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Infections Monitoring Training Registration
For those at high risk of repeated Urine, Chest or Skin infection or their unpaid or paid Carers. Also available to professionals who wish to consider how it could support their work.
Training by Miralife will give background and justification for the pilot. You will be shown how to measure BREATHING, take a PULSE, read a URINE dip test and take a TEMPERATURE. You will be able to have a go at entering results from your monitoring on to the simple Miralife website and be given the equipment, guides and support you need if you decide to continue to take part.
If you have any queries please contact Northamptonshire Carers:
Tel 01933 677837.
TRAINING SESSION YOU WOULD LIKE TO ATTEND (click the circle to select)
PLEASE NOTE:
We are targeting those who have, or look after someone who has repeated infections or have been in hospital because of an infection in the past 12 mths.
In Corby priority is given to those registered with a Corby GP.
*
98. TOWCESTER Wed 28/6/17 10am-12:30pm Brook Surgery, Swinneyford Rd, NN12 6HD
100. CORBY Thur 6/7/17 2pm-4:30pm Lakelands Hospice, Butland Road, NN18 8LX
101. W'BORO Tue 11/7/17 10am-12:30pm Northants Carers, 123 Midland Road, NN8 1LU
102. CORBY Wed 19/7/17 10am-12:30pm Lakelands Hospice, Butland Road, Corby, NN18 8LX
103. KETTS Tues 25/7/17 10am-12:30pm Windsor Gardens, Kettering, NN16 8DV
105. CORBY Tues 8/8/17 10am - 12:30pm Lakelands Hospice, Butland Road, Corby, NN18 8LX
106. RUSH Thurs 17/8/17 10am-12:30pm Salvation Army, 18 Church Street, NN10 9YT
107. BRACKLEY Mon 21/8/17 10am-12:30pm The Old Firestation, High St, NN13 5DW
108. CORBY Thurs 31/8/17 2pm-4:30pm Lakelands Hospice, Butland Road, NN18 8LX
PLEASE ADD ME TO THE WAITING LIST FOR FUTURE TRAINING
THERE WILL BE OTHER TRAINING SESSIONS COMING SOON, IF YOU SELECT THE WAITING LIST OPTION ABOVE YOU WILL BE NOTIFIED BY EMAIL WHEN TRAINING IS AVAILABLE.
In what role are you taking part? You may tick more than one if applicable:
*
Unpaid Carer
Person at risk of infection
Professional
Intersted in Infections Champion Role
How did you become aware of the pilot?
Name
*
First
Last
Gender
Male
Female
Email
*
Phone (land line):
Phone (mobile):
Job Title (if attending as a professional)
Address
Organisation Name (if applicable)
House Name / Number
Street 1
Street 2
Town / Village
County
Post Code
IF REGISTERING SEVERAL PROFESSIONALS FROM THE SAME ORGANISATION PLEASE SUBMIT A FORM FOR EACH PERSON. YOU ONLY NEED TO GIVE FULL ADDRESS ONCE, BUT PLEASE ENSURE YOU GIVE THE ORGANISATION NAME ON EACH FORM.
Do you have access to a computer?
*
Yes
No
Via friends or family
If you don't use a computer yourself, but have friends or family that would enter test results for you, please select 'Via friends or family' button.
Level of confidence using computers:
Not Confident
1
2
3
4
5
Very confident
Please don't worry if you don't feel confident with computers. The system is very easy to use, and we will support you during the training, and provide follow up support if you need it.
If you have any Long Term Conditions you may consider monitoring your self as well as anyone you look after.
It is important we know which conditions are being monitored as this can effect the way the monitoring system is set up.
Your Long Term Conditions (if any):
Long Term Conditions of the person or persons you look after:
Is anyone you might be monitoring under 18?
Yes
No
Does anyone you might be monitoring have COPD? (including your self)
Yes
No
Consent to use data given:
*
Yes I give consent
No I do not consent
I understand that completing this form will lead to a computer record being made which will be treated confidentially. The information provided during registration will be shared with Northamptonshire Carers and Miralife who are the company who provide the training and operate the system used to perform the infections monitoring. The information will only be shared as allowed by the Data Protection Act 1998.
If I have given some details about someone else, I will make sure that they know about this.
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