Annual Report 2010 - St. James's Hospital

Clinical Service Directorates I LabMed
Furthermore, the department has several students in inservice
training in Biomedical Science. It also contributes to
several clinical-pathology conferences and the St. James’s
Hospital “Grand Rounds”.
The Immunology department continues to play an active
role in research with major projects in coeliac disease and
the regulation of infl ammatory pathways. The research
programmes are well integrated with the clinical and teaching
services. Through these projects, the department also
contributes to our general understanding of several diseases
involving the immune system. The department continued to
contribute to international meetings and the peer reviewed
international literature last year.
Transfusion Medicine Department
The Transfusion Medicine department offers a comprehensive
transfusion service to St. James’s Hospital, which includes
the National Adult Stem Cell Transplant Service, the National
Centre for Hereditary Coagulation Disorders and a cardio
thoracic surgery unit.
There were 2,246 patients transfused with blood components
during 2010. 11,814 units of red cells were transfused, a
decrease of 2% on 2009, however the useage by surgical
patients increased by 7%. There were 4,926 units of platelets
transfused (down 18% on 2009) and 3,631 units of plasma
transfused (up 23% on 2009). The biggest users were
haematology/oncology and cardio-thoracic surgery.
The department maintained it’s ISO 15189 Accreditation
in 2010 and this entailed auditing every area of the quality
system and monthly vertical audits of laboratory procedures,
clinical processes and traceability. The Blood and Blood
Product Usage Committee meets regularly and reviews the
audit fi nding in addition to serious non conformances and
advises on hospital transfusion practice.
An electronic system to manage the storage and movement
of red cells which was implemented in 2008 and embedded
across the campus in 2009 was interfaced with the
Laboratory Information System in 2010 which allows for
real time tracking of blood throughout the hospital. Its use,
in conjunction with a paper based system whereby clinical
staff return confi rmation of each transfusion to the laboratory,
provides full traceability for blood in compliance with the
requirements of EU Blood Directive 2002/98/EC.
Clinical staff reported 80 suspected transfusion reactions (78
in 2009). Following investigation, 37 of these were confi rmed
as transfusion reactions. Serious transfusion reactions and
events must be reported to the National Haemovigilance
Offi ce. Twenty six reactions and 14 events fulfi lled the criteria
for reporting in 2010.
Regular audit informs training needs and the haemovigilance
offi ce continued a programme to demonstrate evidence of
competence in transfusion practice for both medical and
nursing staff during the year, with 85% of the nurses and 90%
of the interns having evidence of competency recorded. As
part of the training program an e-learning module for blood
transfusion, is available for all staff.
Posters
Poster presented at the International Society of Blood
Transfusion conference in Berlin titled ‘Red cell usage for Iron
Defi ciency Anaemia in a University Teaching Hospital’.
Poster presented at the National haemovigilance Conference
in Dublin titled ‘Our experience in setting up a system for
undertaking Root Cause Analysis in a University Teaching
Hospital from 2008 to 2010’.
Microbiology Laboratory Services
The Microbiology laboratory provides a diagnostic,
infection control and clinical service to the hospital, GPs of
South Inner City Partnership and Dublin South West and to
external agencies.
The Microbiology Laboratory has continued its’ work in
consolidation and maximising effi ciencies through the
adoption of technology. In addition, the laboratory has
continued developmental work and is now in a position to
introduce new assays for virological diagnosis. The laboratory
introduced the Previ Isola for automated specimen inoculation.
A molecular assay replaced the routine culture for GC.
This has improved throughput, TAT and sensitivity.
Mycology development work has continued and the
laboratory is also in a position to introduce improved
identifi cation and susceptibility testing for common fungal
pathogens. Antimicrobial resistance surveillance data,
compiled by the laboratory’s surveillance scientist, was used
comprehensively in the production of empiric antimicrobial
guidelines for the hospital. The laboratory also contributes
signifi cantly to national surveillance data and is involved with
a number of national surveillance projects.
Education and Research
There has been signifi cant research work carried out in the
department, predominantly relating to antimicrobial resistance
among Gram-negative bacteria, infection caused by meticillin-
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