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

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St.Vincent’s Healthcare Group Department of Clinical Neuro p h y s i o l o g y Department of O p h t h a l m o l o g y Departmental Review Departmental Review 116 Staff Consultant Dr Sean Connolly, MD, FRCPI Neurophysiology Measurement Technicians at SVUH Ms Brigid Clark (full-time senior) Ms Birgitta Levick (part-time senior) SVUH departmental secretary 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 Adelaide & Meath Hospital,incorporating the National Children’s 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). Applications for three additional consultant posts have been submitted to the ERHA for the following: (a) SVUH 6 sessions and Beaumont Hospital 5 sessions (b) AMNCH (Tallaght) 5 sessions and Beaumont Hospital 6 sessions (c) St James’s Hospital 5 sessions and Beaumont Hospital 6 sessions Dr Connolly conducts regular group sessions for neurophysiology measurement technicians approximately monthly at the AMNCH department,with the aim of teaching, and improving methods and standards of the neurophysiological investigations carried out within the service. Technicians from departments in Dublin, Limerick and Cork usually attend. Research projects,currently being carried out mainly at the AMNCH and St Vincent’s departments include Macro-EMG evaluation of the Post-Polio syndrome, surface EMG simulation, exploration of the mis-match negativity evoked potential, neurophysiological investigations in carpal tunnel syndrome, genetically-proven Freidreich’s Ataxia & subclinical hypothyroidism and transcranial magnetic stimulation studies in dystonic disorders. Recent Developments The addition of an experienced,albeit part-time, technologist with new evoked potential and nerve conduction equipment has had a significant positive impact on the number, range and quality of investigations being carried out in this department. Appointment of more technologists is required. Publication Lane H,Bermingham N, Farrell MA,Redmond J, Connolly S, Brett FM. Mitochondrial disorder with a common 4977-bp deletion presenting as a novel multisystem neurodegeneration disorder. IMJ 2003;96:249-250 Staff Consultant Staff St James’ Ward Ophthalmic Theatre Surgical Registrar Medical Registrar Dr Geraldine Kelly Mr Peter Barry Mr William Power Ms Colette Kingston CNM2 Ms Sandra Murphy CNM1 Maeve Williams CNM2 Mr Patrick Talty Dr Magdy Nasralla Lecturer in Ophthalmology Dr Moji Oshodi Clinical Activities The department provides clinical Inpatient and Outpatient services for the hospitals’catchment area in South East Dublin and East Wicklow. Day ward admissions continue to rise and have increased approximately four fold over the last ten years. This has greatly helped alleviate some of the pressures in the busy OPD department. The department’s clinical activity is reflected in the table below. Cataract surgery continues to be the principal ophthalmic procedure carried out in SVUH.Throughout the year both Ms Colette Kingston CNM2 and Sandra Murphy CNM1 were very involved in the accreditation process and have been at the forefront of continuous quality improvement on St James’s ward.Ms Esther McCarthy, senior staff nurse continues to run the European Cataract Outcome Study for the sixth successive year.The ECOS results include data from over 23,000 cataract procedures carried out at a total of 72 European Centres from 1995 – 2003.One of the main purposes of this study is to provide participating units and surgeons with a benchmark for good practice in cataract surgery and to allow surgeons to compare their results in an anonymous way. Staff Nurse Sheila Querubin continues a Diploma course in First Line Management at SVUH in conjunction with the National University of Ireland.She has a vital role on the unit ensuring staff attend in–service education. Staff Nurse Gail Anderson continues her position as link nurse for wound care and ensures the staff are updated in the latest evidence based procedures. Staff Nurse Carol Murphy acts as the link nurse for infection control.This is a vital role as infection is devastating in ophthalmology. Staff Nurse Gerry Porlante acts as the link nurse for the medi sense precision PCx and is responsible for teaching and monitoring the staff in quality assurance programme. Staff Nurse Lu Lu Abellera is responsible for the collection of researched data to ensure evidence based practice. Our exceptionally busy and efficient clerical staff, Jane Caulfield and Margaret Daly, ensures that the unit runs smoothly. Education The department is recognised for basic surgical training and higher specialist surgical training by the Royal College of Ophthalmologists. Mr.William Power is responsible for the 117
Department of Ophthalmology St.Vincent’s Healthcare Group Department of Orthopaedic Surgery Departmental Review 118 weekly in-house teaching sessions in which the medical, nursing and orthoptic staff all participate. Members of the department have made presentations at the European Society of Cataract and Refractive Surgery in Munich, the American Society of Cataract and Refractive Surgery in San Diego and the Association of Research in Vision and Ophthalmology meeting in Fort Lauderdale. Mr Power is author of the chapter "Scleral Transplantation" in "Ocular Inflammatory Disease",Lippencott & Williams,2003. Opthalmology St. James Ward Like all other departments in the hospital, we look forward to the opening of Phase One of the new hospital.This we believe will leave us in a stronger position to introduce daycare cataract surgery coupled with pre-operative assessment clinics.We also look forward to the appointments of Clinical Nurse Specialists and an advanced Nurse Practitioner to help us meet the demands of an ever changing speciality. We would like to take this opportunity to thank the hospital management for their support throughout the years. 2002 2003 St James In-Patients Admissions 458 458 St James In-Patients Discharges 456 451 Cataract Procedures 324 310 Consultants Orthopaedic Theatre Mr.W. Quinlan Mr. B. Hurson Mr. S.K.O’Rourke Mr. E. P. Kelly Mr. S. Dudney Ms.K.Lennon. CNM2 Ms.A. Breen CNM1 St.Laurence’s Orthopaedic Ward Orthopaedic Plaster Service Administration Ms.G. Fields CNM2 Ms.R. Hayden CNM1 Ms. P. Brannigan Clinical Nurse Specialist Ms.A. Camblin CNM1 Ms.Jenni Cross Ms.Frances Doyle This requires cooperation with and expeditious use of facilities provided by the other hospitals and also rehabilitation amenities,which continue to be limited and difficult to access. This is perhaps the greatest challenge to caring for the significant elderly population of our catchment area.The absence of adequate rehabilitation or step-down facilities remains the major impediment to complete care.The development of an Ortho-Geriatric Service is key to development into the future. Although St.Vincent’s caters for trauma associated with commercial activity, domestic and road traffic accidents there is a significant and increasing number of elderly patients in the population presenting with insufficiency fractures. It is a credit to our colleagues in the Dept.of Anaesthesia that they can manage the often-complex medical situations with which an elderly population tend to present. Fracture clinics are carried out in the three hospitals with Mr. Quinlan,Hurson and Dudeney attending clinics in St.Michael’s Hospital, Mr. O’Rourke and Kelly in St.Colmcille’s Hospital and all attend clinics in St.Vincent’s University Hospital.In addition subspecialty clinics are carried out in St.Vincent’s University Hospital – upper limb/joint replacement or Cappagh Hospital - orthopaedic oncology. 119 St James Day Care Admissions 1846 1994 Discharges 1846 1994 St James Day Care Orthoptic Total Attendance's 502 927 St James A/E Ophthalmic Patients Total Attendance's 1261 1016 St James +A2 In-Patient Referrals Total Attendance's 309 327 Ophthalmology Out-Patients New 773 781 The Orthopaedic Dept.as part of the Department of Surgery aspires to deliver a quality service in musculoskeletal trauma to the catchment area of South Dublin and Wicklow, that is,the East Coast area of the Eastern Regional Health Authority. Access to the service is through the three Accident and Emergency Departments of St.Vincent’s University Hospital,St. Columcille’s Hospital and St. Michael’s Hospital to a centralised operative fracture treatment facility at St.Vincent’s University Hospital.This allows the delivery of a same day service to patients presenting for treatment following injury. Elective Surgery from the unit is carried out in The National Orthopaedic Hospital at Cappagh.The Orthopaedic Service of St.Vincent’s University Hospital founded by Mr. Joseph Gallagher in the 1960’s has enjoyed a long and fruitful relationship with Cappagh Hospital under the auspices of The Sisters of Charity. Indeed Mr. Gallagher carried out the first Charnly total hip replacement in Cappagh Total Attendances 2398 2475 St.Laurence’s Ward is at the core of the fracture service. Ms. Gillian Fields and her Staff ensure efficient movement of patients through their treatment in a professional and caring manner.
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