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

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St.Vincent’s Healthcare Group Department of Old Age Psychiatry Departmental Review 156 The Department of Old Age Psychiatry experienced its busiest year in 2003.The increasing demographic pressures on the service have been reflected in large increases in service activity year on year since the inception of the service in 1996.A very committed multi-disciplinary team provides the service and an emphasis is placed on providing comprehensive assessment and thorough management of the mental health needs of patients and their carers. Patients are seen in a wide variety of settings including at home, in hospital, nursing homes, welfare homes and in day care facilities. Staff The Department welcomed a number of new staff to the team including Dr. Siobhan Ni Bhriain,Specialist Registrar in Old Age Psychiatry, and Maria Brennan,Mental Health Nurse in the Community, both of whom have made very valuable contributions to the service. Service Developments and Activities Over 500 new referrals were assessed by the service in 2003, which is a 119% increase in new referrals to the service compared to 1998.In addition,there were over 3140 reviews of patients by the Community Mental Health Nurses in 2003. The designation of another bed in Cois Ceim as a respite care bed has enabled the service to provide extra respite facilities for patients and their families. difficulties within the community and an initial meeting with senior medical and nursing personnel from Community Care Areas 1 and 2 was held in October 2003,with twice yearly meetings planned thereafter. Significant Achievements Catherine Keogh,Senior Occupational Therapist with the service, began her Masters of Science in Occupational Therapy at Trinity College Dublin and was awarded a Post Graduate Fellowship Award from the Dementia Services Information and Development Centre. She presented a paper on "Risk Assessments in Old Age Psychiatry" at the Association of Occupational Therapists in Ireland national conference in March 2003. Martina Dolan Senior Social Worker, has been carrying out a needs assessment study of elderly people referred to the Old Age Psychiatry service using the Camberwell Assessment of Need Questionnaire. Arising from this study Ms Dolan identified the need for information meetings for carers of elderly patients with dementia and plans to set up this service in 2004. Dr. Aideen Lewis,Senior Psychologist,carried out a sur vey of nursing home staff (March to July 2003) to identify the need for an education programme for staff regarding mental health issues.Following on from this a comprehensive education programme for nursing home staff was developed and it is hoped to begin the programme in January 2004. Dr. Cooney was awarded an MD degree at Trinity College Dublin.The subject of his thesis was "The Abuse of Elderly People with Dementia by their Carers". In addition, he co chaired one of the Hospital Groups including Old Age Psychiatry, General Adult Psychiatry, Medicine for the Elderly and Neurology as part of the Accreditation process in the hospital. Maureen Lowney, secretary at the department,has been studying for a diploma degree in first line management at the National College of Ireland. Research and Academic Activities There is a very busy research programme at the department. Current studies in progress include the assessment of needs of patients referred to the service using the Camberwell Assessment of Need for the Elderly (CANE) by Martina Dolan. Dr Freyne is completing her MD thesis on her prospective outcome study of depression in older people and has submitted 2 papers for publication " A longitudinal study of depression in old age – relationship to social networks",and Depression and physical disability". Dr. Martine Stoffels is carrying out a survey of benzodiazepine use by patients referred to the service. . 157 The Day Hospital in its first full year of activity in 2003 had 1294 attendances compared with 304 attendances in the last few months of 2002.There are plans in progress to develop a rehabilitation programme at the Day Hospital for patients who require more intensive input to address their mental health needs and to prevent hospital inpatient admission. In addition,Dr Elaine Greene (Specialist Registrar in Old Age Psychiatry) and Dr.Aideen Lewis developed a psychoeducational programme for patients with depression,which was carried out from September to December 2003.Preliminary outcome results of the programme look very promising. Dr. Freyne together with the medicine for the elderly service has been developing a programme for patients with psychiatric disorders associated with stroke. Maria Brennan,Mental Health Nurse in the Community, started her postgraduate course at Dublin City University.This is a two year Higher Diploma course in Mental Health problems in older people. Greater links with Community Care are essential to identify areas of unmet need for older people with psychiatric
St.Vincent’s Healthcare Group Clinical Biochemistry Department Blood Transfusion Department Staff Staff 158 General Service Development/Activities The major developments in 2003 were: •Commissioning of the new mortuary, which was completed in 2003. •Commencement of the detailed planning process for the equipping and commissioning of the new pathology department. Quality Improvement/Accreditation Further progress was achieved in the pathology accreditation project in 2003 with the implementation of the Office for Health Management e-learning Personal Development Planning Programme. The programme, which was piloted with a group of fifteen staff,will be further rolled out in 2004. Personal Development Planning (PDP) is being implemented to comply with the Clinical Pathology Accreditation (CPA) requirements for staff appraisal/annual joint review. A number of laboratories within pathology including, Histopathology, Haematology, Blood Transfusion and the Chemistry Group applied to CPA (UK) for inspection with assessment visits scheduled for 2004.In addition to the pathology accreditation project,a number of pathology staff have been actively involved on the hospital accreditation programme. Quality Assurance Department of P a t h o l o g y Departmental Review All laboratories in the pathology department continue to participate in relevant external quality assessment (EQA) schemes.An end of year review of departmental EQA results by the Pathology Management Committee indicates that all laboratories are performing satisfactorily in their respective schemes.Results from EQA schemes are available to users on request. The pathology department internal audit process continues to be implemented with various vertical and horizontal audits scheduled on a regular basis. The results from the audits form the basis for various quality initiatives. Departmental Statistics The growth in service activity continued in 2003 with a 2.8% increase in workload. External activity, i.e. workload from general practitioners and external hospitals increased by 8% during the period. Future Plans The main priorities for pathology in 2004 are: •To advance the quality improvement accreditation project with the commencement of CPA inspection of laboratories in 2004. •Planning and commissioning of the new pathology department. Administration There was a sizeable turnover of clerical/administrative staff in 2003 and the following new Grade III Clerical Officers were appointed to Pathology: Louise Sweeney, Sheila McKeon,Fiona O’Neill and Ornella Evangelista. Laura Conroy, Grade IV Officer in Biochemistry, commenced Year 1 of the Diploma in First Line Management held in SVUH by the National College of Ireland. Theresa Ward and Maureen O’Brien registered with the e- learning Personal Development Planning Programme on The Office for Health Management website and set personal objectives to be completed in 2004. Staff also participated in the Mission Effectiveness Programme. Phlebotomy An important development for Phlebotomy in 2003 was the announcement by the Department of Health of a national phlebotomy training programme. St.Vincent’s University Hospital has been chosen as one of the sites piloting the programme.A site accreditation process is currently being finalised which is scheduled for implementation in 2004. Paula O’Shea left for a Senior Biochemist position in the Metabolism Laboratory after 18 years in SVUH.Ms.Myra O’Keane filled her position. Service Developments/Activities In 2003 the Biochemistry Department greatly extended its involvement in Point-of-Care Testing (Near Patient Testing). Following the installation of a new Point-of-Care Glucose Monitoring System throughout the hospital,Biochemistry staff have taken on the role of monitoring and auditing the quality of glucose analyses. In addition,Biochemistry staff are now involved in the maintenance and quality assurance of blood gas analysers in A&E and ICU, together with training of new users of the analysers. Our service to the Cardiology department has been further increased with the provision of high sensitivity CRP (a new cardiovascular risk factor) for the Cardiac Rehabilitation Programme and for the Heart Failure Unit in St Michael’s Hospital. Future Plans In 2004,it is intended to evaluate the usefulness of Ischaemia Modified Albumin (IMA) as an early marker of cardiac ischaemia,in conjunction with the A&E Department. We also plan to introduce BNP (B-natriuretic peptide) as a new diagnostic test for heart failure, which has the potential to significantly reduce the number of patients admitted for more costly investigations such as echocardiograms. Outstanding/Significant Achievements Mr. Rowland Reece was elected Hon.Secretary of the Association of Clinical Biochemists in Ireland (ACBI).Ms Myra O’Keane obtained a MSc. in Biomedical Science (Clinical Chemistry) from the University of Ulster. Dr. Sean Cunningham delivered a presentation entitled "Implications of the new diagnostic criteria for myocardial infarction and acute coronary syndromes" at the Annual Joint Meeting of the Association of Clinical Biochemists in Ireland (ACBI) and the Northern Ireland region of the ACB (UK) Mr R.Reece delivered a presentation entitled "Quality Issues in Clinical Biochemistry" at a Roche Users Conference. Lesley Hopkins returned in December from her two and a half year career break.Deirdre O’Neill commenced her Masters in Biomedical Sciences at the University of Ulster, Coleraine. Denise McHugh commenced her Masters in Blood Transfusion and Transplantation at Bristol University. Eithne Cullinan joined the Department as Transfusion Surveillance Officer. Denise McHugh became Denise Neary and with the co-operation of our colleagues in the Haematology laboratory all of the staff in the Blood Bank were facilitated in witnessing the happy event in Westport. Service Developments The laboratory in collaboration with the Irish Blood Transfusion Service undertook a pilot study on hospital red cell inventory management.The aim of the project was to improve stock management,reduce operating costs and improve the quality of the product to the patient.The early indicators are very encouraging with considerable savings to both parties. The laboratory and the hospital participated in the national near miss project undertaken by the National Haemovigilance Office.The hospital based transfusion surveillance officers developed further nurse training in transfusion practice.The hospital Transfusion Committee have been working on a patient information document on receiving a blood transfusion and intend to publish it in 2004. Outstanding/Significant Achievements Sandra Doyle presented at the International Society of Thrombosis and Haemostasis in Birmingham. P.O’Brien presented a poster on Risk Management in the Blood Transfusion Laboratory at the Annual Meeting of the Haematology Association of Ireland. Laboratory staff participated at the IBTS workshops on Inventory Management, CJD and blood supply. Future Plans Directive 2004/23/EC of the European Parliament and of the Council of the European Union which passes into Irish Law in February 2005 will very much influence the future 159
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