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

Department of Card i o l o g y
St.Vincent’s Healthcare Group
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Ryder M, Travers B,Timmons L, Ledwidge M and McDonald K.
‘Specialist nurse supervised in-hospital titration to target dose ACE
inhibitor – is it safe and feasible in a community Heart Failure
population?’ in European Journal of Cardiovascular Nursing,
Volume 2, Issue 3,September 2003, Pages183 – 188.
Future Plans
The Catheterisation Laboratory has reached the end of its
useful life and we are awaiting the installation of replacement
equipment which has been ordered. It is hoped that this will be
on stream in 2004.In the interim temporary catheterisation
facilities are being provided in an area adjacent to the Accident
& Emergency Department and it is hoped that we will be able
to provide an immediate diagnostic and interventional service
for the acutely ill cardiac patient in this area.The overall
development of the department and particularly the integration
of the acute service with the care of the chronically ill (especially
heart failure and arrhythmias) and the assessment and diagnosis
of patients with different cardiac syndromes demands the prov i s i o n
of increased space and the reorganisation of much of the space
and bed pool currently available. Plans to do this are well
advanced and it is to be hoped that with the opening of the
new section of the hospital in 2005 these aims can be realised.
Heart Failure Unit
Staff Profile
Consultant Cardiologist
Dr. Ken McDonald
Clinical Nurse Specialists
Mary Ryder RGN,ENB 254,BNS
CATHETERISATION LABORATORY STATISTICS 2003
PROCEDURE JAN FEB MARCH APRIL MAY JUNE JULY AUG SEPT OCT NOV DEC TOTALS
Cors.+ Lv 108 110 104 106 105 112 126 103 110 130 102 110 1326
Graft 11 11 14 10 13 6 10 5 11 15 14 8 128
Right Heart 9 12 9 15 15 13 13 18 23 21 11 23 182
Single Lesion PCI 24 8 18 15 17 13 9 8 26 25 15 29 207
Complex PCI 6 5 9 9 6 6 15 10 6 0 4 2 78
Lapb 1 0 1 0 0 0 5 1 0 1 1 0 10
Single Chamber
Pacemaker 4 4 6 7 9 12 8 9 6 9 8 6 88
Dual Chamber
Pacemaker 1 3 4 4 7 4 4 3 3 6 1 0 40
Box Change 1 1 8 7 1 1 0 5 1 2 1 1 29
Lead Repos 3 0 0 0 0 2 3 2 1 3 1 0 15
Bi-Vent 1 0 0 0 1 1 0 0 2 4 1 1 11
Temp Wire 1 2 0 1 0 2 1 4 1 3 2 1 18
ICD 1 3 3 0 2 0 2 0 1 2 0 1 15
Hepatic 3 3 3 4 2 2 0 8 0 7 1 1 34
Total Procedures per month 174 162 179 178 178 174 196 176 191 228 162 183 2181
Bronagh Travers RGN,cert CCU, PG Dip Clinical Nursing
Alison Walshe RGN,ENB 254
Staff Nurses (Funded as Cardiology Research Nurses)
Jennifer Lewin BSc Nursing Carmel Conlon BSc Nursing
Sophie Baldwin BSc Nursing,H.Dip Critical Care
Post Doctoral Fellow
Dr. Ignatius Chakavarthi
Physiotherapist
Karen Cradock
Pharmacist
Clare Kingston
Psychotherapist
Phil Pyne-Daly
Dietician
Julie Dagg
Administrators
Helen Dillon,Ann Tiernan
3320 patients visited the out-patient department based in St.
Michael’s Hospital,Dun Laoghaire.
An expanding service that the Heart Failure Unit now provides
is a new patient Diagnostic Clinic.This clinic takes place on
Fridays and provides a facility for General Practitioners and
Physicians to refer patients suspected to have heart failure.The
patients have all diagnostic tests during their visit including
•History Taking
•Chest X-Ray
•ECG
•BNP
•Physical Assessment •Echocardiogram
The diagnosis of heart failure is confirmed on the same day.
The percentage readmission rate for heart failure to St.
Vincent’s University Hospital remains in single figures since the
introduction of multidisciplinary management of heart failure.
An Bord Altranais approved Heart Failure Nurse Training
programme continues to be a great success nationally.The
course is co-ordinated by Mary Ryder and Bronagh Travers but
has a strong team teaching approach.All of the heart failure
nurses nationally have attended this Category 1 approved
course, which has also received international recognition.
Publications
Ryder, M.,Travers, B.,Timmons,L., Ledwidge, M.T. , McDonald,K.
Specialist nurse supervised in-hospital titration to target dose ACE
inhibitor – is it safe and feasible in a community Heart Failure
population? European Journal of Cardiovascular Nursing,Volume
2,Issue 3,September 2003, Pages183 – 188
McDonald,K.,Ledwidge, M.T. ‘Heart Failure management
programs:Can we afford to ignore the inpatient phase of care?’
Journal of Cardiac Failure,Volume 9,Issue 4,August 2003, Pages
258 –262.
Ledwidge, M.T., Barry, M., Cahill,J.,Ryan,E.,Maurer, B.,Ryder, M.,
Travers, B.,Timmons, B., McDonald,K. ‘Is multidisciplinary care of
Heart Failure cost-beneficial when combined with optimal medical
care?’ European Journal of Heart Failure,Volume 5,Issue 3, June
2003, Pages 381 – 389.
Ryder, M.,Travers, B.,Ledwidge, M.T.,McDonald, K.
‘Multidisciplinary care of Heart Failure:what have we learned and
where can we improve?’ European Journal of Cardiovascular
Nursing.Volume 2, 2003, Pages 247 – 249
McNally C,Travers B, Ryder M, Kieran E,Lewin J,Ledwidge M
and McDonald K. ‘How useful is reported weight gain as a
predictor of clinical decompensation in heart failure’. European
Heart Journal 2003; 24 suppl.pp65
Presentations
Ledwidge, M.T.,Travers, B.,Ryder, M.,Ryan,E.,& McDonald, K.M.
‘Specialist care of heart failure improves appropriate
pharmacotherapy at the expense of greater polypharmacy and
drug-interactions’. European Journal of Heart Failure, 2003;
Supplement 2 (1),pp. 175
Ryan E.,O’Loughlin, C.,Ledwidge, M.T.,Travers, B.,Ryder, M.,
McNally, C.,Walsh,A.,and McDonald, K.M. ‘Long-term benefit of
a hospital based heart failure programme:downgrading the risk of
Class IV patients’. European Journal of Heart Failure, 2003;
Supplement 2 (1), p. 161.
Ryder, M., Kingston, C., Kieran,E., Lewin,J.,Ledwidge, M.T., &
McDonald,K.M. ‘Out-patient intravenous diuretic administration is
a valuable part of a hospital based disease management
programme for heart failure’. European Journal of Heart Failure,
2003;Supplement 2 (1),pp. 72-73.
Ali,A.,Walsh,A.,Ledwidge, M.T., Ryan, E.,Travers, B.,Ryder, M.,
McNally, C.,& McDonald,K.M. ‘Multiple neurohumoral blocade in
heart failure:are we dropping blood pressure too low?’ European
Journal of Heart Failure, 2003;Supplement 2 (1), p. 150.
Karruppiah,S.,Graham, F.,Ledwidge, M.T.,Ryan,E., McManus,J.,
McDonald,K.M. ‘Are "false positives" in BNP screening programmes
for LVSD at high risk of serious clinical events? One year follow-up
in a community population’. European Journal of Heart Failure,
2003;Supplement 2 (1), p. 142.
Travers, B.,Ryder, M.,Ledwidge, M.T.,O’Loughlin, C.,Ryan, E.,and
McDonald,K.M. ‘Resource utilisation of a specialist nurse-led beta
blocker titration:Are there any differences between carvedilol and
bisoprolol?’ European Journal of Heart Failure, 2003; Supplement
2 (1),pp. 135-136.
Abulhul,E.,Ryan,E.,O’Loughlin, C.,Ledwidge, M.T.,& McDonald,
K.M. ‘Does a hospital based disease management programme alter
the pattern of mode of death in severe heart failure?’ European
Journal of Heart Failure, 2003;Supplement 2 (1), p. 111.
Ryan, E.,Ledwidge, M.T.,& McDonald,K.M. ‘Anaemia in a heart
failure disease management program:iron deficiency or anaemia of
chronic disease’. European Journal of Heart Failure, 2003;
Supplement 2 (1), p. 48.
Conlon, C.,O’Loughlin, C.,Ledwidge, M.T.,McDonald, K.
‘Telemonitoring in a heart failure unit:the nature and value of
patient initiated contacts’. European Cardiac Society
Grant Held
Cardiovascular Grant for Health and Research.
Development of shared care strategy for management of
Heart Failure.
Grant Source:
Department of Health and Children
2003 and 2004 Total: €126,972
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