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

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Medical Social Work Department Significant Publications Margaret Cagney, Senior Social Work Practitioner, was involved in the production of a study on the changing face of long term care beds in our catchment area over the past few years and its ramifications for the hospital. 176 Future Plans At present Aine Canny, Senior Social Worker is completing a piece of research concerning older people who are admitted to the Accident and Emergency Department along with the Department of Medicine for The Elderly. 177 Martina Dolan,Acting Senior Social Worker based in The Department of Old Age Psychiatry, is also currently doing a research study on relatives/carers of patients who attend the service. It is based on the Camberwell Assessment of Need for the Elderly Questionnaire, which has been formulated in the UK.This document assesses need across 20 areas of functioning such as housing, finances,self-care, elder abuse, and carer burden. Finally Martina has been having a monthly evening session with carers of relatives in order to provide them with practical information on services, entitlements/benefits etc. This is proving to be very helpful from the feedback received and is being evaluated for future study.
St.Vincent’s Healthcare Group Department of Nutrition and Dietetics Allied Health Professional and Support Services 178 Staff Sinead Curran,senior Dietitian in Diabetes left to take up a position in the National Maternity Hospital.Maeve Moran filled this post in July 2003.Linda Reynolds joined our team as Dietitian to the Care of the Elderly and Neurology services in September 2003. Departmental Statistics: Year Total Total Total Day Total Total Inpatient Outpatient Hospitals/ Attendances Attendances Attendances Attendances Units at Patient at Staff Attendances Group Education Education Sessions Sessions 2001 17,086 2,293 571 1,455 672 staff 2002 18,304 2,077 1,209 1,527 740 staff 2003 17,463 1,762 1,217 1,368 300 staff Variance 4.6% ò 15% ò ‹ 1% ñ 10.4% ò 59.4% ò The staff complement level of the Department is 12 Whole Time Equivalent (WTE) dietitians and one administrator (Grade IV).In 2003,deferral of staff recruitment (reduction of one WTE for 7 months) and absence of locum cover resulted in reduced services.General OPD services were suspended from April to September. However, specialist clinics continued throughout this time. During the period of deferral of staff replacement, inpatient care was prioritised and additional workloads were shared among staff.However, there was an increase of 12% in referred patients being discharged without being seen by a Dietitian. Activities in relation to training and development were reduced by 20% in the same period. Service Developments/Activities Four dietetic students undertook their clinical placement training in the department in 2003. Each student completed 17 weeks of a 26-week programme in St Vincent’s University Hospital. Due to staffing restrictions it was not possible to develop service provision during 2003. However, the Nutrition Sub- Committee (mu l t i d i s c i p l i n a ry representation), which is support e d by this department,undertook to develop a ward-catering manual.This manual contains information on the provision of ward-based meals.It gives relevant information about specific food requirements for individual patients who require a therapeutic diet.The manual is intended for ward catering staff as a resource to which they can refer. It is planned to make it available in all ward kitchens in conjunction with staff training. In collaboration with the Nutrition Committee, the Annual Clinical Nutrition Study afternoon was held in September. 39 staff from St Vincent’s University Hospital,St Michael’s Hospital and the Royal Hospital,Donnybrook attended.Evaluation was very positive and suggestions for 2004 will be considered.As part of the Nutrition Committee’s role, an audit of TPN practice was undertaken in 2002.This prompted a review of the TPN monitoring protocol.This was commenced in 2003 and should be completed in 2004. Significant Achievements Despite staffing shortages,the department undertook a review of all dietary information produced in the department.This was in response to the Health Literacy – Policy and Strategy Report (2002) produced by the National Adult Literacy Agency (NALA).This report highlighted the extent of literacy difficulties and the degree to which this problem can limit access to health information and health services.As dietitians,education of clients is fundamental to p r oviding effe c t i ve healthcare.T h e r e fo r e we undertook to review all diet sheets / dietary information to ensure it complied with the NALA guidelines.Department guidelines were revised to ensure that dietary information produced in the future is in line with the NALA guidelines. Ms Lynda Parke, Senior Dietitian supervised a final year dietetic student who undertook a follow up research project to investigate the effects of eating and drinking during haemodialysis.The findings of this study and an audit undertaken in 2002,confirm previously published research.The results of both audits have been submitted for presentation at the British Renal Society Meeting in 2004. Significant Publications/Presentations Presentations: Vivien Reid,CSD presented a poster presentation entitled "The influence of cardiac rehabilitation on lifestyle change – one-year follow up" at the Irish Association of Cardiac Rehabilitation meeting in October 2003. Catherine Lamont,presented a poster on "The evaluation of education sessions to ward catering staff" at the Health Promoting Hospitals Conference in November 2003 Publications: Freyne A,Doyle M,Clarke A. and Darby M.(2003) "Prevalence of osteoporosis and osteopenia among attenders at an eating disorder programme" Proceedings of the Nutrition Society Nov. 62,24A. Future Plans • We plan to review our general OPD dietetic service, to facilitate the growing demand for services.We currently have a 6-month waiting list for new and review appointments.In turn this is causing an increase in "failure to attend" rates.We will explore providing an "agreed package" of care for clients and priority clinics for urgent consultations. • We plan to formalise our clinical supervisory practice for dietitians, providing training for trainers,which will be rolled out to all members of the department in autumn 2004. • In collaboration with our Speech and Language Therapy colleagues, we have completed a number of projects in relation to improving the care of clients with dysphagia.We plan to review and revise our joint care plans and complete an integrated education booklet. Liz Barnes Dietitian Manager 179
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