Anaesthesia, Intensive Care and Pain Medicine - St Vincent's ...

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Department of Orthopaedics 120 in 1962,an event celebrated by a thirty-year anniversary academic meeting on joint replacement.As the main joint replacement specialist in the unit Mr. Quinlan was integral in the organisation of this conference. It is with great sadness that we now reflect on 2003,as our last year of our relationship in Cappagh with the Sisters of Charity as governance of the trust and therefore the management of Cappagh Hospital is to pass to the The Sisters of Mercy in early 2004.In the year 2003 there were 550 procedures carried out in Cappagh from the St. Vincent’s unit. Activity in the unit remains high as in previous years.The combined clinics in St.Vincent’s University Hospital catered for 12,431 patients,3,412 of these were new patients. The outlying clinics in St.Michaels and St.Colmcilles bring a further 8,406 attendances giving an overall total of 20,837 patient consultations at outpatient for the unit in the year January to December 2003. The fracture operating lists proceed daily seven days a week. This is in line with best practice that treatment is carried out within 24 hrs of patient presentation and in daylight hours leaving out of hours for more dire emergencies.There were total of 2,121 procedures carried out in the current year. The work of the unit could not proceed without the cooperation and commitment of the Medical House Staff.We are happy that the trainees at all levels gain a valuable experience and that St.Vincent’s University Hospital remain an attractive venue on the training rotations.At SHO level our trainees come from the Basic Surgical Training Programme based in St.Vincent’s University Hospital.At the registrar level the trainees are part of the higher surgical training programme administered by The Institute of Orthopaedics. Presented work: ‘M.R.S.A.in patients with intracapsular fractures neck of femur from a nursing home’ M.Cleary, M.Nelligan, M.S.Dudeney,W. Quinlan. ‘Revising the Sheehan total knee arthroplasty:techniques and technical difficulties’ C. Hurson,K.Synnott, O.Powell,W. Quinlan 121
St.Vincent’s Healthcare Group Department of Palliative Medicine Departmental Review Outcomes continued Died in SVUH while awaiting transfer to Our Lady's Hospice 2.3% Transferred to St.Vincent's Private 2.3% Transferred to other hospitals 3.6% Discharged to Nursing Home with community Palliative Care 2.3% Discharged from the Palliative Care Team 3.9% referral forms. A case note review was also carried out of Palliative Care patients presenting to the Accident and Emergency Department. Courses and Conferences Attended by members of the team 15TH Annual Symposium of the Multinational Association of Supportive Care in Cancer, Berlin,June 2003. Cancer Care Ireland,Cork,October 2003. St Francis Hospice International Conference, May 2003. 122 Staff Consultant Dr Eoin Tiernan Clinical Nurse Specialist Ms Barbara Whyte Ms Millie Devenish Ms Olga Price Specialist Registrar Dr Marian Conroy - 01/01/03 to 30/06/03 Dr Norma O’Leary – 01/07/03 to 31/12/03 Registrar Dr Joan Cunningham – 01/01/03 to 30/06/03 Senior Social Worker Ms Susan Cox Dr Carol Stone – 01/07/03 to 31/12/03 Administrative Support Ms Joan Stokes Mr Olajide Ogidan (Nov’03) 2003 saw further development and increased activities in the Palliative Medicine Department. There were a number of changes to the team with Dr Marion Conroy and Dr Norma O’Leary both rotating through the six-month Specialist Registrar post on the Higher Specialist Training Scheme for Palliative Medicine, and in July Dr Carol Stone replaced Dr Joan Cunningham as Registrar for a twelve-month period. Dr Cunningham was successful in gaining entry to the Higher Specialist Training Scheme for Palliative Medicine. In February, Ms Susan Cox took up the new post of Senior Social Worker with the Palliative Care Team. Susan came from a post in Tallaght Hospital but she is originally from Australia and has worked most of her professional life in Australia. She was a very welcome addition to the team and brought with her considerable experience and a keen sense of teamwork. As well as meeting the challenge of establishing this new post within the team and within the wider context of the hospital, Susan took a lead role in facilitating regular meetings of the team to look at issues of development and support. and team-building work within our own team. With the expanding Clinical Team,our administrative support was augmented with the arrival of Mr Olajide Ogidan in November 03 to join Ms Joan Stokes. Service Activity 2003 again saw a significant increase in the number of referrals to the team for advice and support. A total of 567 referrals were received,an increase of 13% compared to 2002. The tables below illustrate the source of referrals, breakdown of malignant and non-malignant conditions,and patient outcomes. Of note, the proportion of patients referred with a nonmalignant diagnosis has increased significantly from 11% of referrals in 2002 to 21% of referrals in 2003. Malignant Disease 79% Non-Malignant Disease 21% Outcomes Total Referrals An increase of 72 Referrals (13%) on 2002 Department Percentage Medicine 89% Oncology 31% Haematology 3.5% Respiratory 16% Surgery 11% Gastroenterology 8% Other 38% Nephrology 3.5% St.Vincent’s Private Hospital For the first time, this year’s Annual Review includes details of the Palliative Care service provided at St.Vincent’s Private Hospital. The service is provided by Carmel Houlihan,Clinical Nurse Specialist with support from Dr. Eoin Tiernan. In 2003 there were 154 referrals to the service. 45 patients died in hospital with the remainder being either discharged home or to alternative inpatient care, such as Hospice or Nursing Home. The majority of referrals to the service i.e. approximately 70% came from medical and radiation oncology, with 20% of referrals from the surgical services and 10% of referrals from other medical services. Carmel provides an excellent singlehanded service to the hospital and joins the larger team in the University Hospital for educational activities. Education The Nursing Team facilitated their Annual Palliative Care Study Day for registered nurses from around the country in the Education Research Centre in Nov 2003. We continued with the one-hour lecture series for NCHDs, and the new scheme for undergraduate medical student attachment to the team has continued successfully. The team continues to contribute to student and registered nurse education,ward attendant programmes and orientation programmes for overseas nurses, as well as facilitating clinical placements for nurses undertaking the Higher Diplomas in Palliative Care Nursing and Pain Management from UCD. Audit and Research The team undertook a number of projects during 2003 including a survey of the Interns in the hospital on issues around care of actively dying patients and a review of the activity of our hospital based team over a three month period which was based on the review on the newly introduced I.A.P. C Education Research Seminar, May 2003. European Association for Palliative Care Conference, Le Hague, February 2003. Advanced Course on Pain and Symptom Management, Newcastle, June 2003. Irish Cancer Society / Our Lady’s Hospice Study Day for Hospital Based Palliative Nurses and Home Care Nurses, September 2003. I.A.P. C Annual Conference, November 2003. Presentations Dr Tiernan was an invited speaker at the Multinational Association of Supportive Care in Cancer, 15th International Symposium in Berlin, and he presented a paper entitled "Communication Training for Professionals". He was also an invited speaker at Cancer Care Ireland,Cork,October 2003 and presented a paper entitled "Preferred Place of Death For Cancer Patients". Publications Tiernan E. Communication Training for Professionals. Support Care Cancer 2003;11:758 – 762. 123 In November, Ursula Bates joined the Oncology Service as Senior Clinical Psychologist.Ursula attends the weekly multidisciplinary palliative care team meeting.She has greatly added to the supportive resources available to patients,and has also already made significant contributions to ongoing evolution Died in S.V.U.H 45% Discharge Home without Community Palliative care 2.3% Discharge Home with Community Palliative care 30% Transferred to Our Lady's Hospice, Harold's Cross 9%
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