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

St.Vincent’s Healthcare Group
Department of
Medicine for the Elderly
Departmental Review
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Departmental Statistics:
2001 2002 2003
Inpatients
Admissions 426 425 317
Discharges 457 443 403
Outpatients
New 261 280 277
Review 532 500 543
Carew Day Hospital
New 404 420 523
Review 1402 1395 824
Stroke Service 194 255
Total Attendance
New 665 700 800
Review 1934 1895 1622
In Patient Consultations
In 2003 over 800 inpatient 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 on whom
consultant colleagues have requested advice.
Stroke Service
Weekly meetings are held and chaired by Dr. Crowe.
Representatives of the nursing,physiotherapy, occupational
therapy, speech and language therapy and other medical
departments attend. There are now 8 dedicated beds,on Our
Lady’s Ward, for patients with stroke. Ms.Imelda Noone, Stroke
Nurse Specialist,is involved in further development of this unit
and the introduction of set guidelines and protocols. An active
stroke follow-up programme is now up and running in Carew
House Day Hospital. A once weekly dedicated TIA clinic was
initiated in January 2003, to facilitate assessment and treatment
of patients with TIA’s, thus avoiding hospital admission.All
necessary investigations are performed at this clinic. To date
105 patients have been assessed.
speech therapy posts have been filled we hope to be able to
run this at the maximum capacity.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. Efforts to further enhance and
strengthen these links are under discussion (with the C.E.O. in
The Royal,Mr. Lindsay).
Staffing
Close liaison is maintained with St.Columcille’s Hospital,
Department of Medicine for the Elderly under the direction of
Dr. Morgan Crowe and with St Michael’s Hospital under the
direction of Dr JJ Barry.
Achievements / Conferences Attended
The multidisciplinary team members at Carew House Day
Hospital attended The Stroke Information Day, Annual Stroke
Study Day,The Irish Gerontological Society Conference,
Parkinson’s Association Meeting,National Council on Ageing
and Older Peoples Conference
Publications / Abstracts
Appropriateness of Implementing Current Recommendations for
Primary and Secondary Prevention of Vascular Disease in the
Extended Nursing Care Setting. N Boyle, M Deane, M Crowe, JJ
Barry, D O’Shea - IGS Meeting 2003
Diagnosing Stroke: The Value of Clinical Assessment -
St.Vincent’s University Hospital
N.Boyle, I.Noone, D. O’Shea,M. Crowe. – IGS Meeting 2003
Factors Associated with Delays in Acute Stroke Management. I.
Noone, M. Crowe,
D. O’Shea – IGS Meeting 2003
Long-term Waiting List in the Community - The Importance of
Regular Review.
O. Collins,A.Collins,L.Murray, D. O’Shea.- IGS Meeting 2003.
How does Clinical Classification of Stroke Subtype compare with CT
findings?
J Ryan,I Noone, D O’Shea,M Crowe - Platform Presentation
- IGS 2003.
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The number of in-patients treated has remained unchanged on
previous years, though out-patient attendances have increased.
New patient attendance is up from 665 in 2001 to 800 in
2003.This is reflected in the throughput in both outpatients and
Carew House Day Hospital. Great credit is due to Ms.Angela
Moriarty, Clinical Nurse Manager and her multidisciplinary team
for the throughput and quality of work there.
Service Developments / Activities
The department’s clinical services provide an in-patient and
out-patient 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 with dignity and a consequent increase in
the number of people awaiting long-term continuing care.
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. This is
geared at providing a comprehensive assessment of elderly
patients presenting with recurrent unexplained falls (> 4 in the
preceding 6 months) to look for attributable and modifiable risk
factors for falls.In total 71 patients were seen this year (of all
age groups). Some progress has been made but the hoped for
introduction of a Falls Nurse Specialist will be crucial to the
further development of what is currently a rudimentary service.
The Royal Hospital Donnybrook
The Royal Hospital Donnybrook makes a very important
contribution to the rehabilitation of our elderly patients.There
are now 40 rehabilitation beds in this unit and when the
nursing,physiotherapy, occupational therapy, social work and
Congratulations to S/N Deborah Sinnot and S/N Jenny Hughes
on Our Lady’s Ward, who were prize winners at the National
Council for the Professional Development of Nursing and
Midwifery Conference in November 2003, for "Screening for
Visual Impairment in Elderly Rehabilitation Patients".