for a primary cause in the Which airway clearance techniques should be taught? context of a deteriorating clinical course or a young patient Recommendations (usually considered to be age 50 and under but not limited ➢ Offer active
Load more

Recommended publications
  • ICM Unit Brief
    Unit Brief v1 ICM Unit Brief Part 1 Hospital Details 1.1 Hospital name Royal Papworth Hospital NHS Trust 1.2 Full address (you must include postcode) 1.3 Hospital Telephone number Papworth Road 01223 638000 Cambridge Biomedical Campus Cambridge CB2 0AY Part 2 ICU Department contact details 2.1 Direct telephone number to Department 01223 638180 2.2 Faculty Tutor name 2.3 Faculty Tutor Email address Dr Nicola Jones [email protected] @nhs.net Part 3 Unit Structure 3.1 Number of Beds 3.2 Number of admissions 46 Beds 2000 - 3000 per year 3.3 Percentage of elective vs emergency admissions Approximately 75% of our work is elective and 25% is emergency 3.4 Overview of case mix within the unit Average occupancy by speciality: Cardiac surgery = 50-60% Transplant/heart failure/VADS =15- 20% Respiratory ECMO = 5-10% Pulmonary Thromboendarterectomy = 5-10% 3.Respiratory/thoracic5 Department of = 5 Anaesthesia% and Intensive Care - Names of Consultants, roles and areas of interest Cardiology = 5% Page 1 (of 4) Unit Brief v1 Dr Estefania Arenas MD Cardiothoracic Anaesthesia ALERT Team Lead Dr Joe E Arrowsmith MD FRCP FRCA Cardiothoracic Anaesthesia, GMC Examiner, LNC Chair Dr Angus Butchart FRCA Cardiothoracic Anaesthesia and ICU Dr Christiana Burt MA FRCA LLM Cardiothoracic Anaesthesia ES – Anaesthesia Trainees Dr Thomas Chloros MD Cardiothoracic Anaesthesia and ICU ES – Foundation Doctors Dr Florian Falter MA MD PhD FRCA Cardiothoracic Anaesthesia Department chairman, ES – Anaesthesia Trainees Dr Roger M Hall FANZCA FRCA Cardiothoracic Anaesthesia,
    [Show full text]
  • Abstract Book 2020
    Abstract Book 2020 Contents Page Calne Williams presentations 3 Medawar Medal presentations 7 Oral presentations 15 Posters 51 2 CW1 The relationship between Cardiopulmonary Exercise Testing (CPET) and muscle volume in liver transplant candidates Mr Ben Fox1,2, Mrs Janice Miller2, Dr Helen Usher2, Mr Richard Skipworth2, Professor Stephen Wigmore2 1University of Edinburgh, Edinburgh, United Kingdom. 2Royal Infirmary of Edinburgh, Edinburgh, United Kingdom Introduction: Sarcopenia is described as the progressive and generalised loss of skeletal muscle mass and strength, which often accompanies liver cirrhosis. Cardiopulmonary Exercise Testing (CPET) is a key clinical tool used to assess exercise capacity and is key in predicting surgical outcomes. This study sought to investigate the relationship between CT measures of muscle volume and CPET performance in patients undergoing liver transplant assessment. The secondary aim was to investigate the relationship between sarcopenia and post-operative morbidity and mortality. Methods: A single-centre retrospective cohort study of 400 patients who underwent liver transplant assessment between 1st July 2016 and 1st July 2018 was performed. Routine pre-operative CT scans were used to analyse muscle and adipose tissue which were indexed for height to generate a Skeletal Muscle Index (Cut-off values shown in Table 1). These were compared with CPET variables collected as part of liver transplant assessment work-up. Groups were evaluated using the independent T-test, Chi-squared test and Kaplan-Meier distribution. Results: Of the 400 patients, 54 met the exclusion criteria, leaving 346 for analysis (121 sarcopenic and 225 non- sarcopenic). Clinical significance was found between sarcopenia and Anaerobic Threshold (AT) (p=0.033), Subcostal Girth (p=0.024), predicted Lung Transfer Factor (TCO) (p=0.010), peak Heart Rate (p=0.030), UKELD score (p=0.003) and transplant suitability (p=0.020) (See Figure 1).
    [Show full text]
  • Annual Report and Accounts April 2018 to March 2019
    Annual Report and Accounts April 2018 to March 2019 Royal Papworth Hospital NHS Foundation Trust Annual Report and Accounts April 2018 to March 2019 Presented to Parliament pursuant to Schedule 7, paragraph 25(4) (a) of the National Health Service Act 2006 Royal Papworth Hospital NHS Foundation Trust - Annual Report 2018/19 ©2019 Royal Papworth Hospital NHS Foundation Trust Contents 1 Performance Report 4 1.1 Overview of Performance 4 1.2 Performance Analysis 15 2 Accountability Report 21 2.1 Directors’ Report 21 2.2 Remuneration Report 29 2.3 Staff Report 38 2.4 Disclosures set out in the NHS Foundation Trust Code of Governance 47 2.5 NHS Improvement’s Single Oversight Framework 53 2.6 Board of Directors 54 2.7 Audit Committee 61 2.8 Council of Governors 65 2.9 Foundation Trust Membership 75 2.10 Sustainability 77 2.11 Equality and Diversity Report 79 2.12 Statement of Accounting Officer’s Responsibilities 85 2.13 Annual Governance Statement 87 Quality Report See separate contents page Annual Accounts This report is based on guidelines issued by NHS Improvement and was approved by the Board of Directors on the 23 May 2019. Royal Papworth Hospital NHS Foundation Trust - Annual Report 2018/19 3 1. Performance Report 1.1 Overview of Performance Statement from Chief Executive Officer The last year 2018/19 has been an incredibly important one for Royal Papworth Hospital. In the last year, our staff and partners have worked extremely hard to maintain our excellent quality standards whilst remaining on our Papworth Everard site for an extended period following the delay in the move to our new hospital.
    [Show full text]
  • PI 41 A4 Cardiac Surgery with Consent Form Vs12.1.Indd
    Patient’s guide and agreement to consent form Cardiac surgery Patient’s guide to surgery and enhancing your recovery Agreement to consent form Important Please bring this booklet into hospital on admission 1 This document contains a consent form which your surgeon will go through with you and ask you to sign if you are willing to proceed. You will be given this booklet which will include a copy of the consent form. This information booklet has been prepared to help you and your relatives understand more about your cardiac surgery. It also gives you general information about what to expect from the time of your admission to your discharge from Royal Papworth Hospital, and some practical advice on what to do when you get discharged. Contents Your heart and how it works .............................................................................................................1 Reasons for needing cardiac surgery .................................................................................................1 Aneurysms ...........................................................................................................................................3 What are the risks? .............................................................................................................................3 Live well ...............................................................................................................................................4 Be prepared .........................................................................................................................................5
    [Show full text]
  • Protocol for an Observational Cohort Study and Biobank in Bronchiectasis
    Early View Study protocol BronchUK: Protocol for an observational cohort study and biobank in bronchiectasis Anthony De Soyza, Philip Mawson, Adam T. Hill, Stuart Elborn, Judy M. Bradley, Charles S. Haworth, R. Andres Floto, Robert Wilson, Michael R. Loebinger, Mary Carroll, Megan Crichton, James D. Chalmers, Anita Sullivan, Jeremy Brown, John R. Hurst, Jamie Duckers, Martin Kelly, John Steer, Tim Gatheral, Paul P. Walker, Craig Winstanley, Alistair McGuire, David Denning, Richard McNally Please cite this article as: De Soyza A, Mawson P, Hill AT, et al. BronchUK: Protocol for an observational cohort study and biobank in bronchiectasis. ERJ Open Res 2021; in press (https://doi.org/10.1183/23120541.00775-2020). This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. ©The authors 2021. This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact [email protected] BronchUK: Protocol for an observational cohort study and biobank in bronchiectasis. 1 19 2 3 3 4 Anthony De Soyza , Philip Mawson , Adam T. Hill , Stuart Elborn , Judy. M. Bradley , Charles S. Haworth , 4 5 5 6 7 R. Andres Floto , Robert Wilson , Michael. R Loebinger , Mary Carroll , Megan Crichton , James D. 7 8 9 10 11 12 13 Chalmers , Anita Sullivan , Jeremy Brown , John.
    [Show full text]
  • Papworth Hospital NHS Trust
    JOB DESCRIPTION LOCUM CONSULTANT in CARDIOTHORACIC ANAESTHESIA & INTENSIVE CARE Contents Section Page 1 Summary and Key Responsibilities 2 Papworth Hospital NHS Foundation Trust 3 Cardiothoracic Anaesthesia - Staffing, Facilities and Activity 4 Duties of the Post and Proposed Clinical Timetable 5 Research Activities 6 Terms and Conditions 7 Brief Terms of Appointment 8 General Information 9 Informal Visits 10 Person Specification SECTION 1 SUMMARY This post provides anaesthetic support for cardiothoracic surgical and Critical Care services at Papworth Hospital. The post holder will contribute to the provision of anaesthetic services for cardiothoracic surgery, transplant surgery, interventional cardiology, critical care and extra-corporeal membrane oxygenation (ECMO). In addition, the post holder will be required to attend pre-assessment clinics and to participate in early evening elective operating sessions as well as Saturday elective operating sessions. The post includes a commitment to the theatre, critical care and ECMO out of hours rotas on a rotational basis. The post- holder will contribute to the training of medical students, foundation, core and specialist trainees and allied health professionals. In addition the post-holder is expected to initiate and participate in clinical audit, quality improvement and academic activities. The post-holder will be employed full time at Papworth Hospital. KEY RESPONSIBILITIES The day-to-day provision and development of cardiothoracic and transplant anaesthesia, critical care and ECMO at Papworth Hospital. KEY TASKS Shared responsibility with other colleagues for the cardiothoracic anaesthetic service, Critical Care, ECMO and on-call duties as outlined above. Teaching, training and clinical supervision of trainees. Participation in the research, audit and quality improvement activities of the Department of Anaesthesia and Intensive Care.
    [Show full text]
  • Ascertainment of Silent Myocardial Infarction in Patients Undergoing Percutaneous Coronary Intervention (From the GLOBAL LEADERS Trial)
    ARTICLE IN PRESS Ascertainment of Silent Myocardial Infarction in Patients Undergoing Percutaneous Coronary Intervention (from the GLOBAL LEADERS Trial) Chun Chin Chang, MDa,b, Ernest Spitzer, MDa,c, Ply Chichareon, MDd, Kuniaki Takahashi, MDd, Rodrigo Modolo, MDd, Norihiro Kogame, MDd, Mariusz Tomaniak, MDa,e, Hidenori Komiyama, MDd, Sing-Chien Yap, MD, PhDa, Stephen P. Hoole, MDf, Tommaso Gori, MDg, Azfar Zaman, MDh, Bernhard Frey, MDi, Rui Cruz Ferreira, MDj, Olivier F. Bertrand, MD, PhDk, Tian Hai Koh, MDl, Amanda Sousa, MDm, Aris Moschovitis, MDn, Robert-Jan van Geuns, MD, PhDa,o, Philippe Gabriel Steg, MDp, Christian Hamm, MDq,r, Peter Juni,€ DMs,t, Pascal Vranckx, MD, PhDu, Marco Valgimigli, MD, PhDn, Stephan Windecker, MDn, Patrick W. Serruys, MD, PhDv,*, Osama Soliman, MD, PhDa,c, and Yoshinobu Onuma, MD, PhDa,c Q-wave myocardial infarction (QWMI) comprises 2 entities. First, a clinically evident MI, which can occur spontaneously or be related to a coronary procedure. Second, silent MI which is incidentally detected on serial electrocardiographic (ECG) assessment. The preva- lence of silent MI after percutaneous coronary intervention (PCI) in the drug-eluting stent era has not been fully investigated. The GLOBAL LEADERS is an all-comers multicenter trial which randomized 15,991 patients who underwent PCI to 2 antiplatelet treatment strate- gies. The primary end point was a composite of all-cause death or nonfatal new QWMI at 2-years follow-up. ECGs were collected at discharge, 3-month and 2-year visits, and analyzed by an independent ECG core laboratory following the Minnesota code. All new QWMI were further reviewed by a blinded independent cardiologist to identify a potential clinical corre- late by reviewing clinical information.
    [Show full text]
  • Papworth Hospital LOGO
    ‘Measurement of mucus plugging with computer tomography before and following implementation of the AffloVest in adults with bronchiectasis – a feasibility study’ STUDY PROTOCOL – AFFLO Study DATE 09/09/2019 CHIEF INVESTIGATOR Dr Charles Haworth List Investigators Siobhan Singh Andres Floto Nicholas Screaton Timothy Baird Investigation Sites: Royal Papworth Hospital NHS Foundation Trust, Cambridge Biomedical Campus, Papworth Road, Cambridge, CB2 0AY, UK Protocol Identification Number: P02552 Date of Protocol: 09/09/2019 Protocol Version Number: 2 Trial Sponsor: Royal Papworth Hospital NHS Foundation Trust AffloVest Study Proposal version 2 03/09/2019 Page 1 of 13 Contents TRIAL OVERVIEW 1. Trial Overview Primary Research Question Study Design Primary Outcome Secondary Outcome Rationale 2. Patient Recruitment Study Population Inclusion Criteria Exclusion Criteria Recruitment Strategy 3. Data Analysis Sample Size Statistical Analysis 4. Consent Process and Visit Schedule Visit 1 Follow-up Visit Informed Consent Procedure Table 2: Visit Schedule Table 3: Trial Specific Procedures versus Routine Procedures 5. Follow up Visits, Travel Expenses and Other Costs 6. Data Collection, Auditing and Retention of Documents Data Collection Form Completion Source Documentation Errors and Correcting Storage of Documents Retention of Documents Monitoring and Auditing Labelling of Source Documentation 7. Adverse and Serious Adverse Events Recording & Reporting 8. Amendments Amendment log 9. References AffloVest Study Proposal version 2 03/09/2019 Page 2 of 13 TRIAL OVERVIEW 1. Trial Overview Principal Objective: The principal objective is to test the feasibility of using computer tomography and the modified Brody score to measure the amount of mucus plugging within the lungs of adults with bronchiectasis at baseline and after six weeks treatment with the AffloVest.
    [Show full text]
  • Handbook for Inpatients
    Handbook for inpatients Handbook for inpatients Coming into hospital 1 Handbook for inpatients Welcome Royal Papworth Hospital is a If, while you are in hospital, special place because of the you require any information extraordinary people that not contained in this booklet, work, teach, treat and are please do speak to the nurse in treated every day. charge of the ward or to your doctor, who will be happy to The safety of our patients and help. the experience they have while in our care is very important to If you require additional all staff at Royal Papworth. We information prior to admission, are proud of our reputation please ring the hospital on as the UK’s largest specialist 01480 830541 and ask to speak cardiothoracic hospital, and to the Booking Office or the we achieve some of the best nurse in charge of the ward outcomes in the world for our indicated on your letter. They patients. will be happy to help you. Our patients often travel long With best wishes. distances to see us, confident in the knowledge that we are at the forefront of providing new and innovative treatments Stephen Posey for heart and lung patients. Chief Executive We will do all we can to make you welcome and make your time with us as pleasant and comfortable as possible. This booklet gives you information about preparing for, and being admitted to hospital and what to do when you arrive. It briefly describes the life of the hospital, how your clinical care is provided and also explains arrangements for going home.
    [Show full text]
  • QUACS Quality of Life After Cardiac Surgery a National Multicentre
    QUACS Quality of life after cardiac surgery a national multicentre observational study Protocol Version 3.0 Date 09/09/19 RESEARCH REFERENCE NUMBERS – 19/WA/0123 IRAS Number: 260891 SPONSORS Number: PO2500 i QUACS protocol 3 09/09/19 sSH SIGNATURE PAGE The undersigned confirm that the following protocol has been agreed and accepted and that the Chief Investigator agrees to conduct the study in compliance with the approved protocol and will adhere to the principles outlined in the Declaration of Helsinki, the Sponsor’s SOPs, and other regulatory requirement. I agree to ensure that the confidential information contained in this document will not be used for any other purpose other than the evaluation or conduct of the investigation without the prior written consent of the Sponsor I also confirm that I will make the findings of the study publically available through publication or other dissemination tools without any unnecessary delay and that an honest accurate and transparent account of the study will be given; and that any discrepancies from the study as planned in this protocol will be explained. For and on behalf of the Study Sponsor: Signature: Date: ....../....../...... ...................................................................................................... Name (please print): ...................................................................................................... Position: ...................................................................................................... Chief Investigator: Signature:
    [Show full text]
  • PI 119 Were Here to Help Vs6.Indd
    Information for patients, relatives and carers Patient Advice & Liaison Service (PALS) We’re here to help Information for patients, relatives and carers 1 Information for patients, relatives and carers We’re here to help when you The service aims to: need advice, have concerns, or • Advise and support patients, don’t know where to turn to. their families and carers. • Provide information on NHS As a patient, relative or carer services. sometimes you may need to turn to someone for on-the- • Listen to your concerns, spot help, advice and support. suggestions or queries. • Help sort out problems This is where the Patient Advice quickly on your behalf. and Liaison Service (PALS) comes in. We act independently when handling patient and We provide confidential advice family concerns, liaising and support, helping you to with staff, managers and, sort out any concerns you where appropriate, relevant may have about the care we organisations, to negotiate provide, guiding you through immediate or prompt solutions. the different services available from the NHS. If necessary, we can also refer patients and families to specific The Patient Advice and Liaison local or national-based support Service focuses on improving agencies. the service to NHS patients. The aim of the service is to make a genuine difference to the overall quality of health services provided and accessed by local people. 1 Information for patients, relatives and carers The service is confidential and can be contacted via: PALS Supervisor Royal Papworth Hospital NHS Foundation Trust
    [Show full text]
  • Appointment of Locum Consultant in Medical Virology (10 Pas)
    Cambridge University Hospitals NHS Foundation Trust Appointment of Locum Consultant in Medical Virology (10 PAs) Available from 01 April 2021 until 30 September 2021 Advert Reference No. 180-LOCON-3648 Medical Staffing Department Box: 154 Cambridge University Hospitals NHS Foundation Trust Cambridge Biomedical Campus Hills Road, Cambridge CB2 0QQ Medical Staffing: 01223 586934 [email protected] www.cuh.nhs.uk IC Approval 23.10.20 Cambridge University Hospitals NHS Foundation Trust CONTENTS SECTION 1 Job Description – General Details SECTION 2 Person Specification SECTION 3 Responsibilities and Expectations of the Role SECTION 4 Job Plan and Timetable SECTION 5 The Department of Clinical Microbiology & Public Health Laboratory SECTION 6 General Information SECTION 7 General Conditions of Appointment SECTION 8 Application Information IC Approval 23.10.20 Cambridge University Hospitals NHS Foundation Trust SECTION 1 Job Description – General Details Title: Locum Consultant in Medical Virology Location: Based at Addenbrooke’s Hospital, Cambridge New or Replacement Replacement Post: Prime responsibility: Contribute to the provision of the Clinical Virology Service within Cambridge University Hospitals NHS Foundation Trust (CUH) Enable the laboratory to fulfil its role as the Public Health England Regional Laboratory Promote high quality care of communicable diseases within the area served by the Trust, and its healthcare partners Accountable to: Dr Ashley Shaw, Medical Director Reports to: Divisional Director for Division
    [Show full text]