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

P h a rmacy Department
190
Pharmacy Technicians and Medicines Management Seminar;
York,September 2003. C. Bogue.
International Psychiatric Pharmacy Conference;Reading,
October 2003.R.Knox.
Irish Association for Cardiac Rehabilitation (IACR) Conference;
Dublin,October 2003. C. Kingston.
Improving Patient Safety Conference;Dublin, November 2003.
N.O’Hanlon.
UK and ROI Liver Transplant Group Annual Clinical Meeting;
London,November 2003. F. Kennedy.
American Society of Haematology (ASH) Conference;San
Diego, December 2003. E.Marsden.
Future Plans
PCA audit in SVUH and SVPH in conjunction with the
Departments of Anaesthesia and Nursing.
New edition of the Prescriber’s Guide and Formulary (July
2004)
Revised editions of the Cytotoxic Drug Spillage Policy and the
Extravasation Policy
New Policy on Safe Handling and Administration of Cytotoxic
Drugs
Review pharmacy software programmes for dispensary and
aseptic services
St.Michael’s Hospital
Service Developments / Activities
The Pharmacy Department supplies medicines to all areas, via a
combination of "top-up" and an individual patient dispensing
system.There is a clinical pharmacy service, a counselling service
for patients on the Pulmonary Rehab programme and a drug
information service. Pharmacy personnel take part in a range of
multidisciplinary committees and are involved in staff education
on medicines.
Outstanding / Significant Achievements
•Began accreditation process (due for survey in May 2004).
•Developed a range of standard operating procedures
(SOPs) for pharmacy processes
•New drug disposal SOP led to a change of waste
management company. Records are now kept for drug
disposal.
•A review of drug storage is ongoing.All fridges used for
drug storage are now of appropriate pharmaceutical grade,
with alarms etc. Room temperature monitoring was
recently introduced in pharmacy.
•New system for prescription pads was introduced to
minimise theft and improve traceability.
•Drug administration guidelines were developed for specialist
areas.
•Developed computerised pulmonary rehab counselling
programme.
•Increased skill mix and flexibility in working hours within the
department.
Future Plans
• Introduce a system of continuous temperature monitoring for
drug fridges.
• Initiate service contract for fridges.
• Review the system for dealing with medication errors.
• Expand the number of drug administration guidelines.
• Further SOPs and improvements in Pharmacy processes
• Under development – protocol for Patient’s Own Drugs
and Self Administration of Medications.
• Increase in joint purchasing agreements between SVUH
and SMH,to maximise savings/ value for money –
this is already under way.
• Development of drug usage reviews/evaluations
(currently undertaking antibiotic audit).
• Documentation of service development, e.g.posters etc.
The main objective of the Physiotherapy Service is to provide
appropriate, effective and timely physiotherapeutic care for
patients on referral.
Service Provision
During 2003 the level of physiotherapeutic care was adversely
affected by the reduction in physiotherapy staffing levels. A
patient prioritisation system based on clinical need was devised
to ensure that the curtailment of services did not compromise
critical care.
Staffing
•Staffing levels January-March ’03 = 33.5 wte staff
•Staffing levels March-December ‘03 reduced by 2.5 wte
to 4 wte.
•No new appointments 2003.
•Ms Judy Scope, Deputy Physiotherapist Manager, resigned
December ’03 to return to Scotland.We wish Judy every
success.
Service Development
Physiotherapy Musculoskeletal Service
The provision of a physiotherapy service to the A&E Dept,
which encompasses musculoskeletal care, respiratory care
(emergency respiratory referrals for Non Invasive Ventilation)
and rehabilitation (mobility assessments to facilitate safe
discharge) has evolved without any staff allocation.This has
been difficult to sustain with current activity levels.
Physiotherapy Department
Allied Health Professional and Support Services
Evidence indicates that that a dedicated unit with a multidisciplinary
team approach to the care of patients on NIV is in
line with best practice and would ensure 24-hour quality care
for these critically ill patients. Based on this review a report will
be completed early 2004.
Physiotherapy Rehabilitation Service
There has been an increase of 5.7% in the number of patients
referred for active rehabilitation post Stroke compared to 2002.
Physiotherapy Ergonomics Service
The Physiotherapy Dept in collaboration with the Occupational
Health Dept initiated and developed a Working Backs
Programme.The Working Backs Programme is an innovative
multidisplinary programme, which offers a streamline evidenced
based management pathway for staff with low back pain.The
programme will be audited by Caitriona Cunningham, Lecturer
in Physiotherapy, UCD, as part of her PhD.
Undergraduate Clinical Education
The undergraduate clinical placement programme continues a
pace with 84 clinical placements being provided annually for
physiotherapy undergraduates from UCD.
Master Classes
The master classes for senior physiotherapists,which proved so
successful 2002,continued in 2003 and included:
1)Pain Management Study Day. Dr Watson,Consultant
Physiotherapist,UK
2)Education session.Dept. of Human Anatomy. UCD
191
Physiotherapy Cardio Respiratory Service
There has been significant growth in the use of Non Invasive
Ventilation (NIV) in recent years.Prompted by this a review of
the service was undertaken 2003 by physiotherapy, medical and
nursing staff.Currently patients requiring NIV are referred to
physiotherapy for respiratory assessment and application of
NIV.This service is provided by physiotherapy on a 24-hour
basis.
Physiotherapy Database System
A database management system was successfully integrated into
the organisation of the Physiotherapy Dept Jan ’03.However
due to the demands on physiotherapists’time and insufficient
secretarial support the system was withdrawn from the
inpatient service April ‘03.