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

Department of Emergency Medicine
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by the Irish Health Services Accreditation Board. Dynamic
quality improvement should be a liberating and an empowering
experience when embraced with confidence and commitment,
and equips health care professionals to deal with the rapidly
changing health care environment. Listening to the needs of the
patient to ascertain the strengths, weaknesses and patient
expectations is a vital quality issue that is inherent in all areas of
health care provision.
Accreditation is a way of identifying and improving the quality of
patient care and services on an ongoing basis through teamwo rk .
Margaret Boland and Derek Barton were appointed as co-team
leaders of the Emergency Medicine/General Internal Medicine
Quality Improvement Team.
Significant Achievements
7 nurses were awarded a Higher Diploma in Emergency
Nursing from UCD. Marianne Kelly was awarded a Bachelor of
Science in Nursing from UCD. Joanne Farren and Jackie
Brennan undertook a Major Incident Medical Management
Support training course, which enabled them to implement
skills acquired for the Major Critical Incident Exercise held in
August 2003. J Conneely, E Ramos,J Mejorada, S Keely and R
Nestor-Martin completed the Advanced Cardiac Life Support
Provider Course. Larry Flynn completed the Advanced Cardiac
Life Support Instructors Course. Anne Carrigan and Jerry
Kearns were appointed Shift Leader’s (CNM2) in September
2003.Mr Derek Barton was appointed Chairperson of the CPR
Committee in September 2003.
Publications & Presentations
Botulism as a cause of respiratory failure in injecting drug users.
FitzGerald S,Lyons R, Ryan J,Hall W, Gallagher C. Ir J Med Sci.
2003;172(3):143-4
Burns from automobile airbags. Nordt SP, Molloy M, Ryan J,
McQuillan RF. J Emerg Med.2003;5(2):201-2
Drs,John Ryan,Jean O Sullivan,Maria Sheyner and Adrian
Moughty presented papers at the Mediterranean Emergency
Medicine conference in Barcelona in September.
John Ryan was an invited speaker at the French Emergency
Medicine Association annual meeting in Beaune in November
and at the Pan Ireland meeting of the Royal College of
Psychiatrists
Dr Kavita Varshney presented a paper on the use of
plethysmography in the Emergency Department diagnosis of
deep vein thrombosis at the Australian Faculty of Emergency
Medicine scientific meeting in Perth in November.
Dr Tom Allen presented a paper on re-hydration in acute
gastroenteritis at the annual meeting of the Faculty of Accident
& Emergency Medicine.
Dr Maria Scheyner won first prize for her presentation at the
Irish Emergency Medicine Trainees Association meeting.
Medical Students Lisa McGrath and Sinead Feeney received
HRB and Faculty awards to examine the usefulness of BNP in
patients with shortness of breath and to examine the
prevalence of Cocaine usage among patients presenting to the
Emergency Department with chest pain.
We held our increasingly successful 2 day Emed-induction
course for new doctors in emergency medicine on two
occasions.
Statistics
The total attendances for 2003 was 37,314,of these 32,537
were new patients with 4,777 review patients. The admission
rate was 23.7% with 7,711 patients admitted through the
Emergency Department. During the same period there were
4,035 elective admissions and 2675 other urgent admissions.
Emergency admissions thus accounted for 53.5% of all hospital
admissions.
There were 35 Trauma By-pass patients treated in the
Emergency Department from the 17th September 2003 to the
31st December 2003.
Future Plans
It is planned to introduce a Self Care Model of Nursing for
patients attending the Minor Injuries Unit (MIU) at SVUH
emphasising the importance of involving the patient in the
health care process and giving information to the patient and
their families. There is a need to provide a Management
Development Programme for Shift Leaders and CNM 2 in the
Emergency Department due to the ever-changing health care
environment in the Emergency Department. The concept of a
Clinical Decision Unit within the ED is an innovative approach
to delivering quality care for emergency patients and meets the
challenges of health care reform. It is envisaged that such a unit
would reduce the need for in-patient admission. Other future
plans include an Advanced Nurse Practitioner Role for the
Emergency Department as well as a Liaison Psychiatric Nurse
Service and Care of the Elderly Nurse Specialist service.
In an effort to improve information management, scanning of all
Emergency Department documentation will be undertaken to
reduce filing and storage cost and create space in the
department.
Staff
Consultants:
Lecturer
Specialist Registrars:
Registrars:
Research Registrars:
Diabetes Centre
Nurses:
Primary Care Liaison: Deirdre Hall
Dieticians:
Primary Care Liaison: Yvonne Ryan
Professor T.J.McKenna,
Dr Malachi McKenna,Dr Donal O’Shea
Dr James Gibney, Department of
Medicine, University College Dublin
Dr Diarmuid Smith,Dr Kevin Moore
Dr Lai Mun Wang, Dr Sally Daly
Dr Twani Tuthill,Dr Tom Cawood
Deirdre Gleeson, Moira Haran,
Nora Collis, Phil Shankey,
Joanne O’Neill,Maureen Quill.
Maeve Moran; Sinead Curran.
Diabetes Liaison Psychiatrist:
Dr. Eamon Kenny
Secretarial Staff:
Heather Bailey, Patricia Sinnott,Brenda Sullivan,Marie McCarrick
Joyce Doyle, Michelle Keane, Fiona Whelan
Endocrine and Diabetes Research Nurse:
Ciara O’Dwyer,
Endocrine Laboratory:
Dr.Tom Smith, Principal Biochemist; Eithne Cuningham,
Anne-Marie Glynn,Martina Cassidy, Paddy Doran,
Sheila McKeon
(Marie Culliton,Senior Medical Scientist,is currently seconded
to introduce the Q-Pulse system throughout pathology
Research-Graduate Students:
Sinead Kelly and Lucille Kavanagh.
Weekly Departmental Academic Events
Monday lunchtime – Diabetes Team Meeting
Monday - 4.00 p.m. – Laboratory/Research Meeting
Tuesday - 8.00 a.m. - Clinical Research Meeting
Tuesday Noon – Endocrine Conference
Friday – 11.00 a.m. – Departmental Journal Club.
Department of
Endocrinology and
Diabetes Mellitus
Departmental Review
Outpatient Clinics
3 Diabetes Clinics per week
1 Joint Endocrinology Clinic (Prof.McKenna and Dr. O’Shea)
Service Developments/Activities
Diabetes Service
Consolidation of the East Coast Area Diabetes Shared Care
Programme has been the significant development in the
Diabetes Service. Since its inception in December 2002 11
practices enrolled in the programme. Following an education
programme organised and delivered by Dr Donal O’Shea,Dr
James Gibney and Nurse Deirdre Gleeson, agreed protocols
were adopted. Essentially the project is focused on the
management of patients with type 2 diabetes mellitus and
ensures that patients get a minimum of one hospital visit and
have a minimum of 2 visits to their general practitioners each
year.The primary care services are augmented by a liaison
diabetes nurse specialist,Deirdre Hall and a liaison dietician,
Yvonne Ryan.The project was designed to enhance the care of
diabetes patients and to increase the access of patients to the
hospital based service while ensuring that a similar standard is
delivered in primary care. It is planned to extend the service to
additional practices and increase the number of patients in all
practices.This project will be further supported by utilisation of
the established computerised hospital diabetes clinical database
for each patient so that it will be shared with the primary care
participants.
The East Coast Area Diabetes Shared Care Programme is now
well established with 276 patients attending St V i n c e n t ’s Unive rs i t y
Hospital,St Michael’s Hospital and St Columcille’s Hospital and
from 11 practices stretching from Arklow to Ringsend.
Endocrine Service
The full spectrum of the Endocrine Service including
management of thyroid and pituitary disease is delivered
principally as an outpatient service. Particular expertise has
been developed in this department in the areas of reproductive
endocrinology, adrenal disorders, the management of obesity,
calcium disorders and metabolic bone disease in all of which
the department enjoys a national profile.
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