Annual Review - St Vincent's University Hospital

St. Vincent’s Healthcare Group Limited - Annual Review 2008 

Mission Statement 

St. Vincent’s Healthcare Group Limited 

St. Vincent’s University Hospital 

St. Michael’s Hospital Dun Laoghaire 

St. Vincent’s Private Hospital 

The values underlying the philosophy of St Vincent’s Healthcare Group in relation to our care 

of patients and staff are those of human dignity, compassion, justice, quality and advocacy, 

which are based on the mission and philosophy of the Religious Sisters of 

Charity, our shareholders. 

We strive to maintain excellence in clinical care, education 

and research. 

We will continue to develop the Healthcare Group in line with the above 

principles and with our responsibilities to the wider Irish healthcare system.


Contents 

Reports 

Mission & Values Committee 6 

Ethics and Medical Research 7 

Report from Clinical Audit Department 8 

Education and Research Centre 9 - 56 

• Reviews and Personnel 11 - 14 

• Research Activities 15 - 39 

• Postgraduate Department 40 - 42 

• Translational Research Seminars 2007/08 43 

• Academic Activities 44 - 46 

• Publications 47 - 51 

• Grants Active 52 - 56 

St. Michael’s Hospital 57 - 62 

• St. Michael’s Hospital Report 58 

• Radiology 59 

• Pharmacy 59 

• I.C.T 59 

• Library 59 

• Laboratory 60 

• Human Resources 60 

• Nursing 60 

• Quality & Risk Department 61 

• Chaplaincy 61 

• St. Michael’s Hospital Organisation Structure 62 

St. Vincent’s Private Hospital 63 - 94 

• St. Vincent’s Private Hospital Report 64 - 65 

• Consultant’s Forum 66 

• Corporate Services Division 67 - 69 

• Nursing Division 70 - 73 

• Human Resources Division 74 - 76 

• Support Services Division 77 - 82 

• Finance Division 83 

• Allied Health Division 84 - 93 

• St. Vincent's Private Hospital Organisation Structure 94 

St. Vincent’s University Hospital 95 - 262 

Reports from the Director of Operations 96 

Report from Chaplaincy/ Pastoral Care Department 100 

Report from Library and Information Service 102 

Report from Medical Records 106


Contents 

Allied Health Professionals and Support Services 107 - 133 

Medical Physics and Clinical Engineering Department 108 

Medical Social Work Department 110 

Department of Nutrition and Dietetics 113 

Occupational Health (OH) Department 116 

Occupational Therapy Department 118 

Pharmacy Department 120 

Physiotherapy Department 125 

Preventive Medicine and Health Promotion Department 128 

Speech and Language Therapy Department 131 

Reports from the Director of Nursing 134 

Director of Nursing Report 135 

Bed Management 138 

Hospital Sterile Services Department 139 

Hospital Hygiene Services 140 

Reports from the Professor of Medicine 141 - 194 

Report from the Professor of Medicine 142 

Report from the Chairman Physicians Subgroup 143 

Department of Anaesthesia, Intensive Care and Pain Medicine 144 

Department of Cardiology 150 

Department of Dermatology 152 

Department of Endocrinology and Diabetes Mellitus 154 

Department of Medical Oncology incorporating 

Lios Aoibhinn Cancer Support Centre 159 

Department of Medicine for the Elderly 162 

Department of Nephrology 165 

Department of Neurology 166 

Department of Clinical Neurophysiology 170 

Department of Palliative Medicine 171 

Department of Respiratory Medicine 174 

Bone & Joint Unit 176 

Department of Rheumatology 183 

Department of Rehabilitation Medicine 193 

4


Contents 

Reports from the Professor of Surgery 195 - 230 

Professor of Surgery Report 196 

Reports from the Chairman of the Surgical Subgroup 199 

Liver Transplant Programme and Liver Unit 200 

Department of Ophthalmology 201 

Operating Theatre Department 203 

Department of Orthopaedics and Traumatology 205 

Department of Plastic Surgery 208 

Department of Urology 209 

Department of Vascular Surgery 213 

Department of Medical and Surgical Gastroenterology 

incorporating the Centre for Colorectal Disease 215 

Report from the Emergency Department 219 

Report from the Pathology Department and Laboratory Medicine 222 

Report from the Radiology Department 225 

Report from the Clinical Director of Psychiatry 228 

Reports from the General Services Manager 231 - 258 

Reports from the General Services Manager 232 

Department of Catering 235 

Department of Fire Safety 236 

Department of Household Services & Cleaning 237 

Department of Portering Services 238 

Department of Security 239 

Department of Technical Services 240 

Department of Telecommunications 242 

Report from the Human Resources Department 244 

Reports from Information and Communication Technology Department 250 

Report from Purchasing and Procurement Department 254 

Report from the Quality, Risk and Consumer Affairs Department 256 

2007 Healthcare Group Committees 259 

Department of Old Age Psychiatry 229 

5


Mission & Values Committee 

As we face the many challenges today that are 

presented to the hospital group, we maintain the 

philosophy of caring which is the very essence of our 

mission. 

Mission Committee 

Our thanks to all the members who gave so generously 

of their time and shared their creative ideas in seeking 

ways to promote the mission. The committee met 

every two months and is an integral part of our 

organisation’s success. 

Mission Education Programmes 

Units 1 & 2 of the Mission Effectiveness Programmes 

were held on a regular basis throughout the year, all 

departments were represented with a total of 208 in 

attendance. 

It was evident from the responses from the groups that 

there was strong support for the mission and efforts 

made in all areas to integrate the values. 

Feedback was collated and presented at the Mission 

Committee. 

A mission component was also included as part of the 

Hospital’s new Corporate Induction Programme which 

was launched in March 2008. This introduces new 

employees to the Mission and Values in their first few 

days in the organisation. 

Accreditation 

In preparation for accreditation, quality standards based 

on evidence in relation to Mission Integration were 

developed and prepared. We continue to liaise with the 

Quality, Risk and Consumer Affairs Department to 

ensure we are meeting all standards. 

Celebrations 

• There was a great attendance at the Mass celebrating 

our Foundation Day on the 23rd January. Many 

enjoyed the refreshments and the interactions 

afterwards. 

• On the 24th of September 2008, at we celebrated a 

mass at 5.00pm for our deceased and bereaved staff. 

This celebration was much appreciated. 

Long Service Awards 

Long service awards will be presented to staff from the 

three hospitals on 23rd January 2009. This is always a 

great celebration for the staff and management of the 

Group. 

Hospital Choir 

The Choir performed in a wonderful and professional 

way at all our important celebrations and the Christmas 

Carol Service in Stephen’s Green. Staff provided the 

music playing - organ, violin, flute & viola. A wonderful 

selection of both carols and music was also performed 

for staff and patients for the Christmas season. Lunch 

breaks were given over to practice and recitals took 

place in the Atrium with excellent acoustics. It is indeed 

an event worthy of note in this report. Thanks to all 

who were so generous with their time and talents. 

6 

Return to Contents


Ethics and Medical Research 

The St. Vincent’s Healthcare Group Ltd., (SVHG) Ethics 

and Medical Research Committee (EMRC) operated as 

a designated recognised ethics committee acting for the 

whole state in compliance with the EU directive 

entitled: “European Communities Clinical Trials on 

Medicinal Products for Human Use”(Regulations 

2004). In September 2007, the Department of Health 

& Children extended our recognition as a designated 

committee for a period of one year and in September, 

2008 the recognition was extended for a further year 

until September 2009. 

Following the implementation of the EU directive 

(2004) the purpose of which was to harmonise and 

standardise approval for clinical trials by regulatory 

authorities and ethics committees across all EU 

member states. It is a requirement that each clinical trial 

must obtain one single ethics committee opinion for 

the conduct of the trial within the state in keeping with 

Directive. 

Revised Forms 

The revised clinical trial application form issued by the 

DOHC, was adopted for use by the Committee. 

The SVHG Site Specific Assessment Form has been 

revised to ensure all/any financial implications for the 

hospital are addressed. 

Committee 

Throughout the year there were a number of changes 

in committee membership and new members were 

duly appointed. 

Meetings 

There were a total of 11 Committee Meetings held 

from 1st January 2008 to 31st December 2008. 

Clinical Trials Reviewed: 

Number of New Clinical Trial Proposals Considered: 10 

Number Issued a Favourable Opinion: 10 

Research Studies: 

Total Research Studies Reviewed 82 

Total Approved 82 

Amendments 

Total Number of Clinical Trial Amendments Reviewed 

and Approved 97 

Quarterly/Annual/Termination Reports 

Total Number of Reports Reviewed and Noted 119 

Copies of all application documents are available 

electronically and in hard copy from 

Ms Joan McDonnell / Ms Anna Brennan, 

Ethics Office, ext: 4117 

(joan.mcdonnell@ucd.ie). 

(anna.brennan@ucd.ie). 

The committee with the agreement of the Department 

of Nursing decided, that nursing studies involving nurse 

to nurse, need only be reviewed/approved by the 

Department of Nursing. A study may be referred to the 

Chairman if the Department deems a particular study 

requires the opinion of the committee. 

SVHG EMRC are the responsible Ethics Committee for 

the following: 

Pharmaceutical Sponsored Trials 28 

Investigator Led Trials 11 

Pharmaceutical/Investigator Led, External Sites only 8 

Registries 6 

Total 53 

Dr. B. Kirby, Chairman. 

7 

Return to Contents


Report from Clinical Audit Department 

Clinical Audit has been formally developed and 

supported for the third year in a row and the efforts that 

the organisation has put into the programme are being 

repaid with greater numbers of clinical audits of higher 

quality being presented to the Clinical Audit Committee. 

The cultural change that fosters clinical audit activity was 

never going to be a quick fix intervention and our 

experience has proven that sustained support and 

encouragement yields the maximum return and reward. 

Audits have been registered from many different areas 

of clinical practice and the variety of these audits 

testifies to the constant and unfailing drive that 

individuals and teams have to improving the care that is 

provided to patients before, during and after their stay 

with us in the hospitals of the group. 

There have been some significant external drivers for 

advancing the clinical audit agenda – chief amongst 

these being the increased awareness of the Health 

Information and Quality Authority as an external agent 

and the development of our Clinical Governance 

Committee internally. 

The Healthcare Group has always striven to be best in 

class and it is our belief that we are ahead in harnessing 

the internal appetite for clinical audit and clinical 

governance. The clinical audit committee gained a new 

chairman in Dr Tom Crotty who has brought his insight 

and commitment to the development of the clinical 

audit agenda. As part of this commitment he has 

successfully encouraged several clinical experts to join 

the clinical audit committee and with this widened and 

multidisciplinary membership, the committee has 

overseen the improvement in the quality and output of 

individual audits as well as encouraging greater 

collaboration across the three hospitals on audits. 

A key feature in clinical audit is the completion or 

closure of the clinical audit loop. This element can prove 

challenging to the individual and to the organisation but 

by harnessing the collective strengths of the committee, 

we have achieved both obvious and implicit 

improvements in-patient care. 

A side effect of clinical audit is the sharing of information 

on the process or results of individual audits. Several 

audits were featured in poster presentations at 

international meetings across the globe and more locally 

in Ireland. Some of these presentations won awards at 

their respective outings. 

The organisation continues to grapple with the possibility 

of audit data being accessed in an uncontrolled fashion 

and used to the detriment of the organisation’s 

reputation. While acknowledging the benefits of the 

Freedom of Information Act, the possibility of stage one 

and two data being circulated publically before the audit 

loop has been closed is a worry to all of us. Conversely, 

the organisation has been very proactive in publishing 

information and completed audit results in poster 

format and in our clinical audit newsletter. To date, we 

have had nothing but positive feedback on this 

approach. The difference between the two perspectives 

lies in the timing of information circulation; in the latter 

case, the organisation is proactive in publishing both 

positive and less than optimal results, when and where 

it has identified a plan of action to address the issue. 

The clinical audit function looks forward to 2009, with 

plans for increasingly proactive audits, audits that span 

the three hospitals and audits that address the tenets 

of patient centred care. We plan to engage with patients 

and carers through a newly formed patient advisory 

panel. We see a very significant role for clinical audit in 

the run up to the University Hospital and St Michaels 

Hospital application for accreditation by the Joint 

Commission International. Continued focus on training 

and education will see more staff knowing how to 

conduct bigger and better audits and ultimately, I have 

no doubt but that patient care will be enhanced. 

8 

Return to Contents


Education and Research Centre 

9



CONTENTS 

Reviews and Personnel 

Review by Director of Translational Research, 

Dublin Academic Health Care, Prof. Douglas Veale 11 

Principal Investigators – 2008 13 

Research Laboratories – Personnel 2008 14 

Research Activities 

Translational Medicine Research Group 

Inflammation, Infection & Immunity 15 

• Rheumatology 16 

• Liver Research 24 

• Obesity 29 

• Dermatology 30 

• Respiratory Sleep 30 

• Neurology Research in Multiple Sclerosis 31 

Cancer 

• Centre for Colorectal Disease Research 35 

• Breast Cancer 37 

Suicide & Depression 

• Psychiatry & Mental Health Research 38 

Postgraduate Department 

• Postgraduate Department 40 

• SHO Teaching 40 

• International Meeting 41 

• Pharmaceutical Representatives 42 

• The Library 42 

Academic Activities 

Translational Research Seminars 43 

Workshops/Guest Lectures 44 

Journal Club/Education & Outreach 45 

Honours /Awards/Prestigious Invitations 45 

Higher Degrees 46 

Publications 

Papers in International Peer Reviewed Journals 47 

Grants Active 

Grants Active in 2008 52 

10 

Return to Contents



Review by Director of Translational Research, Dublin Academic Health Care, 

Prof. Douglas Veale 

Dear Colleagues, 

We have seen another year of unprecedented change, 

with very positive developments in clinical and 

biomedical research activities across the hospitals, the 

Clinical Research Centre (CRC) and the wider campus 

including: 

• Dublin Academic Healthcare Centre (DAHC) 

established; 

• Appointment of DAHC Directors of Translational 

Research and Postgraduate Education 

• Funding 

• Administration 

A key element of the research review was to bring 

researchers in St. Vincent’s University Hospital (SVUH) 

together in a coordinated programme with colleagues 

in University College Dublin (UCD). I am pleased to 

report with the development of the DAHC, we 

established the first academic medical centre in Ireland, 

this goal has been realised. While, undoubtedly 

challenges both logistic and financial remain, I believe 

that we are a much more robust group following this 

development. The DAHC development has already 

provided the infrastructure through the UCD CRC to 

provide essential core resources for clinical trials and 

research studies which has translated into more clinical 

trial activity being attracted to the centre. 

Translational Research 

In addition, to funding of specific programmes which 

was maintained at a high level last year, there were a 

number of new Translational initiatives. A coordinated 

DAHC scientific journal club meeting was established by 

Dr. Jacintha O’Sullivan and Dr. Ursula Fearon which 

welcomes researchers from The Mater Misericordiae 

University Hospital (MMUH) and Conway on a regular 

basis. We completed our first series of Translational 

Research Seminars and are now planning the second 

series. This has led to a number of substantial 

collaborative projects including Colorectal Cancer, 

Obesity, Medicine for the Elderly and Rheumatology to 

mention but a few. Finally, in 2008 we established and 

completed successfully the first year of two new PhD 

programmes in Translational Medicine and 

Biopharmaceutical / Pharmacological Sciences funded 

through UCD from PRTLI 4. Interestingly, in light of the 

recent announcement in relation to PRTLI 5 from the 

Office of the Taoiseach, in relation to joint UCD/Trinity 

College Dublin (TCD) funding of Life Sciences research, 

a joint proposal to fund two new Arthritis Chairs in 

Ireland was agreed, with one based in UCD. I believe 

this will provide significant benefits to the research 

community within the DAHC to create new and exciting 

links with colleagues across the country to enhance our 

international competitiveness. 

Development 

There was a major investment in research equipment 

made in 2008 to fund critical new technology for the 

group based in the ERC. This included a new Lightcycler 

480 analyser, Flow cytometer, LuminoSkan and 

11 

Return to Contents 

Return to ERC Contents



Review by Director of Translational Research, Dublin Academic Health Care, 

Prof. Douglas Veale 

Fluoresecnt microscope. A major new development is 

the new DAHC Biobank which will be situated in the 

CRC/ ERC, this will be completed in early 2009, 

providing an essential resource for researchers across 

the DAHC. 

Funding 

PRTLI 4 funding of €4.5 million in total was received 

and contributed to the establishment of the new PhD 

programmes including the Translational Medicine and 

Biopharmaceutical/Pharmacological Sciences 

programmes. The Translational Medicine Research 

multidisciplinary group including rheumatology, 

colorectal and vascular biology group, based at SVUH 

and the Conway Institute renewed a contract with 

GlaxoSmithKline of €390k bringing the total of active 

grants in 2008 to more than €14M. This is a major 

achievement and all the staff including principal 

investigators, senior scientists, post-doctoral scientists, 

clinical fellows, post-graduate students and research 

assistants should be very proud. The Education and 

Research Centre achieved over 60 publications in peer 

reviewed journals and 2 higher degrees were awarded. 

This could not be achieved without the dedicated 

enthusiasm and hard work from each group, as well as 

the exceptional support of the Laboratory Coordinator, 

Dr. Emer Bairead and the administrative team – 

Geraldine Lanigan Ryan, Louise McCormack and 

Geraldine Jordan. I am sorry to report that Alan Garton, 

who was an integral part of the ERC decided to leave 

us, however he has progressed his career and we all 

wish him the very best in the future. 

Conclusion 

There are significant challenges ahead for the DAHC 

research community in 2009/10, especially in the 

current global economic climate, however I believe that 

we are well positioned after the developments of the 

past three years to meet these challenges and to 

maximise our opportunities in the future. 

12 





PRINCIPAL INVESTIGATORS – 2008 

Prof. Barry Bresnihan 

Dr. Enda McDermott 

Prof. Aongus Curran 

Prof. T. J. McKenna 

Prof. Joe Duffy 

Prof. Walter McNicholas 

Dr. Ursula Fearon 

Dr. Hugh Mulcahy 

Prof. Oliver FitzGerald 

Prof. Diarmuid O’Donoghue 

Prof. Charles Gallagher 

Prof. Cliona O’Farrelly 

Mr. Justin Geoghegan 

Prof. Donal O’Shea 

Prof. John Hegarty 

Dr. Jacintha O’Sullivan 

Prof. Michael Hutchinson 

Prof. Kieran Sheahan 

Dr. Brian Kirby 

Dr. Niall Tubridy 

Prof. Kevin Malone 

Prof. Doug Veale 

13 





Research Laboratories – Personnel 2008 

Senior Scientists & 

Post Doctoral Fellows 

Jacintha O’Sullivan 

Ursula Fearon 

Sinead Nic an Altaigh 

Wei Gao 

Edward Fox 

Aisling Pierce 

Eadaoin McKiernan 

Monika Biniecka 

Emily Collins 

Lydia Lynch 

M.D.’s 

John Garvey 

Peter Barry 

Tariq Tajuddin 

Orla Young 

Chin Teck Ng 

Bernadette Lynch 

Juliette Sheridan 

Ann Marie Tobin 

Eliza Pontifex 

Danny Cheriyan 

Gavin Rush 

Siun Walsh 

Garret Cullen 

Eoin Slattery 

Joe Marry 

Taj Saber 

Dave Kevans 

Jean O’Connell 

Research Assistants 

Anna Kwasnik 

Emma McGrath 

Jennifer McCormick 

Miriam Tosetto 

Owen Sullivan 

PhD Students (Post Grads) 

Aisling Kennedy 

Mary Connolly 

Sheeona Gorman 

Aoife O’Donovan 

Ellen Moran 

Jannie Michielsen 

Conall Dennedy 

Research Nurses 

Blathnaid Nolan 

Catherine McEvoy 

Helen Vaughan 

Lisa McGowan 

14 





Research Activities 2008 

TRANSLATIONAL MEDICINE RESEARCH GROUP 

INFLAMMATION, INFECTION & IMMUNITY 

• Rheumatology 

• Liver Research 

• Obesity 

• Dermatology 

• Respiratory - Sleep 

• Cystic Fibrosis Research 

• Neurology Research in Multiple Sclerosis 

CANCER 

• Centre for Colorectal Disease 

• Breast Cancer 

SUICIDE & DEPRESSION 

• Psychiatry & Mental Health Research 

15 






Research Activities - Rheumatology 

Principal Investigators: 

Professor Barry Bresnihan 

Dr. Ciaran Duffy 

Dr. Ursula Fearon (Senior Scientist) 

Professor Oliver FitzGerald 

Dr. Orla Killeen 

Dr. Anne Barbara Mongey 

Professor Douglas Veale 

Specialist Registrars: 

Dr. Lorraine O’Neill 

Registrars 

Dr. John Paul Doran 

Clinical Research Fellows 

Dr. Bernadette Lynch 

Dr. Chin Teck Ng 

Dr. Taj Saber 

Post Doctoral Fellow: 

Dr. Monika Biniecka 

Dr. Wei Gao 


Ms Jennifer Mc Cormick 

Dr. Ceara Walsh 

Dr. Clare Kiely 

Dr. Aizad Mumtaz 

Dr. Eliza Pontifex 

Dr. Agnes Szentpetery 

Ms Roisin Adams 

Dr. Emily Collins 

Dr. Sinead NicUltaigh 

Mr. Owen O’Sullivan 

Graduate Students 

Mary Connolly 

Ellen Moran 


Educational Activities 

Prof. Anne Barbara Mongey is the Director of the Clinical 

Skills Laboratory at UCD, responsible for designing and 

conducting workshops in clinical skills for the undergraduate 

and graduate entry medicine programmes. In 

addition, Prof. Mongey is involved in the development 

of OSCE examinations, including the use of videotaping, 

to evaluate clinical skills. Integration of the teaching of 

clinical skills into the 1st and 2nd year of the undergraduate 

medical programme is also part of Prof. Mongey’s 

remit as a lecturer in UCD and the development of 

videotapes and handbooks for teaching of clinical skills. 

Furthermore, Prof. Mongey is the co-ordinator of the 

Advanced Clinical Skills module for the Graduate Entry 

Medicine programme and co-ordinator for the Elective 

module for undergraduate and graduate entry medical 

students. 


The Translational Medicine research group includes 

close links with other active research groups including 

the Centre for Colorectal Disease, Diabetes and Obesity, 

Liver Immunology and Psychoimmunology on the ERC 

site and investigators based in the Conway Institute, 

UCD and in TCD. The Rheumatology Research group 

includes Principal Investigators - Prof. Douglas Veale, Dr. 

Ursula Fearon and Prof Oliver FitzGerald with a primary 

clinical focus on early, inflammatory arthritis and a 

scientific focus on mechanisms of angiogenesis, 

inflammation and joint damage. The group has established 

novel models of analysis using serum, synovial fluid, 

synovial tissue and cartilage to search for biomarkers of 

disease, examine mechanisms of angiogenesis and 

hypoxia, novel mediators/cytokines and cartilage 

destruction in the study of pathogenesis of arthritis. 

The research plan for the next five years is to develop 

new expertise and extend national and international 

collaborations to elucidate predictors of response to 

therapy, predictors of remission and to examine the 

mechanisms of disease. A major step has been achieved 

in this regard with the proposal to create a new Centre 

for Rheumatological Diseases incorporating clinical and 

scientific researchers from UCD and TCD. This initiative 

supported by the two universities, Arthritis Ireland and 

the Health Service Executive (HSE) has established two 

Chairs in Rheumatology. 

16 






We have in 2008 commenced a major state-of–the-art 

clinical research programme based around UCD CRC 

bringing together investigators across the newly formed 

Dublin Academic Health Centre. This has included a 

DAHC coordinated Research Journal Club, a DAHC 

Seminar Series for Translational Research. In support of 

this there have been a number of developments 

including the appointment of key personnel – Data 

coordinator, Laboratory Manager, in addition to 

establishing a new UCD CRC Biobank. 

Further progress has been made in relation to novel 

imaging studies with the first concomitant studies of 

PET/CT and MRI in patients with arthritis. 

Specific ongoing projects 

Remission study and Rituximab therapy for resistant 

arthritis 

Dr Ceara Walsh finished her research in July 2007 

under the supervision of Prof. Barry Bresnihan and Dr 

Ursula Fearon. Dr Walsh’s research involved (i) to 

identify predictive markers of relapse and identify a 

genetic profile associated with relapse (ii) to examine 

the effect of Rituximab in-patient’s resistant to anti-TNFα 

therapy, (iii) to examine the presence of latent TB in 

patients receiving anti-TNFα She demonstrated a 

specific expansion of inhibitory receptor CD94/NKG2A 

in remission associated with an increase in the CD8+ T 

cell population. Loss of this expansion may predict 

disease relapse and therefore allow modification of 

dosing schedule with important health-economic and 

patient related benefits. She demonstrated the 

presence of CD20+ cells in the synovium of patients 

with RA resistant to anti-TNFα therapies. Complete 

depletion of synovial B cells following treatment with 

Rituximab is associated with an excellent clinical 

response. She also demonstrated that Rituximab may 

effect depletion of macrophages in the joint suggesting 

that synovial B cells precedes a decrease in local 

inflammation leading to clinical improvement. Ceara is 

currently writing up her PhD thesis. 

Biomarkers and predictors of disease 

This work was performed by Dr Eliza Pontifex under the 

supervision of Prof Barry Bresnihan and Dr Ursula 

Fearon. It is an ongoing collaboration with several 

international groups funded by the EU FP6 Autocure 

grant, led by the Karolinska Institute, Stockholm and 

links with the ‘OMERACT’ international study to develop 

new biomarkers for synovial tissue response to 

treatment. This work demonstrated that the macrophage 

marker - CD68 is good biomarker for response to 

therepy, which correlates with disease activity. 

Furthermore, she demonstrated a correlation between 

results obtained from 2 different centres (Dublin and 

17 






Amsterdam), and thus has validated the method of that 

staining and quantification of sublining CD68 in RA 

making significant progress in standardisation of the 

techniques. This data has now been assimilated into 

manuscript and is currently in press. Under the 

supervision of Prof Oliver FitzGerald and Dr Ursula 

Fearon, Eliza is also examining if change in cell 

infiltration in psoriatic arthritis (PsA) synovial tissue 

correlates with change in DAS28 following initiation of 

biologic therapy. Results have shown that change in 

CD3+ T-cell infiltration correlates both with change in 

DAS28 and also with change in a semi-quantitative MRI 

synovitis score of the same knee joint calculated by Dr. 

Robin Gibney. In collaboration with Professor Patrick 

Brennan’s group from imaging in UCD, a more 

quantitative measure of synovitis is being developed. 

Finally Eliza is examining the role of TLRs in patients 

with PsA. Eliza has demonstrated expression of TLR-2/4 

in the endothelial and lining layer regions of the 

synovium. Currently she is stimulating primary fibroblasts 

from patients with PsA with TLR-2 and 4 +/- cJun 

inhibitors and assessing regulation of chemokines. 

Hypoxia and altered mitochondrial bioenergetics in the 

inflamed joint. 

This major programme funded by a Translational 

Research Award from The HRB (2006-2011) to Prof 

Doug Veale and Dr. Ursula Fearon hypothesizes that 

vascular morphology and synovial invasiveness within 

the inflamed joint and response to therapy, may be 

dependent on activation of mitochondria-derived, 

hypoxia-induced transcriptional and non-transcriptional 

pathways and alterations in genome stability. Using a 

novel pO2 probe we have demonstrated that the joint 

is profoundly hypoxic. Dr. Vincent Ng, clinical research 

fellow, has demonstrated for the first time a direct 

inverse correlation between tissue (t) pO2 levels and 

macroscopic synovitis. Furthermore Dr. Ng has 

demonstrated that low tpO2 levels inversely correlate 

with microscopic markers of synovial T cells and 

macrophages, with no relationship to synovial 

proliferation or apoptosis. In vitro exposing synovial 

cells to tpO2 levels found in the joint,, resulted in 

decreased proliferation, increased cell migration and a 

significant relationship with pro-inflammatory cytokines/ 

chemokines TNFα, IFNg, IL-1b and MIP3a. Together 

these results suggest that low tpO2 in the joint driving 

inflammation through increased cell migration and 

impaired apoptotic pathways. This work was presented 

the American College of Rheumatology, San Francisco, 

Nov 2008. Currently, Vincent is combining both MRI 

and CT/PET imaging to examine the metabolic turnover 

in the joint and it’s relationship to tpO2 levels, 

angiogenesis and blood flow. Vincent is also working to 

identify biomarkers that may predict response to 

treatment, specifically A-SAA and cartilage neoepitopes. 

Preliminary data has demonstrated that high A-SAA 

levels may predict a bad response to biologic treatment 

but also may predict increased risk of cardiovascular 

disease. 

In parallel, Aisling Kennedy, graduate PhD student, is 

examining the effect of hypoxia on the angiopoietins/ 

Tie2 pathway, blood vessel morphology and cell 

stability in the joint. Aisling has demonstrated for the 

first time a mixture of mature and immature vessels in 

the joint. She has demonstrated low NCAM on vessel 

with predominantly focal expression, suggesting that the 

endothelial-pericyte cell-cell interactions are not intact. 

Vessels in this unstable state are more easily targeted, 

which may be due to differential expression of VEGF, 

Angiopoeitin 1, 2 and PDGF. We have also demonstrated 

strong nuclear expression of 8-oxo-DG on the 

endothelial cells, further supporting the hypothesis that 

vessels in the joint are unstable. Finally Aisling has 

demonstrated and inverse relationship between pO2 

levels and both macroscopic vascularity and microscopic 

blood vessel stability and NOTCH expression. These 

results combine with Vincent’s, suggest that while there 

is an increase in number of BV within the joint the rate 

of synovial expansion is faster, resulting in a high 

metabolic turnover and an hypoxic environment. An 

abstract of this work was chosen for an oral podium 

presentation at the American College of Rheumatology, 

18 






San Francisco, November 2008, which Aisling presented 

to a great response from the scientific community. 

Currently, Aisling is examining the effect of anti-TNF 

therapy on blood vessel stability and joint hypoxia. She 

has also transplanted synovial tissue into SCID mice 

and is examining the effects of blocking NOTCH 

signalling on vessel survival. 

Dr Monika Binecka is examining the role of genomic 

instability in the joint and the effect of hypoxia. She has 

demonstrated high oxidative damage in the synovial tissue 

of patients with low pO2 levels. She has demonstrated 

that tpO2 levels inversely correlate with lipid peroxidation 

but not DNA damage. She demonstrated that lip 

preoxidation but not DNA damage correlated closely 

with angiogenic growth factor expression. Exposing cells 

to hypoxia demonstrated a decrease in cell proliferation 

and an increase in anaphase bridging. Currently Monika 

is examining the effects of tpO2 levels on mitochondrial 

pathways. 

(A) 8-oxo DG nuclear staining 

(B) Anaphase bridging 

Fig 1: Demonstrates oxidative damage in the endothelial 

cells and lining layer in RA synovium (stained with 8- 

oxo-dG) (A) and (B) demonstrates Anaphase Bridging 

in primary synoviocytes and chondrocytes 

Cytokines, angiogenesis and invasion 

Recent targeted biologic therapies, including anti-TNF 

and IL-1 blocking drugs are effective, but may not be 

effective in 30% or more patients. The increasing 

evidence shows that complex cytokine networks do not 

operate in isolation to promote new blood vessel 

formation, synovial hyperplasia and joint destruction. 

The effects of TNFα and IL-1‚ β alone and in combination 

with novel cytokines and growth factors, including 

Oncostatin M (OSM), IL-17, acute serum amyloid A (A- 

SAA), IL-22, GMCSF, TLRs and Angiopoietins is being 

examined in the inflammatory process, lead by Dr. 

Ursula Fearon and Dr. Douglas Veale 

Oncostatin M, IL-17, IL-22 

Ellen Moran, is her final year of her PhD student and is 

examining the role of IL-17 on cartilage degradation, 

matrix turnover and cell migration. Ellen has previously 

demonstrated high levels of IL-17 in the joint and 

shown that IL-17 potentiates the effects of OSM and 

TNFα on matrix turnover and cartilage degradation. 

Ellen has now shown that IL-17 has a profound effect 

on cell migration in the joint, possibly mediated through 

GRO-alpha and MIP-1. She has demonstrated IL-17 

induces angiogenesis and invasion, all mechanism that 

contribute to celklular invasion. To examine more 

specifically how IL-17 regulates these events, we have 

examined it’s effects on cytoskeletal rearrangement, 

which is critical for cell movement and shape. We have 

demonstrated IL-17 induces cytoskeletal disassembly 

and focal adjhesion contacts, an effect that is reversed 

through inhibition of RhoGTPases such as RAc1. She 

has also shown that IL-17 regulates the upstream 

triggers specifically integrins avb3 and B1. Currently 

Ellen is elucidating the specific pathways involved in IL- 

17 induced cytoskeletal dynamics. 

Dr. Bernadette Lynch was awarded an HRB clinical PhD 

fellowship in July 2008, to examine the role of IL-22 in 

the joint. She has demonstrated high levels of IL-22 in 

synovial fluid compared to serum, and has demonstrated 

that biologic therapy reduces its expression. Using synovial 

19 






explant cultures and primary fibroblasts Bernadette has 

shown that IL-22 has no effect on regulation of many 

cytokines or chemokine but appears to regulate matrix 

metabolism. Currently Bernadette is examining the 

effect of Il-22 in combination with other cytokines, to 

assess it’s potential for adjuvant therapy. Finally, 

Bernadette has collected a cohort of RA patients, to 

assess the relationship between clinical characteristics 

and high-resolution ultrasound. 

Dr. Taj Saber is an MD clinical fellow and is coordinating 

the arthroscopy programme and the biologic clinics. Taj 

is currently examining the effects of biologic therapy in 

the cohort of inflammatory arthritis patients to establish 

features, which may predict remission in these patients. 

In addition, Taj is engaged in a laboratory project to 

assess the effects of cytokines on MMP production, 

proteoglycan release and invasion. Furthermore she will 

examine the downstream signalling pathways involved, 

specifically the JAK-STAT pathway. 

Serum Amyloid A (A-SAA) 

The role of A-SAA in the pro-inflammatory response is 

an on-going project theme of the unit over the past 10 

years. Mary Connolly has just submitted her thesis 

which examines the effect of A-SAA on cell migration 

and invasion, cartilage metabolism and the related 

transcriptional pathways. Mary has shown A-SAA has a 

potent migrational effect within the joint. She has 

demonstrated that this is mediated through alterations 

in cytoskeletal dynamics. Specifically A-SAA differential 

regulates RHO-GTPAses with upregulation of Cdc42 

and RAC1, which is paralleled by inhibition of RhoA. 

Mary demonstrated that A-SAA significantly increased 

migration of GFP tagged monocyte into human synovial 

tissue in vivo using a novel human RA synovial tissue/ 

SCID mouse chimera model. Furthermore she has 

demonstrated that this effect is only partially mediated 

through increased angiogenesis. The final part of Mary 

work was to examine the effects of A-SAA on synovial 

explants cultures using proteomics. The greatest change 

was in proteins that were involved in ECM, apoptosis and 

cytoskeletal proteins. These are currently being validated. 

Mary had an oral presentation at the American College 

of Rheumatology, San Francisco, November 2008. Mary 

has demonstrated high A-SAA levels in serum and A- 

SAA induces disassembly of actin filaments in primary 

synovial fibroblast, Fig 2. 

Intact Actin Filaments 

Disassembly of actin 

cytoskeleton and 

Induction of filopodia 

formation 

Endothelial cell survival & blood vessel regression. 

One of the main interests of the group is the role of 

angiogenesis in the pro-inflammatory response, with 

specific interest in the pathways of blood vessel 

maturity and survival. This work will provide novel 

insights into the complex mechanisms mediating 

growth factor activation within a synovial EC model. Dr. 

Wei Gao, Jennifer Mc Cormick and Dr. Catherine 

Sweeney. One of the key questions is ‘what are the key 

survival pathways’; we have shown high expression of 

NOTCH signalling components in synovial tissue. We 

have demonstrated it’s expression on both endothelial 

and pericytes, and VEGF and Ang2 regulate shown 

NOTCH1C. Possible upstream triggers of these events 

include hypoxia, neutropeptides or mechanical forces. 

Dr. Sweeney showed that substance P and mechanical 

stress upregulated VEGF, ANg2 and NOTCH 1IC. 

Inhibition of NOTCH was demonstrated with anti-Tie or 

20 






AntiVEGF antibodies. Currently we are carrying out 

experiments to examine if NOTCH blockade results in 

vessel regression, and will establish if this only involves 

immature vessels or are those vessels with pericye 

coverage also targeted. Dr. Gao, has demonstrated low 

Po2 levels in the joint upreguates HIf1a and NOTCH1IC 

in primary cell cultures. Uisng siRNA to NOTCH we have 

shown that VEGF and hypoxia directly regulate NOTCH. 

Currently we are trying to elucidate the signalling pathways 

involved in hypoxia induced NOTCH expression. Using 

NO, DMOG, SiRNA and DAPT we will establish if (i) 

hypoxia induced NOTCH 1IC is HIF1a dependent or 

independent and (ii) establish the downstream effects 

of blocking NOTCH1iC, such as angiogenesis and 

fibroblast invasion. 

Fig 3: Dual immunoflourescent staining with Factor VIII 

(red) and αSMA (GREEN). Blood vessel staining red 

are immature and those staining for red and green are 

mature. This figure shows there is a mixture of 

immature and mature vessels in the joint. 

GMCSF and TLRs 

Dr. Sinead Nic An Ultaigh has been examining the role 

of Toll-Like Receptors (TLRs) in inflammatory arthritis. 

TLRs have been implicated in autoimmune diseases, 

and TLR expression has been found in joint tissue and 

at the sites of invasion into cartilage/bone of patients 

with RA and PsA. Using several primary cell cultures 

Sinead has shown differential effects of timulating TL2 

and TL4 pathways. She has demonstrated TLR2 

agaonist are more effective in regulating cytokines and 

matrix turnover in cells isolated from the joint compared 

to blood. She has demonstrated using synovial cells, 

that TLR2 regulates NOTCH signalling in the joint, 

blockade of which downregaultes the pro-inflammaory 

response. Recently Sinead has demonstrated that TLR2 

may be a possible ligand for A-SAA, which we know, is 

a key molecule in driving inflammation in the joint. Finally, 

using whole tissue synovial explants Sinead, compared 

the effects of blocking TLR2 to known biologic agent 

Humira (anti-TNFα). She showed that blocking TLR2, 

significantly inhibited many pro-inflammatory cytokines 

in the joint, and more importantly showed that this effect 

was equivalent to that of Humira. Currently Sinead is 

will focusing on the interaction between of Notch, A- 

SAA and TLR 2 signalling. 

Proof of Concept Studies 

Jennifer McCormick and Owen O’Sullivan are an integral 

part of the team and are is involved in a number of 

projects in the group. We have developed a number of 

partnerships with the drug discovery and translational 

teams within industry led by Prof Veale. Jenny, Ursula, 

Owen and Sinead carry out these studies using synovial 

explant cultures, MSD multiplex assays and 

transcriptomics to establish pre-clinical and ‘proof of 

concept’ drug development studies of novel bio 

therapeutics and small molecular weight candidates. 

Currently, we are examining the therapeutic potential of 

four new drugs. 

Psoriatic Arthritis Blood Vessel Morphology 

Aisling Kennedy is also examining the mechanism 

involved in the differential blood vessel morphology 

observed in PsA. Consistent with previous studies, she 

has shown vessels in patients with PsA are tortuous, 

elongated and dilated. We have shown this is associated 

with increased tpO2 levels and an increased pericyte 

coverage. However, we have shown differential 

expression of growth factors and NCAM suggesting that 

vessels are very dysfunctional. At a microscopic level it 

is difficult to examine the close alignment of the 

endothelial cells and pericyte, therefore currently Aisling 

is using transmission electron microscopy to examine 

blood vessel stability, activation and endothelial cell - 

pericyte interactions, parameters such as (i) compactness, 

(ii) pinocytic vesicles, (iii) basal lamina, (iv) junctional 

21 






complexes, (v) anchoring filaments, (vi) endothelial 

cytoplasmic and nuclear shape will be assessed. 

Vascularity and blood vessel stability as determined by 

TEM will be correlated with both macroscopic and 

microscopic assessments. tpO2 levels and blood vessel 

pattern stability will also be determined. 

Biomarkers of Biologic Treatment Response: 

Finally, funded by Abbott, Dr. Emily Collins, supervised 

by Prof. Oliver FitzGerald and Dr. Ursula Fearon, is 

examining proteomic profiles in PsA patients’ pre/post 

biologic therapy with Prof Steve Pennington, Conway, 

UCD. We are aiming to identify molecular biomarkers, 

which predict response to anti-TNFα therapy, which are 

present in the synovium at an early stage of treatment. 

Prof FitzGerald and Dr. Fearon in collaboration with the 

P.P. Tak group in Amsterdam, and S. Pennington and M. 

Dunn of the Proteome Research Centre, UCD. Synovial 

tissue has been obtained via arthroscopy at baseline 

and 1 month from a cohort of patients, half of whom 

were receiving Adalimumab and half placebo injections, 

before beginning Adalimumab after 1 month. We are 

using proteomics technology (2D- DIGE and mass 

spectrometry) to analyse the proteome of these 

synovial tissue samples and identify differentially 

expressed proteins and potential biomarkers. These 

potential biomarkers will then be validated using various 

molecular biology methods. A pilot study on a smaller 

cohort has allowed us to optimise the experimental 

methodology and identify several interesting proteins. 

Psoriasis/Psoriatic Arthritis 

There are 4 main areas of interest within Ps/PsA: 

Genetics: 

In collaboration with Professor Robert Winchester at the 

University of Columbia in New York, blood samples have 

been obtained and DNA analysed in a cohort of 400 

probands with PsA as well as more than 200 patients 

with psoriasis alone and 150 normal controlled subjects. 

The focus has been on a detailed molecular genotyping 

of the HLA-B and -C loci using sequence based typing. 

Detailed analysis is ongoing but results suggest that PsA 

is not genetically a simple subset of psoriasis. HLA- 

Cw*0602 is present in 62% of patients with psoriasis 

alone and in only 27.9% of patients with PsA. 

In collaboration with the newly established GRIPPsA 

Consortium, which is an Irish based consortium, DNA 

from a large number of patients with psoriasis and with 

PsA have been collected. Approximately 500 of these 

samples have been contributed to the initial cohort of 

patients who were undergoing genome-wide association 

studies funded by Welcome. This work is being undertaken 

locally in collaboration with Dr. Brian Kirby and 

with the assistance of Anne-Marie Tobin, Dr. Aizad 

Mumtaz and Ms. Phil Gallagher. 

22 






Biomarks of Biologic Treatment Response: 

As part of investigator-originated, single-arm protocols 

looking at mechanisms of effect of biologic therapies, 

synovial membrane samples have been analysed for 

tissue markers of treatment response to biologic 

therapies. Comparisons of immunohistochemical 

changes with clinical changes have identified change in 

CD3-positive T-cells as correlating significantly with 

change in clinical scores. In addition, a semi-quantitative 

score of MRI scans undertaken in collaboration with Dr. 

Robin Gibney have also correlated significantly with a 

change in CD3 synovial tissue counts. In collaboration 

with Professor Patrick Brennan’s group from imaging in 

UCD, a more quantitative measure of synovitis is being 

developed. 

Proteomics Studies in Collaboration with Professor 

Stephen Pennington and Professor Mike Dunn from the 

Proteomic Department at Conway Institute: 

Dr. Emily Collins has been trying to identify synovial 

biomarkers of treatment response to empty TNF 

therapy in patients with PsA. A number of proteins 

have been identified, which significantly associate with 

clinical response and in addition a number of proteins 

have been identified which appear to predict a 

response at baseline. These studies are funded by 

Abbott Pharmaceuticals and validation of proteins 

identified is currently underway. For glycosylation 

changes in inflammatory arthritis patients pre and post 

anti-TNF therapy. In collaboration with Professor 

Pauline Rudd’s group from the Conway Institute and 

with Dr. John Axford from St. George’s Hospital in 

London, Dr. Emily Collins is studying immunoglobulin 

glycosylation changes, which occur in patients with 

inflammatory arthritis and also the effect of anti-TNF 

therapies on such changes in a cohort of 65 patients, 

glycosylation profiles return towards normal as disease 

activity improves following treatment initiation. 

Pharma Co Economics of Biologic Therapies in Patients 

with Inflammatory Arthritis: 

In collaboration with Dr. Michael Barry from the National 

Centre of Pharma Co Economics at St. James’s Hospital, 

Ms. Roisin Adams is examining the Pharma Co 

Economic impact of anti-TNF therapies in patients with 

inflammatory arthritis. These studies are utilising data 

being collected on a large cohort of inflammatory 

arthritis patients currently being followed on anti-TNF 

therapy. 

Thesis Submissions: 

Mary Connolly submitted her PhD thesis (UCD) 

examining the role of A-SAA on cell migration, 

cytoskeletal dynamics and invasion in the pathogenesis 

of inflammatory arthritis, under the supervision of Dr. 

Ursula Fearon and Prof Douglas Veale 

23 






Liver Research 

The Liver Research Group operates a four-stranded 

research programme based on Liver Transplantation, 

Hepatic Malignancy, Hepatitis C Viral Infection (HCV) 

and Basic Immunology of the Liver. 


Prof. Cliona O'Farrelly 

Research Personnel 2008: 

Senior Scientists: 

Nigel Stevenson 

Research Assistants: 

Catherine Keogh 

Research Fellows: 

Kavin Nanda, 

Shahzad Sarwar 

Postgraduate Students: 

Aideen Collins 

Prof. John Hegarty 

Elizabeth Ryan, 

Margaret O’ Brien 

Emma McGrath, 

Tanya Dempsey 

Tariq Tajuddin, 

Masood Iqbal 

Eszter Nèmeth, 

Nollaig Bourke 

Liver Transplantation: 

The Liver Transplant team at St. Vincent’s Hospital 

performs 50-60 transplants per year. A successful 

transplantation programme depends on a steady supply 

of donor organs. Our research is focused on trying to 

maximize the benefit of liver transplantation to the 

patient. 

Patients who undergo liver transplantation due to liver 

cirrhosis caused by Hepatitis C virus infection often 

experience a severe recurrence of infection post-transplantation. 

We found that the pre-Liver Transplantation 

frequencies of circulating CD56 + lymphocytes were 

significantly lower in patients who subsequently 

developed severe HCV recurrence, relative to those 

patients who developed mild histologic recurrence, as 

well as non-HCV controls demonstrating a previously 

unappreciated association between pretransplantation 

CD56 + lymphocytes and outcome of HCV recurrence 

and a possible therapeutic target. 

Badar Zaman, Martin Leonard (Conway Institute, UCD), 

Elizabeth Ryan, Cormac Taylor (Conway Institute, UCD), 

Lucy Golden-Mason*, Hugo Rosen*, Justin Geoghegan, 

Cliona O’Farrelly. 

*University of Colorado Health Sciences Center, Denver, USA 

Hepatic Malignancy 

CD1d is a restriction element for natural killer (NK) T 

cells, a sub-population of lymphocytes expressing a T 

cell receptor together with NK cell markers. CD1d 

molecules bind and present lipids to NKT cells resulting 

in activation and production of cytokines. We have 

found that novel CD1d isoforms are expressed in liver 

and colon cancers and we are investigating their role in 

regulating immune responses to malignancy. 

Margaret O’Brien, Emma McGrath, Cliona O’Farrelly 

24 






HCV & its effect on Bone Metabolism 

Limited data are available on the contribution of chronic 

hepatitis C virus (HCV) infection to the development of 

bone disease in postmenopausal women. We studied 

whether post-menopausal women with chronic HCV 

infection were more at risk of developing osteoporosis. 

Our study found that HCV infection alone had no impact 

on the risk of developing osteoporosis. However, like all 

postmenopausal women, women with hepatitis C virus 

need to ensure that their diet has adequate amounts of 

calcium and vitamin D and take regular exercise to 

protect their bones. 

Our findings have recently been accepted for publication 

in the journal of the American Gastroenterological 

Association ‘Clinical Gastroenterology and Hepatology.’ 

Kavin Nanda, Elizabeth J. Ryan, Barbara Murray*, 

Jennifer Brady*, Malachi McKenna , Niamh Nolan , 

John Hegarty, Cliona O’Farrelly 

* Metabolism Laboratory, DXA Unit and Pathology Dept., SVUH. 

IL-10 and TGFβ‚ mediated suppression of antigenspecific 

Th1 and Th17 responses during HCV infection. 

IL-17-secreting T (Th17) cells play a protective role in 

certain bacterial infections, but they are major 

mediators of inflammation and are pathogenic in organspecific 

autoimmune diseases. 

An examination of patients infected with hepatitis C 

virus (HCV) demonstrated that Ag-specific Th17 cells 

are induced during infection and that these cells are 

negatively regulated by IL-10 and TGF-beta. This may 

represent a novel immune subversion mechanism by 

the virus to evade host-protective immune responses. 

These findings have been recently published in the 

Journal of Immunology. 

Aileen Rowan*, Jean Fletcher*, Elizabeth J. Ryan, 

John Hegarty, Cliona O’Farrelly, Kingston Mills* 

*Immune Regulation Research Group, School of Biochemistry and 

Immunology, TCD. 

Role of G-CSF and GM-CSF in determining the 

outcome of IFNa/Ribavirin therapy of chronic Hepatitis 

C infection. 

The recombinant form of granulocyte colony stimulating 

factor (G-CSF) is an effective treatment for alpha 

interferon (IFNα)-induced neutropenia in patients with 

chronic hepatitis C virus (HCV) infection. However, little 

data exist on the effect of IFN-α therapy on 

endogenous G-CSF production and its role in IFNinduced 

neutropenia. We are examining the effects of 

IFN-α on the production of G-CSF by peripheral blood 

mononuclear cells (PBMCs) in patients with HCV 

infection. 

GM-CSF: 

The development of immune cells of the myeloid 

lineage depends on the growth factor, GM-CSF. GM- 

CSF also has potent immunomodulatory effects and 

can enhance the immune response. Our preliminary 

studies showed that pre-treatment PBMCs of patients 

who subsequently achieved sustained virologic 

response (SVR) produced higher levels of GM-CSF 

compared to non-responders. We are investigating the 

effect of GM-CSF on IFN-alpha signalling pathways in 

cells isolated from HCV patients. 

This work is supported by a Translational Research 

Grant Awarded to the HCV Research Consortium. 

Elizabeth J. Ryan, Tariq Tajuddin,Tanya Dempsey, John 

Hegarty, Cliona O’Farrelly. 

Dendritic Cells 

Dendritic cells play a key role in the initiation of the 

immune response. We are interested in understanding 

how these cells can be manipulated to make more 

effective vaccines and immune therapies. 

We previously characterised a novel C-type lectin-like 

molecule expressed by dendritic cells, Dendritic cellassociated 

lectin-1 (DCAL-1) with Prof Ed Clark, 

University of Washington, Seattle. We found that an 

antibody directed towards this molecule resulted in the 

25 






generation of a ‘tolergenic’ dendritic cell phenotype. 

These results were published in the Journal ‘Human 

Immunology’. 

The recombinant canarypox virus ALVAC is being 

extensively studied as vaccine vector for the 

development of new vaccine strategies against chronic 

infectious diseases and cancer. Gene profiling analysis 

of human monocyte derived dendritic cells (MDDCs) 

upon ALVAC infection (Anke Harenburg, Nicolas Burdin 

and Franca Spada, Sanofi Pasteur) demonstrated that 

the majority of the genes that were up-regulated by 

ALVAC belong to the type I interferon signaling pathway, 

this may have important implications for the use of this 

vaccine system in patients with suppressed IFN 

responses such as those with chronic HCV infection. 

These results were published in the Journal ‘Vaccine’. 

Effect of Chronic HCV infection on Dendritic Cell 

phenotype and function. 

However, to exploit DC targeted therapies in patients 

with chronic infections such as HCV or cancer we need 

to understand how DCs in these patient groups differ 

from those of healthy individuals. We have made a 

number of interesting discoveries, such as finding that 

Dendritic cells of HCV+ patients do not produce IFNalpha 

in response to poly(I:C) stimulation. Conversely, 

MDDCs from HCV+ patients secrete high levels of the 

molecule Osteoprotegerin (OPG) a cytokine that plays 

an important role in protecting bone from degradation 

by osteoclasts. 

We are also evaluating DC numbers and phenotype in 

the blood and liver of HCV patients. 

Elizabeth J. Ryan, John Hegarty, Cliona O’Farrelly 

The characterisation of T cell subsets in normal and 

diseased liver 

T regulatory cells (CD4+CD25+FoxP3+) that secrete 

anti-inflammatory cytokines, such as IL-10 and TGF-β 

can prevent effective cellular responses. By carefully 

characterising this population in normal and diseased 

human liver tissue we aim to determine their importance 

in controlling the immune response in the liver. Previous 

work in Prof. Kingston Mills’ Laboratory has shown that 

Fasciola hepatica infection of mice can lessen the 

severity of Experimental Autoimmune Encephalitis 

(EAE). We aim to characterise liver T regulatory cells in 

this model to determine their role in mediating the 

suppression of inflammation. 

Eszter Nèmeth, Miriam Brady (TCD), Cliona O’Farrelly, 

Kingston Mills (TCD) 

How does HCV inhibit IFN-α treatment? 

The anti-viral action of IFN-α depends on proteins 

within the cell known as the Janus kinases (Jak) and 

Signal Transducers and Activators of Transcription (STAT) 

that make up the JAK/STAT pathway. Since more than 

50% of patients do not respond to IFN-α, we are 

investigating how HCV affects this pathway and its antiviral 

response. 

We have discovered that a number of proteins of the 

JAK/STAT pathway, essential for an antiviral response, 

are absent in many HCV patients. We have also found 

that HCV acts to degrade these proteins, which may 

explain the lack of response to therapy. We plan to 

determine exactly how this virus destroys such 

important proteins and in doing so we hope to provide 

clinicians with a predictive tool of response and identify 

potential targets of for future therapy. 

Nigel Stevenson, Nollaig Bourke, Catherine Keogh, 

John Hegarty, Cliona O’ Farrelly, Aideen Long (TCD), 

Christine Biron (Brown University), Jim Johnston (Queen’s 

University, Belfast), Charlie Rice (Rockefeller University) 

What role does Suppressors of cytokine signalling 

(SOCS) play in HCV resistance to IFN-α treatment? 

IFN-α is a powerful intracellular defence system against 

viruses and resistance to it is manifested by a reduced 

induction of anti-viral genes. SOCS proteins control 

cytokine signalling and have been documented to 

regulate IFN-α signalling and be triggered by HCV 

26 






infection. We hypothesise that HCV may be blocking IFNα 

signalling by specifically inducing SOCS proteins, 

which may reduce anti-viral gene induction. We have 

found a difference in SOCS levels between healthy and 

HCV infected patients and continue to investigate this 

novel area of the immune response to HCV, to further 

understand the mechanism of action of HCV and 

discover complementary therapeutic targets. 

Aideen Collins, Nigel Stevenson, John Hegarty, 

Cliona O’ Farrelly 

HCV Research Consortium: 

The cohort of Irish women infected in 1977 with HCV 

contaminated anti-D is homogenous for time of infection, 

route of infection, racial background, gender and viral 

subtype, providing a unique opportunity to investigate HCV. 

The HCV Research Consortium was established to 

conduct research into different aspects of HCV infection 

of the Irish cohort of women infected in 1977. Profs O’ 

Farrelly and Hegarty coordinate the HCV Research 

Consortium, which includes Irish clinicians who have a 

research interest in HCV infection including: 

Prof. Cliona O'Farrelly, Chairperson, Trinity College Dublin 

Prof. John Hegarty, St. Vincent's University Hospital 

Dr. John Crowe, Mater Misericordeae University Hospital 

Dr. Orla Crosbie, Cork University Hospital 

Dr. Frank Murray, Beaumont Hospital 

Dr. Suzanne Norris, St. James Hospital 

Prof. Dermot Kelleher, St. James Hospital 

Dr. Aideen Long, St. James Hospital 

Dr. Lelia Thornton, National Disease Surveillance Centre 

Dr. Gary Courtney, St Luke’s Hospital Kilkenny 

Dr. John Lee, University Hospital Galway 

The Consortium met to discuss the current research 

projects on the 15th November 2007 and 15th 

February 2008. 

Grants 

Research Frontiers Science Foundation Ireland (SFI) 

(€165,189) “The role of HCV in regulating STAT protein 

expression to evade anti-viral IFN-α responses”. 

Prof. Cliona O’Farrelly 

Post-Doctoral Fellowship Dr. Nigel Stevenson Health 

Research Board (HRB) (€252,069.73), “HCV regulates 

STAT protein expression to escape IFN-α responses: A 

novel immune evasion strategy for HCV”. 

HRB project grant (€299,364) to investigate “SOCS 

Protein Involvement in Chronic HCV Infection and 

Failure to Respond to IFN-α Therapy 

Profs Cliona O’Farrelly and John Hegarty. 

Invited Lectures 

‘Comparative Immunomics: discovery of new immune 

genes and mechanisms’ - the 6th Institute of Molecular 

Medicine Lecture, Dublin 2008 – Cliona O’Farrelly 

‘What the scientist can contribute over the next ten 

years’ at the British Association for the Study of Liver 

Disease annual meeting, Edinburgh 2008 – Cliona 

O’Farrelly 

‘Innate lymphoid cells in the liver’ at the 23rd Erasmus 

Liver Day, Rotterdam 2008 – Cliona O’Farrelly 

‘Lymphoid cells in human liver’ at the British Society of 

Gastroenterology workshop “Liver Immunology”, 

Birmingham 2008 – Cliona O’Farrelly 

‘Liver: An immunological battleground’. King’s College 

Hospital – 2008 Cliona O’ Farrelly 

Oral Presentations 

Ryan E.J, Nanda K.S, Hegarty J.E & O’ Farrelly C. 

Monocyte derived Dendritic Cells isolated from HCV+ 

patients secrete high levels of Osteoprotegerin (OPG). 

Irish Society Immunology Meeting 2008. 

Ryan E.J, Tajuddin T, Hegarty J.E & O'Farrelly C. GM-CSF 

may modulate the response to IFN-alpha in Chronic 

Hepatitis C Virus (HCV) Infection. Keystone Viral 

Immunity Conference 2008. 

27 






Tajuddin T, Ryan E.J, Keogh C, Norris S & O’Farrelly C. 

Hegarty, JE. Suppressed Granulocyte Colony 

Stimulating Factor Production in Chronic Hepatitis C 

Patients on Interferon –Alpha (IFN-α) Therapy; Possible 

Role in IFN-α Induced Neutropenia. Joint International 

Congress of ILTS, ELITA & LICAGE 2008, Paris, France. 

Poster Presentations 

Ryan E.J, Hegarty J.E & O’ Farrelly C. GMCSF may 

modulate the response to IFN-alpha in Chronic 

Hepatitis C Virus (HCV) infection. Keystone Viral 

Immunity Conference 2008, Keystone, USA. 

Nanda K.S, Ryan E.J, Murray B.F, Brady J.J, McKenna M, 

O'Farrelly C & Hegarty J.E. Chronic Hepatitis C (HCV) 

infection in a cohort of post-menopausal Irish women 

contributes to the development of bone fractures. 

Digestive Diseases Week (DDW) 2008, San Diego. 

Ryan E.J, Tajuddin T, Dempsey T, Hegarty J.E & O’Farrelly 

C. GM-CSF modulates IFN-alpha stimulated gene 

expression (ISGs) in peripheral blood mononuclear 

cells (PBMCs) of chronically infected Hepatitis C 

patients. 15th International Symposium on Hepatitis 

C Virus & Related Viruses 2008, San Antonio, USA. 

Nanda K.S, Dempsey T, McGrath E, Hegarty J.E, 

O’Farrelly C & Ryan E.J. Elevated levels of circulating 

osteoprotegerin (OPG) may limit the effect of chronic 

hepatitis C virus infection on bone disease in a cohort 

of postmenopausal Irish women.15th International 

Symposium on Hepatitis C Virus & Related Viruses 

2008, San Antonio, USA. 

Ryan E.J, Tajuddin T, Hegarty J.E & O'Farrelly C. GM-CSF 

modulates IFN-α stimulated gene expression (ISGs) in 

peripheral blood mononuclear cells (PBMCs) of 

chronically infected Hepatitis C patients. British Society 

Immunology Annual Congress 2008, Glasgow, UK. 

Stevenson N.J, Ryan E.J, Keogh C.A, Lloyd A.T, Cormican 

P, Hegarty J.E & O’ Farrelly C. Hepatitis C Virus (HCV) 

regulates signal transducer and activator of 

transcription (STAT) protein expression to escape 

interferon-alpha (IFN-α) responses. Irish Society 

Immunology Meeting 2008. 





interferon-alpha (IFN-α) responses. 15th International 

Symposium on Hepatitis C Virus & Related Viruses 

2008, San Antonio, USA. 

28 










interferon-alpha (IFN-α) responses. British Society 

Immunology Annual Congress 2008, Glasgow, UK. 

Nemeth E, Hopkins A.M & Baird A.W. 

Neuroimmunology of the liver – methodology in intact 

organs. International Neuroimmunology 

Symposium, University College Dublin, Dublin, 

Ireland, 2008. 

Obesity Research 

The Obesity Research group is headed by Prof. Donal 

O’Shea, Consultant Endocrinologist at St. Vincent’s 

University Hospital and Head of the Weight Management 

Clinic at St. Colmcille’s Hospital. Dr. Lydia Lynch is the 

senior research scientist in the group and Andrew 

Hogan is a new postdoctoral scientist with the group. 

Lydia is funded by the Health Research Board and 

UNESCO-L’Oreal partnership. Andrew recently received 

the Sanofi-Aventis Newman Scholarship for his 

postdoctoral studies. 

Dr. Jean O’Connell is a 3rd year clinical PhD student 

funded by the HRB Clinical Research Fellowship, along 

with Dr. Tomas Ahern and Dr. Conall Dennedy who are 

starting their clinical PhDs. Ms. Anna Kwasnik is the 

group’s research assistant funded by the Diabetes 

Federation of Ireland. Ms. Cathy Breen has started in 

the group as a research dietician studying the role of 

carbohydrate in diabetes. Conall received the ICHMT 

Endocrine Research Bursary funded by Sanofi-Aventis. 

Lydia Lynch is working on the immune system in 

obesity, and asking why are some obese subjects 

immune compromised. Obesity is now responsible for 

30-40% of certain cancers. She has found that natural 

killer cells, the bodies first defense against tumors and 

viruses are depleted in the blood of obese patients. 

Lydia is also looking at the immune system in the fat, in 

particular the omental fat, of obese and lean patients. 

She has found that omental fat has its own unique 

immune system, different to every other organ in the 

body and contains the largest number of potent killer 

cells, termed invariant natural killer T cells. 

Jean O’ Connell has found that adipocyte size strongly 

correlates with metabolic healthy and degree of fatty 

liver disease in obese patients. She is now studying the 

rate of proliferation and differentiation of preadipocytes 

from both healthy and unhealthy obese patients, as 

well as the production of pro- and anti-inflammatory 

cytokines from the growing cells. 

Lydia was awarded the UNESCO-L’Oreal International 

Young Woman of Science Fellowship this year, which is 

awarded to 15 young women worldwide. This is the 

first time Ireland has received this award. This fellowship 

will enable Lydia to spend 7 months working in Harvard 

Medical School, Boston each year for 2 years, with the 

aim of returning to Ireland to establish in St. Vincent’s 

University Hospital state of the art techniques learned in 

Harvard. Lydia also won ‘Researcher of the Year’ at the 

Conway Research Festival, UCD in September 2008. 

Lydia was an invited speaker at the International Colorectal 

Cancer Society Conference and the Trinity College 

Dublin Biochemical Society series of talks. 

The Obesity group’s paper entitled “Are natural killer cells 

protecting the metabolically healthy obese patient?” was 

published in Obesity this year and featured in the Irish 

Times. The group has recently submitted their findings 

on adipocyte size in the severely obese patient to 

Journal of Endocrinology and Metabolism. Jean 

O’Connell was also invited to write a book chapter on 

Obesity and Cancer. 

29 






Dermatology Research 

Dr. Anne-Marie Tobin has begun research in the 

Education and Research Centre under the supervision 

of Dr Brian Kirby and Prof Donal O’Shea. She is 

researching the effects of obesity and smoking on 

psoriasis in particular their effects on natural killer cells 

in psoriasis. 

Respiratory Sleep Research 

Principal Investigator: Prof.Walter McNicholas 

Summary of Research Activities 

The Respiratory Sleep Research Laboratory at St. 

Vincent’s University Hospital continues a varied clinical 

and basic science research programme with a particular 

emphasis of cardiovascular interactions in obstructive 

sleep apnoea (OSA). Ongoing collaboration exists with 

the research group of Prof. Cormac Taylor in the 

Conway Institute at UCD and the School of Electronic 

and Electrical Engineering (Prof. Conor Heneghan and 

Dr. Madeleine Lowery), also in UCD. Dr. John Garvey 

and Dr. David McSharry are the Research Fellows 

involved. 

Together with Prof. Taylor we have an ongoing 

translational research programme that explores the role 

of intermittent hypoxia (IH) in the pathogenesis of 

cardiovascular disorders in OSA. In studies of OSA 

patients, and also a unique cell culture model of IH 

utilising bovine aortic endothelial and HELA cells, we have 

demonstrated that IH selectively activates inflammatory 

over adaptive molecular pathways through the selective 

activation of the inflammatory transcription factor NFκB. 

NFκB has been shown to predispose to atherogenesis. 

We have also demonstrated that the NFκB-dependent 

gene TNF-a is elevated in patients with OSA and falls to 

control levels with nasal CPAP therapy. 

Currently we are engaged in studying the role of nitric 

oxide in modulating the NFκB response to intermittent 

hypoxia in an in vitro model and translating the findings 

into studies of nitrate levels in OSAS patients and the 

responses to CPAP therapy. Two abstracts based on the 

findings will be presented at the forthcoming annual 

meeting of the American Thoracic Society meeting in 

San Diego in May, one of which will be an oral 

presentation as part of a mini-symposium. 

In collaboration with Prof. Heneghan, we have studied 

the ability to identify sleep apnoea from digital signal 

processing of the ECG signal, based on characteristic 

changes in the ECG that accompany apnoea. The 

measurement of oxygen saturations and heart rate 

variability has been independently proposed as screening 

tools in the evaluation of patients with suspected OSAS. 

In collaboration with Prof. Conor Heneghan’s group we 

have evaluated a combined electrocardiograph and 

oximeter recorder in patients simultaneously undergoing 

polysomnography. Two original papers based on the 

findings have been published in international peerreviewed 

journals during 2008. 

In collaboration with Dr. Lowery, we have developed 

new surface electrode configurations to record 

genioglossus EMG with a view to studying the role of 

skeletal muscle fatigue in the pathophysiology of OSA. 

Dr. David McSharry is carrying this project forward. 

30 






Neurology Research 

Personnel: 

Dr. Niall Tubridy, 

Dr. Roisin Lonergan, 

Ms. Cheryl Sweeney 

Prof. Michael Hutchinson, 

Dr. Jean Fletcher, 

Summary of Research 

The Department of Neurology has an international 

reputation in the field of multiple sclerosis (MS) and 

research for many years thanks to the work of Professor 

Michael Hutchinson and various colleagues. This research 

has been largely clinically based and in recent years has 

emphasised the use of disability scales in MS. 

In 2005, Dr Niall Tubridy set up a collaboration with the 

laboratory of Professor Kingston Mills in Trinity College 

Dublin with the help of Professor Cliona O’Farrelly of 

the ERC at St. Vincent’s University Hospital (now of 

TCD). The aim of the research is to establish a viable 

translational collaboration between the laboratory and 

the MS clinics at SVUH. 

Dr. Jean Fletcher started in August 2005 and is looking 

at serum samples for people with MS attending the 

neurology clinics. She is looking at the effect of interleukin 

-17 in MS in particular and the aim is to try and 

establish the role of T regulatory cells in this condition. 

It is ultimately hoped that by establishing a role for such 

cells in MS it may be possible to develop potential 

therapies. Jean is also extracting DNA from a second 

sample for storage which we intend to use in further 

work at a later stage and to share with other established 

groups in this area of research. Jean is working with 

Cheryl Sweeney, who is helping with the human work 

but also working for her own PhD using animal models. 

To achieve this, of course, close co-operation is required 

with the clinical team. Drs. Roisin Lonergan (MS research) 

and David Bradley (Dystonia) joined us in July 2007. A 

new clinic was set up in 2005 specifically for people 

with MS. Currently, over 500 patients with MS and 150 

control subjects have been recruited. Lisa Costelloe, 

Roisin Lonergan, Niall Tubridy and Michael Hutchinson 

assessed the patients clinically and document the 

disease phenotype in each individual seen. This is done 

in the course of ‘normal’ clinical care. The work of Katie 

Doyle, MS Research Nurse, Sinead Jordan, Research 

Nurse, and Marguerite Duggan, MS Specialist Nurse, 

has been integral to the smooth running of this project 

and the ongoing care of our patients. 

We have also undertaken work in collaboration with Dr. 

Margaret O’Brien looking at OAS in MS and plan further 

studies in vitamin D receptor genes in 2008 (outlined 

below). 

In addition to immunological research, we have a longstanding 

interest in the evaluation of clinical outcome 

measures for MS drug trials. In particular, the health 

related quality of life of MS patients and its quantification 

is being examined longitudinally in a large MS cohort 

attending this hospital. We have established a clinically 

useful and psychometrically valid “minimal change 

score” for one of the widely used MS self–report 

instruments. Doctor reported MS rating scales are also 

being evaluated for clinimetric characteristics that would 

make them effective outcome measures for RCTs). 

In 2007 and 2008 we began a large scale study of the 

epidemiology of MS in Ireland based in Dublin, Donegal 

and Wexford. We aim to look at immunological, genetic 

and vitamin D markers in a large cohort of people with 

MS and controls in Ireland. 

The Department of Neurology has continued to 

substantially expand in 2008. We still have only two 

Consultants, Professor Michael Hutchinson and Dr. Niall 

Tubridy, and we have applied for at least two more to 

continue the progressive service development. 

The Department was awarded two prestigious HSE 

Innovation Awards in 2008 (regional and national) for 

31 






their presentation of ‘Neurology-changing the way we 

practice’. Health Minister, Mary Harney cited the 

Department in the Dail in May 2008 as an example of 

excellence in the Health Service. 

Significant Achievements in 2008 


Innovation awards in 2008 (regional and national) for 


practice’ 

Dr. Roisin Lonergan won Best Poster Presentation at 

the INA (Cork) 2008. 

Dr. Margaret O’Brien won Best Platform Presentation 

at the INA (Cork) 2008. 

Drs. Lonergan, O’Brien and David Bradley all 

presented papers at the American Academy of 

Neurology in Chicago in 2008. 

The Dystonia work was also presented at The Dystonia 

Europe Congress in Hamburg 2008; 

Drs Bradley and Lonergan also presented papers at 

the EFNS Madrid 2008 

Many of the team presented at the ABN in Dublin in 

2008 including Drs. Roisin Lonergan, Margaret 

O’Brien, Laura Williams, Ailin Rogers, Sinead 

Murphy and John McHugh. 

Dr. J. McNulty also presented a paper at the ABN held 

in Croke Park that was hosted by Professor Hutchinson 

in March 2008. 

Drs. Margaret O’Brien and Anna Heeney presented 

papers at the ENS in Nice in June 2008. 

Conference abstracts 

A reduction in thymically-derived natural regulatory T 

cells in patients with multiple sclerosis. 

J.M. Fletcher, L. Costelloe, N. Booth, M. Vukmanovic- 

Stejic, N. Tubridy, K.H.G. Mills 

Dr Roisin Lonergan, Neurology Specialist Registrar 

presentations at the following meetings (2007-2008): 

ABN (Association of British Neurologists) March 2008, 

Dublin 

AAN (American Academy of Neurology) April 2008, Chicago 

INA (Irish Neurological Association) May 2008, Cork 

ENS (European Neurological Society) June 2008, Nice 

EFNS (European Federation of Neurological Societies), August 

2008, Madrid 

ECTRIMS- ACTRIMS-LACTRIMS, September 2008, 

Montreal 

MD Thesis Projects ongoing: 

(1) Epidemiology of Multiple Sclerosis (MS) in Ireland: 

prevalence study in Dublin, Wexford and Donegal 

looking at differences in clinical, genetic, immunological 

and vitamin D status nationally 

In this multi-centre, cross-sectional study we aim to 

examine the following: 

(a) Prevalence of MS in South Dublin, Wexford & Donegal. 

A previous study from our department suggested 

a gradient in prevalence of MS between Donegal 

and Wexford. More recent studies suggest that 

overall incidence and prevalence of MS is 

increasing worldwide. This study arm will 

reappraise this in 3 areas in Ireland. 

(b) Differences in Vitamin D levels between people with MS 

and controls. 

Studies suggest a role for vitamin D as a potential 

explanation of increased risk of MS as a factor of 

distance from the equator. Vitamin D deficiency 

often co-exists with established MS and oral 

supplementation may be associated with lower 

risk of disease. The findings from this study may 

justify vitamin D supplementation trials in MS. 

32 






(c) 

The link between Vitamin D and regulatory T cells: 

We will examine the correlation between vitamin 

D levels and regulatory T cell frequency in the 

RRMS cohort of patients. We will also investigate 

the functional significance of the regulatory T cell 

subsets. 

(d) Genetic differences between those with MS in northern 

and southern areas of Ireland. 

Certain HLA genotypes are know to increase 

susceptibility, particularly HLA DRB1*1501. We 

aim to see if there is a difference in genotype 

between these patient groups. We also plan to 

examine vitamin D receptor polymorphisms in 

patients and controls. 

(e) As part of the study, we have performed a needs assessment 

for people with MS in different parts of Ireland, to identify 

unmet needs and to maximise benefit from the various 

services available. 

(2). Examination of OAS 1 (oligo-adenylate synthetase 1) 

genotype as a predictor of susceptibility to MS and response of 

interferon therapy. 

It has been proposed that polymorphisms in the 

OAS1 gene could influence susceptibility to 

multiple sclerosis (MS). We examined the 

occurrence of a functional single nucleotide 

polymorphism of the OAS 1 gene in people with 

MS and healthy controls. 

This showed that OAS1 AA genotype is over-represented 

in MS patients compared with controls, suggesting that 

OAS genotype may predict susceptibility to MS. 

We then hypothesised that the AA genotype would also 

be over-represented in people with suboptimal 

response to IFNb therapy: distribution of OAS genotypes 

was significantly different between non-responders and 

both responders and the rest of the MS cohort. 

Thus, a functional SNP in the OAS gene may predict 

both susceptibility to MS and response to treatment. 

This could be invaluable in avoiding expensive therapy, 

and adverse effects, in those unlikely to respond. 

We plan to examine OAS genotype as a predictor of 

disease activity and to examine genotype in a group of 

patients with benign MS. 

(3) Study: To prospectively monitor for reactivation of BK virus 

in RRMS patients receiving natalizumab for 1 year. 

Natalizumab therapy in MS has been associated 

with JC virus-induced PML. Reactivation of BK 

virus, another polyomavirus, has resulted in 

significant morbidity, typically renal (BK Virus- 

Associated Nephropathy), during other 

immunosuppressive therapies. 

All patients receiving natalizumab therapy at our 

clinic have regular screening blood and urine 

samples for polyomavirus PCR, CD4:CD8 ratio 

calculation and renal and liver profile. This is done 

monthly for the first 3 months and three-monthly 

thereafter. BKV subtyping and NCCR sequencing is 

carried out on samples demonstrating reactivation 

(NVRL). 

BK reactivation was observed in a small number 

of patients, but all remain well. 

The significance of viruria or transient viraemia, in 

the absence of renal dysfunction, is unclear. We 

plan to continue regular monitoring for BK 

reactivation and for renal dysfunction, in addition 

to screening for JC virus reactivation, and to 

observe for BK reactivation in a matched control 

group of MS patients not on natalizumab therapy. 

33 






(4) Diffusion Tensor Imaging (DTI) of the Medial Longitudinal 

Fasiculus in Multiple Sclerosis patients with Internuclear 

Opthalmoplegia 

In this study we investigated the relative specificity 

of DTI in the detection and quantification of MLF 

disruption in MS patients with INO. We 

collaborated with Jonathan Mc Nulty and Professor 

Patrick Brennan from the UCD School of 

Diagnostic Imaging. 

We recruited 12 MS patients with INO from our 

MS clinic, and compared DTI and standard MRI 

sequences (T2 weighted, proton density and 

FLAIR) in this group with 12 control subjects. 

A neuroradiologist, blinded to study group, 

reported MLF findings on standard images. 

Diffusion tensor imaging identified areas of 

abnormality in the MLF region for all INO subjects, 

while the MLF in 50% of INO subjects was 

reported as normal following conventional 

imaging. 

Compared to conventional MR imaging, ADC 

values identify areas of abnormality with greater 

sensitivity, allowing confirmation of lesions for a 

range of clinical signs. We propose that DTI could 

enable more accurate monitoring of disease 

progression and response to therapy, and guide 

treatment choices. 

(5) Cognitive Functioning in MS: A Longitudinal ERP Analysis. 

Cognitive impairment (CI) occurs in up to 70% of 

multiple sclerosis (MS) patients. Subtle CI is 

difficult to detect clinically and correlates poorly 

with MRI measures. The Paced Auditory Serial 

Addition Test (PASAT) is useful in assessing CI in 

MS but may be influenced by anxiety and years of 

education. 

Event-related potentials (ERPs; time-locked EEGs) 

are a non-invasive method of detecting cognitive 

activity. Delayed latencies of the P3 wave are a 

reflection of impaired cognitive functioning. 

The aim of the present study was to assess the 

relationship between P3 latency and PASAT 

performance in MS patients. 

To date we have analysed data on 18 patients. It 

shows correlation between P3 latency and PASAT 

score was significant, controlling for age and the 

P3 latency was independent of EDSS score. 

This study demonstrated that P3 latency may be a 

reliable, objective test of CI in MS. 

Current aim: to examine prospectively in RRMS patients 

the relationship over time between ERPs, PASAT, NP 

assessment, disability and MRI measures of brain 

atrophy, in collaboration with the School of Diagnostic 

Imaging in UCD, and the School of Engineering in 

T.C.D. 

Meetings attended in 2008: 

ABN, Spring Meeting, Dublin, March 25th–28th 

AAN, Chicago, April 12th–19th 

EFNS, Nice, May, 13th-16th 

ECTRIMS, Montreal |September 14th. 

34 






Centre for Colorectal Disease Research 


Prof. Diarmuid O’Donoghue Dr. Hugh Mulcahy 

Mr. John Hyland 

Prof. Des Winter 

Prof. Ronan O’Connell Prof. Kieran Sheahan 

Dr. David Fennelly 

Research Team: 

Jacintha O’Sullivan Senior Research Scientist 

Robert Geragthy Senior Medical Scientist 

Blathnaid Nolan Research Nurse 

Dermot Leahy Senior Scientist 

Miriam Tosetto Senior Research Assistant 

Monica Biniecka Postdoctoral Fellow 

Edward Fox Postdoctoral Fellow (NCI/HRB fellow) 

Alan Coss 

MD research fellow (thesis submitted) 

Dave Kevans MD research fellow 

Garret Cullen MD research fellow 

Joe Marry 

MD research fellow 

Eoin Slattery MD research fellow 

Danny Cheriyan MD research fellow 

Sheeona Gorman Ph.D. student 

Juliette Sheridan Ph.D. student 

Maciej Milewski Ph.D. student 

Adriana Michielsen Ph.D. student 

The Centre for Colorectal Disease (CCD) is an 

umbrella for clinicians and scientists with an interest in 

Colorectal Cancer, Inflammatory Bowel Disease and 

Functional Bowel Disorders. The aims of the centre are 

the delivery of state of the art services for our patients, 

research into causes and treatment and the education 

of the public. However, the multidisciplinary team 

would be unable to function successfully without the 

aid of nursing co-ordinators and nurse specialists such 

as Anne White, Denise Keegan and Grace McEvoy who 

lead patients through the varied and complex pathways 

of diagnosis, treatment and postoperative stoma care in 

a way that appears seamless. The Excelicare database 

system is now the backbone of the weekly Colorectal 

Cancer audit organised by Anne White, Marian Ward, 

Stewart Thompson and Ken Curran. 

The research arm of the Centre for Colorectal Disease 

continues to flourish under the guidance of Dr Jacintha 

O’Sullivan, Senior Research Scientist. The main research 

goals of the Centre for Colorectal Disease are to 

achieve a more complete understanding of which 

biological factors that drive colorectal cancer and to 

determine if different biological markers can distinguish 

people at high risk and elucidate which subset of 

patients will response to particular treatment regimes. 

The goal of these translational research projects, based 

on unique and exciting explant work, is to determine 

which cancers require additional treatment and what 

therapies might be most effective. Such work has the 

potential for huge financial savings in the management 

of Colorectal Cancer. The large and detailed databases 

for patients with Bowel cancer and Inflammatory Bowel 

Disease enable many of the projects to be achieved. 

The unit has very productive collaborations with both 

national and international institutions. 

Professors O’Donoghue and O’Connell represent the 

Hospital on the National Colorectal Cancer Screening 

Committee. 

Our Annual International Colorectal Meeting in the 

Education and Research Centre each September 

continues to draw large numbers of attendees and is 

an ideal platform to display the various strengths and 

activities of the unit. Professor Paddy Johnston from 

Queen’s University Belfast - with whom the unit has 

close research collaborations - was this year’s state of 

the art lecturer. 

We wish to record our thanks to the many individuals 

and groups who raise funds for our research. In 

particular we would like to acknowledge foundations to 

the memory of Ellie Brady, Susie Byrne and Darragh 

Gibbons. 

35 






Changes to our research team in 2008 

In 2008, Adriana Michielsen joined our team to embark 

on her Ph.D. studies which will examine how defects in 

the immune system may be important in controlling 

treatment response in colorectal cancer patients. This 

work is funded by an IRCSET grant for 3 years. Eoin 

Slattery and Danny Cheriyan have also begun their MD 

research work. Eoin is investigating how cigarette smoking 

has a protective role in Ulcerative Colitis. Eoin has been 

awarded an Abbott Newman Fellowship (UCD) to 

conduct this work. In collaboration Prof. Paul Murphy 

(NUI, Galway), Danny is analysing the action of newly 

synthesised anti-angiogenetic compounds using our 

human tumour explant tissue model. 

National and international talks in 2008 

Jacintha O’Sullivan: University of Washington, Seattle 

‘Predicting treatment response using a novel tumour 

explant tissue model’. 

Sheeona Gorman: Irish Radiation Research Society 

(IRRS), Belfast. ‘Ex vivo bystander effects promote 

mitochondrial dysfunction and chromosomal bridge 

breakage fusion events in colorectal cancer’. 

Joe Marry: Clinical Plenary Session of the Irish Society 

of Gastroenterology, ‘Evaluating the effects of monoclonal 

antibody therapies on pro-angiogenic growth factors in 

individual colorectal cancer explants’. 

Edward Fox: Association for Cancer Research Annual 

Meeting, San Diego. ‘Mutator phenotype of sporadic 

human colon cancer’. 

Poster Presentations in 2008 

Sheeona Gorman: IACR: Gamma ray-induced bystander 

effects in colorectal cancer: a specific study on anaphase 

bridge and micronuclei formations in unirradiated 

bystander cells. 

Sheeona Gorman: All Ireland Cancer Conference: Ex 

vivo bystander effects promote chromosomal instability 

through bridge breakage fusion events: telomere 

shortening and bridge formations coupled with 

mitochondrial dysfunction. 

Juliette Sheridan: All Ireland Cancer Conference: 

Survival of very elderly patients with colorectal cancer. 

Sheeona Gorman: ISG: Ex vivo bystander effects 

promote mitochondrial dysfunction and chromosomal 

bridge breakage fusion events in colorectal cancer. 

Joe Marry: AntiAngio2008, San Diego, CA. Evaluating 

the effects of monoclonal antibody therapies on proangiogenic 

growth factors in individual colorectal cancer 

explants. 

Garret Cullen: ISG: The effect of cigarette smoking on 

cell cycle kinetics and mitogen activated protein kinases 

in inflammatory bowel disease: implications for disease 

progression. 

Garret Cullen: Digestive Disease Week (DDW): 

Cigarette smoking in inflammatory bowel disease: cell 

cycle arrest may explain the divergent effects in Crohn’s 

disease and ulcerative colitis 

Edward Fox: Association for Cancer Research Annual 

Meeting. Mutator phenotype of sporadic human colon 

cancer. 

Research Collaborators: 

Prof. Peter Rabinovitch, University of Washington, Seattle, USA 

Prof. Larry Loeb, University of Washington, Seattle, USA 

Dr Orla Howe, Dr. Fiona Lyng, DIT, Kevin Street 

Dr. Dermot Leahy, Conway Institute, UCD 

Prof. Martin Tenniswood, Notre Dame, Indiana 

Dr. Cormac Taylor & Dr. Katrina Comferford, Conway 

Institute, UCD 

Dr. Amanda McCann, Conway Institute, UCD 

Prof. Kevin Malone, St Vincents University Hospital, Dublin 

Dr. Ursula Fearon & Dr Doug Veale, Rheumatology, S.V.U.H. 

Prof Walter Kolch, Beatson Institute, Glasgow 

Prof Patrick Johnson, Almac, Craigavon, Belfast. 

Dr. Elizabeth Ryan, Trinity College Dublin. 

36 






Breast Cancer Research 

Principal Investigator: Professor Joe Duffy 

Researchers: 

Dr Aisling Pierce, 

Dr Eadaoin McKiernan, 

Dr Siun Walsh, 

Dr Neil O’Brien (currently visiting scientist in the lab of 

Drs Denis Slamon, University of California at Los Angeles) 

Collaborators (Local): Professor John Crown, 

Mr Enda McDermott, Mr Denis Evoy, 

Dr Liam Gallagher Steve Pennington 

(UCD), Professor (UCD), Professor 

F Martin 

Dr Norma O’Donovan 

(UCD), 

(DCU) 

Collaborators (International): 

Drs Denis Slamon, University of California at Los Angeles; 

Dr Stan Krajewski, Burnham Institute, La Jolla; 

Prof Fred Sweep, Nijmegen; 

Prof Nils Brunner, Copenhagen, 

Prof Manfred Schmitt, Munich. 

Research Focus 

The overall aim of the Breast Cancer Research Group is 

to develop new molecular markers to aid the early 

diagnosis of breast cancer, help with prognosis and 

predict likely response or resistance to specific therapies. 

Dr Siun Walsh is investigating new therapeutic targets 

for the treatment of an aggressive subtype of breast 

cancer, known as the triple-negative subtype. Triplenegative 

breast cancers are so named as they lack 

expression of estrogen receptor (ER), progesterone 

receptor (PR) and do not exhibit overexpression or 

amplification of the HER-2 gene. Consequently, targeted 

therapy is currently unavailable for this subgroup of 

patients. Although triple-negative cancers represent a 

relatively small minority of invasive breast cancers (15- 

20%), they are responsible for a disproportionate 

number of breast cancer deaths. There is thus an 

urgent need to identify novel targets and to develop 

therapeutic strategies that will improve the prognosis for 

this sub-group of breast cancer patients. 

Aisling Pierce is involved in using proteomics and 

glycomics for the early detection of breast cancer. She is 

also investigating the potential role for the breast-specific 

gene, mammaglobin, in the formation of breast cancer. 

Eadaoin McKiernan is attempting to identify new 

markers for predicting the metastatic potential of newly 

diagnosed breast cancers. This work is being carried out 

as part of a HRB-funded Programme Grant. 

Invited Presentations at International 

Meetings 

Duffy MJ, 2ndMultidisciplinary Cancer Symposium, 

Uludag, Turkey, Title of Presentation: Personalised 

Treatment for Cancer: How Biomarkers Can Help. 

Duffy MJ, 36th International Society for Oncology and 

Biomarkers Conference, Tokyo, Title of Presentation, 

The Future of Tumor Markers: New Technologies and 

New Approaches. 

Duffy MJ, 14th Hamburg Symposium on Tumor 

Markers, Hamburg, Title of Presentation, Conformities 

and Inconsistencies in the Use of Tumor Markers 

Duffy MJ, All-Ireland Cancer Conference, Dublin, Title of 

Presentation, uPA and PAI-1 as Validated Biomarkers in 

Breast Cancer: From Pilot Studies to Recommendation 

for Clinical Use. 

37 






Psychiatry & Mental Health Research 

Principal Investigator: 

Prof Kevin Malone 

I. Suicide Studies in Ireland: 

Number of Patient Contacts (2008); 

Over 220 relatives have been interviewed in 

relation to 104 suicide deaths. 

250 Coroners files have also been retrieved for 

research study. 

100 Lived Lives: A Visual Arts Autopsy Study. (Seamus 

McGuinness) 

In addition to talking part in the Suicide in Ireland Survey, 

families are also invited to donate belongings of the 

deceased to the Visual Arts Autopsy study. The aims of 

this project are to provide a greater understanding of 

the deceased individuals behind the suicide statistics 

through a creative arts practice. 60 families have 

participated in this study and donated belongings to the 

Visual Arts Autopsy. 

Description of Project: 

This programme of research focuses on different 

aspects of suicide in Ireland. Specifically, the programme 

includes 4 major research projects. 

The Suicide in Ireland Survey is adopting a novel 

psycho-biographical autopsy methods approach to 

studying young lives lost to suicide in modern Ireland. 

In addition to the Principal Investigator, there are 3 

dedicated Ad Astra PhD Scholars working on discrete 

aspects of the project. The study aims to recruit 120 

cases and 120 living community controls, and will be 

the largest and most comprehensive study of its kind in 

these islands. The study aims to bring greater 

understanding of the problem of suicide in Ireland, and 

will inform tailored strategies to guide new intervention 

and prevention approaches. 

Peer effects of young male suicide in Ireland. 

(Lorna Sweeney) 

The effects of young male suicide deaths on their male 

peers is poorly understood. This project aims to 

interview 50 affected peers in different communities to 

contribute to our understanding about suicide clusters 

in youth suicide in Ireland. 

The Second Chance Study: A study of high lethality 

suicide attempters (Leah Quinlivan) 

This project uses similar psychobiographical interview 

methods to profile and develop models to provide a 

greater understanding of the suicidal process. 

38 






II. Psychobiology Studies in Suicidal Depression: 

This is an inter-disciplinary research programme of 

research exploring biological factors associatred with 

stress and depression. Specifically, projects in this 

programme have examined the links between stress, 

inflammation, cellular aging and depression. The 

collaborative group includes Prof. Donal O’Shea, Prof. 

Cliona O’Farrelly, Dr. Jacinta O’Sullivan and Prof. Malone. 

Dr. Gavin Rush is completing his MD Thesis on the 

effects of ECT on inflammatiory markers in depression. 

Aoife O’Donovan recently successfully defended her 

PhD on “Threat-related psychological variables, 

inflammation and cellular aging”. She has just finished a 

Fulbright scholarship in UCSF where she is currently a 

post-doctoral fellow. 

Presentations 

Contemporary Textiles,the fabric of fine art. Seamus 

Mc Guinness Spaces black dog publishing, London 

2008. 

"A Qualitative Exploration of the Perceptions of 

Depression in Young Irish men". Lorna Sweeney. 

American Men's Studies Association 17th Annual 

Conference on Men and Masculinities, April 4th-6th, 

2008. North Carolina, USA. 

The Postgraduate Department once again had a very 

successful and busy year. The meetings organised at 

postgraduate level for the hospital staff still continue to 

attract a large attendance from St. Vincent’s University 

Hospital and are a vital contact for all the NCHDs. 

Annual Hospital Study Day 

It was agreed by the members of the GP Committee 

that the Annual Hospital Study Day be held this year on 

Saturday 5th April 2008. This proved to be very 

successful. The educational format consisted of two 

Poster Sessions and two Interactive Sessions as follows: 

Poster Sessions: 

1. Assessment of Cardiac Risk in Young Athletes 

Dr. Ken McDonald 

2. Is it Asthma – Is it C.O.P.D – How do I manage it ? 

Prof. Michael Keane 

3. Upper Abdominal Pain – Assessment in General 

Practice 

Mr. Donal Maguire 

4. Benign Anorectal Disease 

Prof. Ronan O’Connell 

Touch, Textiles, Technology; Collaborations across 

Europe. McGuinness S & Malone K. CHRRC, Goldsmiths 

College, University of London, Sept 2008 

39 






Interactive Sessions: 

1. Assessment and Management of Upper Limb 

Problems 

Dr. Bernadette Lynch / Dr. Anne Barbara Mongey 

2. Assessment of Headache 

Dr. Niall Tubridy 

At 6.30pm there was a Panel Discussion on “What 

Hospital Services can the GP Access?” 

Later that evening the reception and dinner was held in 

the atrium of the Ambulatory Day Care Centre and was 

attended by approximately 100 guests. 

Medical and Surgical Meetings 

The Postgraduate Lunch Time Meetings include: 

Intern Report at 1:00pm every Tuesday in the ERC 

Nephrology at 1:00pm every Wednesday in the 

conference room (beside Juice Bar) 

Gastroenterology at 1:00pm every 1st and 3rd 

Wednesday of every month in ERC Rheumatology 

at 1:00pm every Friday in ERC 

The Postgraduate Breakfast Meetings include: 

Colorectal Meeting at 7:30am every Tuesday in the 

Pathology Dept, 3rd Floor 

Grand Rounds 

Respiratory SpR Conference 

Cardiology Meeting 

at 8:00am every Thursday in 

ERC/Old Lecture Theatre 

at 8:00am every Friday 

at 7:30am every Friday 

All of the above meetings are organised by the Postgraduate 

Department. Lunch or breakfast is provided. 

Some meetings do not run for the Summer months 

Intern Lunch Time Seminars 

Monday Lunch Time Seminars for Interns consist of 

Clinical Skills Sessions and Data Interpretation. 

The Tuesday Lunch Time Seminar is organised by the 

Medical Intern Tutor in conjunction with the Postgraduate 

Department. Each week an Intern presents a case to 

the class with a discussion of same afterwards. 

Wednesday conferences can be either surgical or 

medical. 

Thursday Lunch Time Lectures are on matters relating 

to all aspects of Surgery and are given by Consultant 

Surgeons within the hospital. 

Friday Lunch Time Seminars for the Interns are 

presented by guest speakers and include Career 

Guidance, Risk Management, Stress Management and a 

wide variety of other topics. 

SHO Teaching 

Formal Clinical Teaching 

We run a five week intensive programme of bedside 

tutorials three times per year, January/February, May/ 

June, October/November. These courses are aimed 

primarily, but not exclusively at the MRCPI examination. 

These tutorials are all consultant provided and take 

place at 5.00pm to maximise attendance and to allow 

SHOs in peripheral jobs to attend. Consultants are 

asked to focus on a short case format 

At the end of the course feedback from SHOs as to how 

the course could be improved is analysed. We use the 

Pyramid discussion method which has recently been 

successfully implemented for our undergraduate students. 

40 






International Meeting 

In addition to the large number of in-house meetings, 

the Postgraduate Department helped organise the 

Centre for Colorectal Disease 15th International 

Meeting which was held on Friday 12th September 

2008. The programme was as follows: 

Session 1 Inflammation and Cancer 

Genomic Instability & Disease Progression – Dr. J 

O’Sullivan 

Immunosuppression & Obesity – Dr. L Lynch 

Hypoxia, Inflammation & Cancer – Prof. C Taylor 

Session 2 Surveillance for Cancer in IBD 

Recommendations and Reality – Prof. D O’Donoghue 

Case Presentations – Dr. H Mulcahy 

Session 3 Risk Stratification of the patient with 

Colorectal Cancer 

Clinical and Pathological issues – Prof. K Sheahan; 

Dr. H Mulcahy 

Session 4 State of the Art Lecture 

Pharmacogenetics of Colorectal Cancer: 

Concept to Reality – Prof. P Johnson 

There were 100 attendees at the meeting. 

Dinner was held afterwards at the Fitzwilliam Lawn 

Tennis Club. 

Sponsorship for this event was provided by the 

following pharmaceutical companies: 

Astra Zeneca; Healthcare 21; Johnson & Johnson; 

Merck Serono; Sanofi Aventis. 

The Student Summer Project 

As in other years this is an important part of the 

hospital’s academic year and in 2008 it was held on 

Monday 15th December. As you are aware the aim of 

the project is for the student to develop an interest in 

research so that he / she will continue to develop this 

interest at postgraduate level. The judging panel of 

physicians and surgeons were Dr. John Seery, Prof. 

Michael Keane, Mr. Enda McDermott, Mr. Donal O’Shea 

and Dr. Kieran Sheahan. 

The winner was Josen McGrane whose project was 

entitled “Preserved Cognitive Function is Associated 

with Suicidal Ideation and Single Suicide Attempts in 

Schizophrenia”. 

41 






Pharmaceutical Representatives 

The link for the pharmaceutical companies in St. 

Vincent’s University Hospital is the Postgraduate 

Department. The companies sponsor the medical and 

surgical lunch and breakfast meetings and in turn the 

representative meets the consultants and NCHDs to 

discuss their products. This link is important for both 

doctors and medical representatives. 

The Library 

The Library and Information Service (LIS) facilitates the 

staff of the three hospitals in St. Vincent’s Healthcare 

Group and all students, resident or on placement. The 

LIS supports the information needs of its users and 

therefore the clinical practice, education and research 

activities of the Group. 

The LIS collections comprise print and electronic 

resources including books, journals, reports, databases 

etc. The electronic resources can be accessed through 

the SVUH IT network and intranet and are also available 

remotely with an Athens account, which all staff may 

apply for. UCD’s electronic collections are available on 

the 17 PCs in the Library. These are strictly for research 

or hospital business (e.g. patient care) only. We offer 

basic and advanced training on all our electronic 

products, by appointment. 

Other services include: lending service, document 

delivery, photocopying, scanning and printing (b/w and 

colour). 


Co-ordinator of Postgraduate Education. 

42 





Translational Research Seminars 2007/08 

A new series of multidisciplinary research seminars 

were initiated and chaired by the Medical Director of 

the Education and Research Centre, Professor Douglas 

Veale, over the last year to focus on Translational 

research opportunities. The first seminar, held in the 

ERC on 28th June 2007, brought together researchers 

from the Obesity, Liver and Arthritis groups with 

researchers from the Conway Institute to discuss joint 

opportunities in these areas. There was a lively 

discussion in relation the mechanisms of inflammation 

and the potential for novel drug development in the 

common areas in particular cytokine inhibition. 

Interestingly, the possibility of novel biomarkers 

common to obesity and arthritis was discussed 

extensively and this has led to a new cooperative 

research focus. Biomarkers are recognised increasingly 

to be critical to translational medicine for the 

identification and monitoring of disease activity and 

response to therapies. 

The second seminar in this series, held in the ERC on 

22nd November 2007 brought together the 

Professorial Department of Medicine, led by Professor 

Michael Keane, and the wider Respiratory research 

group including cystic fibrosis and sleep disorders along 

with the Cardiology group and basic researchers from 

the Conway Institute. The discussion covered common 

mechanisms of inflammation and fibrosis in lung and 

heart disease, especially heart failure. It is recognised 

that patients suffering from lung fibrosis and heart 

failure may share similar cellular and molecular 

dysfunction and that researchers in both these areas 

can work more closely together to understand the 

pathways involved and possible new therapies to 

intervene in these diseases in the clinic. 

The final seminar of the series held in the ERC on 25th 

June 2008 brought together researchers in skin disease 

led by Professor Sarah Rogers, Dr Paul Collins and Dr 

Brian Kirby (Chairman of the Medical Research and 

Ethics Committee) with the arthritis research group and 

Dr Peter Doran, the newly appointed Scientific Director 

of the UCD Clinical Research Centres based at the 

Mater and St. Vincent’s University Hospitals. Dr. Doran 

introduced the concept of developing an integrated 

research infrastructure across the DAHC, providing core 

research support services such as the Distiller database. 

Prof. Sarah Rogers was pleased to update the group on 

the exciting new developments regarding the Charles 

Institute of Translational Research which will be based 

on the UCD campus next to the Conway Institute. The 

groups identified a number of key common 

translational research interests and significant progress 

has already been made to ensure that the efficient 

collection of clinical and scientific data especially 

relating to patients commencing biologic therapies. It is 

hoped that further close collaboration between these 

groups will provide a model for integrated, 

multidisciplinary and translational research in 

inflammatory diseases in the DAHC. 

43 






Bone Workshop 18/01/2008 

Education and Research Centre, Seminar Room 

St. Vincent’s University Hospital, Elm Park, Dublin 4 

Chairperson: 

Prof O FitzGerald, St Vincent’s University Hospital 

Speaker Schedule 

11:30-11:50 Periarticular Osteoporosis in Inflammatory Arthritis 

Prof Barry Bresnihan, Consultant Rheumatologist at SVUH and Conway PI 

11:50-12:30 Comparison of BMD measurements and bone biomarkers in Rheumatoid Arthritis and Psoriatic Arthritis receiving biologic therapy 

Dr Vincent Ng, Research Fellow, SVUH 

12:30-13:00 Lunch 

13.00-14.00 Prediction of disease progression in rheumatoid arthritis, osteoarthritis and osteoporosis using bone mass measurements. 

Prof David M Reid, Chair of Rheumatology and Head of Department of Medicine & Therapeutics at the University of Aberdeen 

14:00-14:30 DXA diagnosis of Osteoporosis: fact or fiction? 

Dr John Carey, Consultant Rheumatologist and General Physician, University Hospitals Galway 

14:30-15:00 Differential diagnosis of high and low bone mass 

Dr Miriam Delaney, Consultant Endocrinologist 

15:00-15:15 DXA at SVUH-Precision, Prevalence & Problems 

Dr Malachi McKenna, Consultant Endocrinologist St. Vincent’s University Hospital 

44 






Guest Lectures 

Friday 16th May 2008 

Rheumatology Guest Lecture Prof. Patrick Venables, U.K. 

“Citrullinated alpha enolase: a novel autoantigen in RA 

specific aetiological and immungenetic associations” 

ERC Journal Club 2008 

Schedule: Thurs mornings 9.30-10.30am 

Venue: 

Seminar Room, E.R.C. 

Education & Outreach 

S.V.U.H. Schools One Day Seminars: 

Laboratory staff in the E.R.C. contribute by giving talks 

on the workings of the research laboratories to 

secondary school students. 

In 2008 several UCD undergraduates carried out 

research for their theses at SVUH. 

Honours/Awards/Prestigious Invitations 

Mary Connolly; SIAR Award (Oral Presentation) - 

American College of Rheumatolog, San Francisco, 2008 

M. Connolly 1 , J. McCormick 1 , A. Marelli 2 , M. Blades 2 , 

O. FitzGerald 1 , B. Bresnihan 1 , C. Pitzalis 2 , D. Veale 1 , U. 

Fearon 1 - 

A-SAA Induces Rho GTPase-dependent Cytoskeletal 

Rearrangement and In Vivo Migration of Fluorochrome 

Labelled Monocytic (u937) Cells in A Human RA/SCID 

Mice Chimera Model 

Aisling Kennedy; (Oral Presentation)- American College of 

Rheumatology, San Francisco, 2008 

Aisling Kennedy, Monika Biniecka, Chin Teck Ng, 

Jacintha N. O'Sullivan, Ursula Fearon, Douglas J. Veale 

Oxidative Damage in the Arthritic Joint leads to an 

Unstable Environment and Stimulates Abnormal 

Angiogenesis in Synovial Tissue 

Ellen Moran; Travel Award 

Ellen M. Moran, Ronan Mullan, Jennifer McCormick, 

Oliver FitzGerald, 

Barry Bresnihan, Douglas J. Veale, Ursula Fearon. 

IL-17A Expression Is Modulated by Biologic Therapy and 

Drives 

Inflammatory Cell Migration In The Human RA Joint 

Dr. Lydia Lynch awarded UNESCO-L’Oreal 

International Young Women of Science Fellowship 

Dr. Lydia Lynch won Researcher of the Year, Conway 

Festival of Research September 2008 

Dr. Andrew Hogan awarded NUI Maynooth Presidents 

Gold Medal 2008 for achievements in academia 

and sport. 

Dr. Margaret O’Brien won Best Platform Presentation 

at the INA (Cork) 2008 

Dr. Roisin Lonergan won Best Poster Presentation at 

the INA (Cork) 2008 

Sheeona Gorman, UCD Seed Funding Travel Award, 

2008 

Dave Kevans, 3rd poster prize, Irish Society of 

Gastroenterology 

Garret Cullen, 2nd poster prize, Irish Society of 

Gastroenterology 

Joe Marry, Irish Cancer Society Oncology Scholar 

Travel Award 

Professor Dr Joe Duffy 

Prof. Dubby continued to serve as Chairman of the 

National Academy of Clinical Biochemistry (USA) Panel 

for the preparation of guidelines on the Clinical Use of 

Tumor Markers in Breast Cancer. During 2008, 

Professor Duffy also continued to act as Focus Group 

Leader of the Gastrointestinal Group of the European 

Group on Tumor Markers (EGTM). EGTM is a European 

45 






Expert Group involved in preparing guidelines on the 

use of tumor markers in different maligancies. 


Prof. McNicholas gave several lectures as part of major 

symposia at the following international scientific meetings: 

American Thoracic Society, Toronto, May 2008 

American Academy of Sleep Medicine, Baltimore, June 

2008 

European Respiratory Society, Berlin, October 2008 

Prof. Donal O’Shea 

Prof. O’Shea was invited to give a public lecture in the 

RDS entitled ‘Obesity; Treating the Epidemic to Prevent 

the Pandemic’ for a series on Ireland towards 2030. 

Prof O’Shea was the overall winner of the Undergraduate 

Teacher of the Year in UCD, Medical School. 

Prof. O’ Shea was invited to give the Nordisk lecture for 

the Irish Endocrine Society in November 2008. 

Prof Barry Bresnihan 

Co-Chairman, EULAR Synovitis Study Group 

Co-Chairman, OMERACT Synovial Tissue Analysis Study 

Group 

Italian Society of Rheumatology, Catania 

Royal Society of Medicine, London, June 

Chairman scientific session, EULAR, June 

British Bone Society, Aberdeen, July 

Prof Douglas Veale 

Appointed Director of Translational Research, Dublin 

Academic Health Care 

Medical Director, Education & Research Centre, SVUH 

Director of THERAPI - Translational Research Group 

Vice-president, International Scleroderma Clinical Trials 

Consortium 

Strategic Scientific Committee, Arthritis Research 

Campaign, UK 

HRB Infection & Immunity Grant Committee 

Irish Medicines Board, Medicines Committee 

Wyeth Translational Science European Expert Group 

Schering-Plough International Advisory Panel 

Centocor International Advisory Panel 

Co-Chair RCPI Masterclass in Rheumatology 

Progress and Promise, Madrid 

Prof. Anne Barbara Mongey 

Director of the Clinical Skills Laboratory at UCD 

Co-ordinator of the Advanced Clinical Skills module for 

the Graduate Entry Medicine programme. 

Co-ordinator for the Elective module for undergraduate 

and graduate entry medical students. 

Prof Oliver FitzGerald 

Chairman, Arthritis Ireland (Oct-present) 

Member of HSE working group on Arthritis and Allied 

conditions representing the Irish Society of Rheumatology 

Steering committee member for GRAPPA (Group for 

Research and Assessment of Psoriasis and Psoriatic 

Arthritis) 

Member of Abbott International Immunology Advisory 

Board 

Lead Consultant Bone & Joint Unit, SVUH 

Steering committee member of OMERACT Biomarkers 

Group 

Scientific committee member 3e Initiative in 

Rheumatology 

Rochester University, Visiting Speaker 

Progress and Promise, Munich 

Ulster Internal Medicine Association, Belfast 


Senior Scientist Rheumatology 

Chairperson Scientific Sesssion of The American College 

of Rheumatology, 

San Francisco, November 2008 

Higher Degrees 

Ronan Mullen PhD June 2008 

Lucille Kavanagh PhD Sept 2008 

46 





Publications 

Alonderis A, Barbé F, Bonsignore M, Calverly P, De 

Backer W, Diefenbach K, Donic V, Fanfulla F, Fietze I, 

Franklin K, Grote L, Hedner J, Jennum P, Krieger J, Levy 

P, McNicholas W, Montserrat J, Parati G, Pascu M, 

Penzel T, Riha R, Rodenstein D, Sanna A, Schulz R, 

Sforza E, Sliwinski P, Tomori Z, Tonnesen P, Varoneckas 

G, Zielinski J, Kostelidou K. Medico-legal implications of 

sleep apnoea syndrome: driving license regulations in 

Europe. Sleep Medicine 2008 May;9: 362-375 PMID 

17765641 

Baird AW, Skelly MM, O'Donoghue DP, Barrett KE, Keely 

SJ. Bradykinin regulates human colonic ion transport in 

vitro. Br J Pharmacol. 2008 Oct;155(4):558-66. PMID 

18604228 

Beddy D, Hyland J, Winter D, Lim C, White A, Moriarty 

M, Armstrong J, Fennelly D, Gibbons D and Sheahan K. 

A simplified tumor regression grade correlates with 

survival in locally advanced rectal carcinoma treated 

with neoadjuvant chemoradiotherapy. Ann Surg 

Oncol, 2008, Dec15(12):33471-7 PMID 18846402 

Beetz C, Schüle R, Deconinck T, Tran-Viet KN, Zhu H, 

Kremer BP, Frints SG, van Zelst-Stams WA, Byrne P, Otto 

S, Nygren AO, Baets J, Smets K, Ceulemans B, Dan B, 

Nagan N, Kassubek J, Klimpe S, Klopstock T, Stolze H, 

Smeets HJ, Schrander-Stumpel CT, Hutchinson M, van 

de Warrenburg BP, Braastad C, Deufel T, Pericak-Vance 

M, Schöls L, de Jonghe P, Züchner S.REEP1 mutation 

spectrum and genotype/phenotype correlation in 

hereditary spastic paraplegia type 31. Brain 2008 

April; 131(Pt 4):1078-86. PMID 18321925 

Brennan DJ, Rexhepaj E, O'Brien SL, McSherry E, 

O'Connor DP, Fagan A, Culhane AC, Higgins DG, 

Jirstrom K, Millikan RC, Landberg G, Duffy MJ, Hewitt 

SM, Gallagher WM. Altered cytoplasmic-to-nuclear ratio 

of survivin is a prognostic indicator in breast cancer. 

Clin Cancer Res. 2008 May 1;14:2681-9. PMID 

18451232 

Bronner M * , O’Sullivan J * , Rabinovitch P, Crispin D, Chen 

L, Emond M, Rubin C, Brentnall T. Genomic Biomarkers 

Identify Distant Colorectal Cancer in Ulcerative Colitis. 

Am J Pathol. 2008 Dec;173(6):1853-1860. 

* 

Joint first authors PMID 18988798 

Coss A, Tosetto M, Fox E, Sapetto-Rebow B, Gorman S, 

Kennedy B, Lloyd, Hyland J, O’Donoghue D, Sheahan K, 

Leahy D, Mulcahy H * , O’Sullivan J * . Increased 

Topoisomerase II· Expression in Colorectal Cancer is 

Associated with Pathologically Aggressive Disease and 

Leads to Chemotherapy Resistance via Inhibition of 

Apoptosis. * Joint lead investigators. Cancer Lett 2008 

Dec 24. PMID 19111388 

Costello L, Thompson A, Walsh, C. Tubridy N, Hutchinson 

M. Long term clinical relevance of criteria for 

designating Multiple Sclerosis as benign after ten years 

of disease. J Neurol Neurosurg Psychiatry 2008 May 

13. PMID 18477712 

Costelloe L, O’Rourke K, McGuigan C, Walsh C, Tubridy 

N, Hutchinson M. The longitudinal relationship between 

the patient-reported Multiple Sclerosis Impact Scale 

and the clinician-assessed Multiple Sclerosis Functional 

Composite. Mult Scler 2008 Mar;14(2):255-8. PMID 

17942522 

Cullen G, Keegan D, O'Donoghue D. Safety and 

efficacy of cyclosporine therapy in inflammatory bowel 

disease. Am J Gastroenterol. 2008 Oct;103(10):2654- 

5 PMID 18855861 

Doherty LS, Cullen JP, Nolan P, McNicholas WT. The 

human genioglossus response to negative airway 

pressure: stimulus timing and route of delivery. Exp 

Physiol. 2008 Feb;93(2):288-95. PMID: 17951328 

Doran JP, Veale DJ. Biomarkers in systemic sclerosis. 

Rheumatology (Oxford) 2008 Oct;4. Suppl 5:v36-8. 

PMID 18784139 

47 





Publications 

Duffy M, McGowan P, Gallagher W. Cancer invasion 

and metastasis:changing views. J. Pathol 2008 

Feb;214(3):283-93 PMID 18095256 

Duffy MJ, Crown J. A personalized approach to cancer 

treatment: how biomarkers can help. Clin Chem. 2008 

Nov;54:1770-9. PMID 18801934 

Feighery LM, Cochrane SW, Quinn T, Baird AW, O'Toole 

D, Owens SE, O'Donoghue, D, Mrsny RJ, Brayden DJ. 

Myosin light chain kinase inhibition: correction of 

increased intestinal epithelial permeability in vitro. 

Pharm Res. 2008 Jun;25(6):1377-86. PMID 18163202 

Fleming F. Sheahan K. Winter D. Concomitant ulcerative 

colitis and rectal cancer in a patient with Gorlin 

syndrome. Inflamm Bowel Dis. 2008 Aug 4. PMID 

18680193 

Furst DE, Keystone EC, Kirkham B, Kavanaugh A, 

Fleischmann R, Mease P, Breedveld FC, Smolen JS, 

Kalden JR, Burmester GR, Braun J, Emery P, Winthrop K, 

Bresnihan B, De Benedetti F, Dörner T, Gibofsky A, 

Schiff MH, Sieper J, Singer N, Van Riel PL, Weinblatt ME, 

Weisman MH Updated consensus statement on 

biological agents for the treatment of rheumatic 

diseases, 2008. Ann Rheum Dis. 2008 Dec;67 Suppl 

3:iii2-25 PMID 19022808 

Golden-Mason L, Madrigal-Estebas L, McGrath E, 

Conroy M.J, Ryan E.J, Hegarty J.E, O'Farrelly C & Doherty 

D.G. Altered natural killer cell subset distributions in 

resolved and persistent hepatitis C virus infection 

following single source exposure. Gut. 2008 Aug; 

57(8):1121-8. PMID 18567923 

Hanein S, Martin E, Boukhris A, Byrne P, Goizet C, 

Hamri A, Benomar A, Lossos A, Denora P, Fernandez J, 

Elleuch N, Forlani S, Durr A, Feki I, Hutchinson M, 

Santorelli FM, Mhiri C, Brice A, Stevanin G. Identification 

of the SPG15 gene, encoding spastizin, as a frequent 

cause of complicated autosomal-recessive spastic 

paraplegia, including Kjellin syndrome. Am J Hum 

Genet 2008 Apr;82(4):992-1002. PMID 18394578 

Harenberg A, Guillaume F, Ryan E.J, Burdin N & Spada 

F. Gene profiling analysis of ALVAC infected human 

monocyte derived dendritic cells. Vaccine. 2008 Sep 

15;26(39):5004-13. PMID 18691624 

Harte S, McNicholas WT, Donnelly SC, Dodd JD. 

Honeycomb cysts in idiopathic pulmonary 

haemosiderosis: high-resolution CT appearances in two 

adults. Br J Radiol. 2008 Dec;81(972):e295-8. PMID: 

19029052 

Heneghan C, de Chazal P, Ryan S, Chua CP, Doherty L, 

Boyle P, Nolan P, McNicholas WT. Electrocardiogram 

recording as a screening tool for sleep disordered 

breathing. J Clin Sleep Med. 2008 Jun 15;4(3):223-8. 

PMID: 18595434 

Heneghan C, Chua CP, Garvey JF, de Chazal P, 

Shouldice R, Boyle P, McNicholas WT. A portable 

automated assessment tool for sleep apnea using a 

combined Holter-oximeter. Sleep. 2008 Oct 

1;31(10):1432-9. PMID: 18853941 

Hutchinson M, Waters P, McHugh J, Gorman G, 

O'Riordan S, Connolly S, Hager H, Yu P, Becker CM, 

Vincent A. Progressive encephalomyelitis, rigidity, and 

myoclonus: a novel glycine receptor antibody. 

Neurology 2008 Oct 14; 71(16):1291-2. PMID 

18852446 

Jarnicki A, Conroy HE, Brereton C, Donnelly G, Toomey 

D, Sweeney C, Fletcher JM, Lavelle E, Dunne PJ and 

KHG Mills. Attenuating regulatory T cell induction by 

TLR agonists through inhibition of p38 MAPK signaling 

in dendritic cells enhances their efficacy as vaccine 

adjuvants and cancer immunotherapeutics. J. 

Immunol 2008 Mar 15; 180(6):3797-806. PMID 

18322186 

48 





Publications 

Keane J. Bresnihan B. Tuberculosis reactivation during 

immunosuppressive therapy in rheumatic diseases: 

diagnostic and therapeutic strategies. Curr Opin 

Rheumatol 2008 Jul;20(4):443-9. PMID 18525359 

Kennelly R, Kavanagh D, Hogan A, Winter D. Oestrogen 

and the colon:potential mechanisms for cancer 

prevention. Lancet Oncol, 2008, April 9(4):385-391. 

PMID 18374292 

Marnane M, Vincent A, Hutchinson M. New-onset focal 

epilepsy with palatal tremor and glutamic acid 

decarboxylase antibodies responding to intravenous 

immunoglobulin. J Neurol 2008 Oct;255(10):1603-4. 

PMID 18758886 

McGowan PM, McKiernan E, Bolster F, Ryan BM, Hill 

AD, McDermott EW, Evoy D, O’Higgins N, Crown J, 

Duffy MJ. ADAM-17 predicts adverse outcome in 

patients with breast cancer. Ann Oncol. 2008 

19:1075Jan 30 PMID 18238782 

McGowan PM, Duffy MJ. Matrix metalloproteinase 

expression and outcome in patients with breast cancer: 

analysis of a published database. Ann Oncol 2008 

Sep:19(9):1566-72. PMID 18503039. 

McHugh JC, Tubridy N, Collins CD, Hutchinson M. 

Unusual MRI abnormalities in the anti-Yo positive 

“pure” paraneoplastic cerebellar degeneration. 

J. Neurol 2008 Jan;255(1):138-9. PMID 17994310 

McKiernan E, O'Brien K, Grebenchtchikov N, Geurts- 

Moespot A, Sieuwerts AM, Martens JW, Magdolen V, 

Evoy D, McDermott E, Crown J, Sweep FC, Duffy MJ. 

Protein kinase C delta expression in breast cancer as 

measured by real-time PCR, western blotting and 

ELISA. Br J Cancer. 2008 Nov;18;99:1644-50. PMID 

19002183 

McNicholas WT Diagnosis of obstructive sleep apnea in 

adults. Proc Am Thorac Soc. 2008 Feb 15;5(2):154- 

60 PMID 18250207 

McNicholas WT. The nose and OSA: variable nasal 

obstruction may be more important in pathophysiology 

than fixed obstruction. Eur Respir J. 2008 Jul;32(1):3- 

8. PMID: 18591332 

McNicholas WT. Diagnosis of obstructive sleep apnea 

in adults. Proc Am Thorac Soc. 2008 Feb 

15;5(2):154-60. PMID: 18250207 

Merkel PA, Silliman NP, Denton CP, Furst DE, Khanna D, 

Emery P, Hsu VM, Streisand JB, Polisson RP, Akesson A, 

Coppock J, van den Hoogen F, Herrick A, Mayes MD, 

Veale D, Seibold JR, Black CM, Korn JH; Validity, 

reliability, and feasibility of durometer measurements 

of scleroderma skin disease in a multicenter treatment 

trial. CAT-192 Research Group; Scleroderma Clinical 

Trials Consortium. Arthritis Rheum. 2008 May 

15;59(5):699-705. PMID 18438905 

Miller DH, Weinshenker BG, Filippi M, Banwell BL, 

Cohen JA, Freedman MS, Galetta SL, Hutchinson M, 

Johnson RT, Kappos L, Kira J, Lublin FD, McFarland HF, 

Montalban X, Panitch H, Richert JR, Reingold SC, 

Polman CH. Differential diagnosis of suspected 

multiple sclerosis: a consensus approach. Mult Scler 

2008 Nov;14(9):1157-74. PMID 18805839 

Murphy E, Bresnihan B, Fitzgerald O. Measurement of 

periarticular bone mineral density in the hands of 

patients with early inflammatory arthritis using dual 

energy x-ray absorptiometry. Clin Rheumatol 2008 

Feb 21 PMID 18288445 

Murphy SM, Rogers A, Hutchinson M, Tubridy N. 

Counting the cost of complementary and alternative 

therapies in an Irish neurological clinic. Eur J Neurol. 

2008; Dec15(12):1380-3. PMID 19049557 

49 





Publications 

Ng CT, O'Neil M, Walsh D, Walsh T, Veale DJ. Successful 

pregnancy after rituximab in a women with recurrent in 

vitro fertilisation failure and anti-phospholipid antibody 

positive. Ir J Med Sci 2008; Nov 29 PMID 19043774 

O’Brien N, O’Donovan N, Foley D, Hill AD, McDermott 

E, O’Higgins N, Duffy MJ. Use of a Panel of Novel 

Genes for Differentiating Breast Cancer from Non- 

Breast Tissues. Tumour Biol. 2008 Feb5;28(6):312- 

317 PMID 18253069 

O’Donovan, A., Lin, J., Tillie, J., Dhabhar, F., Wolkowitz, 

O., Blackburn, E., Epel, E. Pessimism correlates with 

leukocyte telomere shortness and elevated interleukin- 

6 in post-menopausal women. Brain, Behavior and 

Immunity 2008 PMID 191119222 

O’Donovan, A. & Hughes, B.M. Access to social support 

in life and in the laboratory: combined impact on 

cardiovascular reactivity to stress and state anxiety. J of 

Health Psychology 2008 Nov; 13(8), 1147-1156 

PMID 18987087 

O’Kane M, Markham T, McEvoy AN, Fearon U, Veale DJ, 

Kirby B, Murphy EP. Increased expression of the orphan 

nuclear receptor NURR1 in psoriasis and modulation 

following TNF-alpha inhibition. J. Invest Dermatol 

2008 Feb;128(2):300-10 PMID 17671512 

O’Loughlin, C., Murphy, N.F., Conlon, C., O’Donovan, A., 

Ledwidge, McDonald, K. Quality of life predicts 

outcome in a heart failure disease management 

program. 

Int J of Cardiology 2008 Oct 12 PMID 18851887 

O'Shea U, Abuzakouk M, O'Morain C, O'Donoghue D, 

Sheahan K, Watson P, O'Briain, S, Alexander D, 

Catherwood M, Jackson J, Kelly J, Feighery C. 

Investigation of molecular markers in the diagnosis of 

refractory coeliac disease in a large patient cohort. J 

Clin Pathol. 2008 Nov;61(11):1200-2. PMID 

18955575 

O’Sullivan J, Sheridan J, Mulcahy M, Tenniswood M and 

Morrissey C. The effect of green tea on oxidative 

damage and tumour formation in Lobound-Wistar rats. 

European Journal of Cancer Prevention. 2008, Nov; 

17(6):489-501. PMID 18941371 

Rexhepaj E, Brennan DJ, Holloway P, Kay EW, McCann 

AH, Landberg G, Duffy MJ, Jirstrom K, Gallagher WM. 

Novel image analysis approach for quantifying 

expression of nuclear proteins assessed by 

immunohistochemistry: application to measurement of 

oestrogen and progesterone receptor levels in breast 

cancer. Breast Cancer Res. 2008;10(5):R89. PMID 

18947395 

Rosen H.R, Doherty D.G, Madrigal-Estebas L, O'Farrelly 

C & Golden-Mason L. 

Pretransplantation CD56 (+) innate lymphocyte 

populations associated with severity of hepatitis C virus 

recurrence. 

Liver Transplantation 2008 Jan; 14(1):4-6. PMID 

18161829 

Rowan AG, Fletcher JM, Ryan EJ, Moran B, Hegarty JE, 

O’Farrelly C, Mills KH. Hepatitis C virus-specific Th17 

cells are suppressed by virus-induced TGF-b. 

J. Immunol 2008 Oct1; 181(7): 4485-94. PMID 

18802051 

Rubio JP, Stankovich J, Field J, Tubridy N, Marriott M, 

Chapman C, Bahlo M, Perera D, Johnson LJ, Tait BD, 

Varney MD, Speed TP, Taylor BV, Foote SJ, Butzkueven 

H, Kilpatrick TJ. Replication of KIAA0350, IL2RA, RPL5 

and CD58 as multiple sclerosis susceptibility genes in 

Australians. 

Genes Immun 2008 Oct; 9(7):624-30. PMID 

18650830 

Ryan S, McNicholas WT. Intermittent hypoxia and 

activation of inflammatory molecular pathways in OSAS. 

Arch Physiol Biochem. 2008 Oct;114(4):261-6. 

Review. PMID: 18946786 

50 





Publications 

Sturgeon CM, Duffy MJ, Stenman UH, Lilja H, Brünner 

N, Chan DW, Babaian R, Bast RC Jr, Dowell B, Esteva FJ, 

Haglund C, Harbeck N, Hayes DF, Holten-Andersen M, 

Klee GG, Lamerz R, Looijenga LH, Molina R, Nielsen HJ, 

Rittenhouse H, Semjonow A, Shih IeM, Sibley P, 

Sölétormos G, Stephan C, Sokoll L, Hoffman BR, 

Diamandis EP. National academy of clinical 

biochemistry laboratory medicine practice guidelines 

for use of tumor markers in testicular, prostate, 

colorectal, breast, and ovarian cancers. 

Clin Chem. 2008 Dec;54 (12):e11-79. PMID 

19042984 

Usmani N, Murphy A, Veale D, Goulden V, Goodfield M. 

Photochemotherapy for localized morphoea: effect on 

clinical and molecular markers. 

Clin Exp Dermatol. 2008 Nov;33(6):698-704. PMID 

18699840 

Vandooren B, Cantaert T, van Lierop MJ, Bos E, De 

Rycke L, Veys EM, De Keyser F, Bresnihan B, Luyten FP, 

Verdonk PC, Tak PP, Boots AH, Baeten D Melanoma 

Inhibitory Activity, a biomarker related to chondrocyte 

anabolism, is reversibly suppressed by proinflammatory 

cytokines in rheumatoid arthritis. 

Ann Rheum Dis 2008 Jul 16 PMID 18633128 

Wang L, McNally M, Hyland J and Sheahan K. Assessing 

interstitial cells of Cajal in slow transit constipation 

using CD117 is a useful diagnostic test. 

Am J Surg Pathol, 2008, Jul, 32(7):980-985. PMID 

18460978 

Walsh CA, Mullan RH, Minnock PB, Slattery C, FitzGerald 

O, Bresnihan B. 

Consistency in assessing the Disease Activity Score-28 

in routine clinical practice. 

Ann Rheum Dis. 2008 Jan;67(1):135-6. PMID 

18077544 

Walsh R, O'Dwyer JP, O'Riordan S, Bradley D, Moroney 

J, Hutchinson M. Cervical dystonia presenting as a 

phenocopy in an Irish SCA2 family. 

Mov Disord 2008 Dec 11. PMID 19086087 

Wang L, McNally M, Hyland J and Sheahan K. Assessing 

interstitial cells of Cajal in slow transit constipation 

using CD117 is a useful diagnostic test. 

Am J Surg Pathol, 2008, Jul, 32(7):980-985. PMID 

18460978 

Williams L, O’Connell K, Tubridy N. Headaches in a 

rheumatology clinic: when one pain leads to another. 

Eur J Neurol 2008 Mar;15(3):274-7. PMID 18290847 

51 





Grants Active in 2008 

P.I. Name of Study Source of Grant Fund Start Finish 

Amount Date Date 

Prof. Walter McNicholas Cell and molecular mechanisms of cardiovascular HRB Project Grant €220,000 2005 2008 

disease in obstructive sleep apnoea. 

Prof. Walter McNicholas Non-invasive low cost measurements of sleep, Enterprise Ireland €300,000 2005 2008 

(with Prof C. Henegh 

sleep disruption and sleepiness. 

an UCD) 

Prof. Walter McNicholas Research in sleep apnoea AstraZeneca €75,000 2007 2009 

Prof. Joe Duffy (with W. Breast Cancer Metastasis: Biomarkers and Health Research Board Programme €1,063,000 2005 2010 

Gallagher, F. Martin 

& P. Dervan) Functional Mediators Grant 2005 

Prof. Kieran Sheahan/ Molecular characterisation of familial colorectal cancers HRB €174,400 2006 2009 

Dr. Dermot Leahy 

Dr. Edward Fox The frequency of random mutations and genomic G NCI/HRB €88,000 2006 2008 

instability in colorectal cancer progression 

Centre for Colorectal Disease HRB Project Grant €165,000 2006 2009 

Dr. Garret Cullen Cigarette smoking and genomic instability: factors Altana – Newman €80,000 2006 2008 

controlling disease progression and treatment sensitivity Fellowship 

in inflammatory bowel disease patients. 

52 








Dr. Joseph Marry The effect of genomic instability on monoclonal antibody Merck – Newman Fellowship €138,000 2006 2008 

therapy response in colorectal ex vivo explants. 

Dr. Jacintha O’Sullivan & Frequency of random mutations and genomic instability HRB NCI Cancer €110,000 2007 2009 

Prof. L. Loeb (Seattle) Post events during colorectal cancer progression. Prevention Grant 

Doctoral Fellow Edward Fox 

Prof. D. O’Donoghue, Independent validation of a prognostic gene signature Almac Diagnostics €177,000 2006 2008 

Dr. Jacintha O’Sullivan, 

for Stage II colorectal cancer 

Prof Johnston & Prof. Harkin 

Centre for Colorectal Disease The role of dendritic cell function and its role in governing IRCSET €72,000 2008 2011 

treatment response to molecular targeted therapies in 

colorectal cancer patients 

Dr. J. O’Sullivan microRNA Regulation of the Spindle Assembly Checkpoint Cancer Research Ireland €224,826 2008 2011 

(co-applicant) 

(SAC): Implications for Cell Cycle Dysregulation in Ovarian 

Cancer and Taxol Responsiveness. 

Dr. J. O’Sullivan/ The biological effects of nicotine and cigarette smoke extract Abbott: Newman Fellowship €138,000 2008 2010 

Prof. D. O’Donoghue 

in fibroblasts and explants from Ulcerative and Crohns patients 

Dr. J. O’Sullivan/ Radiation Responses in Rectal Cancer Patients Irish Health Foundation €80,000 2008 2010 

Prof. K. Sheahan 

53 








Prof. D. Veale/Dr. U. Fearon IL-17 regulates cytoskeletal rearrangement and cell matrix PRTLI Cycle 4, PhD studentship €98,000 2008 2011 

interactions to promote cell migration and cartilage invasion in (Bio) Pharmaceutical and 

in inflammatory arthritis. 

pharmacological sciences 

Prof. D.Veale/Dr. U. Fearon/ To examine the expression and functional interactions of HRB PhD Clinical Fellowship €250,000 2008 2011 


IL-22 in the pathogenesis of inflammatory arthritis 

and disease outcome 

Dr. U. Fearon/Prof. D. Veale/ A-SAA regulates cytoskeletal rearrangement and cell matrix HRB Project Grant 2005 €140,000 2005 2008 

Prof B. Bresnihan 

interactions to promote cell migration and cartilage 

invasion in inflammatory arthritis. 

Prof. D. Veale/Dr. U. Fearon/ Hypoxia and altered mitochondrial bioenergetics results HRB Translational €1,500,000 2006 2011 

Dr. J. O’Sullivan/ Dr. C. Taylor in cellular transcriptional and metabolic profiles to drive Programme Award 

angiogenesis and the inflammatory response 

Prof. D. Veale/Dr. U. Fearon Studies of novel cytokines using synovial/cartilage GSK €750,000 2006 2008 

explant cultures 

Prof. D. Veale/Dr. U. Fearon Proof of Concept Studies GSK €680,000 2006 2008 

Prof. B. Bresnihan/ 

Prof. D. Veale/ Curing Autoimmune Disease – translational approach EU 6th Framework €800,000 2006 2011 

Prof. O FitzGerald 

54 








Prof. D. Veale (co-applicant) Biopharmaceutical/Pharmaceutical Science Programme PRTLI Cycle 4 €4,600,000 2007 2012 

Prof. Doug Veale/ To examine the expression and functional interactions of Health Research Board €250,000 2008 2011 

Dr. BernadetteLynch/ IL-22 in the pathogenesis of inflammatory arthritis and PhD Clinical Fellowship 

Dr. Ursula Fearon. 

disease outcome 

Prof. Doug Veale/ IL-17 regulates cytoskeletal rearrangement and cell PRTLI Cycle 4, PhD Studentship in €98,000 2008 2011 

Dr. Ursula Fearon matrix interactions to promote cell migration and (Bio) Pharmaceutical and 

cartilage invasion in inflammatory arthritis 

pharmacological sciences 

Prof. K. Malone Suicide in Ireland Survey Turn the Tide of Suicide Charity €200,000 2006 2010 

National Office for Suicide Prevention €100,000 

National Lottery €200,000 

ESB Electric Aid €75,000 

Be No Afraid €40,000 

Prof. K. Malone & 100 Lived Lives Ireland Funds (Denis Kelleher Ad Astra €100,000 2006 2010 

Dr. S. McGuinness 

PhD Scholarship) 

Prof. K. Malone & Peer Effects of Young Male Suicide in Ireland Turn the Tide of Suicide Charity €75,000 2008 2011 

Dr. L. Sweeney 

(3Ts Ad Astra PhD Scholarship) 

Prof. K. Malone & The 2nd Chance Study Ireland Funds of Monaco (Ad Astra €75,000 2008 2011 

Leah Quinlivan 

Scholarship in Suicide Studies) 

55 








Prof. K. Malone, PsychoNeurobiology Studies in Suicidal Depression Craig Dobbin Newman Scholarship in €75,000 2005 2009 

Prof. C. O’Farrelly, 

Mental Health Research 

Dr. J. O’Sullivan, American Foundation for Suicide €100,000 

Dr. G. Rush. Dr. A. O’Donovan 

Prevention 

Prof. D. O’Shea/ Obesity immunity and inflammation Newman Scholarship (sponsored €100,000 2007 2008 

Dr. L. Lynch 

by Sanofi Aventis) 

Prof. D. O’Shea Obesity and the Immune System Newman Scholarship (sponsored €100,000 2008 2011 

by Sanofi Aventis) 

Dr. L. Lynch Smoking and the development of type 2 diabetes H.R.B. €240,000 2008 2011 

Prof. D O’Shea/ Mesenchymal Stem Cell properties in obesity and ICHMT Endocrine Research Bursuary €50,000 2008 2009 

Dr. M. Dennedy metabolic health (funded by Sanofi Aventis) 

Dr. L. Lynch The human omentum as an immunological tool L’Oreal UNESCO International €35,000 2008 2010 

Women in Science Fellowship 

Prof. D. O’Shea Adipocyte size and type 2 diabetes; a study of patients HRB Clinical Fellowship €180,000 2007 2009 

undergoing bariatric surgery. 

Prof. Donal O’Shea Adipocyte size and type 2 diabetes; a study of patients Diabetes Federation of Ireland & €180,000 2006 2009 

undergoing bariatric surgery. 

Medical Research Charities 

56 



St. Michael’s Hospital 


57


St. Michael’s Hospital Report 

I am pleased to report on the activity and 

developments in St. Michael’s Hospital during 2008. 

We continue to develop services within the Healthcare 

Group, while on a National basis the Health Service 

Executive continued with its programme of reform. 

hospital’s physical facilities and general infra-structure. 

Developments included up-grading ward toilets, 

bathrooms and kitchens and the completion of the 

waste management facility. Work commenced on 

refurbishing the building beside the doctors’ residence. 

St. Michael’s Hospital prepared and submitted a Service 

Plan, in conjunction with St. Vincent’s University 

Hospital to the Health Service Executive (HSE). The 

Service Plan detailed the hospital’s projected 

expenditures, patient activity and capital funding 

requirements. This set the agenda for the Monthly 

Monitoring Performance Meetings with the Health 

Service Executive. 

While demand for hospital services increased the 

hospital achieved break-even in relation to its noncapital 

allocation. Work continued on addressing the 

In 2007 approval was granted to appoint a Design 

Team for a Theatre and a CSSD Up-Grade. In 

conjunction with the Estates Department of the HSE 

this work continued in 2008 and a Design Team was 

appointed. In late 2008 the economic environment 

changed and the HSE has to-date not sanctioned 

Capital Funding to progress to the next stage. 

As part of St. Vincent’s Healthcare Group, we 

commenced the process of applying for Accreditation 

with JCI and had our first consultation meeting with JCI 

surveyors. 

58 

Return to Contents



Radiology 

In 2008 our Radiology System, commonly known as 

RIS/PACs, demonstrated its true potential. This system 

is a major departure from traditional radiology systems 

and has proven to be of immense benefit to both 

patients and clinicians. There has been a steady 

increase in the total patient throughput. 

Pharmacy 

The pharmacy department has added to hospital 

policies and guidelines as part of hospital process of 

application for JCI accreditation. An antibiotic audit was 

carried out with the microbiologist to monitor appropriate 

antibiotic use. Follow-up monitoring of antibiotic 

prescribing is being carried out by ward pharmacists, 

who liaise with microbiology. A new medication record 

is now in use. Future initiatives will include the 

introduction of a new medication management policy, 

new warfarin information packs and a new medication 

incident form. 

I.C.T. 

In 2008 we rolled out our improved hospital website 

which gives the public information about the hospital 

and its services. Other completed projects included the 

final phase of the digital CCTV security system and 

rollout of the latest software for managing large groups 

of Windows-based computer systems. 

2008 also saw the continuous improvement and 

consolidation of ICT in the hospital. This included 

updating the network infra-structure, updating servers 

and desktops, implementing improvements on ICT 

security and maintaining high speed links to St Vincent’s 

University Hospital. These ongoing activities improve 

critical ICT services which support the day to day 

activities of the hospital. 

Library 

The Library was used consistently throughout the year 

as study space by groups such as the final year nursing 

students, the midwifery students and medical students. 

Information services included a monthly current 

notification service to Department Heads, Consultants 

and Registrars. The heritage on-line catalogue is also 

available on the internet and on the general SVHG 

electronic resources web-page. 

59 

Return to Contents



Laboratory 

In Pathology the workload increased by 5.5% 

compared with 2007. New developments included the 

introduction of the “Raid” dose monitoring system to 

the warfarin clinic. This introduced uniformity of warfarin 

dose monitoring across the Healthcare Group. The 

introduction of the electronic issuing of test results to 

GP’s in the community commenced. Preparations 

continued to meet the EU Directives on Blood. A pilot 

blood transfusion service was developed and tested 

between St. Vincent’s University Hospital and St. 

Michael’s Hospital. 

Human Resources 

The Human Resources Department hosted a number 

of Forum meetings with Department Heads and Line 

Managers during the year covering a wide range of 

issues and areas of interest including attendance 

management, occupational health, performance 

indicators, and team based performance management. 

Regular updates on HR related issues at national and 

local level were also given. 

In January five of our long serving staff received awards 

for over 30 years service each at the Annual Service 

Awards held in the Education and Research Centre at 

St. Vincent’s University Hospital. They are Marian Coyle, 

Catherine Fitzpatrick, Marie McBryan, Declan McCallig 

and Paul Riesbeck. Betty Langan who had just recently 

retired also received an award for over 30 years service. 

Congratulations to all of them! 

Retirements during 2008 included Mary Hughes and 

Pauline Wrixon from Radiography, Nuala Kelly from A&E 

and Kathy O’Brien from Nursing Administration. 

Eleanor Keane, CNM2 from Theatre also retired. 

Eleanor previously worked in the Private Hospital and 

also led the development of our Hospital Sterile 

Services Department. Our long standing electrician 

Tony Pritchard retired also. We would like to wish each 

one a long, happy and healthy retirement and to thank 

all of them for their service and dedication to St. 

Michael’s Hospital and to our patients. 

Nursing 

The Nursing Staff are proud to be part of the 

multidisciplinary team at St. Michael’s Hospital and to 

continue in their endeavours to give holistic care to the 

patient population from Dun Laoghaire, the surrounding 

areas and the many visitors that crossed the threshold 

over the past year. 

The Nursing Staff welcomed Frances Campbell to the 

position of Nurse Practice Development and Karen 

Sweeney to the Clinical ADON position. 

The Endoscopy Unit had a significant increase in GP 

referrals for endoscopy procedures. To facilitate this, Day 

Ward patients were accommodated in St. Patrick’s Ward. 

The Infection Control Team led the Hygiene Services for 

the HIQA Hygiene Services Quality Review throughout 

the hospital and they are to be commended for their 

hard work and dedication. The Palliative Care Facilitator 

introduced the Liverpool Care Pathway in November 

and to date patients have been very successfully 

managed on the pathway, which encompasses the 

physical, psychological, religious/spiritual and social care 

of the patient. 

We celebrated our student nurses graduation here in 

July and a number of the graduates joined the staff of 

60 

Return to Contents



the hospital on registration and are a very important part 

of the nursing team. The Nursing Staff in St. Michael’s 

Hospital continue to be advocates for patients and 

strive to deliver efficient, effective and focused care to 

all they meet each day in a professional manner. 

Chaplaincy 

In May we said goodbye to our chaplain, Fr. Seamus 

Fleming who retired after seven years service and took 

a well deserved break in Egypt. We wish Fr. Fleming 

well in his retirement. Fr. Hyacinth Nwakuna assisted 

over the summer months until September when we 

welcomed Fr. Tom McDonald to our staff. 

Quality & Risk Department 

The Quality Department in St. Michael’s Hospital covers 

a number of key elements of hospital activity, such as 

Quality & Risk Management, Patient Services, Complaints 

Management and an input in developing and structuring 

policies and procedures. During 2008 developments 

took place in each of these areas, the most significant 

of which was the successful implementation of the 

New National Patient Chart designed by the NHO 

Healthcare Records Steering Committee. 

Risk Management and Quality systems were further 

developed so that more risks are identified and 

incidents reported. The introduction of a Monthly Risk 

Management Information Report has proved beneficial 

in both the sharing and learning from incidents thereby 

improving our overall risk management approach. 

Conclusion 

I would like to take this opportunity to express my 

appreciation and thanks to all hospital staff for their ongoing 

work and commitment to the provision of quality 

service to patients in St. Michael’s Hospital. 

I thank the Religious Sisters’ of Charity and the Board of 

Directors’ for their continued commitment to 

developing St. Michael’s Hospital. 

I thank the Members of the Executive Council, the 

Medical Forum and members of the various other 

committees within St. Michael’s Hospital for their 

support and help throughout the year. 

Finally, I would like to conclude by thanking the Group 

Chief Executive Officer, Mr. N.C. Jermyn and the HSE for 

their support during 2008. 

61 

Return to Contents



Organisation Structure 

62 

Return to Contents


St. Vincent’s Private Hospital 

63


St. Vincent's Private Hospital 

Overview 

St. Vincent’s Private Hospital achieved an overall surplus 

of €3.3m in 2008 which is in line with budget. This 

was a satisfactory result bearing in mind the additional 

costs associated with JCI Accreditation, implementation 

of the 37.5 hour week and a reduction in average inpatient 

occupancy. The hospital continued to expand its 

day care activity which contributed to the overall 

financial outcome. I would like to thank our Heads of 

Departments, consultants and staff who contributed to 

the various improvements made during the year which 

are outlined in this report. An agreement was reached 

with VHI for an 18 month agreement which will provide 

greater continuity. Agreements were also concluded 

with Quinn-Healthcare and Hibernian Aviva for 2008. 

While a number of public patients were provided with 

radiotherapy treatment as part of a service level 

agreement with the Health Services Executive this 

agreement concluded at the end of 2008. 

The hospital currently has 164 in-patient beds, 36 daycare 

spaces (including day-care oncology), operating 

theatres for major and minor surgery, endoscopy, 

diagnostic imaging which includes general radiography, 

CT, ultrasound and MRI and comprehensive oncology 

and radiotherapy services. Patient satisfaction with the 

hospital’s services remains high as evidenced by the 

results of the Patient Satisfaction Survey (Overall 

satisfaction rating of 97.7% for In-Patient and 98.8% for 

Day Care Services as outlined in the Corporate Services 

Report). Management continued to implement the 

strategic action plan which contains a number of quality 

improvement initiatives. I would like to thank Professor 

Diarmuid O’Donoghue and the members of the 

Consultants Forum for their support in relation to a 

wide range of issues during the year. 

Patient Activity 

In-Patient admissions for 2008 amounted to 7,930 a 

decrease of 5.1% over 2007. However General Day 

Cases were 4.8% up on 2007 as was day care 

oncology cases (12.8%). Radiotherapy activity is 2% 

lower than activity in 2007 and pathology tests are 

16% up overall. A summary of the Patient Activity for 

the year is contained in the Corporate Services Section 

of the Report. 

General Improvements 

A number of improvements were made in 2008 as 

follows: 

• Existing hospital policies updated and stored on 

shared directory 

• JCI Accreditation Survey carried out in October 2008 

with full or partial compliance achieved with 97% of 

the measureable elements. A follow up report will be 

provided to JCI by the hospital 

• Plans agreed and construction commenced in March 

2008 of the new 260 bed Private Hospital on the 

St. Anthony’s Site 

• Quality Improvement and Safety Committee 

Structure developed in compliance with JCI 

Standards 

• Quality Improvement Plan developed and approved 

by Executive Committee 

• Patient Scheduling System in Day Care Oncology 

introduced 

• TSSD computerised tracing system introduced 

A more detailed list of improvements is set out in the 

reports of the Divisional Managers. 

64 

Return to Contents



Executive Committee / Management Team 

The Executive Committee and Management Team 

continued to meet throughout the year to review and 

monitor progress in relation to the budget, service plan 

and performance indicators. The Management Team 

also participated on the Quality Improvement and Safety 

Committee which is responsible for quality and risk 

management at the hospital. 

Regular meetings were held with the Heads of 

Departments and staff during the year. At these meetings, 

the Management Team provided updates on the 

hospital’s clinical and financial performance and on 

relevant internal and external factors affecting the 

hospital. 

The Management Team also provide an induction 

programme for new staff to familiarise them with the 

hospital and its policies and procedures. They also 

produced a number of Newsletters to keep all staff 

updated on developments during the year. 

New Private Hospital 

Work is progressing with the Design Team in relation to 

the design, construction and commissioning of the new 

260 bed private hospital on the St. Anthony’s Site. Senior 

management participated on the user groups with the 

Design Team to finalise the detailed design aspects of 

the hospital. The Design Team comprises Scott Tallon 

and Walker, Architects, Bruce Shaw, Quantity Surveyors, 

Buro Happold, Mechanical and Electrical Engineers and 

ARUP, Structural Engineers. Following a tender John Paul 

Construction was selected as the Main Contractor for the 

project and construction work commenced on 10/3/2008. 

Michael Redmond 

Chief Executive 

65 

Return to Contents



Consultant’s Forum 

The Consultants Forum met on a monthly basis 

throughout the year with hospital management. The 

Forum includes representation from medicine (3), 

surgery (3), anaesthetics (1), Diagnostic Imaging (1), 

Pathology and Board nominations (3). Thanks are due 

to all of the consultants who participated on the Forum 

during the year. 

Among the issues considered by the Forum were the 

following: 

• Development of the New Private Hospital 

• Development of IMRT Services 

• Admitting Privileges 

Professor D. O’Donoghue, Dr. P. Quigley and Mr. D. 

Quinlan represent the Forum on the Executive 

Committee and Professor W. McNicholas and Mr. 

E.McDermott represent the Forum on the Best Practice 

Group. Mr. S. Sheehan and Dr. N. McDonald represent 

the Forum on the Theatre Utilisation Committee. 

Prof. O’Donoghue participated on the Clinical Record 

Review Group which was established to ensure that our 

clinical records are maintained in accordance with the 

HSE Guidelines and JCI Standards. Significant 

improvements were made during the year to ensure 

compliance with the clinical record policies and 

procedures. A number of audits were carried out and 

follow up action taken. 

• Radiology Reporting 

• Review of Hospital Activity Levels 

• Development of RIS/PACS 

• Patient Medical Record 

Professor Diarmuid O’Donoghue 

Chairman, Consultants Forum 

• JCI Accreditation Survey 

• Claims processing working group 

• Theatre Utilisation 

66 

Return to Contents



Corporate Services Division 

The work of the Corporate Services Division comprises 

a number of key elements. These include Quality 

Improvement, Safety and Risk Management, Information 

Technology, Capital Development and Statistics. During 

2008 each element was progressed. 

Quality Improvement, Safety and Risk 

Management 

Quality Improvement and Safety was a core element of 

the entire year, both in the Corporate Services Division 

and throughout the Hospital. In February we applied to 

the Joint Commission International (JCI) for Accreditation. 

Following a consultative survey in April and seven months 

of concentrated work, the Hospital was surveyed by JCI 

in October. A very positive report was received in 

December, with the hospital meeting the vast majority 

of the standards. Three areas were highlighted requiring 

additional work to reach the required standard and a 

report on the hospitals progress in this regard will be 

sent to JCI during 2009. 

A major strengthening of the Governance structure for 

Quality and Safety formed the lynchpin of the hospital’s 

drive for accreditation. The existing Best Practice 

Committee structure was expanded into the Quality 

Improvement and Safety Committee. This Committee, 

reporting to the Chief Executive, provides an overarching 

Governance structure encompassing all hospital 

committees relating to quality, safety and risk 

management. Committees feeding into it include: 

• Health & Safety Committee 

• Radiation Safety Committee 

• Accreditation Steering Committee 

• Incident Reporting Grading Group 

• Hygiene Services Group 

In addition formal linkage with Group Committees was 

established in the following areas: 

• Infection Control 

• Clinical Audit 

• Drugs & Therapeutics 

The Quality Improvement & Safety membership 

comprises the senior management team and two 

representatives of the Consultants Forum. 

The work programme of the Committee in 2008 

included: 

• Development, review and approval of Hospital 

policies in conjunction with the Health & Safety 

Committee. 

• BP001 Moving and Handling 

• BP002 Notifiable Infectious Diseases 

• BP005 Prescription Criteria 

• BP009 Risk Assessment Process 

• BP018 Dress Code Policy 

• BP013 Search Policy 

• BP015 Complaints Policy 

The Hospital Safety Statement (BP000) is reviewed 

annually and was updated in December 2008. The 

Statement was approved by the Quality Improvement & 

Safety Committee and distributed to staff. 

The Hospital Internal Emergency and Contingency plan 

was again reviewed, augmented and approved by the 

Quality Improvement & Safety Committee. A response 

to major external emergencies in the community was 

added. The plan was tested with a programme of 

planned evacuations and desktop exercises. 

67 

Return to Contents




Incident Reporting 

• A report on incidents was presented monthly to 

the Quality Improvement & Safety Committee 

and Heads of Departments. 

• A monthly report of all Medication Incidents was 

presented to the Committee. 

• A monthly report of all incidents rated as 

medium or high risk by the Grading Group was 

presented to the Committee. 

• Information sessions for staff were provided in 

October to raise awareness of the process and 

the importance of staff participation. All induction 

sessions include information on the incident 

reporting process. 

Patient Satisfaction 

• The ongoing satisfaction survey, for in-patients 

and day patients, continued in 2008. 54 inpatient 

submissions were received with an 

overall satisfaction rating of 97.7%. 87 daycare 

submissions were received with an overall 

satisfaction rating of 98.8%. A monthly report 

including statistical analysis and commentary was 

prepared and actions taken, where appropriate, 

arising from patients comments. 

Complaints and Legal Cases 

• The management of patient complaints 

consumed a considerable amount of the time 

and resources of the Corporate Services Division 

in 2008. Forty-eight formal complaints were 

dealt with and concluded with a combination of 

letters, telephone calls and direct meetings with 

the complaining parties. At the commencement 

of 2008 twelve legal cases were active. During 

the year, two cases were cleared and two new 

cases were initiated against the hospital, leaving 

twelve active cases at year-end. 

Infection Control 

• The Group Infection Control Committee provides 

infection control guidance for the three hospitals 

in the St Vincent’s Healthcare Group. The private 

hospital is well represented on the committee. In 

our Hospital two external audits of the control 

and transport of dangerous goods were carried 

out and also a hygiene audit. Action plans were 

developed from the audit findings and the risk 

issues closed out or reduced. From Board level 

through the organisation a culture is fostered to 

control and reduce infection and this goal is 

driven through the Quality Improvement & Safety 

Committee. During 2008 our Clinical Nurse 

Manager in infection control worked closely with 

the Group. 

Health & Safety Committee 

• The Health & Safety Committee prepared a plan 

for 2008 and completed its action points during 

the year. Staff training in Fire Safety, CPR, Manual 

Handling, Hand Hygiene and Food Hygiene was 

actively pursued. The Water Safety Management 

and Waste Management Sub-Groups achieved a 

programme of work to ensure that the hospital 

complies with legislation and safeguards patients 

and staff. 

Information Technology 

The Hospital continued its service level agreement with 

the ICT Department of St. Vincent’s University Hospital 

in 2008. An additional IT project manager was added to 

the team to address a number of the projects which 

will take place in the coming year and in preparation for 

the new hospital. 

Considerable work has been achieved in bringing the 

infrastructure of ICT up to a new level and in providing 

a secure and robust platform for future development. 

68 

Return to Contents




The upgrade work is part of an ongoing programme of 

development. Key enhancements of the IT structure 

were carried out in Pharmacy, Pulmonary Function and 

the hospital network. 

New applications were introduced to provide a patient 

scheduling system in Oncology Daycare and TSSD tracing. 

Planning for ICT in the new Hospital continued, with 

plans being developed for hardware and applications. 

This work will continue to be refined in the next year. 

Capital Development 

The planning and preparation for the new Hospital 

continued in 2008. This exciting project has been 

progressed with the design team and the commitment 

will continue, through the design and build stages, to 

completion in 2009 / 2010. 

In 2008 capital expenditure also continued on major 

and minor developments to ensure the continued high 

level of service in the period prior to the opening of the 

new Hospital. Projects completed included: 

• Fire Safety Doors and Fire Sealing work 

• Emergency lighting and signage 

• Operating theatre Refurbishment 

• HANU ward development 

Jan to Dec Jan to Dec Variance Variance 

2007 2008 % 

Patient Discharges In-patients 8,355 7,930 -425 -5.1% 

In-patient Occupancy 83.54% 81.30% -2.2% -2.7% 

In-patient Bed days 46,336 44,967 -1,369 -3.0% 

Av. Length of stay (Days) 5.55 5.67 0.12 2.2% 

Daycases Daycases 7,482 7,841 359 4.8% 

Oncology Daycases 5,816 6,559 743 12.8% 

Operating Theatres SVPH Theatres 3,941 3,684 -257 -6.5% 

Theatre SVUH 779 991 212 27% 

Minor Operating Theatre 4,979 4,671 -308 -6.2% 

Endoscopy unit 5,760 5,694 -66 -1.1% 

Diagnostic Imaging No of Studies 29,397 29,569 172 0.6% 

Radiotherapy No of Treatments 14,764 14,448 -316 -2% 

Cardiology No of Procedures 6,478 6,572 94 1.5% 

Respiratory Medicine No of Procedures 3,029 3,537 508 17% 

Pathology Tests No of Procedures 466,476 540,097 73,621 16% 

69 

Return to Contents



Nursing Division 

Overview 

Nursing Division made substantial progress in 2008 by 

introducing Quality Improvement initiatives using the 

structure of the Joint Commission International 

Accreditation process as a focus. We worked in close 

collaboration with colleagues in other Divisions. Nursing 

is a collaborative profession existing in a complex health 

care system facing the familiar challenge in 2008 of 

cost versus quality. The availability of qualified nurses to 

the labour market allowed us to work towards our goals 

with a stable workforce and saw us less reliant on 

transient agency nurses. 

June saw the introduction of the 37.5 hour working 

week for nurses within the agreed criteria. 

The summer months saw us engaged in preparations 

for JCI survey. Thanks to the tremendous effort by all in 

the Nursing Division we were able to successfully 

bridge the gaps between the mock survey in April and 

the October survey by meeting the criteria outlined in 

the JCI Manual. 

Staffing 

Much progress was made in 2008 in the area of 

recruitment with nursing complements being filled 

consistently throughout the year. Eleven new graduate 

nurses were recruited in July and following a very 

successful orientation programme integrated very well 

into patient care areas. 

Educational, Professional and Personal Development 

support was valued. Our Clinical Nurse Specialists 

provided expert support and enhanced the quality of 

patient care. 

Clinical Nurse Managers together with their teams 

excelled in their commitment to the hospital most 

especially in the weeks prior to the JCI survey. 

Our portering team underwent a review of the service 

and agreed changes to practice to enhance service 

delivery. 

Our Chaplaincy team provided much support to 

patients and staff. 

The Admissions Department remained adaptable in 

managing demand for in-patient admissions. 

70 

Return to Contents




Service Developments/Activities 

Hawthorn Ward 

The Hawthorn Acute Nursing Unit (H.A.N.U.) opened in 

February to allow for cohorting of patients post major 

abdominal surgeries following return to S.V.P.H. from 

ITU and HDU. Much collaboration with staffing in SVUH 

took place with staff in ITU and with the Outreach 

Programme Co-ordinator in order to develop a nurse 

education programme with a decision tree algorithm. A 

trigger alert system was developed to allow for 

appropriate and timely interventions to prevent patients 

returning to ITU with complications. 

Haemovigilence 

The QI's to date for 2008 Haemovigilance are: 

• Successful completion of Irish National Accreditation 

Board inspection of Hospital Blood Bank and 

Haemovigilance - EU Directive 20002/98/EC. 

(Traceability and Haemovigilance) 

• Audits - Blood Collection 

- Transfusion Documentation 

• Continuous surveillance of transfusion practice 

• Cannulation Training - Ongoing training and clinical 

supervision of staff nurses requiring the skills 

Staff Development & Orientation 

Training needs analysis was undertaken in 2008. Both 

in-service education programmes and support for courses 

were provided. Evaluation on Study Day for night staff 

reported high levels of support from management. 

Some staff identified to undergo Basic Life Support and 

Advanced Life Support Courses in order to train our 

staff. 

Infection Prevention and Control 

The following initiatives were carried out in 2008: 

Decontamination Unit 

Tracking and traceability system was installed in CSSD in 

October. Following an inventory of medical devices 

used in St. Vincent’s Private Hospital, almost all items at 

ward level are now included in the traceability system. 

Day Care Oncology 

Day Care Oncology saw the restructuring of seating 

arrangements to accommodate more patients. Times of 

appointments and opening hours changed to suit 

patient / service needs. A new Patient Information 

Booklet called ‘Avoiding Infections’ was introduced. 

Cardiology 

A four-bedded cardiac specific unit on the Redwood 

Ward continued to facilitate patients having angioplasty. 

Previously private patients had to be nursed for 24 hours 

in the University Hospital following the procedure. This 

unit is also used as a day unit for cardiac procedures such 

as coronary angiogram and transoesophageal echos 

and a rapid admission unit for heart failure patients. 

a) Infection Control Upgrading of all Bedpan 

sterilisers to Washer Disinfectors. 

b) Upgrade of Hawthorn sluice room and HANU Unit 

c) Introduction of Spill kits and Actichlor plus disinfectant 

d) Upgrade of dressing sets to improve antiseptic 

techniques 

e) Public information notice board in main hall 

f) Introduction of new information leaflets 

71 

Return to Contents




g) Introduction of infection control manual group wide 

h) Completed installation of Danicenters (Glove and 

apron holders) outside all patients rooms 

i) Introduction of Wiva Bin Holders in all sluice areas 

j) Programme of installation of hands free silent closing 

bins both for domestic waste and clinical waste 

k) Installation of air-conditioning units in the Cedar ward 

l) Installation of hepafiltered system in Daycare 

Oncology 

r) Upgrade of Cleaners Room on 1st floor with plan 

to upgrading all such rooms 

s) Change in practice in transportation of blood 

samples (introduction of box to carry samples) 

t) Change in practice in transportation and storage of 

clinical waste 

u) Upgrade of linen transport trolleys to ward areas 

v) Replacement of Linen trolleys at ward level 

w) Upgrading dressing clinic with suitable storage 

system. 

m) Installation of air-conditioning unit in Day Surgery 

n) Installation of new endoscope washers in Endoscopy 

o) Commencement of water testing in Day Care 

Endoscopy 

p) Upgrading of hand hygiene facilities i.e. soap and 

c-fold hand towel dispensers 

q) Upgrade of some hand hygiene sinks 

Outstanding/Significant Achievements 

In July we celebrated Sr. Sheila’s Golden Jubilee and 

honoured her much valued service and support to both 

staff and patients. It was fitting that Sr. Sheila’s Golden 

Jubilee year also coincided with a special year in the 

history of The Religious Sisters of Charity as we 

commemorated one hundred and fifty years since 

Mother Mary Aikenhead set up the religious order to 

care for the poor. 

72 

Return to Contents




Ms. Oonagh Ryan (Clinical Nurse Manager 2 – C.S.S.D.) 

represented Ireland when invited to speak at the 

‘Patient Safety Medical Congress Decontamination and 

Sterilisation Conference’ in Abu Dhabi in October 2008 

& ‘World Forum of Hospital Sterile Supplies Conference’ 

in Milan in June. 

Mission Effectiveness 

A Mass to celebrate 150 Years of the Religious Sisters 

of Charity took place on Thursday 19th June 2008 at 

4pm in the Coffee Shop. 

The Endoscopy Department showed an annual 1.1% 

decrease due to technical difficulties in January but 

maintained a monthly increase for the remainder of the 

year. 

SVPH and Minor Operating Theatres showed a 

decrease in activity for 2008 due to vacant sessions. 

Future Plans 

• The appointment of Ms. Deirdre Pyne as Nurse 

Planner assisted us significantly in preparing for the 

move to the New Hospital. Deirdre will continue to 

liaise with staff and the Project Team in 2009 focusing 

on operational policies and human resource 

requirements. 

• Development of a self-medication policy to improve 

quality of care and enhance patients’ knowledge of 

their medication. 

• Provide clinical placement facilities for undergraduate 

student nurses from SVUH and SMH. 

• Develop at least one clinical care pathway. 

A country and western themed barbecue for staff took 

place on 3rd July 2008 in aid of the Chernobyl 

Children’s Project International. €2,723 was raised for 

this project and the night was a great success. 

The Children’s Christmas Party was held on 20th 

December 2008. We had a record number of 

attendees and great fun was had by all. 

Departmental Statistics 

Activity levels increased consistently in 2008 with both 

Day Care and Day Care Oncology increasing throughput 

by 24% compared to 2007. 

Daycases 

Jan to December Jan to December Variance Variance % 

2007 2008 

Daycases 7,482 7,841 359 4.8% 

Oncology Daycases 5,816 6,559 743 12.8% 

Operating Theatres 

Theatre S.V.P.H 3,941 3,684 -257 -6.5% 

Theatre S.V.U.H 779 991 212 27% 

Minor Operating Theatre 4,979 4,671 -308 -6.2% 

Endoscopy Unit 5,760 5,694 -66 -1.1% 

73 

Return to Contents



Human Resources Division 

Mission / Vision 

“The Mission of the HR Division is to design and deliver 

innovative HR services in partnership with the Hospital 

and the Healthcare Group to ensure a progressive, 

equitable and challenging environment for staff, and a 

quality service for patients.” 

Our Vision is to lead the way in HR expertise, creating a 

unique environment for our people that will generate 

success for the Hospital and the Healthcare Group. 

Our Values include: 

• Being the guardian of fairness and equity 

• Valuing all our staff 

• Listening and responding appropriately 

• Balancing people and business needs 

• Learning from our successes and our mistakes 

• Communicating intentions and expectations clearly 

• Advising Managers on how to manage performance 

fairly and firmly 

Overview 

The HR Division continues to manage all of the 

activities relating to the personnel function, namely - to 

assist management to enhance the individual and 

collective contributions of staff in achieving the Mission 

and Objectives of the Hospital; to advise and assist all 

line managers on matters relating to staff; to provide 

information to staff on all employment matters and to 

carry out the Employee Relations function of the 

Hospital. The volume of employment legislation 

continues to grow and the HR Division ensures that the 

hospital complies with all employment legislation 

enacted over the last number of years. 

The main activities that derive from these roles are 

recruitment and selection; staff development and 

training; employee relations, implementation of policies 

and procedures, manpower planning, benefits 

administration, personnel administration and 

organisation development. The wide span of activities 

places an onerous burden on staff and I would like to 

thank Ms Erin Fitzgerald and Ms Barbara Power for their 

commitment and support during the year. Erin joined 

the staff of the HR Division in July 2007 and Barbara in 

December 2007. After nearly seven years service Ms 

Marian Murphy left the Department in September 2007. 

I would like to thank Marian for her major contribution 

to the Hospital during that time. Earlier in the Year Ms 

Colette McNamara left the Department for pastures 

new and I would like to thank Colette for her service to 

the Department and the Hospital. 

Occupational Health Service 

St Vincent’s Private Hospital has entered into an 

agreement with St Vincent’s University Hospital for the 

purchase of Occupational Health Services for Private 

Hospital staff. This service commenced on March 1st 

2005, and the main elements of the service are: 

• Treatment of inoculation injuries and risk 

management follow up 

• Immune status evaluation 

• Pre-employment assessment 

• Flu vaccination 

• Management referrals 

• Pregnancy Risk Assessments 

• Occupational Psychologist 

74 

Return to Contents




The provision of this service supports our duty of care 

to staff under Health & Safety legislation, and also assists 

with Best Practice initiatives. During the year ‘Be Sharp 

Be Safe’ workshops were held on all Nursing floors and 

Theatre. All were well attended by staff. The Occupational 

Health Department also participated in Health & Safety 

Week, orientation days and also at Health Promotion 

events. Advice was given to managers and staff on 

issues concerning Health & Safety matters. The feedback 

from staff has been very positive. During 2007 the 

service was expanded to include Pregnancy Risk 

Assessments and the services of the Occupational 

Health Psychologist (Ms Nuala Gannon). I would like to 

thank Nuala for her support to staff during the year. 

I would also like to thank Ms Ann O’Reilly and all the 

staff of the Occupational Health Department for their 

assistance and support throughout the year. 

Training & Development. 

A Management Development Programme was provided 

for Department Heads in the Support Services and Allied 

Health Divisions. A total of 30 staff attended workshops 

in February / March, May & November. Feedback from 

staff that have participated in the programme is very 

positive This programme will continue in 2009. The 

Training was provided by Quantum Training. 

The Management Team also undertook Management 

Development Training in September and this programme 

will continue in 2009. Induction training was provided 

on five occasions during the year for new staff and 60 

employees attended. Seminars were held in May on 

‘Dignity at Work’, dealing with the whole area of bullying 

and harassment and 45 staff attended. It is planned to 

continue with this programme in 2009. Four staff 

attended Retirement Planning courses. Customer care 

training was provided in May and September and a 

total of 17 staff attended two courses. 

Support was given to a number of staff for courses of 

study in their own time. This support took the form of 

financial support and study leave. A number of staff 

completed the ‘Diploma in First Line Management’ which 

was provided by the National College of Ireland. 10 

Care Assistants completed the FETAC Level Five course. 

Seminars on Pensions and Additional Voluntary 

Contributions (AVCs) were also held for staff and 

delivered by representatives from Mercer and Irish Life. 

Recruitment, Selection & Retention 

Recruitment and retention of staff remains a challenge 

and difficulties continue in sourcing a number of grades 

of staff including Radiographers, Doctors, Nurses, 

Pharmacy and experienced Administration staff. 

75 

Return to Contents




Recruitment of staff from overseas continues on an 

ongoing basis as required. 

The HR Division assisted other Divisions with the 

selection of candidates for internal promotion vacancies. 

Third column is a summary of HR activity in respect of 

Recruitment 

Detail 

Total 

No. of Ads placed 48 

No of Applications 412 

No of HR Interviews 44 

No. attended for interview 145 

meetings with Rights Commissioners, the Labour 

Relations Commission and the Labour Court. 

Throughout the year we worked closely with our 

colleagues in the salaries office - Ms Dorothy Nolan and 

Ms Yvonne Casserly. I would like to thank Dorothy and 

Yvonne for their valued assistance. 

Medical Records 

The HR Division also has responsibility for Medical 

Records (including Floor Secretary staff), and Patient 

Focus. Storage space for charts and x-ray films continues 

to be in short supply, and Day Surgery files are now being 

stored in the Department. Arrangements with ‘Medrex 

Systems Ireland Ltd’ continue to assist in providing 

solutions. Three new staff joined the Department in 2006. 

I would like to thank Ms Caitriona O’Connor, Ms Aoife 

O’Connor, Ms Phoebe Kenny O’Neill, Ms Mary Wolfe, 

Ms Geraldine Pender, Mr Ciaran O’Callaghan, Ms Ann 

Pender, Ms Katie Thompson-Chadwick and Ms Ann 

Cavey for the consistently high level of service they 

provide to patients and staff. 

Neil Twomey 

Human Resource Manager 

Personnel Administration 

In 2007 improvements were made in processes for 

measuring absenteeism and also for staff census / 

employment control 

The Chart below illustrates the starters and leavers for 

each division 

80 

70 

60 

50 

40 

30 

Number of Starters/Leavers by Division 

JOINERS 

LEAVERS 

Employee Relations 

A number of individual staff grievances were resolved 

by agreement with the staff members concerned. 

The HR Division represented the Hospital at various 

20 

10 

0 

ALLIED HEALTH NURSING HR SUPPORT SERVICE FINANCE SVUH 

76 

Return to Contents



Support Services Division 

The Support Services Division incorporates 

Reception, 

Security, 

Hygiene Services, 

Household Services, Maintenance, 

Projects, 

Patient and Staff Catering. 

Reception 

Margaret English and a staff of nine provide reception 

and front of house services throughout the hospital. Ger 

O’Nolan joined the team as Deputy Head Receptionist 

after 20 years working in the catering department. 

As reception is the first point of call for both patients 

and visitors the primary function is to promote a 

friendly and efficient environment. Some of the service 

improvements during the year were: 

Emergency Management 

• New Swipe key for emergency access to SVUH is 

now located at reception. 

• A new Emergency Link phone to SVUH has been 

set up at reception. 

• A new emergency phone was installed into the 

reception back office for use in the event of a 

telephone system breakdown. 

• The reception team were involved in compiling a 

crisis management plan for the Internal Disaster 

and Contingency Plan which incorporated: 

– Hostage siege situation 

– Civil unrest / demonstration 

– Discharge of firearms 

– Suspicious packages 

– Building lockdown 

Car Park 

• A new full time car park attendant/surveillance 

operative has joined the reception team. 

• There have been ongoing developments in relation 

to on site and off site car parking, which is being 

monitored by the reception team on a daily basis. 

• There is now extra security in Wanderers Car Park 

from October. The car park attendant is in the car 

park from 7am to 8am and from 4.30pm to 8.30pm. 

• A review was carried out on the Car Park Attendant’s 

job description in November. 

• The Risk Assessment was updated on the car park 

in November. 

77 

Return to Contents




General 

• All staff were trained on Microsoft Outlook Express 

• Post room was re-organised and new post boxes 

were up-graded 

Household Services 

Yvonne Gleeson, Household Services Officer has a team 

of 5 who provide a six-day service. The team provides 

support in relation to hygiene, laundry and hotel style 

services throughout the hospital. There were a lot of 

improvements during the year in preparation for the JCI 

audit that included upgrading of furniture and painting 

in numerous areas. Other areas that received extra 

attention were: 


• Updated work schedules were issued to all 

household staff 

Health and Safety 

• Skyway installed extra bolts on the roof so Noonan 

Services would have access to all windows 

• To meet the criteria required for our approved 

suppliers list, insurance cover and safety statements 

have been checked for all 13 Household Service 

Contractors 

• The clean-up week was organised for 25th – 29th 

August 2008 

• The format of the Access Route Report was changed 

in November. The new format will continue to be 

discussed at the monthly Health and Safety meetings. 

Hygiene Services 

• Irish Pest Management replaced 26 bait boxes 

(Rodent Monitors) 

• A new Linen and Laundry Policy is now in place 

Maintenance Department 

There are a total of 87 external contractors who service 

and maintain technical services equipment on a regular 

basis. There are two on-site personnel who work over 

six days. Non-routine work and projects are organised 

separately by using reputable outside firms. Approximately 

2,621 requisition dockets were completed in 2008 with 

an average of 240 being completed each month. In 

keeping with Health and Safety Regulations, an External 

Contractors Form is completed by all contractors and 

kept in the relevant project files. 

Service Contracts are in place for all necessary equipment 

and this is monitored through the support services 

administration office. 

Projects Completed 

External contractors carried out a total of 30 projects. All 

projects are monitored through the Projects Team. 

Project No 

Item 

200801 A new Fuse Board was fitted in the Kitchen 

200802 The Hawthorn Ward on the 2nd floor now 

has the 4 bedded HANU Unit 

200803 The Maple Unit got a new Bed Pan Washer / 

Steriliser fitted 

200804 The Nursing Administration Office was 

Restructured 

200805 St Joseph’s room was Refurbished to include 

lighting, painting and new air conditioning 

200806 Repair roof leak on the roof top garden 

200807 2 Bicycle Shelters installed 

200808 Air Conditioning -- Minor Op Unit 

200809 Air Conditioning Units in 4 Kitchenettes 

200810 Refurbishment of gents washroom at reception 

200811 Refurbishment of ladies washroom at reception 

200812 New Smoking Shelter installed at Decking Area 

200813 Refurbishment of Radiotherapy treatment 

planning room 

200814 Refurbishment in Operating Theatre that 

included a new Sluice Washer, Flooring, 

Painting and new fire doors. 

200815 Refurbishment of Cleaning Contractor laundry 

in the basement 

200816 Refurbishment of Pharmacy lobby 

78 

Return to Contents




Project No 

Item 

200817 Essential maintenance in the Heating Plant Rm 

200818 Following the JCI mock audit all fire 

penetration walls sealed to ensue integrity of 

fire compartments 

200819 Upgrade works completed in Pulmonary 

Function Test Wash Rooms 

200820 Air Conditioning in the Linen Room 

200821 Following the JCI mock audit the number of 

emergency lights were and exit signs were 

increased and some of the existing ones 

were upgraded. 

200822 Refurbishment of the dark room in X- Ray 

200823 Safes are now provided in patient areas 

200824 New Storage unit installed for Medical Gases 

200825 Following an external audit based on Hygiene 

Services requirements the Cara Unit/ 

Preparation Room was refurbished. 

200826 A Portocabin was installed to facilitate more 

administration space 

200827 Following recommendations made from an 

external Hygiene Services Audit upgrade 

work’s took place throughout the patient 

areas in the Hospital 

200828 New security cameras installed in the 

basement and the Consultant’s Private Clinic 

200029 Upgrade of cleaners sluice rooms on the 

nursing floors 

200030 New Fire Doors installed in the basement 

and on the 1st floor 

Catering Department 

The Catering Department services the needs of 162 inpatients, 

30 day-care patients and approximately 400 

staff and visitors daily here in the Hospital. 

The Department also caters for various functions 

throughout the year as well as in-house meetings. The 

team consists of 68 staff lead by Yvonne Byrne and 

Geraldine O Nolan (to June 2008). In July Keith 

Wickham was promoted to Catering Officer from Catering 

Supervisor and Richard Connolly joined the team. 

The Department has a fully implemented HACCP system 

and an ISO 22000: 2005 and IS 343 accreditation. 

The Kitchen prepares and cooks the food on the day 

for all areas and is supervised by our Senior Chef 

Michele Pounch. The Coffee Shop opens from 7.00am– 

5.00pm and seats 110 people. This department is very 

quality focused and promotes a culture of continuous 

improvements through out the year. 

Some of the activities for last year are: 

• The catering department held their Management 

Review Meeting’s in April and October. 

• A Healthy Eating week was promoted week 

commencing the 4th June. 

79 

Return to Contents




• In April N.S.A.I. certified the Catering Department to 

I.S.O. 22000 standard. 

• A coffee morning was held on the 18th September 

in the Coffee Shop and raised €540, which was up 

47% on 2007 for the Hospice Foundation. 

• Complete Laboratory Solutions carried out analysis 

on food products and hygiene swabs within the 

Kitchen, Patient Catering and Coffee shop. 

• In December a raffle was held in the coffee shop 

for St Vincent de Paul and €2440.00 was raised. 

• There have been 140 updates to policies as part of 

the Food Safety Management System. 

• The Annual Christmas Party took place in the 

Coffee Shop on the 19th of December. 

• The Annual Children’s Christmas Party took place 

on the 20th December. 

Projects Undertaken 

Financial - Cost & Sales Analysis were introduced in Oct. 

Catering department Stock Take introduced in November 

Food Waste Analysis Sheets introduced in October 

Supplier analysis against S.V.U.H. carried out in October 

All standardised recipes reviewed in October/November 

Nutrition - Catering & Nutrition interdepartmental strategic 

meeting commenced in October. Catering Department 

now attend the Nutrition Interest Group Meetings. 

F.O.G. Fats Oils & Grease programme commenced in 

September following new legislation. 

Equipment - Equipment/Plans for new hospital 

continued from 2007 

Service Trials - Trials for Patient Service in new hospital 

commenced in January. 

E.M.R. - Emergency Response Plan was tested in June 

on electrical failure. 

Theme Day - Vegetarian Theme Day took place in June 

and a Polish Theme Day took place in May 

Waste Mgt. Food composting introduced to all 

kitchenettes 

80 

Return to Contents




Equipment 

• Preventive Maintenance took place in October 

• New Equipment – Upright fridge in Kitchen and 

battery operated floor scrubber 

• Diet weighing scales 

• New curtains for walk in fridges in Kitchen 

• New Fan installed in Coffee Shop 

• Fly screens installed in Coffee Shop 

• Ice Machine in Day Care 

Audits 

• Michele Pounch and Denise Ryan carried out 4 

supplier audit visits in August (Pallas Foods, 

Glanbia, Olhausen & Seaview). 

• Joe Carroll of QMS carried out a systems audit to 

ISO 22000 on the 20th of August 2008. 

• Cater Care carried out on the 28th of May & 16th 

of October. 

• The Environmental Health Officer carried out audits 

of the Catering Department on the 22nd of January 

and the 7th & 29th of April. 

• Air ventilation carried out audits of the extraction 

system in the Coffee Shop in June. Environeering 

carried out two follow up audits following changes 

in extraction equipment to improve efficiency. 

• Happy Heart Audit took place in August. 

• Compliance Consulting carried out on and Fats, Oils 

and Grease Management on behalf of Dublin City 

Council in October. 

• A JCI audit was carried out in October. 

• A Mock Recall took place in September on Patient 

Food. 

• A Country wide pork and bacon recall took place in 

December following issues in the food chain. 

• Dangerous Goods Safety Advisor carried out two 

audit’s in June and December. 

• Chemical Risk Assessments on about 70 products 

were completed from June – September. 

• A Hygiene Services audit took place in August and 

recommendations were completed in November. 

• Buro Happold carried out an audit on the facilities 

department and issued an operational and 

maintenance strategy report. 

• Industrial Water Management takes 15 random 

samples quarterly. 

• The Hospital’s Fire Safety Consultant carried out an 

audit of the building in April. 

Surveys 

Four surveys were carried out in the Catering Department; 

two in the patient catering area and two in the coffee 

shop. 

Patient Catering: Dietary requirements of patients in 

November and Portion sizes and presentation of meals 

in May. 

Coffee Shop: ‘On the Grab & Go’ in November and 

‘Vegetarian Options’ in May 

A survey on the standard of cleaning took place in July. 

Information is also feed back to Support Services on 

the patient satisfaction surveys given out on admission. 

81 

Return to Contents




External Training 

Primary Food Hygiene – Cater Care – January/May/October 

Refresher Food Hygiene – Cater Care – June/July October 

Management Development Training – Quantum Training 

– March/April. 

Operations Training Techniques – Failte Ireland – 

February/September/October 

Management of Food Hygiene – Failte Ireland – 

October/November 

Recruitment & Interviewing Skills – 

Quantum Training – February 

Motivation Team Work – Quantum Training – 

March/April/June 

Risk Assessment Training – S.Q.T. – April 

Coaching Skills Training – Quantum – June 

Dysphasia workshop 

(patients who have difficulty swallowing) – February 

Audit Training – Q.M.S. 

– September 

Manual Handling Trainer and Risk Assessor – 

IBEC – October 

Chemical Training – Ecolab – May/September 

Hand Hygiene – Ecolab – September/August 

Staff 

Richard Connolly and Keith Wickham appointed 

Catering Officers in July. 

Yvonne Byrne, Gemma Cushen, Catherine Unal and 

Dixie Mosebi all commenced maternity leave. 

Ger O’Nolan joined the Reception Team as Deputy 

Head Receptionist in June. 

Margaret English successfully completed a Diploma in 

Front Line Management. 

Janet Murray 

Support Services Manager 

ISO – 22000 – Q.M.S. 

– August 

82 

Return to Contents



Finance Division 

The financial turnover increased by 7.7% from 

€63.5m.in 2007 to €68.4m in 2008. The surplus 

reduced from €3.3m in 2007 to €3m in 2008. Pay 

costs increases were not fully reimbursed as part of the 

agreements with the Medical Insurers. 

Service Development 

A new stock system project commenced during 2008 

aimed at capturing all stock transactions with the 

Supplies Department. The system is due to go live in 

Jan/Feb 2009. 

The software has been installed and and training has 

taken place. We are hopeful the new stock system will 

aid receiving units and reduce paperwork. 

Debtors 

Debtors days have fallen to 55% by year end which is 

a 10% improvement on 2007. 

I believe we have now better procedures in place to 

reduce claims outstanding. 

VHI 

Some new VHI on line system should lead to 

improvements. We are working hard to contain our non 

pay costs which hopefully will increase at a lower % 

level that our increase in revenue. 

The department is staffed as follows: 

Accounting: 

Billing: 

Payroll: 

Creditors: 

James Crowe, 

Mary Kelly 

James Clerkin, 

Joan Swan, 

Sinead O’ Mahony, 

Michelle O’ Dwyer 

Yvonne Casserly, 

Dorothy Nolan (50%) 

Marie Coyne, 

Jason Carson, 

Debtors: 

Stores: 

Total 25.5 

James Crowe 

Financial Controller 

Orla O’ Sullivan, 

Lynn Wiley, 

Aisling Talbot, 

Mary Rose Sweeney, 

C. McArdle, 

G. Milofsky, 

G. Mcteighue, 

J. Balfe, Laura Bertie, 

Neil Abdi, 

Patrice Marjollet, 

Jeffifer Kavanagh. 

J. Kennan, 

E. Murdoch, 

C. Mooney 

83 

Return to Contents



Allied Health Division 

The Allied Health Division incorporates Administration, 

Cardiology, Dietetics, Diagnostic Imaging (Radiology), 

Medical Physics, Pharmacy, Physiotherapy, Radiotherapy, 

Respiratory, and Social Work. 

Departments provide clinical and/or non-clinical support 

services to in-patient wards and offer a range of 

outpatient services. 

The overall objective of the Division is to provide and 

develop services to meet the needs of patients and 

their relatives. 

During the period 1/9/2008 to 31/12/2008 Ms. 

Gerada Warnes, Allied Health Manager was on 

maternity leave and the Division came under the direct 

responsibility of the CEO over that period. However Ms. 

Annette O’Neill represented Allied Health at the 

Management Team Meetings and Ms. Una Gilligan 

represented Allied Health on the JCI Accreditation 

Steering Committee Meetings. 

The following contains an overview of activities and 

events that took place in 2008. 

Radiology Department 

The Radiology Department provides a wide range of 

diagnostic imaging examinations and interventional 

procedures for both in-patient and outpatient referrals. 

Staff work closely with staff at ward level, in day surgery, 

theatre and endoscopy to ensure that their imaging 

requirements are catered for. The department provides 

a key platform service for Consultants within and 

outside the hospital. It also provides a service for GP’s 

within the catchments area. The department provides 

specialised services for a number of specialised 

hospitals. These include St. Luke’s Hospital, Royal Victoria 

Eye and Ear Hospital, National Maternity Hospital, 

Holles Street. 

The first quarter of 2008 was difficult for the department 

in terms of pressure and workload on a small number 

of staff in the specialised areas such as CT and MRI. In 

the second quarter of the year the pressure was 

reduced as three junior staff were able to provide out 

of hours cover for the hospital. 

Similarly to 2007 the impact of VHI direct payment for 

CT scans on all oncology review patients and the 

increase in overall referrals as a result of current best 

practice in imaging resulted in a further 10% increase 

in the workload in CT. As a result it was necessary to 

extend the working day to keep waiting times to a 

minimum. This workload was borne by a limited 

number of radiographers. 

Much time was spent in the third quarter in preparation 

for JCI Accreditation. Policies, Procedures and Guidelines 

were reviewed and revised where necessary and some 

new policies were implemented. New high quality 

patient information leaflets were prepared and 

distributed to clinics and wards. 

There was a significant increase inn the number of 

Cardiac and Breast MRI studies carried out in 2008 

compared to 2007. In line with best practice a number 

of new procedures were introduced in the MRI 

department over the last 18 months. 

While overall activity in terms of examination numbers 

was down in 2008 there are rational reasons for this. 

The general numbers are down as fewer Consultants 

are referring patient for pre-operative chest x-rays, plain 

x-rays of spine and sinuses, in line with current best 

practice. 

The reduction in bed occupancy in October and 

November impacted on the number of in-patient 

referrals to our department. 

84 

Return to Contents




Improvements in Infrastructure 

In line with JCI requirements and following Hygiene 

Audits major improvements were made in the 

department. The old dark room was redesigned as the 

main store room in the department. All open shelving 

in the Fluoroscopy room was removed and new storage 

cupboards were acquired throughout the department. 

The viewing room was decorated and old flooring 

replaced. The corridor in the general area was painted. 

Radiotherapy Department 

Activity 

2008 saw no increase in patient throughput compared 

to 2007. However the number of treatments remained 

the same. This was due increase competition in the 

market place and specific treatment technique options 

in other centres. 

Developments 

It was agreed at management level that the department 

would outsource IMRT to D3. Since this agreement the 

hospital purchased IMPAC which is an integrated 

management solution to RT and it was decided to 

postpone this until impact was installed. 

In 2008 the Radiotherapy Department treated 38 

public patients as part of a HSE Agreement. This made 

a significant contribution to our treatments. However in 

Oct 2008 we were informed that they would no longer 

require the service. 

A new IMPAC System was purchased. The department 

completed the upgraded of its external beam planning 

system with the installation of three new fuel based 

planning systems. Final verification of the new data was 

completed in Jan/08. A new software version (2.16) 

was installed in September 08 and subsequently 

validated. The necessary documentation was filed with 

relevant statutory bodies. 

The journal club continues to meet regularly. There were 

a number of meetings on various aspects of radiation 

therapy with a very successful inaugural meeting on the 

use of ionising radiation in the treatment of benign 

disease at the end of the year. Both the physics and 

the radiography department contributed to the meeting 

in poster format. 

SVPH is currently treating all breast patients with a field 

within field technique. The department explored the 

feasibility of introducing inverse planning IMRT for 

treatment sites (other than breast). Visits to Manheim in 

Germany and an invitation to D3 from the USA to visit 

85 

Return to Contents




the department were explored with this development in 

mind. The decision to pursue the D3 route proved 

more attractive with D3 providing technical support and 

training to the physics staff at the department. 

Refurbishment work on the planning room was 

completed in April of this year. The room is now open 

plan and can accommodate the extra staff member and 

equipment required for a full operational department 

including provision of IMRT services. 

In-house training accounted for the vast majority of the 

training this year owing to the arrival of two new 

members of staff. In addition, it is in the hospital 

interest that each physics staff member should attend 

at least one national and international conference per 

year. This is to comply with professional registration and 

international recommendations to ensure each staff 

member is active and up to date in their area of 

expertise. The accreditation process further strengthened 

the need for an education and training requirement. 

Documented proof in the form of individual training 

records were requested as part of the validation 

process. 

Pharmacy Department 

In 2008 the Dispensary expanded services with the 

introduction of the Clinical Pharmacy Service and the 

Top Up Stock System on the wards. The introduction of 

these services has altered the workflow of the 

Dispensary with staff working at ward level and not just 

at departmental level. 

The setting up of these systems in addition to 

preparations for JCI increased the workload of the 

dispensary staff. 

The workload of the Aseptic Unit continues to remain 

high and volume peaked in January 2008 with 847 

items. The number of patients receiving intravenous 

chemotherapy increased from 5650 in 2007 to 5938 

in 2008. This represents an increase of 5%. The 

extension of opening hours in the Day Care Oncology 

Unit may have contributed to this increase. 

Maintaining adequate staff levels continues to be a 

challenge for the Aseptic Unit as the number of 

technicians dropped to two technicians (who were 

appointed on contract) – both of whom were only in 

their first year of training in Aseptics. The appointment 

of a second senior pharmacist to Aseptics was greatly 

welcomed and her training is progressing well. 

86 

Return to Contents




However, the environmental conditions of the current 

facilities are severely limiting preventing any advance 

compounding from taking place. Given the volume of 

compounding taking place, the lack of a back up to the 

current isolator is extremely worrying. This was highlighted 

when the isolator broke down at the beginning 

of February and was out of commission for three days. 

The new hospital will address these deficiencies. 

The addition of the Mosaiq Scheduling System in Day 

Care Oncology has streamlined the scheduling of 

patients. 

The provision of a Clinical Pharmacy Service 

commenced in 2008. Four additional pharmacists were 

recruited and filled between April 2008 and July 2008. 

The service commenced on Redwood Ward in May 

2008 and then was extended to the other wards by 

October 2008. Currently, there are three full time 

Clinical Pharmacists looking after two wards each. The 

Cara Unit Clinical Pharmacy Service is looked after by 

the Clinical/Dispensary Manager. The Cedar Ward 

Clinical Pharmacy Service is shared between the two 

senior pharmacists in Aseptics. 

With the commencement of the Clinical Pharmacy 

Service it was decided to provide a stock of routinely 

used medications to each ward. The individual 

medication needs of each ward were assessed by the 

Clinical Pharmacist and Clinical Nurse Manager and 

stock medication lists were drawn up. Dedicated 

medication presses which could be locked (JCI 

requirement) were ordered and installed on each ward. 

These presses include a concentrated electrolyte safe 

(JCI requirement). Once the initial stock was dispensed 

the ward would be visited by a Pharmacy Technician on 

a routine basis to replace stock used – Top Up system. 

In 2008 a dedicated Medication Incident Report Form 

(MIR) was introduced to record incidents or near 

misses related to Medications. This form is similar in 

content to the Medication Incident Report Form used in 

SVUH. 

The Admission Medication Record Form, approved by 

the consultant’s forum in 2007 commenced use in 

2008. It is included with the patient pre-admission 

information that is posted out to patients prior to their 

admission by the consultant’s secretaries. 

New Patient Medication Record 

In 2006 the Drugs and Therapeutics Committee set up 

a sub-committee to review the medication records used 

in each of the three hospitals within the group with a 

view to standardising the Medication Record throughout 

the group. As a result of this collaborative process a 

standardised Medication Record was developed. This 

new medication record was launched in July 2008. 

The transition to the new Medication Record was very 

smooth, aided by the educational sessions/memos that 

highlighted the differences between new and old 

medication records and the pilot study that took place 

on Rowan and Cedar wards in 2007. 

JCI 

An entire section of JCI is devoted to Medication 

Management therefore the Pharmacy Department was 

very involved in the JCI process, developing and 

collaborating with other departments on procedures 

and policies. The accreditation process was a great 

mechanism for providing framework and structure in 

the development of new services (see above). Other 

initiatives included the High Alert and Look Alike, Sound 

Alike labelling of medications, and installation of 

Concentrated Electrolyte Safes and Secure Medication 

Presses. 

New Hospital 

The plans for the Dispensary have been finalised and 

work in continuing on the planning of the Aseptic Unit, 

Satellite Pharmacy and Medication Storage in Clinical 

Areas. 

87 

Return to Contents




Respiratory Department 

Activity 

The second PFT lab, which opened June 2007, has 

improved the efficiency of the service. This is evident 

from increased number of PFT’s being performed. 

Table 1: Number of tests 2007 vs 2008 

2007 2008 

Total PFT 2473 2878 

Outpatients 1794 2268 

In-patients 539 610 

There has been an overall increase in number of sleep 

studies carried out in 2008. There was a slight 

reduction in scheduled studies in autumn 2008 due to 

staff issues. There has been a significant drop in waiting 

times in 2008. A number of processes are in place to 

ensure that on a sleep night all 4 beds are utilised and 

to maintain efficiency. Wait times for initiation of sleep 

study treatment have been reduced from 3-4mths to 1- 

2 months. 

Bronchial provocation 30 38 

Skin tests 217 220 

Following advice from infection control, a “Gus cleaning 

and disinfection system” has been installed. Space was 

also found for cardiology to install their “gus cleaning 

system” for Transopesophogeal Endoscopy (TOE) and 

Respiratory have agreed to share the facility with them 

on Wednesday mornings when they carry out this 

procedure. Further refurbishment of room included 

installing new sink & cupboards and covering old drain. 

Table 2: Sleep study activity; 

Total No. studies Waiting times 

All existing guidelines were updated and a number of 

new guidelines No. were Referrals developed in line with JCI standards. 

(PSG & CPAP) PSG CPAP PSG CPAP Total No. 

referrals 

2007 412 6-8 mths 4 mthsResearch 

242 158 400 

2008 495 3-4 mths 1-2 mths Staff have been 272actively involved 180in research projects 452in 

the sleep lab with Prof Mc Nicholas’ team, and a team 

PSG - Polysomnography = diagnostic studies; CPAP -continuous of engineers positive airways from a pressure Nova-UCD = based treatment company, studies 

88 

Return to Contents




BiancaMed, who are developing novel methods of 

screening for sleep apnoea. 

The data produced has been presented at the following 

conferences in 2008: 

• European Sleep Research Society Congress in 

Glasgow by Patricia Boyle 

• American Thoracic Society in USA by Dr John 

Garvey 

• European Research Society in Berlin by Dr Caroline 

O Connell 

Published papers: 

1. Heneghan et al: A portable automated assessment 

tool for sleep apnoea using a combined holter 

oximeter 

Sleep 2008; 31(10) 1432-1439, 

2. Electrocardiogram recording as a screening tool for 

sleep disordered breathing. 

Heneghan et al J. Clin sleep medicine 2008; 

04(03) 223-228 

Physiotherapy Department 

The Physiotherapy Department provides both in-patient 

and outpatients services. In-Patient referrals are received 

from a range of specialties including Colorectal, Breast 

Surgery, Plastic Surgery, Vascular, Respiratory Medicine, 

Liver, Neurology, Orthopaedics, Oncology and Urology. 

A number of improvements were introduced in 2008 

as follows: 

1) Up-to-date leaflets for patient education - back care, 

pelvic floor exercises, respiratory care, orthopaedic 

etc created by the physiotherapy team and displayed 

within the department. 

2) Leaflet created to advertise our outpatient service, 

which is displayed within the department and 

distributed to in-patients in an attempt to increase 

out profile. 

3) Assessment forms created for detailed assessment 

of all patient classifications. 

4) Policies, procedures and guidelines updated. 

5) Storage areas separated into clinical and 

administration rooms. 

6) Hygiene: Cloth chairs replaced with plastic covered 

chairs. 

7) Bed sheets and pillow cases replaced with paper 

towels and disposable pillowcases. 

8) New cleaning protocol for the department itself and 

equipment implemented. 

Hawthorn Ward/ HANU 

HANU is now well established. This has had little 

impact on the Physiotherapy Service in terms of patient 

numbers but because patients are returning in a more 

acute condition, physiotherapy staff have benefitted 

from the respiratory physiotherapy courses attended last 

year. 

Multidisciplinary Team 

Our role in the MDT 

1) Physiotherapy in-patient notes are now filed in the 

medical chart from referral to discharge, to aid inter- 

MDT communication. 

2) Manager meets with MDT - oncology/palliative care 

team weekly. 

3) On an ad-hoc basis Physiotherapists liaise with 

nursing staff, medical staff and family members. 

89 

Return to Contents




4) Physiotherapy manager partakes in the accreditation 

meeting and attends managerial meetings when 

scheduled. 

5) Department welcomes students at preundergraduate 

level to visit the department to 

shadow physiotherapists to experience their day-today 

work. 

Staff Compliment 

WTE Manager. 

2 senior physiotherapists who job share creating 

one post. 

1 senior physiotherapist 

1 basic grade physiotherapist 

Cardiology Department 

Procedures carried out in the Department are 

1. ECG 

2. Echocardiograpahy 

3. Stress Testing 

4. Holter Monitor 

5. Blood pressure Monitor 

6. Pace maker insertion and clinics 

Review statistics enclosed as stated previously in the 

2007 review it is difficult to expand the above services 

as space is a large issue in the department. There are 

only two cubicles and only two tests can be carried out 

simultaneously. Statistics for the above services have 

not increased over the year as the department has had 

severe staffing problems. Locum Cardiac Technicians 

are very difficult to get to cover sick leave, annual leave, 

or study leave etc. This year there has been a problem 

with long term sick leave. 

Stress testing 

Service developing gradually again space is an issue, as 

it is cumbersome and time consuming having only two 

cubicles limits our capacity to expand an example of 

this would be if we increase our stress testing services 

our echo service will suffer. 

Chest pain clinic 

It was proposed to establish a chest pain clinic in 2008 

in consolidation with the Cardiologists. However this 

was not feasible at this time due to staffing and space 

issues. 

The rational for the development was 

1. Provide a more comprehensive service to patients 

in a cost effective manner. 

2. Utilise fully the specific staff mix within the 

department. 

3. Increase range of invasive cardiac investigations. 

4. Increase profile of the Cardiology Department in 

SVPH. 

5. Increase general access of cardiology services to 

general practitioners ie Direct Access 

The following items were acquired during the year 

• Replaced 2 Holter monitors, and 1 blood pressure 

monitor 

• New TOE Probe and Gus sterilising system – 

shared with Respiratory Department 

90 

Return to Contents




Social Work Department 

This year saw a total of 574 new referrals to the Social 

Work Department. Although oncology services account 

for the majority of social work referrals the presence of 

a second (part time) social worker in the department 

has attracted an increase in referrals from other areas of 

the hospital. 

We continue to work with our medical, nursing and 

allied health colleagues towards the provision of holistic 

care for our patients. However, the current economic 

climate has made our traditional role of linking inpatients 

due for discharge with community services 

more difficult. 

Vulnerable elderly patients form a large part of the social 

work caseload. Most of our patients return to their own 

homes after their hospital stay but may require increased 

domiciliary support to remain in the community. We 

find access to community programmes providing 

rehabilitation opportunities has become more difficult 

and financial aid towards nursing home costs is limited. 

The Accreditation process this year has been time 

consuming but we trust this process will lead to 

ongoing improvement in work practices. 

We were pleased to offer observation placements to 

two transition year students who are considering a 

career in social work. 

Training opportunities have been confined to in-house 

education sessions and we have worked closely with 

colleagues in St. Vincent’s University and St. Michael’s 

Hospitals. 

We are currently developing information packs advising 

patients and staff on practical and legal issues – e.g. the 

importance of making a will. 

Because of the pressure on resources we anticipate 

that this year will present new challenges in the 

provision of appropriate services for our patients. 

The cutback in community services for the elderly 

inevitably leads to a longer stay in hospital which 

presents new challenges for the Social Work 

Department. 

91 

Return to Contents




Department of Nutrition & Dietetics 

Patient Activity 

January – December 2008 

Type In-Patients Outpatients 

New 610 108 

Review 2132 137 

Total 2742 245 

In 2008, the number of patient consults decreased by 

5% (⇓162 patient consults), however the time spent 

seeing these patients increased by 5% (⇑ 93 hours). 

This is evident in the complexity of cases referred to the 

department in the past year. In-patient activity 

accounted for 92% of clinical work. 

Outpatient activity increased by 29% (55 patient 

consults). This was due to: 

1) A review of the outpatient services and the 

implementation of a quality improvement process 

2) An increase in staffing levels: 0.5 whole time 

equivalent (wte) senior dietitian. 

Oncology Daycare activity was similar to 2007. 

44% of in-patients referred to the dietitian were for the 

initiation and provision of Parenteral Nutrition (PN), 

which accounted for 42% of in-patient time. This 

represents an increase of 7% and 2% respectively from 

2007, which again highlights the increasing complexity 

of patient management and treatment. 

In 2008 PN use increased by 14% from 2007 at a 

total cost of €183,553.93. 

Staff Complement 

2.5 (1.0 WTE Dietician Manager1.5 WTE Senior 

Dietitians). 

Quality Improvements: 2008 

Malnutrition Universal Screening Tool: 

A key element of the JCI accreditation process is the 

mandatory nutrition screening of in-patients. MUST is a 

five-step screening tool developed by the British 

Association of Parenteral and Enteral Nutrition (BAPEN) 

to identify adults who are malnourished, at risk of 

malnutrition (undernutrition), or obese. The tool was 

trialed and audited on Hawthorn ward and Hazel Unit 

in August 2008. It is planned, to implement it hospital 

wide, by April 2009. 

Following a review of waiting lists for outpatient 

appointments, a quality improvement initiative was 

implemented to reduce these waiting times and nonattendance 

rates at clinics. Waiting times have now 

been dramatically reduced. Patients are now offered 

appointments on the same week as they are referred. 

IT Statistical Analysis Package: 

In 2008, the Department of Nutrition & Dietetics 

completed more detailed statistical records for patients. 

Standardised diagnosis and intervention codes are now 

being used and these records are uploaded onto a 

modified excel spreadsheet. Activity rates for specialities; 

consultants etc can now be easily retrieved using this 

database. 

Parenteral Nutrition (PN) Audit: 

In the three year period, from 2005-2008, the use of 

Parenteral Nutrition in SVPH increased by 107%. PN 

use cost the hospital €183,553.93 in 2008. 

In January, an audit of 21 patients receiving PN was 

completed (Phase I). This was to identify baseline data 

on PN use within the hospital, which could be audited 

against. Phase II of the audit is now in operation, which 

addresses the appropriateness of PN intervention. 

92 

Return to Contents




Enteral Nutrition (EN) Wastage Audit: 

Prior to the Enteral Nutrition Tender in 2008, a wide 

range of nutritional products from a number of 

companies, were used in SVPH. Wastage rates were 

high. This prompted the initiation of an annual audit 

which was carried out over a 3 month period in 2007. 

Following the awarding of the EN contract to Nutricia 

Clinical in March 2008, the wastage audit was repeated. 

EN Wastage had decreased from €270.95/quarter in 

2007 to €18.33/quarter in 2008. 

In 2008, regular meetings were established within the 

department. Weekly team briefings and monthly 

department meetings were held to improve 

communication. These will continue during 2009. 

Monthly SVPH/SVUH joint Nutrition Journal Club 

meetings were established in 2008 and will continue 

throughout 2009. This is an essential component of our 

departments continued professional development, in 

addition to strengthening relations with our dietetic 

colleagues in the St Vincents Healthcare Group. 

The dietitian manager currently participates in 

professional supervision with other dietetic managers 

within the Irish Nutrition & Dietetic Institute. 

Malnutrition Universal Screening Tool (MUST) 

Introduction: The MUST screening tool was trialed on 

Hawthorn and Hazel wards over a 6-week period 

(August 11th-September 22nd 2008). The Department 

of Nutrition & Dietetics provided extensive training on 

its use, to nursing staff. 

Patients were categorised as: 

Low Risk (Score 0) 

Medium Risk (Score 1) 

High Risk (Score 2 or more) 

• Whilst the screening tool was not altered, a 

comprehensive care plan was devised to address 

the needs of each risk group (Appendix I). 

• An audit was completed to identify issues which 

occurred in its implementation and changes which 

were required to the care plan accompanying it. 

Results: The main findings from the audit were as 

follows: 

- 10% of patients had experienced significant 

weight loss (>5% of body weight) 

- 12% of patients were deemed to be at risk of 

malnutrition, however 11% of forms had no 

score recorded, thus making it impossible to 

identify whether they were at risk. 

- The Nutrition Screening Survey in the UK 

(2007): British Association of Parenteral & 

Enteral Nutrition (BAPEN) screened 9336 

patients on admission to hospital using the 

MUST tool. 28% were found to be at risk of 

malnutrition. Our figures (assuming the forms 

with no score, represented patients at risk) are 

comparable. 

- Only 78% of patient care plans were completed. 

- 5% of forms had no weight and 13% had no 

height recorded. 

- 38% of forms had %weight loss missing. 

Outpatient: Quality Improvement 

Primary issue is the waiting lists for outpatients 

attending the dietitian in SVPH. Currently these stand at 

4-6 weeks: New Patient 

3-4 weeks: Review Patient 

Since November 2007, the DNA (Did Not Attend) rates 

for these clinics have been recorded each month. In 

the year to date (Jan-Sept 2008), the DNA rate has 

been 15%. 

93 

Return to Contents



Organisation Structure 

Group Chief Executive 

Chief Executive 


Human Resource 

Allied Health 

DIVISION 

Support Services 

DIVISION 

Corporate Services 

Finance Division 

Director of Nursing 

Assistant Director 

of Nursing (3) 

Patients Floors 

Theatres (2) 

Endoscopy 

Daycare 

Minor Operations 

Pastoral Care/ 

Chaplaincy 

Portering 

Admissions 

Nursing Education 

Nurse Specialists 

Human Resources 

Manager 

Administrative 

Assistant 

Recruitment 

Ward Clerks 

Medical Records 

Staff Training & 

Development 


Medical 

Administration 

Allied Health 

Manager 

Diagnostic Imaging 

Radiotherapy 

Pharmacy 

Dietetics 

Cardiology 

Medical Social 

Worker 

Physiotherapy 

Pulmonary 

Laboratory 

Other Allied 

Health Services 

Support Services 

Manager 

Deputy Services 

Manager 

Reception 

Catering 

Coffee Shop 

Housekeeping 

Cleaning 

Maintenance 

Security 

Grounds 

Head of Corporate 

Services 


Assistant 

Risk Management 

Information 

Technology 

Accreditation 

Statistics 

Patient Complaints 

HIPE 

Capital Projects 


Patients Accounts 

Debtors Accounts 

Creditors 

Salaries 

Materials Manager 


Assistant 

Management 

Accounts 

Medical Physics 

94 

Return to Contents

95 

St. Vincent’s University Hospital


Report from the Director of Operation’s 

Bill Maher 

I would like to start by thanking staff for their constant 

support, enthusiasm and dedication to patient care in 

2008. This year has seen us face many changes and 

challenges. 

2008 saw great changes to the public sector and 

healthcare due to the significant downturn in the 

economic environment. My approach has always been 

to support our clinical services and staff no matter what 

stresses we come under. 

Hospitals are part of the broader healthcare system and 

cannot work in isolation. A significant part of my role, 

along with my senior management colleagues, is to liaise 

with the HSE and Primary Care to develop services, 

improve patient pathways and secure funding. I hope St 

Vincent’ University Hospital continues to play a leading 

role in modernising services and this will be a key area 

for me in 2009. 

This report gives a brief overview of key developments 

across a number of areas. I hope you find and 

recognise a number of our achievements. 

Strategic Plans 

Estates Strategy 

The Estate Strategy group was established in November 

2007 with responsibility for ensuring where possible 

that the development is carried out in a planned, effective, 

efficient and progressive manner across the campus. 

That Group had a busy year in 2008 with 32 projects 

completed on target and within budget. Notwithstanding 

the financial difficulties facing us in 2009 the Group has 

identified a number of key development projects and is 

in discussions with the Health Service Executive to secure 

funding for such. Included in these are significant projects 

such as the new ward block, the additional four theatres 

and the Haematology Daycare Unit. There are also 

plans to continue with the much needed refurbishment 

of bathrooms and kitchens and priority wards. 

Perhaps the most significant achievement was the 

refurbishment of Our Lady’s Ward. The ward is 

unrecognisable from its former self and the feedback 

from patient, carer’s and staff has been excellent. I would 

like to formally thank all who made this possible and 

build on this success to refurbish other wards in 2009. 

Financial Position 

Our allocation for 2009 will be considerably reduced 

and we will no doubt have to make some tough 

decisions. The foundations we have laid in 2008 in 

terms of efficiency and productively will stand to us in 

good stead but it will still need the continued efforts of 

all staff to get through what will be a difficult year. I 

know that we can count on that. We ended 2008, €1.5 

million over spent against our allocation. This is a 

tremendous achievement given the increase in activity 

in all areas, the reduction of waiting lists and the estates 

developments. I would like to thank all staff for their 

efforts in achieving this. 

Quality and Patient Safety 

JCI Accreditation 

In May 2008 Joint Commission International (JCI) first 

visited SVUH. Based on this visit, they submitted a 

report of recommendations to SVUH in order to help us 

achieve accreditation. In September 2008, a working 

group was established to implement these 

recommendations. Read more about this exciting 

initiative in the Quality, Risk and Consumer Affairs 

Report. 

Patient Safety Committee 

St. Vincent’s University Hospital, Patient Safety Committee 

was established in September 2008. This committee 

aims to coordinate, oversee, prioritise and integrate 

patient safety, clinical risk management and continuous 

quality improvement initiatives across the Hospital. 

96 

Return to Contents



Bill Maher 

The Patient Safety Committee meets on a monthly 

basis to review and evaluate patient safety and quality 

of care through data gathered through a variety of 

means such as audit, service review, incident/near miss 

reports, and staff and patient feedback. 

Membership of the Patient Safety Committee includes: 

• Director of Operations (Chairperson) 

• Director of Nursing 

• Chairman Medical Executive 

• Director of Quality, Risk & Consumer Affairs 

• Director of Infection Control 

• Head of Pharmacy 

• Clinical Services Manager 

The Committee receives monthly reports from the 

following departments: 

• Quality Manager 

• Insurance, Risk & Legal Affairs Coordinator 

• Consumer Affairs Coordinator 

• Medication Safety Coordinator 

The Patient Safety Committee will endeavour to promote 

a culture in which patient safety, clinical risk, and quality 

management will continue to be developed as an 

integral and seamless component of the care process. 

Theatres 

Perhaps our most significant achievement in 2008/early 

2009 was the preparation and transfer for our new 

operating theatres. The new theatres provide a 21st 

century environment to deliver patient care and the 

feedback from staff has been excellent. 2009 will see 

the launch of the Theathre Project Group to review 

processes, resource development and policy to further 

maximise efficiency and throughput. 

Development of Effective Reporting Tool – Diver 

In spring 2008, the ICT Department successfully 

implemented a new Management Information System 

(MIS) called Health Diver. The system initially covers 

the Patient Administration System (in-patient, 

outpatients and waiting list), Emergency Department, 

HIPE and Social Work systems. While this data mining 

tool provides comprehensive reports and adhoc queries 

internally and externally one of its main advantages is 

its portal and dashboard capability. This dashboard is 

now available to all Heads of Department and is 

accessed via the Intranet or desktop icon. It currently 

consists of nine KPIs which Diver will automatically 

update from legacy systems but is planned to increase 

to 12 KPI’s in 2009. 

Following the successful of diver, it is planned to 

expand the remit of this project and its users in 2009. 

97 

Return to Contents



Bill Maher 

GP Liaison 

In summer 2008, the GP Liaison Committee was relaunched 

to ensure collaboration of SVUH and GPs 

(including St. Michael’s Hospital) within constraints and 

limitations of the service/provider plan. 

The aim of this committee is to develop and improve 

robust communication channels between GPs and SVUH 

in order to continuously improve and develop services. 

Communications initiatives such as a quarterly GP 

newsletter continued in 2008 and will be further 

developed in 2009. I hope the liaison committee 

becomes the forum to modernise patient pathways and 

drive service improvements. 

Waiting List Management 

The Board of Directors identified the In-patient and Outpatient 

Waiting Lists as two of the Key Performance 

Indicators (KPIs) for 2008. Targets were defined with 

the In-patient Waiting List (IPWL) set at no patient to 

wait over 26 weeks and the Out-patient Waiting List 

(OPWL) set at no patient to wait over 12 weeks by 

December 2008. 

In January 2008 there were 1,079 in-patients waiting 

over 26 weeks and 1,491 out-patients waiting over 12 

weeks. 

In-patient Waiting List (including Day Cases) 

At year-end we have achieved an 82% decrease in the 

In-patient Waiting List over 26 weeks and this has been 

reduced to 195. The In-patient reduction is a 

considerable achievement and the Senior Management 

Team wishes to thank all concerned for this excellent 

performance. Pain Management accounts for 100 of 

this total. 

The reduction in the IPWL has been achieved through 

additional extra activity, use of the National Treatment 

Purchase Fund and effective validation. 

National Treatment Purchase Fund (NTPF) 

725 in-patients were referred to the NTPF across all 

specialties in 2008. Our referral targets were met. NTPF 

referrals will continue through 2009 and all eligible 

patients waiting over 3 months will be offered 

treatment elsewhere. 

Validation 

Continuous validation proved very successful with 

2,910 patients being removed from the waiting list for 

various reasons during the year. 

From January 2009 Consultants will receive a list of 

patients on their waiting list who are waiting over 26 

weeks on a monthly basis. These will need to be 

addressed promptly and where on-going problem areas 

98 

Return to Contents



Bill Maher 

are identified follow-up meetings will be arranged with 

the Director of Operations and the Waiting List Coordinator, 

to explore issues and agree plans for delivery. 

Outpatients Waiting List 

At year-end, 2,044 new patients are waiting to be seen 

over 12 weeks therefore the target was not met in 2008. 

The target will remain the same for 2009 with the aim 

being that no patient will wait over 12 weeks by 

December 2009. The waiting list for new attendances 

has increased by 13.9% compared to December 2007. 

The overall total for new patients stands at 6,717. The 

three specialties with the highest number of patients 

waiting over 3 months are ENT, Orthopaedics and 

Respiratory. 

The OPWL has grown despite considerable additional 

activity, indicating growth in referrals and demand for 

our services. To address this a number of initiatives 

were instigated during 2008 including the formation of 

a Multi-disciplinary Out-patient Waiting List Group 

chaired by Liz Barnes ( Dietician Manager). This group 

began meeting in November and Terms of Reference 

were agreed. Several areas will be tackled in 2009. 

DNA Rate 

The HSE have set a target of 5% DNA rate for 2009. 

In 2008 SVUH had a total of 6,378 new DNA’s and a 

total of 26,878 new and return DNA’s. 

A number of measures were agreed including approval 

for a SMS texting reminder service to try to reduce the 

high number of DNA’s and this will be piloted in the 

ENT and Neurology Departments. 

A decision was made to revise the patients’ 

appointment cards stating the importance of cancelling 

if unable to attend. An information leaflet will also be 

sent with every new appointment with this reinforced. 

In addition posters are now in place in all suites in 

Ambulatory Day Care Centre and will be updated with 

end of year figures to make patients aware of the 

importance of cancelling. 

Consultants are asked to comply with the DNA policy to 

ensure targets are met. 

Non-Catchment Area 

This will become one of our KPIs for 2009, with an aim 

to reduce our out of area treatments (with exception of 

our national services) to 10% of our total outpatient 

activity. 

We have already begun a policy of the deflection of 

non-catchment area referrals and to-date Dermatology 

and Neurology are implementing this policy. Pain 

Management will be deflecting non-catchment area 

referrals from January 2009. This will be monitored 

closely throughout the year, as SVUH are not funded for 

these patients and this will make a significant 

contribution to our cost containment plan. 

New to Review Ratio 

Reducing the New to Review ratio frees up capacity to 

see new patients. SVUH have set a target of 1:3 across 

all specialities with specific targets for each speciality. 

Currently the average new to review ratio is 1:3.4. 

Summary 

In 2008, we built upon the foundations laid in 2007 

which saw a consolidation and evaluation of all our 

major systems and processes, aimed at streamlining 

pathways and supporting patient care with the aim of 

providing clear and consistent approach and 

empowering staff at all levels. 

2009 will be a very challenging year. SVUH allocation is 

expected to be significantly reduced and we will no 

doubt have to make some tough decisions to deliver a 

breakeven situation. But this said we are a resilient 

team who will always strive to achieve excellence for our 

patients no matter what economic pressures we face. 

Bill Maher 

Director of Operations 

99 

Return to Contents


Chaplaincy / Pastoral Care Department 

Chaplaincy Department 

Chaplaincy is a specific and specialised ministry, 

profession and discipline within St. Vincent’s University 

Hospital. Chaplains work in collaboration with 

multidisciplinary colleagues in providing total patient 

care and ministry to families and loved ones within the 

clinical environment. 

Chaplains are professionally prepared through theological 

education and clinical training. The department offers 

spiritual care and emotional support to persons of all 

faith traditions within a multi-cultural environment that 

reflects the current transition in Irish society. 

Two Main Functions of the Department. 

• Provision of Spiritual Care, including Sacramental 

Ministry to Patients, their Families and Loved Ones, 

and Hospital Staff. 

• Through an Accredited Clinical Pastoral Education 

Programme, the department facilitates opportunities 

for preparation for ministry through experiential 

learning for persons pursuing chaplaincy, parish 

ministry, and other forms of ministry. 


Full-Time Permanent Staff 

6: This includes the Interim Lead Chaplain and the 

Director of Clinical Pastoral Education. 

There is one ordained chaplain in this section and four 

non ordained. 

Part Time Staff 

11: This includes nine ordained chaplains and three 

non ordained. 

Assigned Chaplain 

1 Chaplain assigned to hospital by the Church of 

Ireland (Anglican Communion) 

Changes in Staffing Levels 

The Acting Head Chaplain left the Department in May 

2008 to take up a position in a parish. The other priest 

chaplain assumed his role within the department. He 

was appointed to the role of Interim Lead Chaplain. 

Three priest chaplains were appointed to temporary 

positions. One remained a member of the department 

for a three month period and then terminated his 

contract to return to the Missions. The other two 

chaplains continue as active members of the 

department. 

One of the full-time chaplains reduced her hours (from 

39 to 32), and a second part-time chaplain reduced his 

hours to 24. 

Service Developments / Activities 

The Chaplaincy Department developed a new suite of 

policies that are now in the process of being approved 

by the hospital management. 

The policies address standards for best practice in 

chaplaincy within St. Vincents University Hospital. 

The Following Policies were developed: 

• Policy on Patient Visiting 

• Policy on the Chaplain’s Role in the Care of the 

Dying 

• Policy on Sacramental Ministry Policy and 

Procedures for Volunteer Ministers of Holy 

Communion 

• Policy on Record Keeping 

• Policy regarding Representatives of Various Faith 

Traditions within the Community Who Visit Patients 

in SVUH 

100 

Return to Contents


Chaplaincy / Pastoral Care Department 

Significant Achievements 

• Restructuring of the Chaplaincy Department and 

refurbishing of office space to meet current pastoral 

requirements. 

• Chapalincy was intentional about developing stronger 

links with other departments within the hospital, e.g. 

Communications, Quality Assurance, Human 

Resources. 

• In collaboration with Technical Services Department, 

the Chaplaincy Department developed and 

maintained a communication system, through 

Channel 7 on hospital TV. This enables patients in 

the clinical areas to view and participate in liturgies 

being celebrated in the hospital chapel. 

• Chaplaincy produced a Patient Information Leaflet 

regarding the services provided by the Department. 

• The Department negotiated a special Patient Census 

list for chaplains, with appropriate information to 

facilitate more effective chaplain outreach. 

• Chaplaincy, in collaboration with Quality Assurance 

personnel, developed a process of quantitative 

research regarding the professional activities of 

chaplains. 

• The department planned liturgical celebrations to 

mark World Day of the Sick in February. In December 

it hosted a Pastoral Visit by Bishop Raymond Field, 

Representative for Health Care of the Irish Bishop’s 

Conference. 

• Five Memorial Masses were planned for and 

celebrated in the hospital chapel during November. 

A large number of bereaved family members and 

friends participated in each of these special Masses. 

The Catering Department organised a reception 

after each of the Masses. Family members 

appreciated the opportunity to return to the hospital 

and reconnect with staff. 

Significant Publications 

Ongoing contributions to Newsround regarding the 

philosophy and work of the Chaplaincy Department. 

Production and publication of new chaplaincy leaflet. 

Articles in Intercom, The Furrow and The Carer. 

Future Plans 

• Establish a system of documentation for Chaplaincy/ 

Pastoral Care within the Medical Record. 

• Obtain official approval for Chaplaincy/Pastoral Care 

Policies. Education and implementation of policies. 

• Team Building processes within the department. 

• Facilitate more effective pastoral outreach to persons 

of a diversity of faith traditions, and none. 

• Further improvement and enhancement of End of 

Life Pastoral Care. 

Clinical Pastoral Education 

The Department offered three Units of Clinical Pastoral 

Education during 2008. Each unit was of three months 

duration. 

Twenty-two students participated in the education 

process. Students represented a diverse group of 

cultural and faith backgrounds: Ireland, England, Ghana, 

Nigeria. They represented Roman Catholicism and 

Baptist faith traditions. 

Eight graduates of the programme successfully pursued 

Certification as Healthcare Chaplains by The Healthcare 

Chaplaincy Board. 

An Accreditation Site visit by a survey team from the 

Healthcare Chaplaincy Board was prepared for during 

2008. 

A number of graduates are now working as chaplains 

within the health service. Others are involved in parish 

ministry. 

101 

Return to Contents


Library & Information Services Department 


SVUH continued to employ 2 librarians, 1 library 

administrator and one part time library assistant. Julia 

Christopher resigned her post of Evening Library 

Assistant in May and was replaced by Gerry McManus 

in September to provide late opening hours for the 

academic year 2008/9. At the end of the year we 

were very sorry to say goodbye to John O’Grady who 

transferred to Pensions. John worked in Library & 

Information Services for just over three years and was a 

highly valued member of the team, extremely competent 

and professional in his work. He was well regarded by all 

regular users of our service and he is a huge loss to us. 

Breda Bennett continued to provide a one-personoperated 

professional library and information service in 

St Michael’s Hospital. 


Electronic Library Resources 

This year saw significant developments in our policy of 

providing access to high quality health information at 

clinical point of need as we secured funding to provide 

additional core resources. New products purchased in 

2008 included: UpToDate, MD Consult; Health and 

Psychosocial Instruments; and full text content to our 

CINAHL database. As a result of this expenditure the 

Group now has access to over 1,000 e-journals and 10 

core health databases, which are available throughout 

the three hospital campuses (via the ICT network) and 

also remotely via the Athens access management 

system, which is available to all staff. 

Intranet 

We were very excited to work with Claire Finnan, Laura 

Coughlan and Michéal Rourke on the development of 

the new Group Intranet which launched at the end of the 

year. A link to the Library & Information Services page 

appears on the Quick Link menu on every page of the 

Intranet and we are working on further developing 

these pages as the first port of call for SVHG staff who 

cannot easily visit the Library. 

SVHG network 

SVUH library team members were delighted to be able 

to connect to the SVHG ICT network for the first time 

this year, having previously been located on the UCD 

network only. Not only can we now gain access to SVHG 

email, Intranet and the technical and ICT helpdesks but, 

crucially, we are able to more effectively control and 

maintain our electronic library resources. I would like to 

express my thanks to Neal Mullen and team for their 

work in delivering this service to us and other Hospital 

staff working in the ERC. 

102 

Return to Contents



Training Programme 

Anne Madden, Assistant Librarian in SVUH, developed a 

series of courses on information literacy skills for staff 

on the three sites. Following a successful pilot in March 

the first series of training courses were offered in October 

and November to all SVHG staff and took place in 

SVUH and SMH. Courses included: Introduction to 

Library & Information Resources in SVHG; PubMed 

Searching; Advanced Internet Searching; Web 2.0 in 

Healthcare; Critical Appraisal; etc. The courses were over 

subscribed but very well received by those who 

attended, who were awarded a certificate of attendance 

in conjunction with HR’s Learning & Development Unit. 

We intend to offer these and other courses again in 

2009. 

SVHG Collection Development Policy 

A revised edition of this policy, which sets out the 

parameters for the collection of print and electronic 

resources in the Group libraries, was ratified by the 

SVHG Policy Procedures and Guidelines Steering Group 

in December. 

St Michael's Hospital 

The library was used consistently all year as a study 

space by nursing, midwifery and medical students, and 

was equally well used by hospital staff. There was 

significant use of the library book collection and the 

computers. There were frequent requests to allow 

access to the library during the librarian’s lunch time 

and in the evenings. A new safety rail was installed 

beside the ramp. 

The library received 3 new PCs, replacing older models, 

and now has 7 public computers, and the photocopier 

was replaced by a colour printer/copier. A self-pacedlearning 

programme for the ECDL was installed on 3 

library computers during the year. 

Information services included a monthly current 

awareness service to department heads, to consultants 

and registrars, sent electronically. An electronic email 

group of Library Friends is used to communicate library 

news and events, additions to the library or new library 

services. 

The library was included in Audit visits, the hospital 

Accreditation project and Consultant led inspections for 

training accreditation. The librarian participated actively 

in the hospital newsletter committee, and 4 issues 

were produced. She also participated in the general 

induction day for new staff, and in the orientation 

meetings for new NCHDs and nursing students and 

provided a 30 minute presentation on Preparing a 

Good Assignment to a Care Conference for nursing 

students. 

103 

Return to Contents



St Vincent’s Private Hospital 

Mr Peter Sheehan continued to represent the Hospital 

on the Group Library & Information Services Committee. 

Access to the Library premises in SVUH for Private staff 

was an issue, due to the swipe-controlled door, and it 

remains to be fully resolved in 2009. 


SVUH Library recorded 16,700 visits in 2008. The drop 

in figures compared with other years was due to the 

swipe-controlled door to the Library premises. There 

were over 2,000 registered library users by the end of 

the year in SVUH and 482 in SMH, and over 600 staff 

in total had registered for remote access to electronic 

library resources (Athens). We produced 3 issues of our 

newsletter, Update. 

Collection Development 

Print Journals: SVUH Library subscribed to 123 print 

journal titles in the areas of medicine, surgery, nursing 

and allied health, at a cost of approx. €69,000. This is 

joint funded by the Hospital and UCD. Over 60 titles 

were also received on donation. SMH Library subscribed 

to 57 journal titles at a cost of €31,000. 

Books: SVUH Library spent approx. €7,000 on books, 

about €3,000 of which was spent on anaesthesia and 

pain management titles funded by the Department of 

Anaesthesia. We also received a donation of €2,300 

from retired Consultant in Plastic Surgery, Mr Seamus O 

Riain. SMH purchased 79 books at a cost of €3,852. 

Electronic resources: €53,000 was spent on electronic 

resources for the Group. SMH contributed €10,500 

towards this and SVPH contributed €5,000. Access to 

UCD’s vast collection of electronic resources continued 

to be accessible from the SVHERC server in SVUH 

Library 

Interlibrary Loans 

SVUH Library: 620 journal articles and books were 

requested from other libraries: 80 were from the British 

Library; 414 were from Subito; and 126 from the 

network of Irish Healthcare Libraries (IHL). The Library 

supplied 117 to other Hospital libraries nationwide. The 

overall cost of ILLs for the year was €3,840. 

SMH Library requested 26 journal articles from various 

libraries and supplied 31 articles to other libraries 

during the year. 

104 

Return to Contents



Library & Information Services Committee 

The Committee met 6 times this year under the 

chairmanship of Dr Ed McKone and continued to be 

attended by librarians and representatives from user 

groups throughout SVHG. At the end of the year it was 

agreed to move the date for future meetings to the 

second Tuesday of every second month. 


Conferences/Seminars: 

• Health Sciences Libraries Group Annual Conference 

– Hodson Bay Hotel, Athlone 

• Academic & Special Libraries Annual Seminar – 

Clarion Hotel, IFSC, Dublin 

• Critical Appraisal Skills Workshop – BMA House, 

London 

• LIR Annual Seminar – Liberty Hall, Dublin 

• European Association for Health Information and 

Libraries (EAHIL) Conference – Helsinki, Finland 

Future Plans 

Financial constraints and staffing shortages mean 2009 

will be one of the most challenging years for the Library 

& Information Services Departments of SVHG. Our core 

focus will be on supporting patient care and decisionmaking. 

The following are projects the Library & Information 

Services Departments will be working on in 2009: 

• Review of all print and electronic subscriptions to 

reduce costs and maximise usage by clinical staff. 

• Carry out an audit to measure impact of library and 

information services on patient care and key 

decision-making in SVHG. 

• Develop our Intranet pages to provide continuously 

updated information on the library and information 

services and provide a gateway to access our 

resources. 

• Continue to run certified training programmes on 

information literacy and evidence-based practice 

skills. 

• Improve access to and awareness of the library & 

information services for SVPH staff. 

105 

Return to Contents


Medical Records / Patient Services 


A new permanent post was approved for Symptomatic 

Breast Services. The successful appointee for the post 

of Patient Services Coordinator was an internal 

candidate, Dorothy Murray. Dorothy’s previous role in 

Secretarial Services was Grade V Unit Manager for 

Oncology/Breast Services/Palliative Care/Haematology. 

Dorothy takes up her new position on return from 

Maternity Leave. 


Introduction of the national Healthcare Record (HCR) 

began in 2008. Bernadette Howard was appointed 

Project Co-ordinator for HCR implementation. 

Bernadette commenced her new role in May organising 

education and training workshops for all staff, both clinical 

and non-clinical. The plan was to implement the HCR 

by specialty with the first new record being issued in the 

Neurology Unit on August 26th 2008. Workshops and 

roll-out carried on throughout the year, proving to be a 

challenging but successful venture. Roll-out will continue 

into 2009 before it reaches all areas and specialities. 

Changes in service provision, with a focus on increasing 

day case activity and reducing waiting lists, challenged 

many of our staff to re-organise and take on new roles. 

These changes continued in 2008 and many initiatives 

were put in place which focused on improving the 

hospital’s high level Key Performance Indicators. 

An Outpatient Waiting List Project Group was formed 

which meets monthly with an aim to meet the hospital’s 

KPI targets and oversee implementation of strategies 

which will improve the overall operation and 

management of outpatient clinics. The committee 

membership includes clinical and non-clinical staff 

along with a General Practitioner. Nicola Maddock, 

Marian Moran and Tricia Mc Donough represent our 

services. 

A Casemix Review Group was formed which included 

representatives from HIPE, Finance, ICT and Clinicians, 

as required. Several new initiatives and pilots were 

completed, their aim is to facilitate the meeting of 

deadlines in a timelier manner and to allow the hospital 

achieve a maximum value for each patient’s episode of 

care. 

Audits commenced in the filing room with the 

involvement of the Clinic Secretaries. A regular monthly 

audit of the tracer system and chart availability began in 

2008 and will continue into 2009. 

Future Plans 

• During 2009, the Medical Record Audit will be a 

major emphasis. Audits on clinical documentation will 

commence in conjunction with the Clinical Audit 

Team and separate audits will be done on compliance 

with the new HCR filing order. 

• Late in 2008, a management decision was made to 

change the organisational reporting relationship of 

Ward Secretaries, who previously reported to Nursing. 

The Ward Secretaries officially join the Medical 

Records/ Patient Services Department in 2009. We 

look forward to forming this new relationship and 

integrating Ward Secretaries to our team during 2009. 

• A new Digital Dictation System will be introduced 

throughout the hospital. 

• Plans for a Text Reminder Service are underway and 

implementation will commence early in 2009. 

106 

Return to Contents


Allied Health Professionals and Support Services 

107



Medical Physics and Clinical Engineering Department 

Staff Members 

Tom Smyth AEng, 

Frank Kelly 

Derek Farrell 

David Farrell BSc 

John Harte 

Aidan O’Connor 

Declan Murray MSc 

AMIEI Chief Clinical Engineer 

AENG, AMIEL; IENG, MIHEEM 

Principal Clinical Engineer 

Principal Clinical Engineering Technician 

Senior Clinical Engineering Technician 





• Preparation for forthcoming projects, equipping 

• Compiling comprehensive equipment specifications 

• Advising on and evaluating new equipment purchases 

• Continuously updating information on EEC Directives 

• Continuous liaison with health and safety including 

product alerts 

• Quality control, liaising with Irish Medicines Board 

• Technical Specifications for all new electro-medical 

equipment 

• The Department is working towards CPD 

registration with Engineers Ireland 

Academic Achievements 

We currently have some members of staff registered 

with The Institution of Engineers. This is a professional 

representative body for Clinical Engineering in Ireland 

and as such by act of the Oireochtas in 1969 are entitled 

to award the title of Chartered Engineer, Associate 

Engineer and Engineering Technician of the Institution 

confined to suitably qualified candidates. We also have 

applied for CPD Accreditation with The Institution of 

Engineers and are at an advanced stage of the award. 

Achievements 

• Frank Kelly was elected as a Member of Central 

Council of Engineers Ireland 

• John Harte; National Irish Representative for The 

Critical Care Society 

• Frank Kelly; National Treasurer For Biomedical/ 

Clinical Engineering Association of Ireland 

Publications 

Frank Kelly and Derek Farrell Poster: "On-Line 

Haemodiafiltration a Preferred Modality of Treatment" 

9th Annual Interdisciplinary Research Conference Trinity 

College School of Nursing and Midwifery Dublin 5th - 

7th November 2008. 

Frank Kelly and Derek Farrell Poster: Annual Scientific 

Meeting of The Biomedical / Clinical Engineering 

Conference, Tullamore October 2009. 

Frank Kelly and Aidan O Connor members of the 

Consultation Group on Advisory External Defibrillator for 

UCD School of Medicine and Medical Science for 

Immediate Care Services. 

National Pre-Hospital Standards 2008 

On Line Haemodiafiltration a Preferred Modality of 

Treatment. Spectrum Winter 2008 

Medical Device Training 

Frank Kelly and Derek Farrell attended Training on the 

5008 Fresenius Dialysis Machines 

John Harte; Physiology Monitor Training in MDI 

108 

Return to Contents



Medical Physics and Clinical Engineering Department 

Meetings attended: 

Tom Smyth attended Medica Düsseldorf 

Frank Kelly, Derek Farrell and Aidan O’Connor attended 

the B.E.A.I. Annual Scientific Meeting in Tullamore 

Declan Murray attended: 

1. Medica Düsseldorf Nov ‘08 

2. Fresenius HDF presentation RDS Apr’ 08 

3. Healthcare Ireland RDS June ‘08 

Frank Kelly attended The British Renal Association 

Meeting Glasgow 

Frank Kelly attended the European 37th European 

Dialysis Transplant Association and the European Renal 

Care Association Meeting Prague. 


The department has continuously succeeded in 

producing considerable savings in equipment repairs 

and planned preventative maintenance by adopting the 

policy of only outsourcing maintenance when 

absolutely necessary. 

The department is phasing in, along with the 

equipment library, a new I.T. solution to our method of 

equipment management. This will serve to greatly assist 

the task of equipping all new projects. 

The Equipment Library has been introduced and we are 

currently collecting stock. 

John Harte attended Critical Care Society Manchester 

Annual Conference 

109 

Return to Contents



Medical Social Work Department 


Firstly the major achievement of the year in terms of 

staffing was the elimination of all the temporary positions 

in the Department. Presently we have 19 permanent 

posts involving a total staff of 23. Also there was one 

new Senior Social Work position created during the year 

bringing the total to 8. Louise Morgan, who was a Senior 

Practitioner, secured the position. Fiona Byrne, who 

previously worked as a locum, obtained a permanent 

post in August. Nicola Flynn, who was also in a temporary 

position, secured permanency at the same time. Finally, 

Karen Quinn took up a role in the Emergency 

Department in September with a permanent contract. 

During the year Enara Etxebarria resigned her position 

in order to return home to Spain. 

Emer Bissett, who was employed as a locum in the 

Emergency Department, obtained a permanent post in 

Tallaght Hospital in August. 

Naoise Waldron, a former student, provided Social Work 

cover during the months of June, July and August for all 

the staff on vacation. 

Alison Merrigan, provided locum cover for Louise 

Morgan from September until December during the 

latter’s maternity leave. 

In addition it is important to acknowledge the support 

provided by our administrative staff during 2008. There 

are 2 positions, covered by three people. 

Mary Gaughan joined us this year after Mary Brewer had 

resigned her post after 10 years in the role in February. 


We moved into our new suite of offices in July 2008 

which includes an interview room, 2 offices and a 

conference room for business meetings, family 

meetings etc. It has been a wonderful addition to the 

department and enables us to see patients and their 

families in a pleasant, private environment. 

We had a busy and challenging year in 2008 in Social 

Work. Firstly our referral rate continued to increase 

compared to previous years. We had 7,109 open and 

closed cases during 2008. 

Our pivotal role in facilitating discharge for patients to 

either home or long term care came sharply into focus. 

As can be seen from the statistics we placed 119 patients 

in DDI (Delayed Discharge Initiative) beds. Earlier in the 

year the hospital funded from its own resources 45 

patients in private nursing homes to relieve pressure on 

the Emergency Department. The number of patients 

requiring long term care had dropped to an all time low 

of 8 by the end of December after 30 patients had 

been successfully placed during that month. Also it is 

significant to note that the length of stay has dropped 

significantly to less than 3 months i.e. for the patients 

who were longest in the hospital. 

Kiltipper Nursing Home continued to provide “step 

down” beds to our hospital in 2008. There was a total 

of 119 patients who availed of this resource for the 

year. Unfortunately the 6 beds in Our Lady’s Manor 

ceased to operate from July due to a number of 

reasons beyond our control. 

The reduced budget from the HSE with regard to 

support services at home had an impact on our patients. 

However despite this we managed in practically all cases 

to get people packages of care. The younger chronically 

ill patients also had very few allocated resources to 

enable them to receive appropriate services. Yet we 

110 

Return to Contents




were able to place patients (for example) in appropriate 

residential/nursing home care by using DDI monies. 

With regard to other developments, the Old Age 

Psychiatry Social Workers were involved in a number of 

programmes during the year e.g. Healthy Ageing, Anxiety 

Management, Carers Support. A clinical audit was 

carried out on the Carers Information meetings and a 

poster was presented both at the Clinical Audit Day in 

our hospital as well as the National Gerontology 

Association Annual Conference in September 2008. 

The Bereavement Group ran its two courses during the 

year for all relatives/carers of deceased patients in the 

hospital. The response from the evaluation from the 

participants was positive. 

The department also addressed the issue of our role in 

a major emergency and we completed a plan and did a 

“dummy” run to evaluate its effectiveness. 

be launched nationwide. It involves recruiting and 

training volunteers to drive and support these particular 

patients to and from hospital. 

With regard to staff training quite a number of Social 

Workers availed of the in-house programmes on offer 

e.g. Stress Management. The 7 Habits, “Mindfulness” etc 

External training was also availed of by members of the 

team e.g. in relation to bereavement and end of life 

issues, HIV counselling, and motivational training 

associated with taddiction. 

There was a review day organised by the department 

for clinical supervision for both supervisors and 

supervisees. Louise Morgan completed her supervision 

training in the autumn after achieving promotion. 

We had 7,109 open and closed cases in 2008, 

which is an increase from 2007: 

Total Number of Cases opened & closed 

DDI Beds 

Eileen O’Donnell, Senior Social Worker, played a major 

part in the “roll out” of The Care to Drive” Pilot Scheme 

instigated by The Irish Cancer Society in conjunction 

with St Vincent’s University Hospital for oncology patients. 

It has proved to be a major success and as result will 

We received 119 D.D.I. beds from the H.S.E.in 2008, 

which is a decrease from 143 for 2007: 

111 

Return to Contents




Future Plans 

Given the serious economic constraints that exist at this 

present time and for the foreseeable future our 

aspirations for the service are quite modest. Firstly we 

aim to provide a quality service to all our patients and 

the other staff in the hospital. Currently we are looking 

at patient satisfaction and how we can measure this and 

act upon it. We are looking at making positive changes 

with regard to our referral form that will enable us to 

glean essential information so that we can do our work 

more efficiently from the beginning. We will review this 

on a regular basis in consultation with users of the 

service. 

We are also looking at launching an assessment form 

for ourselves that will ensure we are all working to the 

same standard and that there is uniformity in its best 

sense. 

We are keen to contribute to the accreditation process 

currently being undertaken so that what we do as a 

profession is clear and transparent to staff and patients. 

We are very aware of our key role with “vulnerable” 

patients and the need to drive a hospital wide policy 

and training to address the issues that can come up 

from time to time e.g. elder abuse, child protection, 

domestic violence. 

We shall continue to focus on Team Based Performance 

and setting our indicators for the year. We are presently 

working with our professional colleagues both in the 

hospital and externally in endeavouring to drive forward 

the implementation of the Common Summary 

Assessment Record that has been launched by the 

HSE. 

112 

Return to Contents



Department of Nutrition and Dietetics 


There was a 3.4 % decrease in in-patient consultations 

between 2007 and 2008; however we had a slight 

increase in the number of new in-patients referred, with 

a decrease in the number of review consultations 

undertaken. This probably reflects the reduction in 

length of stay (LOS) from 10.6 to 9.3 days in 2008. 

There was a 1.4% decrease in OPD consultations both 

MDT and Dietetic-led clinics. However in our Dietetic 

led OPD clinic we achieved a 3.8% reduction in DNA 

rate while offering an urgent appoint within 4 weeks 

and standard appointment within 8 weeks. Writing to 

patients advising that we have received a referral and 

asking them to contact the Dept to make a suitable 

appointment has reduced the DNA rate. We already 

have a reminder system in place. 56% of patients did 

not request an OPD appointment. 

As in previous years our Day Case rate has increased 

by 2.1% from 2007. There was an increase of almost 

500% in the number of staff attending education/ 

updates in 2008. 


The total staff compliment at the end of 2008 was 

maintained at 16 WTE. Niamh O’Sullivan (Senior 

Dietitian in Liver Transplant), Nicola Dervan, (Senior 

Dietitian ICU) and Aisling Nolan (Entry-level Dietitian) 

joined the Dept throughout the year. As part of the cost 

containment strategy we had over 5 weeks of unpaid 

leave in the Dept without replacement staff, which 

contributed to the reduction in activity and costs. 


In August a weekly dietitian-led Cardiology clinic was 

introduced to meet the needs of patients discharged 

from the Cardiology Unit prior to receiving dietary 

advice, due to the short LOS and to allow monitoring of 

those requiring nutritional support in hospital. This is a 

growing area in Cardiology now representing approx 

36% of dietary interventions on the Cardiac Unit. The 

clinic was designed to be partially booked to allow for 

referrals from the Cardiac Clinic on the same day, but 

113 

Return to Contents




on review of the service, this was changed to a fully 

booked clinic. The DNA rate was 12%, which is lower 

than our general clinic. 

In summer 2008 a tender for enteral and oral 

nutritional supplements was completed with a 

projected saving of €30,000 p.a. 


Nicola Dervan, Senior Dietitian in ICU undertook an 

audit of Nutrition Support practices in ICU. The results 

were benchmarked against best practice guidelines and 

compared to similar ICU units nationally and 

internationally. The findings have been presented at 

Intensive Care Education Sessions and the Surgical 

Grand Rounds. The results will also be used to identify 

areas that need to be targeted in educational updates 

and guideline development. 

During 2008 an audit of PN (parenteral nutrition) 

practice was undertaken on medical and surgical wards 

in St Vincent’s University Hospital. This audit observed 

the current prescribing, administration and monitoring 

of parenteral nutrition practices in St. Vincent’s University 

Hospital and was benchmarked against PN guidelines 

in the Nutrition and Medicines Guide 2007/2009. An 

educational poster was developed on the rules of safe 

practice with parenteral nutrition which is displayed in 

treatment rooms on all wards within the hospital and 

will be used as an education tool in parenteral nutrition 

education sessions in 2009 

The department facilitated a final year thesis for a BSc. 

in Human Nutrition and Dietetics. Laura Keaskin 

completed her thesis entitled “An Investigation into the 

efficacy of four nutritional risk screening tools in 

respiratory patients”. A sample of 50 patients with a 

respiratory diagnosis consecutively admitted during a 

four-week period were nutritionally screened using four 

nutrition risk-screening tools. This was compared to a 

full nutritional assessment incorporating anthropometry 

and dietary assessment. In addition, current compliance 

with the local nutrition-screening tool was examined 

and the opinions of nurses in relation to nutrition risk 

screening were sought in a short questionnaire. More 

than one-third (36%) of the sample were at risk of 

malnutrition according to the nutritional assessment. 

The Malnutrition Universal Screening Tool (MUST) 

performed best in terms of sensitivity (72.2%) and 

specificity (93.8%). Almost all (89%) nurses reported 

using the screening tool most of the time however, only 

28% of patients had their nutrition risk score documented 

on admission. Issues such as being unable to weigh the 

patient or the patient being unable to answer questions, 

lack of time and working equipment were highlighted 

as barriers to completion of the tool. A small working 

group under the auspices of the Nutrition Committee 

has been established to implement the MUST tool as a 

hospital-wide nutritional screening tool in 2009. 

In April 2008, there was a hospital wide introduction of 

Protected Mealtime followed by an audit to examine its 

efficacy in June 2008. Previous work by the Nutrition 

Sub-Committee, a sub-committee of the Nutrition 

Committee, on this topic in SVUH indicated a reduction 

in interruptions during the lunchtime meal on the wards 

where protected mealtimes had been implemented. A 

Protected Mealtimes policy was then approved as a 

hospital guideline and was introduced throughout the 

hospital in April 2008. The roll out included 

• Poster campaign, information leaflets, information 

on the Intranet. 

• Information sessions on all wards and with the 

Catering Department. 

• Presentations at the general Staff Briefing session 

and at the Nurse Managers Meeting. 

• Information stand in the main hospital concourse. 

• Protected Mealtime information was added to the 

electronic media link at the entrance to the hospital. 

• All-user email sent to all hospital staff. 

114 

Return to Contents




In order to assess the efficacy of the Protected Mealtimes 

a post implementation audit was carried out in June 

2008. 129 hospital in-patients’ mealtimes were 

audited. This was carried out throughout the hospital 

where one six bedded bay from each of the 23 wards 

was included. The aims of this audit were 

1. To determine compliance with the Protected 

Mealtime audit hospital wide. 

2. To highlight any issues with the new policy. 

3. To report back to all relevant stake-holders. 

4. To make changes as appropriate. 

The results of the audit were encouraging, showing a 

similar percentage of interruptions to the smaller pilot 

as indicated below 

The results have been presented to the Clinical Nurse 

Managers and have been included in the hospital wide 

newsletter. The Nutrition Sub Committee will depict the 

results in a poster for staff and visitors and hope to have 

the audit accepted for publication in relevant literature. 

Significant Publications/Presentations 

Poster presentations 

M.C. O’Hara, V. Reid, M. Minogue, D. Walsh and C.C. 

Kelleher. 

“Profiling patients after cardiac rehabilitation enrolled in 

an Irish Heart Foundation-funded randomised cookery 

skills intervention: are they compliant with current 

health recommendations?“ 

Irish Association of Cardiac Rehabilitation, Dublin, 

November 2008. 

Barnes, EA, McAuliffe, E, 

“Exploring the information needs of Irish patients with 

colorectal cancer”. Health Policy and Management 

Integrated Care: Putting Research into Practice, TCD, 

Dublin June 2008 

Reilly CM, Keane CM, O'Shaughnessy LM, Hough P, 

O'Brien H, Groenewald L, McKeown C, McKone EF, 

Gallagher CG. 

A retrospective study of End of Life Care in Cystic 

Fibrosis. 

North American CF conference October 08 

Submitted by Liz Barnes, 

Dietitian Manager, 

115 

Return to Contents



Occupational Health Department 


Occupational Physician 

Dr. Paul Guéret 

Dr. Robert Ryan 

Occupational Psychologist 

Nuala Gannon 

Dr. Jacintha More-O’Ferrall 

Clinical Nurse Specialist (CNS) 

Aisling Purcell Ann O’Reilly 

Justine McGrane Siobhan Bulfin (Up to June 2009) 

Marie Hennigan (from July 2009) 

Administrative support 

Áine Yap 

Service activity levels 

Barbara Sheridan. 

• Management referrals (Total.:411) 

• Self referrals (Total: 239) 

• Pre-employment assessments (Total: 868) 

• Occupational injuries -e.g. needlestick & splash 

injuries, slips/trips/falls, MSK (Total: 157) 

• Vaccinations appointments (Total: 1882) 

• Backs appointments (Total: 152) 

• Psychosocial (Total: 613) 

• Education (Total: 1087) 

Breakdown of consultations 

Medical (Total: 1338) Psychosocial (Total: 613) 

CNS appointments (Total: 1899) 

Service activities 

1. Vaccination and immune status evaluation 

A comprehensive vaccination programme was 

undertaken with testing for immune status as 

indicated. The programme provided for the 

evaluation of and vaccination for Measles, Mumps 

and Rubella, Varicella, TB and Hepatitis B titres. 

2. Infection control 

• Exposure Incidents 

Occupational Health managed 28 incidents where 

staff were accidentally exposed to potentially 

infectious blood or body fluids and 98 incidents 

where staff received needlestick injuries. 

• Contact tracing 

Occupational Health managed the process of contact 

tracing of staff exposed to patients who contacted 

infection diseases such as Measles, Mumps, Rubella, 

Varicella, TB and Meningitis. Varicella contact tracings 

were undertaken on 26 occasions in 16 areas and 

397 staff required OH advice. A number of high 

risk groups within the Hospital were identified and 

screening for their immune status is ongoing. 

• Influenza 

Occupational Health provided a flu vaccination 

programme for staff; it was availed of by 656 staff. 

• Norovirus 

There were no outbreaks of the Norovirus in 2008; 

however 170 staff with gastrointestinal upset 

contacted Occupational Health for advice. 

3. Psychological health 

The service offered: 

• Counselling to all members of staff (Total number: 115). 

• Consultative support to Managers and Management 

(Total: 73) 

• Training and Development in the areas of stress 

management and other topics relevant to the 

psychological health and wellness of staff (Total: 215). 

4. Policy development 

The department was involved in: 

• The development of hospital-wide policies through 

the Committees attended; 

• The development and revision of internal 

Occupational Health protocols. 

5. Education and training 

The service delivered training to staff in the following areas: 

• Venepuncture and Cannulation study days; 

• Induction for new staff; 

116 

Return to Contents



Occupational Health (OH) Department 

• Needlestick injury prevention workshops targeting 

specific areas such as Theatre, Laboratories and 

some ward areas, and particular staff groups such 

as NCHD’s. Some 872 staff attended these 

sessions in 2008. 

• Workshops and short courses for Managers: 

i. ‘How to…manage stress’. 

ii. ‘How to…deal with difficult and challenging 

behaviour’ 

iii.‘How to…deal with grief and loss’ – for 

clinical and non-clinical staff groups. 

• Workshops and short courses for staff: 

‘Managing stress’ 

6. Health Promotion 

The Department provided the following staff 

information and wellness programmes: 

i. The ‘Working Backs’ programme 

ii. The ‘Pregnancy At Work’ programme 

7. Committee work 

The OHD was represented on the following hospital 

committees: 

• Health and Safety Committee 

• Infection Control Committee 

• Hygiene Services Committee 

• Pandemic Influenza committee 

• Safety risk quality improvement group 

St Vincent’s Private Hospital (SVPH) 

The service continued to expand with an excess of 200 

staff availing of the following services in 2008: 

• Pre- Employment Health Assessments; 

• Immune status evaluation and vaccination– 

Hepatitis B, Measles, Mumps, Rubella, Varicella and 

Tuberculosis; 

• Management of inoculation injuries (10 needle 

stick injuries and 1 blood splash); 

• Management referrals; 

• OH Psychology service; 

• Cytotoxic Surveillance. 


• The design, development and implementation of 

the ‘Pregnancy at Work’ programme. 

Future Plans - 2009 

1. Develop the OH website on the Intranet, providing 

more information for staff and managers. 

2. Further develop an integrated data management 

system. 

3. Undertake more staff training. 

4. Undertake audit and implement change as indicated. 

117 

Return to Contents



Occupational Therapy Department 

Overview 



St. Vincent’s Public and Private Occupational 

Therapy services 

We enjoyed almost 100% staffing in all Occupational 

Therapy Service Areas throughout the year 2008. This 

resulted in our being able to work on key objectives set 

for the department, which included the following inline 

with the Organisations KPI’s: 

St. Vincent’s 

We were fortunate to have received an additional post 

in 2008. This was an OT splinting and hands post with 

specific responsibilities to the following: 

- 0.5 hands and plastics to make that OT post 1 

WTE. 

St. Vincent’s Occupational Therapy Department 

2008 again was a very successful and productive time 

from an Occupational Therapy perspective. We 

achieved our departmental goal of reviewing our 

standards and completed 4 out of 5 internal audits of 

our service. 

• Reducing waiting lists and time of access for both 

in-patients and outpatients. 

• Tracking and setting targets for the numbers of 

patients facilitated monthly by our pilot Discharge 

Facilitation Post. 

• Reviewing and introducing risk identification and 

systems analysis. 

• Reviewed and updating all our documentation and 

non standardised assessments / forms to be easily 

identified as Occupational Therapy Specific in line 

with the Organisation roll out of the National Patient 

Chart. 

- 0.25 to Hands referrals in ED. 

- 0.25 to tackle Neurology outpatient’s waiting list 

and target patients with urgent splinting needs. 

We also were fortunate to be able to continue our pilot 

Discharge Facilitation post, which continued to expedite 

hospital discharges, which only require Occupational 

Therapy intervention. 

There was some internal movement within the 

Department namely in the areas of Stroke and 

Neurology, Orthopaedics and Medicine for the Elderly. 

We also had 2 staff members successfully go from 

basic grade to acting senior members of staff. 

These audits included: 

- Hands and Plastics OT: Audit of Hand Fractures 

- Old Age Psychiatry OT: Anxiety Management 

Group Programme 

- OT dept- Evaluating the Impact of Occupational 

Therapy Home Assessments and intervention on 

Patient Safety using the SAFER HOME tool as an 

outcome measure. 

- Adult Mental Health OT: Consumer survey 

surrounding Occupational Therapy Interventions. 

118 

Return to Contents



Occupational Therapy Department 

In-patients Totals 2006 - 2008 

Year New Return No. Of Attend. Units of Contact 

2006 897 1065 8851 25742 

2007 993 917 9468 25806 

2008 1480 770 13281 48656 

Outpatients Totals 2006 – 2008 

Year New Return No. Of Attend. Units of Contact 

2006 1296 1342 4931 14119 

2007 1548 1267 6399 20143 

2008 1782 2443 20793 82369 

Occupational Therapy Statistics 

In reviewing our activity statistics for 2008 we have 

seen quite a dramatic increases in the past year and 

this can be contributed in part to our levels of staffing 

throughout the year 2008. 

Future Plans 

The Occupational Therapy Department has the 

following service Objectives for 2009: 

Each Occupational Therapy Service Area to have 

benchmarked their service against National and 

International guidelines and ensure standards set are in 

line with National and International evidence. 

119 

Return to Contents





Major service developments and activities were: 

• Senior pharmacist allocated to co-ordinate clinical 

pharmacy services to surgery 

• Senior pharmacist appointed to oncology position 

shared between aseptic manufacturing and clinical 

service 

Aseptic Service 

There was a 12% increase in the number of items 

manufactured in the Aseptic Unit. This was mainly due 

to: 

• 90% increase in the number of ganciclovir infusion 

bags made for patients in the Liver Unit. 

• Production of pre-filled syringes of heparin in 

support of a new medication safety initiative 

• 7% increase in the number of IV chemotherapy 

items prepared. 

The aseptic service also supported 20 oncology 

research projects in 2008. 

Dispensary Service 

In 2008 there was an increase in activity in dispensary 

services including provision of emergency trays and 

rolls, non-sterile manufacturing and staff prescriptions. 

In October the dispensary took over responsibility for 

supplying outpatient prescriptions (controlled and noncontrolled 

drugs) for all clinical areas. 

Activity in the Aseptic Unit 2000-2008 

Clinical Service 

The SARI pharmacist, Zulema Gonzalez Sanchez, 

organised “Antibiotic Awareness Day” in SVUH in 

October 2008. The main objective was to highlight the 

problems with antibiotic resistance. Staff were invited to 

take part in an antibiotic quiz and information leaflets 

were distributed. 

Education 

Pharmacy staff provided lectures and workshops for 

undergraduate and postgraduate medical, nursing and 

pharmacy educational programmes. 

120 

Return to Contents




Medicines Information (MI) 

Medicines Information (MI) received a total of 1455 

queries in 2008, (up substantially from 1090 in 2007). 

Two-thirds of this total (998) is made up of queries 

relating to administration/dosage, adverse effects and 

choice of therapy. 

Users of the MI service work in many different areas 

around the hospital. Most frequent users of MI are 

pharmacy staff, doctors and nursing staff. Breakdown of 

queries by area of origin in 2008 is indicated below. 

121 

Return to Contents




No. queries by source Jan-Dec 2008 

Medication Safety 

In Jan 2008, the first Medication Safety Seminar was 

held in the ERC with presentations from SVHG and 

speakers from the University of South Manchester and 

Kings College Hospital, London. Initiatives to minimise 

risk to patients, on importance of medical involvement 

in patient safety, audit of services to improve medication 

and patient safety were presented. 

In 2008, medication safety was included in the monthly 

nursing induction sessions. Education sessions were 

also provided at NCHD induction, to the Emergency 

Dept, Theatre staff and UCD final year nursing. 

High alert medications 

• There was a change in practice in relation to 

vincristine reconstitution / administration, in line 

with WHO guidelines, to minimise risk of inadvertent 

intrathecal administration. SVUH practice changes 

were published in the Irish Pharmacy Journal (Feb 

2008). 

• Heparin infusion policy - a revised heparin infusion 

prescription label was introduced. 

122 

Return to Contents




High-risk medication processes: 

Medication safety reports are provided on a monthly 

basis to the Patient Safety Committee. Medication 

incident reports (MIRs) are graded using the National 

Coordinating Council for Medication Error Reporting and 

Prevention (NCCMERP) grading tool. 668 medication 

incident and near miss reports were received in 2008, 

an increase of nearly 90% (N = 352) on 2007, which 

suggests a culture of medication safety is established. 

SVUH is actively working to learn from medication 

incidents and prevent future ones, through the work of 

the Patient Safety and the Drugs & Therapeutics 

committees. 

SVUH continues to actively partake in national 

medication safety initiatives through the Irish Medication 

Safety Network. 

SVHG Drugs and Therapeutics Committee 

The Drugs and Therapeutics Committee introduced a 

new in-patient medication record during the year 

following a pilot in some clinical areas. The new record 

has a highlighted allergy section and includes the 

prescription for intravenous fluids. 

Multidisciplinary working groups were also convened 

and facilitated by the medication safety co-ordinator in 

order to revise guidance and policy in the case of two 

high alert medications, potassium (August 2008) and 

insulin (November 2008). 

The subcommittee facilitating the nurse prescribing 

initiative met regularly through the year. 

The committee approved and introduced a new 

outpatient prescription for SVUH in October 2008. 

Achievements 

Congratulations to the following members of staff: 

Eilis Kearney won first prize at the HPAI Conference 

(April 2008) for her poster “An Audit of Oral and 

Enteral Liquid Medication Administration Guidance 

versus Practice”. 

Grant Carroll won the Servier Award (2008) for his 

project “Construction of a Patient Medication Card 

Database”. 

Elena Castilla completed a Diploma in Clinical 

Pharmacy (Queen’s University, Belfast). 

Annemarie DeFrein completed and received CPD in 

Oncology Pharmacy 

Eilis Kearney completed a Certificate in Clinical 

Pharmacy (Queen’s University, Belfast). 

123 

Return to Contents




Publications and Posters 

Kearney E, O’Hanlon N. An Audit of Oral and Enteral 

Liquid Medication Administration Guidance versus 

Practice. 

Flanagan M, Moran M, Murphy D, O’Hanlon N. 

The Use of Trigger Tools to Help Identify Adverse Events. 

Kennedy, F. Choice of Antihyperlipidaemic Agents 

(chapter in textbook Drugs and the Liver. 

Pharmaceutical Press, 2008) 

Hammond, L. Audit of Vnous Thromboprophylaxis in 

General Surgery Patients on a surgical ward in St 

Vincent’s University Hospital. 

Conferences 

Nutrition Study day, SVUH, February 2008. A. Shorten, 

M. O’Sullivan. 

European Congress of Clinical Microbiology and infectious 

Diseases, Barcelona, April 2008. Z. Gonzalez Sanchez. 

HPAI Annual Educational Conference, Dublin, April 2007. 

BMJ Group International Forum on Quality and Safety, 

Paris, April 2008. N. O’Hanlon, L. Hammond. 

UKCPA Annual Symposium, Hinckley, October 2008. Z. 

Gonzalez Sanchez. 

British Oncology Pharmacists Association (BOPA) 

Conference, Liverpool, October 2008. AM DeFrein, G. 

Carroll. 

BOPA Study Day, May 2008. L. Hammond, C. 

Muldowney. 

North America CF Conference, Orlando, October 2008. 

C. Keane 

National Pharmacist Conference, Badajoz, October 

2008. Z. Gonzalez Sanchez. 

ASHP Mid Year Clinical Meeting; Orlando, December 

2007. M. Moran, N. O’Hanlon. 

Seminar “Focus on Infection”, Dublin, December 2008. 

Z. Gonzalez Sanchez. 

Future Plans 

The focus for 2009 will be on medication management 

issues and meeting the standards for JCI Accreditation. 

A lot of effort is being put into medication policy writing 

and review, addressing issues with medication 

reconciliation and reducing risks with Sound Alike Look 

Alike Drugs (SALAD) or Look Alike Sound Alike (LASA) 

medications. 

124 

Return to Contents





The WTE complement for 2008 was 39.5 therapists. 

Additional posts were sanctioned in Cardiorespiratory 

Practice Education (0.5 WTE) and ED (1WTE). Both 

positions should result in both enhanced care for 

patients and costs savings for the organisation through 

more timely provision of care, decreased overtime costs 

for on-call physiotherapists and improved discharge 

facilitation for ED patients. 


• Departmental KPI set developed. Indicators selected 

were: number of in-patients referred, number of 

outpatients referred, WTE in position, outpatient wait 

time, monthly expenditure, number of patient 

complaints, weekend hours worked, number of 

emergency call ins, DNA rate. These indicators were 

chosen as indicating the department’s most relevant 

performance indicators and as being in line with the 

organisations current strategy. 

• Team Based Performance management was 

introduced to the 3 clinical service areas within the 

department and the first cycle of performance 

management was completed. 

• HSEland Professional Development Planning tool was 

adopted for all seniors. The use of this tool aids staff 

with assessing their current professional development 

level and planning future developments to respond to 

both individual and organisational needs. 

• Summary of Physiotherapy Services revised and 

placed on SVUH intranet for enhanced information of 

hospital staff. 

• Community links enhanced. Increased communication 

between Physiotherapy Managers in SVUH and local 

PCCC areas was commenced, with each organisation 

providing service descriptions and contact information 

for their own services. 

• ED post sanctioned. Service provision to the Emergency 

Department was increased to 1 WTE Senior 

Physiotherapist grade in December 2008 with a main 

focus on improving in-patient length of stay. Benefits 

of this improved service are that patients benefit from 

an enhanced level of initial assessment, shorter time 

to first assessment and greater assurance of the patient 

being treated in the most appropriate environment. 

• Back Pain Screening Programme Proposal presented 

to Professor Brendan Drumm in February 2008. The 

aims of the programme are that the treatment pathway 

125 

Return to Contents




for patients referred to an Orthopaedic Consultant 

with low back pain should be transformed, so that 

patients gain access to the most appropriate 

healthcare professional in a shorter time frame, 

following comprehensive assessment. A 12 month 

pilot of the Back Pain Screening Programme was 

planned for commencement in 2009. 

Ergonomics and Back Care 

25 further electrical beds were purchased in 2008, 

bringing the number of electric beds up to 120. As 

well as Induction and Refresher Manual Handling Training 

Sessions, greater emphasis was placed on departmentspecific 

training in 2008, in line with Health and Safety 

standards. Theresa Flynn and Karen Clerkin were main 

contributors to the work of The Dublin Hospitals Group 

Minimal Handling Advisory Group, who completed 

Guidelines for Acute Adult Spinal Handling and 

facilitated the first Instructor's course at MMUH in June. 


Sheila White and Mairead Dockery successfully 

completed the Masters in Manual Therapy (MMT) from 

Centre of Musculoskeletal Studies, University of Western 

Australia, Perth. 

Sarah O’Driscoll completed first year of UCD’s MSc in 

Neuromusculoskeletal therapy, Orla Daly completed first 

year of the MBA in Healthcare Management and 

Catherine McLoughlin completed first year of the RSCI 

MSc in Creative Leadership and Organisational Learning. 

Keith Smart continued his HRB sponsored PhD entitled 

'The development and preliminary validation of a 

mechanisms-based classification of musculoskeletal 

pain' at UCD. 

John Messitt and Michael Bride commenced the level 

five FETAC course in infection prevention and control, 

occupational first aid, communication, work experience 

and care of the older person. 

Karen Cradock presented 2 posters at the ICD 

Conference in November ‘The Effect Of Multidisciplinary 

Care On Patients Following Implantation Of Cardioverter 

Defibrillator.’ Cradock K, O’Malley M, Keogh S, Pyne 

Daly P, Cahalane S, Quinn M, Keane D. 

‘To Evaluate The Percentage Of Patients Attending The 

Heart Failure Unit In St Vincents University Hospital Who 

Require Social Work Assessment’. Murray A, Cradock K, 

Edwards N, O’Loughlin c, ryder M, O’Neill D, McDonald K. 

Clare Reilly and UCD undergraduate student Paul 

Nicholas completed research on Thoracic Kyphosis and 

its complications in Adult Cystic Fibrosis. This won 1st 

prize at the National CF conference in Killarney in 

2008. Clare Reilly presented a retrospective study 

undertaken by the CF MDT team on End of Life issues 

in CF at the North American CF conference in October 

2008. Authors: Reilly CM, Keane CM, Hough P, O’ 

Brien H, O’ Shaughnessy LM, Groenewald L, Mc Keown 

C, Mc Kone EF, Gallagher CG. 

Margaret Healy appeared in the RTE documentary 

‘Living with CF’ in August 2008. 


Barry P, Waterhouse D, Reilly C, McKenna T, McKone E, 

Gallaghers C (2008) 

Androgens, exercise capacity and muscle function in 

cystic fibrosis. Chest 134 (6) 1258-64. 

Smart, K, Connell N, Doody C, (2008) 

Towards A Mechanisms Based Classification Of Pain In 

Musculoskeletal Physiotherapy. 

Physical Therapy Reviews 13 (1) 1-10 

Smart KM, Blake C, Staines A, Doody C (2008) 

'Clinical indicators of peripheral neuropathic pain: a 

Delphi study of expert clinicians (abstract)'. 

Physical Therapy Reviews, 13 (3):211-212. 

126 

Return to Contents




Future Plans 

Implement a computer based patient scheduling 

system to replace the existing manual diary system. 

Revise tools for team based performance management 

and enhance co-ordination with HR on setting of 

objectives. 

Continue streamlining of activities with community 

services so that patients can access the most 

appropriate level of care in an appropriate environment 


Patient Referrals 

Patient Attendances 

*NB: A change in statistics definitions with the advancement of Healthstat commanded a change (decrease) to 

reporting of two types of patient attendances: double attendances and rounds and conference attendance. This had 

an effect of decreasing monthly attendance statistics by 1200 per month from October, or 3,600 for the year 2008. 

127 

Return to Contents



Department of Preventive Medicine and Health Promotion 


Professor Cecily Kelleher 

MD, FRCPI, MPH, FFPHM, MFPHMI (Head of Department) 

Ms Jacinta Barnewell 

RGN, SCM, Adv. Dip. Montessori Education 

(Health Promotion Officer) 

Dr. Anna Clarke 

LRCP&SI, MB, MPH, FRCPI, FFPHMI, FFPH 

Ms. Denise Comerford 

RGN, RM (Health Promotion Coordinator) 

Ms. Frances Conlan (Secretary) 

Ms. Kirsten Doherty BSc, MPH (Health Promotion Officer) 

Ms. Marion Fitzgerald 

BNS, RSCN, RGN (Health Promotion Officer, since August 2006) 

Ms Irene Gilroy BSc (Health Promotion Officer) 

Ms. Tina Mooney 

RGN, Dip Mgt, HDip HP (Health Promotion Officer, 

since September 2006) 

Ms. Veronica O’Neill RGN, RM (Health Promotion Nurse) 

Ms. Carol Pye RGN, RM (Health Promotion Officer) 

Ms. Vivien Reid MSc, Dip Diet. (Clinical Specialist Dietitian) 

Ms. Brenda Whiteside RGN, RM (Health Promotion Officer) 

Allied UCD staff 

Professor Leslie Daly, MSc, PhD, FFPH 

Dr. Patricia Fitzpatrick MD, MPH, FRCPI, FFPHMI. 

Service Developments/Achievements 

Service to Patients 

Cardiac Services 

• 24 Hour Ambulatory Blood Pressure Monitoring 

Service 

This service is provided for both in-patients and 

outpatients of hospital consultants and general 

practitioners. There has been a 23% increase in the 

number of referrals in 2006. 

Cardiac Rehabilitation 

This department’s support of cardiac rehabilitation 

continues through the monthly cardiac lifestyle 

information session, which is open to patients and the 

wider community. This is under review, with view to the 

development of a Lifestyle Assessment Service. A 

follow-up study of patients five years after attending 

Cardiac Rehabilitation was undertaken as part of an 

undergraduate student dietetic project, in conjunction 

with Dublin Institute of Technology. 

24 Hour Blood Pressure Monitoring Service 

2006 - 2008 

Safe & Moderate Alcohol Consumption 

Safe & Moderate Alcohol Consumption Project (SMAC) 

A multidisciplinary group, comprised of representatives 

from Nursing, Emergency Department, Occupational 

Health, Psychiatry, Medical Social Work, Liver Unit, and 

Baggot Street Community Alcohol Treatment Unit, coordinated 

by this department, was set up to develop a 

multi-pronged approach to safe and moderate alcohol 

consumption. 

128 

Return to Contents




The aims of SMAC are to develop: 

• Standardised and accurate charting in relation to 

alcohol. 

• Staff training sessions in brief intervention. 

• A seamless referral pathway to appropriate hospital 

and community services. 

was awarded the “European & National Network for 

Smoke Free Hospitals Silver award” in recognition of its 

work in smoking management. 

Smoking Cessation Service Activity 

• Appropriate health promotion material. 

Communication Strategy 

Department staff has been working with management 

on the development of a multimedia communication 

strategy for the hospital. This will allow the dissemination 

of health promotion material from the Health 

Promotion Policy Unit and other organisations to 

patients and the general public through a digital 

information system (i.e. hospital channel and hospital 

website) supported by leaflets and other written 

material e.g. Healthwise. 

Smoking Cessation Services 

There has been an increase of 14% in the number of 

in-patients and outpatients who have been referred to 

the service between 2005 and 2006. Several weekly 

stop smoking courses were run throughout the year, 

with an average smoking cessation rate of 52%. SVUH 

129 

Return to Contents




Nutrition 

The Clinical Specialist Dietitian provides an integrated 

clinical and health promotion service. This includes inpatient 

and outpatient services and group sessions. A 

three-day training course to develop and enhance 

Behaviour Change Skills (Level 1): Interpersonal Skills 

was provided for Community Dietitians in association 

with the Health Promotion Unit, DoHC. All HSE areas 

were represented on the course. 

Sensory Garden Project 

Collaborative work was undertaken with final year 

students from the College of Horticulture Botanic 

Gardens. They used SVUH grounds to develop a 

sensory garden. 7 innovative projects were designed 

and presented to hospital management to be used at a 

later time to enhance the outdoor environment for 

patients and staff. 

• “Healthwise SVUH” was published with contributions 

from staff and distributed quarterly. 

• “Bike to Work” for National Health Promoting 

Hospital Challenge Day, focused on healthy food 

choices as well as increased physical activity. Those 

who cycled to work on the day got a free breakfast 

and entry into a raffle for two bikes, one of which 

was sponsored by hospital management. 

• Smoking Cessation Training, Theory & Practice, was 

provided for staff. 

• A smoking cessation service was provided to the 

estimated 18% of staff who smoke. 

Service to the Community 

• Health professionals from all over the country 

attended a Smoking Cessation Training Workshop, 

run in conjunction with the Irish Cancer Society. 

• A smoking awareness stand was set up in the 

hospital for World No tobacco Day. 50 people had 

carbon monoxide tests on the day. 

Health Promoting Hospitals 

Denise Comerford and Dr Anna Clarke are members of 

the National Executive of the National Health Promoting 

Hospital (HPH) Network. 

Service to Staff 

• Bi-monthly health promotion education sessions were 

provided to departments, including medical interns, 

nursing and general staff induction programmes. 

• 1,000 transition year students from schools in the 

catchment area of the hospital attended our 

seminars on alcohol awareness (x2), cancer 

awareness, smoking active and passive and healthy 

eating. New topics offered include “Bugs, Super 

bugs & Antibiotics” and “Minding your mind”. 

130 

Return to Contents



Speech and Language Therapy Department 

Celebrating a year since our move to the 

Allied Therapy Suite (ATS) 

In December’07, the department moved from St. 

Anthony’s Rehabilitation Centre to the newly renovated 

Allied Therapy Suite on the first floor. It is a major 

development for the department to have a base in the 

main hospital, so close to many of our key service 

areas ENT, Neurology and the Stroke & Care of the 

Elderly services. This move has resulted in many 

positive benefits for our patients, staff and overall 

service. The development of the ATS has allowed for a 

more timely, efficient and integrated service model. 

Current Level of Service Delivery: 

The Speech and Language Therapy Department 

provides both an in-patient and outpatient service to 

over 89 consultants, 23 wards, Carew House, and St. 

Michael’s Hospital. The following is a breakdown of the 

speech and language therapy treatment units by clinical 

specialities for 2008. These figures do not include our 

service to St.Michael’s Hospital. 

Clinical Specialities 2007 Clinical Specialities 2008 

Clinical Treatment Treatment Variance 

Specialities Units 2007 Units + 

Medicine for the elderly 1,928 3,198 + 1,270 

ENT / Plastics 1,541 1,853 + 312 


For the first half of 2008, the department was down 

1.5 posts. This improved in June’08 with the return of 

Susan McElwee, Senior Speech & Language Therapist in 

ENT & Surgery from a career break and Deirdre Kidney, 

Senior in Neurology, St. Michael’s Hospital. In July ’08, 

Eavan McSweeney was successful in gaining a 

permanent basic grade position in the department. 

Oncology 359 122 - 237 

Surgical 803 1,795 + 992 

Respiratory 1,235 1,602 + 369 

Gastroenterology 1,176 1,285 + 109 

Neurology 2,411 3,351 + 940 

Cardiology/Gen Med 159 530 + 371 

Endocrinology 208 527 + 319 

Rheumatology 382 549 + 167 

Nephrology/Psychiatry 645 514 - 131 

131 

Return to Contents




Clinical Specialities/Speech and Language Therapy Treatment Units 2007 and 2008 

Specialised Clinics – Swallowing and Voice 

Videofluoroscopy – Established 10 years 

This specialised clinic is run jointly by the Speech and 

Language Therapy Department and Dr. Dermot Malone, 

Consultant Radiologist. It continues to be the only 

videofluroscopy service in the East Coast Area. Referrals 

are accepted from St. Michael’s Hospital, St. Vincent’s 

Private Hospital, the National Rehabilitation Hospital and 

the Royal Hospital Donnybrook. The clinic takes place in 

the Flursoscopy Unit on the 2nd floor of the Ambulatory 

Day Care building. Two weekly clinics are scheduled on 

Wednesday and Friday mornings. 

132 

Return to Contents




Fees 

The Fiberoptic Endoscopic Evaluation of Swallowing 

(FEES) assessment clinic is conducted jointly by the 

Speech and Language Therapy Department and the 

ENT team. This service commenced in July’04 and is 

completed either at the patient’s bedside or in the 

Voice Lab room in the ENT OPD suite on the first floor. 

Digital Stroboscopy 

This service has been running for the past seven years 

and is part of our weekly voice clinics. It provides 

Fees 

accurate information on the shape, condition and 

functioning of the vocal cords. It also allows the team to 

make a permanent record of the vocal cords vibratory 

patterns, which may be used to monitor progress and 

treatment outcomes measures. 

Training and Development 

Throughout 2008, the department was involved in a 

number of presentations both within and outside the 

hospital. 

Digital Stroboscopy 

We continue to provide input to nursing and 

physiotherapy students. 

The department provided several placements for 

speech and language therapy students. 

We also continued our extensive in-service training 

programme. 

Throughout 2008 the department was also involved in 

the Tracheostomy Study Days organised in conjunction 

with the nursing practice development staff. 

Three final year TCD students successfully completed 

their clinical placement examinations. 

Significant Courses/Conferences 

Karen Kirke successfully completed her postgraduate 

dysphagia training. 

Caoimhe McDermott and Eavan McSweeney both 

successfully completed their postgraduate 

videofluoroscopy training. 

Caoimhe McDermott also completed her 

tracheostomy clinical training. 

133 

Return to Contents

134 

Reports from the Director of Nursing


Report from the Director of Nursing 

Introduction 

On behalf of the Department of Nursing, I am delighted 

to provide an overview of our activity during 2008. Our 

focus continues to be our patients, their families and our 

objective is to ensure their experience of our service is 

one they are satisfied with. Increased level of activity in a 

climate of economic change has been very challenging. 

Considering this, our staff led on many quality 

initiatives, demonstrating the team’s resourcefulness 

and commitment to safe patient care. 


Our Department continued to develop its proficiency in 

utilising Team Based Performance Management as a 

tool for aligning its activity with the organisation’s 

strategic objectives. The process resulted in activities 

which enabled our objectives and the principles of 

Transformation “Easy-Access, Confidence and Pride” to 

be realised for our patients and staff. Reconfiguration 

and development of dedicated bed bases in Respiratory 

Medicine, Cystic Fibrosis, Medical / Surgical 

Gastroenterology, and Medicine for the Elderly are but a 

sample of improvements introduced. 

St Vincent’s became a designated Cancer Centre in line 

with the National Cancer Control Programme. The 

transfer of the Symptomatic Breast Service from 

Portlaoise resulted in further development of existing 

services. Nurses embraced the challenge, a new Triple 

Assessment Breast Clinic was developed and nursing is 

now taking the lead in five clinics in the area. The Cancer 

Support Centre, Lios Aoibhinn was re-located to Nutley 

Lane with nursing taking the lead in managing and coordinating 

this initiative. 

In ADCC, St Mark’s Ward relocated to a newly refurbished 

dedicated Day Services Unit. A nurse-led infusion Therapy 

Suite was opened in December to provide treatment 

for patients receiving Biological Therapies resulting in 

improved access for patients. 

A review undertaken during the year of nursing input 

into the heart failure service, found that over 3000 

patient contacts were specifically with the Advanced 

Nurse Practitioners (ANP) or Clinical Nurse Specialists 

(CNSs) in the speciality, these included: home visits, 

telephone calls, education sessions and in-patient visits. 

The Cardiology ANP Review Clinic was introduced in 

2008, 140 patients were reviewed by the nurse 

appointed to this role. 

Nurse Education and Practice Development 

In striving to maintain excellence in clinical care, I would 

like to acknowledge the continued commitment of all 

135 

Return to Contents



staff involved in education of staff and patients, practice 

and professional development. For the first time, the 

national nurse prescribing initiative was introduced in 

nine clinical areas in SVUH. The “Protected Meal Times” 

initiative was successfully rolled out across the hospital 

therefore enabling patients privacy and time to enjoy 

their meals uninterrupted. Development of staff through 

the provision of ward based education and training 

sessions in clinical practice, in line with the development 

of guidelines, policies and procedures continued to 

provide essential support to staff. Practice Development 

facilitated this in conjunction with clinical staff and 

members of the multidisciplinary teams. Examples of 

areas of focus during the year included tracheotomy 

care, continence care and falls prevention. Clinical 

placement co-ordinators, allocations and administration 

staff continued to work with the nursing staff in the 

provision of high standards within the clinical learning 

environments for nursing students at undergraduate 

and post graduate levels. 

The Director and her team in the Nurse Education 

Centre delivered seventeen different programmes to 

nurses, and health care assistants working in St Vincent’s 

University Hospital and the HSE East Coast Area. Sixtysix 

healthcare assistants employed in the organisation 

and within the region graduated with a FETAC Level 5 

Healthcare Support Certificate. At the request of the 

office of the Nursing Services Directorate, HSE, the 

Education Centre increased the training capacity for 

Cannulation and Venepuncture by 50% for nursing 

staff. The centre also facilitated the first five day Cancer 

Care Course for non-specialist nurses for the Irish 

Cancer Society. 

Activity in research and audit continued to develop and 

expand during the year. The Nursing Department 

continues to be involved in collaborative research 

studies with the School of Nursing and Midwifery in UCD. 

Clinical Audit activity included Hygiene Clinical Waste 

and Infection Prevention and Control audits with staff 

developing and implementing action plans accordingly. 

Nurses specialising in Heart Failure focused on the 

impact of their role on care, and evaluation of telephone 

calls to patients. The ANP in Cardiology began an audit 

in evaluating the frequency and outcomes of CT 

Coronary Angiograms for patients in the Chest Pain 

Evaluation Unit and is due for completion in 2009. The 

ANP and Nurse in Stroke Care focused on reviewing 

and reducing patient falls within the clinical areas. 

Nurse and HCA Bank Service 

The Nurse Bank continued to achieve significant savings 

and more efficient use of resources during 2008. 

Monthly targets and budgets in the areas of Nursing 

and HCA overtime, agency and bank hours were 

introduced and successfully achieved by year-end. The 

establishment of a pool of high quality Nurse and HCA 

staff provided greater continuity of care and reduced 

reliance on agency providers. Additionally and most 

importantly there was a marked reduction in the 

number of investigations, incidents and complaints 

received regarding care issues. 


I would like to welcome those who joined our team of 

nurses and healthcare assistants in 2008 and 

congratulate those who were appointed to the following 

positions: 

Assistant Director of Nursing 

Joan Love Night Superintendant 

ADON Brenda Sheridan Out of hours 

CNM3 Finola Gill Lios Aoibhinn & Oncology Services 

Una Nicholson HSSD 

CNM2 Michelle Connell Stem Cell 

Clodagh McGuinness St Mark’s Ward 

Karina Somers St Catherine’s Ward 

Vida Noronha 

Theatre 

Brid Ni Fhionnagain Colorectal 

CNS Sally Casey CAPD 

136 

Return to Contents



Nursing Graduation 

The annual event in the nursing calendar took place in 

June, congratulations to the fifty-seven nursing students 

who graduated. Congratulations also to those who 

completed post graduate programmes and those who 

were awarded prizes during the ceremony: 

Prize 

Mother Mary Aikenhead Medal 

Mother Mary Bernard Medal 

Nuala Deeney Brennan Prize 

Cecil King Memorial Prize 

Preceptorship Award (Medical) 

Preceptorship Award (Surgical) 

Preceptorship Award (Specialist) 

Winner 

Ms. Mary Bugler 

Ms. Amanda Ward 

Ms. Eileen O’Flynn 

Ms. Eithne Cullinan 

Ms. Louise Skerrit 

Ms. Christin Harnett 

Mr. Anto Joseph 

Jayasundar 

I would also like to thank those who retired from the 

organisation for their long and dedicated service and 

wish them every happiness in their future: Ms Catherine 

Walsh, Post Registration Nurse Tutor, Ms Nuala Donnelly, 

Clinical Nurse Manager 2, St Marks Ward, Ms Dolores 

Anne O'Neill, Clinical Nurse Manager 2, St Agnes Ward 

and Nora Tracey, Clinical Nurse Manager 2, Dermatology. 

Plans for 2009 

• Agree a suite of KPIs for the Department of Nursing 

• Implementation of External Review of Nurse 

Education and Practice Development 

• The Education Centre will continue to offer 

academic, training and development programmes 

• Implementation of Nursing Department’s audit plan 

• Continue implementation of Nurse Prescribing 

• Continue with staff undertaking PDP’s in line with 

agreed target 

• Introduction of a hospital wide patient falls 

programme 

• Pilot Clinical Supervision 

• Introduction of Ionising Radiation prescribing 

• Continue the implementation of HR Strategy 

• Achieve National Hygiene Standard in line with 

HIQA recommendations 

• Work towards achieving JCI Accreditation 

• Implementation of Risk Management Strategy 

Mary Duff 


137 

Return to Contents


Bed Management 

The main functions of the bed management team are: 

• Create capacity to meet the demand for emergency, 

urgent and elective admissions. 

• Reduce length of stay for all patient groups by 

improving access to services and specialist beds for 

in-patients, thus increasing throughput through our 

acute care beds. 

• Improve and promote discharge planning processes 

to reduce the number of acute care beds made 

inaccessible due to delayed discharges. 

TBPM - In 2008, we set Bed Management and 

Discharge KPI’s to measure the effectiveness of the 

teams functioning in line with the high level set of 

performance indicators for the organisation. 

DPTF / IDP – The Discharge Planning Taskforce (DPTF) 

continued its work on initiatives to improve discharge 

processes in the organisation. Towards year end, we 

commenced work to meet the standards in the new 

code of practice for Integrated Discharge Planning 

(IDP). This work is ongoing in conjunction with our 

PCCC colleagues and the transformation programme. 

SSG – Speciality Specific Group have been set up for 9 

specialities in 2008 and have yielded streamlined care 

pathways for those patients, reduced length of stays, 

better access for elective patients and improved bed 

utilisation. 

BMC – The Bed Management Committee revised its 

terms of reference and membership in 2008. It 

continues to function as a forum to make 

recommendations for best utilisation of our beds. 

CIT – Through innovation funding, the Community 

Intervention Team was expanded to area 2 mid 2008 

and has proved effective in improving admission 

avoidance and early discharges. 

Bed reconfigurations in 2008: 

• On St. Patrick’s Ward, we created 6 MOU beds, a 4 

bedded bay and 2 single rooms with the capacity for 

telemetry and more space to manage patients in the 

acute phase of their illness. 

• On St. Vincent’s Ward, significant work was 

undertaken to improve the ward as the dedicated 

bed base for Neurology patients. 

• On St. Luke’s 2 Ward, the area that was previously 

the ICU was revamped and added 3 more single 

rooms to the surgical dedicated bed base. 

• A redesign on Our Lady’s Ward has resulted in a 24 

bedded dedicated bed base for Care of the Elderly 

with greatly improved facilities. 

• St. Christopher’s Ward was developed on the site of 

the old St. Mark’s Ward as a dedicated bed base for 

Cystic Fibrosis and respiratory patients. It comprises 

8 single rooms with en-suite facilities. The dedicated 

respiratory bed base was agreed as 55 beds in total 

on St. Paul’s, St. John’s and St. Christopher’s 

• St. Mark’s Day Care Ward moved to the old X-ray 

Department. The area was redesigned and 

comprises 23 day beds, including 3 single rooms. 

• Dedicated 5 day beds for pain patients were 

agreed on St. James’s Ward to address an ever 

increasing waiting list for pain procedures. 

• CDU moved to a redesigned area within the 

Emergency Department. 

138 

Return to Contents


Hospital Sterile Services Department – HSSD 

Activities 

The National Hospitals Office launched the 

Decontamination Basics on line training programme in 

October 2008. The programme has been rolled out in 

departments that carry out decontamination. The 

programme is available to all staff on HSE website 

(www.hseland.ie). 

Ms Ita Balf, HSSD Manager, retired in January 2008. 

The new manager, Ms Una Nicholson, took up her post 

in July 2008. Una has a background in sterile services 

and infection control. 

Ms Maribel Franco, team leader, left the department in 

May to take up the post of Sterile Service Manager in St 

Michael’s Hospital. May we wish her all the best in her 

new position. 


2008 saw a 6.5% increase on 2007 activity levels for 

reprocessing medical devices in HSSD. The department 

has taken on the decontamination and reprocessing of 

medical devices for the new Dental Service in ADCC. 

We continue to sterilize medical devices for St. 

Columcille's Hospital, Loughlinstown because of lack of 

capacity in their HSSD. The unit sterilized over 5500 

pieces for Loughlinstown in 2008. Each day sets are 

received, reprocessed and dispatched back sterile to 

Loughlinstown Hospital. The unit also has undertaken 

external processing of equipment for the Rotunda 

Hospital. 

Education 

• Sinead Moran and Stephen Newman commenced 

their 2nd year BSC, in Sterile Services; at the 

Institute of Technology; Tallaght. September 2008. 

• 7 members of the technical staff undertook the 

NHS On-Line decontamination programme. 3 Staff 

commenced level 5 Skillvec programme. 

139 

Return to Contents


Hospital Hygiene Services 

St. Vincent’s University Hospital is committed to 

consistently providing a clean and safe environment for 

patients, visitors, staff and members of the general public 

as well as continually improving cleanliness standards. 

In November 2008, St. Vincent’s University Hospital 

participated in a National Hygiene Audit undertaken by 

the Health Information and Quality Authority (HIQA) 

and received an overall rating of ‘Fair’, this compares 

with a rating of ‘Good’ in 2007. 23.21 % of scores 

were A ratings (Exceptional Compliance), 55.36 % 

were B ratings (Extensive Compliance), 19.64 % were 

C ratings (Broad Compliance) and 1.79 % were D 

ratings (Minor Compliance). 

The St Vincent’s University Hospital Hygiene Audit Tool 

was rolled out in March 2008, the tool is designed to 

help CNM’s and other department managers to manage 

and improve hygiene practices in their own areas. Two 

full rounds of audits were completed in 2008. The 

results from these audits have been used to develop 

Key Performance Indicators (KPI’S) for hygiene services. 

The plan for 2009 is to carry out quarterly audits across 

the hospital producing a complimentary set of KPI’s. 

The Safety Risk and Quality Improvement Group 

continued to meet. A Health and Safety Week seminar 

themed ‘Risk Assessment’ was run to assist staff in 

conducting risk assessments. The Hospital Hygiene 

Quality Improvement Group continued to meet on a 

monthly basis, chaired by the Director of Nursing. 

The Infection Prevention & Control team carried out a 

review of all education programmes. Enhanced 

surveillance of Health Care Associated Infections 

(HCAI’s) has been introduced. The Infection Prevention 

and Control page on the SVUH intranet has been 

redesigned and the liaison programme has continued. 

2008 saw the establishment of an Estates Strategy 

Group (ESG) to oversee all campus development. A 

number of major projects were completed during the 

year, notably the new Allied Therapy Suite (January), 

new St Mark’s Daycare Ward (June), new 8 bed St 

Christopher’s CF Ward (August), St Vincents Ward 

upgrade (September) and kitchen, toilet and shower 

upgrades in 7 wards (December). Additionally a 

number of essential facilities related improvements 

were carried out by Technical Services. Unfortunately for 

the hospital this significant investment was not reflected 

in our scoring during the October Hygiene Audit. Our 

overall rating decreased from “Good” to “Fair” and was 

not indicative of all the hard work and commitment 

shown by staff to improving hygiene standards. It was 

also not a true reflection of the work put in by many of 

the support services. 

Household Services introduced a curtain changing 

procedure for all clinical areas in March. Members of 

the Household Services staff have been involved in 

hygiene auditing of public areas. 

A new Waste Marshall was appointed in 2008. The 

whole hospital waste policy was reviewed and reissued. 

Members of the portering staff have been involved in 

hygiene auditing. 

The Theatre Infection Control sub group continued to 

meet monthly to monitor hygiene standards in the 

theatre complex. 

Completion of ward kitchen upgrades has ensured they 

are now compliant with hygiene standards. The 

induction package developed in 2007 has been 

reviewed and updated in line with Irish Standard I.S. 

340: 2007 – Hygiene in the Catering Sector. 

St. Vincent’s University Hospital continued its 

partnership with Noonan Services Contract Cleaning 

Limited. The cleaning matrix has been amended to 

incorporate the new areas of St Christopher’s Ward, the 

Allied Therapy Suite and St Marks Day Ward. 

140 

Return to Contents


Reports from Department of Medicine 

141


Report from the Professor of Medicine 


Consultants: 

Specialist Registrars 

Registrars 

Special Lecturers 

Professor Michael Keane 

Dr Seamas Donnelly 

Dr John Seery 

Dr Emer Kelly 

Dr Ruth Lee 

Dr Michael Pallin 

Dr Azhar Jahinger 

Dr Boon Beng Shu 

Dr Shahid Zia 

Dr Ijaz Kamal 

Administration Manager/Student co-ordinator 

Barbara Cantwell 

Service Developments 

Curricular reform continues at UCD with significant 

changes being implemented in the undergraduate 

teaching programme as it moves towards a fully 

modular programme. 2007 was the last year when 

students would follow the old format of “Res Year” and 

they will also be the last group to follow the traditional 

“Final Med” structure in 2009. Graduate entry to 

Medicine was approved for UCD and the first group of 

students commenced in 2008. 

The unit continues to provide a busy clinical service as 

evidenced by the in-patient and outpatient activities. 

The unit has a tradition of providing a national referral 

centre for interstitial lung disease. The unit continues 

with its academic activities with both Professor Keane 

and Dr Donnelly being active investigators at the Conway 

Institute in UCD funded by Science Foundation Ireland. 

Professor Keane is on the editorial board of the American 

Journal of Respiratory and Critical Care Medicine, 

American Journal of Physiology; Lung Cellular and 

Molecular Physiology, Fibrogenesis and Tissue Repair. 

The Dublin Academic Health Centre (DAHC) was 

established to foster greater collaboration and 

interactions between St Vincent’s University Hospital, 

Mater Misericordiae University Hospital and the Medical 

School at UCD. This follows the model of academic 

medical centres, which have been established 

internationally. 

UCD continues its links with Penang Medical College 

and Professor Keane travelled to Penang in June as an 

examiner in the Final Medicine Examination. 


Weigt SS, Elashoff RM, Keane MP, Strieter RM, 

Gomperts BN, Xue YY, Ardehali A, Kubak B, Fishbein MC, 

Saggar R, Ross DJ, Lynch JP, Zisman DA, Belperio JA. 

Aletered levels of CC chemokines during pulmonary 

CMV predict mortality post lung transplantation. 

Am J Transplant. 8(7):1512-22, 2008 

Saggar R, Ross DJ, Saggar D, Zisman DJ, Gregson A, 

Lynch JP, Keane MP, Weigt SS, Ardehali A, Kubak B, Lai 

C, Elashoff D, Fishbein MC, Wallace WD, Belperio JA. 

Pulmonary hypertension associated with lung 

transplantation obliterative bronchiolitis and vascular 

remodeling of the allograft. 

Am J Transplant 8(9):1921-1930, 2008. 

Keane MP, Belperio JA, Strieter RM. Angiogenesis. 

In The Chemokine Receptors. 

Harrison JK and Lukacs NW (eds). Humana Press. 

Keane MP, Belperio JA, Strieter RM. Chemokines in 

Angiogenesis. In Anti angiogenic agents in cancer 

therapy. Teicher BA and Ellis L (eds). Humana Press. 

Keane MP, Strieter RM. Angiogenesis: major mechanisms 

of pulmonary angiogenesis, angiogenesis and cancer. 

"Molecular Pathology of Lung Diseases," 

(Cagle, Barrios, Haque, Jagirdar, Popper and Zander, eds.). 

142 

Return to Contents


Report from the Chairman Physicians Subgroup 


Dr Martin Quinn, 

Chairman of Physicians Subgroup 

Retirements 

Prof Barry Bresnihan retired after many years of 

dedicated service to SVUH. 

Professor Douglas Veale, 

Honory Secretary to Physicians Subgroup 

This year was a busy year for the Department of 

Medicine in St Vincents University Hospital. The 

numbers of patients seen and treated continues to 

increase. The formation of the Dublin Academic Health 

Centre has led to significant collaboration between the 

Mater Misericordiae Hospital and St. Vincent’s University 

Hospital. Professor Doug Veale was appointed the 

Director of Translational Medicine for the DAHC. 

Appointments 

Dr Frances Hayes joined the consultant staff in 

Endocrinology. 

Research and Teaching 

The department continues to have a research output of 

the highest quality with many publications in 

international peer reviewed journals and numerous 

international distinctions. 

Dr Martin Quinn and Prof Doug Veale competed their 

terms of office and will be replaced by Prof Michael 

Keane and Dr Frances Hayes. 

New Developments 

Work commenced on a new Medical Observation Unit 

and this was completed at the end of 2008 with an 

anticipated opening in early 2009. This will provide 

significant improvements in the delivery of care to 

critically ill medical patients within the hospital. 

143 

Return to Contents


Department of Anaesthesia, Intensive Care & Pain Medicine 

2008 brought with it a number significant changes for 

the Department. Dr Tom Owens took over as Chairman 

of the Department from Dr Declan O’Keeffe in January. 

The biggest challenge facing the Department was a 

shortage of staff. 

The completion of negotiations for the new contract 

has meant that the Department could progress any 

proposed new posts. The external review has neared 

completion at the time of writing. 2008 also saw the 

setting up of the Acute Pain Service which is now up 

and running, albeit at a basic level. This is seen as 

being a significant development in peri-operative care 

provided for patients. The Pre-Assessment Clinic has 

also been up and running. We have new premises 

adjacent to St Mark’s Ward which is a significant 

development. In addition to that we have secured the 

services of Olga Treacy three days a week in order to 

staff the Pre-Assessment Clinic. Again this has been a 

significant development for our Department. The Pre- 

Assessment Clinic is being supervised by both Dr Alan 

McShane and Dr Tom Owens. It is hoped that the 

proper and efficient use of the Pre-Assessment Clinic 

will result in better and more efficient use the beds in 

the hospital along with reduced cancellation rates and 

complications for surgery. 

I would like to congratulate Dr Richard Assaf who retired 

in October 2008. Dr Assaf has provided our Department 

with many years of outstanding professional service in 

addition to a commitment to teaching and training. In 

many ways the success of our candidates in the Part 1 

exam is in no small way due to the efforts of Dr Assaf. I 

would like to thank him for the many years of effort he 

has put into the training programme and would like to 

wish him and his wife, Mary Rose, many happy years 

together in their retirement. 

Resident Merit Awards 

The following residents received medals as follows: 

Dr Enda Connolly – Dr Gerry Dorrian 

Award for best SpR in Anaesthesia 

Dr Gavin Weekes – Dr Dick Nolan 

Award for best BST in Anaesthesia 

Dr Stephen Frohlich – Dr Seamus O’Donnell 

Award for best SpR in ICU 

Service Development /Activities 

Activity Report – Operating Statistics 2008 

During 2008 the throughput of surgical cases was 10211 

Hosp PNH Total 

DENTAL 39 2 41 

E.N.T. 264 106 370 

GENERAL 2508 671 3179 

GU ENDO 1032 128 1160 

GU OPEN 151 19 170 

GYNAECOLOGICAL 340 1 341 

OPHTHALMIC 357 1 358 

ORTHOPAEDIC 1913 79 1992 

PAIN 560 22 582 

PLASTIC 1224 75 1299 

THORACIC 219 81 300 

VASCULAR 338 81 419 

8945 1266 10211 

59 liver transplant operations were performed during 

the year, with 75 donor retrievals. 

144 

Return to Contents



Intensive Care Unit 

Medial Director 

Consultants 

Clinical Nurse Manager III 

Dr. Kieran Crowley 

Dr. Pat Benson 

Dr. Caroline Hickey 

Ms Geraldine Carey 

Service workload 

649 patients were admitted to the ICU in 2008, 

another record number. 41% of patients stayed 1 day, 

while 44% stayed 3 days or more, similar to recent 

years. Average length of stay was 4 days. Average 

occupancy for the year was 89%. The ICU continued to 

provide the critical care component of the liver 

transplant programme. 

Organ failure rates and organ support rates were similar 

to recent years: 60% of patients received mechanical 

ventilation. Overall ICU survival was 76%, with hospital 

survival of 68%. 

St. Vincent’s supplied an ICU nurse and registrar to staff 

the transfer of critically ill patients by MICAS (mobile 

intensive care ambulance service) on a 1:4 roster. The 

ICU contributed to a national HSE study on organ 

procurement. The ICU collected data for the HSE (through 

Prospectus) for a nationwide report on ICU services. 


The ICU ran a Foundation Course with 6 nurses 

graduating in March 08 and a Higher Diploma Course, 

with 6 nurses graduating in May 08. These courses 

greatly assist in providing adequate numbers of suitably 

trained nursing staff, which remains an issue. Maureen 

Darcy continued in a temporary capacity in the position 

of ADON. Dr Caroline Hickey was appointed to a 

permanent consultant position, having worked a locum 

for the previous two years. For the second half of the 

year Dr Oleg Ilyinsky worked in a locum consultant 

capacity, filling in for sick leave. 

There are two attendants, one shared orderly, one 

shared technician and three secretaries. The ICU is 

staffed by a registrar or specialist registrar rotating from 

the department of anaesthesia. The aim of achieving 

out-of-hours cover by consultant intensivist staff has not 

yet been met. 

Service developments 

Of the total of 16 beds in the ICU 10 are open, with 

overflows to 13 beds at times. Efforts are being made 

to open further beds. The Clinical Information System, 

which went “live” in August. In December it was 

temporarily suspended to iron out teething problems. In 

conjunction with the Emergency Department, Therapeutic 

145 

Return to Contents



Hypothermia for survivors of out-of-hospital cardiac arrest 

was introduced. S/N Dennis Wedgeworth submitted his 

report to the Director of Nursing on the needs of 

patients after discharge from ICU having completed his 

outreach follow-up of these patients for 12 months. 

Liver Transplantation 

2008 was a very busy year for the Liver Transplantation 

Group. 58 Orthotopic Liver transplants took place. The 

results for 2008 were very good. Transplantation is 

demanding work for all concerned. All credit to the 

Anaesthesia Team: 

Consultant Anaesthetists 

Liver Fellows 

Anaesthetic Nurses 

Dr Neil McDonald 

Dr. John Boylan 

Dr Nageswaran Narayanan 

Dr. Ashit Bardhan 

Sr. Jean McCarthy 

Billie Stafford 

Karl Perocillo 

Karen Ann Keating 

The transplant anaesthesia group provided coverage for 

58 liver transplants, including 52 primary elective 

transplants, during 2008. The 60-day survival for primary 

ICU Activity 

2008 2007 2006 2005 2004 2003 2002 2001 2000 

Admissions 649 628 595 613 516 450 471 421 469 

Average length of stay (days) 4 4 2 4 6 6 6 5 5 

Average occupancy 89% 91% 91% 92% 93% 90% 85% 89% 85% 

Elective surgical 25% 29% 34% 38% 36% 27% 30% 32% 35% 

Emergency surgical 31% 25% 25% 30% 30% 39% 31% 31% 35% 

Medical 43% 46% 43% 32% 34% 34% 39% 37% 30% 

Mechanical ventilation 60% 71% 80% 82% 69% 70% 75% 68% 67% 

Central venous access 72% 77% 73% 77% 64% 73% 81% 69% 78% 

Vasoactive infusions 33% 31% 19% 24% 20% 18% 25% 33% 33% 

Acute renal failure 23% 18% 14% 10% 10% 17% 25% 23% 24% 

Continuous renal replacement 

therapy 22% 18% 14% 10% 10% 16% 21% 16% 14% 

Tracheostomy 10% 10% 7% 6% 6% 13% 11% 13% 6% 

Unplanned ICU discharge 6% - 17% 21% 21% 25% 1.5% 11.4% 6% 

Readmissions 9.3% 9.7% 8.1% 12% 8.3% 2.9% 0.9% 

Brainstem deaths 8 8 7 3 6 8 3 7 4 

Organ donors 1 2 5 2 2 1 0 3 0 

ICU survival 76% 78% 78% 80% 79% 82% 75% 73% 75% 

Hospital survival 68% 77% 76% 78% 75% 78% 70% 68% 70% 

146 

Return to Contents



isolated elective transplants was 96%, with median ICU 

stay and hospital stay of 1 and 21 days, respectively. 

Outcome for primary elective liver transplantation at SVUH 

continues to be one of the best in the UK and Ireland. 

Peer-reviewed papers 

Dr. Alistair Nichol, a former Conway research fellow, was 

awarded a PhD for his research project entitled: 

“Investigation of the effects of buffered hypercapnia on 

the severity of infection-induced lung injury”. 

Ó Cróinín D. Nichol AD. Hopkins N. Boylan JF. O’Brien 

S. O’Connor C. Laffey JG. McLoughlin P. Sustained 

hypercapnic acidosis during pulmonary infection 

increases bacterial load and worsens lung injury. 

Critical Care Medicine 2008; 36: 2128-35 

Editorial 

Boylan JF. Kavanagh BP. Emergency airway 

management: competence versus expertise? 

Anesthesiology 2008; 109:945-7 

Correspondence 

Boylan JF. Kavanagh BP. The name of the game: no 

transfusion (or nontransfusion) by cookbook. 

Anesthesiology 2008; 109:745-6. 

Abstracts 

Naughton FM. Nichol AD. Boylan JF. McLoughlin P. 

Ambient hypoxia and hypercapnia alter lung cytokine 

kinetics but do not impair lung mechanics. 

American Thoracic Society 2008; 177: A329 

Nichol AD. Naughton FM. Ó Cróinín D. Boylan JF. 

McLoughlin P. Buffered hypercapnia worsens E coli 

induced lung injury in vivo. American Thoracic Society 

2008; 177: A752 

Vascular Access 

Director: 

Consultant: 

Dr. Alan McShane 

Dr. Neil McDonald 

The Vascular Access service continues to work with a 

variety of healthcare groups. The requests include device 

placement but consultations are also made to discuss 

the options for patients with complicated conditions. 

Again we continued to work with the cystic fibrosis 

service and the oncology services. Ultrasound usage for 

line placement has almost become routine and has 

aided the teaching and the safety of line placement. 

Formal training in central vascular access is now a training 

requirement of the College of Anaesthetists. Drs McShane 

and McDonald again organised the Vascular Access 

147 

Return to Contents



Study Day in the College of Anaesthetists. This course 

continues to be popular and oversubscribed. It provides 

didactic lectures, live and cadaveric demonstrations and 

tuition in the use of ultrasound. 

South East Dublin Department of Anaesthesia 

(SEDDA) 

Chairman: Dr. Alan McShane 

Secretary: Ms Louise McNicholas 

Again in 2008 there was a heavy reliance of the 

services of locums to help provide consultant cover in 

the constituent hospitals. The service contributed greatly 

to the ongoing growth of cold elective surgery for 

patients seen in St. Vincent's University Hospital and 

carried out in St. Michael’s Hospital Annexe. This model 

is a good one, as it allows planning of elective surgery 

without the anxiety over bed availability that is a part of 

life in the University Hospital because of the unpredictable 

effects caused by events in the Emergency Department. 

The SEDDA training scheme retains its popularity, with a 

constantly increasing number of applications. This reflects 

on the individual teaching done by consultants and the 

facilities and varied clinical experience available in the 

constituent hospitals. Results for trainees taking exams 

were good and that is due to the many who contributed 

to this success. 

Pain Medicine 

2008 was yet another year of vast change in the Pain 

Service in St Vincent’s University Hospital, with the 

significant move of the Department to the new Pain 

Unit located in the Old Convent. 

2008 saw the setting up of 2 new clinics in the Pain 

Service. Since July 2008, Dr Paul Murphy in his new 

Multi -disciplinary Clinic sees all new referrals to the 

Pain Service. In this new clinic, the Consultant as well as 

the Multidisciplinary Team of a Clinical Psychologist, 

Occupational Therapist and Physiotherapist review all 

patients. 

In order to reduce the number of patients attending the 

Tuesday afternoon Pain Clinic, a new Prescription Clinic 

has been set up. This Clinic, on a Monday morning, was 

set up to prevent patients who only needed prescriptions 

from having to wait in the general outpatient Pain Clinic. 

This has greatly reduced the numbers attending the 

Tuesday afternoon Pain Clinic, and is of great benefit to 

those patients who are unable to wait for extended 

periods of time in the outpatient clinic. 

The transfer of the Allied Therapies to the main body of 

the hospital has had a significant effect on the Pain 

Management Programme. Now, all elements of the 

148 

Return to Contents



three-week outpatient programme are deliverable in the 

main body of the hospital. 

A new diagnostic and therapeutic session was set up in 

conjunction with the Department of Radiology. These 

sessions were originally on a Monday afternoon and a 

Tuesday morning for patients requiring diagnostic block 

injections. This enabled the Pain Service to vastly reduce 

the waiting list for patients in need of these procedures. 

Following discussions with a number of departments 

within the hospital, the Pain Service were also granted 

4 in-patient beds in St James’ Ward. These beds have 

also been combined with theatre space on a Monday 

and a Thursday. This has been an important change for 

the Department, allowing for more procedures to be 

done, and thus reducing the waiting time of patients for 

these interventional pain procedures. 

2008 was a busy year for Dr O’Keeffe’s, Dr Murphy’s 

and Dr Victory’s Pain Management outpatient clinics, 

with more than 4,000 patients attending these clinics. 

In 2008, David Sommerfield sat his exams and 

achieved one of the top marks in the country. 

Clinic Day No. of New Return Total 

sessions 

Dr. O'Keeffe (Pain Clinic) Tues 47 214 2,748 2,962 

Dr. O'Keeffe (Prescription Clinic) Mon 5 0 52 52 

Dr. Victory (Pain Clinic) Tues 43 53 321 374 

Dr. Murphy (Pain Management Clinic) Wed 45 73 556 629 

Dr. Murphy (Pain Medicine Clinic) Tues 21 90 4 94 

Dr. O'Keeffe (Pain Unit) 10 278 288 

Total 161 440 3,959 4,399 

149 

Return to Contents


Department of Cardiology 

During the year a total of 7,801 patients were seen at 

cardiology outpatient clinics (including pacemaker clinics), 

which represents an increase of 12% over the previous 

year. The number of non-invasive tests performed in 

the ECG Cardiology Department (echocardiography, 

stress tests, holter monitors, ECG’s, pacemaker checks) 

numbered 18,790 which represents a slight (2%) 

decrease over the previous year. 

The Cardiac Catheter Laboratory activity at 2,549 

procedures represent a 4% increase over 2007. 

Interestingly these figures show a 68% increase in the 

number of ICD insertions and a 42% increase in the 

number of permanent pacemaker procedures 

performed. 


Research 

A cookery skills course was provided for cardiac 

rehabilitation patients in conjunction with the 

Department of Preventive Medicine and Health 

Promotion, as part of a randomised controlled trial. 

Data analyses are in progress. 

Conferences 

Marie Minogue and Veronica O’Neill attended the 

EUROPREVENT conference in Paris in May 2008. 

Kathryn O’Sullivan attended The ESC in Munich in 

September 2008. 

to take up a full-time position in the cardiac cath lab. 

Olajide Ogidan replaced her. 

Heart Failure Unit 

The Heart Failure Unit (HFU) celebrated its 10th year in 

existence in October 2008 at St Vincent’s University 

Hospital with a presentation of research work done to 

the Minister for Health and Children’s Affairs, Ms Mary 

Harney. Patients from the HFU had a chance to discus 

their experiences of the service with the Minister and 

she commented on how services such as the HFU 

600 

Day case admissions numbered 615 which represents 

a 10% increase over the previous year. In-patient 

discharges remain static at 1,418. 

Cardiac Rehabilitation Service 


The Cardiac Rehabilitation Service continues to offer 

four phases to patients recovering from a Myocardial 

Infarction, Angioplasty and Coronary Artery Bypass 

Surgery/Valve Surgery. 


501 patients received Phase 1 and 256 attended 

Phase II. 134 patients completed the six-week Phase III 

programme and 17 dropped out. Approximately 90 

patients attended our Phase IV refresher sessions. 

Although the number of patients requiring cardiac 

rehabilitation is gradually increasing each year, the cardiac 

rehabilitation programme has reached maximum capacity 

and is unable to meet this demand. 


Noeleen Day left the cardiac rehabilitation department 

500 

400 

300 

200 

100 

0 

501 

463 

256 

227 

141 134 

70 

90 

2007 2008 2007 2008 2007 2008 2007 2008 

PHASE I PHASE II PHASE III PHASE IV 

150 

Return to Contents


Department of Cardiology 

could reduce the need for in-patient beds in the current 

constrained economic climate. 

The HFU welcomed 3 new personnel in 2008: Two 

nurses, Elaine Tallon, Research and Clinical HF nurse 

and Denise Gibson, STOP HF Co-ordinator and Clinical 

HF nurse as well as the much needed secretarial 

services of Aileen Burke. 

A major development contributing to the HFU in 2008 

was the association with the new Blood Pressure Unit in 

St Michael’s Hospital. Hypertension is the second major 

contributor to HF after coronary disease so optimizing 

blood pressure management may result in fewer new 

HF cases in the future. The STOP HF programme which 

is a prospective community GP study of patients with risk 

factors for HF and which is in it’s 5th year compliments 

this focus on HF prevention. 

A new innovative GP referral via the internet using the 

SPIRIT HF programme started in 2008 which allows 

GPs easier access to HF screening tools such as brain 

natruieretic peptide (BNP) as well as rapid access to an 

on line consultant opinion of difficult cases. 

Workload has continued to expand with 10,867 patient 

contacts, of which 2000 were from survivors of severe 

HF admissions to hospital with a total of 140 new 

NYHA class IV presentations in 2008 alone. Future 

plans are to expand the HF service to in-patients in St 

Michael’s so they may benefit from the same level of 

HF education and follow up. The expansion of the 

Advanced Nurse Practitioner (ANP) role, particularly 

with nurse prescribing as well as a home visit pilot 

scheme has assisted the HFU’s ability to cope with the 

extra workload. Ongoing laboratory research of HF in 

the Conway Institute, UCD allows questions to be asked 

and explored on a continuous basis. 

In conclusion, the world renowned St Vincent’s University 

Hospital HFU under the direction of Professor Ken 

McDonald is an example of real world translational 

medicine; i.e. where clinical research is combined with 

laboratory research to the benefit of current and future 

heart failure sufferers. The next 10 years however are 

crucial as the success of the HFU needs to be solidified 

and hopefully expanded to other institutions in order to 

deal with the anticipated increase in the country’s HF 

burden by 2018! 

Anaemia in heart failure: to treat or not to treat? 

Mak G, Murphy NF, McDonald K. 

Current Treat Options 

Cardiovasc Med. 2008 Dec; 10(6): 455-64 

Multiple neurohumoral modulating agents in systolic 

dysfunction heart failure: are we lowering blood 

pressure to much? 

Mak G, Murphy NF, Ali A, Walsh A, O’Loughlin C, 

Conlon C, McCaffrey D, Ledwidge M, McDonald K. 

J Card Failure. 2008 Sept 14(7): 555-60 

Diagnosis of new onset heart failure in the community: 

the importance of a shared-care approach and 

judicious use on BNP. 

Mak G, Ryder M, Murphy NF, O’Loughlin C, 

McCaffrey D, Ledwidge M, McDonald K. 

Ir J Med Sci. 2008 Sept; 177(3):197-203 

Need and evolution of need for device therapy in a 

community heart failure population. 

Sulaiman HM, O’Loughlin C, Daly M, Conlon C, 

Ledwidge M, McDonald K. 

Eur J Heart Failure. 2008 June; 10(6):601-7. 

Outpatient intravenous diuretic therapy; potential for 

marked reduction in hospitalizations for acute 

decompensated heart failure. 

Ryder M, Murphy NF, McCaffrey D, O’Loughlin C, 

Ledweidge M, McDonald K. 

Eur J Heart Fail. 2008 Mar; 10(3):267-72 

151 

Return to Contents


Department of Dermatology 

St Vincent’s University & St Michael’s Hospital 


Consultants 

Dr Paul Collins 

Dr Brian Kirby 

Prof Sarah Rogers 

NCHDs 

Spr 

Registrars 

SHO 

Research Registrar 

Nursing Staff 

CNS 

CNS 

CNM1 

Care asssisant 

(9+2 sessions) 

(11 sessions) 

(11 sessions) 

(31 sessions at SVUH, 2 at SMH) 

Dr Caitriona Ryan 

Dr Aisling Ryan, 

Dr Benvon Moran 

Dr Dmitri Wall 

Dr Anne Marie Tobin 

Ms Sheila Ryan 

Ms Nicola Mahon 

Ms Sophie Doyle 

Nurses 11 (full and part-time) 

Ms Maria del Pilar 

Nurses 14.26 WTE 

Administrative Staff 

Ms Caroline Lehane 

Ms Eileen Cusack 

Ms Brenda Harte 

Ms Niamh Spain 

Grade V 

Grade IV 

part time Gr IV 

part time Gr IV 

WTE 3.8 

Patients seen and treated 2008 

at SVUH + (SMH) Clinics 

New patients 2,020 + (335 ) = 2,355 

Return patients 6,890 + (280) = 7,170 

Total patients 8,910 + (615) = 9.525 

Treatment/Procedures 

Including: 

Phototherapy unit 

Skin biopsies 

Patch tests 

Skin excisions 

Total no cases 19,443 

In-patient consults 406 + (78) 

Total no 484 

Consult review - most reviewed at least once 

Nurse led services have increased this year and full 

details are contained in the annual Nursing Report. 

Publications 

Psychological distress but not alcohol intake affects the 

time to clearance of psoriasis patients treated with 

narrowband UVB. 

Kirby B, Dudley J, Tobin AM, O’Brien E, Barry R, Collins 

P, Rogers S. 

Accepted Clinical an Experimental Dermatology 2008 

Adalimumab treatment for severe recalcitrant chronic 

plaque psoriasis. 

Ryan C, Kirby B, Collins P, Rogers S. 

Accepted Clinical an Experimental Dermatology 2008 

Further experience of using azathiaoprine in the 

treatment of severe atopic eczema. 

Clinical and Experimental Dermatology 2008;33 : 

710-711. 

Psoriasis characteristics, psychological effects and 

treatment options. 

Ryan S, 

Br J Nursing 2008; 1765: 284 – 290. 

152 

Return to Contents


Department of Dermatology 

Case Reports 

Allergic contact dermatitis to hydroydecyl ubiqinone 

(idebenone) following application of anti-aging 

cosmetic cream. 

McAleer M and Collins P 

Contact Dermatitis 2008; 59: 173-4174. 

Generalised pustular psoriasis (Von Zumbusch) 

following the use of calcipotriol and betamethsone 

dipropionate (Dovobet®). 

Tobin AM, Langan SM, Collins P, Kirby B. 

Clinical and Experimental Dermatology (in press) 

An erythematous patch and plaque on the shoulder (a 

clinicpathological case). 

McAleer M, Sheahan K, Kirby B, Collins P. 

Archives of Dermatology 2008; 144: 1217-1222. 

The department has presented over 20 presentations at 

national and international meetings 


Achievements 

Dr Paul Collins is Chairman of the Southern group of 

Irish Association of Dermatologists, Board member of 

the Charles Institute and a member of the building 

committee for the same Institute. 

Dr Anne Marie Tobin has joined the department as 

Research Registrar. Dr Tobin is engaged on working for 

a PhD. 

Dr Caitriona Ryan, SpR, is going to Baylor University, 

Dallas, USA for a one year fellowship in dermatology. 

Retirement 

Ms Nora Tracey CNM2 retired during the year. Nora 

worked in the City of Dublin Skin & Cancer Hospital for 

many years and was instrumental in the smooth 

transition of the service from Hume Street to SVUH in 

2006. She ran the Phototherapy Service in the 

department. 

153 

Return to Contents


Department of Endocrinology and Diabetes Mellitus 

Personnel 

Consultants: 

Lecturers: 

Dr Malachi McKenna, 

Prof Donal O’Shea, 

Dr Ronan Canavan, 

Dr Frances Hayes 

Dr. Gianluca Tamagno, 

Department of Medicine, UCD 

Primary Care Liaison Team: 

Deirdre Hall, Diabetes Nurse Specialist. 

Yvonne Ryan, Dietician 

Secretarial Staff: 

Fiona Whelan, Patricia Sinnott, Joyce 

Doyle, Maura Mahony, 

Florence Mhandu, Geri Daly 


Registrars: 

Research Registrars: 

Diabetes Centre 

Nurses: 

Dietician: 

Dr Mensud Hatunic, 

Dr. Hood Thabit 

Dr Gadintshware Gaoatswe, 

Dr. Mohammad Bashir, 

Dr Jean O’Connell, 

Dr Tomas Ahern, 

Dr Conall Dennedy 

Deirdre Gleeson, Nora Collis, 

Moira Haran, Joanne Kildunne, 

Jean O’Brien, Claire Dingle 

Maeve Moran, Carmel Quinn, 

Natalie Wallace 


Weekly Departmental Academic Events 

Diabetes Team Meeting - Monday 12.45 PM 

Endocrine Conference - Tuesday 1.00 PM 

Multi-Disciplinary Thyroid Cancer Group Meeting 

(every 6-8 weeks) 

Departmental Journal Club - Friday 8.00 AM 

Out-Patient Clinics 

3 Diabetes clinics per week 

1 Endocrinology clinic 

Weekly multi-disciplinary group education sessions for 

newly diagnosed patients with type 2 diabetes. 

Monthly patient group education session on cholesterol 

management and diet. 

Quarterly group education sessions for patients with 

newly diagnosed impaired glucose tolerance. 

154 

Return to Contents



Endocrine Clinical Services 

The Endocrine Team provides a comprehensive 

outpatient and in-patient consultation service. In the 

field of thyroid cancer, the development of the 

Multidisciplinary Team Meeting comprising Medical 

Endocrinology, Surgical Endocrinology, Histopathology, 

Radiotherapy and Radiology ensures the provision of a 

co-ordinated service working to approved international 

guidelines. At this conference, patients who have been 

reviewed by any of the groups are presented, have 

their management discussed and key aspects of the 

management of thyroid cancer are reviewed. A similar 

multi-disciplinary team approach to the management of 

gut endocrine tumours was established in September 

2007 and meets quarterly. 

The Endocrine Team provides a national consultation 

service in the areas of reproductive endocrinology, 

adrenal disease, obesity, hypoglycaemia, gut endocrine 

tumours, gender identity disorder, calcium metabolism 

and metabolic bone disease. 

Diabetes Service 

The goal of the Diabetes Service is to keep patients 

well through the linked processes of information, 

education, counseling and empowerment. The Diabetes 

Service is probably unique in the extent to which the 

patients play the central role in the management of 

frequently complex situations. This service is supported 

by time committed to telephone contact with patients 

and the provision of various individual and group 

educational sessions. 

For insulin-dependent patients, there is the “Dose 

Adjustment For Normal Eating” (DAFNE) programme. 

This is a detailed continuous five day course for small 

groups of patients to empower them to tightly link 

insulin adjustment with carbohydrate intake, exercise 

and general health status to ensure tight blood glucose 

levels with the aim of avoiding long-term diabetes 

complications, while at the same time avoiding the 

serious consequences of hypoglycaemia. Detailed 

training and accreditation in DAFNE for doctors, nursing 

staff and dietitians continues as resources permit. 

As St Vincent’s University Hospital is the national referral 

centre for adults with Cystic Fibrosis (CF) and allied with 

medical advances in treatment, we have seen a large 

increase in the number of patients presenting with CFrelated 

diabetes mellitus as life expectancy for this 

condition increases. The treatment and education of 

this group form a complex and demanding facet of the 

caseload of the Diabetes Nurse Specialist and Endocrine 

Medical Team. 

A further aspect of the Diabetes service in SVUH is 

Liver Transplantation related Diabetes, which continues 

to increase our expertise and workload. 

The Shared Care Programme in which a group of 

General Practitioners work in partnership with the 

Diabetes Centre to agreed treatment protocols and 

facilitated by Liaison Diabetes Nurse Specialists and 

Dieticians, has expanded further this year. This 

programme at once expands the base and the 

provision of expert diabetes care, facilitates the provision 

of that care nearer to the patient’s home and relieves 

demands on the hospital based diabetes service. 

Research Projects 

Diabetes & Obesity Research Group 

Personnel: Prof. Donal O’Shea, 

Dr Jean O’Connell, 

Dr Lydia Lynch, 

Dr Tomas Ahern, 

Dr Conall Dennedy. 

The Obesity Research Group is headed by Prof. O’Shea. 

Dr. Lydia Lynch is the senior research scientist in the 

155 

Return to Contents



group and Andrew Hogan is a new postdoctoral scientist 

stared with the group. Lydia is funded by the Health 

Research Board and UNESCO-L’Oreal Partnership. 

Andrew recently received the Sanofi-Aventis Newman 

Scholarship for his postdoctoral studies. Dr. Jean 

O’Connell is a 3rd year clinical PhD student funded by 

the HRB clinical research fellowship, along with Dr. 

Tomas Ahern and Dr. Conall Dennedy who are starting 

their clinical PhDs. Ms. Anna Kwasnik is the group’s 

research assistant funded by the Diabetes Federation of 

Ireland. Ms. Cathy Breen has started in the group as a 

research dietician studying the role of carbohydrate in 

diabetes. Conall received the ICHMT Endocrine 

Research Bursary funded by Sanofi-Aventis. 

Lydia Lynch is working on the immune system in 

obesity, and asking why some obese subjects are 

immune compromised. Obesity is now responsible for 

30-40% of certain cancers. She has found that natural 

killer cells, the bodies first defense against tumors and 

viruses are depleted in the blood of obese patients. 

Lydia is also looking at the immune system in the fat, in 

particular the omental fat, of obese and lean patients. 

She has found that omental fat has its own unique 

immune system, different to every other organ in the 

body and contains the largest number of potent killer 

cells, termed invariant natural killer T cells. 

Jean O’ Connell has found that adipocyte size strongly 

correlates with metabolic healthy and degree of fatty 

liver disease in obese patients. She is now studying the 

rate of proliferation and differentiation of preadipocytes 

from both healthy and unhealthy obese patients, as 

well as the production of pro and anti-inflammatory 

cytokines from the growing cells. 

Achievements and Distinctions 

Dr Donal O’Shea was promoted to Professor of 

Medicine in UCD in recognition of his teaching and 

research activities. He was invited to give a public 

lecture in the RDS entitled “Obesity; Treating the 

Epidemic to Prevent the Pandemic” for a series on 

Ireland towards 2030. He had the distinction of being 

invited to give the Nordisk lecture at the Irish Endocrine 

Society in November 2008. 

Dr Malachi McKenna is a member of the Editorial 

Board of Osteoporosis International. 

Dr. Frances Hayes took up the post of Consultant 

Endocrinologist and Senior Lecturer in Medicine in July 

replacing Professor T J McKenna. She did subspecialty 

training in reproductive endocrinology in Boston and 

was a Consultant Endocrinologist at the Massachusetts 

General Hospital and an Associate Professor of 

Medicine at Harvard Medical School prior to her return. 

She is a member of the Editorial Board of the Journal 

of Clinical Endocrinology and Metabolism. 

Dr. Lydia Lynch was awarded the UNESCO-L’Oreal 

International Young Woman of Science Fellowship this 

year, which is awarded to 15 young women worldwide. 

This is the first time Ireland has received this award. 

This fellowship will enable Lydia to spend 7 months 

working in Harvard Medical School, Boston each year 

for 2 years, with the aim of returning to Ireland to 

establish in SVUH state of the art techniques learned in 

Harvard. Lydia also won ‘Researcher of the Year’ at the 

Conway Research Festival, UCD in September 2008. 

Lydia was an invited speaker at the International 

Colorectal Cancer Society Conference and the Trinity 

College Dublin Biochemical Society series of talks. 

Conferences/Courses/Meetings Attended 

National Cystic Fibrosis Meeting. Killarney, Ireland. 

1st February 2008. 

Annual Abracadabra Diabetes Nursing Conference. 

Birmingham, UK. 29th February 2008. 

European NeuroEndocrine Tumour Society. 

Paris, France. 6-8th March 2008. 

156 

Return to Contents



Diabetes Federation of Ireland Multi-disciplinary 

Diabetes Study Day. Croke Park. 11th April 2008. 

Sanofi Aventis Spring Meeting on Mature Onset Diabetes. 

Dublin. 16th April 2008. 

Insulin Pump Study Day – Roche. Cork. 9th Mary 2008. 

American Diabetes Association Annual Meeting, 

San Francisco, USA. June 6-10, 2008 

American Endocrine Society Annual Meeting. 

San Francisco, USA. June 15-18, 2008. 

American Society of Bone and Mineral Research 

Annual Meeting. Montreal, Canada. September 2008 

EASD. Rome, Italy. 26th-27th September 2008. 

Irish DAFNE Study Annual Meeting. 

Belfast. 10-11th October 2008. 

European NeuroEndocrine Association. 

Antalya, Turkey. 17-20th October 2008. 

American Cystic Fibrosis Conference. 

Orlando, Florida. 22-25th October 2008. 

Irish Endocrine Society 32nd Annual Meeting. 

Maynooth, Ireland. 7th-8th November 2008. 

UK & Ireland NeuroEndocrine Tumour Society. 

London, UK. 1st December 2008. 

Publications 

1. Canavan RJ, Unwin NC, Kelly WF, Connolly VM. 

Diabetes- and non-diabetes - related lower 

extremity amputation incidence before and after the 

introduction of better organized diabetes foot care: 

continuous longitudinal monitoring using a standard 

method. Diabetes Care. 2008 Mar;31(3):459-63. 

2. Dervan E, Lillis D, Flynn L, Staines A, O'Shea D. 

Factors that influence the patient uptake of diabetic 

retinopathy screening. Ir J Med Sci. 2008 

Dec;177:303-8 

3. Tuthill A, McKenna MJ, O'Shea D, McKenna TJ. 

Weight changes in type 2 diabetes and the impact 

of gender. Diabetes Obes Metab. 2008 

Sep;10:726-32. 

4. Quinn A, Doody C, O'Shea D. 

The effect of a physical activity education 

programme on physical activity, fitness, quality of 

life and attitudes to exercise in obese females. J Sci 

Med Sport. 2008;11:469-72. 

5. Dodd JD, Barry SC, Barry RB, Cawood TJ, 

McKenna MJ, Gallagher CG. 

Bone mineral density in cystic fibrosis: benefit of 

exercise capacity. J Clin Densitom. 2008 11:537-42. 

6. McKenna MJ, van der Kamp S, Au-Yeong M, 

FitzGerald O. 

Improving standards of DXA. Ir Med J. 2008;101;101-2. 

7. Morrell MJ, Hayes FJ, Sluss PM, Adams JM, Bhatt 

M, Ozkara C, Warnock CR, Isojärvi J. 

Hyperandrogenism, ovulatory dysfunction, and 

polycystic ovary syndrome with valproate versus 

lamotrigine. Ann Neurol 2008 64:200-11. 

8. Joffe H, Hayes FJ. 

Menstrual cycle dysfunction associated with 

neurologic and psychiatric disorders: their treatment 

in adolescents. Ann NY Acad Sci 2008;1135:219-29. 

9. Cole LW, Sidis Y, Zhang C, Quinton R, Plummer 

L, Pignatelli D, Hughes VA, Dwyer AA, Raivio T, 

Hayes FJ, Seminara SB, Huot C, Alos N, Speiser 

P, Takeshita A, Van Vliet G, Pearce S, Crowley WF 

Jr, Zhou QY, Pitteloud N. 

Mutations in prokineticin 2 and prokineticin 

receptor 2 genes in human gonadotrophin-releasing 

hormone deficiency: molecular genetics and clinical 

spectrum. J Clin Endocrinol Metab 2008;93:3551-9. 

157 

Return to Contents



10. Kupelian V, Hayes FJ, Link CL, Rosen R, 

McKinlay JB. 

Inverse association of testosterone and the 

metabolic syndrome in men is consistent across 

race and ethnic groups. J Clin Endocrinol Metab 

2008;93:3403-10. 

11. Pitteloud N, Dwyer AA, DeCruz S, Lee H, 

Boepple PA, Crowley WF Jr, Hayes FJ. 

The relative role of gonadal sex steroids and 

gonadotropin-releasing hormone pulse frequency in 

the regulation of follicle-stimulating hormone 

secretion in men. J Clin Endocrinol Metab. 

2008;93:2686-92. 

12. Boepple PA, Hayes FJ, Dwyer AA, Raivio T, Lee H, 

Crowley WF Jr, Pitteloud N. 

Relative roles of inhibin B and sex steroids in the 

negative feedback regulation of follicle-stimulating 

hormone in men across the full spectrum of 

seminiferous epithelium function. J Clin Endocrinol 

Metab. 2008;93:1809-14. 

13. Pitteloud N, Dwyer AA, DeCruz S, Lee H, 

Boepple PA, Crowley WF Jr, Hayes FJ. 

Inhibition of luteinizing hormone secretion by 

testosterone in men requires aromatization for its 

pituitary but not its hypothalamic effects: evidence 

from the tandem study of normal and gonadotropin 

-releasing hormone-deficient men. 

J Clin Endocrinol Metab. 2008;93:784-91. 

14 Sluss PM, Hayes FJ, Adams JM, Barnes W, Williams 

G, Frost S, Ramp J, Pacenti D, Lehotay DC, 

George S, Ramsay C, Doss RC, Crowley WF Jr. 

Mass spectrometric and physiological validation of a 

sensitive, automated, direct immunoassay for serum 

estradiol using the Architect. Clin Chim Acta. 

2008;388:99-105. 

15. Rixhon M, Tichomirowa MA, Tamagno G, Daly 

AF, Beckers A. 

Current and future perspectives on recombinant 

growth hormone for the treatment of obesity. Expert 

Rev Endocrinol Metab, 2008 Jan; 3(1): 75-90. 

16. Tamagno G, Daly AF, Deprez M, Vroonen L, 

Andris C, Martin D, Beckers A. 

Absence of hypogonadism in a male patient with a 

giant prolactinoma: a clinical paradox. Ann 

Endocrinol (Paris), 2008 Feb; 69(1): 47-52. 

17. Lelouvier B, Tamagno G, Kaindl AM, Roland A, 

Lelievre V, Le Verche V, Loudes C, Gressens P, 

Faivre-Bauman A, Lenkei Z, Dournaud P. 

Dynamics of somatostatin type 2A receptor cargoes 

in living hippocampal neurons. J Neurosci, 2008 

Apr; 28(17): 4336-49 

158 

Return to Contents


Department of Medical Oncology 

incorporating Lios Aoibhinn Cancer Support Centre 

2008 was an active year in the clinical, education and 

academic activities of the Department of Medical 

Oncology, St. Vincent’s Healthcare Group. 

As is common throughout the world, there is an 

increasing emphasis on ambulatory/outpatient 

treatments which in turn reflects the on-going evolution 

of cancer treatments away from traditional cytotoxic 

forms of therapy, to specific molecularly targeted 

agents. These newer treatments often have much 

more manageable side-effect profiles than older 

chemotherapy treatments. 

It was an extremely active year on the academic front. 

Professor Crown commenced his work as an HRB 

Clinician/Scientist. The research project supported by 

the Health Research Board, spans activities in St. 

Vincent’s University Hospital, University College Dublin, 

and Dublin City University. The major research focus of 

this consortium is novel therapeutics for breast cancer 

with particular emphasis on the increasingly recognised 

problem of “triple negative” breast cancer (breast cancer 

which is negative for oestrogen, progesterone and Her 

2 receptor) and on Her 2 positive breast cancer. 

Active clinical trials and laboratory programmes are 

underway in this programme. The major research 

interest on Her 2 positive breast cancer continues, with 

an emphasis on the development of novel therapeutics 

for patients with Her 2 positive disease whose cancer is 

resistant to Trastuzumab. 

One drug which is used in this setting, Lapatinib, was 

introduced into routine practice, in North America and 

Europe. St. Vincent’s and the Irish Clinical Oncology 

Research Group were part of the international team 

which helped to develop this useful agent. 

Dr. Neil O’Brien continued his work on a funded 

fellowship in the University of California Los Angeles in 

collaboration with Dr. Dennis Slamon. Dr. O’Brien’s work 

is focused on proteomic analysis of Herceptin resistant 

Her-2 positive breast cancer. 

The annual St. Vincent’s University Hospital/UCLA 

Translational Research Symposium took place in 

California is 2008. 

In 2008 a total of 143 patients were recruited on 

clinical trials. 

Professor Crown also was the convenor and inaugural 

chairman for the new melanoma and skin cancer 

committee of the Irish Clinical Oncology Research 

Group and continues in his role as chairman of the 

Breast Committee of that group. 

Publications 

Protein kinase Cdelta expression in breast cancer as 

measured by real-time PCR, western blotting and ELISA. 

McKiernan E, O'Brien K, Grebenchtchikov N, Geurts- 


Evoy D, McDermott E, Crown J, Sweep FC, Duffy MJ. 

Br J Cancer. 2008 Nov 18;99(10):1644-50. Epub 2008 Oct 28. 

Preclinical evaluation of dasatinib, a potent Src kinase 

inhibitor, in melanoma cell lines. 

Eustace AJ, Crown J, Clynes M, O'Donovan N. 

J Transl Med. 2008 Sep 29;6:53. 

A personalized approach to cancer treatment: how 

biomarkers can help. 

Duffy MJ, Crown J. 

Clin Chem. 2008 Nov;54(11):1770-9. Epub 2008 Sep 18. Review. 

Is risk of central nervous system (CNS) relapse related 

to adjuvant taxane treatment in node-positive breast 

cancer? Results of the CNS substudy in the intergroup 

Phase III BIG 02-98 Trial. 

Pestalozzi BC, Francis P, Quinaux E, Dolci S, 

Azambuja E, Gelber RD, Viale G, Balil A, Andersson 

M, Nordenskjöld B, Gnant M, Gutierrez J, Láng I, 

Crown JP, Piccart-Gebhart M; 

BIG 02-98 Collaborative Group. 

Ann Oncol. 2008 Nov;19(11):1837-41. Epub 2008 Jun 18. 

159 

Return to Contents




SNIP/p140Cap mRNA expression is an unfavourable 

prognostic factor in breast cancer and is not expressed 

in normal breast tissue. 

Kennedy S, Clynes M, Doolan P, Mehta JP, Rani S, 

Crown J, O'Driscoll L. 

Br J Cancer. 2008 May 20;98(10):1641-5. Epub 2008 May 13. 

ADAM-17 predicts adverse outcome in patients with 

breast cancer. 

McGowan PM, McKiernan E, Bolster F, Ryan BM, Hill 

AD, McDermott EW, Evoy D, O'Higgins N, Crown J, 

Duffy MJ. 

Ann Oncol. 2008 Jun;19(6):1075-81. Epub 2008 Jan 30. 

Pooled analysis of diarrhea events in patients with 

cancer treated with lapatinib. 

Crown JP, Burris HA 3rd, Boyle F, Jones S, Koehler 

M, Newstat BO, Parikh R, Oliva C, Preston A, Byrne J, 

Chan S. 

Breast Cancer Res Treat. 2008 Nov;112(2):317-25. Epub 2008 Jan 

20. Erratum in: Breast Cancer Res Treat. 2009 Jan;113(2):409-10. 

A phase III randomized comparison of lapatinib plus 

capecitabine versus capecitabine alone in women with 

advanced breast cancer that has progressed on 

trastuzumab: updated efficacy and biomarker analyses. 

Cameron D, Casey M, Press M, Lindquist D, 

Pienkowski T, Romieu CG, Chan S, Jagiello-Gruszfeld 

A, Kaufman B, Crown J, Chan A, Campone M, Viens 

P, Davidson N, Gorbounova V, Raats JI, Skarlos D, 

Newstat B, Roychowdhury D, Paoletti P, Oliva C, 

Rubin S, Stein S, Geyer CE. 

Breast Cancer Res Treat. 2008 Dec;112(3):533-43. Epub 2008 Jan 11. 

Adjuvant chemotherapy with sequential or concurrent 

anthracycline and docetaxel: Breast International 

Group 02-98 randomized trial. 

Francis P, Crown J, Di Leo A, Buyse M, Balil A, 

Andersson M, Nordenskjöld B, Lang I, Jakesz R, 

Vorobiof D, Gutiérrez J, van Hazel G, Dolci S, Jamin S, 

Bendahmane B, Gelber RD, Goldhirsch A, Castiglione- 

Gertsch M, Piccart-Gebhart M; 

BIG 02-98 Collaborative Group. 

J Natl Cancer Inst. 2008 Jan 16;100(2):121-33. Epub 2008 Jan 8. 

Erratum in: J Natl Cancer Inst. 2008 Nov 19;100(22):1655. 

Drug metabolism-related genes as potential 

biomarkers: analysis of expression in normal and 

tumour breast tissue. 

Martinez V, Kennedy S, Doolan P, Gammell P, Joyce 

H, Kenny E, Prakash Mehta J, Ryan E, O'Connor R, 

Crown J, Clynes M, O'Driscoll L. 

Breast Cancer Res Treat. 2008 Aug;110(3):521-30. Epub 2007 Sep 27. 

Prevalence and prognostic and predictive relevance of 

PRAME in breast cancer. Doolan P, Clynes M, 

Kennedy S, Mehta JP, Crown J, O'Driscoll L. 

Breast Cancer Res Treat. 2008 May;109(2):359-65. Epub 2007 Jul 12. 

Lios Aoibhinn Cancer Support Centre 

2008 was a year of great change and developments for 

Lios Aoibhinn Cancer Support Centre. In February the 

centre moved from its location in Herbert House to a 

new location at 85, Nutley Lane, opposite the entrance 

to St. Vincent’s University Hospital. From its new location, 

the centre continues to provide support and information 

for people affected by cancer. 


2008 saw the retirement of Ann Hayes, Director of 

Services. Ann was instrumental in the establishment of 

Lios Aoibhinn and we wish her a healthy and happy 

retirement. 

In November 2008, Finola Gill was appointed CNM3 

for Lios Aoibhinn and Oncology Services. 

Clinical Nurse Manager 3: 

Senior Clinical Psychologist: 

Administrative Support: 

Finola Gill 

Dr. Paul D’Alton 

Caroline Livingstone 

160 

Return to Contents




Sessional Therapists 

• Complementary Touch Therapies: Mary Moriarty 

(from March 2008) 

• Relaxation & Visualisation/ Stress Management: 

Mary Scarff 

• Yoga: 

Connie Walsh 

• Counselling Psychologist: A lison McGrann 

(from August 2008) 

Volunteers 

Aine Coleman Ann Douglas 

Ann Rooney Ann Leyden (from September 2008) 

Breda Reidy Eleanor Quinlan (from September 2008) 

Fiona Hedigan Patricia Kennedy 

Stephen Dollard 

Resignations 

In May 2008, Cecilia Keenan, Complementary Touch 

Therapist retired 


One new course was introduced in 2008. Designed by 

St. Luke’s Hospital, Rathgar, ‘Time to Adjust’ is a coping 

skills programme designed for women who have 

completed treatment for breast cancer and is facilitated 

by Alison McGrann, Counselling Psychologist. 

During 2008 a review of the services offered by Lios 

Aoibhinn Cancer Support Centre was carried out in St. 

Vincent’s University Hospital and St. Vincent’s Private 

Hospital. For patients attending the service, the centre 

was identified as providing an excellent service, helping 

patients come to terms with their diagnosis and providing 

a safe, calming environment where patients fell supported 

and free to talk. Improvements are currently being 

made to the referral process to the centre and also 

advertisement of the centre in response to the findings 

of this review. 

Publications 

Conference Presentations: 

The Experiences of Registered General Nurses Caring 

for Patients with Cancer on Non-Specialist Wards. 

Finola Gill, Haematology Association of Ireland National 

Conference, October 16th-18th, 2008. 

Department Statistics 

During 2008, 399 people used the service on over 

2900 occasions. 248 new clients registered with the 

centre during 2008. 82% of registrations were people 

directly affected by cancer and 18% were relatives and 

friends of people with cancer. 

289 clients attended for education and support around 

dealing with a diagnosis of cancer, its treatment and 

living with a cancer diagnosis. 

1452 clients attended our complementary therapies 

which included relaxation and visualisation, yoga and 

massage. 

The Cancer Support Centre underwent a number of 

changes and developments during 2008 and continues 

to develop to ensure that the service provided meets 

the needs of the population it serves. 

161 

Return to Contents


Department of Medicine for the Elderly 


Consultants 

Dr. Morgan Crowe 

Dr. Diarmuid O’Shea Dr. J. J. Barry 

Dr. Rachael Doyle Dr Graham Hughes (Locum) 

Nursing 

Ms Sinead Brennan, Divisional Nurse Manager 

Ms. Imelda Noone, Advanced Nurse Practitioner in Stroke 

Ms. Hilda Markey, CNM II Our Lady’s Ward 

Ms. Therese Carey, CNM II, Carew House Day Hospital 

Ms. Mary Ann Furigay, CNM1, Our Lady’s Ward 

Ms. Hepsy John, CNM1, Our Lady’s Ward 


2006 2007 2008 

In-patients 

Admissions 456 414 472 

Discharges 503 503 614 

Outpatients 

New 282 293 339 

Review 602 828 790 


2007 was a busy year for the Department of Medicine 

for the Elderly, which continues to provide an in-patient 

and outpatient consultation service, treatment and 

rehabilitation, primarily for elderly patients from the 

hospital’s catchment area in South East Dublin and East 

Wicklow. 

Issues continuing to challenge the service include the 

lack of resources to maintain people in their home and 

in hospital with dignity. Major structural work was 

carried out on Our Lady’s Ward and we are due to 

move back in January 2009. 

Ward Secretary 

Registrars 

Social Workers: 

Administrative Staff: 

Ms Doreen Messitt 

Dr. Aine Fitzpatrick 

Dr. Cassandra Janeczko 

Dr. Martin Mulroy (SpR) 

Dr. Declan Byrne (SpR) 

Ms. Alina Popescu 

Ms. Margaret Cagney 

Ms. Lorraine Murray 

Ms. Joan Magera 

Ms. Doreen Brennan 

Carew Day Hospital 

New 487 536 524 


Stroke In-patient Service 

256 251 279 

Total Attendance 

New 771 829 863 


Great credit is due to Sister Hilda Markey and the staff 

on Our Lady’s Ward for their continued championing of 

improved health care delivery. 

In Patient Consultations 

In 2008 over 850 in-patient consultations were seen in 

St Vincent’s University Hospital by the Elderly Care 

team. Meetings are held weekly between Dr. O Shea, 

the elderly medicine registrars and the Medical Social 

Work Department to facilitate planning of discharge of 

those elderly patients referred. 

162 

Return to Contents



Emergency Department, Carew Day Hospital and 

Community Liaison 

Dr Graham Hughes, in conjunction with the staff in the 

Emergency Department and Carew Day Hospital, is 

piloting this new service to facilitate development of 

stronger links between the Hospital and Community 

Services. He is also looking at strategies for more 

efficient integration of Carew Day Hospital and the 

Emergency Department. The continued support of Mr 

David Walsh in the HSE has been invaluable in this 

process. 

Orthopaedic Liaison Service 

Dr. Rachael Doyle is leading the continued 

development of this service with our consultant 

orthopaedic colleagues. 

Stroke Service 

Weekly multidisciplinary meetings are held and chaired 

by Dr. Crowe. Representatives of the nursing, 

physiotherapy, occupational therapy, speech and 

language therapy and other medical departments 

attend. The recent National Audit on Stroke report will 

guide development in this area. Ms. Imelda Noone, 

Advanced Nurse Practitioner in Stroke, is involved in 

further development of this unit and the introduction of 

set guidelines and protocols. An active stroke follow-up 

clinic is now up and running in Suite 4 in the new 

ADCC. A once weekly, dedicated TIA clinic continues to 

facilitate assessment and treatment of patients with 

TIA’s, who do not require hospital admission. This 

service requires further investment for both 

infrastructure improvement and improved staffing levels 

Falls and Syncope Service 

Space has been provided on Our Lady’s Ward for a falls 

and syncope service for the hospital and the neurocardiovascular 

service, which is being run by Dr. Diarmuid 

O’Shea. Carew Day Hospital developments in the future 

would help provide a more seamless service with the 

Emergency Department and the community in order to 

reduce or prevent hospital admission with this service. 

Ongoing collaborative work is being done in conjunction 

with the Bone and Health Working Group to progress this. 

The Royal Hospital Donnybrook 

The Royal Hospital Donnybrook makes a very important 

contribution to the rehabilitation of our elderly patients. 

There are 40 rehabilitation beds in this unit, 12 are now 

dedicated to stroke rehabilitation. The Day Hospital at the 

Royal in Donnybrook continues to provide outstanding 

care and outpatient rehabilitation services to those with 

multidisciplinary needs. The long established links with 

long-term care facilities continue to evolve through the 

dedicated work of Dr Mary Deane, Medical Director. 

163 

Return to Contents




An additional consultant will be appointed in early 2009 

with a view to improving the service delivery between 

the community and St. Vincent’s University Hospital. 

Currently a Locum Consultant Geriatrician post is being 

supported to help develop the liaison strategies between 

the acute hospital and the community so that we can 

hit the ground running with this new and innovative post. 

Achievements / Conferences Attended 

Congratulations to Ms. Imelda Noone, our Advanced 

Nurse Practitioner in Stroke Care who was appointed as 

a Nurse Prescriber in 2008. The post of Clinical Nurse 

Specialist in Stroke continues to provide a crucial role 

within the service. 

Dr. Declan Byrne won 2nd place for his poster 

presentation at the 56th Annual Irish Gerontological 

Society meeting in Kilkenny – “ Recent discharge to 

extended nursing care as a marker of life expectancy – 

implications for health care delivery”. 

The Sixth Annual Care of the Elderly Study Day took 

place in January 2008, in the Education & Research 

Centre, St. Vincent’s University Hospital. This year it 

focused on more general topics and was attended by 

90 people. This is now be a regular study day in the 

teaching calendar. In 2009 the meeting will focus on 

Links with the Community 

Publications / Abstracts 

Presented at Irish Gerontological Society Meeting 2008 

and published in Irish Journal of Medical Science 

Articles 

Recent Discharge To Extended Nursing Care As A 

Marker Of Life Expectancy- Implications For Health 

Care Delivery. D Byrne, E McDermott, L Murphy, G 

Hughes, JJ Barry, R Doyle, M Crowe, & D O’Shea 

The Case For Online Geriatric Medicine Consultation 

Referrals In A Teaching Hospital. E McGovern, D Byrne, 

E Wallace, G Hughes, M Crowe, & D O’Shea. 

Complications post stroke: Outcome in those over 80 

years. Noone I, Hatton, S, Crowe M, O’Shea, 

Publications 

Noone, I. O’Shea, D. Crowe, M. Stroke in the Very Old, 

Irish Medical Journal 2008; 1: 8-9. 

Thrombolysis 3 to 4.5 hours after acute ischaemic stroke. 

Fitzpatrick A, Noone I, O’Shea D. 

N Engl J Med 2008; 359 (26) : 2839 – 2841 - letter 

164 

Return to Contents


Department of Nephrology 


Consultant Nephrologist: 

Locum Consultant Nephrologist: 

Specialist Registrar: 

Registrars: 

CNM II: 

Newman Scholar: 

Principal Clinical Engineer: 

Peritoneal Dialysis CNS: 

Chronic Kidney Disease CNS: 

Prof Alan Watson 

Dr Malik Minhas 

Dr Frank Ward 

Dr Faisal Khan 

Dr Gamal Hassan Osman 

Michelle Mc Quaid 

Dr. Simon Curran 

Frank Kelly 

Bairbre Moynihan 

Sally Casey 

Emer Kenny 

In March 08 On Line Haemodiafiltration was introduced 

as a new modality of treatment for our patients, making 

SVUH the first dialysis unit in the Republic of Ireland to 

introduce this treatment as standard. 

Outstanding/Significant achievements 

Bairbre Moynihan completed Nurse Prescribing Course. 

Significant publications 

Identification of apolipoprotein A1 as a serum 

biomarker in chronic kidney disease and liver 

transplant recipients, using proteomic techniques. 

O’Riordan A, Jonnston O, Watson A. 

et al, - Proteomics - clinical applications, 1338-1348 

2008. 

Poster Presentations 

9th Annual Interdisciplinary Research Conference Trinity 

College School of Nursing and Midwifery Dublin 

5th - 7th November 2008 

"On-Line Haemodiafiltration a Preferred Modality of 

Treatment" 

F.A. Kelly, D.Farrell, M McQuaid, A.Watson 

Annual Scientific Meeting of The Biomedical / Clinical 

Engineering Conference Tullamore 

"On-Line Haemodiafiltration a Preferred Modality of 

Treatment" 

F.A. Kelly, D.Farrell, M McQuaid, A.Watson 

Future Service Developments 

Designated renal transplant outpatient programme 

Department Secretary: 

Jeni Messitt 


Chronic kidney disease programme developed (2 year 

trial) run by Emer Kenny. 

New Specialist Nurse Sally Casey started in PD. 

New specialist PD clinic every Wednesday. 

Investigation of the effects of age and oral intake of 

insulin and intra dialytic complications, 

Park, L, Brennan L, Younger K, Watson A.; 

Journal of Renal Nutrition, Vol.18, no.3, F41 2008. 

Investigations of the effects of reducing fluid intake 

during dialysis and of other factors in the instance of 

intra dialytic complication. 

Park E.L, Healy L, Kennedy M.C, Watson A. 

Journal of Renal Nutrition Vol.18, no.3, F41 2008. 


Total HD Treatments in 2008: 1132 

Total PD patients in 2008: 31 

Total Cadaveric Renal Transplants 2008: 15 

165 

Return to Contents


Department of Neurology 

166 

The Department of Neurology has continued to 

substantially expand in 2008. We still have only two 

Consultants, Professor Michael Hutchinson and Dr. Niall 

Tubridy and we have applied for at least two more to 

continue the progressive service development. 


Innovation Awards in 2008 (regional and national) for 


practice’. 

Health Minister, Mary Harney cited the Department in 

the Dail in May 2008 as an example of excellence in 

the Health Service. 

Marguerite Duggan, our Multiple Sclerosis Nurse 

Specialist, continues to provide an excellent service for 

people with MS and has been joined by our CNM, 

Heather Kevelighan, as Parkinson’s Nurse Specialist. 

Heather is running the new Parkinson’s Clinics and is 

providing a great service for our patients in this area. 

Dr Graham Hughes, Consultant in Care of the Elderly 

with a special interest in Parkinson’s Disease, has also 

joined the Clinic recently and is a most welcome 

addition to our expanding service. 


Paula Halpin (Departmental Secretary) has helped 

bring a greater deal of cohesion and deals with a huge 

amount of phone calls from concerned patients and 

relatives daily. 

Katie Doyle joined us in 2007 and has done a huge 

amount of background work in addition to her regular 

work as the Neurology Research Nurse. She has been 

integral to our studies in epidemiology in MS and in HSP. 

Sinead Jordan also joined the Team in 2007 and has 

continued the work in MS Treatment Trials and in 

organisation of our research in MS. We are now 

participating in a number of new trials with oral therapies 

in MS and have gradually increased the numbers of 

people with MS who have access to Tysabri as a result 

of her work. 

Drs. Roisin Lonergan (MS Research) and David Bradley 

(Dystonia Research) have been an integral part of the 

Neurology Service and without them the twice-daily 

clinics would not have been feasible. In addition, both 

have been extremely productive in their first year of 

research with numerous presentations at National and 

International meetings. 

The Dystonia group was awarded funding from HRB 

(Partnership Awards 2008); and both MS and Dystonia 

got Enterprise Ireland Grants. We also received the 

Lundbeck Neuroscience bursary. 

Dr. Margaret O’Brien has also played a critical role in 

developing the clinical research in MS and her work on 

OAS in MS has already received many plaudits. 

Dr. Jean Fletcher is working on a joint project in Multiple 

Sclerosis with the Department of Immunology at Trinity 

College under the supervision of Professor Kingston Mills. 

She has funding from the SFI for the next three years. 

The Neurology Ward (in-patients) 

The Neurology Ward (St Vincent’s Ward) now has 

designated beds (since February 2008) and this has had 

a huge impact on our in-patient waiting list. The ward 

was repainted and the shower area improved in 2008. 

Eilish Funge, CMN2 continues to run a great ward and 

shares our aims to improve all aspects of the in-patient 

services. Only patients with the most complex problems 

are admitted to the ward. These patients require skilled, 

high-intensity nursing and multidisciplinary care from 

Physiotherapy, Occupational Therapy and Speech and 

Language Therapy. Many can no longer be managed at 

home or need special advice about aids at home from 

these team members and from the Medical Social Work 

Department. 

There is a great team spirit in the Department of 

Neurology with regular multidisciplinary meetings, radiology



meetings, the Journal Club, and up-date meetings 

about recent advances, new therapies and techniques. 


Neurology in the Ambulatory Day Care Centre (ADCC). 

The move to the new ADCC allowed the development 

of a new rota of Neurology Outpatient services in 2006. 

This involves public neurology clinics twice a day, and 

has already improved the service dramatically. In 2008 

we saw over 6000 outpatients. We have reduced the 

waiting times substantially as part of our continued 

waiting list initiative. 

We now have Specialist Clinics for Parkinson’s Disease, 

Multiple Sclerosis, Neuroinflammation and a Dystonia/ 

Botulinum Toxin Clinic. 

We are running Special Therapy Clinics to facilitate 

patients who otherwise might require hospitalisation. 

We saw over 1000 people in the ADCC for procedures 

such as lumbar punctures and for administration of 

therapies that would previously have required the sue 

of Day Ward facilities and thus have contributed to huge 

savings for the Hospital and the Health Service as a whole. 

The Infusion Unit also began to take patients in late 

2008 so this should further improve access for patients 

with MS. 

We have a dedicated secretary (Orla Bannon) to 

(always cheerfully!) check patients in and we have a 

number of other initiatives planned to make sure that 

attendance at the clinics are less stressful. Orla has 

worked hard with Radiology and Niamh Gaffney to 

deal with the long waiting list for outpatient MRIs and 

we are employing the NTPF currently to obtain MRI 

scans for those outpatients waiting more than 3 

months for a scan with great success. 

All of this has been made possible only with the help 

of a wide variety of people but we would like to thank 

especially Bernadette Howard, Margaret Boland, 

Sinead Brennan, Catherine Slattery and Breege 

Screene. 

Our e-mail neurology service (called ‘Neurolink’) 

continues to work well and we hope to expand it. St 

James’ Hospital, the Mater Hospital and Limerick Regional 

have now adopted the project too which is encouraging 

and we are grateful to Healthlink for all of their support. 

Professor Tom Keane reviewed it on behalf of the 

National Cancer Strategy and they are now using an 

adapted form of Neurolink nationally. We are most 

grateful for the co-operation of the GPs who use it and 

it has been a successful venture in that it has helped 

further reduce the burden on the Emergency Department, 

in-patient beds required and, of course, our patient 

waiting times. We have now expanded the project to 

allow access to over 120 GPs in the South Dublin area. 

We have also introduced a new in-patient referral 

service that is intranet-based and allows us to expedite 

review of people with neurological issues under the 

acre of colleagues in the hospital. This has had a great 

impact particularly in the Emergency Department where 

patients are seen rapidly and a management plan 

formulated to facilitate early discharge. We saw over 

1100 in-patient referrals (nearly 50% from the 

Emergency Department) in the first year of operation. 

The Neurology web-site has been developed over 

2008 and has information not just on our Department, 

but also links regarding research in MS and clinical 

information on Parkinson’s, Epilepsy, Migraine and other 

common neurological problems. 

Tysabri is being administered by an intravenous infusion 

every month and so the amount of work required to 

administer this has greatly increased the demands on 

our service, particularly our MS Specialist Nurse. We 

expect the numbers to gradually increase over the next 

12 months. We have already reached maximum capacity 

for this after three months (i.e. >50 people get a monthly 

infusion and each takes 2-3 hours). To continue to offer 

this treatment we will need another MS Specialist Nurse. 

167 

Return to Contents



Significant Achievements in 2007/2008 


Innovation awards in 2008 (regional and national) for 


practice’ 

Dr. Roisin Lonergan won Best Poster Presentation at the 

INA (Cork) 2008. 

Dr. Margaret O’Brien won Best Platform Presentation at 

the INA (Cork) 2008. 

Drs. Lonergan, O’Brien and Bradley all presented papers 

at the American Academy of Neurology in Chicago in 

2008. 

The Dystonia work was also presented at The Dystonia 

Europe Congress in Hamburg 2008; 

Drs Bradley and Lonergan also presented at the EFNS 

Madrid 2008 

Many of the team presented at the ABN in Dublin in 

2008 including Drs. Roisin Lonergan, Margaret O’Brien, 

Laura Williams, Ailin Rogers, Sinead Murphy and John 

McHugh. 

Dr. J. McNulty also presented a paper at the ABN held 

in Croke Park that was chaired by Professor Hutchinson 

in March 2008. 

Drs. Margaret O’Brien and Anna Heeney presented 

papers at the ENS in Nice in June 2008. 

Recent Publications 

Counting the cost of complementary and alternative 

therapies in an Irish neurological clinic. 

Murphy SM, Rogers A, Hutchinson M, Tubridy N. 

Eur J Neurol. 2008 Dec;15(12):1380-3. 

Replication of KIAA0350, IL2RA, RPL5 and CD58 as 

multiple sclerosis susceptibility genes in Australians. 

Rubio JP, Stankovich J, Field J, Tubridy N, Marriott M, 

Chapman C, Bahlo M, Perera D, Johnson LJ, Tait BD, 

Varney MD, Speed TP, Taylor BV, Foote SJ, Butzkueven 

H, Kilpatrick TJ. 

Genes Immun. 2008 Oct;9(7):624-30. 

Long-term clinical relevance of criteria for designating 

multiple sclerosis as benign after 10 years of disease. 

Costelloe L, Thompson A, Walsh C, Tubridy N, 

Hutchinson M. 

J Neurol Neurosurg Psychiatry. 2008 Nov;79(11):1245-8. 

Cervical dystonia presenting as a phenocopy in an Irish 

SCA2 family. Walsh R, O'Dwyer JP, O'Riordan S, 

Bradley D, MoroneyJ, Hutchinson M. 

Mov Disord. 2008 Dec 11. [Epub ahead of print] 

Progressive encephalomyelitis, rigidity, and myoclonus: 

a novel glycine receptor antibody. 

Hutchinson M, Waters P, McHugh J, Gorman G, O'Riordan 

S, Connolly S, Hager H, Yu P, Becker CM, Vincent A. 

Neurology. 2008 Oct 14;71(16):1291-2. 

Differential diagnosis of suspected multiple sclerosis: a 

consensus approach. Miller DH, Weinshenker BG, 

Filippi M, Banwell BL, Cohen JA, Freedman MS, Galetta 

SL, Hutchinson M, Johnson RT, Kappos L, Kira J, Lublin 

FD, McFarland HF, Montalban X, Panitch H, Richert JR, 

Reingold SC, Polman CH. 

Mult Scler. 2008 Nov;14(9):1157-74. 

New-onset focal epilepsy with palatal tremor and 

glutamic acid decarboxylase antibodies responding to 

intravenous immunoglobulin. 

Marnane M, Vincent A, Hutchinson 

M. J Neurol. 2008 Oct;255(10):1603-4. 

Hanein S, Martin E, Boukhris A, Byrne P, Goizet C, 

Hamri A, Benomar A, Lossos A, Denora P, Fernandez J, 

Elleuch N, Forlani S, Durr A, Feki I, Hutchinson M, 

168 

Return to Contents



Santorelli FM, Mhiri C, Brice A, Stevanin G. Identification 

of the SPG15 gene, encoding spastizin, as a frequent 

cause of complicated autosomal-recessive spastic 

paraplegia, including Kjellin syndrome. Am J Hum 

Genet 2008 Apr;82(4):992-1002. 

Beetz C, Schüle R, Deconinck T, Tran-Viet KN, Zhu H, 

Kremer BP, Frints SG, van Zelst-Stams WA, Byrne P, Otto 

S, Nygren AO, Baets J, Smets K, Ceulemans B, Dan B, 

Nagan N, Kassubek J, Klimpe S, Klopstock T, Stolze H, 

Smeets HJ, Schrander-Stumpel CT, Hutchinson M, van 

de Warrenburg BP, Braastad C, Deufel T, Pericak-Vance 

M, Schöls L, de Jonghe P, Züchner S. 

REEP1 mutation spectrum and genotype/phenotype 

correlation in hereditary spastic paraplegia type 31. 

Brain 2008 Apr;131(Pt 4):1078-86. 

Williams L, O'Connell K, Tubridy N. 

Headaches in a rheumatology clinic: when one pain 

leads to another. 

Eur J Neurol 2008 Mar;15(3):274-7. 

McHugh JC, Tubridy N, Collins CD, Hutchinson M. 

Unusual MRI abnormalities in anti-Yo positive "pure" 

paraneoplastic cerebellar degeneration. 

J Neurol 2008 Jan;255(1):138-9. 

Costelloe L, O'Rourke K, McGuigan C, Walsh C, Tubridy 

N, Hutchinson M. The longitudinal relationship between 

the patient-reported Multiple Sclerosis Impact Scale 

and the clinician-assessed Multiple Sclerosis Functional 

Composite. Mult Scler 2008 Mar;14(2):255-8. 

Future Plans 

GP-led Migraine Clinic – we plan to have a weekly GPled 

migraine clinic for the many thousands of people 

with migraine in our area and require funding for the 

GPs sessions, a migraine registrar and a migraine nurse. 

Such an investment would substantially reduce 

attendances at the Emergency Department and thus 

hospital admissions. It would have a major impact for 

our patients in terms of waiting times and overall 

economic savings would be substantial. 

Audit 

Consultation service for in-patients of all services 

The Neurology service sees 20-25 in-patients (from 

other services) with neurological problems each week. 

Over a 12-month period,1100 referrals were seen in 

2007-2008 and the vast majority are seen directly in 

the Emergency Department to facilitate early diagnosis 

and possible discharge. 

Neurology in the Emergency Department (ED). 

We previously performed an audit of the ED admissions 

at SVUH that had a neurological problem. About 15% 

of all ED admissions had a neurological problem. The 

most common conditions were headaches (19%), 

post-traumatic neurological signs (16%), seizures 

(10%), stroke (17%), loss of consciousness (6%), and 

dizzy/syncope (6%). 

Teaching 

The Department has an excellent reputation in teaching 

under-graduate and post-graduate students. 

The Department runs the MRCP examinations three 

times a year. 

We also run an annual MRCPI course in Neurology as 

well as in hospital MRCP teaching sessions there times 

a year. 

In 2008, the Team has been working to produce a 

video for teaching students and doctors at all levels 

with Clinics in Motion and UCD. This will be available in 

early 2009. 

169 

Return to Contents


Department of Clinical Neurophysiology 


Consultant: 

Dr Sean Connolly, MD, FRCPI 

Neurophysiology Measurement Technicians at SVUH: 

Ms Anne Bjerke (full-time senior) 

SVUH departmental secretary/manager: 

Ms Lesley Bergin 

The department of Clinical Neurophysiology is part of 

the South Dublin Clinical Neurophysiology Service, 

which also includes units at St James’s Hospital and the 

Meath & Adelaide Hospitals, incorporating the National 

Childrens’ Hospital (AMNCH) at Tallaght. As this service 

is currently run by one consultant, it is best to consider 

this service as a whole. 

The range of investigative/diagnostic services provided 

include routine Nerve Conduction Studies (NCS), 

Electromyography (EMG), Quantitative Sensory Testing 

(QST), Electroencephalography (EEG) and Visual 

Evoked Responses (VERs). 

Research, currently being carried out mainly at the 

AMNCH and SVUH departments, includes a nerve 

excitability study in toxic neuropathies. There are also 

research collaborations with the Department of Neuroengineering 

at TCD and with Dr Geraldine Boylan in the 

Department of Paediatrics and Child Health, UCC. 

Recent Developments 

Efforts are continuing to appoint more technologists 

and to provide additional departmental space. 

Recent Publications 

Murray DM, Boylan GB, Fitzgerald AP, Ryan CA, Murphy 

BP, Connolly S. 

Persistent lactic acidosis in neonatal hypoxic-ischaemic 

encephalopathy correlates with EEG and electrographic 

seizure burden. Arch Dis Child Fetal Neonatal Ed. 

2008;93:F183-6. Epub 2006 Nov 28. PMID: 17132680 

Hutchinson M, Waters P, McHugh J, Gorman G, O’Riordan 

S, Connolly S, Hager H, Yu P, Becker C-M, Vincent A. 

Progressive encephalomyelitis, rigidity and myoclonus: 

a novel glycine receptor antibody. 

Neurology. 2008;71: 1291-2. PMID: 18852446 

170 

Return to Contents


Department of Palliative Medicine 


Consultant: 

Clinical Nurse Specialists: 

Dr Eoin Tiernan 

St. Vincent’s University Hospital 

Ms Millie Devenish/ 

Olga Price 

Ms Siobhan Hollingsworth 

Ms Barbara Whyte 

St. Vincent’s Private Hospital: 

Ms. Carmel Houlihan 

Ms. Anthea O’Grady (part-time) 

Specialist Registrars: Dr Kathleen Cronin - 

01/01/08 to 30/06/08 

Dr Brenda O’Connor – 

01/07/08 to 31/12/08 

Registrars: Dr Tim Price – 

01/01/08 to 30/06/08 

Dr David Ngo – 

01/07/08 to 31/12/08 

Principal Psychologist: 

Administrative Support: 

Ms. Ursula Bates 

(2 sessions per week) 

Ms Joan Stokes 

Service Activity 

The significant increase in referrals seen annually to the 

specialist palliative medicine service continued in 2008. 

In total 1050 patients were referred. 24% of new 

referrals had a non-cancer diagnosis. 

As well as the increased numbers of referrals seen over 

the years, the service is also seeing definite changes in 

the nature of the referrals. Cancer patients are being 

referred earlier in their illness, with the Palliative 

Medicine Team providing advice and support to greater 

numbers of patients who are still undergoing active 

oncological therapies. As well as earlier referral, with 

newer oncological therapies available, cancer patients 

are often receiving chemotherapy at more advanced 

stages of their illness. Theses changes have led to the 

need for a more integrated model of palliative medicine 

and oncology, which is happening in this hospital. 

The number of non-cancer referrals remains high, with 

an increasing range of conditions being referred. 

Though most of the non-cancer referrals are still for 

terminal care in the hospital, an increasing number of 

patients with complex multiple symptoms associated 

with chronic life-limiting conditions are being referred, 

for example, young patients with inflammatory bowel 

disease, and, young patients with cystic fibrosis. 

REFERRALS 

1200 

1000 

800 

600 

400 

200 

0 

1038 1050 

931 

817 

774 

721 

2003 2004 2005 2006 2007 2008 

171 

Return to Contents



Developments 

Increasingly the aforementioned changes we are seeing 

in referrals are leading to a need to continuously develop 

the role of specialist palliative medicine in the acute 

hospital setting and also suggest that the traditional 

model of hospice-focused palliative care needs to be 

challenged. It is clear that the majority of complex 

specialist palliative medicine is delivered in an acute 

hospital setting, and services need to develop to reflect 

this. 

In 2007 the team completed the role-out of the 

Liverpool Care Pathway (LCP) for the Dying. However, 

the LCP has a very narrow focus on just care in the final 

hours/days of life and experience is showing that it has 

limited use with only a minority of patients who die 

entering onto the pathway. As a consequence, and 

following a period of consolidation of the clinical 

service, the Palliative Medicine Team began work in 

2008 on an innovative proposal to develop a broader 

framework to replace the Liverpool Care Pathway. This 

innovative work involves new partnerships with 

institutions in the US and the UK. 

The close links between our service and Blackrock 

Hospice continue to develop with our weekly liaison 

meeting between the Hospice Home Care Team and 

the Palliative Medicine and Oncology Teams in St. 

Vincents. Ongoing project and audit work continue to 

support enhancement of continuity of care between the 

acute and hospice inpatient and home care settings. 

A new Palliative Medicine Outpatient Service was 

commenced in 2008 in St. Vincent’s University Hospital 

to support patients in the community and under the 

care of the Hospice Home Care Team. 

Education 

As well as continuing to provide input to a wide range of 

educational initiatives for other healthcare professionals, 

both in-house and externally, all members of the Palliative 

Medicine Department attend to their own continuing 

professional development by way of attendance at both 

in-house and external educational events. 

The clinical nurse specialists continue to facilitate the 

Palliative Care Link Nurse Programme involving monthly 

meetings with the Link Nurses from the wards with a 

structured education programme covering a wide range 

of palliative care issues. 

The team continues to facilitate clinical placements for 

nurses undertaking the Higher Diplomas in Palliative 

Care Nursing and Pain Management from UCD. 

172 

Return to Contents



Courses and Conferences attended by members 

of the team (sample) 

In-house: members of the team attended workshops 

on presentation skills, medication safety, mindfulness 

training, and CPR during the course of the year. 

A selection of the external educational events attended 

by members of the team: 

• Moving Points in Palliative Care (Our Lady’s 

Hospice, Harold’s Cross), 3 - 4 April 2008. 

• EAPC Research Conference, Trondheim, Norway 29 

- 31 May 2008. 

• 7th Annual Kalidoscope Conference (St. Francis 

Hospice) ‘Pearls & Promises’ 11 -12 June 2008, 

Dublin Castle. 

• Design & Dignity, Public Lecture Professor Roger 

Ulrich Thursday 19th June 2008 (Hospice Friendly 

Hospitals Programme). 

Achievements 

During 2008, Ms. Barbara Whyte, Clinical Nurse 

Specialist, was appointed to the Dublin Mid-Leinster 

Regional Development Committee for Palliative Care. 

Ms. Millie Devenish, Clinical Nurse Specialist, was 

appointed to the Nursing Advisory Forum of Irish 

Association for Palliative Care. 

Publications 

Peer-reviewed publications 

Stone CA, Tiernan E, Dooley BA. 

Prospective validation of the palliative prognostic index 

in patients with cancer. 

J Pain Symptom Manage. 2008 Jun;35(6):617-22. 

O'Leary N, Tiernan E. 

Survey of specialist palliative care services for 

noncancer patients in Ireland and perceived barriers. 

Palliat Med. 2008 Jan;22(1):77-83. 

• Beaumont Palliative Care Study Day, Beaumount 

Hospital, 18 Sept 2008. 

• Effective Teaching Skills (RCPI) 7 - 8 Oct 2008. 

173 

Return to Contents


Department of Respiratory Medicine 

Prof. W. McNicholas, Dr. Tim McDonnell. 


In-patients: 

Professor W. McNicholas 

Dr. T. McDonnell 

Dr. John Seery 

Admissions 640 

Discharges 628 

Day Care 79 

Pulmonary Function Laboratory: 

Total Patients: 3525 

Total tests: 8487 

Sleep Laboratory: Total Admissions: 322 

Pulmonary and Sleep Laboratory 


The Sleep Laboratory moved to a new location in July 

2008 adjacent to the new St. Mark’s Day Centre. This 

new location allows for 7 patients per night to be tested 

in individual rooms with separate office and a combined 

Nurse office/patient education room. However, the 

Sleep Laboratory was closed for several months prior to 

this move which has resulted in a significant reduction 

in patient tests during 2008 when compared with 

2007. 

Dr David Mc Sharry was appointed to a temporary halftime 

Consultant post in October 2008 to help deal with 

the lengthy waiting lists of referrals relating to suspected 

sleep apnoea. 

New staff appointed during 2008 

The following technician appointments were made in 

2008: Sonia Eigenheer, Senior (May 08), Emma Smyth 

(Basic split between St Michael’s Hospital + St 

Vincent’s University Hospital), transfer of Brigid Clarke 

from EEG to Pulmonary Laboratory. 

Grade IV secretarial support Catherine Morris appointed 

to the Sleep Disorders Unit in December 2008. 

Welcome babies Niamh and Sabhdh to Sleep Nurse 

Specialists Val and Renata and grandson Jack to 

Geraldine. Thanks to Avril locum Nurse Specialist for 

2008 covering maternity leave. 

Respiratory Education Centre 

A total of 1827 consults were undertaken during 2008. 

This reflects a 10% increase from 2007. 

Outpatients Department 

No. of New Return Total 

Sessions 

Prof. McNicholas (General Respiratory) 51 159 756 915 

Prof. McNicholas (Sleep Apnoea Clinic) 51 241 714 955 

Dr. T. McDonnell 50 96 373 469 

Total 152 496 1,843 2,339 

Staff Education 

The NIV study day was attended by 60 candidates. This 

included 49 nurses and 11 physiotherapists. Our focus 

is to revise the NIV study day, targeting specific clinical 

areas to enhance proficiency. 

HFCPAP training was commenced in April. 65 nursing 

staff have attended the monthly training sessions. 

174 

Return to Contents


Department of Respiratory Medicine 

Guideline development 

HFCPAP guidelines were devised and launched in 

October. 

Nebuliser therapy guidelines are subject to review 

pending audit recommendations. 

Both the Tracheostomy care and NIV guidelines are 

scheduled for review 2009. 

Audit 

A re-evaluation of RNS formal referral system July. 

An evaluation of current nursing practice with regards to 

nebuliser use in SVUH Sept. 

A re-evaluation of RNS telephone advice line in 

November. 

Publications 

Jones, P. (2008) 

Management of Exacerbations and Emergencies, 

World of Irish Nursing July / August, 16, (7), pp40-42 

Brown, L. (2008) 

The Management of Adult Asthma, 

World of Irish Nursing April, 16, (4), pp45-47 

Invited Lectures 

Prof. McNicholas gave several lectures as part of major 

symposia at the following international scientific 

meetings: 

• American Thoracic Society, Toronto, May 2008 

• American Academy of Sleep Medicine, Baltimore, 

June 2008 

• European Respiratory Society, Berlin, October 2008 

Selected Publications 2008 

Riha RL, Diefenbach K, Jennum P, McNicholas WT; 

Management Committee, COST B26 Action on Sleep 

Apnoea Syndrome. Genetic aspects of hypertension 

and metabolic disease in the obstructive sleep apnoeahypopnoea 

syndrome. Sleep Med Rev. 2008 

Feb;12(1):49-63. PMID: 18201663 [PubMed - indexed 

for MEDLINE] 

Ryan S, McNicholas WT. 

Intermittent hypoxia and activation of inflammatory 

molecular pathways in OSAS. 

Arch Physiol Biochem. 2008 Oct;114(4):261-6. 

Review. PMID: 18946786 [PubMed - indexed for 

MEDLINE] 

de Chazal P, Heneghan C, McNicholas WT. 

Multimodal detection of sleep apnoea using 

electrocardiogram and oximetry signals. 

Philos Transact A Math Phys Eng Sci. 2009 Jan 

28;367(1887):369-89. PMID: 18974035 [PubMed - in 

process] 

McNicholas WT. 

The nose and OSA: variable nasal obstruction may be 

more important in pathophysiology than fixed 

obstruction. 

Eur Respir J. 2008 Jul;32(1):3-8. PMID: 18591332 

[PubMed - indexed for MEDLINE] 

Doherty LS, Cullen JP, Nolan P, McNicholas WT. 

The human genioglossus response to negative airway 

pressure: stimulus timing and route of delivery. 

Exp Physiol. 2008 Feb;93(2):288-95. Epub 2007 Oct 

19. PMID: 17951328 [PubMed - indexed for MEDLINE] 

175 

Return to Contents


Bone and Join Unit 

The St. Vincent’s Healthcare Group (SVHG) Bone and 

Joint Unit is comprised of specialities of Orthopaedic 

Surgery, Rheumatology and of Rehabilitation Medicine. 

The Bone and Joint Unit is the only such unit in Ireland 

and the Mission of the Bone and Joint Unit is fourfold. 

1. To provide evidence based, multidisciplinary care 

programme to all patients presenting to SVHG with 

musculoskeletal and rehabilitation related clinical 

related problems. 

2. By linking closely with community care to devise 

programmes of patient management, which are 

designed to offer speedy access, early intervention 

and discharge back to the community where 

appropriate. 

3. By coordinating teaching programmes to provide a 

unique, educational programme for medical 

undergraduates, post-graduate trainees and for 

nurses, physiotherapists and occupational therapists 

wishing to develop specialist musculoskeletal 

expertise. 

4. By promoting interdisciplinary cooperation to further 

develop and expand the academic and research 

infrastructure relating to musculoskeletal disease. 

The Bone and Joint Unit has been operational since the 

summer of 2006. Clinics are provided within the Unit 

operating on the basis of three by three clinics per day 

in addition to daily fracture clinics. Members of the 

Bone and Joint Unit meet on a monthly basis to help 

plan and develop the service and to improve the 

delivery of care to our patients. 

Department of Rheumatology 


Consultant Staff: 

Specialist Registrar: 

Registrar: 


(January-March) 




(March-December) 


Dr. Lorraine O’Neill (June-December) 

Dr. Ceara Walsh (January-June) 

Dr. John Paul Doran (January-June) 

Dr. Claire Kiely (June-December) 

Research Registrar: 

Research Registrar: 

Nursing Staff: 

Administration Staff: 





Dr. Taj Saber 


Ms. Catherine Slattery 

Mrs. Miriam Molloy 

Mrs. Phil Gallagher 

Mrs. Alexia Grier 

Mrs. Marie O’Rourke 

Mrs. Eileen O’Flynn 

Mrs. Susan van der Kamp 

Ms. Imelda Corcoran 

Ms. Bincy Varghese 

Sujata 

Mrs. Jenni Cross 

Mrs. Linda Collins (January-September) 

Mrs. Julie Di Silva 

Mrs. Frances Dwyer 

Ms. Saibh Kelly 

Ms. Ann Claire Nolan 

Ms. Ann Sharkey 

Ms. Mary White 

176 

Return to Contents




Specific programmes, which are operational within the 

Bone and Joint Unit, include the Early Arthritis Clinic, 

the Adolescent Transitional Clinic, the clinic designated 

for patients on biologic therapies and the nurse-led 

Methotrexate Clinic. The Fracture Liaison Nurse Service 

(FLS) position has been in place throughout 2008 

funded by MSD. An audit of this service by FLS nurse 

Annette Whelan has confirmed that patients with low 

trauma fracture are being identified, fully assessed 

including DXA scanning and are being commenced on 

appropriate treatment to prevent further fracture. It is 

hoped that the funding of this position will be taken up 

by the hospital in 2009. 

Other significant achievements, within 2008, include 

the following: 

• The Bone Density Department has expanded with 

two DXA scanners on site within the Bone and Joint 

Unit. To further coordinated development of DXA 

scanning within the St. Vincent’s Healthcare Group, 

a Bone Health Users Group has been established. 

• Coordinated by Dr. Bernadette Lynch, Dr. Aizad 

Mumtaz and Specialist Physiotherapist Martina 

Fitzpatrick, musculoskeletal ultrasound continues to 

be available within the Bone and Joint Unit. A new 

state-of-the-art musculoskeletal ultrasound machine 

including 3D/4D capabilities has been installed. 

• Together with the Physiotherapy department, a back 

care programme funded for 1 year has been 

established. 

• Work is well on the way to develop a database for 

inflammatory arthritis patients. The database will be 

operational by mid-2009. Significant support to 

develop this database has been obtained through a 

grant received from Abbott Immunology. 

• Needle arthroscopy continues to be available within 

the department. The arthroscopies are now being 

undertaken in the Clinical Research Centre and in 

the Bone and Joint Department. Professor Douglas 

Veale is coordinating this programme. 


Consultant achievements 


• Co-Chairman, EULAR Synovitis Study Group 

• Co-Chairman, OMERACT Synovial Tissue Analysis 

Study Group 

177 

Return to Contents




• Chairman, Arthritis Ireland 

• Member of HSE working group on Arthritis and 

Allied conditions representing the Irish Society of 

Rheumatology 

• Steering committee member for GRAPPA (Group 

for Research and Assessment of Psoriasis and 

Psoriatic Arthritis) 

• Member of Abbott International Immunology 

Advisory Board 

• Lead Consultant Bone & Joint Unit, SVUH 

• Medical Director Rheumatology Rehabilitation at 

Harold’s Cross 

• Chairman, Scientific Session at EULAR 

• Steering committee member of OMERACT 

Biomarkers Group 

• Scientific committee member 3e Initiative in 

Rheumatology 

• Invited speaker at the following: 

– Progress and Promise Meeting, Madrid 

– Genetic Clinic, London 

– Turkish Society of Rheumatology, Istanbul 

– Corrigan Club, Keynote Speaker 

– GRAPPA meeting, Leeds 

– Specialist Registrar Training Group, Northern 

Ireland 


• Appointed Director of Translational Research, Dublin 


• Medical Director, Education & Research Centre, SVUH 

• Director of THERAPI - Translational Research Group 

• Vice-president, International Scleroderma Clinical 

Trials Consortium 

• Strategic Scientific Committee, Arthritis Research 

Campaign, UK 

• HRB Infection & Immunity Grant Committee 

• Irish Medicines Board, Medicines Committee 

• Wyeth Translational Science European Expert Group 

• Schering-Plough International Advisory Panel 

• Centocor International Advisory Panel 

• Co-Chair RCPI Masterclass in Rheumatology 

• Progress and Promise, Madrid vvisiting Speaker 


• Director of the Clinical Skills Laboratory at UCD 

• Co-ordinator of the Advanced Clinical Skills module 

for the Graduate Entry Medicine programme 

• Co-ordinator for the Elective module for undergraduate 

and graduate entry medical students 


• Senior Scientist Rheumatology 

• Chairperson Scientific Session of The American 

College of Rheumatology, San Francisco, November 

2008 

Grants 

Differential expression of VEGF, PIGF and the VEGF 

receptors in Inflammatory arthritis. 

HRB Project Grant: ?165,000 (PI-Oliver FitzGerald) 

Differential Protein expression in psoriatic arthritis 

synovial tissue following 

anti-TNF therapy. (PI-Oliver FitzGerald) Abbott: €100,000 

Development of Inflammatory Arthritis database. 

Abbott: €240,000 (PI-Oliver FitzGerald) 

HRB Equipment Grant Award 

(PI-Steve Pennington, Co-investor- Oliver Fitzgerald) 

Hypoxia-induced mitochondrial signalling pathways in 

inflammatory arthritis. 

HRB Translational Award 2006-2011, €1.5m (PI-Douglas Veale) 

178 

Return to Contents



Autocure EU 6th Framework Grant (PI-Barry Bresnihan) 

‘Curing Autoimmune Disease – translational approach’ €212,500 

over 5 years 

Biopharmaceutical/Pharmaceutical Science Programme 

PRTLI Cycle 4, €4.6 million (Co-applicant – Douglas Veale) 

A CELLMAX® Artificial Capillary System and 

Flexercell Strain Unit 

UCD Research Support Schemes. €35k (PI - Douglas Veale) 

Hypoxia-induced mitochondrial signaling pathways in 

inflammatory arthritis promote 

angiogenesis and synovial invasiveness and may predict 

response to therapy. 

HRB Translational Award €1.4 million (PI - Douglas Veale) 

Hypoxia Chambers and Luminometer 

HRB Equipment Grant Award €75k (PI - Ursula Fearon) 

In vivo Hypoxic probes and monitor. 

UCD Seed Funding €20k (PI - Ursula Fearon) 

Proof of concept studies of novel biopharmaceutical 

and small molecular 

weight inhibitors using whole tissue explant cultures. 

GlaxoSmithKline €680k (PI - Douglas Veale) 

Cytokine Regulation in Synovial explant cultures and 

pre/post biologic therapy. 

Wyeth Pharmaceuticals ?350k (PI - Douglas Veale) 

Publications 

Hypoxia activates NF-κB-dependent gene expression 

through the canonical signaling pathway. 

Kathryn M. Oliver, John F. Garvey, Eoin P. Cummins, 

Douglas J. Veale, Ursula Fearon, Cormac T. Taylor. 

In Press 

A Novel Role for the HDL Receptor, CLA-1 in 

Synovial Inflammation via Serum Amyloid-A and 

Apolipoprotein A-1. 

Mullan Ronan, Mc Cormick Jennifer, Connolly Mary, 

Bresnihan Barry, * Veale Douglas James , * Fearon 

Ursula. In Press Am J Pathol 

Synovial tissue sublining CD68 expression as a 

biomarker of therapeutic response in rheumatoid 

arthritis clinical trials: consistency across centers. 

Barry Bresnihan, Eliza Pontifex, Rogier Thurlings, 

Marjolein Vinkenoog, Hani el Gabalawi, Ursula Fearon, 

Oliver Fitzgerald, Danielle Gerlag, Terence Rooney, 

Marleen van de Sande, Douglas Veale, Koen Vos, PP 

Tak 

Adherence to medications in systemic lupus 

erythematosus. 

Koneru S, Kocharla L, Higgins GC, Ware A, Passo MH, 

Farhey YD, Mongey AB, Graham TB, Houk JL, Brunner 

HI. J Clin Rheumatol. 2008 Aug;14(4):195-201 

Drug insight: autoimmune effects of medicationswhat's 

new? Mongey AB, Hess EV; Medscape. Nat 

Clin Pract Rheumatol. 2008 Mar;4(3):136-44. Review 

Walsh CAE, Fearon U, FitzGerald O, Veale DJ, Bresnihan 

B. Decreased CD20 Expression in Rheumatoid 

Arthritis Synovium Following 8 Weeks of Rituximab 

Therapy. Clin Exp Rheumatol. 2008 Jul-Aug;26(4):656-8 

Updated consensus statement on biological agents 

for the treatment of rheumatic diseases, 2008. Furst 

DE, Keystone EC, Kirkham B, Kavanaugh A, Fleischmann 

R, Mease P, Breedveld FC, Smolen JS, Kalden JR, 

Burmester GR, Braun J, Emery P, Winthrop K, Bresnihan 

B, De Benedetti F, Dörner T, Gibofsky A, Schiff MH, 

Sieper J, Singer N, Van Riel PL, Weinblatt ME, Weisman 

MH.Ann Rheum Dis. 2008 Dec;67 Suppl 3:iii2-25 

Rheumatoid arthritis: a novel radiographic 

projection for hand assessment. 

Pearman L, Last J, Fitzgerald O, Veale D, Joyce M, 

Rainford L, McEntee M, McNulty J, Thomas E, Ryan J, 

McGee A, Toomey D'Helft R, Lowe J, Brennan PC 

179 

Return to Contents



Successful pregnancy after rituximab in a women 

with recurrent in vitro fertilisation failure and antiphospholipid 

antibody positive.Ng CT, 

O'Neil M, Walsh D, Walsh T, Veale DJ. 

Ir J Med Sci 2008; Nov 29 

Treatment recommendations for psoriatic arthritis. 

Ritchlin CT, Kavanaugh A, Gladman DD, Mease PJ, 

Helliwell P, Boehncke WH, de Vlam K, Fiorentino D, 

Fitzgerald O, Gottlieb AB, McHugh N, Nash PT, Qureshi 

A, Soriano ER, Taylor WJ. 

Ann Rheum Dis. 2008 Oct 24. [Epub ahead of print] 

PMID: 18952643 [PubMed - as supplied by publisher] 

Consistency in assessing the Disease Activity Score- 

28 in routine clinical practice. 

Walsh CA, Mullan RH, Minnock PB, Slattery C, 

FitzGerald O, Bresnihan B. Ann Rheum Dis. 2008 

Jan;67(1):135-6. No abstract available. PMID: 

18077544 [PubMed - indexed for MEDLINE] 

Increased expression of the orphan nuclear receptor 

NURR1 in psoriasis and modulation following TNFalpha 

inhibition. O'Kane M, Markham T, McEvoy AN, 

Fearon U, Veale DJ, FitzGerald O, Kirby B, Murphy EP. 

J Invest Dermatol. 2008 Feb;128(2):300-10. Epub 2007 

Aug 2. PMID: 17671512 [PubMed - indexed for MEDLINE] 

Differential expression of syndecans and glypicans 

in chronically inflamed synovium. 

Patterson AM, Cartwright A, David G, Fitzgerald O, 

Bresnihan B, Ashton BA, Middleton J. Ann Rheum Dis. 

2008 May;67(5):592-601. Epub 2007 Jun 1. PMID: 

17545191 [PubMed - indexed for MEDLINE] 

Biomarkers in systemic sclerosis. Doran JP, Veale DJ. 

Rheumatology (Oxford). 2008 Oct;47 Suppl 5:v36-8. 

PMID: 18784139 [PubMed - in process] 

Validity, reliability, and feasibility of durometer 

measurements of scleroderma skin disease in a 

multicenter treatment trial. 

Merkel PA, Silliman NP, Denton CP, Furst DE, Khanna 

D, Emery P, Hsu VM, Streisand JB, Polisson RP, Akesson 

A, Coppock J, van den Hoogen F, Herrick A, Mayes MD, 

Veale D, Seibold JR, Black CM, Korn JH; CAT-192 

Research Group; Scleroderma Clinical Trials Consortium. 

Arthritis Rheum. 2008 May 15;59(5):699-705. 

PMID: 18438905 [PubMed - indexed for MEDLINE] 

Development of a provisional core set of response 

measures for clinical trials of systemic sclerosis. 

Khanna D, Lovell DJ, Giannini E, Clements PJ, Merkel 

PA, Seibold JR, Matucci-Cerinic M, Denton CP, 

Mayes MD, Steen VD, Varga J, Furst DE; 

Scleroderma Clinical Trials Consortium co-authors. 

Ann Rheum Dis. 2008 May;67(5):703-9. Epub 2007 

Sep 24. 


Photochemotherapy for localized morphoea: effect 

on clinical and molecular markers. 


Clin Exp Dermatol. 2008 Nov;33(6):698-704. 

Abnormal T cell differentiation persists in patients 

with rheumatoid arthritis in clinical remission and 

predicts relapse. 

Burgoyne CH, Field SL, Brown AK, Hensor EM, English 

A, Bingham SL, Verburg R, Fearon U, Lawson CA, 

Hamlin PJ, Straszynski L, Veale D, Conaghan P, Hull MA, 

van Laar JM, Tennant A, Emery P, Isaacs JD, Ponchel F. 

Ann Rheum Dis. 2008 Jun;67(6):750-7. Epub 2007 Jul 

20. 


Updated consensus statement on biological agents 

for the treatment of rheumatic diseases, 2008. 



Kalden JR, Burmester GR, Braun J, Emery P, Winthrop 

K, Bresnihan B, De Benedetti F, Dörner T, Gibofsky A, 

Schiff MH, Sieper J, Singer N, Van Riel PL, Weinblatt 

ME, Weisman MH. 

Ann Rheum Dis. 2008 Dec;67 Suppl 3:iii2-25. No 

abstract available. Erratum in: Ann Rheum Dis. 2009 

Mar;68(3):452. Kavanaugh, A [added]. 


180 

Return to Contents



Musculoskeletal Disorders. Eliza Pontifex and Barry 

Bresnihan. "Palliative Medicine." Elsevier publishers, 

USA. 2008, p1033-1038 

Melanoma Inhibitory Activity, a biomarker related to 

chondrocyte anabolism, is reversibly suppressed by 

proinflammatory cytokines in rheumatoid arthritis. 



Verdonk PC, Tak PP, Boots AH, Baeten D. 

Ann Rheum Dis. 2008 Jul 16. [Epub ahead of print] 

PMID: 18633128 [PubMed - as supplied by publisher] 

Tuberculosis reactivation during immunosuppressive 

therapy in rheumatic diseases: diagnostic and 

therapeutic strategies. 

Keane J, Bresnihan B. 

Curr Opin Rheumatol. 2008 Jul;20(4):443-9. Review. 


Cardiovascular disease in patients with rheumatoid 

arthritis: results from the QUEST-RA study. 

Naranjo A, Sokka T, Descalzo MA, Calvo-Alén J, 

Hørslev-Petersen K, Luukkainen RK, Combe B, 

Burmester GR, Devlin J, Ferraccioli G, Morelli A, 

Hoekstra M, Majdan M, Sadkiewicz S, Belmonte M, 

Holmqvist AC, Choy E, Tunc R, Dimic A, Bergman M, 

Toloza S, Pincus T; QUEST-RA Group. 

Arthritis Res Ther. 2008;10(2):R30. Epub 2008 Mar 6. 




multicenter treatment trial. Merkel PA, Silliman NP, 

Denton CP, Furst DE, Khanna D, Emery P, Hsu VM, 

Streisand JB, Polisson RP, Akesson A, Coppock J, van 

den Hoogen F, Herrick A, Mayes MD, Veale D, Seibold 

JR, Black CM, Korn JH; CAT-192 Research Group; 

Scleroderma Clinical Trials Consortium. Arthritis Rheum. 

2008 May 15;59(5):699-705. 

The development of the L-QoL: a quality-of-life 

instrument specific to systemic lupus erythematosus. 

Doward LC, McKenna SP, Whalley D, Tennant A, 

Griffiths B, Emery P, Veale DJ.Ann Rheum Dis. 2009 

Feb;68(2):196-200. 

Biological biomarkers in psoriatic disease. A review. 

de Vlam K, Gottlieb AB, Fitzgerald O. 

J Rheumatol. 2008 Jul;35(7):1443-8. Review 

Clues to the pathogenesis of psoriasis and psoriatic 

arthritis from imaging: a literature review. 

Coates LC, Anderson RR, Fitzgerald O, Gottlieb AB, Kelly 

SG, Lubrano E, McGonagle DG, Olivieri I, Ritchlin CT, 

Tan AL, De Vlam K, Helliwell PS. 


Breast cancer and systemic sclerosis: a clinical 

description of 21 patients in a population-based 

cohort study. Lu TY, Hill CL, Pontifex EK, Roberts- 

Thomson PJ. Rheumatol Int. 2008 Jul; 28(9):895-9 

Chapters 

• Professor Oliver FitzGerald, co-editor for new e- 

textbook on “Psoriatic and Reactive Arthritis”. 

• Dr. Eliza Pontifex, Professor Barry Bresnihan for “In 

Palliative Medicine” on “Musculoskeletal disorders”. 

In Press. 

• Professor Oliver FitzGerald, Psoriatic Arthritis in text 

book of Rheumatology. Ed-Firestein et al 2008 

Future Plans 

To make additional appointments in Rheumatology, in 

particular at consultant and clinical nurse specialist levels. 

To continue with development of closer links with 

primary care services with a view to improving interface 

between primary and secondary care. 

To further develop care pathways in collaboration with 

Bone and Joint colleagues in Orthopaedic Surgery and 

Rehabilitation Medicine. 

181 

Return to Contents



Department Statistics 

OPD New Patients Return Patients Total 

Monday Clinic 313 917 1,230 

Tuesday Clinic 11 1,306 1,317 

Wednesday AM Clinic 227 704 931 

Wednesday PM Clinic 191 626 817 

Thursday Clinic 70 359 429 

Dr. Veale (Knee Clinic AM) 5 8 13 

Dr. Veale (Knee Clinic PM) 4 10 14 

Adolescent Clinic 16 60 76 

Biological Clinic 26 642 668 

Mantoux Clinic 14 26 40 

Nurse Led Clinic 12 30 42 

Grand Total 889 4,688 5,577 

182 

Return to Contents




Principal Investigators 

Specialist Registrars 

Registrars 

Clinical Research Fellows 

Post Doctoral fellow 


Dr. Ciaran Duffy 

Dr. Ursula Fearon (Senior Scientist) 





Dr. Lorraine O’Neill 

Dr. Ceara Walsh 

Dr. John Paul Doran 

Dr.Clare Kiely 





Dr. Taj Saber 


Ms Roisin Adams 

Dr. Monika Biniecka 

Dr. Emily Collins 

Dr. Wei Gao 

Dr. Sinead NicUltaigh 


Graduate Students 

Ms Jennifer Mc Cormick 

Owen O’Sullivan 

Mary Connolly 


Ellen Moran 

Educational Activities 

Prof. Anne Barbara Mongey is the Director of the 

Clinical Skills Laboratory at UCD, responsible for 

designing and conducting workshops in clinical skills for 

the undergraduate and graduate entry medicine 

programs. In addition, Prof. Mongey is involved in the 

development of OSCE examinations, including the use 

of videotaping, to evaluate clinical skills. Integration of 

the teaching of clinical skills into the 1st and 2nd year 

of the undergraduate medical programme is also part 

of Prof. Mongey’s remit as a lecturer in UCD and the 

development of videotapes and handbooks for teaching 

of clinical skills. 

Furthermore, Prof. Mongey is the co-ordinator of the 

Advanced Clinical Skills module for the Graduate Entry 

Medicine program and co-ordinator for the Elective 

module for undergraduate and graduate entry medical 

students. 


The Translational Medicine research group includes 

close links with other active research groups including 

the Centre for Colorectal Disease, Diabetes and Obesity, 

Liver Immunology, and Psychoimmunology on the ERC 

site and investigators based in the Conway Institute, UCD 

and in TCD. The Rheumatology Research group includes 

Principal Investigators - Prof. Douglas Veale, Dr. Ursula 

Fearon and Prof Oliver FitzGerald with a primary clinical 

focus on early, inflammatory arthritis and a scientific 

focus on mechanisms of angiogenesis, inflammation 

and joint damage. The group has established novel 

models of analysis using serum, synovial fluid, synovial 

tissue and cartilage to search for biomarkers of disease, 

examine mechanisms of angiogenesis and hypoxia, 

novel mediators/cytokines and cartilage destruction in 

the study of pathogenesis of arthritis. 

The research plan for the next five years is to develop 

new expertise and extend national and international 

collaborations to elucidate predictors of response to 

therapy, predictors of remission and to examine the 

mechanisms of disease. A major step has been achieved 

in this regard with the proposal to create a new Centre 

for Rheumatological Diseases incorporating clinical and 

scientific researchers from UCD and TCD. This initiative 

supported by the two universities, Arthritis Ireland and 

the HSE has established two Chairs in Rheumatology. 

183 

Return to Contents



We have in 2008 commenced a major state-of–the-art 

clinical research programme based around UCD CRC 

bringing together investigators across the newly formed 

Dublin Academic Health Centre. This has included a 

DAHC coordinated Research Journal Club, a DAHC 

Seminar Series for Translational Research. In support of 

this there have been a number of developments 

including the appointment of key personnel – Data 

coordinator, Laboratory Manager, in addition to 

establishing a new UCD CRC Biobank. 

Further progress has been made in relation to novel 

imaging studies with the first concomitant studies of 

PET/CT and MRI in patients with arthritis. 

Specific ongoing projects: 

Remission study and Rituximab therapy for resistant 

arthritis 

Dr Ceara Walsh finished her research in July 2007 

under the supervision of Prof. Barry Bresnihan and Dr 

Ursula Fearon. Dr Walsh’s research involved (i) to 

identify predictive markers of relapse and identify a 

genetic profile associated with relapse (ii) to examine 

the effect of Rituximab in-patient’s resistant to anti-TNF· 

therapy, (iii) to examine the presence of latent TB in 

patients receiving anti-TNF·. She demonstrated a 

specific expansion of inhibitory receptor CD94/NKG2A 

in remission associated with an increase in the CD8+ T 

cell population. Loss of this expansion may predict 

disease relapse and therefore allow modification of 

dosing schedule with important health-economic and 

patient related benefits. She demonstrated the 

presence of CD20+ cells in the synovium of patients 

with RA resistant to anti-TNF· therapies. Complete 

depletion of synovial B cells following treatment with 

Rituximab is associated with an excellent clinical 

response. She also demonstrated that Rituximab may 

effect depletion of macrophages in the joint suggesting 

that synovial B cells precedes a decrease in local 

inflammation leading to clinical improvement. Ceara is 

currently writing up her PhD thesis. 

Biomarkers and predictors of disease 

This work was performed by Dr Eliza Pontifex under the 

supervision of Prof Barry Bresnihan and Dr Ursula 

Fearon. It is an ongoing collaboration with several 

international groups funded by the EU FP6 Autocure 

grant, led by the Karolinska Institute, Stockholm and 

links with the ‘OMERACT’ international study to develop 

new biomarkers for synovial tissue response to 

treatment. This work demonstrated that the 

macrophage marker - CD68 is good biomarker for 

response to therepy, which correlates with disease 

activity. Furthermore, she demonstrated a correlation 

between results obtained from 2 different centres 

(Dublin and Amsterdam), and thus has validated the 

method of that staining and quantification of sublining 

CD68 in RA making significant progress in standardisation 

of the techniques. This data has now been assimilated 

into manuscript and is currently in press. Under the 

supervision of Prof Oliver FitzGerald and Dr Ursula 

Fearon, Eliza is also examining if change in cell 

infiltration in psoriatic arthritis (PsA) synovial tissue 

correlates with change in DAS28 following initiation of 

biologic therapy. Results have shown that change in 

CD3+ T-cell infiltration correlates both with change in 

DAS28 and also with change in a semi-quantitative MRI 

synovitis score of the same knee joint calculated by Dr. 

Robin Gibney. In collaboration with Professor Patrick 

Brennan’s group from imaging in UCD, a more 

quantitative measure of synovitis is being developed. 

Finally Eliza is examining the role of TLRs in patients with 

PsA. Eliza has demonstrated expression of TLR-2/4 in 

the endothelial and lining layer regions of the synovium. 

Currently she is stimulating primary fibroblasts from 

patients with PsA with TLR-2 and 4 +/- cJun inhibitors 

and assessing regulation of chemokines. 

Hypoxia and altered mitochondrial bioenergetics in the 

inflamed joint. 

This major programme funded by a Translational 

Research Award from The HRB (2006-2011) to Prof 

Doug Veale and Dr. Ursula Fearon hypothesizes that 

184 

Return to Contents



vascular morphology and synovial invasiveness within 

the inflamed joint and response to therapy, may be 

dependent on activation of mitochondria-derived, 

hypoxia-induced transcriptional and non-transcriptional 

pathways and alterations in genome stability. Using a 

novel pO2 probe we have demonstrated that the joint 

is profoundly hypoxic. Dr. Vincent Ng, clinical research 

fellow, has demonstrated for the first time a direct 

inverse correlation between tissue (t) pO2 levels and 

macroscopic synovitis. Furthermore Dr. Ng has 

demonstrated that low tpO2 levels inversely correlate 

with microscopic markers of synovial T cells and 

macrophages, with no relationship to synovial 

proliferation or apoptosis. In vitro exposing synovial 

cells to tpO2 levels found in the joint,, resulted in 

decreased proliferation, increased cell migration and a 

significant relationship with pro-inflammatory 

cytokines/chemokines TNF·, IFNg, IL-1b and MIP3a. 

Together these results suggest that low tpO2 in the joint 

driving inflammation through increased cell migration 

and impaired apoptotic pathways. This work was 

presented the American College of Rheumatology, San 

Francisco, Nov 2008.Currently, Vincent is combining 

both MRI and CT/PET imaging to examine the 

metabolic turnover in the joint and it’s relationship to 

tpO2 levels, angiogenesis and blood flow. Vincent is 

also working to identify biomarkers that may predict 

response to treatment, specifically A-SAA and cartilage 

neoepitopes. Preliminary data has demonstrated that 

high A-SAA levels may predict a bad response to 

biologic treatment but also may predict increased risk of 

cardiovascular disease. 

In parallel, Aisling Kennedy, graduate PhD student, is 

examining the effect of hypoxia on the angiopoietins/ 

Tie2 pathway, blood vessel morphology and cell 

stability in the joint. Aisling has demonstrated for the 

first time a mixture of mature and immature vessels in 

the joint. She has demonstrated low NCAM on vessel 

with predominantly focal expression, suggesting that the 

endothelial-pericyte cell-cell interactions are not intact. 

Vessels in this unstable state are more easily targeted, 

which may be due to differential expression of VEGF, 

Angiopoeitin 1, 2 and PDGF. We have also demonstrated 

strong nuclear expression of 8-oxo-DG on the endothelial 

cells, further supporting the hypothesis that vessels in 

the joint are unstable. Finally Aisling has demonstrated 

and inverse relationship between pO2 levels and both 

macroscopic vascularity and microscopic blood vessel 

stability and NOTCH expression. These results combine 

with Vincent’s, suggest that while there is an increase in 

number of BV within the joint the rate of synovial 

expansion is faster, resulting in a high metabolic turnover 

and an hypoxic environment. An abstract of this work 

was chosen for an oral podium presentation at the 

American College of Rheumatology, San Francisco, 

November 2008, which Aisling presented to a great 

response from the scientific community. Currently, 

Aisling is examining the effect of anti-TNF therapy on 

blood vessel stability and joint hypoxia. She has also 

transplanted synovial tissue into SCID mice and is 

examining the effects of blocking NOTCH signalling on 

vessel survival. 

Dr Monika Binecka is examining the role of genomic 

instability in the joint and the effect of hypoxia. She has 

demonstrated high oxidative damage in the synovial 

tissue of patients with low pO2 levels. She has 

demonstrated that tpO2 levels inversely correlate with 

lipid peroxidation but not DNA damage. She 

demonstrated that lip preoxidation but not DNA 

damage correlated closely with angiogenic growth factor 

expression. Exposing cells to hypoxia demonstrated a 

decrease in cell proliferation and an increase in 

anaphase bridging. Currently Monika is examining the 

effects of tpO2 levels on mitochondrial pathways. 

185 

Return to Contents



(A) 8-oxo DG nuclear staining 

(B) Anaphase bridging 

Fig 1: Demonstrates oxidative damage in the 

endothelial cells and lining layer in RA synovium 

(stained with 8-oxo-dG) (A) and (B) demonstrates 

Anaphase Bridging in primary synoviocytes and 

chondrocytes 

Cytokines, angiogenesis and invasion 

Recent targeted biologic therapies, including anti-TNF 

and IL-1 blocking drugs are effective, but may not be 

effective in 30% or more patients. The increasing 

evidence shows that complex cytokine networks do not 

operate in isolation to promote new blood vessel 

formation, synovial hyperplasia and joint destruction. 

The effects of TNF· and IL-1‚ ?alone and in combination 

with novel cytokines and growth factors, including 

Oncostatin M (OSM), IL-17, acute serum amyloid A (A- 

SAA), IL-22, GMCSF, TLRs and Angiopoietins is being 

examined in the inflammatory process, lead by Dr. 

Ursula Fearon and Dr. Douglas Veale 

Oncostatin M, IL-17, IL-22 

Ellen Moran, is her final year of her PhD student and is 

examining the role of IL-17 on cartilage degradation, 

matrix turnover and cell migration. Ellen has previously 

demonstrated high levels of IL-17 in the joint and 

shown that IL-17 potentiates the effects of OSM and 

TNF· on matrix turnover and cartilage degradation. Ellen 

has now shown that IL-17 has a profound effect on cell 

migration in the joint, possibly mediated through GROalpha 

and MIP-1. She has demonstrated IL-17 induces 

angiogenesis and invasion, all mechanism that 

contribute to celklular invasion. To examine more 

specifically how IL-17 regulates these events, we have 

examined it’s effects on cytoskeletal rearrangement, 

which is critical for cell movement and shape. We have 

demonstrated IL-17 induces cytoskeletal disassembly 

and focal adjhesion contacts, an effect that is reversed 

through inhibition of RhoGTPases such as RAc1. She 

has also shown that IL-17 regulates the upstream 

triggers specifically integrins avb3 and B1. Currently 

Ellen is elucidating the specific pathways involved in IL- 

17 induced cytoskeletal dynamics. 

Dr. Bernadette Lynch was awarded an HRB clinical PhD 

fellowship in July 2008, to examine the role of IL-22 in 

the joint. She has demonstrated high levels of IL-22 in 

synovial fluid compared to serum, and has demonstrated 

that biologic therapy reduces its expression. Using synovial 

explant cultures and primary fibroblasts Bernadette has 

shown that IL-22 has no effect on regulation of many 

cytokines or chemokine but appears to regulate matrix 

metabolism. Currently Bernadette is examining the effect 

of Il-22 in combination with other cytokines, to assess 

it’s potential for adjuvant therapy. Finally, Bernadette has 

collected a cohort of RA patients, to assess the 

relationship between clinical characteristics and highresolution 

ultrasound. 

Dr. Taj Saber is an MD clinical fellow and is coordinating 

the arthroscopy programme and the biologic clinics. Taj 

is currently examining the effects of biologic therapy in 

186 

Return to Contents



the cohort of inflammatory arthritis patients to establish 

features, which may predict remission in these patients. 

In addition, Taj is engaged in a laboratory project to 

assess the effects of cytokines on MMP production, 

proteoglycan release and invasion. Furthermore she will 

examine the downstream signalling pathways involved, 

specifically the JAK-STAT pathway. 

Serum Amyloid A (A-SAA) 

The role of A-SAA in the pro-inflammatory response is 

an on-going project theme of the unit over the past 10 

years. Mary Connolly has just submitted her thesis 

which examines the effect of A-SAA on cell migration 

and invasion, cartilage metabolism and the related 

transcriptional pathways. Mary has shown A-SAA has a 

potent migrational effect within the joint. She has 

demonstrated that this is mediated through alterations 

in cytoskeletal dynamics. Specifically A-SAA differential 

regulates RHO-GTPAses with upregulation of Cdc42 

and RAC1, which is paralleled by inhibition of RhoA. 

Mary demonstrated that A-SAA significantly increased 

migration of GFP tagged monocyte into human synovial 

tissue in vivo using a novel human RA synovial 

tissue/SCID mouse chimera model. Furthermore she 

has demonstrated that this effect is only partially 

mediated through increased angiogenesis. The final part 

of Mary work was to examine the effects of A-SAA on 

synovial explants cultures using proteomics. The 

greatest change was in proteins that were involved in 

ECM, apoptosis and cytoskeletal proteins. These are 

currently being validated. Mary had an oral presentation 

at the American College of Rheumatology, San 

Francisco, November 2008. Mary has demonstrated 

high A-SAA levels in serum and A-SAA induces 

disassembly of actin filaments in primary synovial 

fibroblast, Fig 2. 

Intact Actin Filaments 

Disassembly of actin 

cytoskeleton and Induction of 

filopodia formation 

Endothelial cell survival and blood vessel regression. 

One of the main interests of the group is the role of 

angiogenesis in the pro-inflammatory response, with 

specific interest in the pathways of blood vessel maturity 

and survival. This work will provide novel insights into 

the complex mechanisms mediating growth factor 

activation within a synovial EC model. Dr. Wei Gao, 

Jennifer Mc Cormick and Dr. Catherine Sweeney. One 

of the key questions is ‘what are the key survival 

pathways’; we have shown high expression of NOTCH 

signalling components in synovial tissue. We have 

demonstrated it’s expression on both endothelial and 

pericytes, and VEGF and Ang2 regulate shown 

NOTCH1C. Possible upstream triggers of these events 

include hypoxia, neutropeptides or mechanical forces. 

Dr. Sweeney showed that substance P and mechanical 

stress upregulated VEGF, ANg2 and NOTCH 1IC. 

Inhibition of NOTCH was demonstrated with anti-Tie or 

AntiVEGF antibodies. Currently we are carrying out 

experiments to examine if NOTCH blockade results in 

vessel regression, and will establish if this only involves 

immature vessels or are those vessels with pericye 

coverage also targeted. Dr. Gao, has demonstrated low 

Po2 levels in the joint upreguates HIf1a and NOTCH1IC 

in primary cell cultures. Uisng siRNA to NOTCH we have 

shown that VEGF and hypoxia directly regulate NOTCH. 

Currently we are trying to elucidate the signalling 

pathways involved in hypoxia induced NOTCH 

expression. Using NO, DMOG, SiRNA and DAPT we will 

establish if (i) hypoxia induced NOTCH 1IC is HIF1a 

dependent or independent and (ii) establish the 

downstream effects of blocking NOTCH1iC, such as 

angiogenesis and fibroblast invasion. 

187 

Return to Contents



Fig 3: Dual immunoflourescent staining with Factor VIII 

(red) and ·SMA (GREEN). Blood vessel staining red are 

immature and those staining for red and green are 

mature. This figure shows there is a mixture of 

immature and mature vessels in the joint. 

GMCSF and TLRs 

Dr. Sinead Nic An Ultaigh has been examining the role 

of Toll-Like Receptors (TLRs) in inflammatory arthritis. 

TLRs have been implicated in autoimmune diseases, 

and TLR expression has been found in joint tissue and 

at the sites of invasion into cartilage/bone of patients 

with RA and PsA. Using several primary cell cultures 

Sinead has shown differential effects of timulating TL2 

and TL4 pathways. She has demonstrated TLR2 agaonist 

are more effective in regulating cytokines and matrix 

turnover in cells isolated from the joint compared to 

blood. She has demonstrated using synovial cells, that 

TLR2 regulates NOTCH signalling in the joint, blockade 

of which downregaultes the pro-inflammaory response. 

Recently Sinead has demonstrated that TLR2 may be a 

possible ligand for A-SAA, which we know, is a key 

molecule in driving inflammation in the joint. Finally, 

using whole tissue synovial explants Sinead, compared 

the effects of blocking TLR2 to known biologic agent 

Humira (anti-TNF·). She showed that blocking TLR2, 

significantly inhibited many pro-inflammatory cytokines 

in the joint, and more importantly showed that this effect 

was equivalent to that of Humira. Currently Sinead is 

will focusing on the interaction between of Notch, A- 

SAA and TLR 2 signalling. 

Proof of Concept Studies 

Jennifer McCormick and Owen O’Sullivan are an integral 

part of the team and are is involved in a number of 

projects in the group. We have developed a number of 

partnerships with the drug discovery and translational 

teams within industry led by Prof Veale. Jenny, Ursula, 

Owen and Sinead carry out these studies using synovial 

explant cultures, MSD multiplex assays and 

transcriptomics to establish pre-clinical and ‘proof of 

concept’ drug development studies of novel bio 

therapeutics and small molecular weight candidates. 

Currently, we are examining the therapeutic potential of 

four new drugs. 

Psoriatic Arthritis Blood Vessel Morphology 

Aisling Kennedy is also examining the mechanism 

involved in the differential blood vessel morphology 

observed in PsA. Consistent with previous studies, she 

has shown vessels in patients with PsA are tortuous, 

elongated and dilated. We have shown this is associated 

with increased tpO2 levels and an increased pericyte 

coverage. However, we have shown differential expression 

of growth factors and NCAM suggesting that vessels are 

very dysfunctional. At a microscopic level it is difficult to 

examine the close alignment of the endothelial cells 

and pericyte, therefore currently Aisling is using 

transmission electron microscopy to examine blood 

vessel stability, activation and endothelial cell - pericyte 

interactions, parameters such as (i) compactness, (ii) 

pinocytic vesicles, (iii) basal lamina, (iv) junctional 

complexes, (v) anchoring filaments, (vi) endothelial 

cytoplasmic and nuclear shape will be assessed. 

Vascularity and blood vessel stability as determined by 

TEM will be correlated with both macroscopic and 

microscopic assessments. tpO2 levels and blood vessel 

pattern stability will also be determined. 

188 

Return to Contents



Biomarkers of Biologic Treatment Response: Finally, 

funded by Abbott, Dr. Emily Collins, supervised by Prof. 

Oliver FitzGerald and Dr. Ursula Fearon, is examining 

proteomic profiles in PsA patients’ pre/post biologic 

therapy with Prof Steve Pennington, Conway, UCD. We 

are aiming to identify molecular biomarkers, which 

predict response to anti-TNF· therapy, which are present 

in the synovium at an early stage of treatment. Prof 

FitzGerald and Dr. Fearon in collaboration with the P.P. 

Tak group in Amsterdam, and S. Pennington and M. 

Dunn of the Proteome Research Centre, UCD. Synovial 

tissue has been obtained via arthroscopy at baseline 

and 1 month from a cohort of patients, half of whom 

were receiving Adalimumab and half placebo injections, 

before beginning Adalimumab after 1 month. We are 

using proteomics technology (2D- DIGE and mass 

spectrometry) to analyse the proteome of these 

synovial tissue samples and identify differentially 

expressed proteins and potential biomarkers. These 

potential biomarkers will then be validated using various 

molecular biology methods. A pilot study on a smaller 

cohort has allowed us to optimise the experimental 

methodology and identify several interesting proteins. 

Psoriasis/Psoriatic Arthritis 

There are 4 main areas of interest within Ps/PsA: 

(i) Genetics: 

In collaboration with Professor Robert Winchester at 

the University of Columbia in New York, blood 

samples have been obtained and DNA analysed in 

a cohort of 400 probands with PsA as well as more 

than 200 patients with psoriasis alone and 150 

normal controlled subjects. The focus has been on 

a detailed molecular genotyping of the HLA-B and - 

C loci using sequence based typing. Detailed 

analysis is ongoing but results suggest that PsA is 

not genetically a simple subset of psoriasis. HLA- 

Cw*0602 is present in 62% of patients with 

psoriasis alone and in only 27.9% of patients with 

PsA. 

In collaboration with the newly established GRIPPsA 

Consortium, which is an Irish based consortium, 

DNA from a large number of patients with psoriasis 

and with PsA have been collected. Approximately 

500 of these samples have been contributed to the 

initial cohort of patients who were undergoing 

genome-wide association studies funded by 

Welcome. This work is being undertaken locally in 

collaboration with Dr. Brian Kirby and with the 

assistance of Anne-Marie Tobin, Dr. Aizad Mumtaz 

and Ms. Phil Gallagher. 

(ii) Biomarks of Biologic Treatment Response: 

As part of investigator-originated, single-arm 

protocols looking at mechanisms of effect of 

biologic therapies, synovial membrane samples 

have been analysed for tissue markers of treatment 

response to biologic therapies. Comparisons of 

immunohistochemical changes with clinical changes 

have identified change in CD3-positive T-cells as 

correlating significantly with change in clinical 

scores. In addition, a semi-quantitative score of MRI 

scans undertaken in collaboration with Dr. Robin 

Gibney have also correlated significantly with a 

change in CD3 synovial tissue counts. In 

collaboration with Professor Patrick Brennan’s group 

from imaging in UCD, a more quantitative measure 

of synovitis is being developed. 

(iii) Proteomics Studies in Collaboration with Professor 

Stephen Pennington and Professor Mike Dunn from 

the Proteomic Department at Conway Institute: 

Dr. Emily Collins has been trying to identify synovial 

biomarkers of treatment response to empty TNF 

therapy in patients with PsA. A number of proteins 

have been identified, which significantly associate 

with clinical response and in addition a number of 

proteins have been identified which appear to 

predict a response at baseline. These studies are 

funded by Abbott Pharmaceuticals and validation of 

189 

Return to Contents



proteins identified is currently underway. For 

glycosylation changes in inflammatory arthritis 

patients pre and post anti-TNF therapy. In 

collaboration with Professor Pauline Rudd’s group 

from the Conway Institute and with Dr. John Axford 

from St. George’s Hospital in London, Dr. Emily 

Collins is studying immunoglobulin glycosylation 

changes, which occur in patients with inflammatory 

arthritis and also the effect of anti-TNF therapies on 

such changes in a cohort of 65 patients, 

glycosylation profiles return towards normal as 

disease activity improves following treatment 

initiation. 

(iv) Pharma Co Economics of Biologic Therapies in 

Patients with Inflammatory Arthritis: 

In collaboration with Dr. Michael Barry from the 

National Centre of Pharma Co Economics at St. 

James’s Hospital, Ms. Roisin Adams is examining 

the Pharma Co Economic impact of anti-TNF 

therapies in patients with inflammatory arthritis. 

These studies are utilising data being collected on a 

large cohort of inflammatory arthritis patients 

currently being followed on anti-TNF therapy. 

Student Awards and Oral Presentations 

Mary Connolly; SIAR Award (Oral Presentation) - 

American College of Rheumatolog, San Francisco,08 

M. Connolly 1 , J. McCormick 1 , A. Marelli 2 , M. Blades 2 , O. 

FitzGerald 1 , B. Bresnihan 1 , C. Pitzalis 2 , D. Veale1, U. Fearon 1 

A-SAA Induces Rho GTPase-dependent Cytoskeletal 

Rearrangement and In Vivo Migration of Fluorochrome 

Labelled Monocytic (u937) Cells in A Human RA/SCID 

Mice Chimera Model 

Aisling Kennedy; (Oral Presentation) - American 

College of Rheumatology, San Francisco, 2008 

Aisling Kennedy, Monika Biniecka, Chin Teck Ng, 

Jacintha N. O'Sullivan, Ursula Fearon, Douglas J. Veale 

Oxidative Damage in the Arthritic Joint leads to an 

Unstable Environment and Stimulates Abnormal 

Angiogenesis in Synovial Tissue 

Ellen Moran ; Travel Award 

Ellen M. Moran, Ronan Mullan, Jennifer McCormick, 

Oliver FitzGerald, Barry Bresnihan, Douglas J. Veale, 

Ursula Fearon. 

IL-17A Expression Is Modulated by Biologic Therapy 

and Drives Inflammatory Cell Migration In The Human 

RA Joint 

Thesis Submissions 

Mary Connolly submitted her PhD thesis (UCD) 

examining the role of A-SAA on cell migration, 

cytoskeletal dynamics and invasion in the pathogenesis 

of inflammatory arthritis, under the supervision of Dr. 

Ursula Fearon and Prof Douglas Veale 

Committees and Invited Talks 


• Co-Chairman, EULAR Synovitis Study Group 

• Co-Chairman, OMERACT Synovial Tissue Analysis 

Study Group 

• Italian Society of Rheumatology, Catania 

• Royal Society of Medicine, London, June 

• Chairman scientific session, EULAR, June 

• British Bone Society, Aberdeen, July 


• Appointed Director of Translational Research, Dublin 


• Medical Director, Education & Research Centre, SVUH 

• Director of THERAPI - Translational Research Group 

190 

Return to Contents



Prof Douglas Veale continued 

• Vice-president, International Scleroderma Clinical 

Trials Consortium 

• Strategic Scientific Committee, Arthritis Research 

Campaign, UK 

• HRB Infection & Immunity Grant Committee 

• Irish Medicines Board, Medicines Committee 

• Wyeth Translational Science European Expert Group 

• Schering-Plough International Advisory Panel 

• Centocor International Advisory Panel 

• Co-Chair RCPI Masterclass in Rheumatology 

• Progress and Promise, Madrid 


• Director of the Clinical Skills Laboratory at UCD 

• Co-ordinator of the Advanced Clinical Skills module 

for the Graduate Entry Medicine program 

• Co-ordinator for the Elective module for undergraduate 

and graduate entry medical students. 


• Chairman, Arthritis Ireland (Oct-present) 

• Member of HSE working group on Arthritis and 

Allied conditions representing the Irish Society of 

Rheumatology 

• Steering committee member for GRAPPA (Group 

for Research and Assessment of Psoriasis and 

Psoriatic Arthritis) 

• Member of Abbott International Immunology 

Advisory Board 

• Lead Consultant Bone & Joint Unit, SVUH 

• Steering committee member of OMERACT 

Biomarkers Group 

• Scientific committee member 3e Initiative in 

Rheumatology 

• Rochester University, Visiting Speaker 

• Progress and Promise, Munich 

• Ulster Internal Medicine Association, Belfast 


• Senior Scientist Rheumatology 

• Chairperson Scientific Sesssion of The American 

College of Rheumatology, San Francisco, 

November 2008 

Publications 

Hypoxia activates NF-κB-dependent gene expression 

through the canonical signaling pathway. 

Kathryn M. Oliver, John F. Garvey, Eoin P. Cummins, 

Douglas J. Veale, Ursula Fearon, Cormac T. Taylor. 

In Press 

A Novel Role for the HDL Receptor, CLA-1 in Synovial 

Inflammation via Serum Amyloid-A and Apolipoprotein 

A-1. Mullan Ronan, Mc Cormick Jennifer, Connolly Mary, 

Bresnihan Barry, *Veale Douglas James , *Fearon Ursula. 

In Press Am J Pathol 

Synovial tissue sublining CD68 expression as a biomarker 

of therapeutic response in rheumatoid arthritis clinical 

trials: consistency across centers. 

Barry Bresnihan, Eliza Pontifex, Rogier Thurlings, Marjolein 

Vinkenoog, Hani el Gabalawi, Ursula Fearon, Oliver 

Fitzgerald, Danielle Gerlag, Terence Rooney, Marleen 

van de Sande, Douglas Veale, Koen Vos, PP Tak In press 

Adherence to medications in systemic lupus 

erythematosus. 

Koneru S, Kocharla L, Higgins GC, Ware A, Passo MH, 

Farhey YD, Mongey AB, Graham TB, Houk JL, Brunner 

HI. J Clin Rheumatol. 2008 Aug;14(4):195-201 

Drug insight: autoimmune effects of medicationswhat's 

new? 

Mongey AB, Hess EV; Medscape. Nat Clin Pract 

Rheumatol. 2008 Mar;4(3):136-44. Review 

Walsh CAE, Fearon U, FitzGerald O, Veale DJ, Bresnihan B. 

Decreased CD20 Expression in Rheumatoid Arthritis 

Synovium Following 8 Weeks of Rituximab Therapy. 

Clin Exp Rheumatol. 2008 Jul-Aug;26(4):656-8 

191 

Return to Contents



Updated consensus statement on biological agents for 

the treatment of rheumatic diseases, 2008. 



Kalden JR, Burmester GR, Braun J, Emery P, Winthrop K, 

Bresnihan B, De Benedetti F, Dörner T, Gibofsky A, 

Schiff MH, Sieper J, Singer N, Van Riel PL, Weinblatt ME, 

Weisman MH. 

Ann Rheum Dis. 2008 Dec;67 Suppl 3:iii2-25 

Melanoma Inhibitory Activity, a biomarker related to 

chondrocyte anabolism, is reversibly suppressed by 

proinflammatory cytokines in rheumatoid arthritis. 



Verdonk PC, Tak PP, Boots AH, Baeten D 

Rheumatoid arthritis: a novel radiographic projection 

for hand assessment. 

Pearman L, Last J, Fitzgerald O, Veale D, Joyce M, 

Rainford L, McEntee M, McNulty J, Thomas E, Ryan J, 

McGee A, Toomey D'Helft R, Lowe J, Brennan PC 

Successful pregnancy after rituximab in a women with 

recurrent in vitro fertilisation failure and antiphospholipid 

antibody positive.Ng CT, O'Neil M, Walsh 

D, Walsh T, Veale DJ. Ir J Med Sci 2008; Nov 29 

Biomarkers in systemic sclerosis. Doran JP, Veale DJ. 

Rheumatology 2008;47: Suppl 5:v36-8 

Photochemotherapy for localized morphoea: effect on 

clinical and molecular markers. 


Clin Exp Dermatol. 2008 Nov;33(6):698-704. 



multicenter treatment trial. Merkel PA, Silliman NP, 

Denton CP, Furst DE, Khanna D, Emery P, Hsu VM, 

Streisand JB, Polisson RP, Akesson A, Coppock J, van 

den Hoogen F, Herrick A, Mayes MD, Veale D, Seibold 

JR, Black CM, Korn JH; CAT-192 Research Group; 

Scleroderma Clinical Trials Consortium.Arthritis Rheum. 

2008 May 15;59(5):699-705. 

The development of the L-QoL: a quality-of-life 

instrument specific to systemic lupus erythematosus. 

Doward LC, McKenna SP, Whalley D, Tennant A, Griffiths 

B, Emery P, Veale DJ. 

Ann Rheum Dis. 2009 Feb;68(2):196-200. 

Biological biomarkers in psoriatic disease. A review. 

de Vlam K, Gottlieb AB, Fitzgerald O. 


Clues to the pathogenesis of psoriasis and psoriatic 

arthritis from imaging: a literature review. 

Coates LC, Anderson RR, Fitzgerald O, Gottlieb AB, Kelly 

SG, Lubrano E, McGonagle DG, Olivieri I, Ritchlin CT, 

Tan AL, De Vlam K, Helliwell PS. 


Breast cancer and systemic sclerosis: a clinical description 

of 21 patients in a population-based cohort study. 

Lu TY, Hill CL, Pontifex EK, Roberts-Thomson PJ. 

Rheumatol Int. 2008 Jul; 28(9):895-9 

Musculoskeletal Disorders. Eliza Pontifex and Barry 

Bresnihan. "Palliative Medicine." Elsevier publishers, 

USA. 2008, p1033-1038 

2008 was another busy year for the Rehabilitation 

Medicine Department. The number of referrals 

continues to increase and outpatient activity continues 

to rise. 119 new referrals were received in 2008 an 

increase of over 100% from 2007 and 161 patients 

were seen in outpatients, 57 of which were new 

patient assessments. Unfortunately this has resulted in 

an increased waiting time for new patient outpatient 

assessment and the Rehabilitation Medicine Department 

look forward to working with hospital management to 

try and resolve this issue. 

192 

Return to Contents


Department of Rehabilitation Medicine 

The Rehabilitation Medicine Department welcomed Dr 

Andrew Hanrahan to SVUH in early July 2008 as locum 

for Dr Nicola Ryall. He completed his Rehabilitation 

Medicine training in the Oxford Deanery, UK in March 

2008 and has been very actively involved in Hospital 

activities since he joined us. 

Staff within the Department 

Consultant in Rehabilitation Medicine 

Dr. Nicola Ryall, FRCPI, 

Dr. Andrew Hanrahan, 

(current Locum, Consultant in Rehabilitation Medicine) 

Consultant in Rehabilitation Medicine 

Dr. Áine Carroll, MD, FRCPI, 

Specialist Registrar in Rehabilitation Medicine 

Dr. Jackie Stow, 

Clinical Governance 

The Rehabilitation Medicine Department was active in 

Clinical Governance in 2008. Dr. Carroll carried out a 

review of all referrals to the department and the results 

are soon to be published in the Irish Medical Journal. 

Strategic Developments 

Rehabilitation Medicine Department Consultants have 

been very involved in Strategic developments in 2008. 

Dr. Áine Carroll is currently on a Working Group for the 

development of a National Strategy for Rehabilitation, the 

results of which should be published later this year and 

she is also one of 3 Irish Association of Rehabilitation 

Medicine (IARM) representatives on the Irish Heart 

Foundation Council on Stroke. She is also the current 

President of the IARM. 

Dr. Andrew Hanrahan was also involved in a subgroup 

looking at Prosthetic, Orthotic and Limb absence 

Rehabilitation. 

The National Rehabilitation Hospital New Hospital 

Project continued to progress and in December, a 

representative group from the Hospital Board, including 

Dr. Carroll, met with the Minister for Health and 

Children to advise the Minister on the importance of 

the project for the welfare of the people we serve. 

Dr. Hanrahan has been the Consultant lead on a Falls 

Prevention and Management Strategy for the NRH in 

the light of the recently published Draft Guidelines to the 

HSE by the Dublin Hospitals Group Risk Management 

Forum in March 2009. 

Undergraduate and Postgraduate Education 

All Rehabilitation Medicine Department Consultants 

have been busy with teaching the UCD 3rd year medical 

students and we welcomed Damian Townsend, a final 

year medical student from Australia in the summer. 

Dr. Ryall and Dr. Carroll are now Senior Clinical Lecturers 

for UCD and participate in the final Medical 

Examinations in SVUH. 

All Consultants continue to be actively involved in 

specialist registrar supervision, NCHD teaching 

programmes and medical student teaching and 

assessments. 

Dr Hanrahan has presented two Medical Grand rounds 

at St Vincent’s University Hospital on the Permanent 

Vegetative States and Complex Neuro-rehabilitation in 

Wilson’s disease. 

Dr. Áine Carroll presented on “The Multidisciplinary 

management of Spasticity”, Care of the Elderly Study 

Day, St. Vincent’s University Hospital, Dublin in February 

and on “Rehabilitation and Parkinson’s Disease” 

Parkinson’s Patient Information Update in April. 

193 

Return to Contents


Department of Rehabilitation Medicine 

Dr. Carroll also worked with Dr. Eimear Smith and Dr. 

Mei in Soon respectively on “Prevalence of low bone 

mineral density in patients at a national rehabilitation 

centre” Society for Research in Rehabilitation, Oxford, 

Platform presentation in May 2008 and “Cerebral 

Venous Thrombosis” Spring meeting of the Association 

of British Neurologists, Dublin. Poster Presentation 

Dr. Smith also presented “A study of bone mineral 

density in disabled adults at a national rehabilitation 

hospital” at the European Congress of Physical 

Medicine & Rehabilitation, Brugge. 

Dr. Mei Ming Soon presented a poster on “Cerebral 

Venous Thrombosis” at the Irish Association of 

Rehabilitation Medicine in Belfast in October. 

Congratulations to Dr. Éimear Smith who’s platform 

presentation “A study of bone mineral density in 

disabled adults at a national rehabilitation hospital” 

won 1st Prize at the Irish Association of Rehabilitation 

Medicine, Belfast. 

Publications 

Dr. Carroll: Carroll Á. Book Chapter: 

The use of Botulinum Toxin in Neck and Back Pain. In: 

The Clinical Use of Botulinum Toxins. Editors: 

Michael P Barnes MD FRCP & Anthony B Ward BSc MB 

ChB FRCP (Lon) FRCP (Ed): 

Publishers: Cambridge University Press. 2008 

E. Smith, A Carroll. 

Bone Mineral Density in patients with disabilities due 

to acquired non-traumatic brain injury. 

Abstract Published Clinical Rehabilitation. 2008;22:86-94 

Mei Min Soon, Aine Carroll 

Cerebral venous thrombosis presenting as a 

complication of inflammatory bowel disease 

Ir J Med Sci. 2008 Jul 16 

E. Smith, A Carroll. 

Prevalence of low bone mineral density in patients at a 

National Rehabilitation Hospital 

Clin Rehabil 2008 22;9:859 

Carroll A, Barnes M, Comiskey C. 

A prospective randomized controlled study of the role 

of botulinum toxin in whiplash-associated disorder. 

Clin Rehabil. 2008 Jun;22(6):513-9. 

194 

Return to Contents


Reports from Surgery 

195


Report from the Professor of Surgery 

Surgical Professorial Unit 


Head of Subject: 

Professor P. Ronan O’Connell 

University Senior Lecturer: Mr Enda W McDermott 

Clinical Associate Professor: Professor Des Winter 

Clinical Senior Lecturer: Mr John Hyland 

Adjunct Professor: Professor M Joe Duffy 

Special Lecturers: 

Mr Farrukh Naseem 

Mr Cormac Joyce 

Ms Niamh Bambury 

Senior Research Associate: Dr Neil Docherty 

Research Fellows: 

Dr Colin Pierce; 

Dr Michael Cunningham 

Dr Fiachra Rowan 

Dr Siun Walsh 

Dr Aisling Hogan 

Dr Rory Kennelly 

Ms. Karen Griffin 

Ms Maria Buffini 

Senior Laboratory Technician: Mr Dermot Carty 

Clinical Research Nurse: Ms Helen Vaughan 

Executive Assistants: Mrs Patricia O’Shea 

Ms. Aine Begley 

The Surgical Professorial Unit at St Vincent’s University 

Hospital is responsible for undergraduate teaching of 

surgery to students from University College Dublin, coordination 

of post-graduate learning and supervision of 

post-graduate research. 

Professor P. Ronan O’Connell was appointed Head of 

the Section of Surgery and Surgical Specialties at UCD. 

With his appointment in 2007, the clinical interests of 

the Surgical Professorial Unit have been reconfigured 

to reflect his clinical interest in colorectal surgery while 

maintaining the Unit’s well established interest in breast 

and endocrine surgery under the academic leadership 

of Mr Enda McDermott, Senior Lecturer. In March 2008, 

Professor Des Winter and Mr John Hyland were 

recognized by the University by conferment of the title 

Clinical Associate Professor and Clinical Senior Lecturer 

respectively. 

During 2008 the Surgical Professorial Unit moved to 

purpose built accommodation in a link corridor off St 

Luke’s Ward on the second floor. The new unit provides 

office, administration and teaching accommodation 

immediately adjacent to the general surgical wards. 

Research from the Surgical Professorial Unit has been 

recognised by several national and international awards 

in 2008. Dr Rory Kennelly won the Sylvester O'Halloran 

prize at the University of Limerick in March 2008 while 

Dr Aisling Hogan won the prize for best paper 

presented at the European Society for Surgical Research 

in Warsaw in May 2008. Dr Michael Cunningham 

presented at the Patey Prize session of the Society of 

Academic and Research Surgery. 

The Final Medical Year students of 2008 did 

spectacularly well in their Final Surgical Examination. 

The following prizes in Surgery were awarded in 2008 

– The O’Farrell Gold Medal in Surgery - Dr. Emily 

Stenke, McArdle Prize in Surgery – Dr. Rebecca Fry, and 

Tobin Prize in Surgery – Ms. Aoife McKeating. 

Professor O’Connell was invited to speak at several 

national and international meetings. The highlights for 

2008 were lectures at the Malaysian Colorectal 

Conference, the American Society of Colon and Rectal 

Surgeons Annual Meeting and the Association of 

Coloproctology of Great Britain and Ireland Annual 

Meeting. 

2008 was a productive year in terms of publications. 

Representative articles are listed below. In addition 

numerous presentations were made at national and 

international scientific meetings. 

196 

Return to Contents



Books Edited 

1. EUROPEAN MANUAL OF COLOPROCTOLOGY, 

Herold A, Matzel K, Lehur PA, O’Connell PR eds. 

Springer, Frankfurt 

2. BAILEY and LOVE’S SHORT PRACTICE OF SURGERY 

(25th Edition) Bulstrode C, O’Connell PR, Williams 

NS eds. Arnold, London 

Book Chapters 

1. O’Connell PR 

ANAL CANCER in Herold A, Matzel K, Lehur PA, 

O’Connell PR eds, EUROPEAN MANUAL OF 

COLOPROCTOLOGY, Springer, Frankfurt pp 219- 

224 

2. Shields C, O’Connell PR 

ELECTROCAUTERY in Trimbos JB, Trimbos-Kemper 

TC eds. BASICS OF SURGERY:tools, techniques, 

attitude and expertise. 2007 Elsevier, Maarssen, 

pp67-77 

3. Joyce M, O’ Connell PR 

ANO-RECTAL STENOSIS: in Clavien JC, Mortensen 

NMcC eds ANORECTAL SURGERY, A PRACTICAL 

GUIDE TO MANAGEMENT. Springer, Frankfurt (in 

press) 


1. Mahoney RT, Behan M, Daly L, O’Herlihy C, 

O’Connell PR 

EFFECT OF SECOND VAGINAL DELIVERY ON ANAL 

FUNCTION IN PATIENTS AT RISK OF OCCULT 

ANAL SPHINCTER INJURY FOLLOWING FIRST 

FORCEPS DELIVERY 

Dis Colon Rectum 2008; 51:1361-6. 

2. Healy CF, McMorrow C, O’Herlihy C, O’Connell PR, 

Jones JF 

EXTERNAL ANAL SPHINCTER FATIGUE IS NOT 

IMPROVED BY N-ACETYLCYSTEINE IN AN ANIMAL 

MODEL 

Neurogastroenterol Motility 2008; 20: 719-24. 

3. Burke JP, Ferrante M, Dejaegher K, Watson RWG, 

Docherty NG, De Hertogh G, Vermeire S, 

Rutgeerts P, D'Hoore A, Penninckx F, Geboes K, Van 

Assche G, O’Connell PR . 

TRANSCRIPTOMIC ANALYSIS OF INTESTINAL 

FIBROSIS ASSOCIATED GENE EXPRESSION IN 

RESPONSE TO MEDICAL THERAPY IN CROHN’S 

DISEASE. Inflam Bowel Dis 2008;14:1197-204 

4. Healy CF, O’Herlihy C, O’Brien C, O’Connell PR, 

Jones JF 

EXPERIMENTAL MODELS OF NEUROPATHIC FECAL 

INCONTINENCE: An Animal Model of Childbirth 

Injury to the Pudendal Nerve and External Anal 

Sphincter Dis Colon Rectum 2008;51(11):1619- 

26; discussion 1626 

5. O'Riordan JM, Healy CF, McLoughlin D, Cassidy M, 

Brannigan AE, O'Connell PR. 

SACRAL NERVE STIMULATION FOR FAECAL 

INCONTINENCE. Ir J Med Sci. 2008; 177: 117-9 

6. Beddy D, Hyland JM, Winter DC, Lim C, White A, 

Moriarty M, Armstrong J, Fennelly D, Gibbons D, 

Sheahan K. A SIMPLIFIED TUMOR REGRESSION 

GRADE CORRELATES WITH SURVIVAL IN LOCALLY 

ADVANCED RECTAL CARCINOMA TREATED WITH 

NEOADJUVANT CHEMORADIOTHERAPY. Annals of 

Surgical Oncology 2008;15(12): 3471-3477. 

7. Collins D, Winter DC. ELECTIVE RESECTION FOR 

DIVERTICULAR DISEASE: AN EVIDENCE-BASED 

REVIEW. World Journal of Surgery 2008;32(11): 

2429-2433. 

197 

Return to Contents



8. Hogan AM, McCormack O, Traynor O, Winter DC. 

POTENTIAL IMPACT OF TEXT MESSAGE 

REMINDERS ON NON-ATTENDANCE AT 

OUTPATIENT CLINICS. Irish Journal of Medical 

Science 2008;177(4): 355-358. 

9. Hogan AM, Winter DC. DOES PRACTICE MAKE PER 

FECT? Annals of Surgical Oncology 2008;15(5): 

1267-1270. 

10. Hogan BA, Winter DC, Broe D, Broe P, Lee MJ. 

PROSPECTIVE TRIAL COMPARING CONTRAST 

SWALLOW, COMPUTED TOMOGRAPHY AND 

ENDOSCOPY TO IDENTIFY ANASTOMOTIC LEAK 

FOLLOWING OESOPHAGOGASTRIC SURGERY. 

Surgical Endoscopy 2008;22(3): 767-771. 

11. Kennelly R, Kavanagh DO, Hogan AM, Winter DC. 

OESTROGEN AND THE COLON: POTENTIAL 

MECHANISMS FOR CANCER PREVENTION. Lancet 

Oncology 2008;9(4): 385-391. 

13. Coss A, Tosetto M, Fox EJ, Sapetto-Rebow B, 

Gorman S, Kennedy BN, Lloyd AT, Hyland JM, 

O'Donoghue DP, Sheahan K, Leahy DT, Mulcahy 

HE, O'Sullivan JN. INCREASED TOPOISOMERASE 

IIALPHA EXPRESSION IN COLORECTAL CANCER IS 

ASSOCIATED WITH ADVANCED DISEASE AND 

CHEMOTHERAPEUTIC RESISTANCE VIA INHIBITION 

OF APOPTOSIS. Cancer Letters 2009;276(2): 228- 

238. 

14. Sheridan J, Wang LM, Tosetto M, Sheahan K, Hyland 

J, Fennelly D, O'Donoghue D, Mulcahy H, O'Sullivan 

J. NUCLEAR OXIDATIVE DAMAGE CORRELATES 

WITH POOR SURVIVAL IN COLORECTAL CANCER. 

British Journal of Cancer 2008;100(2): 381-388. 

15. Wang LM, McNally M, Hyland J, Sheahan K. 

ASSESSING INTERSTITIAL CELLS OF CAJAL IN 

SLOW TRANSIT CONSTIPATION USING CD117 IS A 

USEFUL DIAGNOSTIC TEST. American Journal of 

Surgical Pathology 2008;32(7): 980-985. 

17. Dillon MF, Stafford AT, Kelly G, Redmond AM, 

McIlroy M, Crotty TB, McDermott E, Hill AD, Young 

LS. CYCLOOXYGENASE-2 PREDICTS ADVERSE 

EFFECTS OF TAMOXIFEN: A POSSIBLE MECHANISM 

OF ROLE FOR NUCLEAR HER2 IN BREAST CANCER 

PATIENTS. Endocrine-Related Cancer 2008;15(3): 

745-753. 

18. McGowan PM, McKiernan E, Bolster F, Ryan BM, 

Hill AD, McDermott EW, Evoy D, O'Higgins N, 

Crown J, Duffy MJ. ADAM-17 PREDICTS ADVERSE 

OUTCOME IN PATIENTS WITH BREAST CANCER. 

Ann Oncol 2008;19(6): 1075-1081. 

19. McKiernan E, O'Brien K, Grebenchtchikov N, Geurts- 


Evoy D, McDermott E, Crown J, Sweep FC, Duffy 

MJ. PROTEIN KINASE CDELTA EXPRESSION IN 

BREAST CANCER AS MEASURED BY REAL-TIME 

PCR, WESTERN BLOTTING AND ELISA. British 

Journal of Cancer 2008;99(10): 1644-1650. 

12. Myers E, Hurley M, O'Sullivan GC, Kavanagh D, 

Wilson I, Winter DC. LAPAROSCOPIC PERITONEAL 

LAVAGE FOR GENERALIZED PERITONITIS DUE TO 

PERFORATED DIVERTICULITIS. British Journal of 

Surgery 2008;95(1): 97-101. 

16. Dillon MF, Maguire AA, McDermott EW, Myers C, 

Hill AD, O'Doherty A, Quinn CM. NEEDLE CORE 

BIOPSY CHARACTERISTICS IDENTIFY PATIENTS AT 

RISK OF COMPROMISED MARGINS IN BREAST 

CONSERVATION SURGERY. Mod Pathol 

2008;21(1): 39-45. 

198 

Return to Contents


Reports from the Chairman of the Surgical Subgroup 

Chairman of Surgical Subgroup 

Secretary to the Surgical Subgroup 

Mr Sean Dudeney 

Mr Denis Evoy, Hon 

2008 was another productive year for the surgical 

division. Much of the focus of the year was around 

preparation for the subsequent move of much of our 

activity to the new theatre block. A truly huge amount 

of time and effort has been spent by numerous parties, 

both medical and logistics, in fact over many years. We 

are indebted to all concerned. 

Our vision remains the provision of excellent healthcare 

to our patient population. The restructuring of cancer 

services in Ireland has led to St Vincent’s being asigned 

as one of the future “Centres of Excellence” for certain 

cancer subtypes. We look forward to these developments 

and to the associated resources which will go towards 

making these aspirations a reality. As cancer services 

develop we have been careful to focus also on ongoing 

development in other surgical services not directly 

involved in the treatment of malignant disease. 


After a long period of planning and preparation a 

significant subset of surgical practice has moved to the 

new operating theatres. With the exception of some 

largely predicatable teething problems the move has 

gone well. Four of the original theatres continue to run. 

The final plan of four further operating rooms attached 

to the new theatre complex remains. Unfortunately the 

period of “WonderBra” economics is over and the 

current financial reality precludes construction of these 

theatres in the immediate future. St Vincent’s still 

remains in the unique situation however of having an 

abundance of potential operating space. This places us 

in a favourable position to be able to provide additional 

services with appropriate funding, at a time when the 

delivery of cancer services are being restructured. 

The development of productive collaboration continues 

between St Vincent’s University Hospital Campus and 

The Mater Hospital to further consolidate the U.C.D. 

Dublin Academic Health Centre. 

The building of the new Bed Block remains an 

important part of the development plan. 

The construction of the new St Vincent’s Private 

Hospital building is progressing well 

Retirements 

2008 saw the retirement of Mr David Luke, Consultant 

Cardio-thoracic surgeon and Dr John Murphy, Consultant 

Gynaecologist. After many years of distinguished service 

they will be greatly missed. We have been lucky to 

have such great colleagues and wish them all the best 

for the future. 

Resignations 

Ms Margaret O’Donnell, Consultant Plastic Surgeon 

resigned from St Vincent’s University Hospital in 2008 

to enable her to spend more time on her family 

commitments. She has provided many years of service 

to patients and been an excellent colleague. 

Appointments 

There were no consultant surgical appointments in the 

year 2008. 

Research and Teaching 

The undergraduate teaching program underwent 

significant development this year. Many groups within 

the surgical division have had a productive year from a 

research perspective. Teaching, Post-graduate training 

and Research remain areas of ever greater concern as 

we look forward to a period of greater financial 

constraint. 

199 

Return to Contents


National Liver Transplant Programme and Liver Unit 

During 2008, a total of 58 liver transplants were 

performed for 53 patients at St Vincent’s University 

Hospital. There were 48 elective transplants for patients 

with end-stage liver failure, 4 emergency transplants for 

patients with acute liver failure and 6 retransplants for 

patients with recurrent liver problems. A total of 577 

transplants have now been performed for just under 

500 patients since the programme began in January 

1993. The success rate remains excellent with an 86% 

one year survival. This figure is very much in keeping 

with the best results obtained in large liver transplant 

units around the world. 

A total of 23 patients were admitted to St Brigid’s Ward 

with acute liver failure during 2008. Of these, 18 were 

associated with Paracetamol toxicity. Four patients with 

acute liver failure required liver transplantation; a further 

15 patients recovered without the need for liver 

transplantation; and 4 patients died from complications 

of acute liver failure. 

Organ donation continues to be good in Ireland. A total 

of 75 livers were donated in Ireland during 2008. 

Ireland continues to have a very strong organ donation 

rate compared to most other European countries. The 

organ donation rate in Ireland is 22 per million 

population per annum. This compares favourably with 

the organ donation rate in the United Kingdom (13 per 

million per annum) but still falls short of organ donation 

rates in some European countries (e.g. Spain, 36 per 

million per annum). 

The workload in the Liver Unit continues to increase 

each year and there are an increasing number of 

patients being referred with hepatobiliary and pancreatic 

problems which do not necessarily require liver 

transplantation. This has placed a significant burden on 

the resources available in St Brigid’s Ward and there is a 

need for an expansion in the bed pool for the liver 

programme. In particular, there has been a very marked 

increase in the number of patients being referred for 

assessment and management of primary liver tumours 

(hepatocellular carcinoma and cholangiocarcinoma). 

These patients are resource intensive, requiring 

significant input from surgery, medical hepatology, 

medical oncology, interventional radiology, and 

radiotherapy. 

200 

Return to Contents


Department of Ophthalmology 


Consultants: 

Mr P Barry, 

Mr W Power, 

Mr N Horgan 

St James Ward: Sandra Murphy CNM2 

Esther McCarthy CNM1 

Ophthalmic Theatre: Ms Annette Cullen CNM2 

Medical Research Ophthalmologist: 

Dr Aideen Hogan 

The Tables below summarise the department’s activity 

for the year 2008. 

The department of ophthalmology continues to be 

extremely busy with day care attendances exceeding 

2,000 for the first time. The majority of these attend 

for serial glaucoma monitoring and assessment and 

laser treatment for diabetic retinopathy and age related 

macular degeneration. 

The hospital approved the use of intravitreal Lucentis 

for exudative macular degeneration and 150 intravitreal 

injections were administered in the first year. 

We continue to try to move cataract surgery to day care 

which is difficult given the patients’ co-morbidities but it 

does maximise the utilisation of hospital beds. 

A & E ( Emergency) attendances in the ward and inpatient 

consultation referrals continue to expand and, 

like everyone else, we need more space. 

The department continues to provide services for St. 

Vincent’s Private Hospital and the Eye and Ear Hospital 

on a reciprocal basis. The senior nurses, Sandra 

Murphy and Esther McCarthy continue to provide 

superb nursing care and encourage it in their more 

junior colleagues. 

Surgical Registrars: 

Medical Registrar: 

Dr Princeton Lee 

Mr Qasiem Nasser 

Dr Magdy Nasralla 

St. James’ Ward Inpatient Admissions 2008 (including transfers) 

Ophthalmology Other Specialities Total 

Lecturer in Ophthalmology: 

Orthoptist: 

Unit Secretary: 

Dr Ruaidhri Kirwan 

Dr Shwan Kadare 

Vacant Post 

Ms Jane Caulfield 

ELECTIVE 339 71 410 

VIA A & E 0 175 175 

OTHER URGENT 3 8 11 

TRANSFERS (from other wards) 2 32 34 

TRANSFERS (from other hospitals) 0 4 4 

TOTAL 344 286 634 

201 

Return to Contents


Department of Ophthalmology 

The department continues to participate in the Pan 

European Audit of cataract surgery for benchmarking 

purposes. 

Dr. Aideen Hogan continues as medical research 

ophthalmologist and Mr. Qasiem Nasser is our current 

surgical registrar partnered by Dr. Magdi Nasralla as our 

medical registrar. Dr. Shwan Kadare as lecturer looks 

after the students. 

Ms. Jane Caulfield continues to provide an astonishing 

secretarial role. 

Mr. William Power continues as Chairman of the 

Medical Board of the Royal Victoria Eye and Ear 

Hospital and Mr. Peter Barry was awarded the first 

Eustace Med. Lecturer of the Royal Academy of 

Medicine in Ireland. 

We welcome Mr. Noel Horgan as the replacement 

consultant for Dr. Geraldine Kelly. His particular interest 

in ocular oncology will be a major addition to the 

hospital’s services. 

OPHTHALMOLOGY: ST. JAMES WARD 

2001 2002 2003 2004 2005 2006 2007 2008 

In-patients 

Ophthalmology 461 458 458 442 365 366 344 285 

Admissions 

Ophthalmology Discharges 457 456 451 434 363 362 344 285 

In-patients Cataract Procedures 330 324 310 299 300 331 321 256 

Day Care Cataract Procedures – – – – – – – 29 

Day Care – medical & surgical mix 

Admissions 1611 1846 1994 1729 1647 1536 1649 2083 

Discharges 1611 1846 1994 1729 1647 1536 1649 2083 

Total Attendances 607 502 927 777 973 282 0 0 

Orthoptic 


A/E Ophthalmic 


In-patients Referrals 

New 745 773 781 729 836 742 – – 

Outpatients 


202 

Return to Contents


Operating Theatre Department 


Promotional appointments; 

Maura McEvoy was promoted to CNM 2 grade. Linda 

Mullen CNM2 was seconded to the project in preparation 

for move to the Clinical Service Building theatres. Vida 

Norondha joined the staff as a CNM 2. 

Two portering staff members were promoted to 

portering supervisor grade in the hospital. 

Retirements; 

Mr David Luke, thoracic surgeon retired. 

A celebratory evening was held in April in the Raddison 

Hotel to mark the retirement of Breda O Donoghue 

and Bernadette Farrell in December 2007. The 

contribution to service at St Vincent’ Theatres of Ita 

Balfe and Maeve Nicholson who had left the employ in 

2007 was also recognised. Several past and present 

members of the multidisciplinary team attended. 

Education / Conferences 

Staff attended the Operating Theatre National 

Conference in Castlebar, three presenting scientific 

posters. Eithne Cullinan presented at the Anaesthetic 

Nursing conference in Limerick. Several workshops were 

held throughout the year in the department. Regular inservice 

education continued in the department every 

Wednesday morning. The Nursing Journal Club was 

further developed and each speciality group meet 

simultaneously on a monthly basis. Ms M. McGinley 

and Ms E Ellis attended Liver Transplantation meetings. 

Caroline Higgins was elected as President of the 

European Operating Room Nurses Association. 

Support for students (nursing and medical) is a fundamental 

activity for the operating team. During the year, 12 staff 

nurses completed preceptorship training. Nursing students, 

78 pre-registration students undertook four weekly 

placements in the department. Feedback from students 

on placement was a positive experience and a valuable 

educational environment. Members of the theatre aide 

and portering teams attended skill vec course. 

Developments/ Activities 

The inaugural foundation course in perioperative 

nursing commenced in Nov 2007 and all but one of 

these students completed the course in 2008. The 2nd 

course commenced in November 2008. 

Theatre Commissioning 

A multidisciplinary steering group was formed to coordinate 

the transfer of services to the Clinical Services 

Building. The Extra Mural Theatre undertook further 

transfer of its services to ADCC. 

203 

Return to Contents


Operating Theatre Department 

Committees 

The Health and Safety and Infection Control Groups 

met on a regular basis throughout the year. Promotional 

events were co-ordinated such as infection control, 

health and safety and hand hygiene awareness. 

Product Evaluation 

The Operating Department Product Committee 

continued to meet to streamline the introduction of 

new products and equipment to the department. 


During 2008 the throughput of surgical cases was 10,211 

HOSP PNH TOTAL 

DENTAL 39 2 41 

E.N.T. 264 106 370 

GENERAL 2508 671 3179 

GU ENDO 1032 128 1160 

GU OPEN 151 19 170 

GYNAECOLOGICAL 340 1 341 

OPHTHALMIC 357 1 358 

ORTHOPAEDIC 1913 79 1992 

PAIN 560 22 582 

PLASTIC 1224 75 1299 

THORACIC 219 81 300 

VASCULAR 338 81 419 

8945 1266 10211 

Fifty-nine liver transplant operations were performed during the year, with 75 donor retrievals. 

204 

Return to Contents


Department of Orthopaedics and Traumatology 


Mr. Sean Dudeney 

Mr. Brian Hurson 

Tumour and Spine 

Tumour, Sports Knee Injury, 

Adult reconstruction. 

Mr. E.P. Kelly 

Upper Limb 

Mr. S.K. O’Rourke Adult Reconstruction 

Mr. G. O’Toole Tumour and Adult Reconstruction 

M. W. Quinlan Rheumatoid Surgery and Adult 

Reconstruction. 

Administration 

Grade V Officer 

Grade IV Officer 

Operating Theatre 

CNM2 

CNM1 

Orthopaedic Ward 

CNM2 

CNM1 

Nurse Specialists 

CNS 

CNM2 

Ms. Jenni Cross 

Ms. Frances Dwyer 

Ms. Catriona Lennon, 

Ms. Anna Marie Bos, 

Ms. Sarah Cusack 

Ms. Gillian Fields, 

Ms. Rachel Hayden 

Ms. Andrea Marnell 

Ms. Ann Camlin 

Ms. Natalie Landers 

SN. 

SN. 

Fracture Liason Nurse 

CNS 

Ms. Josephine Ubas 

Ms. Deirdre Kelly 

Ms. Annette Whelan 

The Department of Orthopaedics and Traumatology is 

based in the Bone and Joint Unit of St Vincent’s 

University Hospital. 

The Traumatology Service caters for patients presenting 

by ambulance to the Emergency Department of St 

Vincent’s University Hospital and also Trauma 

presenting to any of the three portals in: St Vincent’s 

University Hospital, St Columcille’s Hospital or St 

Michael’s Hospital. Over recent years there has been a 

focus in delivering the acute and severe trauma directly 

to St Vincent’s University Hospital. However, there is still 

an access for patients in the two outlying Emergency 

Departments. Non-operative cases are followed up in 

Fracture Clinics in St Michael’s and St Columcille’s 

Hospital, whereas the operative patients are transferred 

to St Vincent’s University Hospital for their surgery. 

The orthopaedic staff in St Vincent’s University Hospital 

provides a twenty-four hour consultant led service. 

205 

Return to Contents



Patients who present are operated on, where possible, 

within the first twenty-four hours following their 

presentation. This is facilitated by a daily trauma list 

seven-days a week, which allows for more efficient use 

of the surgery facilities and this allows a more efficient 

turnover of the in-patient beds available to the Unit. The 

opening of the new Day Care facility within the hospital 

has increased the availability of day beds and further 

assisted the turnover of the Unit. In the year 2008 

approximately nineteen hundred cases were carried out. 

Patients who are referred to the Unit who require 

elective surgery by enlarge are operated on in Cappagh 

National Orthopaedic Hospital, where all of the 

surgeons in St Vincent’s University Hospital have 

attachment. In 2008 a total of 671 patients were 

operated on in Cappagh National Orthopaedic Hospital 

on referral from St Vincent’s University Hospital. This is 

a reduction in the year-on- year figures, which reflects 

the restriction of activity allowed in Cappagh National 

Orthopaedic Hospital for that twelve-month period. 

The Outpatient Department operates from the Bone & 

Joint Unit in the new extension of St Vincent’s University 

Hospital. The development has allowed the Department 

to move to a three-session day with separation of 

Fracture and Elective Clinics. In the year ending 

December 2008 there were 4,500 elective orthopaedic 

patients seen and in the Trauma Clinics there were 

10,665 attendances, which is a total of 15, 253 patients 

seen in the Outpatients in St Vincent’s University Hospital. 

Outside St Vincent’s University Hospital there are three 

Fracture Clinics per week in St Michael’s Hospital and 

two in St Columcille’s Hospital. These account for a 

total of 7,023 outpatient attendances. Together with the 

specialty clinics some of which are run in Cappagh 

National Orthopaedic Hospital, there is an excess of 

22,000 patient attendances at the Unit per year. 

Plaster Services 

The Plaster Service in St Vincent’s University Hospital 

provides back up for the clinics and also ongoing care 

for patients who require either supervision of wounds 

or specialist casts or splints. This is a very valuable 

Service to the patients as they have a point of reference 

within the Unit, which is available to them regardless of 

which clinic is running. Ms. Camlin, Clinic Nurse 

Specialist, is responsible for a number of audits and 

development of protocols within the Unit to facilitate 

the care of the patients. 

Clinic Developments 

During the year 2008 physiotherapy led the Back 

Assessment Clinic who have been established, initially 

on a trial basis to reduce the very considerable waiting 

list for back pain and also to audit and manage the 

types of referral and their suitability to the clinic. It 

would appear to have been a very successful 

programme and the figures in respect of same will be 

available shortly. It is envisaged that this may be an 

ongoing Service. It is a fact that many of these patients 

are not appropriate to a surgical clinic and therefore the 

availability of surgical facilities to patients is reduced 

because of the need to deliver a Service to these sort 

of patients. The appropriateness of such a clinic will be 

reviewed at the end of 2008. 

Training/Education 

The Unit continues to be involved in medical education 

at all levels. There are organised training student 

programmes through St Vincent’s University Hospital 

and Cappagh National Orthopaedic Hospital, the Unit 

takes trainees from the Basic Surgical Training 

Programme through the College of Surgeons, the 

orthopaedic trainees are taken from both the Regional 

Training Programme and the National Programme for 

Higher Surgical Training. All of the Orthopaedic 

206 

Return to Contents



Surgeons in the Unit are involved and take part in the 

Programme devised for the training of the Residents, 

both in the hospital, in Cappagh National Orthopaedic 

Hospital and nationally at the rotating Core Curriculum 

Programme. 

Mr Quinlan has stepped down from his position as 

Chair of the Institute of Irish Orthopaedic Surgeons. Mr 

Kelly remains as Regional Representative on the 

Council and trainer on the Trainers Committee of the 

Institute of Irish Orthopaedic Surgery. 

Publications 

Cost induced by hip fractures. 

Azhar A, Lim C, Kelly E, O'Rourke K, Dudeney S, 

Hurson B, Quinlan W. 

Ir Med J. 2008 Jul-Aug;101(7):213-5. 


“S" Quattro external fixation for complex intra-articular 

thumb fractures. 

Byrne AM, Kearns SR, Morris S, Kelly EP. 

J Orthop Surg (Hong Kong). 2008 Aug;16(2):170-4. 


Long-term functional outcome in pyogenic spinal 

infection. 

O'Daly BJ, Morris SF, O'Rourke SK. 

Spine (Phila Pa 1976). 2008 Apr 15;33(8):E246-53. 


Bilateral olecranon fracture as first presentation of 

sarcoidosis: case report and review of the literature. 

O'Daly BJ, Harty JA, O'Malley N, Killeen R, 

McDonnell TJ, Quinlan WR. 

J Shoulder Elbow Surg. 2008 Jul-Aug;17(4):e1-5. Epub 

2008 Jan 7. Review. No abstract available. 


Isolated proximal tibiofibular joint dislocation in an elite 

rugby union player. 

MacGiobain S, Quinlan JF, O'Malley N, Brophy D, 

Quinlan WR. 

Br J Sports Med. 2008 Apr;42(4):306-7. Epub 2007 

Nov 29. 


The longitudinal relationship between the patientreported 

Multiple Sclerosis Impact Scale and the 

clinician-assessed Multiple Sclerosis Functional 

Composite. 

Costelloe L, O'Rourke K, McGuigan C, Walsh C, 

Tubridy N, Hutchinson M. 

Mult Scler. 2008 Mar;14(2):255-8. Epub 2007 Oct 17. 


207 

Return to Contents


Department of Plastic Surgery 


Consultants 

Registrars 

Occupational Therapist 

Hand Therapist 

Unit Secretary 

Mr Tom O’Reilly 

Mr Sean M Carroll 

Dr Catriona Lawlor 

Mr Colin Riordan 

Mr John Curran 

Ms Clare Davidson 

Mr Yasir Katab 

Aine O’Reilly 

Hand Therapist 

Emily Hosford 

Alison Kelly 

Service Development and Activities 

The Department of Plastic Surgery provides a general 

plastic surgery service within the St. Vincent’s Healthcare 

Group and drains significant portions of the southeast 

of the country. We provide a specialised service in hand 

surgery, micro surgery, breast reconstruction, skin cancer 

surgery; pressure sore surgery, head and neck 

reconstruction, sarcoma reconstruction as well as pelvic 

surgery reconstruction. 

St Agnes’s Ward remains the plastic surgery ward as we 

await the completion of our new premises due for 

commissioning at the end of the year. The expertise of 

the staff in St. Agnes’s Ward make the post operative 

care of our breast reconstruction patients as well as our 

free flap reconstruction as seamless as possible and we 

acknowledge the dedication and hard work of the 

highly competent ward staff. 

Clinical activity at an outpatient level continued to 

increase this year. We would not be able to continue to 

produce the increases that we do if it wasn’t for the 

excellence of the ADCC Nurses. The Hand Surgery 

Clinic has received a second Occupational Therapist 

and has covered from a second Physiotherapist and 

this has improved matters greatly. 

Our waiting times for skin cancers continue to fall in no 

small part to the continuing of use of the Friday 

morning list in St. Michaels Hospital as well as maximal 

capacity use of the EMT theatre. We are immensely 

grateful to the EMT Theatre Nurses for there dedication 

and hard work. We now have reached maximal clinical 

activity levels and the unit is running very efficiently 

because of the continued hard work of the 

Consultants, Registrars, Nurses & Therapists. 

Our various sub specialist activities remains as 

described before and the service to the National 

Rehabilitation Hospital has been continued but 

improved by organising immediate access for these 

patients to weekly outpatient services in St. Vincent’s 

University Hospital rather than the monthly service that 

had been provided previously. 

The numbers of cases performed continue to increase 

as do the complexity of reconstructive procedures both 

in head and neck surgery and breast surgery. 

Academic output is not being ignored and we have had 

multiple publications and presentations throughout the 

year. 

208 

Return to Contents


Department of Urology 


Consultants 

Mr David Quinlan, 

Mr Gerald Lennon 

Mr David Mulvin 

Senior Registrars Mr Rowan Casey (from 01/01/08) 

Mr Stephen Connolly (from 01/07/08) 

Registrars Mr Ivor Cullen (from 01/01/08) 

Mr Jawad Ul Islam (from 01/07/08) 

Senior House Officers Dr Lisa Smyth (from 01/01/08) 

Dr Sheng Fei Oon (from 01/07/08) 

Interns 

Ward Sisters 

Theatre Sisters 

Dr Robert Smyth, 

Dr Eric Roche, 

Dr Karen O’Connell, 

Dr Kathy Rock, 

Dr Aine Mitchell, 

Dr Caitriona Tiernan, 

Dr Louisa O’Neill, 

Dr Claire O’Sullivan 

Sr Mary Nevin 

Sr Denise Murray (St Charles' Ward) 

Sr Vida Noronha 

Sr Angelina Tabamo 

Urology Cancer Nurse Coordinator 

Helen Forristal 

Urodynamics/Urology Nurse Practitioner 

Siobhan Gardner 

In-patient Clinical Coordinator 

Nuala Kennedy 

St Charles Ward Secretary 

Krystle Finnegan 

Urology Secretaries 

Louise Bradbury 

Margot Hennigan 


During 2008 there were 9,273 patient presentations 

(calculated from presentation to outpatients, admissions 

includes theatre, urodynamics and in-patient consults) 

which included: 

• Outpatients: A total of 5120 outpatients were 

seen by the Urology Department. Three Urological 

outpatients occur per week on the St Vincent's 

Campus with 4,338 outpatient attendances. Of 

these 857 were new patient attendances. There 

were 782 outpatient attendances in St Michael's 

Hospital seen in one weekly outpatients of which 

287 were new patient attendances. 

• Theatre: Surgical procedures totaled 2,817 with 

1,973 surgical procedures performed on the St 

Vincent's Campus, 330 performed at St Michael's 

Hospital and a further 514 procedures performed 

in St Michael's Annexe. 

• Consults: 424 in-patient consultations in 2008. 

• Urodynamics: There were 912 urodynamic 

procedures performed. 


The year 2008 was again a busy year for the Department 

of Urology. As in previous years St Charles' Ward 

continues to have a major throughput mainly due to its 

protection from admissions from other disciplines from 

the 1st of March to the 31st of December. Between 

the 1st of January and the end of February, St Charles’ 

Ward is available to the Emergency Department for direct 

admission of patients from other disciplines. This 10 

month protection is invaluable in permitting orderly and 

timely admissions of patients on Urological and 

Gynaecological waiting lists. From a Urological 

perspective, this permitted the treatment of patients with: 

• Urological malignancies, 

• Need of complex urological surgery 

209 

Return to Contents



• A requirement for complex Urological reconstruction 

or other intervention 

• Urological complications of other malignancies 

(including gynaecological and colorectal 

malignancies). 

This would all not be possible without the invaluable 

dedication of our Admissions Coordinator, Nuala 

Kennedy, who has her office opposite the nurses 

station on St Charles’ Ward and makes herself so 

available to patients on waiting lists for in-patient care. 

Cancer remains a significant focus for the Urology 

Department in St Vincent’s University Hospital and has 

done so for the last 4 decades. The 2005 Irish National 

Cancer Registry figures (the latest figures available) 

show that nationally prostate cancer was the commonest 

solid organ cancer with 2407 cases, breast cancer was 

second at 2379 cases and colorectal cancer third at 

2184 cases. If one adds in cancers of the kidney (375), 

bladder (504) and testis (162) the total number of 

Urological Cancers numbers 3,448 cases. This figure 

does not include less common Urological cancers such 

as cancer of the ureter, urethra, penis and scrotum 

(Table 1). 

Table 1: Common Cancers in Ireland 2005 

(National Cancer Registry) 

Cancer 

Number of 

New Cases 

Prostate 2407 

Bladder 504 

Kidney 375 

Testis 162 

Total Urological 3448 

Breast 2379 

Colorectal 2184 

St Vincent’s Urology has had a sizeable 

contribution to these figures. 

Surgically 2008 saw increasing development of 

Laparoscopic Urology under the direction of Mr David 

Mulvin. Laparoscopic nephrectomies are now a weekly 

occurrence with more laparoscopic nephrectomies now 

being performed for renal cell carcinoma. This is 

providing significant improvements in hospital stay and 

early return to work for patients. There has also been 

an upsurge in partial nephrectomies for smaller renal 

cell carcinomas performed by all three Urological 

Surgeons in St Vincent’s. Surgery for female 

incontinence remains strong with use of sling 

procedures and transobturator tape procedures for 

stress incontinence and injection of botulinum toxin for 

refractory detrusor instability. 

One day and five day activity remains vibrant. It must 

be remembered that the Department of Urology has no 

dedicated 5 day beds on the campus of St Vincent's 

University Hospital (having relinquished St Kevin's Ward 

for five day activity in 2000 in order to obtain protection 

for in-patients on St Charles’ Ward). Its five-day activity 

continues to occur off site in St Michael’s Hospital (under 

Mr Mulvin), the Annexe of St Michael's Hospital (under 

Mr Mulvin and Mr Quinlan) and St Columcille’s Hospital 

(under Mr Lennon). One day activity occurs via St 

Mark’s Ward, St Michaels Annexe, St Michael’s Hospital 

210 

Return to Contents



and St Columcille’s Hospital. Also, at St Vincent’s, the 

Ambulatory Day Care Unit (ADCC) accommodates 12 

to 18 patients per week who are undergoing flexible 

cystoscopies in the ADCC. 

Urodynamics remains very active. Complex 

urodynamics under the expert guidance of Mr Lennon 

continue for patients with incontinence and difficult 

voiding problems. Urodynamics also provides a 

tremendous service for male patients presenting for the 

first time to the outpatients with Prostate symptoms. 

These men undergo a pre-assessment with Siobhan 

Gardner consisting of urinalysis, renal profile, prostate 

specific antigen, symptoms score, uroflow and estimation 

of post void residual prior to seeing their consultant in 

the ADCC. This provides for instant decision making at 

the patient’s first consultation and has been invaluable. 

The purpose built Urology Unit in the new Ambulatory 

Day Care Centre provides an ideal environment in which 

to treat Urological patients in a private and confidential 

setting. As has been the case now in Urology for the 

past five years, patients are given timed appointments 

for their clinic visits and every effort is made to see 

patients in a timely, courteous and professional manner. 

This provides a significant challenge for Urology with only 

three clinics per week and the time constraints of three 

hours per clinic. The numbers of patients seeking 

Urological appointments now far outstrips the numbers 

of available appointments. 

2008 also saw the introduction of an annual “Visiting 

Professor” with Dr Alan Partin, arriving in July 2008. 

Professor Alan Partin is the David Hall McConnell 

Professor and Chair of the Department of Urology at 

the Johns Hopkins University Hospital. For over two 

decades he has been at the forefront of research into 

Prostate Cancer. To avail of Prof Partin’s expertise we 

had present and past Urology Residents from St Vincent’s 

presenting their clinical research papers on Prostate 

Cancer topics to Prof Partin for his views and for audience 

discussion. This was followed by Professor Partin’s State 

of the Art Lecture on “Beyond PSA- 2008” which was 

attended by the Minister of Health, Mary Harney T.D. 

This was followed by a reception in the ADCC. 

In 2008 Mr Quinlan became Chairman Elect of the 

Board of the British Journal of Urology. He was also reelected 

to a second term on the Council of the British 

Association of Urological Surgeons. 

During 2008 improvements in ward accommodation for 

in-patients on St Charles’s ward took place. We were given 

new shower and toilet facilities, which have greatly improved 

privacy and hygiene for patients. In 2009 we look 

forward to more ward refurbishment on St Charles’ Ward. 

Publications 

O'Connor KM, Davis N, Lennon GM, Quinlan DM, 

Mulvin DW. 

Can we avoid surgery in elderly patients with renal 

masses by using the Charlson comorbidity index? 

BJU Int. 2008 Dec 5. [Epub ahead of print] 

Dowling CM, O'Brien MF, Gardner S, Lennon G, 

Mulvin D, Quinlan DM. 

Can pre-assessment of patients with LUTS result in 

early discharge from urology clinic? 

Ir Med J. 2008 Jul-Aug;101(7):203-4. 

Hogan A, Smyth GK, D'Arcy C, O'Brien A, Quinlan DM. 

Renal capsular leiomyoma. 

Urology. 2008 Jun;71(6):1226.e1-3. Epub 2008 Mar 4. 

Connolly SS, Mulvin DW, Quinlan DM, Lennon GM. 

Painful hydronephrosis of pregnancy. 

Eur J Obstet Gynecol Reprod Biol. 2008 

Sep;140(1):145-7. 

Collins D, Myers E, Kavanagh D, Lennon G, McDermott 

E.: 

Mesenteric desmoid tumor causing ureteric obstruction. 

Int J Urol 2008 15:261-2 

211 

Return to Contents



Teaching 

For the urological trainees there is a major emphasis 

placed on teaching with academic conferences, 

teaching in the operating room and research endeavours. 

Each day starts with an organised teaching session with 

weekly conferences on: 

• Research Conference and Journal Review 

(Monday 8:15AM) 

• Uroradiology Conference (Tuesday 8:15AM), 

• Surgical Conference (Wednesday 8:15AM), 

• Uropathology Conference (Thursday 8:15AM) 

• Audit (Friday 8:15AM) 

Monthly meetings occur as below: 

• Multi-Disciplinary Team Meeting (Monthly, Monday 

8:15 AM) 

Mr Quinlan continues to be the Director of the 

Urological Trauma Course at the Annual Meeting of 

the British Association of Urological Surgeons. 

Future Plans 

• Urology has the potential to take advantage of its 

new outpatient setting with the development of 

“one stop shops” for: 

– Haematuria Clinics (with same day renal 

ultrasound and flexi-cystoscopy) 

– Prostate Clinics (with same day urodynamics, 

PSA testing etc) 

– Dysfunctional Voiding / Incontinence Clinics 

(with same day urodynamics and flexicystoscopy) 

• The application for a fourth Urological Consultant 

has been reactivaterd following the resolution of 

the new consultants’ contract. 

• Outpatient numbers pose a difficult problem. The 

numbers per clinic must be reduced to provide a 

higher quality service to each individual patient. 

Demand far outstrips supply of appointments. A 

fourth Urological appointment would certainly help. 

Novel solutions such as private practice Urologists 

being contracted for outpatient sessions may need 

to be looked at to cope with the growing volumes 

of patients. 

212 

Return to Contents


Department of Vascular Surgery 


Consultants: 

Mary Barry 

Stephen Sheehan 

Senior Registrars: 

Tony Moloney 

Fraser Smith 

Registrars: 

Bunmi Esam 

Tahir Khani 

Senior House Officers: 

Lange Nqwena 

Interns: 

Lucy Belton 

Breda Cushion 

Assistant Director of Nursing: 

Margaret Cullen 

Clinical Nurse Managers: 

Theatre Clinical Nurse Manager: 

Plethysmographist: 

Tissue Viability Nurse: 

Denis Mehigan 

Noel O’Brien 

John McCormack 

John Bourke 

Claire Leonard 

Fionnuala McCusker 

Catriona Keogh 

Maura McEvoy 

Catherine Kelly 

Deirdre Cornally 

The Vascular Surgery Unit at St. Vincent’s University 

Hospital had another busy year in 2008. The Department 

serves a population of up to 750,000 in our catchment 

area of Dublin and also the south east of the country. 

Bed shortages remain a major problem but effective 

cooperation with our referral hospitals has helped to 

maintain turnover of a satisfactory volume of elective as 

well as urgent and emergency work. The situation has 

been somewhat alleviated by the provision of beds and 

theatres sessions in St. Michael’s Hospital for five day 

cases which has greatly reduced waiting times for 

varicose vein surgery and renal access procedures. 

The aortic stent programme has continued successfully 

technology has allowed us to expand the cohort of 

patients suitable for the procedure. This has resulted in 

a reduction in the number of patients requiring open 

abdominal aortic aneurysm repair with obvious advantages 

for patients and for resource use within the hospital. 

The Vascular Dressing Clinic run by Deirdre Cornally, 

Tissue Viability Nurse Specialist continues to be a success 

with growing numbers of patients being treated. Over 

time the opening hours of this unit will require to be 

expanded to meet demand. The great success of the 

latter has already posed its own strains on resources 

and plans to extend its hours of operation are under 

consideration. 

213 

Return to Contents


Department of Vascular Surgery 

Department Activity 2008 

Admissions 2008 

Elective 364 

7 day 293 

5 day 2 

Urgent/Emergency 234 

Day Care 77 

Total 606 

Outpatient Attendances 2008 

New Patients 874 

Return Patients 3018 

Total 3892 

Operative Procedures 

2008 2007 2006 

Elective 333 317 273 

Emergency 86 97 51 

Total 419 414 324 

Meetings attended by members of the Department 

during the year were: 

• Charing Cross Meeting, London, April 2008 

• Venous Forum, London, June 2008 

• European Society of Vascular Surgery, Nice, Sept 08 

• Vascular Society, November 2008 

• Veith Vascular Symposium, New York, November 08 

Mr. Denis Mehigan is a member of the executive of the 

Irish Association of Vascular Surgeons and represents 

that body on the Vascular Advisory Committee. He is 

also a member of the Court of Examiners (FRCSI). 

Mr. Stephen Sheehan is an instructor on the Basic 

Surgical Skills Course and is an examiner of the European 

Board of Vascular Surgery. He is a member of the 

executive of the Irish Association of Vascular Surgery and 

represents the RCSI on the Vascular Division of the UEMS. 

Ms. Mary Barry is Secretary of the Basic Surgical Training 

Committee, RCSI and a faculty member on the Care of 

the Critically Ill Surgical Patient (CCRISP) Course. 

Academic Activity 

Publications 

Moran D, Roche-Nagle G, Ryan R, Brophy D, Quinlan W, 

Barry M. 

Pseudoaneurysm of the brachial artery following 

humeral fracture. 

Vasc Endovasc Surg 2008 Feb. 42(1): 65-8 

Roche-Nagle G, O’Donnell DH, Brophy DP, Barry MC 

Primary aorto-enteric fistula. 

Am J Surg 2008;April;195(4):506-7 

Roche-Nagle G, Murphy D, Collins A, Sheehan S. 

Frostbite: Management options 

Eur J Emerg Med 2008 June;15(3):173-175 

Murphy I, Moneley D, Kelly D, Foley B, Sheehan S. 

Endoscopic thoracic sympathectomy for long QT 

syndrome. Ir J Med Sci 2008 June; 177(2):167-9 

Roche Nagle G, Walsh S, Barry MC 

Chylous ascites following abdominal aortic aneurysm 

repair. Vascular 2008;16:1-3 

Roche Nagle G, McGuire C, Ryan R, Brophy D, Mehigan 

D. 

Postpartum carotid dissection. 

Int J Gynaecol Obstet 2008 Oct;103(1):66-67 

Mofidi R, Powell TI, Crotty T, Mehigan D, MacErlaine D, 

Keaveney TV. 

Angiogenesis in carotid atherosclerotic lesions is 

associated with timing of ischaemic neurological 

events and presence of computed tomographic 

cerebral infarction in the ipsilateral cerebral hemisphere. 

Ann Vasc Surg 2008; Mar;22(2):266-72 

214 

Return to Contents


Medical and Surgical Gastroenterology incorporating Centre 

for Colorectal Disease 

Consultant Medical and Surgical staff 

Medical Gastroenterology: 

Prof DP O’Donoghue, 

Colorectal Surgery: 

Mr J Hyland, 

Professor R O’Connell 

GI Pathology: 

Prof K Sheahan, 

GI Diagnostic Imaging: 

Dr C Collins, 

Prof D Malone. 

Medical Oncology: 

Dr D Fennelly 

Radiation Oncology: 

Prof J Armstrong, 

Dr HE Mulcahy 

Prof D Winter, 

Dr D Gibbons 

Dr R Gibney, 

Dr D Brophy. 

Dr S Spensley 

Non-Consultant Medical and Surgical staff 


Dr A O’Toole 

Dr A Al Akkari 

Dr C Dunne 

Mr C Coffey 

Mr E Andrews 

Mr J O’Riordan 

Clinical Nurse Managers: 

St. Luke’s Ward 3 CNM2 Ms A Smyth, 

St. Lukes Ward 2 CNM2 Ms U Power 

Endoscopy Unit 

Mr R Marshall, 

Ms F Kavanagh 

Research Team 

Jacintha O’Sullivan Senior Research Scientist 

Robert Geragthy Senior Medical Scientist 

Blathnaid Nolan Research Nurse 

Dermot Leahy Senior Scientist 

Miriam Tosetto Senior Research Assistant 

Monica Biniecka Postdoctoral Fellow 

Edward Fox 

Postdoctoral Fellow 

(NCI/HRB fellow) 

Dave Kevans 


Garret Cullen MD research fellow 

Joe Marry 


Eoin Slattery 


Danny Cheriyan MD research fellow 

Sheeona Gorman Ph.D. student 

Juliette Sheridan Ph.D. student 

Maciej Milewski Ph.D. student 

Adriana Michielsen Ph.D. student 

Dieticians 

Medical Gastroenterology 

Surgical Gastroenterology 

Specialist support staff 

Cancer Nurse Co-ordinator 

Colorectal Nurse Specialists 

IBD & Genetics Nurse Specialist 

IT/Excelicare 

Secretary 

Ms M Doyle 

Ms N Bates 

Ms A White 

Ms G McEvoy 

Ms W Hillery 

Ms D Keegan 

Mr S Thompson 

Mr K Curran 

Ms M Ward. 

Ms G O’Neill 

Clinical 

The recent move of Medical and Surgical Gastroenterology 

to a single department in St Luke’s wards 3 & 2 has 

been an outstanding success. Patients with acute 

gastrointestinal illnesses are admitted to these wards 

either via the Emergency Department or off the waiting 

lists. This relative protection has greatly improved the 

functioning of the unit and allows for a more rapid 

throughput of patients. Thus Medical and Surgical 

Gastroenterology now encompasses combined 

outpatient clinics, weekly clinical and audit meetings 

215 

Return to Contents


Medical and Surgical Gastroenterology incorporating Centre for Colorectal Disease 

and a shared ward. Close to one third of all hospital 

admissions fit into the category of acute or chronic 

gastroenterological disease and these integrated 

services, unique in the country, are clearly appropriate. 

The move to the Ambulatory Day Care Centre in the 

new building continues to bear fruit with greater numbers 

undergoing procedures each year under the excellent 

management of Mr Richard Marshall and his team. The 

appointment of a GI Registrar to the unit has been of 

major benefit to the Endoscopy unit but, more specifically, 

to the Emergency Department. We are now in a 

position to offer almost immediate endoscopy facilities 

to patients in the A&E such that many are able to go 

home on the same day and thus free up badly needed 

beds. The number of bed days saved by this innovation 

has been documented and presented to the HSE. 

The dedicated St Luke’s Ward and the additional staff 

has allowed the early development of specialty referral 

whereby many patients arriving in the Emergency 

Department are now seen and taken over by Medical 

Gastroenterology, again ensuring a quicker and more 

focused admission. The weekly Radiology and Pathology 

conferences run with our colleagues in Diagnostic 

Imaging and Pathology allow for best practice in patient 

care and provide an excellent source of teaching for 

junior staff. We wish to acknowledge the close clinical 

and scientific support we receive from our colleagues in 

Medical and Surgical Oncology and Palliative Care. 

We also wish to put on record our thanks to Ms 

Clodagh Maguinness and her staff in the new and 

expanded St. Marks Day Ward for all their magnificent 

work throughout the year. This facility has greatly 

improved the numbers of patients who can avail of the 

endoscopy suites. The opening of an infusion suite 

under the direction of Ms Catherine Slattery has been 

of enormous benefit as regards the speedy delivery of 

biologics therapies. 

Research and Education 

The Centre for Colorectal Disease (CCD) is an 

umbrella for clinicians and scientists with an interest in 

Colorectal Cancer, Inflammatory Bowel Disease and 

Functional Bowel Disorders. The aims of the centre are 

the delivery of state of the art services for our patients, 

research into causes and treatment and the education 

of the public. However, the multidisciplinary team 

would be unable to function successfully without the 

aid of nursing co-ordinators and nurse specialists such 

as Anne White, Denise Keegan, and Grace McEvoy who 

lead patients through the varied and complex pathways 

of diagnosis, treatment and postoperative stoma care in 

a way that appears seamless. The Excelicare Database 

System is now the backbone of the weekly Colorectal 

Cancer audit organised by Anne White, Marian Ward, 

Stewart Thompson and Ken Curran. 

The research arm of the Centre for Colorectal Disease 

continues to flourish under the guidance of Dr Jacintha 

O’Sullivan, Senior Research Scientist. The main research 

goals of the Centre for Colorectal Disease are to 

achieve a more complete understanding of which 

biological factors that drive colorectal cancer and to 

determine if different biological markers can distinguish 

people at high risk and elucidate which subset of 

patients will response to particular treatment regimes. 

The goal of these translational research projects, based 

on unique and exciting explant work, is to determine 

which cancers require additional treatment and what 

therapies might be most effective. Such work has the 

potential for huge financial savings in the management 

of Colorectal Cancer. The large and detailed databases 

for patients with Bowel Cancer and Inflammatory Bowel 

Disease enable many of the projects to be achieved. 

The unit has very productive collaborations with both 

national and international institutions. 

Professors O’Donoghue and O’Connell represent the 

Hospital on the National Colorectal Cancer Screening 

Committee. 

Our Annual International Colorectal Meeting in the 

Education and Research Centre each September 

continues to draw large numbers of attendees and is 

an ideal platform to display the various strengths and 

216 

Return to Contents



activities of the unit. Professor Paddy Johnston from 

Queen’s University Belfast - with whom the unit has 

close research collaborations - was this year’s state of 

the art lecturer. 

We wish to record our thanks to the many individuals 

and groups who raise funds for our research. In particular 

we would like to acknowledge foundations to the 

memory of Ellie Brady, Susie Byrne and Darragh Gibbons. 

Papers accepted in 2008 

Coss A, Tosetto M, Fox E, Sapetto-Rebow B, Gorman S, 

Kennedy B, Lloyd, Hyland J, O’Donoghue D, Sheahan K, 

Leahy D, Mulcahy H, O’Sullivan J. 

Increased Topoisomerase II· Expression in Colorectal 

Cancer is Associated with Pathologically Aggressive 

Disease and Leads to Chemotherapy Resistance via 

Inhibition of Apoptosis (In press). 

Sheridan J, Wang L, Tosetto M, Dave Kevans, Hyland J, 

Sheahan K, O’Donoghue D, Mulcahy H & O’Sullivan J. 

Nuclear oxidative damage correlates with poor survival 

in colorectal cancer. (In press). 

Kevans D, Foley J, Tenniswood M, Sheahan K, Hyland J, 

O’Donoghue D, Mulchay H and O’Sullivan J. 

High clusterin expression correlates with a poor 

outcome in Stage II T3NO colorectal cancer (In press). 

O’Sullivan J, Sheridan J, Mulcahy M, Tenniswood M and 

Morrissey C. The effect of green tea on oxidative 

damage and tumour formation in Lobound-Wistar rats. 

European Journal of Cancer Prevention. 2008, Nov; 

17(6):489-501. 

Wang L, Kevans D, Mulcahy H, O’Sullivan J, Hyland J, 

O’Donoghue D and Sheahan K. 

Tumour budding is a strong and reproducible prognostic 

marker in T3N0 colorectal cancer (in press). 2008 

Bronner M*, O’Sullivan J*, Rabinovitch P, Crispin D, 

Chen L, Emond M, Rubin C, Brentnall T. Genomic 

Biomarkers Identify Distant Colorectal Cancer in 

Ulcerative Colitis. Am J Pathol. 2008 Dec;173(6):1853- 

1860. *Joint first authours 

Howe O, O’ Sullivan J, Nolan B, Vaughan J, Clarke C, 

Gorman S, McClean B, Lyng F. Do radiation-induced bystander 

effects correlate to the intrinsic radiosensitivity of 

individuals and have clinical significance? 2008, (In press). 

Sullivan S, Tosetto M, Kevans D, Coss A, Wang L, 

O’Donoghue D, Hyland J, Fennelly D, Sheahan K, 

Mulcahy H* & O’Sullivan J*. 

Localization of a nuclear Cathepsin L and its 

association with disease progression and poor 

outcome in colorectal cancer’. Joint lead investigators 

(In press). 

Wang LM, Kevans D, Mulcahy H, O Sullivan J, Fennelly 

D, Hyland J, O Donoghue D, Sheahan K. Tumor 

Budding is a Strong and Reproducible Prognostic 

Marker in T3N0 Colorectal Cancer. Am J Surg Pathol. 

2008 Oct 28. [Epub ahead of print] 

O'Shea U, Abuzakouk M, O'Morain C, O'Donoghue D, 

Sheahan K, Watson P, O'Briain, S, Alexander 

D, Catherwood M, Jackson J, Kelly J, Feighery C. 

Investigation of molecular markers in the diagnosis of 

refractory coeliac disease in a large patient cohort. 

J Clin Pathol. 2008 Nov;61(11):1200-2. 

Cullen G, Keegan D, O'Donoghue D. 

Safety and efficacy of cyclosporine therapy in 

inflammatory bowel disease. Am J Gastroenterol. 2008 

Oct;103(10):2654-5 

Baird AW, Skelly MM, O'Donoghue DP, Barrett KE, Keely 

SJ. Bradykinin regulates human colonic ion transport in 

vitro. Br J Pharmacol. 2008 Oct;155(4):558-66. Epub 

2008 Jul 7. 

Feighery LM, Cochrane SW, Quinn T, Baird AW, O'Toole 

D, Owens SE, O'Donoghue, D, Mrsny RJ, Brayden DJ. 

Myosin light chain kinase inhibition: correction of 

increased intestinal epithelial permeability in vitro. 

Pharm Res. 2008 Jun;25(6):1377-86. 

217 

Return to Contents



Beddy D, Hyland J, Winter D, Lim C, White A, Moriarty 

M, Armstrong J, Fennelly D, Gibbons D and Sheahan K. 



with neoadjuvant chemoradiotherapy. Ann Surg Oncol, 

2008, Oct 10 (Epub ahead of print). 

Wang L, McNally M, Hyland J and Sheahan K. 

Assessing interstitial cells of Cajal in slow transit 

constipation using CD117 is a useful diagnostic test. 

Am J Surg Pathol, 2008, Jul, 32(7):980-985. 

Kennelly R, Kavanagh D, Hogan A, Winter D. 

Oestrogen and the colon:potential mechanisms for 

cancer prevention. 

Lancet Oncol, 2008, April 9(4):385-391. 

Mc Cormack O, Chung WY, Fitzpatrick P, Cooke F, Flynn 

B, Harrison M, Fox E, Gallagher E, Goldrick AM, Dervan 

PA, Mc Cann A, Kerin MJ. 

Growth arrest-specific gene 6 expression in human 

breast cancer. Br J Cancer. 2008 Mar 25;98(6):1141-6. 

Epub 2008 Feb 19. 

Mc Cormack O, Chung WY, Fitzpatrick P, Cooke F, Flynn 

B, Harrison M, Fox E, Gallagher E, McGoldrick A, Dervan 

PA, McCann A, Kerin MJ. 

Progesterone receptor B (PRB) promoter hypermethylation 

in sporadic breast cancer: progesterone 

receptor B hypermethylation in breast cancer. Breast 

Cancer Res Treat. 2008 Sep;111(1):45-53. 

Bielas JH, Vermulst M, Fox EJ, Ericson NG, Loeb KR, 

Rubin BP, O'Sullivan JN, True LD, Loeb LA. Nuclear and 

mitochondrial mutations in cancer ENVIRONMENTAL 

AND MOLECULAR MUTAGENESIS 

Volume: 49 Issue: 7 Pages: 562-562 2008 

Collins D, Winter DC. 

Elective resection for diverticular disease: an evidencebased 

review. World J Surg. 2008 Nov;32(11):2429-33. 

Active Grants in 2008 

IRCSET fellowship. 2008-2011. PI. Jacintha O’Sullivan, 

Ph.D. student: Ms. Adriana Johanna Michielsen. 

Dendritic cell function and its role in governing drug 

treatment resistance to molecular targeted therapies in 

colorectal cancer. 78,000 euro. 

Cancer Research Ireland. 2008-2011, co-applicant Dr. 

O’Sullivan. PI: Fiona Furlong. microRNA Regulation of 

the Spindle Assembly Checkpoint (SAC): Implications 

for Cell Cycle Dysregulation in Ovarian Cancer and Taxol 

Responsiveness. 224,826 euro. 

Abbott: Newman Fellowship. 2008-2010. PI: Dr. O’Sullivan 

& Prof. O’Donoghue. The biological effects of nicotine 

and cigarette smoke extract in fibroblasts and explants 

from Ulcerative and Crohns patients. 138,000 euro. 

Irish Health Foundation. 2008-2010. Radiation Responses 

in Rectal Cancer Patients. 80,000 euro. PI’s: Dr. 

O’Sullivan and Prof. Sheahan. 

Health Research Board Translational Research Grant 

2006-2011. PI: Dr. Veale, co-applicants: Dr. Fearon, Dr. 

Taylor & Dr. O’Sullivan. The role of hypoxia and genomic 

instability in Rheumatoid Arthritis. 1.5 million euro. 

Health Research Board NCI Cancer Prevention Fellowship 

2006-2008. PI’s: Dr. O’Sullivan & Prof. Loeb (Seattle). 

Postdoctoral Fellow: Edward Fox. Frequency of random 

mutations and genomic instability events during 

colorectal cancer progression. 110,000 euro. 

Almac Diagnostics 2006-2010. Prof. O’Donoghue, Dr. 

O’Sullivan, Prof. Johnston & Prof Harkin. Independent 

Validation of a Prognostic Gene Signature for Stage II 

Colorectal Cancer. 166,000 euro. 

Nycomed Newman Fellowship 2006-2008. PI’s: Dr. 

O’Sullivan & Prof. O’Donoghue. Newman fellow: Dr. 

Garret Cullen. 80,000 euro. 

Merck Newman Fellowship 2006-2008. PI’s: Dr. 

O’Sullivan & Dr. Fennelly. Newman fellow: Dr. Joe Marry. 

138,000 euro. 

218 

Return to Contents


Report from the Emergency Department 

Introduction 

The department saw a 3% increase in attendances 

compared to last year. This is in spite of an increase in 

the alternative venues available for emergency care. On 

average 105 patients attend the department on a daily 

basis of these 80 are discharged 64% within 6 hours. 

Twenty five patients per day are admitted and these 

continue to cause a problem due to persisting difficulty 

in obtaining in-patient beds. We are grateful to Bed 

Management for their efforts to keep the department 

free to allow us to attend to new patients. Delay for in 

patient admission continues to be our major problem 

for efficient patient care and although highlighted during 

the inspection by the office of the Auditor and 

Comptroller General in August 2008 the situation has 

shown no improvement. 

Service developments 

The Clinical Decision Unit was incorporated back into 

the main department during the year and this has 

improved its function as a valuable assessment tool 

allowing a significant reduction in patient admissions. 

Facilities for psychiatric care were improved and 

pathways for psychiatric care developed. 

The Rapid Assessment and Treatment (RAT) Unit was 

enlarged ensuring early senior assessment of patients 

and accurate streaming into appropriate pathways of 

care. This has allowed us to liaise with our in-house 

colleagues to further develop these pathways to 

achieve full speciality specific admissions. Early referral 

to Neurology and rapid availability of consultant opinion 

has allowed 36% of reviewed patients to be sent to 

ADCC, 15% discharged or sent to their G.P. and just 

45% requiring immediate admission. The Chest Pain 

Evaluation Pathway with the Department of Cardiology 

allows 20% of patients to be referred to ADCC, 36% of 

patients to be discharged to their G.P. and 28% admitted. 

Emergency Department assessment by Care of Elderly 

Consultants defers admission for approximately 10 

patients per month. Immediate and early access to 

endoscopy has allowed 30 patients per month in the 

Emergency Department to have endoscopies with less 

than a 1% admission rate. The Departmental Social 

Worker assesses 40 patients per month and places 4 

per month in step-down facilities directly from the 

department. 

The Emergency Department team has been strengthened 

by the appointment of department based staff in 

Occupational Therapy, Physiotherapy Pharmacy and 

Social Work. This early assessment in their pathway of 

care has facilitated early rehabilitation and discharge. 

219 

Return to Contents



The JCI survey in May 2008 was positive and emphasized 

the need to audit all aspects of the patient’s journey to, 

through and from hospital. Multidisciplinary integrated 

care pathways must be developed and the Emergency 

Department would be a focal point for many of these. 

Audit related to risk management continues as do the 

regular and important hygiene audits. Key Performance 

Indicators have been established and will be important 

in the future development of work in the department. 

Publications and presentations 

Mr John Ryan chaired the organising committee of the 

very successful College of Emergency Medicine meeting 

in Dublin 23-25 September 2008. 

‘An unusual cause of collapse and neck pain’. 

Emerg Med J. 2008 Dec;25(12):857-8. 

Buckley M, Kuan S, Barton D. 

Presentation: DVT Care Pathway – Entry and Exit Clinics 

Medication Safety Seminar, St Vincent’s University 

Hospital, Jan 2008 

Hosny G, Kidney R. 

Medical Practitioners of The Year. Irish Healthcare 

Awards, October 2008. 

Hosny G, Kidney R. 

'Emergency medicine in conflict zones'. 

IAEM Conference Dublin, September 2008 

O’Callaghan H. 

‘Comparison of blood gas analysis with i-STAT point of 

care analyzer.’ 

Hassan T, Drew D. 

Lactate as a confirmatory test in aiding the diagnosis 

of epilepsy. 

Ryan J, Hassan T. 

‘Bacterial Meningitis vs Cocaine-Induced Cerebral 

Vasculitis – a diagnostic dilemma’ Intensive Care 

Society of Ireland, Belfast, October 2008 

Menzies D, Nix C, Crowley K, Ryan J. 

‘Does the LUCAS device increase trauma during CPR’ 

IAEM Conference Dublin, Sept 2008. 

Menzies D, Barton D. 

The end of the line? The visual analogue scale and 

verbal numeric rating scale as pain assessment tools 

in the Emergency Department 

Autumn Scientific Conference, IAEM, Dublin, September 

2008 

H Mohan, J Ryan, B Whelan, A Wakai. 

‘How are the presentations and outcomes of patients 

presenting to the emergency department with no 

primary care physicians different from patients with 

primary care physicians?’ 

Leonard F, Buckley M, Ryan J. 

‘Content of General Practice referral letters to the 

Emergency Department’ Presentation, IAEMTA 

conference, September 2008 

Moisey D, Keenan C, Mitchell A, O’Sullivan C. 

General Practice referral letters to the Emergency 

Department; qualitative analysis for legibility 

Moisey D Keenan C Mitchell A O’Sullivan C 

The Use of Propofol for Procedural Sedation in 

Emergency Departments 

Cochrane Database of Systematic Reviews Issue 4, 

2008 The Cochrane Library 

Cochrane Review ID: 492205121412595497 Protocol 

approval stage 

Wakai A, Cummins F, O’ Sullivan R - October 2008 

‘The Exit Exam’ 

Irish Emergency Medicine Trainees Association - Spring 

Meeting 2008 

Cummins F 

220 

Return to Contents



‘The Stable Upper GIT Bleed Pathway’ presentation at 

the Irish Emergency Medicine Trainees Association - 

Spring Meeting 2008 

Carr S, Rosyn K, Cummins F, Mc Inerney J. 

‘The Stable Upper GI Bleed Pathway’ Poster presented 

at the CEM Inaugural Scientific Conference, Chelsea 

Football Club, London 14 - 16 May 2008. 

Carr S, Rosyn K, Cummins F, McInerney J. 

‘Major Emergency Alert Systems. Are They Internally 

Efficient and Can They Be Improved?’ Poster 

presentation Connolly Hospital, Mater Misericordiae 

Hospital, St Michaels Hospital, Emergency Management 

Office, HSE. Connolly Hospital Annual Audit / Research 

Symposium 2008 

Molloy MS, Cummins F, Sherif Z, Lawlor B, 

O’Connor C, McKeever J 

Case report: Post-dural puncture headache and 

treatment with epidural blood patch. 

IEMTA meeting in Dublin Autumn 2008. 

Hassan T 

‘Legionella’ Presentation - Munich 2008 

Fogarty E 

Future plans 

The emphasis will be on developing new pathways of 

care and integrated care pathways with a view of having 

a full speciality specific assessment/admission system. 

Presentation: ‘A Computer Game to Assist in Medical 

Education’ 

College of Emergency Medicine – Trinity College Dublin, 

Autumn Meeting 2008 

Carr S, Cummins F 

221 

Return to Contents


Report from the Pathology Department and Laboratory Medicine 


The molecular laboratory was fully equipped and Ms. 

Deirdre Keating appointed as a Specialist Senior Medical 

Scientist ensuring that planned new development could 

proceed. Preparatory work for the molecular identification 

of Ps aeruginosa for CF patients was completed. 

The Biochemistry Laboratory continued with the 

programme of test menu expansion and consolidation 

of tests on the main analyser platforms. Analysis of the 

therapeutic drugs carbamazepine and valproate was 

established in house. The urinary protein:creatinine 

ratio was initiated, in line with recent guidelines on 

kidney disease. 

During 2008 there was a continued emphasis on quality 

initiatives, audits and review of procedures. The Hospital 

Blood Bank was inspected by the Irish National 

Accreditation Board (INAB) in January and was awarded 

accreditation to the ISO15189 standards and compliance 

with the EU Blood Directive 2002/98/EC for 

haemovigilance and traceability. The Microbiology 

Laboratory was assessed by CPA (UK) in March and 

was awarded full CPA accreditation (incorporating 

ISO15189). The Stem Cell Laboratory made further 

progress towards full implementation of a Quality 

Management System to meet the requirements of the 

EU Tissue Directive 1004/23/EC. 

In November 2008 the hospital blood bank laboratory 

commenced phase one of the provision of a blood 

transfusion service to St. Michael’s Hospital to ensure 

compliance with the requirements of the Blood 

Directive for the Healthcare Group. 

The role of the pathology staff in point of care 

continued to expand in 2008. Biochemistry staff were 

involved in validation of a new blood gas analysers for 

the Emergency Department and St. Brigid’s Ward. 

Haematology staff were involved in the commissioning 

of Haematology point of care instrumentation for the 

new theatres. 

The Endocrine Laboratory derived a series of new 

gender specific reference ranges for prolactin and 

macroprolactin, which have been introduced into 

clinical practice. 

In the Metabolism Laboratory the clinical utility of 

measuring CTX-11 in-patients with rheumatoid and 

psoriatic arthritis following anti-TNF-α therapy was 

examined and evaluated. The results demonstrate that 

measuring CTX-11 can provide both an estimate of the 

degree of cartilage destruction in these diseases and 

has clinical potential in monitoring response to biologic 

treatment. 

Key Performance Indicators (KPIs) specific to Pathology 

have been developed and the department was an 

active participant in the team based performance 

management programme. The department also 

supported various research trials being carried by 

clinical teams in the hospital. 

The level of achievement in the above projects could 

not have been achieved without the commitment and 

team effort of all pathology staff. 


New staff who joined the department included the 

following: 

Ms. Annette Quinn, Ms. Ciara Lawless, 

Ms. Sarah Jane Ryan Ms Emer Harte, 

(Grade III Admin Staff) 

Ms Geraldine O’Brien, Ms Kate Dillane, 

Ms. Mary Casey, 

Ms. Michelle Morrin, 

Ms. Niamh O’Conell, Ms. Claire Larkin, 

Ms. Abigail Salmon, Ms. Ruth O’Brien 

(Medical Scientists) 

Dr. Marie-Claire Greenan (Clinical Biochemist). 

222 

Return to Contents



Dr. Deirdre Byre, Dr. Brianan Mc Govern, 

Dr. Alido Fe Talento. 

Ms. Gillian Schorman, CNM2, anti-coagulant monitoring service. 

Ms. Deepu Mathews, Ms. Lynn Healy, 

Ms. Lynsey Doran, Ms. Kim Hopkins, 

Mr. Kieran Kishan Ms. Jennifer Barr, 

(Laboratory Aides) 

Ms. Alison Nolan, Mr. Raise Paul (Phlebotomists). 

Staff who achieved promotion to higher grades in 2008 

included: 

Consultant Microbiologist - Dr. Suzy Fitzgerald. 

Specialist Medical Scientist - Ms. Deirdre Keating 

Grade IV Admin - Ms. Jemimah Dionela 

Grade IV Admin - Ms Mireia Giralt Cubi 

Senior Clinical Biochemist - Ms. Eileen Byrne 

Staff who retired include: 

Mr. Seamus Connolly, 

Ms. Ann Morley, 

Ms. Ann Browne 

Ms. Geraldine Collier resigned as Senior Clinical 

Biochemist to take up a Principal Clinical Biochemist 

post in Beaumont. 

Outstanding Achievements 

Prof. Dr. Joe Duffy continues to act as Chairman of the 

National Academy of Clinical Biochemistry (USA) panel 

for preparation of new guidelines on the clinical use of 

tumour markers in breast cancer. 

Ms. Orla Maguire was appointed Vice-President of the 

Association of Clinical Biochemists in Ireland (ACBI) and 

continues as Joint Chairman of the SVUH Partnership 

Committee. 

Dr. Sean Cunningham is Chairman of the Clinical 

Biochemists Registration Board. 

Mr. Rowland Reece is a member of the Irish Expert 

Body on Fluoride & Health. 

Dr. Gordon Dixon achieved membership of the 

Academy of Medical Laboratory Science. 

Dr. Tom Smith represents the Association of Clinical 

Biochemists on the Irish External Quality Assurance 

Steering Committee. 

Ms. Sarah Carroll and Ms. Aoife Prendergast passed 

the examination to obtain the special certificate in 

Blood Transfusion practices awarded by the BBTS. 

Ms. Cara Ward and Ms Aine Lennon achieved a 

Higher Diploma in Healthcare Training and Quality 

Management. 

Prof. Kieran Sheahan was appointed Associate 

Professor, University College, Dublin. 

Mr. Eddington Permalino, Mr. Alan Byrne, Ms. Antje 

Preuss, Ms. Marie Cantwell, Mr. Jerry Noone junior, 

completed the DCU Phlebotomy conversion course. 

Ms. Jennifer Barr and Ms. Alison Nolan successfully 

completed the DCU New Entrants course in Phlebotomy. 

Ms. Mairead Moore successfully completed the Skills- 

VEC programme. 

Ms Barbara Murray is a member of the Executive 

Committee of Eurachem Ireland 


Pathology activity increased by 13.5% in 2008. 

Publications 

Maguire OC, McCarthy D, Cunningham SK. 

The effect of plasmapheresis on the concentration of 

certain plasma proteins: a case identified by an 

inaccurate LDL-cholesterol estimation. 

Ann Clin Biochem 2008; 45: 436-9. 

223 

Return to Contents



McKenna, TJ, Smith, TP 

Hyperprolactinemia Due to Macroprolactin: A 

Commonly Unrecognized Phenomenon 

Causing Misdiagnosis and Mismanagement. 

The Endocrinologist 2008; 18: 249-254. 

Kennedy S, Clynes M, Doolan P, Mehta JP, Rani S, 

Crown J, O'Driscoll L. SNIP/p140Cap mRNA expression 

is an unfavourable prognostic factor in breast cancer 

and is not expressed in normal breast tissue. 

Br J Cancer. 2008 May 20;98(10):1641-5. 

Beddy D, Hyland JM, Winter DC, Lim C, White A, 

Moriarty M, Armstrong J, Fennelly D, Gibbons D, 

Sheahan K. 



with neoadjuvant chemoradiotherapy. 

Ann Surg Oncol. 2008 Dec;15(12):3471-7. 

McMenamin MB, Jackson AD, Lambert J, Hall W, Butler 

K, Coulter-Smith S, McAuliffe FM. 

Obstetric management of hepatitis C-positive mothers: 

analysis of vertical transmission in 559 mother-infant 

pairs. Am J Obstet Gynecol. 199:315. e1-5. 2008 

Duffy MJ, McGowan P, Gallagher WM. Cancer invasion 

and metastasis: changing views. 

J Pathol. 2008;214:283-93. 

Future Plans 

Develop the molecular laboratory service with the 

provision of: 

- Molecular typing of Pseudomonas aeruginosa 

from CF patients. 

- Molecular typing of VRE and C.difficile strains. 

- Diagnostic molecular tests for K ras mutation for 

colorectal cancer patients to determine optimum 

treatment. 

- Haemochromatosis genetic testing. 

Completion of the transfer of the blood transfusion 

laboratory service from St. Michael’s Hospital to St. 

Vincent’s University Hospital. 

The introduction of the electronic issue of red cells to 

reduce the time taken to provide compatible blood to 

qualifying patients. 

A major focus on accreditation with most labs scheduled 

for CPA assessment in 2009. Point –of-care testing will 

be included in these assessments and also in the JCI 

hospital accreditation process. 

Introduce the BNP test for the evaluation of heart 

failure and perform certain toxicology tests such as 

paracetemol, salicylate and blood alcohol. 

224 

Return to Contents


Report from the Radiology Department 

Radiology Management Team 

Clinical Director of Radiology 

Radiography Service Manager 

Clerical Supervisor 

Grade VI Officer 

Clinical Nurse Manager II 

Dr Conor Collins 

Sharon Simpson 

Helen O’Reilly 

Sara Nicholson 


Over the last year the service delivered by the Radiology 

Department has continued to expand and improve. 

The state-of-the art equipment available throughout the 

department has facilitated the development of a wide 

range of exciting new procedures such as Cardiac CT 

Angiography and CT Colonoscopy. 

Rapid advances have occurred in Interventional 

Radiology resulting in a large increase in the number 

and variety of examinations being performed. 

The introduction of Enterprise Wide PACS has greatly 

improved clinical access throughout the hospital group. 

New Technology 

Throughout 2008 the learning curve continued for 

Radiology staff with the introduction of a large number 

of previously unperformed procedures. The department 

also opened its DEXA unit as part of a HSE funded 

initiative to encourage referrals from GPs. DEXA is 

located within the mammography and ultrasound area 

on the first floor. 

Specialist training in a wide range of new examinations 

and applications presented a huge challenge for 

Radiologists, Radiographers and Nurses in the 

department. 

All staff in Radiology have shown great commitment to 

providing the best service possible by embracing the 

new technology installed and adapting to the changes 

in workflow which have occurred as a result. 

Staff Movement 

Radiology 

Dr. Colin Cantwell (special interest interventional radiology) 

joined the consultant staff during 2007. Dr. Eric 

Heffernan joined the department as Locum Consultant 

Radiologist (special interest musculoskeletal radiology). 

Fifth Year specialist registrar Dr. David O’Donnell 

departed having successfully completed his fifth year of 

training. We wish him well in his future career. 

We welcome Drs. Ailbhe O’Neill and Jan Gurstenmeir as 

first year specialist registrars. Dr Ronan Killeen commenced 

his appointment as a fifth year specialist registrar. 

Radiography 

We were delighted to have the following Radiographers 

join us during 2008: 

Aine Brennan Keyna O’Dwyer 

Maeve O’Donnell Bronagh Moynagh 

Anna Hayes Emma Caulfield 

Aaron O’Beirne Linda Tutty 

Deborah Sudding Toun Sillo 

Natalie Sweet 

In 2008 we said goodbye to the following group of 

Radiographers. We were very sad to see them go but 

wish them all the best for the future. 

Mary Aulin 

Patrick Doherty 

Maxwell Mkhandawire 

Selina NicAirt 

Jason Groarke 

Joanne Leamy 

Verna Vengadajellum 

225 

Return to Contents



Nursing 

We welcomed the following new staff nurses who 

joined the team in 2008 

S/N Valerie Prado 

S/N Stefan Baczkowski 

We said goodbye and thank you to the nurses & hca 

who left in 2008 

S/N Stefan Baczkowski 

HCA Anna Moreno 

S/N Lucile Rivera 

Clerical 

Congratulations to Sylvia Hughes on the birth of her 

baby boy (Shane). 

The following staff joined us during 2008: 

Carol Walsh Jeasonraj Kanagaraj 

Karen Finegan Liza O’Riordan 

Miriam Palfi Rebecca Noonan 

Silvia Sanchis Elizabeth Sweeney 

Eilish McNeill Magdalena Hering 

The following staff left us during 2008: 

Emer Timony Nolan Petrutchka Jack 

Lindi Phakoe Rebecca Noonan 

Liza O’Riordan Fiona Burns 

Samantha Alford 

Ancillary Staff 

The Radiology Aides have continued to contribute 

significantly to the workflow of the Radiology Department. 

Outstanding Achievements 

Administrative and Academic achievements by consultant 

radiologists in 2006 

The following appointments were made by UCD. Dr. 

Dermot Malone was appointed associate professor, Drs. 

Conor Collins, Stephen Skehan and David Brophy were 

appointed as clinical senior lecturers and Dr. Jonathan 

Dodd was appointed as clinical lecturer. 

Dr Conor Collins continues as Hon. Secretary of the 

International Cancer Imaging Society and delivered an 

invited lecture on the Sentinel Node in Breast Cancer at 

the 8th annual meeting of the Society in Bath, October 

2008. 

Dr O Laoide took up the post of Dean at the Faculty of 

Radiologists 

Dr Skehan continues as examiner to the part II 

Fellowship. 

Specialist Registrar achievements 

Drs Ingrid Heaslip and Deirdre Moran were successful 

in the primary examination for the Fellowship. 

Drs Ronan Ryan and Deirdre Moran were successful in 

the FFRRCSI examination. 

Selected Publications 

Heffernan EJ, Dodd JD, Malone DE. 

Cardiac multidetector CT: technical and diagnostic 

evaluation with evidence-based practice techniques. 

Radiology. 2008 Aug;248(2):366-77. 


O'Connell AM, O'Doherty A, Malone DE. 

Can ultrasound evaluate axillary lymph node status in 

patients with breast cancer? 

Can Assoc Radiol J. 2008 Feb;59(1):19-21. Review. No 

abstract available. 


Killeen RP, Harte S, Maguire D, Malone DE. 

Achievable outcomes in the management of proximal 

cholangiocarcinoma: an update prepared using 

"evidence-based practice" techniques. 

Abdom Imaging. 2008 Jan-Feb;33(1):54-7. Review. 


226 

Return to Contents



Malone DE. 

Evidence-based practice in radiology: what color is 

your parachute? 

Abdom Imaging. 2008 Jan-Feb;33(1):3-5. 


Collins CD. 

The sentinel node in breast cancer. 

Cancer Imaging. 2008 Oct 4;8 Suppl A:S10-8. Review. 


Dodd JD, de Jong PA, Levy RD, Coxson HO, Mayo JR. 

Conventional high-resolution CT versus contiguous 

multidetector CT in the detection of bronchiolitis 

obliterans syndrome in lung transplant recipients. 

J Thorac Imaging. 2008 Nov;23(4):235-43. 

PMID: 19204467 [PubMed - in process] 

Killeen RP, Dodd JD. 

RE: Considerations when introducing a new cardiac 

MDCT service. Avoiding the pitfalls. 

Clin Radiol. 2009 Feb;64(2):219; author reply 219-20. 

Epub 2008 Oct 21. No abstract available. 


Dodd JD, Kalva S, Pena A, Bamberg F, Shapiro MD, 

Abbara S, Cury RC, Brady TJ, Hoffmann U. 

Emergency cardiac CT for suspected acute coronary 

syndrome: qualitative and quantitative assessment of 

coronary, pulmonary, and aortic image quality. 

AJR Am J Roentgenol. 2008 Sep;191(3):870-7. 


Ryan R, Abbara S, Colen RR, Arnous S, Quinn M, Cury 

RC, Dodd JD. 

Cardiac valve disease: spectrum of findings on cardiac 

64-MDCT. 

AJR Am J Roentgenol. 2008 May;190(5):W294-303. 

Review. 


Okumu RO, O'Donnell D, McCreery CJ, Luke D, Dodd JD. 

Cabrol shunt for iatrogenic aortic dissection: evaluation 

with cardiac 64-slice 

CT. 

Eur Heart J. 2008 Mar;29(5):617. Epub 2007 Oct 24. 

No abstract available. 


Conferences 

All of the major national and international radiology 

conferences were attended. 


Statistics for the Radiology Department for 2008 are as 

follows: 

IR Rooms 9957 

CT 20044 

MRI 4354 

DEXA 83 

Mammo 6571 

RNI 7185 

DR 86651 

US 14163 

TOTAL 149091 

This figure represents an 8% increase compared with 

2007 (total no. 138305) 

Future Plans 

2009 will see further upgrades to the PACS in 

Radiology in addition to the introduction of electronic 

requesting. Further new services provided by 

interventional radiology will also be undertaken. 

227 

Return to Contents


Report from the Clinical Director of Psychiatry 

Elm Mount Psychiatric Unit 

Elm Mount continued to strive for clinical excellence 

during 2008. The Refocusing Project, which started in 

October 2007 and continued through 2008, was felt to 

be of benefit to the care of all our patients. The 

Refocusing Project is a practice development and 

change management model sponsored by the 

Nursing/Midwifery Planning and Development Unit. 

The aim is to: 

• Foster effective team work amongst staff 

• Collaboration with service receivers 

(patients/carers) 

• Whole team staff training to share ideas and good 

practice 

• Have clear targets for change 

• Strong leadership to manage and maintain the 

changes made 

Following the new Medical Practitioner Act, Irish 

Psychiatry which had previously been affiliated to the 

Royal College of Psychiatrists in London, had to set up 

its own College during 2008. This involved the 

amalgamation of the Irish Division of the Royal College, 

the Irish Psychiatric Training Committee and the Irish 

Psychiatrist Association to form the new Irish College of 

Psychiatry of Ireland. Two of our Consultants, Dr 

Consilia Walsh as the last Chair of the Irish Division and 

Dr Anthony McCarthy as Chair of the Irish Psychiatric 

Training Committee were part of the committee which 

brought the Irish College into being. Elm Mount is 

proud of their contribution to the new College, of which 

Dr McCarthy is Vice President. 

As an approved centre for the detention of patients 

under the 2001 Mental Health Act there were 82 

involuntary admissions. One detained patient had her 

case brought to the High Court by her legal team, the 

issue of capacity being central to the case. The lack of 

capacity legislation in Ireland impacts on patient care 

where the person’s capacity is impaired. 

228 

Return to Contents


Department of Old Age Psychiatry 

The Department of Old Age Psychiatry continues its 

tradition of providing community-orientated, multidisciplinary 

mental health care to the catchment area 

population of over 34,000 people of 65 and over. The 

service produced a comprehensive service development 

plan, which was developed through extensive consultation 

and circulated to senior management within St Vincent’s 

University Hospital and the HSE. This provides a very 

useful framework for the development of the service in 

the context of an increasing elderly population. We are 

committed to its implementation notwithstanding the 

constraints of the current economic downturn. 


The Department welcomed a number of new staff to the 

unit including Dr Sarah Prasad, Senior Registrar in Old 

Age Psychiatry, Dr Deirdre McNally, Clinical Psychologist, 

Therese Woods and Ann O Keefe Assistant Directors of 

Nursing who provide ongoing supervision and support 

to our nursing staff across the service. Ann Hutton, will 

be retiring from the service in 2009. She has provided 

outstanding service to our Day Hospital and will be 

greatly missed by her colleagues and patients and their 

families who have benefited from her wisdom, 

compassion and dedication. We would like to thank Dr 

Trudy Meehan, Clinical Psychologist, who left the 

Department last year to take up a senior post. She gave 

a valuable contribution to the service and we wish her 

well in her new role. 

Service developments and Activities 

There were 2195 medical reviews of patients in 2008. 

This included 752 new referrals of which 215 were 

liaison consults seen by the service. The commonest 

mental problems seen in the hospital is delirium, while 

dementia and depression are the two most common 

mental health disorders seen in community settings. 

The Day Hospital plays an invaluable role in the 

management of our patients in preventing admissions 

and facilitating and supporting early discharge from inpatient 

care. The Healthy Ageing Course and Anxiety 

Management Courses are run at the Day Hospital with 

multi-disciplinary involvement from Occupational Therapy, 

Medical Social Work, Nursing and Psychology. The 

Healthy Ageing Course was expanded from an 8 week 

to a 10-week programme. This programme was evaluated 

using pre and posttest measures of psychological health 

including the Geriatric Depression Scale and the 

General Health Questionnaire and significant 

improvements for individual patients were found. 

229 

Return to Contents


Department of Old Age Psychiatry 

There were 1004 attendances at the Day Hospital last 

year and 291 attendances at the Group programmes of 

the Day Hospital. 

A model for a Rapid Response service for nursing home 

referrals has been developed and its introduction will 

depend on allocation of resources to support this. 

Elements of this service have been implemented such 

as the introduction of standardised behavioural 

assessments. In addition, individual Community Mental 

Health Nurses have been assigned to Nursing Homes 

in the catchment area. The Department will continue to 

develop the Nursing Home Education Programme 

with the team Psychologists Dr Aideen Lewis and Dr. 

Deirdre McNally playing a lead role in this. 

Medical Social Work (Martina Dolan) and Psychology 

(Deirdre Mc Nally) are developing and piloting a Needs 

Assessment Form Tool to help plan for older persons 

with severe dementia moving into long term care. The 

instrument is divided into 4 parts, will inform the 

planning process and assist in providing the best 

possible care for people with severe levels of dementia. 

The Medical Social Workers on the team continue to 

provide the Carer Information Meetings several times 

per year and their audit of the programme has shown 

high levels of satisfaction from participants. This Carer 

Support Programme includes a lecture from Dr. Freyne 

providing information on dementia to carers and advice 

about the caring role. In addition, a Carer Support 

Meeting follows two weeks after the Information 

Meeting giving carers an opportunity to share their 

experiences and to access support in their caring role. A 

facilitator from the Alzheimer’s Society attends to 

facilitate carers receiving additional support from the 

Alzheimer’s Society if required. 

The Medical Social Workers continue to refine and 

develop the interaction between our service and St 

John of God’s Hospital to facilitate seamless working 

between our services to maximise benefits for patients. 

Teaching and Research 

The Department has an active research programme. 

There are two main databases in the Department 

including the Lithium Clinic Database and the COMCAR 

Databases, which have a record of service activity and 

patient diagnoses. The Department has several ongoing 

studies including research of cognitive function in 

patients on lithium treatment, measurement of renal 

function in patients on lithium using eGFR, and drug 

treatment of delirium. 

The Clinical Psychologists co-ordinated a weeklong 

programme (Older Adult Specialist Week) for doctoral 

students of Clinical Psychology at UCD in November. 

The Clinical Psychologists have been active in teaching 

within the hospital including presentations and 

interactive workshops to the Academic meetings of the 

Department of Old Age Psychiatry. 

There are a number of research projects ongoing under 

the direction of Dr. Aideen Lewis, Principal Psychologist 

with the service. Ms. Antionette Copley completed her 

Master of Psychological Science on the topic of 

“Selfhood in Alzheimer’s Disease” and Ms. Ann Demery 

has been researching the topic of Stroke and Self- 

Concept as part of her training in Clinical psychology 

with Trinity College Dublin. 

230 

Return to Contents


General Services 

231


Report from the General Services Manager 

General Services 

Departments within the General Services portfolio are 

responsible for the provision of non-clinical support 

services to the hospital along with ensuring a clean and 

safe environment for our patients, visitors and staff. 

The General Services portfolio consists of the following 

key functions: 

Catering 

Fire Safety 

Health & Safety 

Household Services & Cleaning 

Portering Services 

Security 

Technical Services 

Telecommunications 


Staff within the General Service portfolio of 

departments represent a diverse range of skills, which 

are directed to providing support to assist core clinical 

areas deliver a patient focused service. 

The staff compliment in 2008 has remained constant 

when compared with the levels in 2007. 

The management of the Health and Safety Department 

was greatly enhanced with the introduction of a new 

structure during 2007. This new structure amalgamates 

the Fire Safety Co-ordinator and the Health and Safety 

Co-ordinator roles together. In addition to the improved 

day-to-day running of the service, this development 

provides a much welcomed structured approach to 

health and safety across the campus and has reduced 

the duplication of staff attending committees and 

meetings with regards to H&S matters. The support and 

co-operation received from all staff members during the 

implementation of this new structure was appreciated. 


The establishment of an Estates Strategy Group (ESG) 

in late 2007 created a foundation for the effective, 

efficient and progressive management of major and 

minor capital development projects across the campus. 

In 2008 the Hospital embarked on an ambitious 

programme of development projects designed to 

improve hygiene and health & safety standards. 

232 

Return to Contents



Key Projects Completed in 2008 

Patient / Clinical Areas 

• New Allied Therapy Suite (January) 

• Cancer Support Centre relocated to Nutley Lane 

(February) 

• Relocation of Pain Management to the SVUH 

campus (February) 

• St Camillus Ward upgrade (February) 

• St Monica’s Ward kitchen upgrade (March) 

• Emergency Department – 4 new CDU beds (June) 

• New Social Work Offices (June) 

• Refurbishment of Suite 6 – OPD Dept (June) 

• New St Mark’s Daycare Ward (June) 

• St Luke’s 2 Ward upgrade (June) 

• Emergency Department – Extended Triage area 

(August) 

• New 8 bed St Christopher’s (CF) Ward (August) 

• New Histopathology Storage area (August) 

• Professor of Medicine Suite (September) 

• Professor of Surgery Suite (September) 

• St Vincent’s Ward upgrade (September) 

• Additional Dexa Scanner for GP referrals (October) 

• St Patrick’s Medical Observation Unit (November) 

• Toilet and Showers Upgrade – Phase 1 consisting 

of 7 wards (December) 

• Ward Kitchen Upgrade – Phase 1 consisting of 7 

wards (December) 

• Our Lady’s Ward refurbishment (expected 

completion January ’09) 

Staff / Support Services 

• New Emergency Department Offices (February) 

• New Cycle Stands–164 new spaces created (April) 

• New Staff Rest Room (May) 

• ERC chiller replacement (March) 

• ERC Entrance Doors replaced (April) 

• HIPE Offices upgraded (June) 

• Toilet upgrade basement offices (September) 

• Ward Block signage (Phrase 1 completed) 

December) 

• Installation of new boiler (December) 

The successfully completion of so many projects on 

time and within budget is largely due to the support 

and co-operation of all the staff. 

In addition to the above projects a number of essential 

facilities related improvements were carried out e.g. 

improvements to fire detection, mains water supply 

contingency, electrical supply improvements, painting, 

new blinds, furnishings etc. The window replacement 

programme continued and in excess of €200K was 

allocated to this project this year alone. Necessary 

remedial work to repair flooring across the campus was 

initiated and is planned to continue in 2009 finances 

permitting. 

The department was very disappointed in the results 

obtained following a HIQA Hygiene audit of the hospital 

in October. The Hospitals’ overall rating decreased from 

“Good” to “Fair” and it was felt that this was not indicative 

of all the hard work and commitment shown by staff to 

improving hygiene standards. 

Unfortunately for the hospital and especially for staff 

working in the support services under the General 

Service’s remit their significant effort and investment 

made to addressing hygiene matters and improving 

services was not reflected in our scoring. This was not a 

true reflection of the work put in by many of the 

support services. 

233 

Return to Contents



I am very proud of all the work that was undertaken by 

the staff within the General Services portfolio in 2008 

and would like to thank them for all their hard work, 

achievements and continued support over the past 

year. 

Other Improvements / Initiatives for 2008 

included 

• Two dangerous goods audits were carried out in 

May and Novemeber. 

• Energy and Utility management continued. 

Monitoring and corrective action was initiated and is 

to be a key priority for 2009 as part of cost 

containment plans. 

• Water management continues to be an important 

issue. Technical Services currently work very closely 

with Infection Control and Microbiology 

implementing policies to minimise risk and meet 

legalisive standards. 

• Whole Hospital Policies continued to be developed 

for the management of services throughout the 

hospital including the updating of the Whole Hospital 

Waste Policy in line with new regulations. Other 

policies developed include Curtain Changing and 

Laundering of non-rental items. 

• Following a mock JCI accreditation survey in May 

work commenced on addressing the 

recommendations made in respect of 

Environment and Facility management. 

Achieving JCI Accreditation will become the main focus 

for 2009. All Service Departments have commenced 

their preparation for the proposed October 2009 audit. 

Each of the departments within the General Services 

portfolio has had a productive year as can be seen by 

the following outline of their role and activities. 

• Portering and Household Services continued a 

programme of decluttering with special emphasis 

on the basement and convent areas. 

234 

Return to Contents



Catering Department 


2008 was a busy year for the staff of the Catering 

Department. The long awaited upgrade of the ward 

kitchens commenced in September. A lot of time and 

effort was put in to getting the design and installation of 

the kitchens right. It was only with the co-operation and 

goodwill of all the staff involved; Catering, Technical 

Services, Nursing, Health Care Assistants, Portering, 

Finance, Infection Prevention and Control and the 

Environmental Health Officer that this project was 

completed on time and without any major hitches. 

Thanks is extended to all those who participated and 

assisted in this project. 


The first phase of the upgrade of the ward kitchens 

commenced in September 2008 and was completed 

by Christmas. The kitchens in St Paul’s, St Joseph’s, St 

Luke’s 1, St Charles’s, St Patricks and Our Lady’s Wards 

were completely renovated and fitted with new 

stainless steel furniture. 

The entrance to each kitchen was reconfigured to open 

directly on to the corridor of the ward. The work that 

was carried out has ensured that the kitchens are now 

compliant with the relevant food safety legislation. 

The cafeteria opening hours were adjusted to facilitate 

the change in starting times for nurses when new 

rosters were introduced in the summer of 2008. 

Breakfast service now commences at 07.00 hours. 

A ‘bean to cup’ coffee machine, which produces freshly 

brewed coffee on demand, was introduced in April 

2008. The service has proved to be so popular that we 

are now awaiting the installation of a new machine that 

has double the capacity of the current machine. 

Fairtrade coffee and a selection of fair-trade teas are 

now available in the Cafeteria. 

Awards 

The Healthcare Food Award from the Irish Heart 

Foundation was awarded to the hospital’s staff catering 

facility in April 2008. 

Future Plans 

The second phase in the upgrade of the ward kitchens 

is expected commence in early 2009 and be 

completed by early summer. The wards in question are 

St. Michael’s, St. Luke’s, St. Laurence’s and St. John’s. 

235 

Return to Contents



Health & Safety and Fire Safety 

Management 

The role of health and safety has never been busier 

especially with the preparations in advance of the 

proposed JCI accreditation survey scheduled to take 

place in the latter half of 2009. Our Fire Safety Coordinator 

has taken on the vacant role of Health & 

Safety Co-ordinator on an acting basis to ensure that 

any safety related recommendations following the mock 

JCI survey can be addressed. 


Training remains to be a high priority for health and 

safety with further sessions to be provided by the 

hospital in a number of disciplines. The rollout of 

mandatory training for new-starters during corporate 

induction has helped tackle the problem of releasing 

staff to departments who may have had little or no 

understanding of the safety requirements expected by 

them within the hospital environment. This training 

includes fire safety, manual handling, major emergency 

plan, infection control & waste management, occupational 

health, risk management, health & safety, and health 

promotion. 

Fire training was revamped with a more flexible outlook 

so that training sessions can work around individual 

departmental arrangements and not those of health 

and safety. This approach proved invaluable as it 

resulted in less disruption to departmental services and 

record attendance figures for fire training being 

achieved. Overall a massive increase of 23.2% in 

attendance figures was obtained in 2008 compared 

with 2007 attendance rates. This is also partly due to 

the awareness campaigns that were instigated by health 

and safety at the start of the year to encourage 

departmental managers to assess their staff training 

attendance. 

The Hospitals’ Dangerous Goods Safety Auditor 

conducted two inspections that once again resulted in 

zero non-conformances by the hospital. Special thanks 

goes to portering, waste marshalling, stores, labs and 

pharmacy for their full co-operation as always. The 

DGSA auditor also assisted the hospital by providing a 

number of chemical awareness & spills training sessions 

to SVUH staff. These sessions proved invaluable to staff 

and requests have been made by a number of 

departments for further sessions to become available. 

On a downside the number of nuisance fire alarm 

activations in 2008 was not helpful to the hospital or 

the fire service as it increased by over 31.7%. This was 

due to two factors – the first being the high volume of 

construction works that took place during the year that 

involved hot or dusty works. The second factor was the 

number of unauthorised toasters that still occupy many 

of the staff rest rooms and tea areas. Not only are these 

domestic toasters not suited to the volume of usage 

that they receive but also the rooms that they are 

located in are not designated fire-rated kitchen areas. 

A routine inspection by the Health & Safety Authority 

took place in September that included a visit to a 

number of areas within the hospital. The two inspectors 

spent time exploring the hospitals safety statements, 

risk management occurrence forms and safety meetings 

before visiting Occupational Health, Insurance & Risk, 

Pathology, St. Charles Ward, as well as the Waste 

Marshal Yard. All in all, the visit proved invaluable as 

much praise was expressed by the HSA inspectors to 

SVUH staff for the safety systems in place that they had 

witnessed throughout the organisation. 

Outstanding / Significant Achievements 

In October 2008 the European Health & Safety Week 

theme was ‘Risk Assessment’. A health and safety 

breakfast morning was held by SVUH in the Education 

and Research Centre that was open to all staff and 

attracted a number of outside agencies, notably the 

236 

Return to Contents



Health & Safety Authority and Beauchamps Solicitors. 

Prizes such as home safety kits were presented to staff 

that successfully answered the quiz questions in the 

H&S draw which were kindly donated by a number of 

the hospitals safety suppliers. Sincere thanks goes once 

again to all who participated especially Catering, the 

ERC staff, and all the stand promoters. 

Staff Safety Representative 

Ms. Margaret Britain resigned after 4 years in the role of 

Staff Safety Representative and was replaced by Mr. 

Joseph Mooney following a ballot of all staff. The 

Hospital would like to thank Margaret for her dedication 

and many years of service to the role and to wish 

Joseph every success in this role. 

Future Plans 

The Hygiene Audit in late 2008 proved to be 

challenging with the demands for the hospital to meet 

the extensive and sometimes vague expectations 

required by HIQA. Health and Safety along with the 

Hygiene Co-ordinator will continue to work together to 

ensure that all levels of hygiene are met to the highest 

standard. The upgrade of the ward kitchens and toilets 

has helped address a lot of the issues that were 

expressed by HIQA in this regard. 

Hygiene - Cleaning and Household 

Services 

Cleaning 

The Hospital views maintaining the highest standards of 

cleaning and hygiene as an integral part of quality 

patient care. All cleaning and hygiene activities are 

guided by best infection control practices and national 

guidelines. The majority of cleaning activities are 

provided under a contracted service and the hospital 

endeavours to ensure the services provided continue to 

meet our ever-changing needs. 

Pressures in the Emergency Department led to 

additional beds being opened at various stages during 

2008. This proved to be a major challenge in terms of 

managing cleaning resources and significantly increased 

cleaning costs especially in the last quarter of 2008. 

Another challenge faced during the winter months by 

the service was the increased demands for second 

clean at ward level during the Norovirus outbreaks. The 

department worked closely with the Infection Control 

Team to help minimise cross infection and to deep 

clean affected areas as required. Restricting public 

access during times of outbreak was a challenge for all 

the support services and the lack of support by the 

visiting public to the Hospital’s appeals was a 

tremendous strain on the front line staff including the 

Security and Portering Departments. 

It was a big year again for hygiene initiatives across the 

campus. The focus remained on expanding staff and 

patient awareness of good Hand Hygiene practices and 

a number of staff information sessions were held to 

educate and promote better hand hygiene practices. 

The expansion of communication channels for patients 

and staff proved to be very useful in helping us 

promote the hygiene messages. 

The review and updating of cleaning specifications 

continued in 2008 and was supplemented by the 

launch of hygiene audits at ward level. Improving the 

hospital’s cleaning standards is expected to continue 

and will be developed further in the 2009 Hygiene 

Plan. The roll out programme of local audits to general 

areas within the hospital will also be a priority in the 

coming year. 

Cost containment plans and value for money reviews 

will be necessary in 2009 if we are to continue to meet 

current standards. The planned opening of new services 

including the new theatre block and the newly refurbished 

St Clare’s Ward in early 2009 is expected to significantly 

increase demands on all the services and budgets. 

237 

Return to Contents



Household Services 

The household function provides support services to 

ensure the rest, welfare and the accommodation 

facilities for the staff and patient’s relatives are 

maintained to the highest standards. The team are 

responsible for the co-ordination of all contracted 

household service providers and work extensively at 

local level with departments to ensure services are 

delivered in an efficient and proactive manner. 

In 2008 the department initiated minor refurbishment 

projects including the planning and commissioning of 

the new Staff Rest Room. 

Household Services continued to work in conjunction 

with the hospital’s cleaning service providers Noonan 

Services Group to monitor cleaning outcomes and 

participated in many quality improvement initiatives. 

Household Services directed its focus in 2008 to the 

preparation by the Hospital for the HIQA Hygiene Audit 

and developed new policies and procedures to 

supplement the new initiatives introduced within the 

department. The department implemented a new 

curtain changing procedure and continues to monitor 

weekly changes to maintain standards. The Household 

staff participated in the Hospitals Hygiene Awareness 

Week and found this to be very beneficial and 

productive. 

In late September the department bid a fond farewell 

to Margaret Beyan, who decided to retire after a 

number of years of dedicated service. Ms Kathleen Gill, 

Department Supervisor and the all the Household Team 

wished Margaret bon voyage with a farewell party, 

which was attended by staff from other departments. 

The staff compliment for 2008 is currently 35. 

Portering Services 

The Portering department provides support services to 

a diverse range of departments around the hospital 

campus. Departments serviced include complex areas 

such as Laboratories, Theatres, Pharmacy, Radiology, 

Ambulatory Day Care Clinics and the large Waste 

Management Section. The Department continues to 

develop its responsibility for the provision and coordination 

of whole hospital activities such as waste 

management, post and patient transport. 


The staff compliment in 2008 was 93. Mr Gerry 

Noone, Portering Services Manager retired from the 

department after 39 years of dedicated service in 

September and we would like to wish him well in his 

retirement and acknowledge his dedication and 

commitment to the department during his time in the 

Hospital. 

Congratulations to Mr Donal Sheeran, who has taken 

up the role of Acting Portering Services Manager. In 

addition there were several career advancements by 

staff into supervisory roles and we wish them and all 

the new recruits to the department every success in 

their new roles. The co-operation received from all 

members of the department during the changeover of 

management was appreciated. 


Demands on the service increased significantly during 

2008 due in particular to the commencement of 

numerous hospital re-development projects. The 

decanting and relocation of departments to facilitate 

refurbishment projects was a logistic challenge that the 

department confronted with their usual resourceful and 

hands on approach. The department looks forward to 

continuing to support project developments in 2009. 

Following a review of reception services at the main 

entrance, a restructured approach was taken to improve 

the service to complement the needs of patients and 

238 

Return to Contents



visitors. Staff participated in customer service focused 

training sessions and the desk area was redesigned to 

help identify it as a central enquiries point for visitors 

and which allowed staff to approach their roles in a 

more professional and courteous manner. 

Waste management continued to be the focal point for 

2008 and the hard work of all the portering staff in the 

department was instrumental in achieving top marks in 

the bi-annual Dangerous Goods Safety Audits. The 

waste management structure was further strengthened 

by the appointment of Mr Derek Martin as the new 

Waste Marshall. Derek has been working closely with all 

the hospital departments and external contractors to 

develop initiatives to enhance the management of the 

waste stream throughout the hospital and to promote 

education of staff. 

Staff training continued throughout the year and a total 

of 17 staff participated in the ‘Skills Programme’. All 

new staff now complete their mandatory training i.e. 

manual handling, fire training during the employee 

induction programme and this has been very beneficial 

for the department. 

Security 

The Hospital’s Security Department plays a central role 

in the management and co-ordination of our safety and 

security activities on the campus. The Hospital is 

committed to provide a safe and secure environment 

for all employees, patients, visitors and contractors. 

The Security Manager was also actively involved (right 

from planning stage) of major developments around 

the campus. This has proved to be a success in 

ensuring security and access control issues are 

incorporated into development plans and addressed 

prior to work commencing. 

The department operates on a 24 hour 7 day a week 

basis, with particular focus on fire and emergency 

response procedures. The department participates in a 

number of quality improvement committees such as 

the Safety, Risk and Quality Improvement Group, Fire 

Safety Group and the Health & Safety Committee. 

Jim Mitchell manages the department and the staff 

compliment in 2008 was 16. 

239 

Return to Contents




The Department participated in review of traffic flow 

and parking needs on the campus that led to the 

recon-figuration of the staff and public car parks. This 

included the creation of an additional 10 designated 

disabled parking spaces, which increased the number 

permit spaces to 42 across the campus. 

2008 was a busy year for the department, particularly 

with the commencement of so many building projects. 

This was a major challenge for the department from a 

traffic management and security aspect. Another major 

challenge faced by the department during the year was 

staff shortages and meeting services demands at times 

was extremely difficult and on occasion was 

supplemented by the recruitment of agency staff. 

One area that has seen a rise in the demand for 

intervention by security personnel is the Emergency 

Department. This is due mainly to the growing number 

of verbal and physical assaults experienced by staff 

from members of the public. Security is present on 24- 

hour 365-day basis within the Emergency Department. 

The Security team continue to work very closely with 

the medical and nursing staff to ensure staff and patient 

safety. 

The department continued to roll out access control in 

various departments including Theatre and Liver Unit 

and issued approximately 1000 new cards and 

reactivated 1500 cards this year alone. Access control 

was also introduced to all staff car parks to help control 

and improve parking within the campus. 

The department continues to facilitate staff participation 

in training programmes with emphasis on patient 

handling and fire safety. 

Technical Services 

Technical Services is responsible for the management, 

design, installation and maintenance of engineering 

services within the Hospital. It is also involved in the 

broader areas of energy management and sustainability 

planning. Four key areas of activity in 2007 were: 


Due to the amount, complexity and cost of building 

services in new developments, systematic inspections 

and routine maintenance were devised to ensure 

continuity of good service and economy of resources. 

New maintenance schedules were planned using the 

manufactures specifications with O&M manuals. As 

most of the equipment was on a first year schedule, 

isolation and hazards had to be identified to ensure 

continuous support to the hospital. All plant equipment 

was identified and ranked to ascertain the impact of a 

failure to the hospital. Planned preventative maintenance 

was introduced to avoid disruption to the activities of 

the various areas covered, i.e. chillers were maintained 

in off peak hours. The new Allied Health Department 

Refurbishment came on stream in 2007. The process of 

integrating new developments into the campus has 

been a demanding, challenging and interesting one and 

we look forward to implementing the lessons learned 

as future projects come on stream during 2009. 

Estates Strategy Technical Services Projects 

Technical Services was a key stakeholder in the 

development of the Estates Strategy Group. Its Projects 

Team completed a substantial number of new projects 

with the combination of in-house technical services staff 

and outside contractors. 

A summary of these is: 

• Catheterisation Laboratory Recovery Room 

Refurbishment 

• Window replacement included ward isolation 

cubicles and ancillary areas 

240 

Return to Contents



• Cardiology ECG Offices 

• Medical Records Filing Room Refurbishment & 

Mobile shelving Replacement 

• Dryer & Cleaning Room Refurbishment 

• Clinical Services Building Air Conditioning 

• Roof repairs on Ancillary Buildings 

• Numerous office upgrades were completed around 

the campus 

• Bone & Joint Treatment Room 

• Ward Courtyard Drainage Revamp 

• HSSD Reverse Osmosis Plant Upgrade 

• St. James Ward Room Conversions 

• Catering Department new main kitchen flooring and 

window replacement 

Planned & Reactive Maintenance 

Day-to-day operational maintenance continued within 

the department, the online helpdesk - PEMAC received 

over 10,000 requests. All reactive maintenance was 

prioritised to achieve a quicker and more streamlined 

response. With the help of our online helpdesk all 

requests can be logged & tracked electronically to allow 

for more positive feedback. Planned preventative 

maintenance programmes were implemented for 

engineering plant and building services to eliminate 

failure and break downs, a brief outline of areas 

maintained is as follows. 

Asset Plant Management 

AHU’s and air conditioning 

Central Plant Operations 

Cleanroom validation 

Carpentry Repairs 

Emergency Lighting Test & Repair 

Environmental Testing – 

Events Set-up – indoor 

Electrical Maintenance & Repairs 

Fire Alarm Testing/Management 

Fire Hydrant & Sprinkler Testing 

Flooring Repairs 

Generator Maintenance 

Glazing Repairs 

Infection Control wall washing 

Landscape maintenance 

Lock Repairs & Key Replacements 

Medical Gas Pipeline Systems 

Night-time maintenance / Emergency Call –out 

Facility Response 

Nurse Call Systems 

ICT Network Cabling 

Painting 

Phone Maintenance & Installation 

Plumbing Maintenance & Repairs 

Roof Repairs 

Service Contract Management 

Signage Maintenance & Replacement 

Site Grounds cleaning and general maintenance 

Storm Drainage Maintenance 

Uninterruptable Power Supplies 

Water Chillers 

Water management 

Window Repair 

241 

Return to Contents



Energy & Utility Management 

Operating data recorded through a Building Management 

System is monitored and corrective action was initiated 

to ensure an efficient energy usage policy. Areas were 

identified for control upgrades which will allow for more 

automated control and decreases energy expense. 

Water management continued with the sampling and 

testing across various areas on the campus to ensure 

the services comply with the relevant standards and 

decrease the risk of legionella. The impact of new 

developments led to increased loads, notably electrical 

which was 2.25 KWT max demand and water which 

was 430,000 litres daily. 

The Technical Services Manager is Peter Mortell and the 

department has a complement of 46 staff. Staff 

changes in 2007 were: William Hanlon, Deputy 

Technical Services Manager and John Hickey, Electrician 

who left to pursue new career paths and we wish them 

success. Also we would like to welcome Ciaran Ryan, 

Leo Hughes Deputy Technical Service Manager, Facilities 

Engineer, Robert Coffey and Derek Kelly, Electricians to 

the Department 

Telephone and Communication 

Services 

The Telecommunication Department provides 

switchboard and other communication related services 

to internal and external customers. The Switchboard 

staff are responsible for handling and dealing with over 

1,300,000 internal and external calls per annum. The 

department is committed to providing the hospital and 

its associated services with a professional and efficient 

service at all times. 

In addition to our main responsibility as the call centre 

for the Hospital the department is also responsible for 

all hospital long-range pagers and bleeps. The 

department also continues to offer technical assistance 

following new developments and refurbishment 

programmes. This proved to be a busy facet of the 

department in 2008. 


The Telecommunications Supervisor is Bernie Deignan. 

The service operates on a 24-hour 7-day basis and is 

staffed by a team of 14 full and part time members 

who continue to provide a first class service. 

242 

Return to Contents




The Department is working on a range of strategies to 

help reduce the number of calls to the switchboard. 

The priority of the Telephony staff in 2008 was to work 

towards improving customer service through a 

reduction in “call waiting” or ‘speed or answer’ times. 

To help eliminate any “unnecessary” directory related 

calls looking for contact numbers / extensions etc, work 

commenced on the design and specification for a new 

Hospital Telephone Directory. Following approval of the 

basic layout design by Senior Management, a draft 

version was launched on the hospital intranet site. It is 

hoped that a fully comprehensive directory should be 

completed by mid 2009 and will include key contact 

details for the other hospitals in the St Vincent’s 

Healthcare Group. The objective of this is to allow the 

Telephony staff more time to focus on external calls 

thereby improving answer response times. 

The department continued in its role as a key 

stakeholder in the co-ordinating of all internal 

emergency communications and Major Emergency Plan 

activations. The department participated in a simulated 

Major Emergency activation, which proved to be a great 

learning and productive exercise. The department 

implemented all observations and recommendations 

following the desktop exercise. 

Finally 

General Services would like to express our thanks to 

staff in all its departments for their hard work and 

commitment to the team over the past year. Also to 

acknowledge the other departments that work in 

association with us in helping us to deliver a quality 

service in a customer focused manner. 

243 

Return to Contents


Report from the Human Resources Department 

Introduction 

The HR Strategy & Action Plan (2007-2010) was 

completed in December 2007, following extensive 

consultation, and was formally launched in February 2008. 

Since that time the HR team has been working in cooperation 

with managers and staff across the hospital in 

advancing a range of projects, initiatives and activities 

linked to the six themes in the Action Plan itself. Some 

restructuring and reorganisation has taken place within 

the HR function to better position the Department to 

address this change agenda. 

Significant progress was made on this programme of 

work in the first year and we have an overall ‘game 

plan’ for the remaining two years. Action areas within 

the plan are being progressed by specific Divisions 

within the HR Department, others by cross-divisional 

HR teams, with appropriate input in both cases from 

managers and staff here in the hospital. 

The HR function developed a suite of ten HR key 

performance indicators (consistent with the nine 

hospital wide high level indicator set) which link to key 

activities within the plan. These indicators include 

managing probation, retention management, 

attendance management, staffing levels, overtime 

hours, agency hours, average time to fill a vacancy, 

pension cases pending, number of teams engaged in 

TBPM and number of staff who have successfully 

completed their first PDP discussion. They are monitored 

and rated on the ‘RAG’ traffic light system monthly. Below 

you will see some of the key areas we are currently 

working on and which progressed during the year. 

Organisational Development 

In line with the corporate and organisational 

development strategies of 2006 and 2007, 2008 has 

been a year of accelerated development. Moving from 

initiation in 2007 to implementation and roll-out in 

2008 the organisation has embraced and deepened 

performance management, team development, 

management development and enhanced internal 

communication as part of its culture aligned to the 

mission. Learning strategies and events are now aligned 

to operational strategies. Key performance indicators in 

clinical areas focus on the patient, the service and on the 

performance and development of staff and teams who 

deliver those services. Continuous improvement initiatives 

are beginning to be tracked in association with KPI sets 

which facilitates preparation of teams and services for 

accreditation and this will become an increasing area 

for focus in 2009 as we approach our first JCI audit. Remapping 

of the reporting structure of the organisation 

has commenced and will be completed in 2009. This 

area of focus is foundational to the continuous 

improvement of manager to team communications and 

of individual developmental discussions. Foundations 

have also been set for the involvement of multidisciplinary 

teams for example in ICU, theatre, in joint setting of 

KPIs for 2009. External validation of the efforts of the 

hospital in development and continuous improvement 

are seen in consistent positive feedback from Healthstat, 

PMU and Partnership. 

If we examine the Organisational Development template 

of 10 action points under the 3 strategic headings 

Performance Management, Training Strategy and 

Communications Strategy, 9 out of 10 items are 

progressing to plan with line manager briefings requiring 

renewed impetus especially in preparation for JCI 

accreditation. 

Partnership 

The accomplishments in 2008, of staff, management 

and union representatives in this hospital working 

together to improve the service to patients in line with 

the Mission of the group have been exemplary. In 

February 2007 a plan was proposed, supported by 

Partnership and brought to reality through the Hospitals 

long standing and innovative approach of partnership, 

to deliver for our patients on our mission of 

“…excellence in clinical care, education and research. 

244 

Return to Contents



• A series of structures, processes and training 

interventions 

• To transform management processes and 

communication processes 

• Alignment of Team efforts with Key Performance 

Indicators derived from Strategic/Service plans 

• Improve the service that we deliver 

• Devise training strategy 

• Gain support 

• Roll-out training strategy 

• Monitor progress and efficacy to KPI’s 

from the SVUH Partnership Service Plan, 19 Feb 2007 

Starting from the 2006 SVHG strategic framework, as a 

base, and building step by step, Partnership and the 

plans and projects that have been supported by the 

HSNPF, have consistently contributed to the kinds of 

service improvement seen below: 

Service improvements 

ALOS (length of stay) 

from 11.4 Jan 08 to 9.3 in Dec 08 (18%) 

MRSA metric 

from 238 in 2006 to 136 in 2008 (43%) 

In-patient waiting list 

from 1079 Jan 08 to 195 in Dec 08 (82%) 

Delayed Discharge 

40 in Jan 08 to 15 in Dec 08 (62%) 

A&E over night stays 

20.9 avg 2007 18.7 avg 2008 (11%) 

Other KPI’s 

• 73 Teams in place under Team Based Performance 

Management 

• 258 training courses run in 2007 with 3552 staff 

• 353 training courses run in 2008 with 5059 staff 

Feedback from managers at end of year on 

training of staff: 

• Application of learning to workplace 30% above, 

69% met, expectations 

• Relevance to the job 

23% above, 76% met, expectations 

• Improvement in work performance 


• Contribution to the Team 


We have built up Partnership (formally) and partnership 

on a practical level in this Hospital over many years 

with the intention of having closer and stronger 

involvement of all of the partners in this organisation in 

delivering an excellent service to our patients: present 

and future. 2008 has been a year when the tangible 

results of the Partnership ways of working, have been 

evidenced. 

245 

Return to Contents



Learning and Development 

2008 saw the Learning and Development Division 

continue to support the Hospital’s mission of delivering 

excellent care to patients by providing and supporting 

learning, throughout the organisation. Learning takes 

place in SVUH on a continuous basis through teams 

giving in-service training, departmental trainers, the Skill 

Project, the Nurse Education Centre, the Education & 

Research Centre and the Library. The Learning & 

Development Division continues to work with trainers 

throughout the hospital in the provision of these various 

training interventions. 

Learning & Development led the development of a new 

3 day Corporate Induction Programme which was 

launched in March 08 for all new staff joining the hospital. 

Other internal programmes available to staff during the 

year included: the Legal Framework 1 and 2, The 7 Habits 

of Highly Effective People, Team Based Performance 

Management, Trust in Care in addition to various 

mandatory training programmes. The development of 

the “How to Series” of short workshops for managers 

continued with the roll out of workshops such as ‘How 

to Give and Receive Feedback,’ and ‘How to Manage 

Difficult and Aggressive Behaviour.’ Developments for 

2009 will include further expansion of the ‘How to 

Series’ management development initiatives and the 

delivery of ICT training for staff. 

Learning & Development provides information and 

support to staff to enable them to complete Personal 

Development Plans. These plans are a way of aligning 

the individual’s development needs with the 

organisation’s goals and objectives. This process allows 

individuals to assess their current skills on an online 

system and to meet with their manager to discuss their 

future personal and professional development plan. 

In 2008 we were in a position to support staff undertaking 

third level courses to further the development of 

their professional skills and knowledge. The M. Sc. in 

Creative Leadership with the Royal College of Surgeons 

(with the support of the other Dublin Academic Teaching 

Hospitals) entered its second year in 2008. The objective 

of this programme is to develop future leaders of the 

hospital and the health service and forms part of our 

leadership development and succession planning 

strategy. 

The hospital continued to support the National SKILL 

Programme and achieved the objective of becoming a 

critical mass site in 2008. The programme is run in 

conjunction with the VECs and is for Support Staff and 

Support Staff Managers to improve and develop their 

professional skills and practices while achieving FETAC 

Certification. There are over 40 Support Staff participating 

in this programme. 


For the Employee Relations Division of the HR 

Department 2008 was a particularly demanding year. 

The Employee Relations Division works closely with 

Heads of Service/Line Managers in advising on the 

provisions of employment legislation, managing 

performance, employee grievances and managing 

attendance. In addition it also provides additional 

support to the operational areas of HR in relation to 

preventing and resolving issues which affect work 

situations and service delivery. 

Some of the key activities of the division are: 

a) Advice: Advice is provided to Heads of Service/ 

Line Managers on how to address poor performance 

and deal with employee misconduct. The provision of 

guidance on the application of policies and procedures 

on matters such as grievance and disciplinary, disputes, 

Dignity at Work, Trust in Care is a key activity. 

b) Information: Information is provided to 

employees to promote a better understanding of 

management's goals, objectives and policies. 

Information is also provided to employees to assist 

them in correcting poor performance, on or off duty 

misconduct, and/or to address personal issues that 

affect them in the workplace. Employees are advised 

about legislation, applicable employment regulations 

246 

Return to Contents



and collective bargaining agreements. Employees are 

also advised about grievance and disciplinary policies 

and procedures and other policies such as Dignity at 

Work, Trust in Care and “whistleblower” protections. 

c) Representation: Representing the Hospital at 

third party hearings involving Equality Tribunal, LRC 

Conciliation Service, Rights Commissioner Services 

and Labour Court. 

Key activities for the Division during 2008 were: 

Enhancing, promoting and maintaining positive employee 

relations at local level through meaningful engagement 

with employees and their representatives regarding 

impending/ongoing change. In this context, also 

ensuring compliance with the provisions of Towards 2016. 

The recruitment of a HR Relationship Manager to work 

with the HR Director and Deputy Director in translating 

the HR strategy into practical applications which support 

the Hospital’s service plan. The HR Relationship Manager 

also works closely with the operational Heads of HR in 

providing professional HR/ER advice and innovative 

solutions which create positive and sustainable outcomes. 

Supporting and enhancing the skills of Heads of 

Service/Line Managers in employee relations to enable 

them to resolve employee problems quickly and 

informally whenever possible. 

Responding to expanding body of legislation regarding 

employment rights. 

Developed and implemented new models for workplace 

investigations in line with relevant policies and “best 

practice”. In this context the division worked with an 

external provider to deliver Investigation Training for 

managers involved in investigations conducted under 

the Trust in Care Policy. 

Participation in initiatives such as HR Strategy 

development, Partnership, Accreditation and Smoke 

Free Campus. 

Participation in national talks in relation to the extended 

working day/week under clause 30.4 of Towards 2016. 

Delivery of the reports for the Performance Verification 

Process Phase 4 (June 2008) under the terms of 

Towards 2016. 

Monitoring and review of attendance records in line 

with national guidelines for Health Service Employers 

on Managing Attendance. 

Workforce Planning, Resourcing and Information 

Management Division 

The Workforce Planning, Resourcing and Information 

Management Division was formed as a result of restructuring 

in the HR Department in the latter part of 

2008. This re-structuring followed from the development 

of the HR Strategy. The functions of the Division are in 

the main a re-configuration of existing services (e.g. 

Resourcing and Retention Division, Employment Control, 

HR Systems, Information Management & Pension 

Scheme Management – Benefits Unit) which are 

provided by the HR Department. However some 

elements of the portfolio have been strengthened. For 

example integrated organisation wide Workforce Planning 

is assuming a new importance and is at a very early 

stage of development. 

The development of organisation wide and integrated 

workforce planning was highlighted as a key priority in 

our HR Strategy. It was summarised well in our strategy 

as “…. a discipline which is, as yet, at a fairly embryonic 

stage in its development and in its application within 

the health service in Ireland. It is a very complex 

activity, especially when it is multi-disciplinary, as it 

involves formalising the assessment of need, skill mix, 

numbers, etc. for a given service.” 

The Exit Survey Model was reviewed and rolled out 

across the Hospital in 2008. The survey is designed to 

obtain feedback from employees leaving the hospital 

on working conditions and experiences during their 

time in St. Vincent’s University Hospital. The information 

247 

Return to Contents



gathered is used to identify general employment trends, 

to support staff retention and to make continuous 

improvements in the workplace including improved 

employee satisfaction where possible. 

The provision of an Employee Benefits service is also a 

key element of the Division and this includes the efficient 

management of the Hospitals Pension Scheme. The 

Benefits Section was successful in meeting its 2008 

deadline for the project to assess the eligibility to 

reckon prior part time service for our current and 

former staff. This resulted in a significant number of 

staff, who had previously been excluded from the 

pension scheme, gaining access to pension benefits. 

Significant progress was also made on the development 

of a pensions management module on the Hospitals 

payroll system (Northgate). 

HR Operations - Nursing Division 

In 2008 the HR Operations in the Nursing Division 

worked closely with the Senior Nurse Management 

Team to deliver on a number of goals and objectives, 

which were designed to support the provision of highclass 

healthcare by all nursing staff. Key objectives and 

achievements include the following: 

Recruitment and Retention 

Against the backdrop of the economic changes as the 

year progressed, there were still considerable 

achievements in key recruitment and retention initiatives 

during the year. In total 138 staff joined in 2008, 66 of 

which were management level positions. St Vincent’s 

University Hospital witnessed an unprecedented number 

of applications to the Graduate Nurse Programme and 

consequently the standard of applicants considered for 

places was higher than ever before. Applications were 

received from 12 different universities across Ireland 

and the UK and fifty newly qualified nurses commenced 

employment on the enhanced Graduate Nurse 

Programme in August and November 2009. There was 

reduction in overseas recruitment in 2008 with a single 

overseas intake in May 2008. Foundation level courses 

in Critical Care and Peri-operative were run by the 

respective specialist areas in conjunction with the Nurse 

Education Centre to assist with recruitment, development 

and retention of specialist nurses. 

Supporting Nurse Developments 

The Nursing Division of the HR Department has also 

actively supported a number of developments in the 

Nursing Division such as: 

– Supporting the introduction of nurse prescribing 

model 

– Assisting the move from a 3rd year 12-month 

Rostered Placement for Nursing BSc Students to 

a Student Nurse Intern Model. 

Supporting Performance Management 

In 2008 Nursing HR supported and assisted Nursing 

Managers with over a hundred employee relations 

issues ranging from managing performance issues, trust 

in care, attendance management, grievance and 

disciplinary issues. 

Nurse and Health Care Assistant Bank 

The Nurse Bank was formally established in October 

2007 with the appointment of Ms Liz Tuohy, Nurse 

Bank Manager and her team. After achieving significant 

savings in its first year, the Bank was extended to include 

Health Care Assistants in 2008. 

HR Operations - Medical Division 

2008 has been an extremely busy and challenging year 

for the Medical HR Division. In terms of recruitment, 

Medical HR appointed 275 new doctors to the hospital. 

This included the appointment of over 250 Non 

Consultant Hospital Doctors, 2 Permanent Consultants 

and 19 Locum & Temporary Consultants. The number of 

permanent consultants appointed was low in comparison 

248 

Return to Contents



to previous years as the appointment of permanent 

consultants was suspended pending agreement of the 

new consultant contract. 

Agreement on this was finally reached at the end of 

July 2008, with permanent consultant interviews taking 

place in the last quarter of 2008. 

As mentioned the new consultant contract, which is 

known as ‘consultant contract 2008’ was finalised in July 

2008. Consultants were asked to indicate in writing if 

they wished to opt for the new contract or remain on 

their existing contract. Consultants who opted for the 

new contract were then issued with a personalised copy 

which in turn was signed by the Group CEO and any 

associated employers. This meant a considerable volume 

of work for the Consultant Team who also undertook 

the above task for St. Michael’s Hospital consultants. 

The close off date for acceptance of the new contract 

was 31st December 2008. Out of a total of 173 

consultants, 148 accepted the contract, which means 

85.5% of consultants employed by the St. Vincent’s 

Healthcare Group are now working under the terms 

and conditions of the new contract. 

The postgraduate administrator role was incorporated 

under the remit of Medical HR in June 2008 and has 

brought advantages in terms of cross-cover and other 

support for this role. 

As Medical Human Resources already has responsibility 

for administration of the Post Graduate Medical & 

Dental Board Training Fund, as well as the NCHD 

Training Grant, this allows Medical Human Resources to 

provide an enhanced Learning & Development service 

to medical staff. 

A review of Post Graduate input into ‘Grand Rounds’ 

resulted in changes being made to the way these events 

are publicised around the hospital. Email notifications 

are now sent on a weekly basis and posters are more 

widely distributed and displayed. Prizes have also been 

introduced for Best Attendance, Best Presentation and 

Best Speaker in an effort by Medical HR to increase 

attendance, which have been well received. 

HR Operations - Clinical Administration and 

General Services (CAGS) Division 

The HR CAGS Division is an integration of HR 

resourcing and retention and HR Services for the 

Clinical, Administration and General Services areas of 

the hospital. 

This integration occurred end September 2008. From 

September 2008 the division has developed a 

partnership with the relevant Senior Management Team 

members with the aim of providing a customer focused 

overall HR Service covering clinical, administrative and 

general services. This includes: 

Recruitment and Retention 

The CAGS HR Division continued to promote HR 

‘Best Practice’ for recruitment and selection of staff. A 

total of 261 clinical (excluding medical and nursing), 

administrative and general support staff were 

recruited throughout the year filling a wide variety of 

temporary, permanent and locum roles. 

Supporting Policy Developments 

Contributing to the ongoing development and 

implementation of HR policies, procedures and 

practices, consistent with the development of ‘Best 

Practice’ people management in the service. 

Supporting Management 

Providing ongoing advice and support to the relevant 

members of the Senior Management Team and 

Heads of Service/Line Managers on all HR matters. 

249 

Return to Contents


Information and Communication Technology Department ICT 


In 2008 we were glad to welcome Reno Jacob to the 

department as a replacement member to our support 

team. We also recruited two additional contract project 

managers Janet Daly and Martina Corcoran to support 

the implementation of systems both within St. Vincents 

University and St. Vincents Private Hospital. 

Service Development/Activities 

It was a busy year for the ICT Department with the 

completion of existing projects and the commencement 

of new projects. Our strategy in recent years was to 

focus on consolidating our infrastructure creating a 

stable platform on which to build our clinical application 

portfolio. Having created a stable infrastructure we are 

now focused on implementing and enhancing new and 

existing systems. 

Projects completed in 2008: 

Our projects team continued to provide application 

support upgrades and enhancements for applications 

within the hospital. The team also continued to respond 

to change requests/ report requests for systems such 

as Emergency Department, Allied Health Systems, 

Nurse Bank, and PAS. 

The following projects went live in 2008: 

• Breast Symptomatic This system went live in the 

last quarter of 2008. An expansion of the Excelicare 

system, it supports the entire patient journey 

through the breast service. 

• In March we implemented the Endorad Endoscopy 

System. This not only digitally captures and stores 

endoscopy studies but also has a web client for 

image distribution and tracks the patient journey 

from scheduling to reporting. 

• The Clinical Intensive Care Unit Management 

System went live in August. This system is 

seamlessly linked to medical monitoring equipment 

and PAS. A second phase will be implemented in 

2009 which will include a full Pathology interface. 

• We worked with Media One, a subsidiary of Eircom, 

to develop a new SVUH and Group Website which 

went live in July and to create a new Group Intranet 

which was completed in November 2008. Both of 

theses solutions have user friendly content 

management systems which will ensure that 

information remains up to date. The website and 

intranet significantly enhance our internal and 

external communications capability. 

250 

Return to Contents



• A body of changes were implemented on SVUH 

PAS to address some data integrity issues and 

provide additional functionality. 

• DI DIVER –In June we went live with a new version 

of our Management Information System (MIS) 

called Health Diver. While this data-mining tool 

provides comprehensive reports and adhoc queries 

on core systems internally and externally, one of its 

main advantages is its portal and dashboard 

capability. We have used this to deliver the SVUH 

Key Performance Indicator and Corporate Dashboard. 

• Northgate were engaged during July 2008 to 

review management information capability and to 

suggest the development of this service moving 

forward. Northgate have significant experience of 

the delivery of MIS solutions within the UK. The 

main areas covered were the current capability an 

assessment of the tools at our disposal, advice on 

the development of a data quality service and 

areas for the next phase of development. 

This was a very useful exercise an we will use their 

recommendations in our future ICT information 

developments. 

Initiatives commenced in 2008: 

At the end of 2008 we received capital funding to carry 

out enhancements to existing systems and for a 

number of add on solutions to existing systems. 

PAS enhancements: 

We are implementing a number of PAS developments 

covering functional changes and increased data integrity 

measures. This includes: 

• Patient Wristbands: a bar-coded patient wristband 

system which will produce wristbands with typed 

rather than handwritten patient details thus reducing 

the risk of incorrect identification. The wristband will 

also include a code 39 and 2D barcode, which will 

be a cornerstone of initiatives in areas such as 

Phlebotomy, Pharmacy and Haemovigilance. 

• Bed Management: a module as an add-on 

application to our existing patient administration 

system, to improve patient flow from admission to 

discharge. This system will help to achieve this by 

accurately deriving bed availability, by improving 

bed occupancy and automating key elements of 

bed turnaround. 

• Patient Texting: a general texting solution for the 

hospital but with the added advantage of integration 

to the Patient Administration System. This can 

therefore be used as a text reminder tool for 

patients. 

Cancer System 

We are implementing phase two of the cancer clinical 

system using the Excelicare application from Axsys 

Technology, this has links to the Patient Administration 

System as well as diagnostic systems e.g. Pathology. 

Departmental Systems 

• We are implementing an Excelicare Framework 

System of integrated clinical departmental systems. 

This suite of applications will form a clinical data 

repository with interfaces to the Patient Administration 

System (PAS) and diagnostic systems (such as 

Pathology) and advanced reporting tools. The first 

example of this will be the Inflammatory Arthritis 

System which will go into UAT in January. 

• Complaints and FOI Database 

• Digital Dictation - we procured the TA+ application 

from DictateIT/CBay Systems this year to replace 

251 

Return to Contents



our analogue dictation system. This system is fully 

integrated to our patient administration system and 

can therefore associate voice files with the patient 

record. It offers greater flexibility in terms of 

recording and accessing dictated records as well as 

higher quality digital functionality. 

• Healthlink – Radiology Reports to GP’s within our 

cachement area. 

Operations 

Support 

2008 was a very busy year for our helpdesk; we 

received an increase of 2,317 calls put through our 

helpdesk system. Out of these 14,575 calls we 

improved our SLA by 9.59% on 2007. Throughout 2008 

we closed 89.02% of our calls within our agreed SLA. 

Accreditation 

Assisted Pathology with their INAB accreditation and 

SVPH with their JCI accreditation. 

Network 

We completed our network upgrade; all areas are now 

running at a minimum of 1Gb to the desktop with a 

10Gb backbone. We also completed the network 

integration between SVUH and SVPH. Completed 

phase one of wireless coverage, 65% of the hospital 

campus is covered by Wi-Fi. 

Internet Access 

Upgraded our old 100Mb single link to the internet to 

two 1000Mb (1Gb) links to the internet. This has 

greatly improved our connectivity to the internet and 

other hospitals. We expanded the number of hospital 

and healthcare accessing our network to include National 

Maternity Hospital, Our Lady’s Hospice, Beaumont, 

Mater, Healthlink, GE Medical (India), Charter Medical 

(UK), D3 (USA), St Luke’s Hospital, Breast Check Unit, 

Royal Victoria Eye and Ear, NorthGate, National 

Rehabilitation Hospital, St. Vincent’s Private Hospital, St. 

Michael’s Hospital, Dr Stephen’s Hospital, HSE, Mater 

Private and UCD. 

Server Infrastructure 

Increased our Storage Area Network storage capacity 

from 11Tb to 31Tb, we now have 87% of all systems 

directly SAN attached. This has greatly improved speeds, 

security and disaster recovery solutions from these 

systems. Working with SVPH we have now replicated 

all of this data to a second identical SAN which will be 

moved to the new SVPH building in 2010. We 

continued to increase the size of our VMware and 

Blade Chassis environment. We now have 68 servers 

running on VMware and 37 servers running on Blades. 

252 

Return to Contents



Security 

Our overall security rating has improved from a 3.7 in 

2007 to a 1.3 (5 being bad, 1 being good). This security 

rating brings the overall hospital security in line with 

financial and banking sectors. We have achieved this 

through the following programmes 

• Laptop Encryption 

• USB encryption 

• Anti Virus Software Upgrade to include additional 

tools like spyware detection, intrusion detection, 

network security, desktop security, server security 

• Improved password protection 

• ICT released 26 SVHG Security Policies 

Disaster Recovery & Business Continuity 

Designed and implemented an improved backup 

strategy. We have used the geographically dispersed 

locations of the three hospitals within the group to 

ensure all of our backups are located in four locations. 

This ensures we have off site disaster recovery options. 

We have reused the old PACS equipment to place large 

SANs and tape libraries in three different buildings in 

SVUH, SVPH and STMH. This has been fully audited 

and meets ISO standards. All data is fully encrypted 

and secure. This has also greatly reduced the backup 

and restoration times for all of our systems. 

We now have 27Tb of SAN for backups located in three 

locations in SVUH, 8Tb in STMH and 157Tb of tape 

library located in SVUH and SVPH. All backups are now 

stored with 1024bit AES encryption. The amount of 

data we backup per month has increased from 3.9Tb in 

2007 to 14.9Tb per month in 2008. 

We developed disaster recovery plans for many of our 

core systems and will complete plans for all other 

systems throughout 2009. 

Archiving 

Implemented an archiving solution on our e-mail 

system and file servers. This ensures users an 

unlimited storage for their e-mails, personal file and 

departmental file shares. 

System Upgrades 

Upgraded server infrastructure of many of our existing 

departmental systems including 

• Q-Pulse 

• Clinical Engineering 

• Pharmacy 

• Payroll 

• Print Server 

• Domain Controllers 

• Microbiology 

• Xcelera 

• File Server 

253 

Return to Contents


Purchasing & Procurement Department 


Staff in the Supplies Department performed well in 

2008 and continue to achieve best value for money for 

products within their remit, in conjunction with user 

departments and suppliers. 


The Supplies Department were successful in merging 

the CSSD and Main Stores stock management systems 

towards the end of 2008. All products from both stores 

are now held on one stock master file and are 

requisitioned and purchased together. 

Due to an upgrade of the Integra Financial System 

during 2008, all Purchase Orders for mainstream 

suppliers are now automatically emailed once updated, 

which has significantly reduced the lead-time from 

order date to delivery date. 

Web based requisitioning for certain categories of stock 

items was also introduced in late 2008 and has proved 

to be hugely beneficial to the departments who use 

this function. 

Project Procurement 2008 

The past year saw the completion of the new Allied 

Therapy Suite, St Mark’s Day Care Centre, and St 

Christopher’s CF Unit. The equipping programme for 

the new Theatres in the Clinical Services Building is 

now complete with Theatres due to be commissioned 

early in 2009. 

Tenders for the 120 Bed Ward Building were issued for 

consultancy services, including Project Management and 

Design Consultancy. The EU Restricted Process was 

employed to invite interested parties to submit for prequalification. 

A short-list was prepared, with short-listed 

candidates being invited to tender for the contracts. The 

outcome of this process was the appointment of MCO 

Projects Ltd (Project Management) and Scott Tallon 

Walker Architects (Design Consultancy) for Stages (i) 

and (ii) of the this development. The Restricted Process 

has also commenced for the Design Build contractor 

who will be responsible for the construction of the ward 

building. 

Activities 

The Supplies Department placed approximately 21,800 

orders during 2008, amounting to a spend of €42 

million which includes the Purchase of Capital Equipment 

as well as consumable supplies. All tenders for the 

Procurement of goods, services and capital equipment 

are tendered using the Irish Government “e-tenders” 

website, which enables staff to upload tender documents 

for suppliers and eliminates the need to send out 

tender packages. The department also takes part in joint 

tendering procedures with the Hospital Procurement 

Services Group, which covers a wide range of product 

categories to secure contract pricing for the coming years. 

Staff continue to increase the amount of call-off and 

standing orders to suppliers in order to secure contract 

pricing for the term of the order and this also helps to 

reduce the amount of orders placed with a given supplier. 

Number of Purchase Orders Placed 

Total number 21,956 

Number of GRNs Processed 

Total number 34,689 

254 

Return to Contents


Purchasing & Procurement Department 

Gross Value of Purchases placed 

Non stock €39,148,500 

Stock €5,056,266 

Project €1,592,264 

Total €45,797,030 

VFM Achievements 

New Product Introduction €380,674 

Renegotiated Price Increases €74,769 

Credit Notes €119,502 

HPSG €31,780 

Total €606,725 

Future Plans 

The Supplies Department continues to expand the 

amount of pre-printed requisition lists to areas not 

presently using them. This makes it more efficient for 

departments to request non-stock products for purchase, 

as all the information required will appear on one list. 

Staff will also continue to expand the use of Web based 

requisitioning for stock items in early 2009, with a view 

to having non-stock items on agreed templates for web 

based requisitioning throughout 2009. 

Online requisitioning will be rolled out on a phased 

basis with the co-operation of user departments. 

• VFM savings plan €1,000,000, monitor and set 

targets 

To include; 

New product introduction, 

Product trials, 

Supplier price negotiations, 

• Roll out Stock Management system in new Theatres 

• Install storage and top up solution for St Luke’s 

1,2 & 3 

• Assist wards in management of stock levels 

• Extend exercise in stock removal and redistribution 

at ward levels 

255 

Return to Contents


Report from the Quality, Risk and Consumer Affairs Department 

IIntroduction 

The main components of the Quality Risk and Consumer 

Affairs division include; Quality and Accreditation, 

Insurance, Risk and Legal Affairs, Communications and 

Consumer Affairs. The Department focuses on 

engagement with patients and their families and staff 

with the objective of patient safety and quality care and 

service. 

Developments in 2008 

Quality Standards 

In 2007, the Irish Health Services Accreditation Board 

(IHSAB) was integrated into the Health Information and 

Quality Authority (HIQA). In late 2007, the St. Vincent’s 

Healthcare Group accreditation teams had completed a 

self-assessment against the IHSAB standards. In the 

absence of a national quality framework, St. Vincent’s 

University Hospital decided to review the requirements 

of Joint Commission International (JCI) accreditation 

standards. 

Joint Commission International (JCI) is the most widely 

recognised and longest running whole hospital 

accreditation scheme in the world and hospitals that 

achieve JCI accreditation are recognised as world class 

centres of excellence. In May 2008 three JCI consultants 

spent a full week at the hospital conducting “patient 

tracers” to assess both clinical and support systems in 

place. The Patient tracer methodology used by JCI 

aims to be patient focused by following patients 

through the hospital system. 

Following this visit, the hospital and the Board of 

Directors made the decision to become the first 

publicly funded hospital in Ireland to undergo JCI 

accreditation. The subsequent quality improvement 

report and a self assessment against JCI standards 

formed the hospital quality improvement action plan 

and a JCI Project Group was set up to guide this in 

September 2008. During 2008 a considerable amount 

of work was done by hospital staff along with the 

quality and accreditation team to ensure that the 

hospital was meeting JCI standards in preparation for a 

full hospital accreditation survey planned for 2010. 

Other quality improvement schemes and surveys have 

included the hospital assessment in October 2008 

against the national standards for breast cancer by the 

Health Information and Quality Authority (HIQA). A 

breast cancer quality improvement group was set up in 

late 2007 and met monthly during 2008 in preparation 

for this review. 

Hygiene Standards 

The Hospital Hygiene Quality Improvement Group 

(HHQIG) continued to meet in 2008 to ensure 

compliance with the national hygiene standards. A 

hygiene audit was undertaken by HIQA in November 

2008 resulting in an overall score of ‘fair’ for St. Vincent’s 

University Hospital. 2008 also saw the introduction of 

internal hygiene auditing and the development of 

hygiene key performance indicators (KPIs). 

Insurance, Risk and Legal Affairs 

The department in collaboration with an external 

Training Consultant ran a two day workshop on ‘Root 

Cause Analysis’ for senior managers within St. Vincent’s 

Healthcare Group. The aim of the course was to teach 

staff on how to carry out a systematic review arising 

from a serious untoward event. Subsequently, the HSE 

provided one-day ‘Systems Analysis Training’ course 

which was attended by a number of senior nurse 

managers from St. Vincent’s University Hospital. By 

year end, approximately 23 managers were trained in 

root cause and system analysis. 

The Clinical Indemnity Scheme (CIS) operations team 

provided great assistance to the SVUH risk management 

team in designing a local enterprise bespoke risk 

256 

Return to Contents



management report in 2008. This provides greater 

flexibility for the hospital when running trend analysis 

reports for hospital managers and committees. 

The Insurance, Risk and Legal Affairs Coordinator 

attended the Dublin Hospital Group Risk Managers 

Forum in 2008 and other members of the organisation 

provided their expertise to assist and participate with 

Sub Committees in designing very worthwhile policies 

and guidelines. 

Consumer Affairs 

In 2008, the Consumer Affairs office developed and 

implemented a Complaints Management Policy in 

keeping with national statutory requirements this 

included the provision of guidelines for staff in the local 

resolution of complaints, along with templates to 

support the complaints investigation process. Information 

for patients about the complaints process was 

published in leaflet and poster format, and a patient 

feedback form was implemented. 

The specification for a complaints management 

database was completed in 2008 and implemented in 

January 2009. This provides us with more meaningful 

data and reports about complaints for staff and other 

stakeholders. 

Hospital wide quality improvement resulted from many 

of the complaints investigated during 2008. Trends in 

complaints were analysed along with other quality 

indicators and presented for discussion and action to 

the Patient Safety Committee, and Clinical Governance 

Committee. A number of patient feedback activities 

were conducted during 2008 including feedback from 

in patients of the SVUH stroke service. 

A Customer Care Standard developed during 2008, will 

be rolled out through a front line staff education 

programme in conjunction with colleague in the HR 

Department during 2009. 

Communications 

Equally, the Communications division continued to grow 

and expand in 2008. Work was commisionned in 

February 2008 to design and implement a state of the 

art and user friendly Intranet for St. Vincent’s Healthcare 

Group. The intranet was design and built over a six 

month peroid and launched live to the three hospital 

sites in December 2008. 

The SVUH Website was also totally revised and all 

Heads of Department/Service were invited to engage 

with the Communications Team to ensure their content 

pages contained safe and accurate information. 

257 

Return to Contents



As per the communications strategy, the GP Liaison 

Group was reformed and a quarterly GP newsletter 

produced. A GP study day was also held and the SVUH 

website was updated with a new subsection that 

sought to deliver information that GP’s requested on a 

regular basis. This process has aided patients in 

receiving a more seamless transition between primary 

and secondary care. 

Plans for 2009 

• Implement the JCI International Patient Safety 

Goals. 

• Participate in national accreditation schemes and 

continue to self-assess against national quality 

standards. 

• Develop organisation–wide quality improvement 

initiatives. 

• Continue to promote staff and public awareness 

of the complaints process. 

• Develop and implement the hospital quality 

improvement action plan. 

• Commence tracer audits throughout the hospital 

to prepare the hospital and staff for a JCI survey. 

• Conduct hospital wide communication and 

training in relation to the JCI process. 

• Prepare the hospital for a JCI Accreditation survey. 

• Identify and develop organisation – wide quality 

improvement initiatives. 

• Implement phase two of the Intranet project. 

• Standardise all patient information produced and 

design and implement the first Patient Information 

Centre/Library for St. Vincent’s. 

• Standardise the system for managing and 

controlling hospital policies, procedures and 

guidelines. 

• Further develop channels for patient / consumer 

engagement. 

258 

Return to Contents


2008 Healthcare Group Committees 

Board Members 2008 

Professor Noel Whelan (Chairman) 

Mr. Nicholas C. Jermyn (Group Chief Executive) 

Ms. Gemma McCrohan 

Sr. Agnes Reynolds 

Sr. Eugene Butler 

Mr. Stewart Harrington 

Professor Bill Powderly 

Mr. Patrick Meade 

Mr. Michael Meagher 

Mr. Joe Leyden 

Mr. Conor Sexton (retired Dec. 08) 

Mr. W. R. Quinlan 

Mr. Edmond J. Bergin 

Ms. Louise English 

Dr. Michael Somers 

Dr. Risteárd Ó Laoide 

Professor Diarmuid O’Donoghue 

In Attendance: 

Mr. Cormac Maloney, Director of Finance & Company Secretary 

Mr. Michael Redmond, Chief Executive, SVPH 

Mr. Bill Maher, Director of Operations, SVUH 

Mr. Seamus Murtagh, General Manager, SMH 

Ms. Mary Duff, Director of Nursing, SVUH 

Sr. Mary Benton, National Director of Mission 

Members of the Group Executive 2008 

St. Vincent’s University Hospital: 

Mr. Nicholas C. Jermyn Group Chief Executive 

Mr. Bill Maher Director of Operations 

Mr. Cormac Maloney Financial Controller & 

Company Secretary 

Ms. Mary Duff Director of Nursing 

Mr. John McPhillips Director of HR 

Mr. Dermot Cullinan Director of I.T. 

Mr. Frank Smyth General Services Manager 

Ms. Mary Shore Director of Quality, Risk 

& Consumer Affairs 

Mr. Sean Kingston Group Internal Audito 

St. Vincent’s Private Hospital: 

Mr. Michael Redmond Chief Executive 

Mr. Peter Sheehan Head of Corporate Services 

Mr. Neil Twomey HR Manager 

Ms. Mary Connolly Director of Nursing 

Mr. James Crowe Financial Controller 

Ms. Janet Murray Head of Support Services 

Ms. Gerada Warnes Allied Health Manager 


Mr. Seamus Murtagh General Manager 

Mr. Ken Bale 


Ms. Josephine Barrett Acting Director of Nursing 

Mr. Ian Maguire Human Resource Manager 

259 

Return to Contents



Members of the Medical Executive 2008 

Dr. Risteard Ó Laoide Chairman 

Dr. Hugh Mulcahy Honorary Secretary 

Mr. Sean Dudeney Chairperson of the Surgical Division 

Mr. David Quinlan Consultant Urologist Elected Member 

Dr. Donal McCarthy Director of Pathology 

Mr. Enda McDermott Oncology Committee Representative 

Dr. Tom Owens Chairman of the Anaesthetic Division 

Professor. Diarmuid O’Donoghue 

Consultant Gastroenterologist – 

Chair of Medical Forum SVPH 

Dr. Colm Cooney Consultant Psychiatrist 

Mr. Donal Maguire Chairman of Medical Forum, 


Dr. Malachi McKenna Consultant Endocrinologist – SMH REP 

Dr. Martin Quinn Chairman of Division of Physicians 

Dr. Doug Veale Consultant Rheumatologist – 

Elected Member 

Dr. Conor Collins Chairman of the Division of Radiology 

Mr. John Ryan Consultant Emergency Department – 

Elected Member 

Prof. Michael Keane Chair of Medicine & Therapeutics 

Prof. Ronan O’Connell Chair of Surgery 

Prof. Charles Gallagher Consultant Respiratory Physician 

Mission Committee 

Sr Eugene Butler (Chair) 

Ms Theresa Ward ( Hon Secretary) 

Sr M Angela Kelly 

Mr Nicholas Jermyn 

Mr Bill Maher 

Ms Gemma Mc Crohan 

Sr Margaret Hilliard (St Michael’s Hospital) 

Ms Niamh Ni Fhlionn (St Michael’s Hospital)) 

Dr Diarmuid O’Shea 

Ms Barbara Cantwell 

Ms Louise Doyle 

Ms Emily Hosford 

Mr Sean Dudeney 

Ms Orla Fitzgibbons (St Vincent’s Private Hospital) 

Ms Ann Cavey (St Vincent’s Private Hospital) 

Ms Geraldine Maddock 

Ms John Delea 

Ms Phil Pyne Daly 

Ms Tany King 

Ms Helen Forristal 

Members of Finance Committee 2008 

Conor Sexton (Chairman) 

Patrick Meade 

Louise English 

Retired as a member of the BOD and as 

Chairman of the Finance Committee on 

15th December 2008. 

All above named are external members (board 

directors) 

Nicky Jermyn 

Cormac Maloney 

Sean Kingston 

Bill Maher 

Seamus Murtagh 

Ken Bale 

Hospital 


James Crowe 


Dr. Risteard O’Laoide 

General Manager, St. Michael’s Hospital 

Financial Controller, St. Michael’s 

CEO, St. Vincent’s Private Hospital 

Financial Controller, St. Vincent’s 

Private Hospital 

260 

Return to Contents



Audit Committee 2008 

Dr Michael Somers 

Mr Michael Meagher 

Stewart Harrington 

In attendance are 

Nicky Jermyn 

Bill Maher 

Cormac Maloney 

Seamus Murtagh 

Ken Bale 


James Crow 

Sean Kingston 

Group Clinical Governance Committee 

Membership 2008 

Dr. Risteard O’Laoide, Chair 

Mr. Edmond Bergin 

Mr. Joe Leyden 

Mr. Nicky Jermyn 

Ms. Mary Duff, 

Mr. Bill Maher 

Mr. Dermot Cullinan 

Mr. Martin Quinn 

Dr. Tom Crotty 

Mr. Ian Callinan 

Ms. Mary Shore 

Mr. Sean Dudeney 

Mr. Peter Sheehan 


Mr. John Ryan, 

Professor Kevin Malone 

Health and Safety Committee 2008 

Core Resource Group: 


Mr. Frank Smyth 

Ms. Margaret Boland 

Ms. Sinead Brennan 

Director of Quality, Risk & Consumer 

Affairs (Chair) 

General Services Manager 

Clinical Services Manager 

A Senior Nursing Representative 

Health & Safety Co-ordinator 

Mr. Clive Whyte Fire Safety Co-ordinator 

Mr. Paul Gueret Occupational Health Physician/ 

Psychologist/CNS 

Ms. Sarah Mansfield Insurance, Risk & Legal Affairs 

Co-ordinator 

Ms. Lynda Fenelon Consultant Microbiologist/Infection 

Control CNS 

Mr. Peter Mortell Technical Services Manager 

Ms. Karen Clerkin Ergonomics & Back Care Specialist 

Mr. Jim Mitchell Security Manager 

261 

Return to Contents



Health and Safety Committee 2008- Continued 

Satellite Groups: 

AHP Catering Nursing 

Pathology Pharmacy Radiology 

Technical Services General Support Services 

Theatre 

Clinical Care 

In Attendance: 

Mr. Peter Sheehan Representative from SVPH 

Mr. Peter Mansfield Representative from AON 

Patient Safety Committee 2008 

Committee Members 

Mr. Bill Maher 

Director of Operations - Chairman 

Ms. Mary Duff 


Dr. Risteard O’Laoide Chairman Medical Executive 


Ms. Ann Flynn 

Ms. Suzy Fitzgerald 

Ms. Margaret Boland 

Ms. June O’Shea 

Director of Quality, Risk & Consumer 

Affairs 



Clinical Services Manager 

Head of Pharmacy 

In Attendance 

Ms. Siobhan Reynolds 

Ms. Sarah Mansfield 

Ms. Niamh O’Hanlon 

Ex Officio 

Mr. Nicholas Jermyn 

Quality Manager 

Insurance, Risk & Legal Affairs 

Coordinator 

Medication Safety Officer 

Group Chief Executive Officer 

262 

Return to Contents

Annual Review - St Vincent's University Hospital

Create successful ePaper yourself

Delete template?

Save as template?