Review 2005 - St Vincent's University Hospital

Review 2005
St. Vincent’s Healthcare Group
Limited
INCORPORATING
St Vincent's University Hospital
St. Vincent's Private Hospital
AND
St. Michael's Hospital

St. Vincent’s Healthcare Group Limited
3
Contents
Publications
Reports
Mission and Values 5
Ethics and Medical Research Commmittee 7
Hospital Development 8
Health and Safety Review 9
ERC
Reviews and Personnel
Review by Medical Director of the E.R.C. 12
Introduction 13
ERC Principal Investigators 14
Research Laboratories - Personnel 2005 15
Review by Director of Research Laboratories 16
Research Groups & Table of Groups 17
Research Activities
Tumour Biology Group 19
Bioinformatics Group 20
Innate Immunity Group 21
Regional Immunity Group 22
Liver Research Group 23
Respiratory Sleep Research Laboratory 26
Centre for Colorectal Disease 27
Department of Rheumatology 30
Department of Endocrinology & Diabetes Mellitus 35
Endocrinology & Adipocyte Group 38
Department of Psychiatry & Mental
Health Research 39
Department of Neurology Research in
Multiple Sclerosis 40
Postgraduate Department 41
Academic Activities
Annual Biomedical Research Symposium 46
Research Courses/Workshops Journal Club 49
Education & Outreach 50
Prestigious Invitations/Honours 51
Prizes and Degrees Awarded in 2005 53
Papers in International Peer Reviewed 54
Journals 2005
Chapters in Books 60
Invited Reviews 60
Grants Active
Grants Active in 2005 61
St. Michael's Hospital
Overiew 66
Pharmacy Department 66
Nursing Administration 67
Pathology Department 68
Human Resource Department 68
I.T. Department 69
Thanks 70
Organisational Structure 71
St. Vincent's Private Hospital
Overview 73
Allied Health Division
Overview 76
Training & Education 76
Health & Safety Committee 76
Accreditation 77
GP Open Night 77
Cardiology 77
Academic Achievements 77
Diagnostic Imaging 77
Academic Achievements 78
Attending Post Graduate Courses in MRI 78
Dietetics 78
Conferences 79
Pharmacy 80
Auditor’s Report 80
Service Requirements Survey 80
Joint Nursing & Pharmacy Meetings 80
Academic Achievements 80

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Review 2005
Contents
Physiotherapy 80
Courses 81
Radiotherapy(Including Medical Physics) 81
Academic Achievements (Physics Staff) 82
Conferences 82
Presentations 82
Radiation Therapists 82
Conferences 82
Courses 82
Respiratory Department(Pulmonary
Function and Sleep Lab) 82
Presentations 83
Social Work 83
Nursing Division 84
Support Services Division 87
Human Resource Division 92
Corporate Services Division 95
Organisational Structure 98
St Vincent's University Hospital
Departmental Review
Department of Anaesthesia, Intensive
Care and Pain Management 100
Department of Cardiology 108
Department of Dermatology 110
Department of Emergency Medicine 114
Department of Endocrinology and
Diabetes Mellitus 116
Liver Transplant Programme and Liver Unit 123
Department of Medical Oncology incorporating
Lios Aoibhinn Cancer Support Centre 125
Outpatient Department 128
Medical and Surgical Gastroenterology
incorporating the Centre for Colorectal Disease 129
Department of Medicine for the Elderly 134
Department of Metabolism 138
Department of Nephrology 142
Department of Neurology 144
Department of Clinical Neurophysilogy 147
Department of Nursing 149
Department of Ophthalmology 154
Department of Orthopaedic Surgery 156
Department of Palliative Medicine 158
Department of Pathology 160
Department of Plastic Surgery 164
Department of Psychiatry & Mental
Health Research 166
Department of Old Age Psychiatry 168
Department of Radiology 170
Department of Respiratory Medicine 174
Department of Rheumatology 176
Surgical Professorial Unit –
St Raphael’s Ward 179
Department of Urology 183
Department of Vascular Surgery 188
Allied Health Professional and Support Services
Chaplaincy/Pastoral Care Department 192
Information, and Communication Technology
(ICT) Department 195
Library and Information Service 198
Medical Physics and Clinical
Engineering Department 201
Medical Social Work Department 204
Department of Nutrition and Dietetics 207
Occupational Health 210
Occupational Therapy Department 217
Pharmacy Department 220
Physiotherapy Department 225
Department of Preventive Medicine
& Health Promotion 229
Speech and Language Therapy
Department 233
Service Departments
Catering Department 239
General Services Department 241
Human Resources Department 243
Medical Records/ Patient
Services Department 247
Purchasing and Procurement Department 249
Technical Services Department 251
Theatre Sterile Services Unit / Central
Sterile Supplies Department 253
Healthcare Group Committees 254

St. Vincent’s Healthcare Group Limited
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Mission & Values
Mission Committee
We welcomed Sr Margaret Hilliard RSC, Hospital Chaplain and Ms Nicola Geoghegan, Secretary to the
General Manager from St Michael's Hospital to our Committee. Five meetings were held throughout the
year. We thank our committee members for their enthusiasm, time and expertise so freely shared as they
worked to ensure that the Philosophy & Values of our Health Service are constantly communicated to all staff.
Mission Education Programmes
Large numbers of staff from St Vincent's University Hospital and St Michael's Hospital, attended Units One
and Two of the Programmes. The feedback from staff was very positive. To date 1,170 staff members have
attended Unit 1.
Unit 2, held in April covered areas of Ethics, Values and Spirituality for an Effective Mission. A total of 210
staff members attended this Unit. The following speakers gave input: -
Fr Paul Tighe who serves as Ethics Consultant for the Religious Sisters of Charity Healthcare Services.
Breda O'Neill works in the area of Human Resources.
Anne O'Dwyer is an experienced accredited Hospital Chaplain and completed her training as a
Relaxation Tutor at Harvard University.
Introduction to Mission & Values
All newly appointed staff attended a 45-minute session on the Introduction to the Mission and Values of St
Vincent's Healthcare Group as part of their orientation programme.
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Review 2005
Mission & Values
Hospital Intranet
A special link for Mission was created; this will be further developed giving staff opportunities to access
information on our Mission and Heritage.
Celebrations
We began the year by celebrating the Foundation of the Hospital on the 23rd January.
On the Feast of St Vincent de Paul, on the 27th September Mass was celebrated in the evening for our
bereaved and deceased staff members. The choir gave generously of their time practising for the occasion.
We received many emails and letters of thanks. We extend our sympathy to the families of the late Myles
Yeats, secretarial staff, Accident & Emergency, Norah Shandu, Department of Nursing and Dr. Niamh Watters
who experienced great sadness due to the unexpected deaths of their loved ones.
The Committee organised an Ecumenical Service for our retired Radiography Services Manager - Deirdre
Scott Hayward, who died shortly after her retirement. Deirdre was one of the first Mission Committee
members. This service was greatly appreciated by her parents and family.
Care of the Dying Project
This project, a quality improvement initiative was undertaken to ensure that the best quality of care possible
is given to the significant number of patients who die each year in St Vincent's Healthcare Group. The aims
and objectives are very much in keeping with our ethos and philosophy. Sr Angela represents Mission on the
steering Group set up to provide direction and guidance to this project.
History Panels
An additional five panels updating the history of the hospital
will be added to the existing display on the corridor later this year.
Candle Lighting ceremony
held on September 27th
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St. Vincent’s Healthcare Group Limited
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Ethics and Medical Research Committee
The St. Vincent's Healthcare Group (SVGH) Ethics and Medical Research Committee (EMRC) operated as a
designated recognised ethics committee acting for the whole state in compliance with the EU directive
entitled: “European Communities Clinical Trials on Medicinal Products for Human Use”(Regulations 2004).
The committee met on twelve occasions during 2005 and the committee reviewed 17 clinical trial applications
and 101 research studies. Following appropriate review and incorporation of recommended revisions, all
studies were approved.
Following the implementation of the EU directive (2004) the purpose of which was to harmonise and
standardise approval for clinical trials by regulatory authorities and ethics committees across all EU member
states, a document entitled “Guidance on the application for recognised ethics committee opinion and the
ethical review of clinical trials on medicinal products for human use” was issued in December 2005. Included
in this document are the transitional requirements for clinical trials that had obtained local ethical approval pre
May 2004 and will continue after May 2006. It is a requirement that each clinical trial must obtain one single
ethics committee opinion for the conduct of the trial within the state in keeping with Directive. This document
also includes standardised application forms and standardised letters.
A sub-group of the committee met with representatives from the Department of Health & Children on two
occasions to clarify the committee's responsibilities for reviewing SUSARS. The December guidelines state
it is requirement that the committee acknowledge receipt of Suspected Unexpected Serious Adverse
Reaction (SUSARs) and we would like to extend are thanks to Dr. Richard Assaf, Consultant Anaesthetist and
Clinical Risk Facilitator who has reviewed these SUSARS on behalf of the committee, which he has at all
times performed to the highest standard.
Since the new EMRC was formed we have revised our standard patient information leaflet and consent form
templates in addition to our revised application forms. Two forms are now used (i) for clinical trials of
medicinal products for Human Use, and (ii) for investigator-driven and non-invasive research studies.
Copies of all documents are available electronically and in hard copy from
Ms Joan McDonnell, Ethics Office, ext: 4117 (joan.mcdonnell@ucd.ie).
Dr. Doug Veale
Chairman.
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Review 2005
Hospital Development
St. Vincent's University Hospital Redevelopment Project
During the year practical completion of the new 5-storey building was achieved in February 2005. The
completion of this building brought to a conclusion all new work as part of the Phase 1 Development of the
site.
Work was also completed on the installation of fire doors in the existing building as well as refurbishment of
the existing passenger and service lifts.
A significant number of specifications for equipment requiring to be procured for the new 5-storey building
were completed and following approval to proceed from HSE, the following packages were successfully
tendered and awarded during the year
Radiology Equipment General & Emergency Department
PACS
Gamma Cameras Nuclear Medicine
Mammography & Ultrasound equipment
Mobile X-Ray Units
Dialysis Machines
Dialysis Chairs
Patient Monitoring System Emergency Department
Patient Trolleys
Office and general furniture
Theatre Instruments
Infusion Devices
Difibulators
Pathology Analysers
Cubicle Curtains
HSSD Equipment
Evaluations of a number of major equipment packages i.e. anaesthetic machines, ventilators, endoscopy
management system, scopes and washers commenced and user groups started work to complete the
remaining equipment packages, the largest element of this being theatre equipment.
It should be noted that all the major items of equipment were procured and installed in the Emergency
Department, and the supporting Radiology equipment in anticipation of the department opening early in
2006.
The main focus of attention as we approached the year-end was the Emergency Department opening.
However it was not the sole focus of attention, Operational plans were also developed with a view to bringing
a number of other departments, live in this first quarter of 2006. The new HSSD, Pathology, Radiology
Department and the first of the Ambulatory Day Care facilities.
It has to be acknowledged that once again there has been a magnificent effort made by all staff involved in
the operational commissioning process, whilst maintaining existing services both on a local and regional
basis.
I would therefore take this opportunity to formally thank everyone involved in the development, for their
continued support and commitment.
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St. Vincent’s Healthcare Group Limited
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Health and Safety Review
St Vincent's University Hospital continues to place significant emphasis on the management of Health and
Safety within the workplace. The hospital recognises its responsibility to provide a safe environment for
patients, relatives, visitors and staff members. This is achieved by meeting and exceeding our statutory
requirements and through adherence to best practise.
Our Occupational Safety Program is co-ordinated and managed through a Health & Safety Committee
structure. The Committee comprises of representatives of local safety groups working with key resource
personnel from functions such as Infection Control, Back Care and Ergonomics, Occupational Health and
General Management. In addition to our committee structure the Hospital recognises the legal obligation of
all managers and other persons in senior positions to ensure the safety and welfare of all persons working
in, or coming in contact with, their areas of responsibility.
The activities of local safety groups makes a significant contribution to the overall safety program and the
hospital would wish to thank most sincerely all members and co-ordinators of safety groups for their
continued commitment. Currently the hospital enjoys representation from a variety of departments including
Administration, Allied Health Professions, Catering, Nursing, Pathology, Pharmacy, General Services,
Technical Services, Radiology and Operating Theatres. We also benefit from representation from the relevant
safety groups in St Michael's Hospital and St Vincent's Private Hospital.
Our ongoing participation in the Accreditation process continues to influence the direction of our health and
safety program. Quality Improvement Plans that will have a positive impact on safety and welfare will
continue to be prioritised. The forthcoming commissioning of our new facilities presents an opportunity to
further raise standards within this new working environment and matters pertaining to safety and welfare will
receive a particular focus in our plans for the new building.
The Hospital was delighted to appoint Regina Rooney as our new Health and Safety Co-ordinator in
September 2005. The designation of this role discharges our obligations under Section 18 of the Safety
Health and Welfare Work Act (2005) and assists the Hospital in our aim to ensure we meet and exceed all of
our regulatory responsibilities.
Our commitment to invest in focused training programs continued throughout 2005 with significant
participation in programs in key areas such as fire safety, manual handling, non-violent crisis intervention and
sharps awareness.
Larry Clancy
General Services Manager
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Review 2005
Education & Research
CENTRE
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Education & Research Centre
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Contents
Reviews and Personnel
Review by Medical Director of the E.R.C. 12
Department of Psychiatry & Mental
Health Research 39
Department of Neurology Research in
Multiple Sclerosis 40
Postgraduate Department 41
Introduction 13
ERC Principal Investigators 14
Research Laboratories - Personnel 2005 15
Review by Director of Research Laboratories 16
Research Groups & Table of Groups 17
Research Activities
Tumour Biology Group 19
Bioinformatics Group 20
Innate Immunity Group 21
Regional Immunity Group 22
Liver Research Group 23
Respiratory Sleep Research Laboratory 26
Centre for Colorectal Disease 27
Department of Rheumatology 30
Department of Endocrinology &
Diabetes Mellitus 35
Endocrinology & Adipocyte Group 38
Academic Activities
Annual Biomedical Research
Symposium 46
Research Courses/Workshops 49
Journal Club 49
Education & Outreach 50
Prestigious Invitations/Honours 51
Prizes and Degrees Awarded in 2005 53
Publications
Publications 54
Papers in International Peer Reviewed
Journals 2005 54
Chapters in Books 60
Invited Reviews 60
Grants Active
Grants Active in 2005 61
“Reach for the stars and you'll get
the whole of the moon”
The Waterboys
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Review 2005
Review by Medical Director, Education
& Research Centre
Prof. Oliver FitzGerald
The mission statement of the St Vincent's Healthcare Group (SVHG) indicates that there are three principle
functions for the group including delivery of patient care, research and education. All three are essential for
the wellbeing of the hospital and it's patients and all three are interdependent. As of yet, SVHG does not
have a detailed research strategy. A significant step in the development of such a strategy was taken in early
2005 with the appointment and first meeting of the Research Advisory Board (RAB). Under the leadership
of Professor Patrick Fottrell, the RAB is currently undertaking a review of research activity at SVHG and will
contrast and compare (benchmark) against international standards. It is hoped that this review process will
be completed shortly allowing the RAB to move forward on developing a comprehensive research strategy.
It is expected that the strategy will identify the key research strengths that will be supported by both SVHG
and by University College Dublin (UCD).
The other major development in 2005 was the completion of the conversion of the old medical residence
building to the Genome Resource Unit (GRU). The wonderfully appointed GRU is due to open its doors in
early 2006 and will provide clinical researchers with state-of-the-art facilities for patient assessment and
investigation studies as well as for novel treatment protocols. Dr Seamas Donnelly and the members of the
GRU project management team, architects, engineers and builders are to be congratulated on successful
completion of this important project. Going forward, it is critical that the new facility does blend well with
the existing research facilities, so as to maximise research output.
Meanwhile 2005 has been another record-breaking year for Principal Investigators and their teams at the
Education and Research Centre (ERC) with over 65 publications, several degrees awarded and in excess of
€8 million of current grant support.
After 5 years as Interim Director at the ERC, I have taken the decision to step down from this position as of
December 31st 2005. I am delighted to hear that Dr Douglas Veale has agreed to take on the post in the
short term pending the RAB report. Longterm, it is hoped that there will be a senior academic appointment
in translational research which will help bridge the gap between the clinical facilities at SVHG and the more
basic research facilities at the Conway Institute and elsewhere in UCD. In resigning from the position of
Interim Director, I would like to acknowledge and thank a considerable number of people who have made my
job easier in 2005 and in previous years. In particular, I would like to thank members of the ERC Management
Committee; Professor Cliona O'Farrelly for her ongoing enthusiastic support for research at St Vincent's;
Senior Scientists Jacintha O'Sullivan and Ursula Fearon for their assistance, advice and organisational skills
in relation to our Annual Symposium; and Geraldine Lanigan Ryan, Louise McCormack and Alan Garton for
their considerable administrative support.
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Education & Research Centre
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Introduction
Research at S.V.U.H.
St Vincent's University Hospital (SVUH) is renowned in Ireland for the excellence of clinical care given to its
patients. For decades, this excellence has been supported by a commitment to research. SVUH extended
this reputation with the development of the Education and Research Centre as one of its key initiatives for
increasing the knowledge base in the hospital and improving patient care. This initiative has been
complemented by the collaborative development of the Genomic Research Unit with UCD. With dedicated
laboratory and clinical research facilities, research programmes have developed which complement the
primary clinical, diagnostic and treatment challenges faced by healthcare workers at SVUH, as well as the
biomedical research initiatives at the Conway Institute, UCD. In particular, clinical and basic research into
arthritis, liver disease and breast cancer are now integral components of Ireland's premier Early Arthritis
Clinic, the National Liver Transplant Programme and the National Breast Cancer Unit which are all based at
SVUH. A major clinical and basic research initiative in Respiratory Medicine over the years has also resulted
in the development of expertise in integrative biology, respiratory physiology and sleep disorders as well as
a nationally recognised expertise in the management and research of Cystic Fibrosis. Continuous clinical
research over two decades in Endocrinology has made significant contributions to clinical management of
Diabetes and Infertility at SVUH. An ambitious combined clinical and basic research programme in Colorectal
Disease is contributing to the emerging research profile of SVUH.
SVUH researchers from clinical and scientific backgrounds collaborate with clinicians and researchers from
leading national and international institutes to address major questions in the diseases that afflict the Irish
population including Rheumatoid Arthritis, Hepatitis C, Cancer and Diabetes. A common theme of the
research programmes is the investigation of molecular mechanisms of inflammatory and malignant disease
with a particular focus on gene expression and its regulation. Identification of specific changes in gene
expression will lead to the development of novel diagnostic and prognostic applications, insight into failure of
current therapeutic strategies as well as identification of new therapeutic targets for arthritis, liver disease
and malignancy.
Biorepositories at SVUH
A strong feature of the research is the collection, over many years, of tissue samples from well-defined
cohorts of patients and from normal donors. The clinical data on these cohorts is collated and stored in
databases, constituting a valuable research resource. The combination of these clinical data with state-ofthe-art
molecular techniques for the analysis of disease markers and mechanisms places the E.R.C. in a
position to make singular, clinically relevant contributions to biomedical research that will have implications
worldwide.
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Review 2005
ERC Principal Investigators
Principal Investigators 2005
Prof. Barry Bresnihan
Prof. Aongus Curran
Prof. John Crown
Prof. Joe Duffy
Dr. Ursula Fearon
Dr. Lynda Fenelon
Prof. Oliver FitzGerald
Dr. Charles Gallagher
Mr. Justin Geoghegan
Dr. Lucy Golden-Mason
Prof. John Hegarty
Mr. Arnold Hill
Dr. Andrew Lloyd
Prof. Kevin Malone
Dr. Donald McCarthy
Dr. Ken McDonald
Mr. Gerry McEntee
Prof. T.J. McKenna
Prof. Paul McLoughlin
Prof. Walter McNicholas
Dr. Hugh Mulcahy
Prof. Diarmuid O'Donoghue
Prof. Cliona O'Farrelly
Prof. Niall O'Higgins
Dr. Donal O'Shea
Dr. Jacintha O'Sullivan
Dr. Kieran Sheahan
Dr. Tom Smith
Prof. Oscar Traynor
Dr. Niall Tubridy
Dr. Leonie Young
Dr. Doug Veale
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Education & Research Centre
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Research Laboratories - Personnel 2005
Director, Research Laboratories: Prof. Cliona O'Farrelly
Laboratory Co-ordinator: Michelle Ipadeola/Lorna Gallagher
Senior Scientists & Post Doctoral Fellows
Jimmy Tharappel Jacintha O'Sullivan Andrew Lloyd
Kirsty O'Brien Lucy Golden-Mason Louise Flanagan
Ursula Fearon Catherine Sweeney Margaret O'Brien
Kieran Meade Elizabeth Ryan Brid Ryan
Jean Fletcher Arlene Kelly Neil O'Brien
Research Assistants
M.D.
Lorna Gallagher Emma McGrath Diarmuid Manning
Laura Greenan Geraldine Scaife Tariq Tajuddin
Sarah Cahalane Shane Sullivan Lorraine Power
Miriam Tosetto Gerard Moloney Alan Coss
Jennifer McCormick Diarmaid O'Meara Juliette Sheridan
Jessica McMahon
Deirdre Waterhouse
Gavin Rush
Post Graduate Students PhD Students (Post Grads) MCh .
Rowan Higgs Lydia Lynch Mohammad R. Zaman
Jane Culleton Patricia McGowan Caitriona Canning
Jody Madigan
Lucille Kavanagh
Tom Cawood Martina Gogarty MSc.
Ellen Moran Ashling Kennedy Julie Gorman
Ronan Mullan
Mary Connolly
Sheeona Gorman Paul Cormican Under Graduate Students
Aoife O'Donovan Keith McQuillan Fiona Behan
Alison Beirne Keith McQuillan Jamie Butler
Lisa Shine
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Review 2005
Review by Director, Research Laboratories
Prof. Cliona O'Farrelly,
Director Research Laboratories
Research activities at St Vincent's University Hospital have been progressing dramatically in 2005 with major
grants awarded to several of the research groups, significant papers published and higher degrees awarded.
A unifying theme is emerging from these activities, which focuses on molecular and genomic mechanisms
in inflammation and malignancy. The coming on stream of extra research space in the GRU and in the ERC,
together with the recommendations of the Research Advisory Board, will now allow development in this area
to move to a different level.
A significant resource generated by SVUH researchers and key to successful translational research has been
the generation of biorepository collections which include tens of thousands of samples from well
documented cohorts of patients. These are proving to be of significant interest to collaborating researchers
here, in the Conway and to pharmaceutical companies. It is critical that we provide the appropriate
infrastructure to maintain, develop and effectively use these collections.
Another major resource are our young researchers, science graduates and medical graduates, of whom
almost 20 based here at SVUH, are registered for higher degrees in UCD. Significant effort is going into
providing appropriate training and support to researchers so that they have the skills to bridge the clinical
demands and intellectual challenges of internationally competitive translational research. The programme for
Conway graduate training, the DMMC courses and the weekly journal club here and a monthly training
session with PhD students are all designed to improve facilities for fourth level training of biomedical
researchers. Improved infrastructure, support staff and most importantly, facilitated career paths for these
young researchers will be key to the development of SVUH as an internationally competitive centre for
translational research.
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Education & Research Centre
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Research Groups 2005
Liver Transplantation, Malignancy & Hepatitis C
Cliona O'Farrelly P.I. John Hegarty P.I.
Diarmuid Manning MD Tariq Tajuddin MD
Zaman Badar MCh Elizabeth Ryan Post Doc.
Arlene Kelly Post Doc. Margaret O'Brien Post Doc.
Lorna Gallagher Research Assistant Jody Madigan PhD
Geraldine Scaife Research Assistant
Innate Immunology Group
James Tharappel Senior Scientist Cliona O'Farrelly P.I.
Kieran Meade Post Doc. Rowan Higgs PhD
Sarah Cahalane Research Assistant
Regional Immunology Group
Cliona O'Farrelly P.I. Lydia Lynch PhD
Emma McGrath Research Assistant
Bioinformatics Group
Andrew Lloyd Senior Scientist Cliona O'Farrelly P.I.
Paul Cormican PhD
Psycho Immunology Group
Kevin Malone P.I. Aoife O'Donovan PhD
Gavin Rush
MD
Rheumatology Group
Barry Bresnihan P.I. Doug Veale P.I.
Oliver FitzGerald P.I. Ursula Fearon P.I.
Ceara Walsh MD Catherine Sweeney Post Doc.
Martina Gogarty PhD Mary Connolly PhD
Ronan Mullan PhD Aisling Kennedy PhD
Ellen Moran PhD Jenny McCormick Research Assistant
Gerard Moloney Research Assistant
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Review 2005
Research Groups 2005
Colorectal
Diarmuid O'Donoghue P.I. David Fennelly P.I.
Kieran Sheahan P.I. John Hyland P.I.
Jacintha O'Sullivan P.I. Alan Coss MD
Joseph Marry MD Juliette Sheridan MD
Sheeona Gorman PhD Julia Gorman MSc Student
Miriam Tosetto Research Assistant Shane Sullivan Research Assistant
Blathnaid Nolan Research Nurse
Respiratory/Physiotherapy Group
Charles Gallagher P.I. Walter McNicholas P.I.
Deirdre Waterhouse MD Silke Ryan PhD
Sinead Barry
Research Fellow
Endocrinology Group
Charles Gallagher P.I. Walter McNicholas P.I.
Deirdre Waterhouse MD Silke Ryan PhD
Sinead Barry
Research Fellow
Neurology Group
Niall Tubridy P.I. Jean Fletcher Post Doc Fellow
Lisa Gribbin Research Nurse Lisa Costello MD student
Tumour Biology Group
NJoe Duffy P.I. Kirsty O'Brien Post Doc
Brid Ryan Post Doc. Patricia McGowan PhD
Jane Culleton PhD Helen Vaughan Research Nurse
Endocrinology & Adipocyte
Donal O'Shea P.I. Cliona O'Farrelly P.I.
Tom Cawood PhD Jean O'Connell Registrar
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Education & Research Centre
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Research Activities
Tumour Biology Group
Principal Investigator:
Researchers:
Professor Joe Duffy
Dr Kirsty O'Brien, Dr Neil O'Brien, Ms Brid Ryan, Ms Jane Culleton,
Ms Patricia McGowan,
Collaborators (Local):
Professor John Crown, Mr Enda McDermott,
Professor Niall O'Higgins (SVUH), Dr Liam Gallagher,
Professor Steve Pennington, Professor F Martin (UCD)
Collaborators (International): Drs Denis Slamon/Gottfried Konecny, University of California at Los Angeles; Dr
Stan Krajewski, Burnham Institute, La Jolla; Professor Fred Sweep, Nijmegen; Professor Nils Brunner,
Copenhagen, Professor Manfred Schmitt, Munich.
Research Focus
The overall aim of the Tumour Biology Group is to develop new molecular markers to aid the early diagnosis
of breast cancer, help with prognosis and predict likely response or resistance to specific therapies.
Jane Culleton is investigating a gene that is preferentially expressed in breast tissue, ie, lipophilin B (LPB).
Jane has shown that although LPB is massively overexpressed in breast cancer, its expression correlates
with parameters of a favourable prognosis. The hypothesis is currently been tested in a large patient
population, using tissue microarrays. This part of the project is being done in collaboration with Professor G.
Landberg, Malmo, Sweden.
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Review 2005
Research Activities
Aberrant gene methylation is now recognized as one of the key events in cancer formation and progression.
Specifically, methylation in the promoter regions of specific genes has been shown to result in gene silencing
or shutting down of gene expression. Many of the genes silenced by methylation are known as tumor
suppressor genes, ie, genes that prevent the formation of cancer. Failure to express these tumor suppressor
genes is one of the critical events in the transformation of a normal cell into a malignant cell. Dr Kirsty O'Brien
is investigating the potential of methylated genes to determine prognosis and predict response to therapy in
breast cancer. This project is part of an EU Consortium involving 8 different collaborating institutions in
Europe.
Brid Ryan's work involves investigating survivin which is both an inhibitor of apoptosis (or cell death) and a
regulator of cell division. Although not specific for breast tissue, surviving is one of the most pan tumourspecific
genes identified to-date. Brid has shown that survivin is present in almost all breast cancers but is
rarely detected in normal breast tissue. Surprising, levels of survivin in breast cancer do not appear to
correlate with rates of apoptosis but do correlate with rates of proliferation. These findings suggest that the
primary function of survivin in breast cancer may be to control proliferation rather than inhibit apoptosis.
Consistent with its role in proliferation, Brid recently showed that survivin was a powerful and independent
prognostic marker in breast cancer.
Patricia McGowan is working on TACE (ADAM17), a multidomain protein possessing both a protease and an
adhesion domain. It is thus potentially involved in cancer progression. Patricia's early results suggest that the
TACE is significantly upregulated in breast cancer and furthermore that TACE protein exists in multiple
molecular forms in breast cancer. The clinical significance of these different forms are now being investigated.
Higher Degrees
Brid Ryan received her PhD in 2005 for her research on “Survivin in Breast Cancer”. During the year, Brid was
also awarded a Health Research Board/National Cancer Institute Fellowship in Preventative Oncology. This
Fellowship will allow Brid to work at the world famous National Cancer Institute in the US.
Bioinformatics Group
Principal Investigator:
Senior scientist:
Graduate student:
Cliona O'Farrelly
Andrew T. Lloyd PhD
Paul Cormican
Research
The principal research project, funded by the Department of Agriculture, continues to investigate innate
immunity in chickens. We have developed a new discovery pipeline for analysing the frequency of Single
Nucleotide Polymorphisms (SNPs) in chickens and identifying SNP-rich genes in its genome. We have
discovered and characterised a novel Toll-Like Receptor TLR15 in the chicken and developed a method of
modifying anti-microbial peptides to improve their efficacy. We have identified 18 putative anti-microbial
peptides in the Bovine genome and are in the process of characterising them.
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Education & Research Centre
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Research Activities
Consultancy and Collaboration
The Bioinformatics Group is available to consult with and advise other research groups in the ERC about all
aspects of bioinformatics and molecular evolution. Andrew Lloyd has been collaborating with the Colon
Cancer Group in analysing Microarray Comparative Genome Hybridisation (Array CGH) data. Paul Cormican
has helped the Rheumatology and Tumour Biology groups with DNA sequence analysis. The group has
helped supervise undergraduate project students.
Posters
July 2005: Identification of novel Toll-Like Receptors in Chicken. Paul Cormican. Immunology Master Class
at the Irish Society of Immunology. Maynooth.
Sept 2005: Investigating the effect of genomic context on the evolution of orthologous genes. Paul
Cormican. The 3rd RECOMB Satellite Workshop on Comparative Genomics 2005, Trinity College Dublin.
Innate Immunity Group
Principal Investigator: Cliona O'Farrelly
Senior scientists: Andrew T. Lloyd PhD, James Tharappel PhD (until July 2005)
Post Doctoral Researcher: Kieran Meade
Graduate students:
Paul Cormican M.Sc. Rowan Higgs
Research Associate:
Sarah Cahalane
Invited talks
Feb 2005 'Characterisation and Function of Novel Chicken Antimicrobial Peptides' Rowan Higgs. VIDO
Saskatoon, Canada.
International Visits
Feb 2005. Sarah Cahalane and Rowan Higgs to VIDO, Saskatoon, Canada to measure the effects of
Salmonella infection in chickens.
Aug 2005 Kieran Meade to VIDO, Saskatoon, Canada for further Salmonella infection experiments.
Posters
March 2005: The Synthetic Form of a Novel Chicken β-Defensin Identified in Silico is Predominantly Active
against Intestinal Pathogens. Rowan Higgs Gordon Conference on Antimicrobial Peptides. Ventura Beach,
California.
July 2005: Identification of novel Toll-Like Receptors in Chicken. Paul Cormican.
Immunology Master Class at the Irish Society of Immunology. Maynooth.
Aug 2005: Upregulation of a Novel Chicken TLR Following Salmonella enterica Serovar Typhimurium Infection.
Rowan Higgs, Paul Cormican, Sarah Cahalane, Brenda Allan, Andrew T. Lloyd, Kieran Meade, Tharappel
James, David J. Lynn, Lorne A. Babiuk and Cliona O'Farrelly. Sixteenth Western Meeting of Poultry Clinicians
and Pathologists, Lake Louise, Alberta, Canada. 2005
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Research Activities
Sept 2005: Investigating the effect of genomic context on the evolution of orthologous genes. Paul
Cormican. The 3rd RECOMB Satellite Workshop on Comparative Genomics 2005, Trinity College Dublin.
Research
The principal research project, funded by the Department of Agriculture, continues to investigate innate
immunity in chickens. We have developed a new discovery pipeline for analysing the frequency of Single
Nucleotide Polymorphisms (SNPs) in chickens and identifying SNP-rich genes in its genome. We have
discovered and characterised a novel Toll-Like Receptor TLR15 in the chicken and developed a method of
modifying anti-microbial peptides to improve their efficacy. We have identified 18 putative anti-microbial
peptides in the Bovine genome and are in the process of characterising them.
Education and Outreach.
The Bioinformatics Group continues to consult with and advise other research groups in the ERC. In
particular Andrew Lloyd have been collaborating with the Colon Cancer Group in analysing Array CGH
microarray data.
Dec 2005: Playing Chicken with Bacteria by Dick Ahlstrom article in Irish Times
Regional Immunity Group
Principal Investigator:
Postgraduate Student:
Research Assistant:
Collaborators:
Endometrium Study:
Intestinal Study:
Professor Cliona O'Farrelly
Lydia Lynch
Emma McGrath
Professor C. O'Herlihy, Dr. M. Eogan; National Maternity Hospital, Holles St.
Professor D. O'Donoghue; St. Vincent's University Hospital
The Regional Immunity Group is currently undertaking a number of projects involving the study of the origin
and function of cells of the immune system in both the human intestine and endometrium. It is believed that
many of these cells develop locally rather than infiltrating from surrounding areas. It is also possible that if
these cell populations develop locally they may have specific functions specialised for the part of the body in
which they are found. The details of these individual studies are described below.
Project Title: Haematopoietic Stem Cells in Human Intestine
The concept of lymphoid differentiation in the human gastrointestinal tract is controversial, but is the focus
of this study, which examined adult human small intestinal tissue for the presence of CD34 + CD45 +
haematopoietic stem cells (HSCs) and lymphoid progenitors. The data from this study suggest that the
epithelium may be a preferential site of NKR+ lymphoid differentiation. In addition, the phenotype of intestinal
HSCs, which differs significantly from circulating or bone marrow HSCs, is consistent with a role in local
lymphoid development in the adult human intestine.
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Research Activities
Project Title: Natural Killer Receptor Positive Cells in Human Endometrium
Endometrial lymphoid cells that express natural killer (NK) cell receptors are thought to be critical for
successful pregnancy but little is known about their phenotype or origin. This work aims to compare uterine
NK (uNK) and NKT cell populations from fertile and infertile women. We found that uNK CD94 expression
decreased significantly during the secretory phase of the menstrual cycle in fertile endometrium. However
this decrease was not observed in infertile endometrium, suggesting the failure to down-regulate CD94
locally may lead to uNK cell dysfunction in infertile women. It is possible that these NK populations
differentiate locally. We therefore set out to examine endometrium as a source of NK progenitors.
Project Title: Haematopoietic Stem Cells in Human Endometrium
Uterine lymphoid cell repertoires are specialized in order to meet the twin demands of successful pregnancy
and local immuno-surveillance. We examined human endometrial tissue for haematopoietic stem cells
(HSCs) and lymphoid progenitors from women with a history of infertility as well as fertile controls using
three colour flow cytometry. Significant levels of HSCs (CD34 + CD45 + ) were detected in all samples. This is
the first demonstration of haematopoietic stem cells in the human endometrium and increased levels of NK
progenitors in endometrium of women with infertility suggests a dysregulation of this pathway that may
contribute to infertility.
Liver Research Group
Principal Investigators:
Prof Cliona O'Farrelly & Prof John Hegarty
Research Personnel 2005
Senior Scientists:
Post-Doctoral Fellow:
Research Assistant:
Research Fellows:
PhD Student:
Lucy Golden-Mason (now Assistant Professor,
Division of Gastroenterology, Denver, U.S.A.)
Elizabeth Ryan
Margaret O'Brien (also currently 4th year Medical Student)
Arlene Kelly: (S.V.U.H. / T.C.D.)
Gegs Scaife
Diarmuid Manning, Tariq Tajuddin, Badar Zaman
Jody Madigan
The Liver Research Group operates a four stranded research programme based on Hepatic Malignancy, Liver
Transplantation, Hepatitis C viral infection and Basic Immunology of the liver.
Liver Research
Hepatic Malignancy Basic Immunology Hepatitis C Liver Transplantation
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Research Activities
Liver Transplantation
Mr Muhammad Badar Zaman is an MCh research fellow whose interest is Ischaemia- Reperfusion injury in
Liver Transplantation. He is investigating the activation of Nrf2 and other mechanisms of cytoprotection
against reactive oxygen species and their clinical implications. He is working in collaboration with Post -
Doctoral scientist Martin Leonard at the Conway institute in UCD.
Hepatic Malignancy
Jody Madigan is a PhD student working in the area of hepatic malignancy :-
The aim of his project is to investigate the role of CD1d isoforms in regulating immune responses to
malignancy. CD1 molecules are related to MHC, and predominantly present glycolipid antigens. CD1d is a
restriction element for natural killer (NK) T cells, a sub-population of lymphocytes expressing a T cell receptor
together with NK cell markers. CD1d molecules bind and present lipids to these NKT cells resulting in
activation and production of cytokines. Immune regulatory functions such as development of tolerance,
regulation of autoimmunity, and potent antitumour and antiviral activities have been ascribed to NKT cells
HCV
Over the next 10-20 years chronic Hepatitis C is predicted to become a major burden on the health care
system as patients who are currently asymptomatic with relatively mild disease progress to end-stage liver
disease and develop hepatocellular carcinoma.
There is no vaccine for HCV. The best weapon against HCV is a combination therapy (interferon α with
ribavirin), but success rate is at best 40-60%, and it has severe side effects. A wider range of treatments is
needed to combat HCV more effectively in more people. One way to do this is to boost the patient's own
immune response to HCV, but to successfully achieve this we need to understand why most people fail to
clear HCV infection in the first place
Senior scientist Liz Ryan has commenced an investigation into the role of Dendritic Cells and how their
dysfunction might contribute to chronic Hepatitis C infection:-
This study aims to characterize how HCV interacts with DC-SIGN allowing the virus to hijack DCs and switch
off the immune response. Disrupting the interaction between these DC receptors and HCV may offer a new
therapeutic strategy for chronic HCV infection.
Cytokine and chemokine profiles that might predict the response of HCV patients to therapy :-
Alpha Interferon in combination with Ribavirin is the current standard treatment for chronic HCV hepatitis.
However, more than 50% of patients do not respond to this combination therapy and suffer significant side
effects unnecessarily.
Analysis of in vitro Interferon Alpha / Ribavirin induced cytokine and chemokine expression in cohorts of
responding and non-responding patients will identify signatures predictive of in vivo response to treatment.
We propose to design an assay based on these characteristic signatures that will be used to predict the
potential efficacy of Alpha Interferon / Ribavirin therapy on an individual patient basis, prior to commencement
of treatment. Chemokines and cytokines that are over- or under- expressed in non-responders will be
potential targets for the rational development of novel therapies.
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Research Activities
Immunogenomics of HCV Infection
The aim of this project is to analyse interferon alpha production and response in hepatitis C virus infection.
Approximately 50 - 80% of patients develop chronic infection following inoculation with the virus. However,
only half of these patients respond to combination treatment with Interferon Alpha / Ribavirin. The reasons
for both the high rate of chronic infection and variation in treatment outcome are not fully understood.
Analysis of variations (polymorphisms) in the interferon alpha and interferon alpha response genes and the
resulting difference in response to interferon alpha may help us determine patients who are most likely to
respond to therapeutic interferon alpha.
HCV Research Consortium
The cohort of Irish women infected in 1977 with HCV contaminated anti-D provide an important opportunity
for analysis of host genetic factors in HCV as this group is homogenous for time of infection, route of
infection, racial background, gender and viral subtype. Resolution rates in this cohort have been significantly
better than the average reported rates of approximately 20% and several preliminary studies of these
patients have suggested genetic influences including association between HLA and viral clearance and also
an association between MMP3 and chronicity. The Consortium will investigate the contribution of KIR
genotype and/or phenotype to resolution of HCV in the Irish population. The HCV Consortium was
established to conduct research into different aspects of HCV infection in this cohort.
Consortium Members
Prof Cliona O'Farrelly Chairperson, St Vincent's University Hospital
Dr John Crowe
Mater Misericordeae Hospital
Prof Dermot Kelleher St James Hospital
Prof John Hegarty St Vincent's University Hospital
Dr Orla Crosby
Cork University Hospital
Dr Frank Murray
Beaumont Hospital
Dr Suzanne Norris St James Hospital
The group has recently been awarded a grant from the HRB of €234,473.60 for “An Investigation of KIR
genotypes in the resolution of HCV infection”.
Post Doctoral Researcher, Dr Arlene Kelly was appointed to work in collaboration with the HCV Research
Consortium and Dr Claire Gardiner of TCD on this immunogenetic study:-
In this study, the contribution of genes coding for NK cell receptors (Killer-cell immunoglobulin-like receptors)
to the resolution of HCV infection will be studied. NK cell receptor genotyping will be performed together
with and some preliminary phenotyping. In particular, this new data will be correlated with HLA data
previously collected to confirm a potential role of KIR receptors in influencing the prognosis and outcome of
HCV infection.
Papers Published
The Hepatitis C Envelope 2 Protein inhibits LFA-1 Transduced protein kinase C signaling for T-Lymphocyte
migration.
Volkov V, Long A, Freeley M,Golden-Mason L,O'Farrelly C, Kelleher D, Murphy A.
Gastroenterology (in press)
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Research Activities
Reconstitution of hepatitis C virus-specific T-cellmediated immunity after liver transplantation.
Weston SJ, Leistikow RL, Reddy KR, Torres M, Wertheimer AM, Lewinsohn DM, Chou S, Davey MP, Corless
C, O'Farrelly C, Nelson DR, Rosen HR.
Hepatology 2005 41(1)72-81 PMID 15619226
Liver Immunity and Tumour Surveillance
Caitriona Canning 12 ; Margaret O'Brien 2 ; John Hegarty 1, 3 ; Cliona O'Farrelly 2, 3
Degrees awarded and Submitted:
Susan Behan:
Anna Kelly:
Caitriona Canning:
Awarded Ph.D - Alpha interferon and HCV
Submitted MD thesis: Cytokines and Malignancy
Submitted MCh thesis: Cytokines and Colon Metastases
Respiratory Sleep Research Laboratory
Director:
Research Lecturer:
Chief Technician:
Prof. Walter McNicholas
Dr. Silke Ryan
Ms. Geraldine Lawless
Summary of Research Programme
The Respiratory Sleep Research Laboratory at St. Vincent's University Hospital continues a varied clinical and
basic science research programme with a particular emphasis of cardiovascular interactions in obstructive
sleep apnoea (OSA). Ongoing collaboration exists with the research group of Dr. Cormac Taylor in the Conway
Institute at UCD and the School of Electronic and Electrical Engineering (Dr. Conor Heneghan and Prof. Mark
O'Malley), also in UCD.
Together with Dr. Taylor we have an ongoing translational research programme that explores the role of
intermittent hypoxia (IH) in the pathogenesis of cardiovascular disorders in OSA. In studies of OSA patients,
and also a unique cell culture model of IH, we have demonstrated that IH selectively activates inflammatory
over adaptive molecular pathways through the selective activation of the inflammatory transcription factor
NFkB. NFkB has been shown to predispose to atherogenesis. We have also demonstrated that the NFkBdependent
gene TNF - a is elevated in patients with OSA and falls to control levels with nasal CPAP therapy.
In collaboration with Dr. Heneghan, we have studied the ability to identify sleep apnoea from digital signal
processing of the ECG signal, based on characteristic changes in the ECG that accompany apnoea. We are
working towards the development of a simplified ambulatory diagnostic system for OSA based on detailed
analysis of the ECG, oxygen saturation and related derived signals such as pulse transit time. In collaboration
with Prof. O'Malley, we have developed new surface electrode configurations to record genioglossus EMG
with a view to studying the role of skeletal muscle fatigue in the pathophysiology of OSA.
We have also undertaken several clinical studies that have been completed during 2005 comparing standard
CPAP therapy for OSA with the more sophisticated auto-adjusting positive pressure system (APAP).
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Research Activities
Presentations at International meetings during 2005
Presentations of original research were given by members of the research team at the annual meeting of the
American Thoracic Society in San Diego in May and the annual meeting of the European Respiratory Society
in Copenhagen in September.
Centre for Colorectal Disease
Clinical & Research Team
Diarmuid O'Donoghue Consultant Gastroenterologist (Director of Centre for Colorectal Disease)
John Hyland Consultant Surgeon Des Winter Consultant Surgeon
Kieran Sheahan Consultant Pathologist Hugh Mulcahy Consultant Gastroenterologist
David Fennelly Consultant Oncologist Jacintha O'Sullivan Senior Research Scientist
David Gibbons Consultant Pathologist John Armstrong Consultant Radiation Oncologist
Michael Moriarty Consultant Radiation Oncologist Denise Keegan Genetic Nurse Specialist
Anne White Cancer Nurse Coordinator Nikki Smith Nurse Specialist
Grace McEvoy Nurse Specialist Blathnaid Nolan Research Nurse
Dermot Leahy Senior Research Scientist Miriam Tosetto Research Assistant
Robert Geragthy Senior Medical Scientist Juliette Sheridan MD Research Fellow
Alan Coss MD Research Fellow Edward Fox Ph.D Student
Sheeona Gorman Ph.D Student Shane Sullivan MSc. Student
Julie Gorman MSc. Student
Overall Research Theme
The main research goals of the Centre for Colorectal Disease is to achieve a more complete understanding
of which biological factors drive colorectal cancer and to determine if different biological markers can
distinguish people at high risk and elucidate which subset of patients will respond to particular treatment
regimes. These translational research projects will result in early detection and early medical intervention and
more effective treatment of the disease. To carry out these research studies, we utilise our longstanding
inflammatory bowel disease and colorectal disease databases, both established over 20 years ago and
containing over 2,000 cases each. Extensive clinical, pathological and survival data are available on most
patients.
In May 2005, Ms. Sheeona Gorman joined our research group to embark on her Ph.D studies. Sheeona's
thesis project is focused on understanding how mechanisms of genomic instability can govern treatment
responses and possibly secondary tumour formations using in vitro and ex vivo explant material. This work is
done in collaboration with St Lukes Hospital, Rathgar, and using the cell flow sorting facilities in the Conway
Institute, UCD. Sheeona's initial data suggests that bystander secreted factors from the primary treated
tumours can accelerate genomic instability (anaphase bridge formation) in untreated epithelial cells. If this
rampant genomic instability accelerates, these genomic instable cells could become immortal, invade and
may rise to secondary cancer formations.
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Research Activities
In December 2005, Ms. Julie Gorman joined the research team as a MSc student. She is investigating if
combination therapy using telomerase inhibition with standard radiation and chemotherapeutic treatments
can accelerate tumour cell death, decrease invasion and can improve overall drug response.
Invited Talks at Conferences
The following talks were presented at the Irish Society of Gastroenterology Winter Meeting 2005:
Shane Sullivan, “Localisation and expression of a novel Cathepsin L isoform in colorectal cancer”
Alan Coss, “Use of array comparative genomic hybridisation to differentiate between metastatic and
non-metastatic colorectal cancer”
Jacintha O'Sullivan, “Glycosylation and golgi apparatus structural integrity are essential in targeting
Glut1 to membranes of colorectal cancer cells”.
Jacintha O'Sullivan, “Glut1 staining pattern in contiguous and non contiguous adenomas and their
corresponding tumours”.
Juliette Sheridan, “Effect of Radiation on Levels of DNA Damage in Normal Mucosa of Colorectal
Cancer Cases”.
Current National & International Research Collaborators
Prof. Peter Rabinovitch, University of Washington, Seattle, Prof. Larry Loeb, University of Washington,
Seattle, Dr. Phillipe Anker, University of Geneva, Switzerland, Prof. Martin Tenniswood, Notre Dame,
Indiana, Dr Orla Howe, Dr. Fiona Lyng, DIT, Kevin Street, Dr. Cormac Taylor, Conway Institute, UCD,
Prof. Kevin Malone, St Vincents University Hospital, Dublin, Dr. Dermot Leahy, Conway Institute, UCD,
Prof. Alan Baird, Vet School, UCD, Dr. Paul Walsh, National Cancer Registry for Ireland, Cork.
Updated Project Summaries
The role of hypoxia and genomic instability in governing response to monoclonal antibody therapies in
colorectal cancer patients. Treatment options for colorectal patients are becoming more complex with the
introduction of the new monoclonal antibody therapies, bevacizumab (Avastin) and cetuximab (Erbitux), which
specifically target vascular endothelial growth factor and epidermal growth factor receptor respectivity.
Multidisciplinary teams are now faced with the insurmountable decision making of who will benefit from
these newer, highly expensive, combined treatment regimes, costing over 250,000 euros per patient until
disease progression. These therapies are currently only offered to late staged metastatic colorectal cancer
patients. Using our unique ex vivo explant culture technology, we are now in a position to test, which
colorectal tumours will respond to the different therapies and elucidate whether non-metastatic tumours
(stage I and II) could also benefit from these treatments. What factors may control these responses?. We
hypothesise that the degree of hypoxia (reduction oxygen levels in the tumour), as well as alteration in
genomic instability (oxidative damage, telomere length changes, telomerase activation) will significantly
affect the response rates of these therapies. This work is currently been carried out in collaboration with Dr.
Cormac Taylor, Conway Institute UCD and the telomerase work with Prof. Philipe Anker, University of Geneva.
Juliette Sheridan's preliminary data (with the research aid of Miriam Tosetto) suggests that under graded
hypoxic conditions and high levels of oxidative stress, sensitivity to mono (5FU) combined treatment
(FOLOFOX, 5FU, Oxaliplatin and leucovorin) and to monoclonal antibody treatment is significantly reduced.
In vivo, Juliette has also demonstrated in defects in base pair excision and high levels of 8 oxo dG levels
(marker of DNA damage) and high levels of tumour infiltrating lymphocytes (done by Dr. LiaMun Wang) is
significantly higher in non metastatic vs metastatic tumours. This increase in reactive oxygen species and
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Research Activities
inflammtion may contribute to the increased levels of 8-oxo dG with subsequent promotion of genomic
instability, consequent risk of cancer development and further neoplastic progression.
Timing and rates of random nuclear and mitochondrial spontaneous mutations in colorectal cancer:
implications for early detection and chemotherapy resistance. Numerous random mutations could account
for tumour herterogenity and represent a mutator phenotype. The study of a mutator phenotype in colorectal
carcinogenesis has been precluded by technical limitations until recently (Bielas and Loeb, Nature Methods,
2005). In collaboration with Prof. Loeb, we are elucidating the timing of nuclear and mitochondrial random
mutation accumulations in colorectal tumourigenesis, using his recently validated assays of random mutation
capture and single molecule sequencing of mitochondrial DNA. This study will constitute the first description
of the frequency of random nuclear and mitochondrial mutations in colorectal cancer and the rates of these
temporal variations. In addition, we propose to examine if a correlation exists between these random
mutations and treatment response rates to the new monoclonal antibody therapies described above. This
transatlantic collaboration combines the clinical resources and genomic instability expertise of the Centre for
Colorectal Disease, Dublin and random mutation analyses and the mutator phenotype expertise of the
Joseph Gottstein Memorial Cancer Research Laboratory, University of Washington, Seattle.
Screening for Microsatellite Instability and loss of mismatch repair protein in sporadic and familial colorectal
cancers. Through a previous HRB grant, we have identified familial HNPCC families that have high
microsatelitte instability and loss of mis-match repair proteins. These changes are controlled by epigenetic
mechanisms. This has been the focus of Edward Fox's Ph.D work with the supervision of Dr. Dermot Leahy.
This work is due to be published in February 2006: Fox et al, Journal of Molecular Diagnostics, vol 8. no 1.
Using the technologies described in this paper, these genomic instability tests have now translated into the
routine pathology labs for prospective screening of all colorectal cancer patients. To develop this research
project, we will elucidate the expression of genes containing coding repeat sequences liable to be mutated
at these repeats in MSI tumours, these include TGF - betaRII, BAX and AXIN. Mutations in BRAF and KRAS
genes are postulated to discriminate between hereditary and sporadic MSI and we will test this in our patient
group. This should lead to improved diagnosis and prognosis and provide a basis for future “molecular targetbased”
intervention studies. Molecular differences between the MSI subsets would also account for
inconsistencies observed regarding their natural history and responsiveness to adjuvant chemotherapy.
Use of array comparative genomic hybridisation to differentiate between metastatic and non-metastatic
colorectal cancer. This work has formed the main part of Alan Coss's MD research project. Chromosomal
instability is a key pathway involved in colorectal cancer (CRC) progression. However, little is known about
how patterns of this instability may vary according to tumour stage and survival. Array comparative genomic
hybridisation (array CGH) is a highly sensitive method of detecting changes in chromosomal DNA copy
number across the human genome. This technology was used to assess gains or losses in tumour DNA copy
number relative to control DNA at 287 known gene loci across all chromosomes in our non-metastatic and
metastatic tumour samples. Alan has identified amplifications on chromosomes 20q, 7q and 13q, and
deletions on chromosomes 1p, 8p and 17p. Using a bio-informatic approach (correspondence and between
groups analyses), we identified a number of genes potentially associated with non-metastatic versus
metastatic disease. These included some established markers such as EGFR and DCC, as well as more novel
targets; including cyclin D2, PTEN, BCR, RAF1 and TOP2A, which could be involved in progression and
survival. Array CGH is an effective tool for identifying differences in chromosomal instability patterns between
non-metastatic and metastatic colorectal cancers. This work is currently been prepared to submit for
publication.
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Research Activities
Department of Rheumatology
Principal Investigators
Postdoctoral Scientist
Graduate Students
Research Assistants
Clinical Research Fellows
Research Nurses
Professor Barry Bresnihan, Professor Oliver FitzGerald
Dr Douglas Veale, Dr Ursula Fearon
Dr Catherine Sweeney
Ms Mary Connolly, Ms Martina Gogarty, Ms Aisling Kennedy,
Ms Ellen Moran
Ms Laura Greenan, Ms Jennifer McCormick, Mr Keith McQuillan
Mr Gerard Moloney, Mr Diarmaid O'Meara
Dr Adrian Gibbs, Dr Ronan Mullan, Dr Ceara Walsh, Dr Eliza Pontifex
Dr Wahlid Al-Shehi, Dr Bea Radovitis, Dr Julia Martin
Ms Felicitas Froehlich-Grimm, Ms Marie O'Rourke
Research Activities
Rheumatology Research Group SVUH
A coordinated Rheumatology Research group has developed with Prof Barry Bresnihan, Dr Doug Veale, Prof
Oliver FitzGerald and Dr Ursula Fearon (Senior Scientist). This is a truly translational research group with a
primary clinical focus on inflammatory arthritis (RA and PsA) and a scientific focus on mechanisms of
inflammation and joint damage. The group uses synovial membrane analysis to examine biomarkers of
disease, the role of angiogenesis, novel mediators/cytokines and cartilage destruction.
The research plan for the next five years is to build on the current expertise to develop predictors of response
to therapy, prediction of remission and to further examine the mechanisms of disease. We intend to expand
the use of novel human models of disease, which we have demonstrated in partnership with GlaxoSmithKline
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as important models in pre-clinical drug development. GSK and Cambridge Antibody Technology will fund
(€0.5m; €100k respectively) over the next 2 years for monoclonal antibody drug development research.
Furthermore genetic and bioinformatic analysis of both the in vivo - and in vitro - generated data sets from a
clinical trial with Amgen (SPECTRA) is now being carried out to determine mediators of initiation, persistence
or resolution in inflammatory joint disease. In addition, it is intended to develop a state-of-the-art clinical
research programme to examine mechanisms of disease, identify early biomarkers and novel targets for new
therapies for inflammatory diseases. Furthermore, we will work with colleagues in SVUH, UCD and across
the DMMC to develop the full potential for clinical and molecular Imaging. Our vision, which we share with
medical and scientific colleagues, is to develop a centre of excellence for Immunotherapy Research funded
through partnership with industry, HRB, SFI, and multidisciplinary clinical and basic scientists across Dublin.
Specific ongoing projects
(1) SPECTRA Study: In collaboration with Amgen, we have conducted a study comparing Anakinra:IL-1
receptor antagonist (IL - 1ra) monotherapy versus a combination of IL - 1ra plus soluble TNF receptor 1
(PEGsTNF - R1) in 22 active RA patients led by Prof Bresnihan. Genetic and bioinformatic analysis of both the
in vivo - and in vitro -generated data sets is now underway to determine mediators of initiation, persistence
or resolution in inflammatory joint disease. With further analysis of gene expression in PBMCs and synovial
tissue samples and by comparison with patient response to biologic intervention, it is expected that gene
profiles of patients destined to respond to or to fail specific treatments will be elucidated. (In collaboration
Prof. JM Dayer, Geneva). Gene profiles will be validated in a number of in vitro cell models.
(2) Remission study and Rituximab
Withdrawal of anti-TNFα therapy in patients with rheumatoid arthritis in clinical remission: can maintenance
of remission be predicted? The primary goal of this trial is to determine if clinical remission can be maintained
in patients with RA following withdrawal of their anti-TNF -α therapy, by substituting optimal DMARD therapy.
We propose to identify predictive markers of relapse and identify a genetic profile associated with relapse.
Dr Ceara Walsh (clinical fellow) led by Prof Barry Bresnihan and Dr Ursula Fearon is examining the role
NK/NKT/NKR+ cells in the patients with active RA compared with those in remission following anti-TNF-α
therapy. To date results have shown an expansion of inhibitory receptor CD94/NKG2A in remission associated
with an increase in the CD8+ T cell population. We continue to follow these patients after withdrawal of
biologic therapy to identify predictors of relapse following therapy withdrawal. Furthermore we are showing
a distinct population in the joint of RA and PsA patients compared to the peripheral circulation with expansion
of CD56high NK cells with an activatated phenotype (upregulation of CD69, HLA-DR and CD25 and inhibition
of CD158 KIR and apoptotic CD57). Currently, we are examining the cytokine and cytotoxocity profile of these
patients. Furthermore we are also examining the immunological effects of kineret therapy (SPECTRA).
Rituximab is an as yet unlicensed therapy, targeting B cells, which is increasingly used in the treatment of
refractory RA. We demonstrate that an improvement in disease activity parameters and functional
assessments is associated with a reduction in synovial expression of CD20 following treatment with
rituximab.
(3) The molecular mechanisms of dysregulated angiogenesis are fundamental to the pathogenic
changes in articular cartilage.
This programme aims to link novel imaging technology and basic science research, in patients with
inflammatory arthritis led by Dr Doug Veale and Dr Ursula Fearon. Arthroscopy and dynamic (MRI/PET)
imaging will be used to determine if macroscopic vascularity and microscopic measures of angiogenesis
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Research Activities
predict cartilage degradation/turnover in arthritis patients, pre/post biologic therapy. Recent targeted biologic
therapies, including anti-TNF and IL - 1 blocking drugs are effective. These agents however, are expensive, and
up to 30% of patients will fail to respond. It is becoming increasingly evident the cytokine networks do not
operate in isolation but interact in the complex inflammatory milieu to promote new blood vessel formation
and synovial cell hyperplasia. We are examining the effects TNF -α and IL - 1α alone and in combination with
novel mediators including Oncostatin M (OSM), IL - 17, acute serum amyloid A (A-SAA) and Angiopoietins to
promote angiogenesis and cartilage invasion.
(i) Oncostatin M and IL - 17
Previous work has demonstrated that OSM promotes adhesion, angiogenesis, cell migration and matrix
degradation in primary synovial cultures. Using whole tissue synovial explants and co-culture cartilage
models (which more closely reflect the in vivo environment) we have demonstrated a dramatic synergistic
reaction between OSM and IL - 1 in promoting matrix degradation and subsequent cartilage degradation
compared to either alone. This work is being continued by Ellen Moran who started a PhD in Oct 2005. Ellen
has been examining the interactions between TNF -α, OSM and IL - 17. OSM in combination with TNF -α
synergistically increases matrix turnover in primary fibroblast, however in whole cartilage explants OSM
synergistically acts with both TNF and IL - 17 in promoting matrix turnover and subsequent cartilage
degradation. These results demonstrate differential cytokine signalling pathways within the joint, dependent
on cell type. Further experiments are being carried out using co-cultures of chondrocytes and fibroblast to
identify the key signalling pathways involved.
(ii) Serum Amyloid A (A-SAA)
Dr Ronan Mullan and Mary Connolly focus on the role of A-SAA in driving the pro-inflammatory response. Dr
Ronan Mullan has demonstrated that A-SAA-induces adhesion molecule, angiogenesis and matrix
metalloproteinase expression in the inflamed joint an effect that is mediated through nuclear factor kappa B
(NFκB) dependent pathways. Furthermore he has demonstrated increased matrix turnover in whole cartilage
explants, along with correlation of A-SAA with cartilage breakdown products in the serum of patient pre/post
biologic therapy, suggesting that targeting A-SAA, or its signaling pathways, may represent a realistic
therapeutic approach in the treatment of inflammatory arthritis. Finally Ronan has demonstrated that A-SAA
may mediate pro-inflammatory responses through a novel HDL receptor CLA-1. Mary Connolly is also
examining the role of A-SAA as a key inflammatory mediator in RA. Specifically, this project examines the
effects of A-SAA on cell migration, cartilage metabolism and the transcriptional pathways mediating this
process. Mary has demonstrated that A-SAA stimulates chemokines expression, invasion, neutrophil
transendothelial cell migration and B1-integrin adhesion. Using an ex-vivo synovial explant model Mary has
shown high spontaneous release of A-SAA locally in the joint, and has demonstrated A-SAA induced CXCL8
and CCL2 expression is mediated in part through the NFκB and PI3κ pathways. Furthermore Mary has
demonstrated that A-SAA specifically alters the cytoskeletal rearrangement in RA synoviocytes producing
filopodia protrusion and migration. Currently she is examining the key protein involved in cytoskeletal
rearrangement and cell movement, with particular focus on PAX, FAK and GTPases. Both Mary and Ronan
won firstt prize for best oral presentations for their research in 2005. Mary also was awarded a SIAR travel
scholarship to present her work at the American College of Rheumatology, San Diego, 2005.
(iii) Endothelial cell survival and blood vessel regression. One of the main interests of the group is the role of
angiogenesis in driving the pro-inflammatory response, with specific interest in dissecting out the pathways
involved in blood vessel maturity and survival. This proposed work will provide novel insights into the complex
mechanisms mediating growth factor activation within a synovial EC model. It will further identify
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Research Activities
downstream signalling pathways involved in regulating cell fate decisions (in particular EC survival). Previous
work in the group has identified key synerigistic reactions between VEGF and the Angiopoetin Tie-2 pathways
which is associated with differential blood vessel morphology in the inflamed joint. Dr Catherine Sweeney
(post-doctoral fellow) has continued this work and has demonstrated that VEGF synergistically interacts with
Angiopoietin 2 to promote expression of survival proteins specifically the Notch and XIAP (survivin) families.
Furthermore she has demonstrated using Confocal microscopy a mixture of immature and mature blood
vessel within the inflamed tissue. Currently Catherine is using a number of models to examine the effects
of blocking these pathways on blood vessel regression. Catherine is also developing new models to examine
angiogenesis in the joint, specifically laser capture and a SCID mouse model. Catherine was awarded a SIAR
travel scholarship to present her work at the American College of Rheumatology, San Diego, 2005.
(iv) Hypoxia and altered mitochondrial bioenergetics in the inflamed joint.
This project proposes that vascular morphology, synovial invasiveness and response to therapy, may be
dependent on activation of mitochondria-derived, hypoxia-induced transcriptional and non-transcriptional
pathways and alterations in genome stability. We aim to establish the oxygen tension of the joints,
macroscopic vascular changes, blood flow and glucose metabolism by dynamic imaging (MRI and PET), and
cellular changes in mitochondrial respiration. In addition, we aim to establish the responses to graded
hypoxia focusing specifically on mitochondrial regulation of inflammatory pathways in vitro. Aisling Kennedy
started as a PhD student in Oct 2005 and is examining the effect of hypoxia on the angiopoietins/Tie2
pathway, blood vessel morphology and cell survival in the joint. Preliminary data has demonstrated
differential expression of Angiopoietin 2 and VEGF from different cell types within the synovial tissue. She
has demonstrated that exposure of primary SFC and EC to graded hypoxia led to induction of VEGF and
MMP-1 production, in contrast to Ang 2 which showed minimal change. Using whole tissue synovial explants
increased levels of VEGF secretion were demonstrated following exposure to 1% hypoxia, in contrast to
Ang2, which was only induced in the presence of TNF -α Currently Aisling is dissecting out the pathways
that may mediate hypoxia induced growth factor expression, specifically NFκB and HIF1 -α. Furthermore she
is examining the downstream role of genomic instability in mediating cell survival. Further upstream triggers
are also being examined with specific focus on mechanical forces, sonic hedgehog and neuropeptides alone
and in combination. This work is in collaboration with Dr Cormac Taylor and Dr Jacintha O'Sullivan.
(4) Psoriasis/Psoriatic Arthritis
There are 3 main areas of interest within Ps/PsA:
(i) Genetics: Using a well characterized cohort of 129 early PsA patients, we have previously identified an
association between a functional polymorphism in the TNF308A-allele and disease progression. DNA has also
been collected from 100 carefully ascertained subjects with Ps only. In addition, as part of a long-term and
on-going collaboration with Prof. Robert Winchester at the University of Columbia in New York, blood samples
have been obtained and lymphoblastoid cell lines have been established from an additional cohort of 270
probands with PsA of varying disease-duration from the same Irish population as well as from >90 control
subjects. To the extent possible, detailed pedigrees have been made and blood obtained from about 15% of
affected relatives. The initial focus has been the detailed molecular genotyping of the HLA-B and -C loci using
sequence-based typing. This has now been completed and detailed analysis is underway. The preliminary
results strongly suggest that PsA is not genetically a simple subset of psoriasis. It is planned to expand the
numbers in the Ps and PsA cohorts to a minimum of 500 probands in each, since this number of subjects
will be required for the establishment of a cross-validation cohort as well as to facilitate stratification-based
analyses (subject of SFI grant application).
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ii) Biomarkers of Biologic Treatment Response: As part of investigator-originated pilot, single-arm protocols looking
at mechanisms of effect of biologic therapies, 6mm skin biopsy (uninvolved at baseline only; leading edge of
Ps lesion at baseline and follow-up) and synovial membrane (obtained under local-anaesthetic at miniarthroscopy
pre-and post-biologic therapy) samples are available for study following infliximab (n=15), IL - 1Ra
(n=12) and etanercept (n=6, of 15 to be collected). Comparisons of immunohistochemical (IH) changes will
be made with standard clinical measures and with MRI changes in the affected knee joint. The IH analysis
has been completed for the first 2 studies. These studies for the first time include clinical, MRI and
immunohistological comparisons which should allow for the identification of novel biomarkers of response.
In addition, it is intended to use the same samples to explore changes in gene and protein expression that
might also predict response to therapy.
(iii) Expression and Regulation of Transcription factors in Ps/PsA: Together with Dr. Evelyn Murphy and Dr. Brian
Kirby, the expression and regulation of NURR proteins pre-and post-treatment is being explored. In addition,
a recent paper suggests a key regulatory role for the AP-1 transcription complex in Ps/PsA. We are further
exploring the possible link between TLR engagement and AP-1 transcription function.
(iv) T cell Receptor Phenotype: Following on previous publications in PsA, the observations are currently being
extended, in collaboration with Prof Bob Winchester, to ankylosing spondylitis where the patients are
carefully HLA-matched. Preliminary results indicate significant clonal expansion within both the CD4 and CD8
populations.
Other projects:
Establishing a carefully characterised cohort of patients with rheumatoid arthritis with DNA bank. Together
with DMMC investigators and Dr. Seamas Donnelly, this project has begun.
Accelerated atherosclerosis in patients with early inflammatory arthritis. With Dr Al-Shehhi, this project has
been completed and is being written up at present.
22nd July 2005 - On the occasion of
Rheumatology Presentations at the E.R.C. by
Professor Cornelia M. Weyand MD, Ph.D. &
Professor Jorg J. Goronzy MD, of the Emory
University School of Medicine, Georgia, U.S.A.
Pictured L to R Front Row: Diarmuid O'Meara,
Catherine Sweeney, Mary Connolly,
Ursula Fearon, Ceara Walsh, Back Row:
Doug Veale, Cornelia M. Weyand,
Barry Bresnihan, Adrian Gibbs, Martina Gogarty,
Jorg J. Goronzy, Eliza Pontifex & Chin Teck NG
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Research Activities
Department of Endocrinology & Diabetes Mellitus
Consultants:
Professor T.J. McKenna, Dr Malachi McKenna, Dr Donal O'Shea
Lecturers:
Department of Medicine, U.C.D.: Dr Diarmuid Smith and Dr Marie-Louise Healy
Specialist Registrars: Dr Chong Yew Tan, Dr Shazli Yusof
Registrars:
Dr Montasir Hammam, Dr Tomás Ahern
Research Registrar: Dr Tom Cawood
Endocrine Laboratory, Principal Biochemist: Dr. Tom Smith
Research-Graduate Students: Ms Sinead Kelly and Ms Lucille Kavanagh
Research Nurse: Ciara O'Dwyer
Research Projects
The regulation of Adrenal Steroidogenesis: (Sinead Kelly)
Classically, the adrenal cortex consists of three morphologically distinct layers. The zona glomerulosa cells
produce aldosterone and the zona fasciculata and reticularis secrete glucocorticoids and adrenal androgens.
ACTH is thought to be the master secretagogoue and stimulates both cortisol and adrenal androgen
production. There are however physiological and pathophysiological states in which cortisol and androgen
levels are dissociated. Angiotensin II (AII) is mainly responsible for aldosterone secretion. In this study we
examined the capacity of H295R human adrenocortical cell line to produce cortisol, adrenal androgens and
aldosterone in response to these secretagogues and their ability to regulate the expression of key
steroidogenic enzymes, CYP21 and CYP17. Our data implicate forskolin, AII and insulin in the differential
regulation of cortisol and adrenal androgens through the relative modulation of CYP21 and CYP17 expression.
Recent studies suggest a key role for nuclear receptor proteins in the expression of genes encoding the
cytochrome P450 enzymes responsible for steroid hormone biosynthesis. We propose that SF - 1 is
responsible for regulating all hydroxylase enzymes under basal conditions and in the presence of
secretagogues. In the human adrenal, ACTH and AII may preferentially stimulate cortisol production by
signalling through nur77.
The extent of gene regulation is influenced not only by the transcription factors involved but also the
presence of specific coregulatory proteins, which modulate transcription. We investigated the expression and
differential interaction of coactivator SRC-1 and corepressor SMRT with transcription factors SF-1 and nur77
in the human adrenal cell line under the influence of forskolin and AII. These data provide evidence that
secretagogues can utilise co-regulatory proteins to discretely regulate expression of key steroidogenic
enzymes in the human adrenal cortex.
Taken together these findings confirm a central role for transcription factors; nur77 and SF-1 and coregulators;
SRC-1 and SMRT in integrating and modulating enzyme expression pertinent to cortisol and adrenal androgen
production. These mechanisms may be critical in the differential secretion of cortisol and adrenal androgens.
Macroprolactinaemia: (Lucille Kavanagh)
Separation Techniques
Macroprolactin is an inactive form of prolactin in vivo. However it is detected, to various degrees, by assays
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Research Activities
commonly used in routine endocrine laboratories. The presence of macroprolactin in a serum sample can
therefore, contribute to a falsely elevated prolactin result. We have completed a comprehensive evaluation
of methods available to screen for macroprolactin. Some methods deplete the serum sample of
macroprolactin prior to analysis. When analysed, the pre-treated serum sample then provides an index of the
clinically relevant i.e. the bioactive prolactin in the sample. We looked at 6 different methods of pre-treating
macroprolactinaemic serum samples, to determine the most precise, accurate and reliable method for use
in the routine laboratory. Assessed against the gold standard but expensive and tedious method of gel
filtration chromatography, we found that pre-treatment with 25% polyethylene glycol (PEG) was the most
practical and cost effective separation method. Where PEG cannot be used, Protein G-sepharose was the
next best performing reagent. Less efficient methods utilited Protein A-sepharose, anti human IgG and
ultrafiltration.
Structure of Macroprolactin
The structure of macroprolactin is presumed to be a monomeric prolactin molecule bound by an
autoantibody. We have used reagents such as Protein G-sepharose and Anti-hIgG-Agarose capable of
precipitating the macroprolactin complex out of solution. This indirectly shows that Macroprolactin has an
immunoglobulin G component. We are developing an assay to measure the macroprolactin autoantibody
directly using an ELISA assay. We are also attempting to assess the prolactin-binding capability of the
autoantibody, by facilitating the autoantibody in taking up a tracer-labelled prolactin molecule.
Bone Metabolism: (Ms Barbara Murray, Dr M-L Healy, Dr D Smith)
Thyroid Disorders: Over activity of the thyroid glands is associated with increased bone turnover and
decrease in bone remodelling balance which will lead to osteoporosis. The Department has examined the
impact of both hyper and hypothyroidism on bone turnover. In patients with hyperthyroidism, a negative
remodelling balance and high bone turnover state has been observed before treatment and is corrected
when the euthyroid state is restored. In patients with hypothyroidism, replacement with L-thyroxine results
in a significant increase in and normalisation of bone turnover.
Anorexia Nervosa: A study of bone biomarkers in patients with Anorexia Nervosa is ongoing in the
Department. Nutritional rehabilitation results in a reduction in bone resorption and an increase in bone
formation. Longer follow-up has been undertaken.
Primary Hyperparathyroidism: Correction of primary hyperparathyroidism is associated with rapid bone
remineralisation. Hungry bone syndrome, a complication of parathyroid surgery, occurs when correction of
primary hyperparathyroidism is associated with intense bone formation causing severe and prolonged
hypocalcaemia. We have recently reported a pattern of post-operative secondary hyperparathyroidism which
maintained eucalcaemia despite the intensive re-uptake of calcium and phosphate into bone. Normalisation
of parathyroid levels occurs as the bones are replenished. We have designed a study to observe parathyroid
hormone levels, indices of bone remodelling and bone density before, immediately after and more remotely
following parathyroid adenomectomy in patients with primary hyperparathyroidism. This will allow us to
establish if early secondary hyperparathyroidism post parathyroid adenomectomy is regularly required to
prevent hypocalcaemia. This study will also provide insight into the validity or otherwise of the concept of
delayed recovery of suppressed normal parathyroid glands following parathyroid adenomectomy for primary
hyperparathyroidism. Hypocalcaemia may only develop in those who fail to mount an early secondary
hyperparathyroidism response.
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Research Activities
Bone Biomarkers in the assessment of Breast Cancer Patients: Over 100 patients have entered in a study
whereby the sensitivity of bone biomarkers for the detection of bone metastases in breast cancer patients
with normal bone scan is ongoing. This study will take several years to complete.
Macroprolactin: (Dr M-L Healy, Dr T Smith)
It has been demonstrated that 10-20% of laboratory findings of elevated prolactin do not indicate a true
excess of biologically available prolactin, but are essentially artefactual due to the presence of macroprolactin.
This is a high molecular mass complexed form of prolactin, together with an anti-prolactin igG antibody and
is screened for routinely in the Department since 1998. From that time on, reports indicated that although
patients had hyperprolactinaemia, this could be entirely accounted for by the presence of non bio-active or
bio-available prolactin in the form of macroprolactin. If screening for macroprolactin indicated that when
elevated levels of prolactin were corrected for the presence of macroprolactin the result fell within the
appropriate reference range, the report received by the clinician indicated a normal result. The present study
was undertaken to gain information on the final diagnosis for patients whose symptoms had prompted the
measurement of prolactin and who were identified as having hyperprolactinaemia but when this was
corrected for the presence of macroprolactin, a normal value was obtained. The present study is based upon
delivering a questionnaire to these patients (with the permission of their consultant/general practitioner) to
obtain information on whether or not an alternative diagnosis for their symptoms had been obtain and, if so,
what that diagnosis was? How many patients had been treated for hyperprolactinaemia notwithstanding the
diagnosis of macroprolactinaemia? What had been their response to this treatment?
Thyroid Eye Disease: (Dr T Cawood)
Dr T.Cawood is continuing his research into potential therapeutic targets in thyroid associated ophthalmology
and was awarded a Clinical Research Training Fellowship from the Health Research Board.
Achievements and Distinctions
Sinead Kelly was conferred with a PhD degree in June 2005 for her Thesis entitled “Transcriptional regulation
of key steroidogenic enzymes in the human adrenal gland.”
Abstracts
The 24th Joint Meeting of the British Endocrine Societies:
Harrogate, England: 4th - 6th April 2005.
Kavanagh L, Smith TP, McKenna TJ. The value of ultrafiltration in the detection of macroprolactin.
Endocrine Abstracts (2005) 9; p52.
Kavanagh L, Smith TP, McKenna TJ. Bioactivity of macroprolactin in vitro. Endocrine Abstracts (2005) 9; p45.
Cawood TJ, Moriarty P, Golden-Mason L, O'Farrelly C, O'Shea D. Anti-TNFalpha Therapy Inhibits TNFalpha-
Dependent ICAM1 Up-regulation in Orbital Fibroblasts from Patients with Thyroid Associated
Ophthalmopathy. Endocrine Abstracts April 2005; OC38.
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Research Activities
American Association of Clinical Chemistry 2005 Annual Meeting:
Orlando, Florida: 24th - 28th July 2005.
Smith TP, Kavanagh L, Fahie-Wilson M, McKenna TJ. Specificity and clinical utility of methods for the detection
of big-big prolactin (Macroprolactin). Clinical Chemistry (2005), 51(6); pA229.
Kavanagh L, Smith TP, Gibney J, McKenna TJ. Autoimmune status of patients with macroprolactinemia.
Clinical Chemistry (2005), 51(6); pA229.
Meetings attended
Annual Meeting of the Royal Australasia College of Physicians, Wellington, New Zealand.
8th-10th May 2005. Professor McKenna invited speaker.
Endocrine Society Meeting, San Diego, USA. 4th-7th June 2005. Professor McKenna invited speaker:
“Meet-the-Professor” session on “Hyperprolactinaemia and Macroprolactin”.
Proteomics: Methods & Applications: Co-ordinated by Dublin Molecular Medicine Centre (DMMC) in
Royal College of Surgeons of Ireland, Dublin; 2nd - 16th June 2005.
Annual Meeting of Academies of Medicine of Malaysia and Singapore. 30th June-1st July 2005.
Macroprolactin: Clinical Significance, Detection and Quantitation of Monomeric Prolactin. Workshop
Presentation, 19th International Congress of Clinical Chemistry. Orlando. 24-28th July 2005.
Corrigan Club Annual Meeting: Trinity College, Dublin. 29th-30th September 2005.
Chairman: Professor T J McKenna.
Irish External Quality Assessment Scheme. Dublin. 5th October 2005.
Association of Clinical Biochemists in Ireland. Limerick, 14th October 2005.
Annual Meeting of the Colleges of Medicine of South Africa. 20th-23rd October 2005.
Endocrinology & Adipocyte Group
Principal Investigator:
PhD:
Dr. Donal O'Shea
Dr. Tom Cawood
Dr Tom Cawood, an endocrinology specialist registrar, is working on a Ph.D. entitled Potential Therapeutic
Targets in Thyroid Associated Ophthalmopathy (TAO). This project is supervised by Dr Donal O'Shea and is
funded by a Clinical Research Training Fellowship from the Health Research Board. The work includes using
an in vitro model of TAO to explore the use of possible new treatments such as anti-cytokine agents. One of
the clinical risk factors for severe is TAO is smoking and this project is also investigating how cigarette smoke
affects TAO with the aim being to identify novel therapeutic targets.
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Research Activities
Department of Psychiatry & Mental Health Research
Mental Health Research
The Department has over 10 active research projects running at present. These include the Suicide in Ireland
Survey in association with the charity Turning the Tide of Suicide at UCD. This project is interviewing families
who have been bereaved by suicide over the past two years in Ireland (Ms. Sharon Bolger, Research
Coordinator, s.bolger@st-vincents.ie). Other major projects include a study of all near-miss suicides
presenting to intensive care units in the DATHS hospitals to understand more about high lethality suicidal
behaviour (Dr Maria Ryan). The Department is also commencing a study of death on all Irish waterways for
the past ten years in collaboration with the Irish Water Safety Association. Following a research grant from
the American Foundation for Suicide Prevention, the Department is conducting a Functional Neuroimaging
Study of Suicidal Depression (Dr Rob Whelan). Through the UCD Newman Scholar Programme we are
conducting a study on Immune Surveillance, Oxidative Stress and Depression (Ms. Aoife O'Donovan) as part
of an Inter-disciplinary Research Programme on PsychoNeuroImmunology with Prof. Cliona O'Farrelly.
Collaborative projects between St Vincent's University Hospital (Professor Malone) and St Patrick's Hospital,
Dublin 8 (Dr James Lucey).
Project 1: "Electroconvulsive therapy and the immune System"
Research Personnel: Dr Gavin Rush Ms Aoife O'Donovan
Prof Cliona O'Farrelly
Ms Lydia Lynch
Prof Joe Duffy
Ms Isobel de Gardelle
This current research project is designed to clarify the immunological changes occuring during a course of
electroconvulsive therapy. The project will explore the underlying biological changes occuring in the
depressive state and further our understanding of the mechanism of action of one of our most powerful antidepressant
treatments.
Project 2: "Cellular ageing in major depression"
Research Personnel: Ms Aoife O'Donovan Dr. Jacintha O'Sullivan
Dr Gavin Rush
Prof. Cliona O'Farrelly
Ms Lydia Lynch
Prof Phillipe Anker (University of Geneva)
Depression is associated with increased risk for many diseases of ageing, including heart disease and cancer.
The mechanism by which depression may be associated with such diseases is not known. Genomic
instability represents one possible mechanism. We are examining genomic instability markers in patients
with major depression and in age- and sex-matched healthy controls. We predict that genomic instability will
be significantly increased in people with major depression relative to controls.
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Research Activities
Department of Neurology Research in Multiple Sclerosis
The Department of Neurology has an international reputation in the field of multiple sclerosis (MS) research
for many years thanks to the work of Professor Michael Huchinson and various colleagues. This research has
been largely clinically based and in recent years has emphasised the use of disability scales in MS.
In 2005, a collaboration was set up with the laboratory of Professor Kingston Mills in Trinity College Dublin
with the help of Professor Cliona O'Farrelly of the ERC at St. Vincent's University Hospital. The aim of the
research is to establish a viable translational collaboration between the laboratory and the MS clinics at
SVUH.
Dr. Jean Fletcher started in August 2005 and is looking at serum samples for people with MS attending the
neurology clinics. She is looking at the effect of interleukin -17 in MS in particular and the aim is to try and
establish the role of T regulatory cells in this condition. It is ultimately hoped that by establishing a role for
such cells in MS it may be possible to develop potential therapies. Jean is also extracting DNA from a second
sample for storage which we intend to use in further work at a later stage and to share with other established
groups in this area of research.
To achieve this, of course, close co-operation is required with the clinical team. Dr. Lisa Costelloe is doing an
MD in this area at the Dept of Neurology. A new clinic has been set up in 2005 specifically for people with
MS. In 6 months, over 200 patients with MS and 70 control subjects have been recruited. Lisa Costelloe, Niall
Tubridy and Michael Hutchinson assess the patients clinically and document the disease phenotype in each
individual seen. This is done in the course of 'normal' clinical care. The information gained is data-based on
the internationally established iMed database. The work of Lisa Gribben, MS Research Nurse, and Marguerite
Duggan, MS Specialist Nurse, has been integral to the smooth running of this project and the ongoing care
our patients. The group has applied for a number of grants to enable this project to continue apace.
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Postgraduate Department
The Postgraduate Department once again had a very successful and busy year. The meetings organised at
postgraduate level for the hospital staff still continue to attract a large attendance from St. Vincent's
University Hospital and are a vital contact for all the NCHDs.
Annual Hospital Study Day
The Hospital Annual G. P. Study Day is still a very important event for the hospital staff and the general
practitioners in the community. This year our Study Day was held on Saturday 12th November and was
attended by 83 General Practitioners. The educational format was similar to that of 2004 and consisted of
Poster Sessions as follows:
1. Common Dermatological Dilemmas in General Practice
- Dr. Paul Collins, Consultant Dermatologist
2. Type 2 Diabetes
- Dr. Donal O'Shea, Consultant Endocrinologist
3. Interstitial Lung Disease: Relevance to GP Practice
- Prof. M. X. FitzGerald, Consultant Respiratory Physician
4. Update on Large Bowel Disease
- Mr. John Hyland, Consultant General Surgeon
There were also two Practical Workshops:
1. Polypharmacy Problems
- Dr. Diarmuid O'Shea, Consultant Geriatrician
2. General Malaise and Low Grade Fever in General Practice
- Dr. Mary Crowe, Consultant Microbiologist
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Postgraduate Department
At 6.30pm there was a lecture by Mr. John Ryan, Consultant in Emergency Medicine entitled “Optimising
the Interface between General Practice and The Emergency Department” followed by a discussion.
Later in the evening a reception and dinner were held in the hospital restaurant and the consensus was that
this was a great way to end a successful day.
Medical and Surgical Meetings
The Postgraduate Lunch Time Meetings include:
Respiratory Gastroenterology Neurology
Nephrology Palliative Care Endocrinology
Colorectal Surgical Audit Rheumatology
There are also breakfast meetings as follows:
Thursday at 8.00am
Friday at 7.30am
Medical Conference (Grand Rounds)
Cardiology Conference
All of the above meetings are organised by the Postgraduate Department. Lunch or breakfast is provided.
Intern Lunch Time Seminars
Monday lunchtime seminars for Interns consist of clinical skills sessions and data
interpretation.
The Tuesday Lunch Time Seminar is organised by the Medical Intern Tutor in conjunction with the
Postgraduate Department. Each week an Intern presents a case to the class with a discussion of same
afterwards.
Thursday Lunch Time Lectures are on matters relating to all aspects of surgery and are given by Consultant
Surgeons within the hospital.
Friday Lunch Time Seminars for the Interns are presented by guest speakers and include Career Guidance,
Risk Management, Stress Management and a wide variety of other topics.
Due to demand it was decided to introduce further lectures for Interns on Wednesdays at lunch time which
commenced in January 2003.
SHO Teaching
Formal Clinical Teaching
In response to our SHO's requests, we have recently re-organised their formal teaching programme. We now
run a five week intensive programme of bedside tutorials three times per year (January/February, May/June,
October/November. These courses are aimed primarily, but not exclusively at the MRCPI examination. The
tutorials are all consultant-provided and take place at 5pm to maximise attendance and to allow SHOs in
peripheral jobs to attend. Consultants are asked to focus on a short case format (See page 7 of the
Postgraduate Medical Training Booklet).
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Postgraduate Department
At the end of the course, feedback from the SHOs as to how the course could be improved is analysed. We
use the Pyramid discussion method which has recently been successfully implemented for our
undergraduate students.
Clinical Science Course
The above course has been organised by the Postgraduate Department for many years, but following recent
discussions with the Royal College of Physicians of Ireland it was decided to discontinue this series of
lectures.
International and National Meetings
In addition to the large number of in-house meetings, the Postgraduate Department helped organise the
Centre for Colorectal Disease, 12th International Meeting which was held on Friday 9th September 2005. The
programme was as follows:
Session 1Biology of Early Stage CRC
Light Microscopy - Value and Limitations
Proteomics: A Novel Screening Method for Colorectal Cancer
Epigenetic Mechanisms in Colorectal Cancer
Genomic Instability, Oxidative Damage and Telomeres
- Dr. Kieran Sheahan
- Dr. Ann Marie Lennon
- Dr. Dermot Leahy
- Dr. Jacintha O'Sullivan
Session 2Treatment of Early Stage CRC
Transanal Endoscopic MicroSurgery - (T.E.M.S.)
Laparoscopic Surgery
Adjuvant Chemotherapy for Stage 11 Disease
- Prof. Frank Keane
- Mr. John Hyland
- Dr. David Fennelly
Session 3Public Issues in CRC
The Medical Perspective
The Economic Impact of Colorectal Cancer
- Dr. Hugh Mulcahy
- Ms. Linda Sharp
The State of the Art Lecture was given by Prof. David Ransohoff from the University of North Carolina at
Chapel Hill and was entitled “CRC Screening in 2005: Challenges and Controversies”
The organizing committee included Dr. D. Fennelly, Mr. J. M. Hyland, Prof. D. P. O'Donoghue, Dr. H. Mulcahy
and Dr. K. Sheahan.
The meeting was attended by 87 doctors.
A dinner was held afterwards in the Fitzwilliam Lawn Tennis Club and was attended by 66 guests.
“Get to Know You Function” for Incoming NCHDs
Again this year we had a very successful and enjoyable welcoming lunch for incoming NCHDs on Wednesday
13th July 2005. This event is an opportunity to give incoming NCHDs the relevant information about ongoing
lectures/conferences and welcome them to the hospital. This is now an annual event.
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Postgraduate Department
The Student Summer Project
This continues to be an important part of the hospital's academic year and this year was held on Tuesday 15th
November. The aim of the project for the student is to develop an interest in research so that he/she will
continue to develop this interest at postgraduate level. The judging panel of physicians and surgeons were
Dr. John Seery (Chairman), Dr. Kieran Sheahan, Mr. Enda McDermot, Mr. Myles Smith and Dr. Ruth Barragry.
This year the winner was Alex Singer whose project was entitled “Database Analyzing the Natural History of
Hepatopulmonary Syndrome”. Along with the prestige of winning this award the student also receives a
monetary amount.
The Library
The Library is located on the first floor of the Education & Research Centre and is open to all staff of St.
Vincent's Healthcare Group. Its collection includes books, journals and audiovisual material covering all
disciplines. Some journals are available online and many more are available via the UCD Library Website.
There are 17 PCs in the Library providing access to several databases including Medline, the Cochrane Library
and Web of Science. Advance training on these products is available free of charge by appointment only.
Internet, document-creating, printing, scanning and multimedia projection facilities are also available.
Postgraduate Education Committee
This committee is now well established and meets annually to discuss postgraduate education in the
hospital. Its aim being to enhance the educational environment of postgraduate doctors at St. Vincent'
University Hospital.
Pharmaceutical Representatives
The link for the pharmaceutical companies here in St. Vincent's University is the Postgraduate Department.
The companies sponsor the Medical and Surgical Lunch and Breakfast Meetings and in turn the medical
representative meets the consultants and NCHDs to discuss their products. This is an important link for both
the doctors and medical representatives.
Postgraduate Medical Training Booklet
The Medical Training Booklet is now compiled and circulated bi-annually by the Postgraduate Department. It
contains valuable information for hospital staff re conferences and tutorials in the hospital.
Prof. Walter McNicholas
Co-ordinator of Postgraduate Education
Betty McArdle
Administrator
Postgraduate Department
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Academic Activities
Annual Biomedical Research Symposium 2005
Education & Research Centre
St. Vincent’s University Hospital
and Conway Institute UCD
Friday 2nd December 2005
12.00 noon. - 6.30 p.m.
Education & Research Centre, St. Vincent's University Hospital
Common Molecular Mechanisms in Inflammation and Malignancy
12.00 Registration and Lunch. Poster Viewing
13.00 Welcome: Prof. Des Fitzgerald, Vice President for Research, U.C.D.
Session I:
Basic Molecular Mechanisms in Malignancy
Chair: Prof. Des Fitzgerald
Keynote Speaker:
Prof. JoEllen Welsh, University of Notre Dame
“Vitamin D signalling in Cancer: Implications for Prevention & Therapy”
Prof. Tom Cotter, University College Cork
“Cell survival pathways in tumour development”
Selected Oral Presentations
1. Survivin protein expression predicts poor outcome in patients with breast cancer
Brid M.Ryan 1,2 , G. Konecny 3 , S. Kahlert4, H. Wang 3 , J. Crown1, M. Untch 4 , M. Pegram 3 , D. J. Slamon 3 ,
M. J. Duffy 1,2 ; St. Vincent's University Hospital, Dublin, Ireland1; Conway Institute of Biomedical and
Biomolecular Research 2 , UCLA School of Medicine, Los Angeles, CA 3 ; Ludwig-Maximilians-Universität,
München-Großhadern, Germany4.
2. Use of Array Comparative Genomic Hybridisation to differentiate between Metastatic
and Non-Mesastatic colorectal cancer.
Alan Coss*, Edward Fox, Andrew Lloyd, Shane Sullivan, Diarmuid O'Donoghue, John Hyland,
Kieran Sheahan, Jacintha O'Sullivan, Hugh Mulcahy, Dermot Leahy
Centre for Colorectal Disease & Education & Research Centre, St Vincent's University Hospital &
Conway Institute, University College Dublin, Dublin.
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Academic Activities
Tea & Posters
Session II: Basic Molecular Mechanisms in Inflammation
Chair: Prof. Barry Bresnihan & Prof. Joe Duffy
Keynote Speaker:
Prof. Tim Cawston, University of Newcastle Upon Tyne
“Regulation of matrix degrading enzymes by combination of cytokines”
Dr. Paul Moynagh, U.C.D.
“Pellino proteins and pro-inflammatory signalling pathways”
Selected Oral Presentations
3. A-SAA induces chemokine expression, cell invasion and cytoskeletal disassembly in rheumatoid
arthritis (RA) synovial tissue, in part through the PI3 kinase pathway.
Mary Connolly, Mullan RH, Sweeney CH, FitzGerald O, Bresnihan B, Veale DJ, Fearon U. Dept. of
Rheumatology, St Vincent's University Hospital and Conway Institute, Dublin, Ireland.
4. The effect of immunosuppressive agents on human mesangial cells
Sein O'Connell, Niamh Tuite and Michael P. Ryan. UCD School of Biomolecular and Biomedical Research,
Conway Institute University College Dublin.
Tea/Coffee
Session III: The Future of Immunobiologic Treatment Strategies
Chair: Prof. Oliver FitzGerald & Prof. Diarmuid O'Donoghue
Dr Joseph Keane, St. James Hospital
“Immunobiologics and infection; A predictable way to make these drugs safer”
Dr. Doug Veale, S.V.U.H.
“Is there life after TNF-inhibition? Predicting future of immunotherapies!”
Session IV: Poster Discussion
Chair: Prof. JoEllen Welsh and Prof Tim Cawston
Poster Presentations
Prizes given for the best oral presentation and the best poster.
Winner of Oral Presentation: Mary Connolly
Two prizes for Poster Presentations
Winners: Katja Strohfeldt & Martina Gogarty
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Review 2005
Academic Activities
DMMC/Conway Institute
Immunobiology Course 2005
Venue:
Time:
Education & Research Centre,
St. Vincent's University Hospital,
Elm Park, Dublin 4
2.00 - 4.00pm
8 sessions 2nd February - 23rd March 2005
Course Leader:
Prof. Cliona O'Farrelly
Contributors: Lucy Golden-Mason, SVUH John Baugh PhD Dept. Medicine UCD
Prof Denis Reen, Our Lady's Hospital for Sick Children, Crumlin
Introductory Overview - Cliona O'Farrelly
Organs, cells and molecules of the immune system
Innate Immunity 1 - John Baugh
Toll like receptors; cytokines; chemokines; anti-microbial peptides
Innate Immunity 2 - John Baugh
Complement; inflammation; anti-inflammatory mechanisms
MHC - Lucy Golden Mason
Antigen processing and presentation; dendritic cell maturation
Cellular and Molecular Components of Adaptive Immunity - Cliona O'Farrelly
T and B lymphocytes; TCR; Immunoglobulins; regulatory cytokines
Lymphocyte Development- Lucy Golden Mason
Haematopoietic stem cells; thymus; bone marrow; gene rearrangement; positive
and negative thymic selection
Effector Mechanisms in Immunology - Cliona O'Farrelly
Cytotoxicity; apoptosis; immune responses to pathogenic challenge; tolerance induction
Immunological Dysregulation - Denis Reen
Malignancy, autoimmunity and allergy
Objectives of the Course
At the end of this course, participants should be familiar with the basic terms and concepts of innate and
adaptive immunity and will hopefully be conversant with the names and functions of the main organs, cells,
molecules and genes involved in initiating and mediating immune responses. They should be able to explain
fundamental immunological concepts and discuss the roles of functional components of the immune system
including acute phase proteins, complement, haematopoietic cells, immunoglobulins and cytokines in
protecting against disease. They should also understand some basic concepts of immunological
dysregulation seen in inflammatory and autoimmune diseases, allergy, malignancy and
immunopathogenesis.
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Academic Activities
Lecture Series 2005
22nd July 2005 - Lecture Hall, E.R.C.
Rheumatology Lecture
Professor Cornelia M. Weyand MD, Ph.D.,
Director, Lowance Centre for Human Immunology, Emory University School of Medicine
“Premature Immunosenescence in Rheumatoid Arthritis”
&
Professor Jorg J. Goronzy MD,
Director, Lowance Centre for Human Immunology, Emory University School of Medicine
“T Lymphocyte Senescence and Autoimmunity”
Career Workshop for PhD Students
“Where do we go from here?”
Wednesday 30th November 2005
Seminar Room, E.R.C.
Career advice and future prospects from PhD graduates working in a variety of different fields
Speakers:
Dr. Patrick Costello (Blood and Tissue Manager, Compliance Dept., Irish Medicines Board)
Dr. Teresa Maguire (Head of Division, Research and Development for Health, Health Research Board)
Dr. Christine Loscher (Academic staff, Lecturer, D.C.U.)
Dr. Clare Blaney (Business Unit Manager, Roche Pharmaceuticals)
Dr. Yvonne McKeown (European Patent Officer, MacLachlan and Donaldson)
ERC Journal Club 2005
Schedule: Thurs mornings 9.00-10.00am
Venue: Seminar Room, E.R.C.
13th January 2005
Nobel Laureate Prof. Peter Doherty, Chairman of the Immunology Dept. at St. Jude Children's Research
Hospital in Memphis USA visited ERC Journal Club.
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Review 2005
Academic Activities
Education & Outreach
S.V.U.H. Schools One Day Seminars:
Laboratory staff in the E.R.C. contribute by giving talks on the workings of the research laboratories to
secondary school students.
Healthwise Newsletter:
Articles from E.R.C. researchers appear regularly in Dept. Preventive Medicine Healthwise Newsletters.
The Irish Scientist Yearbook 2005:
The E.R.C. contributed two articles to the Irish Scientist Yearbook 2005 “Translational research at
St. Vincent's University Hospital: the path to new cures” & “Improving on nature - modifying natural
antibiotics”
In 2005 several UCD undergraduates carried out research for their theses at SVUH, students from TCD
Molecular Medicine Science course and several Secondary school students were also accommodated.
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Academic Activities
Prestigious Invitations/Honours
for E.R.C. Researchers
Prof. Cliona O'Farrelly
Appointed Chairperson of Cancer Research Ireland 2005-2008
Appointed member of Irish Council for Bioethics 2005-2008
Appointed to the Infections, Immunity and Host Defence panel of the Health Research Board 2005-2009
Evaluator for:
Heritage Medical Health Senior Scholar Application - Alberta Heritage Foundation for
Medical Research (AHFMR), Canada
European Commission Sixth Framework Programme, Biotechnology, Agriculture and Food Directorate
European Young Investigator Awards in collaboration with European Science Foundation
Hep-Net Start-Up Fund - funded by the German Ministry of Education and Research
Irish College of Opthalmologists Fellowships Examiner
Invitations to speak/chair:
“Innate Immunity: First Line of Defense” Immunology for the Clinical Hepatologist Session at AASLD
2005 Post Graduate Course San Francisco
“Organ Resident Blood Stem-cells: Source of Specialised Descents” Irish Network of Neural Stem-cell
Investigators, Conway Institute UCD
“Hepatitis C Viral Infection: or How a tiny organism can overcome the might of man”
BA Festival of Science in Trinity College: “Viruses: The Deadly Enemy?”
Chaired launch of Medical Research Charities Group (MRCG), RSCI Dublin
“Inflammatory immunological and malignant mechanisms of the gastrointestinal tract”
Histopathology/Immunology session at the Association of Clinical Pathologists National Scientific
meeting, London
“Predicting outcome to transplantation: what can the donor organ tell us?” Irish Transplant Society
Conference, Mater Hospital, Dublin
“NKR+ T Cells and Gut Regional Defence against Malignancy”: SWAN Meeting. St. James Hospital
Prof. Joe Duffy
16th IFCC/FESCC European Congress of Clinical Chemistry and Laboratory Medicine: Glasgow, Proteases
as Markers for the Formation of Metastasis
XIX International Congress of Clinical Chemistry: Orlando, National Academy of Clinical Chemistry
Guidelines for Clinical Use of Tumor Markers in Breast Cancer.
ISOBM Meeting, Rhodes, Secretoglobins: potential markers for breast cancer.
Strategic Consensus Conference on Biomarker Research in Breast Cancer, Philadelphia, Tumor markers in
breast cancer.
Prof. Walter McNicholas
Prof. McNicholas completed a 3-year term as President of the European Respiratory Society. He was also
appointed Vice-Chair in 2005 of an EU-funded Concerted Action on sleep apnoea which includes experts
from 15 European countries and was elected the Founding President of the Irish Sleep Society, which is a
new scientific society devoted to developing the specialty of sleep medicine in Ireland. The society includes
respiratory physicians, otolaryngologists, orthodontists, neurologists, psychiatrists and technicians among
the membership (currently in excess of 100).
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52
Review 2005
Academic Activities
Prof. McNicholas gave invited lectures at many international scientific conferences including the European
Respiratory Society (Copenhagen, Denmark), American College of Chest Physicians (Montreal, Canada) and
Asia Pacific Society of Respirology (Guangzhou, China).
Prof. Barry Bresnihan
Professor Bresnihan was an invited speaker at the Advances in Targeted Therapies meeting in Cannes and
the BA Festival of Science in Dublin. In May he was invited to visit Australia to speak on anakinra by Amgen.
He was also an invited speaker at the Latin American MabThera Event in Guatemala in September and the
Chilean Rheumatology Congress in October. Professor Bresnihan continues to co-chair the European
Synovitis Study Group. He is chairman of the Subcommittee for Academic Support, Arthritis Research
Campaign (UK). He is chairman of Arthritis Ireland and a member of the Oliver Bird Programme Selection
Committee. Professor Bresnihan continues to serve on the Editorial Board for the Journal of Rheumatology,
Annals of the Rheumatic Diseases, Joint, Bone and Spine and Bailliere's Clinical Rheumatology.
Prof. Oliver FitzGerald
Professor FitzGerald was a guest lecturer at the Welsh Society for Rheumatology in March and at the EULAR
AGM in Vienna in June. He was an international speaker at Abbott/Wyeth sponsored meetings in Marrakech,
Vienna, Dublin and London. He attended the Irish Society for Immunology as a keynote speaker. Professor
FitzGerald is a Council Member for Arthritis Ireland and a member of the Editorial Board of Rheumatology
and of Current Rheumatology.
Dr. Doug Veale
Dr Veale was an invited to speaker at the University of Zurich, the combined Irish/Scottish Societies for
Rheumatology and at the American College of Rheumatology Annual Meeting in San Diego. Dr Veale is
Clinical Research Director (Rheumatology) Wyeth Consortium, National Speciality Director (Rheumatology),
Chairman SVHG Ethics and Medical Research Committee, Medical Director, Our Lady's Hospice, and
Chairman Arthritis Action Ireland. He is editor of E-Medicine and a reviewer for Arthritis & Rheumatism
Annals of the Rheumatic Diseases, Rheumatology, and Journal of Rheumatology.
Prof. T. J. McKenna
Professor T J McKenna is President of the Royal College of Physicians of Ireland. Professor McKenna is a
member of The National Taskforce on Medical Manpower and a member of its Medical Education and Training
Group, whose report will be published by Government in 2006. Professor McKenna is also on the Editorial
Boards for the journals, Clinical Endocrinology (Oxford) and The Endocrinologist (U.S.). He is also a member
of the Students Affairs Committee of the Endocrine Society (U.S.). In May 2006 Professor McKenna was
admitted as Honorary Fellow of the Royal Australasian College of Physicians in Wellington. Professor
McKenna delivered the Greenaway Lecture of RACP entitled “The evolving impact of reduced working
hours on doctors training and patient care; An Irish Perspective”. In June, he was admitted as a Fellow of
the Academy of Medicine in Singapore. In October, he was admitted to Honorary Fellowship of The
College of Physicians of South Africa in Capetown. Professor McKenna was Chairman of the Annual
Corrigan Club Meeting this year held in Trinity College, Dublin in September.
Dr. Tom Smith
Dr Tom Smith is Chairman of the Association of Clinical Biochemists, Republic of Ireland Region and a
Committee Member of the Irish Endocrine Society.
Dr. Diarmuid Smith
Dr Diarmuid Smith was appointed Consultant Endocrinologist, Beaumont Hospital.
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Academic Activities
Prizes and Degrees Awarded in 2005
PhD Master Class - Lydia Lynch won the Dorothy Price Immunology Medal, PhD Master Class, NUI
Maynooth. 2005
ISR Best Oral presentation - Dr Ronan Mullan won the best oral presentation prize, at the ISR AGM
October for 'Acute-phase serum amyloid A stimulation of angiogenesis, leukocyte recruitment and matrix
degradation in rheumatoid arthritis through an NF - kappaB-dependent signal transduction pathway.' Ronan
Mullan, Bresnihan B, Mason L, O'Hara R, Markham T, FitzGerald O, Veale DJ and Fearon U.
ERC Best Oral Presentation - Mary Connolly (PhD student) won best oral presentation, at the ERC Annual
Symposium 2005 for “A-SAA Induces Chemokine Expression, Cell Invasion and Cytoskeletal Disassembly
in RA Synovial Tissue, in Part through the P13 Kinase Pathway” Mary Connolly, Ronan Mullan, Catherine
Sweeney, Oliver FitzGerald, Barry Bresnihan, Douglas Veale, Ursula Fearon.
ISR-Ely Lilly Bursary awarded to Dr Adrian Gibbs, Specialist Registrar, at the ISR AGM in October for his
proposed study entitled 'Comparison on bone mineral density measurements, bone and cartilage
biomarkers in rheumatoid and psoriatic patients receiving biological therapy'.
SIAR Travel Scholarships awarded to Dr Catherine Sweeney and Mary Connolly to present their work at
the American College of Rheumatology San Diego for
“A Role for the Survivin and Notch Signaling Pathways in Blood Vessel Maturation and Synovial Hyperplasia
in Rheumatoid Arthritis” Catherine Sweeney, Paul A. Cahill, Ronan Mullan, Bresnihan B, FitzGerald O,
Fearon U, Veale DJ.
“A-SAA Induces Chemokine Expression, Cell Invasion and Cytoskeletal Disassembly in RA Synovial Tissue,
in Part through the P13 Kinase Pathway” Mary Connolly, Ronan Mullan, Catherine Sweeney, Oliver
FitzGerald, Barry Bresnihan, Douglas Veale, Ursula Fearon.
Shane Sullivan, 1st prize for best oral presentation, Irish Society of Gastroenterology Winter Meeting,
“Localisation and expression of a novel Cathepsin L isoform in colorectal cancer” 2005.
Juliette Sheridan, Irish Cancer Society: Oncology Scholars Travel Award 2005.
Alan Coss, Irish Cancer Society: Oncology Scholars Travel Award 2005.
Juliette Sheridan, NCI cancer consortium conference travel award 2005.
Alan Coss, NCI cancer consortium conference travel award 2005.
Degrees Awarded
Ms Susan Behan PhD Ms Brid Ryan PhD
Ms Marie Mc Nally MSc in Molecular Pathology Ms Salih Bakheit MSc
Ms Anne Marie Lennon Ph.D
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54
Review 2005
Publications
Publications
Published or Accepted for Publication in International Peer Reviewed Journals 2005
Ahern T, O'Shea D. Practical management of obesity. Heartwise 8(3) 2005.
Benito M, Veale D, FitzGerald O, van den Berg W, B. Bresnihan
Synovial tissue inflammation in early and late osteoarthritis
Ann Rheum Dis 2005;64:1263-1267
Brennan DJ, O'Brien SL, Fagan A, Culhane AC, Higgins DG, Duffy MJ, Gallagher WM.
Application of DNA microarray technology in determining breast cancer prognosis and therapeutic
response. Expert Opin Biol Ther. 2005 Aug;5(8):1069-83. PMID: 16050784
Bresnihan B, Baeten D, Firestein GS, Fitzgerald OM, Gerlag DM, Haringman JJ, McInnes IB, Reece
RJ, Smith MD, Ulfgren AK, Veale DJ, Tak PP.
Synovial tissue analysis in clinical trials. J Rheumatol. 2005 Dec;32(12):2481-4.
Cawood TJ, McKenna MJ, Gallagher CG, Smith D, Wen YC, Dodd JD, O'Shea D.
Oral bisphosphonates improve bone mineral density in adults with cystic fibrosis.
Irish Med. J. 98; 270-273; 2005
Cawood TJ, Moriarty P, O'Shea D.
Thyroid eye disease; recent advances in management. Invited review for BMJlearning.com. May 2005
Curry MP, Hegarty JE.
The gallbladder and biliary tract in cystic fibrosis.
Curr Gastroenterol Rep. 2005 May;7(2):147-53. Review. PMID: 15802104
Dean J, McCarthy D, Golden-Mason L, O'Farrelly C.
Trephine biopsies are enriched for activated T/NK cells and cytotoxic T cells.
Immunol Lett. 2005 Jun 15;99(1):94-102. Epub 2005 Feb 16. PMID: 15894117
Dean, J. McCarthy D., Lawler M., Doherty D.G., Golden-Mason L., O'Farrelly C.
Characterisation of NKR+T-cell subsets in human bone marrow: implications for immunosurveillance of
neoplasia Clin Immunol 2005 Jan;114(1):42-51 PMID 15596408
Dodd JD, Barry SC, Daly LE, Gallagher CG.
Inhaled beta-agonists improve lung function but not maximal exercise capacity in cystic fibrosis.
J Cyst Fibros. 2005 May;4(2):101-5. PMID: 15978535
Doherty LS, Kiely JL, Swan V, McNicholas WT.
Long-term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in
sleep apnea syndrome.
Chest. 2005 Jun;127(6):2076-84. PMID: 15947323
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Publications
Doherty LS, Nolan P, McNicholas WT.
Effects of topical anesthesia on upper airway resistance during wake-sleep transitions.
J Appl Physiol. 2005 Aug;99(2):549-55. Epub 2005 Mar 24. PMID: 15790683
Doherty LS, McNicholas WT. Home Mechanical Ventilation. Ir Med J 2005; 98(7): 202-6 PMID 16185015
Duffy MJ. Predictive markers in breast and other cancers: a review.
Clin Chem. 2005 Mar;51(3):494-503. Epub 2005 Jan 6. Review. PMID: 15637130
Duffy MJ, Bonfrer JM, Kulpa J, Rustin GJS, Soletormos G, Torre GC, Tuxen M, Zwirner M.
CA 125 in ovarian cancer:
Eupopean Group on Tumor markers guidelines for clinical use. Int J Gynecol Cancer 2005;15:679-691.
Duffy MJ, Kelly Z, Culhane AC, O'Brien SL, Gallagher W.
DNA microarray-based gene expression profiling in cancer: aiding cancer diagnosis, assessing prognosis
and predicting response to therapy. Current Pharmacogenomics 2005;2:289-304.
Evans TR, Yellowlees A, Foster E, Earl H, Cameron DA, Hutcheon AW, Coleman RE, Perren T, Gallagher
CJ, Quigley M, Crown J, Jones AL, Highley M, Leonard RC, Mansi JL.
Phase III randomized trial of doxorubicin and docetaxel versus doxorubicin and cyclophosphamide as
primary medical therapy in women with breast cancer: an anglo-celtic cooperative oncology group study.
J Clin Oncol. 2005 May 1;23(13):2988-95. PMID: 15860854
Fraser AD, van Kuijk AW, Westhovens R, Karim Z, Wakefield R, Gerards AH, Landewe R, Steinfeld SD,
Emery P, Dijkmans BA, Veale DJ. A randomised, double blind, placebo controlled, multicentre trial of
combination therapy with methotrexate plus cyclosporin in patients with active psoriatic arthritis.
Ann Rheum Dis. 2005 Jun;64(6):859-64.
Gibney J, Smith TP, McKenna TJ. Clinical relevance of macroprolactin.
Clin Endocrinol (Oxf). 2005 Jun;62(6):633-43. Review. PMID: 15943822
Gibney J, Smith TP, McKenna TJ. The impact on clinical practice of routine screening for macroprolactin.
J. Clin. Endocrinol. Metab. 90: 3927-3932, 2005.
Hall MJ, McDonnell SO, Killoran J, O'Shea DF .
A modular synthesis of unsymmetrical tetraarylazadipyrromethenes.
J Org Chem. 2005 Jul 8;70(14):5571-8. PMID: 15989339
Haringman JJ, Gerlag DM, Zwinderman AH, Smeets TJ, Kraan MC, Baeten
D, McInnes IB, Bresnihan B, Tak PP.
Synovial tissue macrophages: a sensitive biomarker for response to treatment in patients with rheumatoid
arthritis. Ann Rheum Dis. 2005 Jun;64(6):834-8.
Healy ML, Smith TP, McKenna TJ. Diagnosis, misdiagnosis and management of hyperprolactinaemia.
Expert Rev. Endocrinol. Metab. (In press).
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Review 2005
Publications
Healy DG, Fleming FJ, Gilhooley D, Felle P, Wood AE, Gorey T, McDermott EW, Fitzpatrick JM,
O'Higgins NJ, Hill AD.
Electronic learning can facilitate student performance in undergraduate surgical education: a prospective
observational study. BMC Med Educ. 2005 Jun 29;5:23. PMID: 15987526
Higgs R, Lynn DJ, Gaines S, McMahon J, Tierney J, James T, Lloyd AT, Mulcahy G, O'Farrelly C.
The synthetic form of a novel chicken beta-defensin identified in silico is predominantly active against
intestinal pathogens.
Immunogenetics. 2005 Apr;57(1-2):90-8. Epub 2005 Mar 3. PMID: 15744537
Hyvelin JM, Howell K, Nichol A, Costello CM, Preston RJ, McLoughlin P.
Inhibition of Rho-kinase attenuates hypoxia-induced angiogenesis in the pulmonary circulation.
Circ Res. 2005 Jul 22;97(2):185-91. Epub 2005 Jun 16. PMID: 15961717
Kavanagh L, McKenna TJ, Fahie-Wilson MN, Gibney J, Smith TP.
Specificity and clinical utility of methods for the detection of macroprolactin. Clinical Chemistry (In Press).
Kavanagh D, Neary P, Dodd JD, Sheahan KM, O'Donoghue D, Hyland JM.
Diagnosis and treatment of enterovesical fistulae. Colorectal Dis. 2005 May;7(3):286-91.
Kee F, Sheehy N, O'Hare L, Bane C, Bell A, Dempster M, FitzGerald O.
Rheumatologists' judgements about the efficacy of anti-TNF therapy in two neighbouring regions.
Rheumatology (Oxford). 2005 Nov;44(11):1407-13.
Kelly LM, Buggy Y, Hill A, O'Donovan N, Duggan C, McDermott EW, O'Higgins NJ, Young L, Duffy MJ.
Expression of the breast cancer metastasis suppressor gene, BRMS1, in human breast carcinoma: lack of
correlation with metastasis to axillary lymph nodes.
Tumour Biol. 2005 Jul-Aug;26(4):213-6. Epub 2005 Jul 6. PMID: 16006775
Kelly SN, McKenna TJ, Young LS. Coregulatory protein-orphan nuclear receptor interactions in the human
adrenal cortex. J Endocrinol. 2005 Jul;186(1):33-42. PMID: 16002533
Krajewska M, Kim H, Shin E, Kennedy S, Duffy MJ, Wong YF, Marr D, Mikolajczyk J, Shabaik A,
Meinhold-Heerlein I, Huang X, Banares S, Hedayat H, Reed JC, Krajewski S.
Tumor - associated alterations in caspase-14 expression in epithelial malignancies.
Clin Cancer Res. 2005 Aug 1;11(15):5462-71. PMID: 16061862
Le Bas MD, McKinley NF, Hogan AM, O'Shea DF.
Imidazo[5,1-b]thiazol-3-ones/thiazin-4-ones: synthesis and reactivity investigation for library generation.
J Comb Chem. 2005 Jul-Aug;7(4):503-6. PMID: 16004487
Ledwidge M, Ryan E, O'Loughlin C, Ryder M, Travers B, Kieran E, Walsh A, McDonald K.
Heart failure care in a hospital unit: a comparison of standard 3-month and extended 6-month programmes.
Eur J Heart Fail. 2005 Mar 16;7(3):385-91. PMID: 15718179
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Publications
Mackarel AJ, Plant BJ, FitzGerald MX, O'Connor CM, Martin L, Elborn JS, Gallagher CG.
Cystic fibrosis sputum stimulates CD18-independent neutrophil migration across endothelial cells.
Exp Lung Res. 2005 May;31(4):377-90. PMID: 16025919
Mahon MJ, Tobin JP, Cusack DA, Kelleher C, Malone KM. Suicide Among Regular-Duty Military
Personnel: A Retrospective Case-Control Study of Occupation-Specific Risk Factors for Workplace Suicide.
Am J Psychiatry. 2005 Sep;162(9):1688-1696. PMID: 16135629
Manzo A, Paoletti S, Carulli M, Blades MC, Barone F, Yanni G, Fitzgerald O, Bresnihan B, Caporali R,
Montecucco C, Uguccioni M, Pitzalis C. Systematic microanatomical analysis of CXCL13 and CCL21 in
situ production and progressive lymphoid organization in rheumatoid synovitis.
Eur J Immunol. 2005 May;35(5):1347-59. PMID: 15832291
Martial FP, Dunleavy M, Nolan P, McNicholas WT, O'Regan RG, Bradford A.
Simultaneous recording of breathing and respiratory related neuronal activity in the brainstem
of conscious rats. Respir Physiol Neurobiol. 2005 Feb 15;145(2-3):301-6. PMID: 15705544
Milak MS, Parsey RV, Keilp J, Oquendo MA, Malone KM, Mann JJ.
Neuroanatomic correlates of psychopathologic components of major depressive disorder.
Arch Gen Psychiatry. 2005 Apr;62(4):397-408. PMID: 15809407
McDonald K. Current guidelines in the management of chronic heart failure: practical issues in their
application to the community population.
Eur J Heart Fail. 2005 Mar 16;7(3):317-21. Review. PMID: 15718171
McKenna MJ. Bone density testing guidelines. Osteowise 2005; 1(4): 12-14.
McKone EF, Barry SC, Fitzgerald MX, Gallagher CG. Role of arterial hypoxemia and pulmonary
mechanics in exercise limitation in adults with cystic fibrosis.
J Appl Physiol. 2005 Sep;99(3):1012-8. Epub 2005 Apr 28. PMID: 15860682
McLoughlin P, Hyvelin JM, Howell K. Pulmonary hypertension. N Engl
J Med. 2005 Jan 27;352(4):418-9; author reply 418-9. PMID: 15673812
McMenamin M, Barry H, Lennon AM, Purcell H, Baum M, Keegan D, McDermott E, O'Donoghue D,
Daly L, Mulcahy H. A survey of breast cancer awareness and knowledge in a Western population: lots of
light but little illumination. Eur J Cancer. 2005 Feb;41(3):393-7. PMID: 15691638
McNicholas WT. Sleep Apnoea Syndrome Breathe 2005; 1:218-227
Molina R, Barak V, van Dalen A, Duffy MJ, Einarsson R, Gion M, Goike H, Lamerz R, Nap M,
Soletormos G, Stieber P. Tumor markers in breast cancer: European Group on Tumor Markers
Recommendations.
Tumor Biol 2005;26:281-293.
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58
Review 2005
Publications
Mullan RH, Bresnihan B, Golden-Mason L, Markham T, O'hara R, Fitzgerald O, Veale DJ, Fearon U.
Acute-phase serum amyloid A stimulation of angiogenesis, leukocyte recruitment and matrix degradation in
rheumatoid arthritis through an NF-kappaB-dependent signal transduction pathway.
Arthritis Rheum. Epub Dec 2005. 105-14.
Myers E, Hill AD, Kelly G, McDermott EW, O'Higgins NJ, Buggy Y, Young LS.
Associations and interactions between Ets-1 and Ets-2 and coregulatory proteins, SRC-1, AIB1, and NCoR
in breast cancer. Clin Cancer Res. 2005 Mar 15;11(6):2111-22. PMID: 15788656
O'Brien NA, O'Donovan N, Ryan B, Hill AD, McDermott E, O'Higgins N, Duffy MJ.
Mammaglobin a in breast cancer: existence of multiple molecular forms.
Int J Cancer. 2005 Apr 20;114(4):623-7. PMID: 15609337
O'Connor TM, Haider W, Crotty T, McDonnell TJ, McNicholas WT.
Immunosuppressant-responsive idiopathic lymphocytic pleuritis.
Respiration. 2005 Mar-Apr;72(2):202-4. PMID: 15824533
Oquendo MA, Krunic A, Parsey RV, Milak M, Malone KM, Anderson A, van Heertum RL, John Mann J.
Positron emission tomography of regional brain metabolic responses to a serotonergic challenge in major
depressive disorder with and without borderline personality disorder.
Neuropsychopharmacology. 2005 Jun;30(6):1163-72. PMID: 15770239
Ponchel F, Verburg RJ, Bingham SJ, Brown AK, Moore J, Protheroe A, Short K, Lawson CA, Morgan
AW, Quinn M, Buch M, Field SL, Maltby SL, Masurel A, Douglas SH, Straszynski L, Fearon U, Veale
DJ, Patel P, McGonagle D, Snowden J, Markham AF, Ma D, van Laar JM, Papadaki HA, Emery P,
Isaacs JD. Interleukin-7 deficiency in rheumatoid arthritis: consequences for therapy-induced lymphopenia.
Arthritis Res Ther. 2005;7(1):R80-92. Epub 2004 Nov 16. PMID: 15642146
Power RE, Kennedy J, Crown J, Fraser I, Thornhill JA. Pelvic recurrence in stage I seminoma: a new
phenomenon that questions modern protocols for radiotherapy and follow-up.
Int J Urol. 2005 Apr;12(4):378-82. PMID: 15948726
Power C, Kavanagh D, Hill AD, O'Higgins N, McDermott E. Unusual presentation of a giant parathyroid
adenoma: report of a case. Surg Today. 2005;35(3):235-7. PMID: 15772795
Ralph JA, McEvoy AN, Kane D, Bresnihan B, FitzGerald O, Murphy EP. Modulation of orphan nuclear
receptor NURR1 expression by methotrexate in human inflammatory joint disease involves adenosine A2A
receptor-mediated responses.
J Immunol. 2005 Jul 1;175(1):555-65. PMID: 15972692
Roddam AW, Duffy MJ, Hamdy FC, Ward AM, Patnick J, Price CP, Rimmer J, Sturgeon C, White P,
Allen NE; On behalf of the NHS Prostate Cancer Risk Management Programme. Use of prostatespecific
antigen (PSA) isoforms for the detection of prostate cancer in men with a PSA level of 2-10 ng/ml:
systematic review and meta-analysis. Eur Urol. 2005 Sep;48(3):386-99; discussion 398-9. PMID: 15982797
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Education & Research Centre
59
Publications
Ryan B, O'Donovan N, Browne B, O'Shea C, Crown J. Hill ADK, McDermott E, O'Higgins N, Duffy MJ.
Expression of surviving and its splice variants surviving-2B and surviving-deltaEx3 in breast cancer.
Br J Cancer 2005;92:120-124.
Ryan S, Taylor CT, McNicholas WT.
Selective activation of inflammatory pathways of intermittent hypoxia in obstructive sleep apnea syndrome.
Circulation 2005; 112(17):2660-7. PMID 16246965
Ryan R, Gibbons D, Hyland JM, Treanor D, White A, Mulcahy HE, O'Donoghue DP,
Moriarty M, Fennelly D, Sheahan K.
Pathological response following long-course neoadjuvant chemoradiotherapy for locally advanced rectal
cancer. Histopathology. 2005 Aug;47(2):141-6.
Smith D, Murray BF, McDermott E, O'Shea D, McKenna M, McKenna TJ.
Hungry bones without hypocalcaemia following parathyroidectomy.
J. Bone and Mineral Metabolism. 23; 514-515, 2005.
Smith D, Crotty TB, Murphy JF, Crofton ME, Franks S, McKenna TJ.
A steroid cell tumour outside the ovary is a rare cause of virilization. Fertility and Sterility (In Press).
Singer GA, Lloyd AT, Huminiecki LB, Wolfe KH. Clusters of co-expressed genes in mammalian genomes
are conserved by natural selection. Mol Biol Evol 2005 Mar;22(3):767-75. PMID 15574806
Thin AG, Kelly GE, Daly L, McLoughlin P.
Repeated measurement of the gas exchange threshold: relative size of measurement and biological
variabilities. Comput Biol Med. 2005 Dec;35(8):703-16. PMID: 16124991
Varadarajulu S, Eloubeidi MA, Patel RS, Mulcahy HE, Barkun A, Jowell P, Libby E, Schutz S, Nickl NJ,
Cotton PB. The yield and the predictors of esophageal pathology when upper endoscopy is used for the
initial evaluation of dysphagia.
Gastrointest Endosc. 2005 Jun;61(7):804-8. PMID: 15933679
Volkov V, Long A, Freeley M, Golden-Mason L, O'Farrelly C, Kelleher D, Murphy A.
The Hepatitis C Envelope 2 Protein inhibits LFA-1 Transduced protein kinase C signalling for T-Lymphocyte
migration Gastroenterology (in press)
Weston SJ, Leistikow RL, Reddy KR, Torres M, Wertheimer AM, Lewinsohn DM, Chou S, Davey MP,
Corless C, O'Farrelly C, Nelson DR, Rosen HR.
Reconstitution of hepatitis C virus-specific T-cellmediated immunity after liver transplantation.
Hepatology. 2005 Jan;41(1):72-81. PMID: 15619226
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60
Review 2005
Publications
Chapters in Books
McNicholas WT. Assessment of respiratory function during sleep in chronic lung disease. In: Pulmonary
Rehabilitation; edited by C. Donner, R. Goldstein. Hodder Arnold 2005: 91-97
McNicholas WT. Sleep apnoea in adults. In: Encylopedia of Respiratory Medicine. Editors: Geoffrey Laurent
and Steven Shapiro. Elsevier 2005.
Invited Reviews
Bresnihan B, Baeten D, Firestein GS, FitzGerald OM, Gerlag DM, Haringman JJ, McInnes IB, Reece
RJ, Smith MD, Ulfgren AK, Veale DJ, Tak PP;
Omeract 7 Special Interest Group. Synovial tissue analysis in clinical trials.
J Rheumatol. 2005 Dec;32(12):2481-4.
Fitzgerald O.
Psoriatic arthritis synovial histopathology: commentary on the article by Kruithof and colleagues.
Arthritis Res Ther. 2005;7(3):124-5. Epub 2005 Apr 18. PMID: 15899064
Leong TT, Fearon U, Veale DJ.
Angiogenesis in Psoriasis and Psoriatic Arthritis: Clues to Disease Pathogenesis.
Curr Rheumatol Rep. 2005;7(4):325-329. PMID: 16045837
Smith MD, Baeten D, Ulfgren AK, McInnes IB, Fitzgerald O, Bresnihan B, Tak P, Veale D.
Standardisation of Synovial Tissue Infiltrate Analysis: How far have we come? How much further do we
need to go?
Ann Rheum Dis. 2005 Jun 23; [Epub ahead of print] PMID: 15975970
Veale D, Ritchlin C, FitzGerald O.
Immunopathology of psoriasis and psoriatic arthritis
Ann Rheum Dis 2005;64(Suppl II):26-29
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Education & Research Centre
61
Grants Active in 2005
P.I. Name of Study Source of Grant Fund Amount Start Finish
Date
Date
Prof. Walter Cell and molecular HRB Project Grant €220,000 2005 2008
McNicholas mechanisms of cardiovascular
disease in obstructive
sleep apnoea.
Prof. Walter Non-invasive low cost Enterprise Ireland €300,000 2005 2008
McNicholas measurements of sleep,
(with Dr. C. sleep disruption and
Heneghan UCD) sleepiness.
Prof. Joe Duffy Role of ADAM17(TACE) Health Research €107,600 2003 2006
in breast cancer
Board
Prof. Joe Duffy Mamaglobin as a marker for Irish Cancer Society €164,000 2003 2006
breast cancer
Prof. Joe Duffy/ Studies on lipophilin B in Irish Research Council €65,000 2002 2006
Jane Culleton breast cancer for Science, Engineering
and Technology (IRSET)
Prof. Joe Duffy/ Functional genomics Irish Cancer Society €209,000 2002 2005
Dr. W. Gallagher in breast cancer:
(Pharmacology a focus on metastasis
Dept, UCD)
Prof. Joe Duffy Epigenetic profiling of breash EU Sixth Framework €2,533,758 2004 2006
(in collab. With 8 other cancer: prognostic and Programme total
European Institutions) therapeutic application €186,720
to SVUH/UCD
Prof. Joe Duffy Breast Cancer Metastasis: Health Research €1,063,000 2005 2010
(with W. Gallagher, Biomarkers and Functional Board Programme
F. Martin & Mediators Grant 2005
P. Dervan)
Dr. Leonie Young/ Molecular mechanisms of Cancer Research €97,700 2002 2005
Mr. Arnold Hill Surviving regulation in Ireland
breast cancer
Dr. Leonie Young/ Chromatin remodelling in St. Lukes Institute €100,000 2003 2005
Mr. Arnold Hill/ estrogen receptor target of Cancer Research
genes in breast cancer.
Prof. Cliona O' Evolution based approaches Enterprise Ireland €90,086 2005 2006
Farrelly
to directed alteration of AMPs Proof of Concept
for improved efficacy against phase Winter
Propionibacterium acnes and Call 2005
MRSA
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62
Review 2005
Grants Active in 2005
P.I. Name of Study Source of Grant Fund Amount Start Finish
Date Date
Dr. Conor O'Brien Cytokine Gene Polymorphisms HRB Clinical €89,500 2002 2005
(Prof. Cliona and their association with the Research Training
O'Farrelly) outcome of Hepatitis C viral
infection
Prof. Cliona O' Characterisation Hepatitis C HRB Programme €552,000 2003 2006
Farrelly/ Prof. Induced Immunological Grant
Dermot Kelleher/ Subversion and its
Prof. Kingston Mills/ Implications for Treatment
Dr. Derek Doherty Response
Prof. Cliona O' Cytokine Milieu, Natural Killer Enterprise Ireland €149,293 2003 2006
Farrelly/Prof. Colm Receptor Positive Cells, Basic Research Grant
O'Herlihy/Dr. Lucy Haematopoietic Progenitors Programme
Golden-Mason in Human Endometrium
Prof. Cliona O' A combined bioinformatic, Dept. Agriculture €671,437 2001 2005
Farrelly molecular and biochemical FIRM Grant
approach to the identification
and analysis of antimicrobial
peptides in Hen Eggs
Prof. Cliona O' Antimicrobial activity in Hen Dept. Agriculture €55,000 2004 2005
Farrelly Eggs, a Combined Extension to FIRM
Bioinformatic, Biochemical Grant
and Molecular Biological
Approach
Prof. Cliona Functional immunogenomics Dept. Agriculture €691,286 2004 2007
O'Farrelly in the chicken: relevance to FIRM Grant 2004
campylobacter jejuni infection.
Prof. Cliona SFI Research Frontiers Role of CD1d €229,766 2005 2008
O'Farrelly Programme 2005 isoformsand reactive
cells in regulating
immune responses to
malignancy
Prof. Cliona HRB Research Project Grant - Investigation of KIR €234,473.6 2005 2008
O'Farrelly/ General 2005 genotype in the
Dr. ClairGardiner
resolution of HCV
infection
Dr. Tom Smith/ Structure and Etiology of Health Research €110,000 2002 2005
Prof. T.J. McKenna Macroplactin Board
Dr. Jacintha The role of genomic instability Health Research €185,000 2004 2007
O'Sullivan/ in promoting colorectal cancer Board
Prof.Diarmuid development in Ulcerative
O'Donoghue/ Colitis patients
Dr.Kieran Sheahan
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Education & Research Centre
63
Grants Active in 2005
P.I. Name of Study Source of Grant Fund Amount Start Finish
Date Date
Dr. Jacintha The role of telomeres and Cancer Research €135,000 2004 2007
O'Sullivan telomerase in colorectal Ireland
cancer growth, progression
and metastasis.
Dr. Hugh Mulcahy Protease profiling in early Cancer Research €135,000 2003 2006
Colorectal Cancer and its Ireland
association with chromosomal
abnormalities, anatomical
stage and clinical progression.
Dr. U. Fearon/ A-SAA regulates cytoskeletal HRB Project €140,000 2005 2008
Dr. D. Veale/ rearrangement and cell matrix Grant 2005
Prof B. Bresnihan interactions to promote cell
migration and cartilage
nvasion in inflammatory
arthritis.
Dr. D. Veale/ The role of angiopoietins in Health Research €160,000 2004 2007
Dr. P. Cahill/ driving angiogenesis in Board
Dr. U. Fearon inflammation
Dr. U. Fearon/ Studies of novel cytokines Glaxo Smith Kline plc €250,000 2003 2006
Dr. D. Veale Using synovial/cartilage
metablism
Dr. D. Veale/ The clinical application for Health Research €109,000 2004 2006
Dr. U. Fearon/ Acute phase protein serum Board
Dr. R. Mullan amyloid A in RA
Dr. U. Fearon/ The mechanistic role of SFI €162,000 2004 2007
Dr. D. Veale cytokines in regulating
angiogenesis and cartilage
metabolism
Prof O. FitzGerald Kineret in psoriasis and Amgen €90,000 2002 2005
psoriatic arthritis: a single
center, open label pilot study
Prof. O. FitzGerald Differential expression of HRB Project Grant €165,000 2004 2007
VEGF and PIGF and VEGF
receptors in inflammatory
arthritis
Prof. O. FitzGerald Etanercept in psoriasis and Wyeth €120,000 2004 2006
psoriatic arthritis: a single
center open label pilot study
Prof. O. FitzGerald SWITCH Efficacy of writching Abbott €64,000 2004 2005
Anti-TNF therapies in patients
with RA
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64
Review 2005
Grants Active in 2005
P.I. Name of Study Source of Grant Fund Amount Start Finish
Date Date
Prof. B. Bresnihan Withdrawal of anti-TNF Health Research €175,428 2004 2006
therapy
Board
Prof. Kevin Malone Psychological Stress, Craig Dobbin €85,000 2004 2006
Dept. Psychiatry & Optimism and Immune Newman Scholarship
Mental Health System
Research
Prof. Kevin Malone Brain Imaging Studies in AFSP Distinguished €100,000 2004 2006
Dept. Psychiatry & Suicidal Depression
Investigator
Mental Health
Research
Prof. Kevin Malone Brain Imaging Studies in National Neuroscience €160,000 2004 2006
Dept. Psychiatry & Suicidal Depression
Network
Mental Health
Research
Prof. Kevin Malone Suicide and other causes of HSE/National Suicide €30,000 2004 2005
Dept. Psychiatry & mortality in Medical
Review Group & Irish
Mental Health Practitioners in Ireland Medical Council
Research 1978-2005
Prof. Kevin Malone Suicide and other causes of Iarnrod Eireann €30,000 2004 2005
Dept. Psychiatry & mortality on Irish Railways
Mental Health
Research
Prof. Kevin Malone Suicide and other causes of Irish Medical Council €20,000 2004 2005
Dept. Psychiatry & mortality in Medical
Mental Health Practitioners in Ireland
Research 1978-2005
Prof. Kevin Malone Suicide and other causes of Health & Safety €15,000 2004 2005
Dept. Psychiatry & mortality in An Garda Authority/ National
Mental Health Siochana Suicide Research
Research
Review Group
Prof. Kevin Malone Molecular Genetic Factors Astra Zeneca Suicide €30,000 2004 2005
Dept. Psychiatry & Associated with Suicidal Research Fellow
Mental Health Behaviour
Research
Dr. Donal O'Shea/ Clinical Research Training Health Research €192,000 2005 2007
Prof. Cliona Fellowship Board
O'Farrelly/
Dr. Tom Cawood
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St. Michael’s Hospital
65
St. Michael’s
HOSPITAL

66
Review 2005
St. Michael's Hospital
Overview
In 2005 the on-going development and integration of services in St. Michael's Hospital within the St.
Vincent's Healthcare Group continued. On a national basis the structure and development of healthcare
management changed during 2005. Following the dismantling of the Health Board system, the new Health
Service Executive (HSE) was established to manage the health service.
Similar to previous years the hospital prepared and submitted a service plan in conjunction with St. Vincent's
University Hospital to the HSE. The service plan detailed the hospital's expenditure, projected activity, and
service requirements for 2005. It also emphasised the urgent need for capital funding which had been the
subject of discussions with the Eastern Regional Health Authority. The requirement for capital funding
primarily related to the need to undertake a major fire safety upgrade programme in the Hospital. In 2005 a
series of meetings where held with the HSE. The budgetary position in 2005 was difficult in relation to
achieving break even at the year-end.
In 2005 work continued on addressing the hospital's physical facilities and general infrastructure. Major
developments in this area included the continuing work on the link corridor between the two hospital
buildings scheduled for completion in the first quarter of 2006. Following negotiations between the Fire
Officer and the hospital consultants, work commenced on up-grading the electrical protective services in
September 2005. I would like to thank all hospital staff, visitors and patients for their co-operation and
support throughout the unavoidable inconvenience these projects caused. The on-going window replacement
and painting programmes continued throughout 2005.
In 2005 a number of significant developments commenced in the Radiology Department. Kodak installed
their computerised Radiography system and printer. These have contributed to significant improvements in
the quality and ease of producing images. In December, following the installation of the Axiom Siroscope SD
imaging system, the new Fluoroscopy Room was commissioned. This will allow the production of digital
images.
Plans for 2006 include the installation of digital equipment, which will facilitate a closer working relationship
with St. Vincent's University Hospital via the new RIS/ PACS System.
Pharmacy Department
The Pharmacy Department has further built on accreditation initiatives in 2005. There has been greater
documentation of service developments, with poster presentations on the patient own drugs (POD) system,
antibiotic audit, new drug guidelines, drug storage developments and on disposal of pharmaceutical waste.
Approval was obtained for a system of continuous temperature monitoring of drug fridges (with remote alarm
system), in conjunction with the Laboratory. This will go ahead in 2006. The Chief Pharmacist is involved with
the HPSG in developing purchase agreements - a wound dressing tender has successfully been completed
in 2005, which will result in considerable savings. Plans for 2006 include further educational developments
(including training for nursing staff on the POD scheme), more drug audits, risk management initiatives,
improvement of drug storage processes and updates on guidelines and procedures already developed.
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St. Michael’s Hospital
67
Nursing Administration
During 2005 a number of changes took place in the Nursing Management Division.
Ms. Marianne Byrne resigned to go to Liberia to work with Concern with whom she had worked with on
previous occasions. Ms. Robyn Henderson, Acting Director Of Nursing, went on special leave to spend time
with her ill mother in New Zealand. Her mother has since died and our sympathy is with her at this time.
Josephine Barrett took up the post of Acting Director Of Nursing.
Ita Wright (CNM2) and Margot Mescall (CNM1) retired in 2005. We wish both of them long and happy
retirement.
St. Michael's Hospital took part in the HSE International Recruitment Project and a number of nurses
commenced work in January and March 2006. This year we have continued the Pre-Registration adaptation
and clinical assessment programme for overseas nurses to support nurse recruitment for hospitals and
nursing homes. The BSc student programme continues in conjunction with UCD, with an added 38 students
in September 2005.
The establishment of nurse led services in the Respiratory Unit, Cardiac Rehabilitation, Prostate Assessment
and the Warfarin Clinic, continues to enhance the service we offer to our patients. Various Clinical Nurse
Specialists made presentations during the year. CNS Mary Frances O'Driscoll, Respiratory Unit in
conjunction with Dr. Tim McDonnell presented a study “An Evaluation of nurse-led respiratory service in the
21st. Century: Can clinical nurse specialists make a difference”, at the Irish Thoracic Society meeting in
November 2005. CNS Anne Vaughan in Cardiac Rehabilitation presented a paper on “Comparisons on pre
and post stress testing in the elderly patient”, at the I.A.C.R. Satellite Symposium at the Irish Cardiac Society
in October 2005.
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68
Review 2005
Nursing Administration
A variety of in-service education continued during 2005, with I.V. Theoretical instruction and Practical
Assessment for both I.V. administration of medication and Venopuncture and Cannulation. A number of
nurses are trained BLS instructors. One of our instructors Chris O'Connor organised BLS and ACL's “train
the trainer's” courses throughout the year, in conjunction with SVUH and St Columcilles Hospital.
Pathology Department
The pathology staff were delighted to welcome Dr. Gerard Connaghan, Consultant Haematologist, as a
member of their team. This appointment increases the number of consultant staff to three in the Pathology
Department. Congratulations also to Ms. Fiona O'Donoghue who was appointed as Senior Medical Scientist
in Haematology and Ms. Angela O'Broin who was appointed Senior Medical Scientist in Biochemistry during
the year.
Installation of new windows, painting the laboratories and provision of new changing facilities for the staff
greatly enhanced the infrastructure in the laboratories during 2005. Automated equipment was replaced in
Haematology and Biochemistry; this provided a more efficient distribution of work throughout the
department. The Vitek installed in Microbiology introduced automated antibiotic sensitivity for the first time
to the St. Vincent's Healthcare Group. Two external audits were carried out during the year: The Dangerous
Goods Advisor Audit and the Fire Safety Audit.
Staff in the Pathology Department regularly participated on St. Vincent's Healthcare Group Committees. Ms.
Veronica Condon participated on the Information Committee. Ms. Sarah-Jane Slattery was appointed to the
Infection Control Committee as St. Michael's Hospital Surveillance Scientist. Ms. Catherine Fitzpatrick, Ms.
Karen Sweeney, and Ms. Marie McBryan attended the Group Blood Transfusion Committee meeting.
The Pathology Strategic Planning Committee met during the year with S.V.U.H. to plan and examine the
future development of pathology services in St. Michael's Hospital.
The workload in the Pathology Department continued to rise in 2005. There was an 11% increase in the
number of samples received in the department since 2004.
Human Resources
In the H.R. Department 2005 was another stable year for St. Michael's Hospital with low staff turnover across
all categories of employees. Once again we experienced a high quality response to vacancies advertised, in
addition to receiving regular unsolicited applications for positions across all occupation categories.
Training and development was a major focus of H.R. activity in 2005, with nearly 200 staff attending internal
and external programmes and joint training programmes at SVUH and SVPH. Key themes covered during the
year included People Management Skills, Employment Law, Interviewing Skills, Team Based Performance
Management, Personal Development Planning and Integrated Care Pathways. A major emphasis was placed
on dignity and equality in the workplace and managing diversity, including the training of 'support contact
persons' to support these policies. In addition we now have five graduates of the Diploma in First Line
Management (delivered in-house at SVUH in a joint initiative with the National College of Ireland). Other St.
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St. Michael’s Hospital
69
Human Resources
Michael's Hospital staff are in the process of completing this Diploma. Three of our clerical officers in the
Patient Services Department received certificates in Medical Records and Patient Services Management
from Kevin Street D.I.T., in October 2005.
The St. Michael's Hospital H.R. Forum for Department Heads and Line Managers met regularly throughout
the year to share experience and information and to discuss H.R. policies, practise and issues. As a result of
the H.R. Forum initiatives, over 100 staff are now actively involved in preparing and implementing their own
'Personal Development Plans' supported by their line managers.
Further progress was made with our H.R. colleagues at SVPH and SVUH on harmonisation and on quality
improvement initiatives associated with Accreditation, and there was a significant level of engagement in
preparing for the IHSAB Mid-Cycle Review in January 2006.
During 2005 a number of affinity schemes for staff were put in place with various institutions, both at Group
and at local level, which have already benefited St. Michael's Hospital staff in enjoying access to a range of
preferential and discounted key financial services and easy payment facilities.
Preparation work also commenced for the introduction of a new H.R. information management system in
early 2006. This will facilitate improved record keeping, processing, reporting and monitoring across a range
of H.R. activities and indicators.
2005 also saw the retirement of Dr. Michael Slazenger (Consultant Anaesthetist), and Mr. Michael Fox
(Consultant Surgeon) after many years of dedicated service to St. Michael's Hospital. Ms. Mary O'Neill and
Ms. Imelda Walshe retired from our Patient Services Department. So too did Esmay Rothschild and Anne
Kearney from the Diagnostic Imaging Department. We wish them all long, happy and healthy retirements.
John Kane left us after his long service as Medical Scientist to take up an Officials position with the Medical
Laboratory Scientists Association, and we wish him well in his new role.
I.T. Department
We welcomed Mr. Cathal Prendergast back to the IT Department after his sojourn to Australia. We upgraded
the link to St. Vincent's University Hospital, which will be further upgraded in the New Year, in order to
facilitate the implementation of the hospital-wide PAC's system.
The Hospital network was upgraded which resulted in enhanced e-mail, file and print sharing for users. The
latest virus protection software is now in place, in order to protect the network. New servers were installed
to facilitate these developments and many extra PCs are now located throughout the hospital.
A lot of groundwork was achieved in preparation for the new laboratory system, which is expected to go live
in the first quarter of 2006.
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70
Review 2005
Thanks
Thanks
The Sisters Of Charity Advisory and Consultative Forum comprising of all hospitals under the care of the
Sisters of Charity continued to meet in 2005. These meetings continued to be of great benefit to St.
Michael's Hospital, in particular the sharing of information with our colleagues from the other hospitals. I
would especially like to thank the Sisters Of Charity for their dedication and commitment to developing the
role of the hospital.
I would like to thank Ms. Ann Riordan, chairperson of the Fund Raising Committee and her team for it's
continued work in organising functions and raising funds on behalf of St. Michael's Hospital. Many thanks
also to the volunteers who help run the St. Michael's Charity Shop and all those who attended fundraising
functions or donated resources to the Hospital.
I would like to extend my sincere thanks on behalf of the Executive Council, the Board Of Directors', the
Group Chief Executive and all hospital staff who have demonstrated such a deep commitment and
professionalism in their efforts to meet the needs and demands of management and patients.
I would also like to extend my thanks to the other committees of the hospital and their members for all their
help and support throughout the year.
I wish to express my thanks to the Group Chief Executive and the Executive of the HSE for all their support
and commitment to St. Michael's Hospital.
Finally, I wish to convey my extreme gratitude to each and every member of staff for all their hard work,
commitment and co-operation during 2005 in the delivery of care to patients and their relatives.
Mr. Seamus Murtagh
Hospital Manager
St. Michael’s Hospital
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St. Michael’s Hospital
71
St. Michael's Hospital
Organisational Structure
St. Michael’s Hospital
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72
Review 2005
St. Vincent’s Private
HOSPITAL

St. Vincent’s Private Hospital
73
St. Vincent's Private Hospital
Overview
St. Vincent's Private Hospital continued to make steady progress in improving quality and increasing
reimbursement levels for its services in 2005. Hospital turnover increased from €43.4m in 2004 to €50.6m
in 2005 and a surplus of €1.417m was generated during the year compared to €812,000 in 2004. This was
achieved through the development of the business model which focused on increasing activity and
reimbursement levels during the year. Our thanks are due to the team leaders, consultants and staff who
contributed to the various improvements made during the year which are outlined in this report. Average
debtors days have dropped from 68 to 61 days due to the collaborative efforts of the Finance Department,
Consultants and their secretaries. The hospital currently has 164 inpatient beds, 36 day care spaces (including
oncology), operating theatres for major and minor surgery, endoscopy, diagnostic imaging which includes
general radiography, CT, ultrasound and MRI and comprehensive oncology and radiotherapy services.
Patient Activity
In-patient occupancy increased to 86.26% in 2005 from 82.71% in 2004 in spite of a drop in admissions of
0.5%. An increase in average length of stay from 5.15 to 5.38 days reflects a change in the complexity of our
case mix. Theatre activity increased by 2.8% to 3,914 cases which can be attributed to better utilisation of
theatres during holiday periods and the allocation of theatre space to new consultants. The Diagnostic
Imaging Department reported a significant increase in the volume of MRI Scans (11.1%) and CT Scans
(10.9%) in spite of increasing competition. While general day care procedures dropped by 1.6%, day care
oncology cases increased by 7.7% reflecting an increasing demand for this service. A summary of in-patient
and outpatient activity is set out in the Corporate Services Division Report.
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74
Review 2005
St. Vincent's Private Hospital
Service Developments and General Improvements
A number of development were completed in 2005 as follows:
• Completion of a €4.4m capital programme which included the supply and commissioning of 2 new
linear accelerators in the Radiotherapy Department
• Establishment of a Triple Assessment Clinic (TAC) for women with symptomatic breast pathology
• A new four bedded Coronary Care Step Down Unit was established
• A new backup generator was installed and relocated (Cir. €0.3m)
• The electrical switch room was upgraded
• Medical gases and vacuum plant were upgraded in theatre
• Day Care Endoscopy Equipment was replaced (cir. €0.4m)
• First phase of the bed replacement programme
A more detailed list of improvements is set out in the reports by the Divisional Managers
Consultants Forum
The forum provided valuable advice and support on a range of matters during the year including clinical
policies/ procedures, debtors days and clinical service developments. Dr. J. Griffin resigned from the Forum
during 2005 and Dr. Conor Collins was co-opted in his place. Professor D. O'Donoghue continues to
represent the Forum on Best Practice Committee and Dr. Maurer, Dr. Eamonn Kelly and Dr. Griffin participated
on the Executive Committee. Amended rules relating to the granting and withdrawal of admitting privileges
to consultants at St. Vincent's Private Hospital were circulated to all consultants in March 2005 having been
approved by the Forum. Among the issues discussed by the Forum during the year were the following:
• Participation in a unified regional cancer patient information system
• Development of a phlebotomy service within St Vincent's Private Hospital
• Participation in the St Vincent's University Hospital General Practitioner Study Day on 12/11/2005
• Policy on Non Consultant Hospital Doctors assisting in St Vincent's Private Hospital Theatres
• Review of out-patient services offered to General Practitioners
• Extension of RIS PACS System to St Vincent's Private Hospital
• Ongoing review of patient activity.
Thanks are also due to Ms. Yvonne Farnan who continues to provide secretarial support to the Forum.
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St. Vincent’s Private Hospital
75
St. Vincent's Private Hospital
Management Team and Executive Committee
The Management Team and Executive Committee of the private hospital continued to meet throughout the
year to review and monitor progress in relation to the budget and service plans. Ms. Annette O'Neill joined
the Management Team during the year as Acting Allied Health Manager and Ms. Gretta Colbert retired as
Director of Nursing after almost 40 years of service. Gretta had served as night sister and Administrative
Sister before being appointed Director of Nursing in 1996. Gretta made a great contribution to the hospital
over the years and her retirement party which was held in December 2005 was attended by a large group of
colleagues and friends. We wish her well in her retirement.
Regular meetings were held with the Team Leaders/Heads of Departments during the year. At these
meetings the Management Team provided updates on clinical and financial performance and on relevant
internal and external factors affecting the hospital.
The Management Team also provided an induction programme for new staff to familiarise them with the
hospital and its policies and procedures. They also produced a number of newsletters to keep all staff updated
on developments during the year. General staff briefings were provided for staff in 2005.
New Archive Store and Staff Rest Room
A small working group was established during the year to free up space in a multi-function room on the lower
ground floor and create a new archive store on the grounds. All records stored in the Archive Store are now
labelled and a section of the room is allocated to each division, which is maintained by them.
The vacated multi-function room was refurbished and opened on Monday 4th July 2005 as a staff rest room.
The staff room is available for all staff and the introduction of the room facilitated the closure of the Coffee
Shop at 5.00 p.m. daily and the creation of two shared offices. Facilities include a relaxing seating area and
dining area, vending machine, microwave, fridge and TV.
Pension Scheme
The new Defined Contributions Pension Scheme which applies to new staff appointed after 1 January 2005
was launched during the year. The existing Defined Benefit Scheme will continue to operate for staff
employed before 1st January 2005.
Michael Redmond,
Chief Executive, SVPH
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76
Review 2005
Allied Health Division
Overview
The Allied Health Division had a challenging and increasingly busy year in 2005. Departments within the
Division continued to develop and work towards annual action plans. While lack of space impeded growth in
some of the departments, there was significant increases in overall activity in 2005 compared to 2004 (see
Corporate Services section).
Much of this is due to the dedicated, highly professional and hardworking staff. The contribution of staff is
greatly appreciated in overcoming difficulties such as staff shortages.
There were welcomed improvements in IT infrastructure, with Local Area Networks installed in many
departments. Access to e-mail and the internet helped improve overall efficiency and the quality of service
offered by many of the departments.
New office accommodation was provided for a number of the Allied Health Managers and a member of the
physics staff.
There was major capital investment in the Radiotherapy Department, which will allow the department to
provide a high quality service to its patients.
Training & Education
Allied Health staff took part in mandatory Induction, Fire, Moving and Handling and Bullying and Harassment
Training. CPR training was also provided for many of the clinical staff in the Division.
Many of the Allied Health subdivisions are technology driven. This results in rapid changes in technology,
diagnostic tools and treatment. As a result Continuous Professional Development (CPD) for clinical staff in
the Division is necessary. Throughout 2005 CPD was actively encouraged and supported by Senior
Management. Members of the administration staff undertook ECDL advanced courses in Word and Excel.
There was significant representation from the Allied Health Division at the Health Promotion, European
Health & Safety Week and Dignity at Work Training workshops organised through the Health & Safety
Committee.
Health & Safety Committee
Two members of the allied health staff are involved with other divisional representatives on the Health and
Safety Committee, helping to formulate policies and addressing many of the Health & Safety issues that
arise.
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Allied Health Division
Accreditation
Allied health staff are represented on some of the clinical, the HR, the environment and leadership and
partnership teams. Members have been involved in working towards the quality improvement initiatives
identified during the accreditation process.
GP Open Night
Allied health staff participated and helped to organise a GP open night in September. Posters were displayed
outlining the services offered by the departments and information leaflets were distributed. Short
presentations were given by Consultant Radiologists Dr Stephen Skehan on Multislice CT & Dr. Ann
O'Doherty on Breast Imaging. Dr. O'Doherty stressed the importance of a multidisciplinary approach to the
diagnosis and treatment of breast cancer. Dr. Walter Mc Nicholas and Dr Tom Crotty outlined the services
offered by the Respiratory and Pathology Departments.
Cardiology
The activity in the department increased by over 18% compared to 2004 despite very restricted working
space. Service developments in 2005 included pacemakers and insertion of internal cardiac debribrillators
(ICD). Follow up clinics for ICD and pacing were introduced towards the end of the year. Jane Maher resigned
from the staff in 2005. Lara Connolly joined the staff in April and Denis Scannell in October 2005.
Academic Achievements
Claire O'Leary
Medical Physics and Physiological Certificate (DIT Kevin Street).
Courses attended
Lara Connolly
Claire O'Leary
Denis Scannell
Advanced AICD and Biventricular Pacing Course.
Basic Pacing Course (Medtronics).
Basic Pacing Course (Medtronics).
Conferences
Lara Connolly
Denis Scannell
AGM - The British Society for Cardiology.
AGM - The Irish society of Cardiology.
Diagnostic Imaging
Diagnostic services continue to be the most significant provider of outpatient services by the hospital.
Despite keen competition from other providers in the South East Dublin region there was despite this, an
increase in overall activity in the department with significant increases in MRI and CT.
Equipment replacements in 2005 included a high-speed laser imager and two new advantage windows
workstations.
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Review 2005
Allied Health Division
Service quality improvement initiatives provided by the department included the provision of a Triple
Assessment Clinic (TAC) for women with symptomatic breast pathology. In collaboration with the Dietetics
department new patient information leaflets were designed for CT Colonography. The pre examination
preparation was particularly tailored to minimise discomfort for elderly patients prior to the procedure.
The MRI and CT departments were involved in a number of clinical trials, particularly in relation to Multiple
Sclerosis and Oncology.
Recruitment and retention remained a challenge with some staff having to be recruited from overseas to
provide locum cover.
Kolbe Mooney was appointed as a permanent member of staff. Eileen Kelly resigned and relocated to
Galway. Clare McFarland replaced her as Clinical Specialist in CT.
Academic Achievements
Veronica Gibbons
Post Graduate Cert in CT, University of Bangor, Wales.
Veronica Gibbons
IV Course UCD.
Christine Mc Kenna
Diploma in first line management
Eileen Kelly
Part 1 Diploma in first line management
Maire Hayes
Part 1 Diploma in first line management
Attending Post Graduate Courses in MRI
Deirdre Gahan
Aisling Power
Conferences
A. O'Neill, M. Hayes & K. Mooney Irish Institute of Radiography Annual Conference.
Clare Mc Farland & Veronica Gibbons 4th Annual GE Multislice CT Meeting.
Christine Mc Kenna
9th Annual MRI Users Conference.
Toinette Tunney & Edel Cusack
The Mater 8th International Breast Cancer Meeting.
Clare Mc Farland & Christine McKenna Radiological Society North America Annual Conference
Presentations at Conferences
Maire Hayes
Eileen Kelly
IIR Annual Conference. Double Contrast MRI Liver.
4th Annual GE Multislice CT Meeting. CT Colonography.
Dietetics
Throughout 2005 staff in the Dietetics Department made a conscientious effort to raise staff awareness at
ward level of services available to inpatients. Patient information leaflets were also distributed to all wards
and Day Care Oncology. This resulted in an increase in the referral rate by 16% compared to 2004.
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Allied Health Division
While the referral rates were the same for outpatient there was a decrease in the number of reviews. The
reasons for this included a reduction in the number of liver and jejunal biopsies leading to fewer new Coeliac
and Fatty Liver/NASH patients.
There were also planned reductions of Outpatients in January 2005 due to staff shortage, and outpatient
appointments were curtailed during the summer due to lack of locum cover for annual leave.
The Sleep Laboratory only returned to full activity in August and as another source of referral this impacted
on the Dietetic activity. It has been noted that the DNA rate for review of sleep apnoea patients is high.
Outpatient information leaflets were distributed to the Consultants Private Clinic, Wound Care Clinic, Daycare
and Radiotherapy waiting areas.
Dietary information material for the management of patients undergoing Virtual Colonography was developed
for the Department of Diagnostic Imaging.
A Web Page for the Dietetic Department was also produced.
Nutrition Folders were circulated to Nursing Admin and wards providing all current guidelines and procedures
relating to TPN, EPN, TPN Regimes, Enteral feeding at weekends, return of enteral feeding pumps for repair
and out of hours contact procedures.
Staff education included a presentation during Healthy Eating Week, and two presentations on TPN/Enteral
Feeding Guidelines to Nursing Staff.
Staff compliment increased from 1.5 to 2.0 WTE in 2005. Sinead Mathews joined the staff in November and
Carol Reid returned home to New Zealand.
Conferences
Alice Cromian, Marge Young and Carol Reid. AGM and Annual Study Conference, INDI.
Study Days & Evening Seminars
Alice Cromian
Marge Young
Marge & Cari
Alice Cromie
Carol Reid
Carol Reid
All staff
Alice Cromien
Marge Young
The Medical & Dietary Management of Diabetes.
Coeliac Disease a Review.
Pre and Post Op Nutritional Support.
Community Nutrition Interest Group along with the Weight Management
Interest Group of the INDI Interest Group, Annual
Study Day - Looking at Other Approaches to Obesity (INDI).
Nutrition in the critically ill. Study Day INDI.
Dietician Innovation -Abbott sponsored.
Milk Consumption, CVD and Stroke - a review of the evidence Dairy Board
Sponsored (INDI).
Diabetes Update, and COPD - Nutricia sponsored (INDI).
Fresni Stedy Cook. Nutrition in the Elderly.
Nutrition in Liver Disease, Study Day
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Review 2005
Allied Health Division
Pharmacy
Louise Mc Donnell was appointed as the new Pharmacy Services Manager in September 2005.
Increased workload, staff shortages, and change in management of unit made 2005 an increasingly busy and
challenging year for staff in the pharmacy
The average number of dispensed items per month increased by 5% over 2004 while the average number
of patients treated with intravenous chemotherapy per month increased by 12% for the same period.
Auditor's Report
The internal Group Auditors audited the department in September 2005 and a number of recommendations
were made and a time frame for implementation given. Many of these have been implemented. New
operational procedures have been devised.
Service Requirements Survey
A questionnaire study was carried out by the Pharmacy Department to identify requirements of hospital from
Pharmacy Department. Arising from the study a number of changes have been implemented to improve the
service particularly outside normal working hours. The need for the provision of a clinical pharmacist service
at ward level was identified. This project is ongoing.
Joint Nursing & Pharmacy Meetings
Regular meetings took place in 2005. Many of the suggestions and recommendations on service
improvements have been implemented.
Academic Achievements
Louise McDonnell
Jenny Dowling
Diploma in Management.
Aseptic Compounding Course, Leeds.
Courses
Helen O'Hare
Chemical Risk Assessment Management Training Programme.
Physiotherapy
The Department provides services for both inpatients and outpatients. Despite the ongoing lack of space,
activity in 2005 increased considerably compared to 2004. The 18% increase in the inpatient workload was
primarily due to an increased demand for rehabilitation and the Summer Initiative.
Increased referrals from Respiratory, Neurology and Geriatric Consultants and an increased demand to treat
patients suffering from oncology fatigue were the main sources of referral for rehabilitation.
Public patients, both medical and surgical were treated in SVPH as part of a Summer Initiative to reduce the
waiting list in SVUH and provide full utilisation of beds in SVPH. The physiotherapy staff in SVPH treated fifty
percent of the patients requiring physiotherapy.
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Allied Health Division
Other services include orthopaedic (sports injuries, back care & rehabilitation) and breast care (post operative,
reconstruction and plastic surgery).
Courses
Anne Broderick Muscle Imbalance (Upper Limb) May 2005
Anne Broderick Muscle Imbalance (Trunk) Sept 2005
Anne Broderick Muscle Imbalance (Lower Limb) Oct 2005
Anne Broderick, Deirdre Menton & Eileen Gallagher
Breast Awareness. May 2005
Eileen Gallagher Lymphodema. Apr. 2005
Eileen Gallagher Dignity at Work. Nov. 2005
Deirdre Menton Therapeutic handling to promote balance in adult neuro patients.
Deirdre Menton Combined approach to SIJ Therapy. Apr 2005
Deirdre Menton Incident Reporting, Risk Assessment and Hygiene awareness.
June Gallagher Advanced Respiratory, Oct. 2005
Radiotherapy (Including Medical Physics)
There was significant investment in the Radiotherapy Department in 2005. A second new Linear Accelerator,
a CT Simulator, upgrading of planning system, replacement of wet processor with dry laser processor and a
new patient administration (Clinisys) system were some of the major capital investments.
Considerable refurbishment and redesigning of the Department also took place. The Physics Department
relocated to the old boardroom and the old location now houses the Radiotherapy Manager, Principal
Physicist and a new filing room.
The radiotherapy reception was modified to accommodate space for a new administration post and a new
work desk was designed for this area. Clinical rooms remain the same but additional software was installed
for the Clinicians e.g. portal imaging terminal and Clinisys terminal.
On the lower ground floor the old storerooms became one and a new patient room is now available. New
control areas, which are larger and more suitable to the needs of the staff, were provided. This investment
should have considerable impact on the staff work environment and quality and range of services that will be
provided in 2006.
Activity in the area was down marginally on 2004. This was to be expected due to continuing problems with
old linear accelerator, major refurbishment work, commissioning of first and installation of the second new
linear accelerator.
Three new therapeutic radiographers were appointed to the staff, Kirsten Dollery, Niamh Gargan and Una
Monaghan. Paul Collins joined the physics staff. Lucinda Ryan (Radiotherapy) and Aoife Brown (Physics)
resigned and relocated to Galway.
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Review 2005
Allied Health Division
Academic Achievements (Physics Staff)
Aoife Brown
Colin Rooney
MSc in Physical Sciences in Medicine, Dublin University.
Part 1 - Practical & Theoretical Radiotherapy Physics.
Courses
Eimer O'Neill
Aoife Brown
Marty Grady
Martin Sheridan
3D/IMRT Clinical Training Program, Precise Treatment
July 2005, Mannheim, Germany.
Precise Plan, Clinical Application Training, Feb. Crawley. UK
Electa Digital Linear Accelerator 1st Line Training Course. April, Crawley, UK.
Electa Portal Imaging System iViewGT. Nov, Crawley, UK.
Practical Training Program, Precision Treatment, Nov., Mannheim, Germany.
Conferences
Aoife Brown
Colin Rooney
Irish Radiotherapy Group Conference, Feb., Galway
Irish Radiotherapy Group Conference, Feb., Galway
Presentations
Aoife Brown
Colin Rooney
Comparison of Brachytherapy versus Electron Treatment post
Mastectomy. IRPG Galway.
Radiotherapy Diode Assessment in Radiotherapy. IRPG, Galway.
(Poster Presentation )
Radiation Therapists
Conferences
Ten members of staff attended the Irish Institute of Radiography (IIR) Annual Conference, Nov. 2005
Courses
Patricia Flanagan, Olivia Scollard & Elaine Dolan - Training Linear Accelerator, Leeds
Patricia Flanagan, Aileen Ward & Margaret Lynch - Training on MDCT Scanner & Virtual Simulation, Cantebury.
Margaret Lynch, Kathleen Corr, & Leanne McNamara - 1 Day student clinical training course in Trinity.
Members of staff from the department attended study days in SVUH on colorectal cancer & prostate cancer.
Respiratory Department (Pulmonary Function and Sleep Lab)
There was a 27% increase in the workload in the department in 2005 compared to 2004. This was primarily
due to increased staffing levels and the trained status of staff. It also impacted on the waiting list for the sleep
laboratory. The waiting times were halved compared to 2004.
Patricia Boyle returned from leave in June on a part time basis. New office space was located and refurbished
for the department's manager.
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Allied Health Division
Academic Achievements
Nicola McGovern
& Kevin Fennell
Higher Certificate in Medical Physics and
Physiological Measurement
Conferences
Anna O'Brien
Irish Sleep Society, February 2005, Dublin
Anna O'Brien & Kevin Fennell ARTI/ARTP Joint Annual Meeting, 7th- 8th October 2005
Presentations
Nicola Mc Govern gave a captivating talk about sleep hygiene at the Healthy Eating Week
Social Work
There was a small increase in referrals in 2005 reflecting the limitations of a single staffed Social Work
service.
The 479 new referrals in 2005 repeat the pattern of previous years in a mainly elderly patient group. Timely
referral to our Geriatricians helped identify those patients requiring further rehabilitation or extended nursing
care placements.
The high demand for social work services to the Oncology unit continued but the current staffing situation
made it difficult to provide a holistic service to patients and their families.
The appointment of the new neurologist had implications for social work services as many neurological
patients required multi-disciplinary intervention.
Annette O'Neill,
Acting Allied Health Manager.
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84
Review 2005
Nursing Report
Overview
In 2006 the Nursing Division continued to focus on the provision of highly skilled nursing expertise with the
delivery of patient care underpinned by core values. In tandem with this many initiatives were undertaken
to develop practice using a multidisciplinary team approach.
The commitment and dedication of staff has allowed for presenting challenges to be overcome in such a way
that patient service provision has increased and flourished.
Recruitment
Much energy was expended on recruitment in a year with no nurse graduates coming on stream. We were
able to replace nurses resigning and maintain the status quo.
Staff Recruited
Staff Nurses 26
Theatre Attendant 1
Clinical Nurse Manager II 3
Porters 3
Phlebotomist 3
Resignations
Staff Nurses 27
Porters 3
Care Assistants 3
Phlebotomists 3
Clerical Assistants 1
TSSD Operative 1
In 2005 we said goodbye to a number of staff members
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Nursing Report
2005 saw the appointment of Mary Donohue as Oncology Nurse Co-ordinator. This post provides for smooth
delivery of oncology services with liaison between relevant departments and personnel. Patient and family
education and support are provided by Mary and her role has proved invaluable.
Una Nicholson took up her position in April 2005 as Infection Control Nurse Specialist having received her
Higher Diploma in Infection Control Nursing.
Portering Service
A new 'pool' system was introduced in October 2005 successfully orchestrated by Mr Michael Smith,
Portering Supervisor. This system has worked very well and is providing an even more efficient system to
patients and staff.
Urodynamics Department
The Urodynamic Department commenced in March 2005. Prior to March the Day Surgery staff carried out
Urodynamic Tests. The service initially commenced 20 hours per week. This changed to 25 hours per week
in January 2006 due to increasing demands for the service. The department offers a number of different
tests to both in-patient and out-patient e.g. Uroflow, Bladder Scans, Cystometrogram and Self Intermittent
Catherization Tuition.
Cardiology Step Down Unit
The new 4 bedded cardiology step down unit opened on Redwood to receive patients from CCU after a
programme for staff training involving collaboration and assistance from cardiologists and staff in CCU.
Mission Committee Report
In December 2005 Gretta Colbert resigned as the Mission Committee Chairperson. Her successor was Orla
FitzGibbon.
Education and Training
A number of committees met regularly throughout 2005 in order to advance staff education within the
nursing division. These committees included:
• Policy & Procedure Committee
• Staff Development Committee.
As with other years many staff commenced higher education courses in 2005.
• Joanne Cadogan - Higher Diploma in Health Promotion.
• Christine Leonard - BSc in Nursing
• Elizabeth Looney - Diploma in Healthcare Management
• Marie Nolan - BSc in Nursing
• Aideen O'Callaghan - BSc in Nursing
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Review 2005
Nursing Report
• Phil O'Neill - Masters in Ministry
• Joanne Power - Higher Diploma in Gastrointestinal & Colorectal Studies.
• Annette Reilly - Higher Diploma in Healthcare Management
• Eleanor Scully - Graduate Diploma in Health & Safety
• Caroline Whelan - Higher Diploma in Diabetes Nursing
Annual in-service training took place in the hospital. These included:
• Fire Training
• Fire Marshall Training
• Manual Handling
• CPR
• Induction Training
• In Service Speciality Training including guest lecturers on:
- TPN/NG Protocols
- Microbiology in Oncology
- Wound Care
- Handwashing Techniques
- Analgesia in Cancer Care
Retirements
Ms Gretta Colbert - Director of Nursing
Ms Gretta Colbert retired from her post as Director of Nursing at the end of December 2005.
Ms Colbert was a dedicated and committed member of staff always ensuring the highest quality care was
delivered to the patients of St. Vincent's Private Hospital. She worked tirelessly over the years to create a
harmonious environment both for patients and nursing staff.
Gretta continued her patient focused ethos, whether it be in her role as mission liaison person or as nursing
administrator.
Ms Brid Orbinski
Ms Brid Orbinski retired in December 2005 having given a long and committed service to the patients of St.
Vincent's Private Hospital. Brid carried out her duties in a caring, professional and sensitive manner. She will
be greatly missed by all her colleagues.
On behalf of all the staff we wish them a happy retirement and good health to enjoy their well-earned free
time.
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Support Services Division
The Division is split into two separate areas. Yvonne Byrne and Geraldine O'Nolan manage the catering and
hospitality area and Jennifer Calton heads up the facilities and maintenance section.
Reception
Reception is the first area of the hospital our customers see. One of its primary functions is to promote a
warm and friendly welcome for patient's visitors and staff. The reception provides switchboard and
communication services throughout the hospital. The service operates seven days a week from 7.00am -
11.00pm Monday -Friday and from 8.00am- 9.00pm Saturday-Sunday and is staffed by a team of nine. The
team under the supervision of Margaret English made some improvements to the service during the year.
• New uniforms were introduced to promote a more professional appearance.
• Standard procedure for answering the telephone
• Standard procedure for handling of post and parcels
• New database for patient telephone accounts was installed in the post room.
• A new franking machine was purchased to deal with increase in postage requirements.
Next year the car park attendant will join the reception team. This will help to have a more cohesive security
function at the front desk.
Car Park
• A credit card software programme was installed by Integral into the Car Park Payment Machine. The
additional facility will provide a convenient method of payment to patients and visitors to the hospital.
• A car park attendant is on duty Monday - Saturday each week.
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Review 2005
Support Services Division
Household Services
The Household Services Department provide a quality cleaning and hygiene service throughout the hospital.
The department works closely with in-house and external maintenance personnel. Yvonne Gleeson is the
Household Services Officer and has a team of five staff working with her. They provide a six-day service.
The Household Services team provide assistance and support to all departments in the hospital. There is an
ongoing refurbishment programme in all patient areas, which is implemented in conjunction with a household
inventory checklist.
In March a tendering process was initiated to review our cleaning service. The new cleaning specification was
used as a benchmark for our required standard. Formal interviews were held using a consistent format and
questioning process. Maybin Clean were selected as the successful service provider. This will be their second
term in the hospital. The cleaning company will operate closely with household services and infection control
on a daily basis. A formal meeting is held weekly.
Some new initiatives during the year were:
• Programme for washing fire blankets.
• Programme for changing shower curtains and bath mats.
• Housekeeping routines to complement the Fire Safety Plan
Other areas supervised by the team are the, patient linen service, laundering of catering uniforms, dry
cleaning, window cleaning and a hair dressing service.
Maintenance Department
There are two full time maintenance operatives Eddie Hartland and Rory McElhinney. As part of our
agreement with William Farrell Electrical LTD an after hours call out service is also provided.
There are a total of 74 external contractors who service and maintain equipment and services on a regular
basis. Non-routine work and projects are organised separately by using reputable outside firms who continue
to complete the majority of our project work.
Our plan this year is to use our new software maintenance package to compile reports on categorisation of
requests i.e. maintenance, enhancement or project work.
Projects
External and internal maintenance personnel carried out a total of thirty-three projects. Fifteen major projects
were carried out and a total of eighteen minor projects. These also require assistance from our internal
facilities staff in household and maintenance. As part of ongoing Health & Safety improvements, the
introduction of a new Maintenance & Projects Safety Statement was introduced as part of the hospital safety
statement.
Some of the projects completed last year include
Fire Prevention
• New sprinkler system installed in the kitchen
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Support Services Division
• Installation of an additional fire satellite panel
Grounds
• Inactive storage unit installed
• Remarking of car park lines
Patient Areas
• Six new showers installed
• Shower heads replaced in all bathrooms
General
• Painting programme continued throughout the year
• Stainless steel surrounds fitted in six lift lobbies.
• Ceiling tiles were replaced in various areas.
All major works are project managed by a team incorporating Support Services,
Finance and Corporate Services.
• New linear accelerators was installed in radiotherapy.
• Refurbishment of office and patient areas in radiotherapy.
• New GE Light Speed Scanner was installed in Radiotherapy.
• New backup Generator was installed and relocated.
• Upgrade of electrical switch room.
• Medical gases and vacuum plant upgrade in theatre.
• Refurbishment of two assisted bathrooms.
• New staff rest room.
• Refurbishment of meeting room.
• Boardroom was converted to Phlebotomy room.
• Refurbishment and enhancement of four nurses stations.
• Two staff rooms were converted to office accommodation.
Catering Department
The catering department has a team of 64, which services the needs of both patient catering and the coffee
shop.
The department has a fully implemented HACCP System and are accredited with ISO 9001:2000 IS 343.
The coffee shop seats 105 and is open from 7.00 a.m. to 5.00 p.m. daily providing service to both staff and
visitors in a busy environment.
All of the food is cooked and served on a daily basis supervised by Senior Chef Michelle Pounch. The
department does its utmost to cater for all patient needs and customer satisfaction is of paramount
importance to us.
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Review 2005
Support Services Division
Internal Audits
Eight internal audits were carried out last year by the Catering Officers. An example of three are:
January
IS 340 Section 4
ISO Section 7 Service
IS 343 Section 4 HACCP
Cleaning
Realisation
Planning/Pre-requisite programme and flow chart.
March
IS 340 Section 5 Pest Control
IS 340 Section 2 Food Safety
ISO Section 8 Validation and Auditing.
June
ISO 340 Section 1 Hygiene Policy
ISO Section 8 Measurement Analysis and Improvement
External Audits
• Cater Care carried out two audits in March and October.
• CVA International carried out a surveillance audit in May on the Departments ISO & HACCP system.
• Gwen Neary Environmental Health Officer visited the Catering Department in June with a
follow up visit in August.
Departmental Statistics
The catering department provides service to 162 inpatients, 30 day-care patients and approximately 300 staff
daily. The department also caters for various functions throughout the year as well as in-house meetings.
Minor Capital Developments/Improvements
The new staff room was opened on 6th July 2005. The room seats 30 people. It is equipped with a fridge,
vending machine, microwave, and beverage making facilities. A new Bean to Cup Coffee Machine was
installed in the Coffee Shop.
Future Plans
Review how the split of the nursing floors has impacted on service delivery. There are now eight nurses
stations to communicate with instead of the original four.
Carry out customer surveys to ascertain our customer needs.
To review our accredited system in line with new legislation ISO 22000.
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Support Services Division
Training
A training plan is devised annually. It includes mandatory training such as refresher food hygiene, manual
handling and fire training.
• Leona Dowd, Mary Gavin and Stephanie Watson completed an Advanced Access Computer
Training Course.
• Yvonne Gleeson, Eddie Hartland, John Grey and Tony Murray attended Safe Pass Training.
• Siobhan Kelly completed a course on Team Leading Skills for Supervisors.
• Barbara McMullen, Aisling Murphy, and Levant Unal attended Primary Food Hygiene training.
• Mary Kelleher and Fiona Connolly attended a Customer Services course.
Staffing
• Congratulations to Florence Quinn who completed 25 years service in the catering department.
• Bill Hannon retired in October from our Reception team after 16 years of service.
We wish him very best wishes for the future.
Welcome to
• Mary Gavin who joined the Support Services Administration office in January.
• Margaret English who commenced her new position as Head Receptionist in May.
• In the catering department there were eight new catering assistants, two chefs and one kitchen porter.
Janet Murray
Support Services Manager
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Review 2005
Human Resources Division
Mission / Vision
“The Mission of the HR Division is to design and deliver innovative HR services in partnership with the
Hospital and the Healthcare Group to ensure a progressive, equitable and challenging environment for staff,
and a quality service for patients.”
Our Vision is to lead the way in HR expertise, creating a unique environment for our people that will generate
success for the Hospital and the Healthcare Group.
Our Values include:
• Being the guardian of fairness and equity
• Valuing all our staff
• Listening and responding appropriately
• Balancing people and business needs
• Learning from our successes and our mistakes
• Communicating intentions and expectations clearly
• Advising Managers on how to manage performance fairly and firmly.
Overview
The HR Division continues to manage all of the activities relating to the personnel function, namely - to assist
management to enhance the individual and collective contributions of staff in achieving the Mission and
Objectives of the Hospital; to advise and assist all line managers on matters relating to staff; to provide
information to staff on all employment matters and to carry out the Employee Relations function of the
Hospital. The volume of employment legislation continues to grow and the HR Division ensures that the
hospital complies with all employment legislation enacted over the last number of years.
The main activities that derive from these roles are recruitment and selection (including recruitment for St
Vincent's Healthcare Group); staff development and training; employee relations, implementation of policies
and procedures, manpower planning, personnel administration and organisation development.
The wide span of activities places an onerous burden on staff and I would like to thank Ms Marian Murphy
for her commitment and support during the year. I would also like to thank Ms Barbara Power for her valued
contribution to the Division and the Hospital during the year also.
Occupational Health Service
St Vincent's Private Hospital has entered into an agreement with St Vincent's University Hospital for the
provision of Occupational Health Services for Private Hospital staff. This service commenced on March 1st
2005, and the main elements of the service are:
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Human Resources Division
• Treatment of inoculation injuries and risk management follow up
• Immune status evaluation
• Pre-employment assessment
• Flu vaccination
• Management referrals
The provision of this service supports our duty of care to staff under Health & Safety legislation, and also
assists with Best Practice initiatives.
During the year 'Be Sharp Be safe' workshops were held on all Nursing floors and Theatre. All were well
attended by staff. The Occupational Health Department also participated in Health & Safety Week, orientation
days and also at Health Promotion events. Advice was given to managers and staff on issues concerning
Health & Safety matters. Overall the feedback from staff has been very positive and it is hoped to expand the
service in 2006.
I would like to thank Ms Ann O'Reilly and all the staff of the Occupational Health Department for their
assistance and support throughout the year.
Training & Development
Induction training was provided on a number of occasions during the year for new staff. In June a number of
workshops and seminars were held for Team Leaders and staff on the topic of 'Equality and Diversity in the
Workplace'. The aim of this training was to create and maintain an awareness of best practice in this area, as
well as informing staff of statutory obligations. Similar workshops and seminars were held in November on
'Dignity at Work', dealing with the whole area of bullying and harassment. It is hoped to continue with this
programme in 2006.
Support was given to a number of staff for courses of study in their own time. This support took the form of
financial support and study leave. A number of staff completed the 'Diploma in First Line Management' which
was provided by the National College of Ireland. Seminars on Pensions and Additional Voluntary Contributions
(AVCs) were also held for staff and delivered by representatives from Mercer and Irish Life.
Recruitment, Selection & Retention
Recruitment and retention of staff remains a challenge and difficulties continue in sourcing a number of
grades of staff including Radiographers, Doctors, Nurses, Pharmacy and experienced Administration staff.
Recruitment of staff from overseas continues on an ongoing basis as required.
The HR Division assisted other Divisions with the selection of candidates for internal promotion vacancies.
The Hospital website was adapted to facilitate 'on-line' applications by applicants. This has proven to be very
popular and successful.
Staff Benefits
A major change to staff benefits took place with the introduction of a Defined Contribution Pension scheme
for all new staff recruited after January 1st 2005. (This change reflects the increasing cost of pension
provision for staff taking into account the increase in liabilities into the future). Changes were made in the
administration of the Disability Benefit scheme for staff aged sixty and over. 'Death in Service' benefits were
increased substantially for staff in 2005.
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Review 2005
Human Resources Division
Employee Relations
Discussions on various issues took place with trade unions and staff representatives throughout 2005. A
number of individual staff grievances were also resolved by agreement with the staff members concerned.
During the year we worked closely with our colleagues in the salaries office - Ms Dorothy Nolan and Ms
Yvonne Casserly. I would like to thank them for their valued assistance.
Medical Records
The HR Division also has responsibility for Medical Records (including Floor Secretary staff), and Patient
Focus. In order to improve access security (especially after normal working hours) a new entry security
system was installed. This has helped to control access. Storage space for charts and x-ray films continues
to be in short supply, and Day Surgery files are now being stored in the Department. New arrangements were
entered into with 'Medrex Systems Ireland Ltd' to assist in providing solutions.
In order to improve the quality of service to patients a number of audits were carried out to measure
completeness and accuracy of charts. In addition a number of measures were put in place to reduce the risk
of duplicate medical record numbers occurring. I would like to thank Ms Caitriona O'Connor, Ms Ann Marie
Kavanagh, Ms Joanne Clarke, Ms Geraldine Pender, Mr Ciaran O'Callaghan, Ms Ann Pender, Ms Katie
Thompson-Chadwick and Ms Ann Cavey for the consistently high level of service they provide to patients and
staff.
Neil Twomey
Human Resource Manager
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St. Vincent’s Private Hospital
95
Corporate Services Division
The principal areas of emphasis in the Corporate Services Division relate to Quality & Risk Management,
Information Technology, Capital Development and Statistics. During 2005 each element was progressed.
Quality and Risk Management
Quality and Risk Management are key elements of the normal work of all divisions and departments in the
Hospital. The Best Practice Group provides an overarching framework for same. It also draws together the
work of the Health & Safety Committee, the Radiation Protection Committee and the Infection Control group.
The Best Practice Group membership in 2005 was:
Prof. D. O'Donoghue Mr Michael Redmond Mr Kieran Ryan Ms Janet Murray
Ms Gerada Warnes Mr Neil Twomey Ms Greta Colbert Mr Peter Sheehan
The Health & Safety Committee membership was:
Ms Janet Murray Ms Gerada Warnes Ms Annette O Neill Mr Neil Twomey
Ms Una Nicholson Ms Helen O Hare Ms Patricia Flanagan Ms Mary Connolly
Ms Gretta Colbert Ms Siobhan Connolly Ms Rita Leamy Ms Clare Jordan
Ms Eleanor Scully Ms Yvonne Casserly Ms Jennifer Calton Mr Peter Sheehan
The work programme for 2005 included:
• Development, review and approval of Hospital policies in conjunction with the
Health & Safety Committee.
1. BP000 Safety Statement
2. BP001 Moving and Handling
3. BP002 Notifiable Infectious Diseases
4. BP003 Visual Display Units
5. BP005 Prescription Criteria for Diagnostic Imaging Procedures
6. BP006 Smoke Free Policy
7. BP007 Review of existing policies
8. BP008 Incident Reporting
9. BP009 Risk Assessment Process
10.BP010 Facilities and Maintenance Safety Arrangements
11. BP011 Fire Safety Policy
• Development of the Incident Reporting system
1. A monthly report on incidents is presented to the Best Practice Group, Team Leaders and
Heads of Departments
2. A monthly report of all Medication Incidents is presented to the Best Practice Group
3. A monthly report of all incidents rated as medium or high risk by the Grading Group is
presented to the Best Practice Group
4. Information sessions for staff were provided in May and October to raise awareness of the process
and the importance of staff participation. These sessions were incorporated into a programme of
events that were organised as a health promotion week and a health & safety awareness week.
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Review 2005
Corporate Services Division
• Patient Satisfaction Survey
1. A satisfaction survey for inpatients was introduced during 2005 and is conducted on an ongoing basis.
2. A monthly report including statistical analysis and commentary is presented to the Best Practice group
and actions taken as appropriate by the management team.
• Accreditation
During the interim period between the 2004 survey and the mid cycle review of 2006 work continued
across the group on the quality improvement plans. A series of meetings were organised at the hospital
to bring together staff of St. Vincent's Private Hospital who were members of Quality Improvement
Teams. In this way a cross current of information was generated between teams and it assisted team
members in identifying improvements at the hospital that would contribute to the overall improvement
plans for the Group.
Information Technology
IT development in 2005 concentrated on expansion of the Hospital network, the introduction of the clinical
network in Radiotherapy and the linking of the two systems.
51 users were added to the network bringing the year end number to 82. The majority of users were supplied
with new PCs of an approved specification. The hospital continues to use an external computer company for
maintenance and support. However, in house support has been strengthened with an additional contracted
staff member.
The IT development in Radiotherapy was completed in 2005 with the introduction of the clinical network
throughout the entire department. A fibre backbone was installed with links to the diagnostic imaging
department. Images can now be transferred from CT and MRI to the Radiotherapy treatment planning
system.
The Hospital continued its investment in hardware and software to enhance the security and reliability of the
system. An additional router was installed to protect the link between the two hospitals on the campus.
Capital Development
A team incorporating Support Services, Finance and Corporate Services manages all major capital projects.
Major projects in 2005 included:
• Installation of 2 new Linear Accelerators, CT simulation and Treatment Planning system in the
Radiotherapy department. The first Accelerator commenced clinical activity during the year and the
second unit was commissioned in preparation for clinical work early in 2006.
• Installation of a new emergency generator to cover the entire Hospital.
• Replacement of the main plant providing electrical service to the Hospital.
An ongoing programme of minor capital development works continued through the year.
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St. Vincent’s Private Hospital
97
Corporate Services Division
Statistics
The collection of statistical information and presentation of reports continued in 2005. The system has been
refined and expanded to provide further information behind the headline statistics with a view to providing a
suite of reports that is relevant to the decision making process at the hospital. Details of activity in clinical
areas such as theatre, minor theatre and endoscopy were reported. In addition, Allied Health departments
such as Radiotherapy, Diagnostic Imaging and Respiratory medicine reported details of both outpatient and
inpatient throughput in each modality.
Headline Statistics
Jan to December Jan to December Variance Variance
2004 2005 %
Patient Discharges
Inpatients 9,127 9,081 -46 -0.5%
Inpatient Occupancy 82.71% 86.26% 3.55% 4.29%
Inpatient Bed days 46,994 48,884 1,890 4.0%
Average Length of Stay(Days) 5.15 5.38 0.23 4.5%
Daycases 5,317 5,233 -84 -1.6%
Oncology Daycases 5,127 5,524 397 7.7%
Operating Theatres
SVPH Theatres 3,808 3,914 106 2.8%
Minor Operating Theatre 2,967 3,586 619 20.9%
Endoscopy unit 5,203 4,986 -217 -4.2%
Diagnostic Imaging
No of Studies 29,324 30,648 1,324 4.5%
Radiotherapy
No of Treatments 11,594 11,272 -322 -2.8%
Cardiology
No of Procedures 6,458 7,669 1,211 19%
Respiratory Medicine
No of Procedures 2,300 2,910 610 27%
Pathology Tests
No of Procedures 380,444 438,352 57,908 15%
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Review 2005
St. Vincent's Private Hospital
Organisational Structure
St. Vincent's Private Hospital
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Departmental Review
99
St. Vincent’s University Hospital
DEPARTMENTAL
REVIEW

100
Review 2005
Department of
Anaesthesia, Intensive Care & Pain Medicine
Staff
There are currently 23 Consultant Anaesthetists working in St. Vincent's University Hospital, 12 of these
Consultants have significant commitments to other hospitals. Consequently there are 12 whole time
equivalents to staff all services in the hospital (incorporating St. Michael's Hospital). Among the services
requiring cover are:
Fifteen Operating Theatres, including;
1 in St. Michael's Annexe
2 in St Michael's Public
2 in St. Vincent's Private Hospital
We would like to welcome Dr. Cathal Nolan and Dr. Robert Plant who took up their positions as Consultant
Anaesthetists with an interest in ICU during 2005. We would also like to thank Dr. Tom Owens for all his hard
work and commitment to the department in his term as Chairman. Dr. Owens stepped down as Chairman
in October 2005 and Dr. Declan O'Keefe became the Chairman of the Department on the 1st November
2005.
Service Development / Activities
Activity Report - Operating Statistics 2005
Category St Vincent’s St. Michael's St. Michael's St. Vincent's
University Hospital Annexe Public Private
Dental 50
Dermatology 148
E.N.T. 314 180 37
General 2,613 434 1,018 457
G.U. Endo 1,568 305 40
G.U. Open 171 306 223 3
Gynaecology 256 47 78 1
Ophthalmology 302 19
Orthopaedic 1,785 270 77
Pain 526 38
Plastic 945 250 50
Thoracic 212 103
Vascular 258 89
TOTALS 9,148 1,522 1,589 914
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St. Vincent’s Healthcare Group
101
Significant Achievements
Congratulations to Dr. Bernard Masuku who passed his Primary Examination in 2005.
Resident Merit Awards
For the first time a Clinical Excellence in Anaesthesia Award ceremony was held on Friday the 2nd December
2005 to recognise the outstanding contributions that some of the residents had made both to theatre and
the ICU since the beginning of 2005. There were six presentations made on the evening and a number of
people from around the hospital were invited to attend. It was very successful evening and was followed on
by a dinner for the department. The event was sponsored by both Abbott Laboratories and Napp Laboratories.
The presentations were made to:
Dr. Daniel Collins - Abbott Gerry Dorrian Memorial Award for best SpR in Anaesthesia
Dr. Alan Gaffney - Dr. Dick Nolan Memorial Award for best BST in Anaesthesia
Dr. Daniel Collins - Dr Seamus O'Donnell Memorial Award for best SpR in ICU
Dr. Louise Brennan - Napp Pain Medicine Medal
Dr. Debbie D'Oyley - Hapatobiliary Excellence Award
Significant Publications
Three former Liver Transplant Fellows, Drs. Ahtsham Niazi, David Honan and Michael Moore, were appointed
to consultant posts in 2005, as was a Registrar attached to the Conway Institute, Dr. Brendan McGarvey. Dr.
David Honan, who was also a Conway fellow (2002-2003), was awarded an MSc by UCD for his thesis
entitled 'Hypercapnia attenuates depressant effects of interleukin-1 beta on ex vivo aortic relaxation by a
mechanism not involving nuclear factor-kappaB'. Dr. John Laffey, a former HRB funded post-doctoral research
fellow (2001-2), was appointed Professor of Anaesthesia at NUI (Galway). The department's
Consultant/Senior Lecturer in Anaesthesia position was filled by Dr. Dara Breslin, currently Associate
Professor of Anesthesiology at Duke University.
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Review 2005
Department of Anaesthesia, Intensive Care & Pain Medicine
Peer Reviewed Publications
1. C.L. McCaul, D. Harney, M. Ryan, C. Moran, B.P. Kavanagh, J.F. Boylan.
Airway management in the lateral position: a randomized controlled trial.
Anesthesia & Analgesia 2005; 101: 1221-5
2. D.F. Ó Cróinín, N.O. Hopkins, M. Moore, J.F. Boylan, P. McLoughlin, J.G. Laffey.
Hypercapnic acidosis does not modulate the severity of bacterial pneumonia-induced lung injury.
Critical Care Medicine 2005; 33: 2606-12
3. D. Harney, J.J. Magner, D. O'Keeffe. Complex regional pain syndrome: the case for spinal cord stimulation.
Injury 2005; 36: 357-62.
4. I. Browne, I. Brady, V. Hannon, K. McKeating.
Anesthesia for pheochromocytoma and sickle cell disease in pregnancy.
International Journal of Obstetric Anesthesia 2005; 14: 66-9.
Publications
McShane AJ. Safer Central Venous Access. Anaesthesia 2005; 60: 618
Burlacu CL, Gaffney AM and McShane AJ. Propofol requirements for effective insertion of laryngeal tube
versus laryngeal mask airway. Anesthesiology 2005; 103: A 797
Abstracts
1. D.V. Collins, C. Twomey, K.J. Crowley, J.F. Boylan. Adoption of an intensive glucose management protocol
and outcome measures in a mixed Irish ICU. Intensive Care Society of Ireland, June 2005
2. J.J. Magner, K.J. Crowley, J.F. Boylan. Fatal hyperfibrinolysis during orthotopic liver transplantation with
solvent-detergent treated plasma instead of FFP: a comparison of two cases and review of the literature.
American Society of Anesthesiologists, October 2005
Risk Management
Dr Richard Assaf has been appointed, for an initial period, as Clinical Risk Facilitator. He is involved in liaising
with the Medical Board and Administration on Medical Risk Management issues and teaching the NCHD
staff.
Vascular Access
Director:
Consultant:
Dr. Alan McShane
Dr. Neil McDonald
The Vascular Access service has seen a continuing growth in activity over the last year. The main users of the
service continue to be the oncology, haematology, renal medicine and cystic fibrosis services. However, all
other services avail of the service from to time.
Use of the ultrasound device, which was purchased in 2004, has increased dramatically. The trainees are
often getting their first exposure to such equipment here and are enthusiastic beneficiaries. The usage and
demands on the device mean that we will have to purchase more such devices in the near future.
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Departmental Review
103
Department of Anaesthesia, Intensive Care & Pain Medicine
Paradoxically, access to the operating room was easier in the last year. This was due to the frequent
difficulties in getting elective surgical patients into the hospital due to bed shortages. It is clear however that
the need for dedicated theatre availability each day still persists.
The College of Anaesthetists again requested that Dr. McShane organise a workshop to teach Vascular
Access. Dr. McDonald was again on faculty. The workshop comprised of didactic lecturers, video clips and
anatomical specimens and hands-on exposure to and teaching of ultrasound use. It was attended both by
doctors in training and consultants.
The increasing interest of trainees in vascular access training suggests to us that we should be offering
modular rotations in vascular access. This will need dedicated theatre facilities, as mentioned above.
South East Dublin Department of Anaesthesia (SEDDA) Report
Co-ordinator:
Dr. Alan McShane
The South East Dublin Department of Anaesthesia (SEDDA) was delighted to welcome the appointment of
two new consultant colleagues who will work between St. Vincent's University Hospital and St. Michael's
Hospital. Drs. Cathal Nolan and Robert Plant were appointed to these posts and each is a highly trained
intensivist. They will split their time between both hospitals. In St. Vincent's University Hospital they will
work as intensivists and in St. Michael's Hospital will work as anaesthetists.
Other new consultant jobs in the region have been somewhat slow in being processed. This is due to a
variety of reasons. There is nonetheless a need for more consultant anaesthetists in St. Vincent's University
Hospital, St. Columcille's Hospital, The National Maternity Hospital and the Royal Victoria Eye & Ear Hospital.
The integration and rationalization of night rosters between the constituent hospitals remains a pressing
issue. There is much work going on in this difficult area at present and hopefully a better roster system can
soon be evolved.
The SEDDA rotation for anaesthesia trainees remains popular. We hold interviews each six months and
appoint successful candidates for up to 3 years. While rotating through the constituent hospitals the trainees
are encouraged to take part in the teaching activities and facilities at St. Vincent's University Hospital.
During the year Dr. Gabriella Iohom who was filling a Consultant Locum position between St. Vincent's
University Hospital and St. Michael's Hospital was appointed as permanent Lecturer in Anaesthesia at Cork
University Hospital and University College Cork. We wish her every success in her new position.
Intensive Care Unit
Medial Director:
Dr. Kieran Crowley
Consultants: Dr. Pat Benson Dr. Cathal Nolan Dr. Robert Plant
Clinical Nurse Manager III:
Ms. Geraldine Carey
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Review 2005
Department of Anaesthesia, Intensive Care & Pain Medicine
Service Workload
Six hundred and thirteen patients were admitted to the ICU in 2005, a further increase on recent years. 51%
of patients stayed 1 day, while 35% stayed 3 days or more, similar to recent years. Average length of stay
shortened to 4 days. Average occupancy for the year was 92% (international recommendations are 70%):
for eight months the monthly average was over 90%. The ICU had to overflow using PACU for 49 patient
nights, placing enormous strain on resources. The ICU continued to provide the critical care component of
the liver transplant programme. The year saw a record of 55 transplants.
Severity of illness increased again (having appeared to have plateaued): average APACHE II score was 24, up
from 19 last year. Similarly organ failure rates and organ support rates increased again: 82% of patients
received mechanical ventilation. Overall ICU survival was 80%, with hospital survival of 78%. There is a
welcome trend of increasing post-ICU discharge hospital survival.
St. Vincent's supplied an ICU nurse and registrar to staff the transfer of critically ill patients by mobile
intensive care ambulance service (MICAS) on a 1:4 roster.
Staffing
Nursing staffing remained at or near to its full complement during, allowing utilization of all beds for almost
all of the year. It is hoped that the nursing complement can be increased to open all beds in the new ICU.
There are two attendants, one shared orderly, one shared technician and a shared ICU secretary. The ICU
is staffed by a registrar or specialist registrar rotating from the department of anaesthesia, available 24 hours
a day.
During 2005 Geraldine Carey was appointed as CNM III, Caroline Donoghue was appointed Acting Clinical
Facilitator and Anne Hughes was appointed CNM1. Dr. Cathal Nolan and Dr. Robert Plant joined the
consultant staff. An aim is to achieve out-of-hours cover by consultant intensivist staff: this is now achieved
for 3 /4 of weekends.
We wish all the new appointees well in their new posts.
Service Developments/Activities
The structure of the new ICU is now completed and orders for all the major components of equipment have
been completed. There will be 16 beds in the new development. Our hope is to move to the new ICU during
the middle of 2006. Guidelines for Weaning Patients off Mechanical Ventilation were introduced. Hygiene
practices were audited in the ICU as part of the Nation Hygiene Audit, achieving a reasonable report. As part
of the commitment to continuing education, the ICU Nursing Staff hosted their first educational conference
in February 2005.
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Departmental Review
105
Department of Anaesthesia, Intensive Care & Pain Medicine
ICU ACTIVITY
2005 2004 2003 2002 2001 2000 1999 1998 1997
Admissions 613 516 450 471 421 469 556 551 537
Average length
of stay (days) 4 6 6 6 5 5 3.4 3.9 4.8
Average occupancy 92% 93% 90% 85% 89% 85% 64% 75% 92%
Elective surgical 38% 36% 27% 30% 32% 35% 36% 43% 43%
Emergency surgical 30% 30% 39% 31% 31% 35% 31% 30% 30%
Medical 32% 34% 34% 39% 37% 30% 33% 27% 28%
Mechanical ventilation 82% 69% 70% 75% 68% 67% 58% 57% 69%
Central venous access 77% 64% 73% 81% 69% 78% 75% 65% 74%
Vasoactive infusions 24% 20% 18% 25% 33% 33% 26% 22% 27%
Acute renal failure 10% 10% 17% 25% 23% 24% 14% 13% 16%
Continuous renal
replacement therapy 10% 10% 16% 21% 16% 14% 10% 8% 12%
Tracheostomy 6% 6% 13% 11% 13% 6% 6% 9% 9%
Unplanned ICU
discharge 21% 21% 25% 1.5% 11.4% 6% 5% 4% 5%
Readmissions 12% 8.3% 2.9% 0.9% 6.3% 9.6%
APACHE II
score (mean) 24 19 20 19 20 18 14 15 16
ICU survival 80% 79% 82% 75% 73% 75% 81% 82% 83%
Hospital survival 78% 75% 78% 70% 68% 70% 71% 75% 73%
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106
Review 2005
Department of Anaesthesia, Intensive Care & Pain Medicine
Pain Medicine
A new walk - in pain service was set up in St. Michael's Hospital, Dun Laoghaire. 168 patients were treated
and 221 procedures were carried out. This was carried out with the support of Mr. N. Jermyn Group CEO and
under the guidance of Ms. Mary Shore. A special post of Coordinator of this programme was created and
was very well managed by Ms. Lisa Naughton. The programme ran for three months from late September to
mid-December 2005. Our thanks to Mr. Mervyn Hollywood for coordinating the nursing to this programme
and due to his unstinting efforts we almost had a full quota of nurses for each day period who provided this
service on Mondays, half day Tuesdays and half day Thursday.
Significant Publications
Presentation by Dr. Declan O'Keeffe to the Pan Pacific meeting in Sydney in August 2005 entitled “Use of
New Technologies in the area of Neuro Modulation”.
Staff
Director:
Dr. Declan O'Keeffe
Consultants:
Dr. Hugh Gallagher, Dr. Ray Victory
Clinical Psychologist:
Dr. Rosemary Walsh
0.5 WTE Physiotherapist: Martine Darcy, Jane Dawson
0.5WTE Occ. Therapist:
Amanda Wallace, Shannon Barr, Caroline Burke
Pain Management Co-ordinator: Laura Hamilton
Secretary to Pain Programme: Sarah Brady
Service Developments /Activities
Outpatient Clinics
Day Consultant Number New Return Total
of Sessions Patients Patients
Tuesday Dr. O'Keeffe 51 201 2,545 2,476
Tuesday Dr. Victory 46 33 130 163
Wednesday Dr. O'Keeffe 51 66 892 958
Wednesday St. Michaels Dr. O'Keeffe 13 0 153 153
Saturday Dr. O'Keeffe 3 0 45 45
WL Validation Clinic
TOTAL 164 300 3,765 3,795
In patients
Admissions 106
Discharges 116
Day Care
St. Mark's Day Centre 116
Extra Mural Theatre 270
Pain Unit 207
Total 593
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Departmental Review
107
Department of Anaesthesia, Intensive Care & Pain Medicine
Pain Management Programmes
Type Programme No. of courses in 2005 Total Number of Patients on Course
3 week 7 69
1 Day 5 46
Education and Training
Dr O'Keeffe continued to be president of the Pain Society and resigned and completed his term in October
2005.
Dr. O'Keeffe attended the Irish Pain Society Meeting in October 2005 which was held in the College of
Anaesthetists and presented a paper entitled 'Recent Advances in Neuromodulation'.
Dr. Hugh Gallagher presented a paper at the Irish Pain Society in October 2005. He also had previously
presented a paper at the Pan Pacific meeting on Neuro Modulation in Sydney in August 2005.
Dr Walsh also presented a paper on Pain Research at the Annual Conference of the Psychological Society of
Ireland in November 2005.
Future Developments
We expect to move into our new theatres in June 2006 and also into our new ICU around the same time.
We have 10 new theatres in this new unit plus we have ultimately 4 theatres left in the old theatre suite. The
year ahead is going to be an exciting year in terms of education with the imminent arrival of our Senior
Lecturer Dr. Dara Breslin and in terms of infrastructure with the development of new theatres and ICU.
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108
Review 2005
Department of Cardiology
The Coronary Care Unit continues to be extremely busy. The patient mix has changed substantially in line
with national trends. Fewer patients are presenting with acute myocardial infarction but these have been
replaced by patients with unstable coronary syndromes. This has placed greater demands on the Cardiac
Catheterisation Laboratory. The problem has been alleviated by the opening of the new laboratory but this is
already working to full capacity. Elective admissions for investigation or treatment have suffered and the
waiting list has lengthened.
The Heart Failure (HF) service continues to grow. Our 1year mortality rate of 16% for survivors of hospital
admission for HF compares favourably with international norms of >30%. Furthermore, the 4-year mortality
rate for this population is 35%, again comparing very favourably with international figures. The chronic
ambulatory care facility of the HF service follows over 1,000 patients. An integral component of this service
is the Primary Care Direct Access facility, which encourages patients and General Practitioners to contact the
clinic directly if they suspect clinical deterioration. Our audit figures indicate that this prevents 247
hospitalisations/year creating €1.37M worth of direct-cost savings to the hospital.
The demands for diagnostic services continues to increase and unfortunately waiting lists particularly for
procedures such as echocardiography have grown to an unacceptable level. Additional echocardiographic
machines have been purchased. They will reduce the waiting times within a few months. Space continues
to be a major problem for the department and staff are working under conditions, which are less than ideal.
With the move to the new Ambulatory Day Centre many departments hope that this situation will be relieved
if not fully alleviated next year. All staff in the department have contributed to maintaining the service in
extremely difficult conditions and despite the overcrowding and problems in the waiting area, patient
satisfaction with the service appears to be high.
The Open Access Clinic continues to operate but is due for re-evaluation by the Health Service Executive. It
is hoped that this will be done during the current year.
The Chest Pain Evaluation Service functioned as a virtual unit during the year, but 2006 will see the
introduction of a full service in the new Emergency Department. The reconfiguration of the Pulmonary
Laboratory as a facility for the emergency angiography and for use in elective pacing and electrophysiological
work will allow the introduction of acute cover on a 24-hour basis by the Cardiology Department and it will
service St. Michael's and St. Columcille's Hospitals as well as St. Vincent's University Hospital.
Stephen McGrath retired after over 30 years service to the department. He played a crucial role in the
development of the pacing (now electrophysiology) service and we thank him greatly for his contribution to
our department.
The Active Resuscitation Department provided education and training to 815 staff members during the year.
112 staff trained as ACLS providers and 425 trained as Basic Life Support providers. The department will be
responsible for implementing new international resuscitation guidelines during 2006.
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Departmental Review
109
Department of Cardiology
The consultant staff in the unit have continued to have major involvement at local and national level in both
research and in the development of cardiological services.
Post graduate and Specialist Registrar training is a major feature of the department's work. All Consultants
participate by teaching, by helping organisation and evaluation at national level and by undertaking
responsibility for the supervision of the training of Specialist Registrars. It has been a particular privilege to
train a number of outstanding individuals from overseas including Dr. Salah Mohammed who spent six years
in this department, Dr. Zuhair Yousif and Dr. Sinna Karrupiah. These individuals contributed enormously to this
hospital during their training. Dr. Mohammed and Dr. Yousif have returned to Sudan to take up senior
positions in government service and in the development of cardiology in that country. Ongoing research in
the department has covered diverse fields such as heart failure, rehabilitation, medical device and
instrumentation development, clinical audit and evaluation.
Publications
Ledwidge M, et al.
Heart Failure care in a hospital unit: a comparison of standard 3-month and extended 6-month programs.
Eur J Heart Fail. 2005;7.
McDonald K. Current
Guidelines in the management of chronic heart failure: practical issues in their application to the community
population.
Eur J Heart Fail. 2005;7.
Ledwidge M, et al. Prevention of heart failure: further insight from BNP. British J Cardiol. 2005;12.
Lewin J, et al.
Clinical Deterioration in Established Heart Failure: What is the value of BNP and Weight Gain in Aiding
Diagnosis?
Eur J Heart Fail. 2005
Article
Collier P, Quinn M. Perils of Polypectomy. Heart 2005 Nov:91(II):1437
Book
Platelet Function Quinn M, Fitzgerald D
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110
Review 2005
Department of Dermatology
The Department of Dermatology at St Vincent's University Hospital together with Hume Street and St
Michael's Hospital provide dermatology services for patients living in Dublin South-East and Wicklow.
Staff
Consultants:
Dr Paul Collins and Dr Sarah Rogers.
Specialist Registrar: Dr Liz Calally (SpR locum) January-June
(St Vincent's/St Michaels) Dr Fergal Moloney (SpR4) July-December
Registrar: (Hume St/St Vincent's) Dr Khasif Ahmed January-December
Clinical Nurse Specialist:
Staff Nurse:
Administrative Assistants:
Ms Sheila Ryan
Ms Nicola Mahon
Mrs Eileen Cusack and Mrs Brenda Harte (both half time)
Clinical Service
Inpatients
Urgent admissions were admitted through the Emergency Department under the care of the physician on
call. Patients with chronic stable skin conditions, including psoriasis and atopic eczema, requiring five day
elective inpatient dermatology nursing, were admitted (8am to 8pm only) to Hume Street Hospital until the
beds closed in August (140 patients).
Three hundred and fifty patients at St. Vincent’s University Hospital and sixty-one patients at St Michael's
Hospital were referred by medical and surgical teams for inpatient dermatology consultation.
Day-care
Extramural Theatre
Day case surgery, predominantly for non-melanoma skin cancer and atypical melanocytic naevi,
was performed for 142 patients at extramural theatre. Many patients had more than one lesion excised.
St Mark's Ward
There were 31 patient episodes for infusions of infliximab or immunoglobulin and phlebotomy as day
case patients.
Dermatology day-care unit
Narrowband UVB phototherapy, PUVA therapy, patient education, cryotherapy, dressings including scalp
therapy were provided by Ms Sheila Ryan and 1,118 episodes were recorded.
Narrowband UVB phototherapy and PUVA therapy were discontinued during the year because we did not
have adequate nursing staff to continue the service and patients were referred to Hume Street Hospital
instead.
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Department of Dermatology
Outpatient clinics
There were 94 Dermatology Clinics at which 2,245 patients (754 new referrals) were treated at SVUH. There
were 50 Dermatology Clinics at which 743 patients (267 new referrals) were treated in St Michael's Hospital.
Outpatient investigation and therapy including cryotherapy, diagnostic punch biopsy, four layer bandaging,
wart dressings/treatments, wound care and light cautery for macrocomedones was provided for patients
during outpatient clinic time.
Patients were referred to Hume Street Hospital for photodynamic therapy, patch testing and
phototherapy/PUVA and there were 10,928 patient treatments. There were 397 new and 3864 return patients
seen at clinics in the Outpatients and in Daycare.
Postgraduate and undergraduate education
Higher Specialist training for Specialist Registrars in dermatology and General Professional training for Senior
House Officers was provided at St Vincent's and Hume Street Hospitals. There was a weekly postgraduate
dermatology session with dermatologists from St James's Hospital and Adelaide/Meath Hospitals
comprising journal club and combined clinical case meeting at Hume Street on Wednesday mornings. The
fortnightly histopathology meeting took place at St Vincent's University Hospital.
Dr Collins taught on the membership course at St Vincent's University Hospital three times during the year.
Dr Collins presented a poster at the General Practitioners Study Day in November 2005.
Fifth year medical students joined the Dermatology team for three week rotations between St Vincent's and
Hume Street Hospitals.
Ms Sheila Ryan taught third year student nurses on atopic eczema, psoriasis and skin cancer.
Conferences/Courses attended
Dr Rogers:
Irish Association of Dermatologists meetings, Cork and Coleraine.
American Academy of Dermatology, New Orleans.
Psoriasis-from gene to clinic, London.
Consultants course London.
Dr Collins:
Irish Association of Dermatologists meetings, Cork and Coleraine.
British Association of Dermatologists annual meeting, Glasgow.
Consultants course London.
Ms Sheila Ryan:
British Dermatology Nursing Group Annual Meeting, Glasgow.
Irish Association of Dermatologists meetings, Cork and Coleraine.
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Department of Dermatology
Publications
The genetic basis of Pachyonychia Congenita
Smith FJD, Cassidy AJ, Stewart A, Liao H, Hamill KJ, Wood P, Joval I, van Steensel MAM, Bjorck EJ, Callif-
Daley F, Pals G, Collins P, Leachmann SA, Munro CS, Mc Lean IWH.
J Invest Dermatol (Symposium Proceedings) 2005;10:21-30.
Chalmers RJ, Kirby B, Smith A, Burrows P, Little R, Horan M, Hextall JM, Smith CH, Klaber M, Rogers S.
Replacement of routine liver biopsy by procollagen III aminopeptide for monitoring patients with psoriasis
receiving long-term methotrexate: a multicentre audit and health economic analysis.
Br J Dermatol 2005; 152: 444-50.
Cutaneous Lupus Erythematosus. Annegret Kuhn, Percy Lehmann Thomas Ruzicka (Editors)
Collins P. Ir Med J 2005;98:127 (book review).
A randomized, double-blind placebo-controlled study of the efficacy of lignocaine 2.5% and prilocaine 2.5%
(EMLA R ) analgesia during topical ALA-PDT.
Langan SM and Collins P. Br J Dermatol in press July 2005.
Generalised pustular psoriasis (Von Zumbusch) following the use of calcipotriol and betamethasone
dipropionate (Dovobet ® ).
Tobin AM, Langan SM, Collins P, Kirby B. Clin Exp Dermatol in press July 2005.
Presentations
A randomized, double-blind placebo-controlled study of the efficacy of lignocaine 2.5% and
prilocaine 2.5% (EMLA R ) analgesia during topical ALA-PDT.
SM Langan and P Collins.
Irish Association of Dermatologists meeting April 2005.
British Association of Dermatologists annual meeting, July 2005.
Fumaric acid esters in the management of psoriasis.
L Brewer and S Rogers.
Irish Association of Dermatologists meeting April 2005.
Photocontact allergy to oxybenzone and contact allergy to lignocaine and prilocaine
SM Langan and P Collins.
British Association of Dermatologists annual meeting, July 2005.
Dr Rogers gave three lectures to the Psoriasis Association of Ireland.
Phototherapy Module.
S Ryan.
British Dermatology Nursing Goup, annual meeting, July 2005.
Nursing the acutely ill dermatology patient.
S Ryan.
Irish Dermatology Nursing group, annual meeting, April 2005.
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Department of Dermatology
The effects of alcohol intake and psychological distress on time to clearance of psoriasis
treated with narrowband UVB.
Barry RBM, Dudley J, Tobin AM, O Brien E, Rogers S, Collins P, Kirby B.
British Association of Dermatologists annual meeting, July 2005 (poster).
Infliximab for recalcitrant psoriasis.
K Ahmad and S Rogers.
Irish Association of Dermatologists meeting April 2005 (poster).
A retrospective study of azathioprine in severe atopic eczema.
L Brewer, P Collins, S Rogers.
Irish Association of Dermatologists meeting April 2005 (poster).
A prospective study of dermatology inpatient referrals in a Dublin teaching hospital over two years.
EL Calally, S Rogers, P Collins.
Irish Association of Dermatologists meeting April 2005 (poster).
A review of etanercept in 44 patients with recalcitrant psoriasis.
K Ahmed and S Rogers.
Psoriasis - from gene to clinic. International conference,London, December 2005(poster).
Staphylococcal scalded skin syndrome
S Ryan.
East Coast Dermatology Nursing Group, April 2005.
Dermatological diagnostic dilemmas in general practice.
Collins P.
St Vincent's University Hospital Annual Study Day, October 2005 (poster discussion).
Dr Rogers presented My experience with biologics for psoriasis to the Department of Dermatology in
Dundee, December 2005.
Appointments
Dr Brian Kirby was appointed Consultant Dermatologist in May 2005 and will start work at St Vincent's
University Hospital in January 2006. Dr Sarah Rogers was appointed as the Ireland representative to the
Board of the European Academy of Dermatology and Venereology.
Ms Sheila Ryan is the Secretary of the Irish Dermatology Nursing Group and the Irish representative on the
Council of the British Dermatology Nursing Group. Ms Nicola Mahon was appointed as staff nurse in
Dermatology in July 2005.
Achievements
Dr. Rogers and Dr. Calally were awarded joint first prize for the best medical grand rounds presentation of the
year entitled “Photo-induced toxic epidermal necrolysis secondary to hydroxychloroquine”.
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Review 2005
Department of Emergency Medicine
Introduction
Throughout 2005 the Emergency Departments in St Vincent's University Hospital and St. Michael's Hospital
were concerned with departmental overcrowding. This persisted even after the introduction of many
initiatives on admission avoidance and the increased placement of long stay patients. It will be a continuing
challenge for 2006. A patient satisfaction survey undertaken as part of our Quality Improvement Plan showed
significant patient satisfaction in spite of this overcrowding. Ninety two percent of patients felt that the
Emergency Department met their needs. The Tribal Secta analysis of patient flow throughout the hospital was
undertaken during 2005. The Emergency Department streaming of patients was noted to work well and is a
cornerstone of all future development plans. It was expected that we would move into our new department
in late 2005 or early 2006 and very extensive planning and gap assessment analysis was undertaken under
the leadership of Margaret Boland and Derek Barton. Margaret and Derek as co-team leaders of the
Emergency Medicine/General Internal Medicine Quality Improvement Team continue to oversee our Quality
Improvement Plan based on our performance indicators
Service Developments
We continue to strive for a seamless pathway of patient care. Areas of potential delay are identified and
minimised. Within a few minutes of registration patients care begins when they are assessed and triaged.
The Rapid Assessment and Treatment team have been reinforced during the year. They work combined with
triage and ensure early intervention for patients requiring time critical investigations. Patients are streamed
to the area most appropriate for their care, Minor area, Major area and Resuscitation with further options to
the Chest Pain Evaluation Unit and Clinical Decision Unit. The Chest Pain Evaluation Unit is protocol driven,
supported by a nurse practitioner and has ready access to exercise stress testing and support by the
cardiology team. Close liaison with cardiology has also improved thrombolysis and direct access to the
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Department of Emergency medicine
cardiac catheterisation laboratory. The Clinical Decision unit was introduced during the year to assess patients
on a rule-in, rule-out basis. A dedicated Registrar was appointed to oversee patient care based on the agreed
protocols. A total of 986 patients were assessed in the department during 2005 with a significant saving of
in-patient beds.
The ready access to diagnostic imaging and laboratory investigations combined with point of care testing and
focused abdominal ultrasound for trauma has streamlined patient assessment. The development of care
pathways for respiratory disease, deep vein thrombosis, cellulitis and transient ischaemic attacks has reduced
patient admissions
The departmental I.T. system was enhanced and there were further improvements in networking with the
Patient Administration System, the laboratory and diagnostic imaging systems. An agreed supplier was
identified for the document imaging system.
Publications and Presentations
Acute Liver Failure. J Ryan, Textbook of Emergency Medicine. (2nd edition) 2005,
Authors: AM Kelly, P Cameron, G Jelinek, Churchill Livingstone
Feeney L, Ryan J, Moran P.
Parasuicide assessment in the emergency department. Irish Med J 2005 98(4):111-3
R McNamara, J Ryan. Planning long-term care for the elderly - Does Emergency Medicine have a role.
Presented at the annual Irish Gerontological Society annual scientific meeting Dublin 2005
Menzies D, Ryan J. Demographic changes in emergency admissions through a university hospital
emergency admission over 20 years. Presented at the 3rd Mediterranean Emergency Medicine Congress
Sept 2005
Kieran I, Ryan J, Woods G. Difficulties and solutions encountered in the introduction of emergency
department hands-free defibrillation. Presented at the 3rd Mediterranean Emergency Medicine Congress
Sept 2005
Coughlan E, McNamara R, Ryan J. Lessons to be learnt from an audit of mortality in the Emergency
Department. Presented at the 3rd Mediterranean Emergency Medicine Congress Sept 2005
Statistics
There were 33,460 new attendances and 3,117 return attendances during 2005, a re-attendance rate of 9.3%.
There were 8,629 Emergency Department admissions giving an admission rate of 25.8%.
Future Plans
The new department will allow us to enhance our current initiatives and develop new areas such as care of
the elderly, psychiatric liaison, nurse prescribing and nurse x-ray requesting, telemedicine, sports injury clinic,
back pain clinic, and an Emergency Department based pharmacist. The role of St. Michael's Emergency
Department will be further defined and developed. Disaster planning needs to be enhanced on a regional and
national level.
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Department of Endocrinology and Diabetes Mellitus
Staff
Consultants:
Lecturers:
Specialist Registrars:
Registrars:
Research Registrar:
Secretary:
Professor T.J. McKenna, Dr Malachi McKenna, Dr Donal O'Shea
Department of Medicine, U.C.D./Locum Consultants,
Dr Diarmuid Smith and Dr Marie-Louise Healy
Dr Chong Yew Tan, Dr Shazli Yusof
Dr Montasir Hammam, Dr Tomás Ahern
Dr Tom Cawood
Ms Geri Daly
Diabetes Centre
Nurses:
Dietician:
Primary Care Liaison Team:
Secretarial Staff:
Ms Deirdre Gleeson, Ms Moira Haran, Ms Nora Collis, Ms Phil Shankey,
Ms Joanne O'Neill, Ms Jean O'Brien.
Ms Maeve Moran.
Ms Deirdre Hall, Diabetes Nurse Specialist and Ms Yvonne Ryan, Dietician.
Ms Fiona Whelan, Ms Patricia Sinnott, Ms Marie McCarrick,Ms Joyce Doyle,
Ms Catherine Brady.
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Department of Endocrinology and Diabetes Mellitus
Endocrine Laboratory
Principal Biochemist:
Senior Medical Scientist:
Acting Senior Medical Scientist:
Medical Scientist:
Locum Biochemist:
Laboratory Aide:
Clerical Officer:
Research-Graduate Students:
Dr. Tom Smith
Ms. Anne Dickinson
Ms. Martina Cassidy
Mr. James Connolly
Dr. Monika Biniecka
Mr. Paddy Doran
Mr. John Savage
Ms. Sinead Kelly and Ms. Lucille Kavanagh.
Weekly Departmental Academic Events
Diabetes Team Meeting:
Laboratory/Research Meeting:
Endocrine Conference:
Departmental Journal Club:
Monday lunchtime
Monday - 2.00 p.m.
Tuesday Noon (Quarterly Multi-disciplinary Thyroid Cancer
Group Meeting)
Friday - 11.00 a.m.
Out-patient Clinics
3 Diabetes Clinics per week
1 Joint Endocrinology Clinic (Prof. McKenna and Dr. O'Shea)
Weekly multidisciplinary group education sessions for newly diagnosed patients with Type 2 diabetes.
Monthly group education session on cholesterol management and diet.
Quarterly group education sessions for patients with newly diagnosed impaired glucose tolerance.
Service Developments/Activities
The Endocrine Service in St Vincent's University Hospital provides a comprehensive clinical and laboratory
service for patients referred for investigation for a wide range of endocrine disorders. The service is closely
integrated with the Endocrine Services in St Michael's Hospital, Dun Laoghaire (Dr Malachi McKenna) and St
Columcille's Hospital, Loughlinstown (Dr Donal O'Shea). The diabetes service is an integral part of the
general endocrine service but has a distinct cohort of diabetes nurse specialists, diabetes dieticians and
secretarial staff. The Endocrine Laboratory service provides measurement of a wide range of steroid
hormones, glycoproteins, haemoglobin A1c, insulin, insulin like growth factor 1 and hormone binding proteins
e.g. sex hormone binding globulin. The endocrine team provides regional/national services for reproductive
endocrinology, adrenal cortical disorders, metabolic bone disease and obesity through its close connections
with the obesity programme based in St Columcille's Hospital. The department has also recently developed
particular strengths in the management of thyroid eye disease in collaboration with Mr Paul Moriarty. The
investigation of hypoglycaemia in association with the Radiology Department has been developed to provide
a regional service.
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Department of Endocrinology and Diabetes Mellitus
Diabetes Service
This year we successfully initiated a recognised structured intensive education programme for people with
type 1 diabetes. The “Dose Adjustment for Normal Eating” (DAFNE) course has been steered by Ms Joanne
O'Neill, Diabetes Nurse Specialist and Ms Maeve Moran, Senior Dietician, who completed the DAFNE
training course in June 2005. This was followed by a two day educator provider course in Nottingham on the
6 th -7 th September 2005. The first DAFNE course for 8 people with type 1 diabetes was successfully run over
the week of 7 th -11 th November 2005. DAFNE is a structured education programme for patients with type 1
diabetes mellitus. This is based on a 35 hour intensive education programme on skills to facilitate self
adjustment of insulin according to diet and lifestyle. The focus is jointly on skills training and quality of life
issues and aims to reduce haemoglobin A1c. This enables patients to become more independent of health
care professionals by promoting self management of diabetes. Despite its demands on patients' time, it is
very popular. Providing this course is a Diabetes Centre commitment that is time and resource intensive.
In May 2005, the opening hours of the Diabetes Centre were extended from 7.45am to 6.00pm to cater for
patients wishing to attend the Centre before or after work and to facilitate the running of the busy afternoon
out-patient clinics.
The Centre also combined with St Columcille's Hospital and the HSE Shared Care Co-ordinators to launch a
structured education programme for people with impaired glucose tolerance.
Endocrine Laboratory
The Endocrine Laboratory workload increased by 12% during 2005. Particularly large increases for some of
the more manual and labour intensive tests e.g. Aldosterone (23%) and PRA (19%) were noted.
The laboratory was inspected by a team from Clinical Pathology Accreditation (UK) Ltd. in June. While still
awaiting the official report, feedback was very positive. The relatively minor deficits in infrastructure and
working conditions highlighted, will be rectified by the move to the new laboratory.
Tendering and planning for the move to the new laboratory continued throughout the year. Major pieces of
equipment have now been selected and evaluations are currently in progress.
During 2005 the Endocrine Laboratory initiated a study to examine the reliability of routine HbA1c
measurements in patients who possess variant haemoglobins. This project was undertaken in conjunction
with the Irish External Quantity Assessment Scheme and involved circulating blood from individuals with
haemoglobinopathies to laboratories using different methodology throughout the country. The aim is to
highlight the potential for misreporting of HbA1c levels by certain instruments in such patients.
Research Projects
The regulation of Adrenal Steroidogenesis: (Sinead Kelly)
The extent of gene regulation is influenced not only by the transcription factors involved but also the
presence of specific coregulatory proteins, which modulate transcription. We investigated the expression and
differential interaction of coactivator SRC-1 and corepressor SMRT with transcription factors SF - 1 and nur77
in the human adrenal cell line under the influence of forskolin and AII. These data provide evidence that
secretagogues can utilise co-regulatory proteins to discretely regulate expression of key steroidogenic
enzymes in the human adrenal cortex.
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Department of Endocrinology and Diabetes Mellitus
Taken together these findings confirm a central role for transcription factors; nur77 and SF-1 and coregulators;
SRC-1 and SMRT in integrating and modulating enzyme expression pertinent to cortisol and adrenal androgen
production. These mechanisms may be critical in the differential secretion of cortisol and adrenal androgens.
Macroprolactinaemia: (Lucille Kavanagh)
Separation Techniques
Macroprolactin is an inactive form of prolactin in vivo. However it is detected, to various degrees, by assays
commonly used in routine endocrine laboratories. The presence of macroprolactin in a serum sample can
therefore, contribute to a falsely elevated prolactin result. We have completed a comprehensive evaluation
of methods available to screen for macroprolactin. Some methods deplete the serum sample of
macroprolactin prior to analysis. When analysed, the pre-treated serum sample then provides an index of the
clinically relevant i.e. the bioactive prolactin in the sample. We looked at 6 different methods of pre-treating
macroprolactinaemic serum samples, to determine the most precise, accurate and reliable method for use
in the routine laboratory. Assessed against the gold standard but expensive and tedious method of gel
filtration chromatography, we found that pre-treatment with 25% polyethylene glycol (PEG) was the most
practical and cost effective separation method. Where PEG cannot be used, Protein G-sepharose was the
next best performing reagent. Less efficient methods utilited Protein A-sepharose, anti human IgG and
ultrafiltration.
Macroprolactin: (Dr M-L Healy, Dr T Smith)
It has been demonstrated that 10-20% of laboratory findings of elevated prolactin do not indicate a true
excess of biologically available prolactin, but are essentially artefactual due to the presence of macroprolactin.
This is a high molecular mass complexed form of prolactin, together with an anti-prolactin IgG antibody and
is screened for routinely in the Department since 1998. From that time on, reports indicated that although
patients had hyperprolactinaemia, this could be entirely accounted for by the presence of non bio-active or
bio-available prolactin in the form of macroprolactin. If screening for macroprolactin indicated that when
elevated levels of prolactin were corrected for the presence of macroprolactin the result fell within the
appropriate reference range, the report received by the clinician indicated a normal result. The present study
was undertaken to gain information on the final diagnosis for patients whose symptoms had prompted the
measurement of prolactin and who were identified as having hyperprolactinaemia but when this was
corrected for the presence of macroprolactin, a normal value was obtained. The present study is based upon
delivering a questionnaire to these patients (with the permission of their consultant/general practitioner) to
obtain information on whether or not an alternative diagnosis for their symptoms had been obtain and, if so,
what that diagnosis was? How many patients had been treated for hyperprolactinaemia notwithstanding the
diagnosis of macroprolactinaemia? What had been their response to this treatment?
Thyroid Eye Disease
Dr T.Cawood is continuing his research exploring underlying mechanism and identifying potential therapeutic
targets for thyroid associated ophthalmology.
Diabetes
Clinical trials ongoing in the Department include a study to assess the impact of a long acting insulin in
combination with fish oils, or fish oils alone or neither treatment in patients with mild diabetes and evidence
of vascular risk. Another study compares the efficacy of three therapeutic strategies for treating Type II
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Department of Endocrinology and Diabetes Mellitus
diabetes patients who are poorly controlled with basal insulin combined with oral agents. Bolus insulin is
introduced in a step-wise manner to intensify treatment and maximise control. The Department is also
participating a trial to examine the effects of the angiotensin receptor blocker, Candesartan, on diabetic
retinopathy.
Significant Achievements
Professor T J McKenna is President of the Royal College of Physicians of Ireland. Professor McKenna is a
member of The National Taskforce on Medical Manpower and a member of its Medical Education and Training
Group, whose report will be published by Government in 2006. Professor McKenna is on the Editorial Boards
for the journals, Clinical Endocrinology (Oxford) and The Endocrinologist (U.S.). He is also a member of the
Students Affairs Committee of the Endocrine Society (U.S.). In May 2006 he was admitted as Honorary
Fellow of the Royal Australasian College of Physicians (RACP) in Wellington. Professor McKenna delivered the
annual Greenaway Lecture of RACP. In June, he was admitted as a Fellow of the Academy of Medicine in
Singapore. In October, he was admitted to Honorary Fellowship of The College of Physicians of South Africa
in Capetown. He was Chairman of the Annual Corrigan Club Meeting this year held in Trinity College, Dublin
in September.
Dr Donal O'Shea is Secretary of The Irish Endocrine Society. He is also a member of the National Taskforce
on Obesity and Chairman of the Detection and Treatment Subgroup. Dr O'Shea is Chairman of the Nutrition
Council of the Irish Heart Foundation and Chairman of the St Vincent's Healthcare Group Drugs and
Therapeutics Committee. Dr O'Shea received an undergraduate-nominated Premier Award for Teaching
Excellence from the Faculty of Medicine, UCD. Dr O'Shea was elected a Fellow of the Royal College of
Physicians (Lond.) and was also elected to the Council of the Royal College of Physicians of Ireland.
Dr Tom Smith is Chairman of the Association of Clinical Biochemists, Republic of Ireland Region and a
Committee Member of the Irish Endocrine Society.
Dr Diarmuid Smith was appointed Consultant Endocrinologist, Beaumont Hospital.
Martina Cassidy was appointed acting Senior Medical Scientist in place of Anne Dickinson who is currently
on maternity leave.
Sinead Kelly was conferred with a PhD degree in June 2005 for her Thesis entitled “Transcriptional regulation
of key steroidogenic enzymes in the human adrenal gland.”
Tom Cawood was awarded a Clinical Research Training Fellowship from the Health Research Board.
Jean O'Brien successfully completed a Higher Diploma in Diabetes Nursing at University College Dublin.
Conferences/Courses/Meetings Attended
4th February 2005, Killarney; 5th Annual Cystic Fibrosis Clinical Meeting
25th February 2005, Gresham Hotel, Dublin, Irish Endocrine Society Annual Study Day
11th March 2005, Croke Park, Dublin, International Diabetes Study Day - “Diabesity - Fighting the Fats”
11th April 2005, Four Seasons Hotel, Dublin, New Therapeutic Approaches for Obesity
12th April 2005, Dublin, The Royal Victoria Eye & Ear Hospital: Nurses Study Day,
Invited Speaker: Deirdre Gleeson, Diabetes Nurse Specialist.
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Department of Endocrinology and Diabetes Mellitus
8th-10th May 2005, Wellington, New Zealand. Annual Meeting of the Royal Australasia College of
Physicians:. Professor McKenna invited speaker. The Greenaway Lecture “The evolving impact of
reduced working hours on doctors training and patient care; An Irish Perspective.”
4th-7th June 2005, San Diego, USA, Endocrine Society Meeting. Professor McKenna invited speaker:
“Meet-the-Professor” session on “Hyperprolactinaemia and Macroprolactin”.
2nd - 16th June 2005, Proteomics: Methods & Applications: Co-ordinated by Dublin Molecular Medicine
Centre (DMMC) in Royal College of Surgeons of Ireland, Dublin.
23rd June 2005, SVUH, Dublin, Training Programme in the Management of Peripheral Arterial Disease
30th June-1st July 2005, Singapore, 39th Singapore-Malaysia Congress of Medicine
24th - 28th July 2005, Orlando, Florida, USA, 19th International Congress of Clinical Chemistry:
Macroprolactin: Clinical Significance, Detection and Quantitation of Monomeric Prolactin. Workshop, Tom
Smith invited speaker.
July 2005, Bundoran, Co Donegal, Diabetes Federation of Ireland Kids Camp:
Joanne O'Neill, Diabetes Nurse Specialist, volunteer medical attendant.
10th-15th September 2005, Athens, European Association for the Society of Diabetes Meeting
29th-30th September 2005, Trinity College, Dublin Corrigan Club Annual Meeting, Chairman: Professor T
J McKenna.
30th September - 1st October 2005, Dublin, Irish Diabetes Nurse Specialist Association Clinical
Meeting and AGM: Deirdre Gleeson, Diabetes Nurse Specialist, invited to chair meeting on the 30th
September 2005.
5th October 2005, Dublin, Irish External Quality Assessment Scheme
14th October 2005, Limerick, Association of Clinical Biochemists in Ireland
20th-23rd October 2005, Capetown, South Africa, Annual Meeting of the Colleges of Medicine of South
Africa
17th November 2005, Tara Towers Hotel, Dublin, Diabetes Federation of Ireland. Currrent nutritional
issues in diabetes management.
5th, 6th, 7th September and 30th November 2005, Queens Medical Centre, Nottingham, UK, DAFNE
Educator Programme.
7th December 2005, St Luke's Hospital Dublin, Nurses Study Day
Invited Speaker: Deirdre Gleeson, Diabetes Nurse Specialist.
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Department of Endocrinology and Diabetes Mellitus
Significant Publications
Gibney J, Smith TP, McKenna TJ. The impact on clinical practice of routine screening for macroprolactin.
J. Clin. Endocrinol. Metab. 90: 3927-3932; 2005.
Gibney J, Smith TP, McKenna TJ. Clinical Review: Clinical relevance of macroprolactin.
Clin. Endocrinol. 62: 633-643; 2005.
Kelly S, McKenna TJ, Young LS.
Co-regulatory protein - orphan nuclear receptor interactions in the human adrenal cortex.
J. Endocrinol. 186: 33-42; 2005.
Smith D, Murray BF, McDermott E, O'Shea D, McKenna M, McKenna TJ.
Hungry bones without hypocalcaemia following parathyroidectomy.
J. Bone and Mineral Metabolism. 23: 514-515; 2005.
Cawood TJ, Moriarty P, O'Shea D.
Thyroid eye disease; recent advances in management.
Invited review for BMJlearning.com. May 2005.
Abstracts
The 24th Joint Meeting of the British Endocrine Societies:
Harrogate, England: 4th - 6th April 2005.
Kavanagh L, Smith TP, McKenna TJ. The value of ultrafiltration in the detection of macroprolactin.
Endocrine Abstracts (2005) 9; p52.
Kavanagh L, Smith TP, McKenna TJ. Bioactivity of macroprolactin in vitro.
Endocrine Abstracts (2005) 9; p45.
Cawood TJ, Moriarty P, Golden-Mason L, O'Farrelly C, O'Shea D.
Anti-TNFalpha Therapy Inhibits TNFalpha-Dependent ICAM1 Up-regulation in Orbital Fibroblasts from Patients
with Thyroid Associated Ophthalmopathy.
Endocrine Abstracts April 2005; OC38.
American Association of Clinical Chemistry 2005 Annual Meeting:
Orlando, Florida: 24th - 28th July 2005.
Smith TP, Kavanagh L, Fahie-Wilson M, McKenna TJ.
Specificity and clinical utility of methods for the detection of big-big prolactin (Macroprolactin).
Clinical Chemistry (2005), 51(6); pA229.
Kavanagh L, Smith TP, Gibney J, McKenna TJ.
Autoimmune status of patients with macroprolactinemia.
Clinical Chemistry (2005), 51(6); pA229.
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Liver Transplant Programme and Liver Unit
Significant Achievements
Fifty-six liver transplants were performed in the unit during 2005, which is the highest number to date.
Actuarial one year survival was 94% for patients transplanted in 2005.
Out-patient assessment for liver transplant was introduced and approximately 65% of patients are now
assessed in this way.
The Mayo Clinic protocol was introduced to allow liver transplantation in patients with cholangiocarcinoma.
The liver biopsy waiting list was reduced from 46 to 4 in 2005.
Service Developments/ Activities
St. Brigid's Ward Beds
The extensive infrastructural changes for St. Brigid's Ward were completed. The ward now has 15 ward beds
and 4 HDU beds, up from 11 beds in 2004. Currently 17 beds are open and it is hoped to have all 19
operational in coming months.
To improve bed utilization a pilot project of out-patient assessment was introduced by the Liver Transplant
Coordinators in April 2005. As a result, 65% of patient assessments are now managed as out patients by
the Co-ordinators.
Accreditation
The Liver Transplant Quality Improvement Team made significant progress on the prioritised Quality
Improvement Plans (x 10), which included inpatient satisfaction surveys, updated Standard Operating
Procedure (SOPs) for the new Ambulatory Day Care Unit and a new integrated care pathway (ICP) for
microbiology surveillance. A successful bid for part funding for the purchase of a Fibroscan was obtained
from the Health Service Executive. Two members of the team completed training on process mapping.
Half-Way-House
The Half-Way House for patients and relatives was officially opened. The hospital's Chaplaincy Department
carried out a blessing of the house and many recipients and staff who were involved in fundraising attended
the opening. A long-term dream was finally realised, which in no small part, was due to the generosity of
the Religious Sisters of Charity in donating Herbert House to the hospital, and those hardworking recipients
who undertook fundraising for the project.
Education
• St Vincent's University Hospital Liver Update was held on April the 22nd with local and international
speakers and a large number of people attended.
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Liver Transplant Programme and Liver Unit
• The third Hepatology Nursing Study Day, organised and facilitated by the nursing staff of the Liver Unit
was held on 21st March with 90 nurses attending from Ireland and the UK.
• Antoinette Flynn (CNM1) and Dolores Dempsey-Ryan (CNM1) successfully completed the course in
Principles of Hepatology and Transplant Nursing for Adults at the University of Birmingham
Staff
We extend congratulations and a warm welcome to Anne Brennan in her new role as CNM2, to Rolando
Espina Acting CNM1 and to Aileen Murphy as Hepatitis C nurse and 13 new Critical Care Nurses from
overseas, who have enabled us to open our HDU beds.
Significant Publications
Staunton M, Dodd JD, McCormick PA, Malone DE.
Finding evidence-based answers to practical questions in radiology: which patients with inoperable
hepatocellular carcinoma will survive longer after transarterial chemoembolization? Radiology. 2005
Nov;237(2):404-13.
Kelleher T, Staunton M, O'Mahony S,
McCormick PA. Advanced hepatocellular carcinoma associated with cystic fibrosis.. Eur J Gastroenterol
Hepatol. 2005 Oct;17(10):1123-4.
Curry MP, Hegarty JE. The gallbladder and biliary tract in cystic fibrosis.
Curr Gastroenterol Rep. 2005 May;7(2):147-53.
O'Riain,C, Corless CL, Heinrick MC, Keegan D, Vioreanum M. Maguire D, Sheahan K.
Gastrointestinal stromal tumors: insights from a new familial GIST kindred with unusual genetic and
pathologic features.
Am J Surg Pathol. 2005 Dec;29(12):1680-3.
Sutcliffe R, Maguire D, Murphy P, Portmann B, Rela M, O'Sullivan G.
Detection and clinical significance of bone marrow micrometastases in patients undergoing liver
transplantation for hepatocellular carcinoma.
Transplantation. 2005 Jul 15;80(1):88-94.
Future Developments
Increasing demand
Referrals to the Liver Unit continue to increase, reflecting the increasing prevalence of alcoholic liver disease,
viral hepatitis and fatty liver disease in the population and mirrors trends in the UK (Lancet 2006; 367:52-6).
There is a parallel increasing incidence of hepatocellular carcinoma. Treatments such as TACE (transarterial
chemoembolization) and radio-frequency ablation (RFA) improve survival but have significant staffing and
resource implications for both the Liver Unit and the Department of Radiology.
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Department of Medical Oncology
Medical Oncology Unit
2005 was a highly successful year for patient care, educational and research activities of the Medical
Oncology Department of St. Vincent's University Hospital, and of its affiliates and collaborating investigators
in University College Dublin, Dublin City University, and the University of California Los Angeles.
Clinical developments in the department paralleled worldwide trends in medical oncology. The face of our
speciality is changing dramatically with an increasing focus on novel, translationally driven, molecularly
specific anti-cancer agents given either alone or together with more traditional forms of chemotherapy and
hormonal therapy.
Many of the new treatments are administered in the ambulatory setting, and are associated with decreased
side-effect profiles compared to older forms of therapy. As a result, the gradual evolution of oncology to a
largely ambulatory rather than inpatient speciality is proceeding dramatically.
With the support of the Anne Burn's Bursary, we have an on-going programme of collaboration with the
University of California and Los Angeles. Drs. Norma O'Donovan, Neil O'Brien and Ms. Brigid Browne, have
all taken part in this fellowship, and now continue to work together with investigators from our unit in
developing Multi-Institutional Translational Research Programme for the treatment of breast cancer. We are
very grateful for the opportunity to work with highly regarded collaborators such as Professor Martin Clynes,
Professor Joe Duffy and Professor Dennis Slamon in this undertaking.
The major clinical research achievement during 2005 was the description of activity of Herceptin in early
stage patients with breast cancer. Data from four large randomised trials, one of which was co-chaired by
our unit, was presented in 2005. All of these have shown dramatic reductions in the recurrence rate of
patients with high risk breast cancer who receive this drug. In addition, collaborative translational work in our
study has also identified some specific molecular markers which may predict which are the most appropriate
chemotherapy treatments to give these patients.
During 2005 Professor Crown lectured in Belgium, Switzerland, USA, Canada, Hong Kong, Greece, Turkey,
Spain, France, Lithuania and Moscow. He served on the Education Committee of the American Society of
Clinical Oncology.
We would also like to congratulate our alumni who have had great success at home and abroad. Dr. Michael
Martin, one of our former Registrars was appointed to a Consultant position in Sligo and Dr. Oscar Breathnach
was appointed to a post in Beaumont. Dr. Wei Seong Ooi has commenced fellowship training in oncology in
Toronto. Dr. Corona Gainford has commenced a senior oncology fellowship in Sydney. Our link with
University College Dublin has been strengthened with the appointment of Professor Crown to the Newman
Clinical Research Professorship. Our work was also recognised with the Anglo-Celtic paper winning the
Journal of Medical Science (JMS) Oncology and overall awards in the Doctor Awards, 2005.
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Review 2005
Medical Oncology Unit
Publications
D. Slamon, W. Eiermann, N. Robert, T. Pienkowski, M. Martin, M. Pawlicki, M. Chan, M. Buyse, V. Bee, J.
Crown.
BCIRG 006: Superior cardiac safety of adjuvant docetaxel (T), carboplatin (C) and trastuzumab (H) compared
to doxorubicin (A) and cyclophosphamide (Cyc) followed by TH in patients with early stage breast cancer
and altered HER2 gene. Proc ECCO 2005 Oct Abs 265 pg 74.
Evans TR, Yellowlees A, Foster E, Earl H, Cameron DA, Hutcheon AW, Coleman RE, Perren T, Gallagher CJ,
Quigley M, Crown J, Jones AL, Highley M, Leonard RC, Mansi JL.
Phase III randomized trial of doxorubicin and docetaxel versus doxorubicin and cyclophosphamide as
primary medical therapy in women with breast cancer: an anglo-celtic cooperative oncology group study.
J Clin Oncol. 2005 May 1;23(13):2988-95.
Mijovic A, Russell N, Clark RE, Morris TC, Browne P, Crown J, Potter M, Mufti GJ.
Ancestim associated with Filgrastim and/or chemotherapy can improve blood progenitor yields in patients
who previously failed mobilisation.
Bone Marrow Transplant. 2005 May;35(10):1019;
Ryan B, O'Donovan N, Browne B, O'Shea C, Crown J, Hill AD, McDermott E, O'Higgins N, Duffy MJ.
Expression of survivin and its splice variants survivin-2B and survivin-DeltaEx3 in breast cancer.
Br J Cancer. 2005 Jan 17;92(1):120-4.
Ryan R, Gibbons D, Hyland JM, Treanor D, White A, Mulcahy HE, O'Donoghue DP, Moriarty M, Fennelly D,
Sheahan K.
Pathological response following long-course neoadjuvant chemoradiotherapy for locally advanced rectal
cancer. Histopathology. 2005 Aug;47(2):141-6.
Lios Aoibhinn Cancer Support Centre
Director of Services:
Admin. Assistant:
Psycho-oncologist:
Sessional Therapists
Anne Hayes
Mary Hennigan
Ursula Bates
Mary Scarff
Relaxation and Stress Management Course Facilitator, Complementary Touch Therapist:
Cecilia Keenan
Anne Marie McGrath
Yoga Teacher:
Art Therapist:
Connie Walsh
Wendy Marlatt
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Volunteers: Aine Coleman Alice Davy Mary Pat Killeen
Freda McSweeney Mary Killeen Anne Rooney
Patricia Kennedy
Eleanor Quinlan
Service Activities / Developments
Predictably challenging, satisfying and swift is how 2005 could best be described. Much was achieved,
targets were met and there is now a firm foundation on which to continue the development of the Cancer
Support Centre.
Lios Aoibhinn opened mid 2004 to provide an information and support resource for people who are affected
by cancer. As well as a Drop-in Centre there are 6-10 week group programmes in for example, Stress
Management and Art Therapy. Other groups which run each week include Yoga and Relaxation. Short courses
of Counselling and Massage Therapy are also provided. A key feature of the centre is that it is integrated with
the oncology service.
In 2005 a total of 395 clients used the service on 2,893 occasions. This represents a steady increase in the
number of clients attending and overall levels of activity.
The centre acts as a base for the Psycho-oncologist. As well as providing a service to patients in the hospital
and in the East Coast area through satellite centres, Ms. Ursula Bates provided a psychological service on a
referral basis to clients attending the centre, who were experiencing significant distress.
An audit of client users has indicated high levels of satisfaction with the service. In November Dr. Leslie
Walker, (Chair of Cancer Rehabilitation and Director of the Oncology Centres, University of Hull, U.K.) carried
out an External Review of the Cancer Support Centre and psycho-oncology service.
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Review 2005
Outpatient Department
The following consultants commenced clinics in the Outpatient Department:
• Mr. Denis Evoy - Consultant General Surgeon
• Dr. Elizabeth Chacko - Locum Consultant Ophthalmic Surgeon
• Dr. Caitriona Lawlor - Locum Consultant Plastic Surgeon
Staff
• Julija Meirane took up a Temporary Grade V position to assist with the up-coming move to the new
Ambulatory Day Care Centre.
• Alison O'Donnell joined the reception team.
Service Developments / Activities
• The Outpatient Committee met regularly during the year. The main focus of meetings was to plan for the
move of clinics into the new Ambulatory Day Care Centre. It is expected that the first clinics will transfer
over in early 2006.
• In preparation for the Accreditation mid-cycle review, teams began to meet and review progress made
with regard to Quality Improvement Plans.
• Mr. S. Dudeney's clinic was restructured to allow for orthopaedic referrals to be seen on a separate day
from fracture patients.
• As a result of reorganisation of Neurology Services, a special clinic was set up to review Multiple
Sclerosis patients.
• A new Cystic Fibrosis (CF) Clinic commenced on a fortnightly basis to allow for the annual assessment of
a defined group of CF patients.
• Psychiatric clinics, which are held in Baggot Street, have been set up on the Patient Administration System
(PAS). Recorded attendances at these clinics are being introduced on a phased basis.
Departmental Statistics
In the year 2005 a total of 3,910 sessions were held. Total attendances were 94,420 of which 20,835 were
new referrals. Overall, attendances showed an increase of 3.9% from last year. DNA's (did not attend) for
the year were 19,035 and walk-ins (arriving with no booked appointment) were recorded as 2,236.
Future Developments
• Planning the move of clinics into the new Ambulatory Day Care Centre (ADCC) is on-going. The clinics will
begin to move in the month of March 2006 starting with the Neurology Services.
• Operational policies are being reviewed and revised in conjunction with the move to the ADCC.
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Medical and Surgical Gastroenterology incorporating
Centre for Colorectal Disease
Consultant Medical and Surgical Staff
Medical Gastroenterology:
Colorectal Surgery:
GI Pathology:
GI Diagnostic Imaging:
Medical Oncology:
Radiation Oncology:
Professor DP O'Donoghue, Dr HE Mulcahy
Mr J Hyland, Mr D Winter
Dr K Sheahan, Dr D Gibbons
Dr C Collins, Dr R Gibney, Dr D Malone
Dr D Fennelly
Dr M Moriarty, Professor J Armstrong
Non-Consultant Medical and Surgical Staff
Specialist Registrars:
Dr J Canavan, Dr G Doherty, Ms E. Carton.
Clinical Nurse Managers
St. Teresa's Ward:
St. Patrick's Ward:
Endoscopy Unit:
Ms A Smyth, Ms G O'Neill
Ms A Kiely, Ms S Steen
Mr R Marshall, Ms G Hickey
Research Staff
Senior Research Scientist:
Dr J O'Sullivan
Senior Biochemist and Honorary Lecturer: Dr D Leahy
Research Assistant:
Ms M Tosetto
Research Fellows:
Dr A Coss, Dr J Sheridan
Research Nurses:
Ms D Keegan, Ms B Nolan
PhD students:
Mr E Fox, Ms S Gorman
MSc. Students:
Mr S Sullivan, Ms J Gorman
Dietitians
Medical Gastroenterology:
Surgical Gastroenterology:
Ms M Doyle
Ms L Palado
Specialist Support Staff
Senior Medical Scientist:
Cancer Nurse Co-ordinator:
Colorectal Nurse Specialists:
Research Nurse Specialists:
Secretary:
Mr R Geraghty
Ms A White
Ms G McEvoy, Ms N Smyth
D Keegan, B Nolan
Ms M Dargan
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Review 2005
Medical and Surgical Gastroenterology incorporating Centre for Colorectal Disease
Clinical
Medical and Surgical Gastroenterology continues to play a major role in the activities of St Vincent's
Healthcare Group. Close to one third of all hospital admissions fit into the category of acute or chronic
gastroenterological disease and it is appropriate that the medical and surgical departments work so closely
together to provide a patient oriented service. For some years now, Medical and Surgical Gastroenterology
have run a combined Colorectal Clinic which is probably unique in Ireland. This clinic, (plus weekly Radiology
and Pathology conferences run, with our colleagues in Diagnostic Imaging and Pathology), allows for best
practice in patient care and provides an excellent source of teaching for NCHD's. Further combined meetings
include a monthly Audit of Colorectal Cancer and monthly research symposia in Inflammatory Bowel disease
and Cancer. We wish to acknowledge the close clinical and scientific support we receive from our colleagues
in Medical and Surgical Oncology and Palliative Care.
The Centre for Colorectal Disease is an umbrella for clinicians and scientists with an interest in Colorectal
Cancer, Inflammatory Bowel Disease and Functional bowel disorders. The aims of the centre are the delivery
of state of the art services for our patients, research into causes and treatment and the education of the
public. However, the multidisciplinary team would be unable to function successfully without the aid of
nursing co-ordinators and nurse specialists such as Anne White, Grace McEvoy and Nikki Smyth who lead
patients through the varied and complex pathways of diagnosis, treatment and postoperative stoma care in
a way that appears seamless. An information book for patients undergoing total colectomy designed by Grace
and Nikki continues to be enthusiastically received by many units throughout the country.
The centre welcomes the return of Mr Des Winter, from the Mayo Clinic to take up his post as Colorectal
Surgeon.
We wish to thank our nursing colleagues on St.Teresa's and St. Patrick's Wards who manage our
gastroenterology patients despite major involvement in general medical and surgical call. St. Teresa's ward
has seen a 50% increase in the number of patients coming from the Intensive Care Unit and the High
Dependency Unit (HDU). Mr Richard Marshall and Ms Grainne Hickey have been heavily involved throughout
the year as they prepare to move the Endoscopy Department to the new hospital block. As usual, Ms Nuala
Donnelly and staff in St. Mark's Day Ward organise beds for our sick patients. Like us, they are looking
forward to moving to a larger and purpose built ward adjacent to the new Endoscopy Department. This will
facilitate the rapid transfer of patients between units.
Research
Dr Jacintha O'Sullivan, Senior Research Scientist continues to lead a very busy and productive research unit.
The main research goal of the Centre for Colorectal Disease is to achieve a more complete understanding of
which biological factors drive colorectal cancer and to determine if different biological markers can distinguish
people at high risk and elucidate which subset of patients will response to particular treatment regimes.
These translational research projects will result in early detection and early medical intervention and more
effective treatment of the disease. To carry out these research studies, we utilise our longstanding
inflammatory bowel disease and colorectal disease databases, both established over 20 years ago and
containing over 2,000 cases each. Extensive clinical, pathological and survival data are available on most
patients.
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Medical and Surgical Gastroenterology incorporating Centre for Colorectal Disease
In May 2005, Ms. Sheeona Gorman joined our research group to embark on her Ph.D studies. Sheeona's
thesis project is focused on understanding how mechanisms of genomic instability can govern treatment
responses and possibly secondary tumour formations using in vitro and ex vivo explant material. This work is
done in collaboration with St Lukes Hospital, Rathgar, and the Conway Institute, UCD.
In December 2005, Ms. Julie Gorman joined the research team as an MSc student. She is investigating if
combination therapy using telomerase inhibition with standard radiation and chemotherapeutic treatments
can accelerate tumour cell death, decrease invasion and improve overall drug response.
As always, our collaborations with other research departments both within the UCD campus and farther afield
have added considerable value to our research and we would especially like to thank Professor Cliona
O'Farrelly and Professor Alan Baird amongst others for their continued collaborations.
In October the centre attended “En Bloc” the internationally renowned Colorectal training unit in
Basingstoke. The ever-popular International Colorectal Meeting was once again held before a large audience
in the Education and Research Centre in September. This year's guest lecturer was Professor David Ransahoff
from Chapel Hill, North Carolina who spent the previous day with us in a workshop where scientists and
clinicians had the opportunity to present their research and obtain helpful criticisms.
Much of the Centre's work would not be possible without generous donations for research and education
from Mr Bob Joyce, the Anglo Irish Bank and the family and friends of the late Ellie Brady. Likewise we wish
to express our sincere thanks to the family of the late Susie Byrne for all their help during the year.
Grants Active in 2005
PI Jacintha O'Sullivan, Kieran Sheahan & Diarmuid O'Donoghue
Name Source of Found Start Finish
of study Grant Amount Date Date
Role of genomic instability in Health €185,000 October October
promoting colorectal cancer Research 2004 2007
development in Ulcerative
Board
Colitis
PI Jacintha O'Sullivan
Name Source of Found Start Finish
of study Grant Amount Date Date
The role of telomeres and Cancer €135,000 October October
telomerase in colorectal cancer Research 2004 2007
development, progression and Ireland
metastasis
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Review 2005
Medical and Surgical Gastroenterology incorporating Centre for Colorectal Disease
PI Hugh Mulcahy
Name Source of Found Start Finish
of study Grant Amount Date Date
Protease profiling in early Colorectal Cancer 35,000 September September
Cancer and its association with Research 2003 2006
chromosomal abnormalities,
Ireland
anatomical stage and clinical
progression.
Honours & Awards/Academic prizes
Shane Sullivan 1st prize for best oral presentation, Irish Society of Gastroenterology Winter
Meeting, “Localisation and expression of a novel Cathepsin L isoform in
colorectal cancer” 2005.
Juliette Sheridan Irish Cancer Society: Oncology Scholars Travel Award 2005.
Alan Coss Irish Cancer Society: Oncology Scholars Travel Award 2005.
Juliette Sheridan NCI cancer consortium conference travel award 2005.
Alan Coss NCI cancer consortium conference travel award 2005.
Invited talks at conferences
The following talks were presented at the Irish Society of Gastroenterology Winter Meeting 2005
Shane Sullivan “Localisation and expression of a novel Cathepsin L isoform in colorectal cancer”
Alan Coss
Jacintha O'Sullivan
Jacintha O'Sullivan
Juliette Sheridan
“Use of array comparative genomic hybridisation to differentiate between metastatic
and non-metastatic colorectal cancer”
“Glycosylation and golgi apparatus structural integrity are essential in targeting
Glut1 to membranes of colorectal cancer cells.
“Glut1 staining pattern in contiguous and non contiguous adenomas and their
corresponding tumours”.
“Effect of Radiation on Levels of DNA Damage in Normal Mucosa of Colorectal
Cancer Cases”.
Degree awarded in 2005
Marie Mc Nally, MSc in Molecular Pathology 2005
Salih Bakheit, MSc 2005
Anne Marie Lennon, Ph.D. 2005
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Medical and Surgical Gastroenterology incorporating Centre for Colorectal Disease
Significant Publications
McMenamin M, Barry H, Lennon AM, Purcell H, Baum M, Keegan D, McDermott E, O'Donoghue
D, Daly L, Mulcahy H.
A survey of breast cancer awareness and knowledge in a Western population: lots of light but little
illumination.
European Journal of Cancer 2005; 41: 393-7.
Ryan R, Gibbons D, Hyland JM, Treanor D, White A, Mulcahy HE, O'Donoghue DP,
Moriarty M, Fennelly D, Sheahan K.
Pathological response following long-course neoadjuvant chemoradiotherapy for locally advanced rectal
cancer.
Histopathology. 2005 Aug;47(2):141-6.
Diagnosis and treatment of enterovesical fistulae.
Kavanagh D, Neary P, Dodd JD, Sheahan KM, O'Donoghue D, Hyland JM.
Colorectal Dis. 2005 May;7(3):286-91.
O'Riain, Ciaran; Corless, Christopher L; Heinrich, Michael C]; Keegan, Denise;
Vioreanu, Mihai; Maguire, Donal; Sheahan, Kieran;.
Gastrointestinal Stromal Tumors: Insights From a New Familial GIST Kindred With Unusual Genetic and
Pathologic Features.
American Journal of Surgical Pathology 29:1680-1683, 2005.
Current National & International Research Collaborators: Prof. Peter Rabinovitch, University of Washington,
Seattle, Prof. Larry Loeb, University of Washington, Seattle, Dr. Phillipe Anker, University of Geneva,
Switzerland, Prof. Martin Tenniswood, Notre Dame, Indiana, Dr Orla Howe, Dr. Fiona Lyng, DIT, Kevin Street,
Dr. Cormac Taylor, Conway Institute, UCD, Prof. Kevin Malone, St Vincents University Hospital, Dublin, Dr.
Dermot Leahy, Conway Institute, UCD, Prof. Alan Baird, Vet School, UCD, Dr. Paul Walsh, National Cancer
Registry for Ireland, Cork.
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Review 2005
Department of Medicine for the Elderly
Staff
Consultants: Dr. Morgan Crowe Dr. Diarmuid O'Shea Dr. J. J. Barry
Dr. Rachael Doyle
Registrars: Dr. Nicola Boyle (SpR) Dr. Joseph Browne Dr. Graham Sutton
Dr. Kevin McCarroll
Nursing:
Mr. Pat Gargan, Divisional Nurse Manager
Ms. Imelda Noone, Clinical Nurse Specialist in Stroke
Ms. Helen Doolan, CNM2, Our Lady's Ward
Ms. Angela Moriarty, CNM2, Carew House Day Hospital
Ms. Mary Ann Furigay, CNM1, Our Lady's Ward
Ms. Maryam Husiam, CNM1, Our Lady's Ward
Social Workers: Ms.Michelle Harte
Ms.Margaret Cagney
Administrative Staff: Ms. Lorraine Murray Ms. Joan Magera Ms. Cherryle Millo
Service Developments / Activities
2005 was a busy year for the department of Medicine for the Elderly which continues to 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. Great credit is due to Ms. Helen Doolan, CNM2 and
her team for their continued dedication to Our Lady's Ward, which continues to be a challenge for all involved.
The number of in-patients treated is gradually increasing, as is the number of out-patient attendances. New
patient attendance is up from 665 in 2001 to 815 in 2005. This is reflected in the throughput in both the
Outpatients Department and Carew House Day Hospital. Great credit is due to Ms Angela Moriarty, CNM II,
and her multidisciplinary team for the throughput and quality of work there.
In Patient Consultations
In 2005 over 850 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.
Orthopaedic Liaison Service
Dr. Rachael Doyle, newly appointed Consultant Geriatrician is now leading the development of this service
with our consultant orthopaedic colleagues.
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Department of Medicine for the Elderly
Stroke Service
Weekly multidisciplinary 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 9 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 continues to facilitate assessment and treatment of patients with TIAs, who
do not require hospital admission.
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. In total 120 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 40 rehabilitation beds in this unit, managed by Ms. Margaret Dwyer, CNM3, of which 12
are now dedicated to stroke rehabilitation. The Day Hospital at the Royal Hospital 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.
Departmental Statistics
2003 2004 2005
Inpatients
Admissions 317 405 445
Discharges 403 429 451
Inpatients
Stroke Inpatient Service 255 256 316
Outpatients
New 277 252 221
Review 543 546 498
Carew Day Hospital
New 523 571 594
Review 824 774 804
Total Attendance
New 800 823 815
Review 1367 1320 1302
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Review 2005
Department of Medicine for the Elderly
Staff
Close liaison is maintained with St. Columcille's Hospital, Department of Medicine for the Elderly under the
direction of Dr. Morgan Crowe and Dr. Rachael Doyle, with St Michael's Hospital under the direction of Dr JJ
Barry. Dr. Rachael Doyle has been appointed as a Consultant Geriatrician to St. Columcille's Hospital.
Additional consultant posts are being looked for, to improve the service delivery in St. Vincent's University
Hospital.
Congratulations to one of our recent SpR's, Dr. Clare Fallon, who was appointed as Consultant Geriatrician in
Connolly Memorial Hospital, Blanchardstown. She is due to commence work there in July 2006.
Significant Achievements/ Conferences Attended
We hosted the 53rd Irish Gerontological Society Meeting, in O'Reilly Hall, U.C.D. in September.
Congratulations to all in the organising group, in particular Lorraine Murray.
The multidisciplinary team members at Carew House Day Hospital attended The Stroke Information Day,
Annual Care of the Elderly Study Day, The Irish Gerontological Society Conference, Parkinson's Association
Meeting, National Council on Ageing and Older People's Conference and Creating a Culture of Education in
Dementia Care Conference.
The second Annual Care of the Elderly Study Day took place on 28th January, 2005, in the Education &
Research Centre, St. Vincent's University Hospital. This year it focused on more general topics and was
attended by 140 people. This is now to be a regular study day in the teaching calendar.
Significant Publications
The Evaluation of a Risk Assessment Tool for the Prediction of Falling in the Acute Hospital Setting.
I. Noone, M. Furigay, M. Crowe, D. O'Shea
Stroke Risk Factor Management - A Comparative Study.
L. Cogan, I. Noone, A. Barry, M. Crowe
The Outcome of Stroke in the Very Old.
I. Noone, O. Rooney, D. O'Shea, M. Crowe
Reduced Access to Public Extended Care Beds - Is this a cause for concern?
N. Caffrey, J.J. Barry, M. Crowe, D. O'Shea.
The Treatment and Management of Transient Ischaemic Attack - The Role of the TIA Clinic.
C. Fallon, I. Noone, J. Ryan, D. O'Shea, J. Ryan, R. O'Laoide, M. Crowe.
(In Press: Irish Journal of Medical Science)
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138
Review 2005
Department of Metabolism
Staff
Medical Director:
Principal Biochemist:
Senior Biochemist:
Locum Biochemist:
Laboratory Aide:
Secretary:
Professor TJ McKenna
Ms Barbara Murray
Dr Jennifer Brady
Ms Jillian Munoz
Ms Mairead Moore
Ms Siobhan Kelly
Julie Riordan who was Medical Scientist in the department has joined the Biochemistry Laboratory in Our
Lady of Lourdes Hospital in Drogheda.
The Metabolism Laboratory provides a comprehensive analytical and consultation service on metabolic
problems for medical and surgical patients at St. Vincent's Healthcare Group, and acts as a referring centre
for specialist markers of bone and renal disease nationally.
Service Developments / Activities
An assessment of the Metabolism Laboratory was carried out by Clinical Pathology Accreditation (UK) Ltd
(CPA) on the 10th June 2005. The CPA team of assessors included a Medical Consultant and Senior Medical
Scientist. The assessment involved audits of all aspects of the service against the CPA standards for
laboratories and included a meeting with users of the service. The assessment was very successful with
complimentary comments from the assessors on the quality of the service provided. This positive outcome
was achieved through the commitment and dedication of all the laboratory staff.
During 2005, the tendering for equipment for the new laboratory took place.
Since the Albumin/Creatinine ratio measurement (ACR) was introduced into the service there has been a
major increase in the number of requests for this test and it is now included as part of the annual review of
the diabetic patient.
The recent use of calcimimetic agents to manage secondary hyperparathyroidism among patients
undergoing dialysis regularly in the Renal Unit, involves the regular measurement of bone biomarkers in order
to assess the impact of this agent on bone turnover. This service is also provided to patients attending the
Dialysis Unit in the Beacon Hospital.
An increased number of patients with severe osteoporosis receiving Forsteo (recombinant PTH) are having
bone biomarkers measured to monitor the effect of this therapy on bone remodelling.
There has been an increase in the number of requests for measurement of parathyroid hormone levels in
infants/children with renal disease from Our Ladys Hospital for Sick Children in Crumlin. Similarly there has
been an increase in requests for measurement of 25 Hydroxy vitamin D in infants/children from an ethnic
background.
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Department of Metabolism
Bone biomarkers are being measured in selected Anorexia Nervosa patients attending the
Psychiatry/Dietetics Outpatient Clinic. This decision was made following our findings of a significant impact
of nutritional rehabilitation on bone formation. It is hoped that by measuring these parameters, positive
feedback to the patient may encourage them to persist with the nutritional programme.
Research / Future Plans
Several aspects of parathyroidectomy are being studied.
• The effect of parathyroidectomy on bone turnover in the primary hyperparathyroid patient.
• Bone turnover in the 'Hungry Bone Syndrome' post parathyroidectomy.
New cellular markers of osteoblasts and osteoclasts activity are being studied in Anorexia Nervosa patients
before and after a nutritional rehabilitation programme.
Bone turnover is being studied and compared to aged matched controls in newly diagnosed breast cancer
patients.
Early and longterm effects of Anti-TNFα Therapy on bone turnover markers in patients with Rheumatoid
Arthritis and Psoriatic Arthritis are being studied in collaboration with the Rheumatology Research Team.
Representative Functions
Barbara Murray is a member of the Executive Committee of Eurachem Ireland.
Meetings attended by Department Personnel
Servier Meeting on Osteoporosis / Strontium Ranelate Dublin, 10th March 2005
Focus 2005 Glasgow, 9th - 12th May 2005
European Calcified Tissue Society Geneva, 24th -29th June 2005
International Symposium on Paget's Disease. Oxford, 8th - 9th July 2005
European Summit on the Role of Vitamin D in
the Management of Osteoporosis : A Metaforum. Dublin, 10th -11th October 2005
Association of Clinical Biochemists in Ireland Limerick, 14th - 15th October 2005
Irish Osteoporosis Foundation Annual Conference Dublin , 22nd October 2005
Oral Presentations
Focus 2005, Glasgow, 9th - 12th May 2005
Murray BF, Smith D, Doyle M, Darby M, Malone K, McKenna TJ.
The effects of Nutritional Rehabilitation on Bone Remodelling in Anorexia Nervosa.
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Department of Metabolism
International Symposium on Paget's Disease, Oxford, 8th - 9th July 2005
Murray BF, Riordan JA, McKenna MJ, McKenna TJ
The Utility of Measuring Bone Biomarkers (Procollagen type 1 N-terminal propeptide and N-terminal
Telopeptide of type 1 collagen) to assess the longterm effects of Bisphosphonate treatment on bone
turnover in Paget's Disease.
Poster Presentations
Focus 2005, Glasgow, 9th - 12th May 2005
Brady JJ, Murray BF, McKenna TJ.
Biochemical Indices of Bone Metabolism are useful in assessing metabolic bone disease in Primary
Hyperparathyroidism.
Murray BF, Smith D, Doyle M, Darby M, Malone K, McKenna TJ.
The effects of Nutritional Rehabilitation on Bone Remodelling in Anorexia Nervosa.
Joint meeting of the European Calcified Tissue Society and the International Bone and Mineral
Society, Geneva, 24th - 29th June 2005
Smith D, Murray BF, Doyle M, Tan CY, Malone K, Darby M, O'Shea D, McKenna MJ, McKenna TJ.
Analysis of Bone Turnover in patients with Anorexia Nervosa.
Smith D, Murray BF, O'Shea D, McKenna MJ, McKenna TJ.
Development of Bone Remodelling Balance and Turnover Indices in Patients with Metabolic Bone Disease.
International Symposium on Paget's Disease, Oxford, 8th - 9th July 2005
Riordan JA, Murray BF, McKenna MJ, McKenna TJ.
The Utility of Measuring Bone Biomarkers (Procollagen type 1 N-terminal propeptide and N-terminal
Telopeptide of type 1 collagen) to assess the longterm effects of Bisphosphonate treatment on bone
turnover in Paget's Disease.
Association of Clinical Biochemists in Ireland, Limerick, 14th - 15th October 2005
Brady JJ, Murray BF, McKenna TJ.
The Clinical Impact of introducing the Albumin Creatinine Ratio.
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Department of Metabolism
Publications / Abstracts
Smith D, Murray BF, McDermott E, O'Shea D, McKenna MJ, McKenna TJ.
Hungry bones without hypocalcaemia following parathyroidectomy.
J Bone Miner Metab (2005) 23:514-515
Murray BF, Smith D, Doyle M, Darby M, Malone K, McKenna TJ.
The effects of Nutritional Rehabilitation on Bone Remodelling in Anorexia Nervosa.
Clinica Chimica Acta Vol 355/S (2005) S243
Brady JJ, Murray BF, McKenna TJ.
Biochemical Indices of Bone Metabolism are useful in assessing metabolic bone disease in Primary
Hyperparathyroidism.
Clinica Chimica Acta Vol 355/S (2005) S251
Smith D, Murray BF, Doyle M, Tan CY, Malone K, Darby M, O'Shea D, McKenna MJ, McKenna TJ.
Analysis of Bone Turnover in patients with Anorexia Nervosa.
Bone 36 (2005) S227
Smith D, Murray BF, O'Shea D, McKenna MJ, McKenna TJ.
Development of Bone Remodelling Balance and Turnover Indices in Patients with Metabolic Bone Disease.
Bone 36 (2005) S230
Riordan JA, Murray BF, McKenna MJ, McKenna TJ.
The Utility of Measuring Bone Biomarkers (Procollagen type 1 N-terminal propeptide and N-terminal
Telopeptide of type 1 collagen) to assess the longterm effects of Bisphosphonate treatment on bone
turnover in Paget's Disease.
Proceedings of the International Symposium on Paget's Disease.
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Review 2005
Department of Nephrology
Service Developments/Activities
The major initiative in the year 2005 was the development of a pre-dialysis programme. This programme is
a multi-disciplinary approach to identifying patients with renal disease well before they reach the stage of
dialysis to allow for optimal management.
Publications
1. Acute renal disease post liver transplantation: O'Riordan A, Wong V, McQuillan R, McCormack PA,
Hegarty JE, Watson AW, Nephrology Dialysis Transplantation, 20, Supplement 5, 3-414, June 2005.
2. Chronic kidney disease post liver transplantation: O' Riordan A, Wong V, McCromick PA, Hegarty JE,
Watson AW, Nephrology Dialysis Transplantation, 20, supplement 5, 3-414 June 2005
3. Proteome analysis and biomarker discovery in calcineurin inhibitor nephrotoxicity post liver transplantation;
O'Riordan A, Johnstown O Mc Morrow T, Gallagher W, Watson AJ, Ryan M.
Journal of the American Society Nephrology 2005.
Presentations
Acute renal disease post-liver transplantation:
O'Riordan A, Wong V, McQuillan R, Mc Cormick PA, Hegarty JE, Watson AJ.
Oral presentation: Irish Nephrological Society (INS), Dublin, 2005.
Poster Presentation: British Renal Association (BRA), Belfast, 2005
European Dialysis and Transplant Association meeting (EDTA), Istanbul, 2005.
Chronic kidney disease post-liver transplantation:
O'Riordan A, Wong V, Mc Cormick PA, Hegarty JE, Watson AJ.
Poster presentation: Irish Nephrological Society, Dublin, 2005.
European Dialysis and Transplant Association meeting, 2005
British Renal Association, 2005
Estimation of glomerular filtration rate in liver transplant recipients:
O'Riordan A, Mc Cormick PA, Hegarty JE, Watson AJ.
Poster Presentation: Irish Nephrological Society
British Renal Association 2005.
Proteome analysis and biomarker discovery in calcineurin inhibitor nephrotoxicity post liver
transplantation:
O'Riordan A, Johnston O, Mc Morrow T, Gallagher W, Watson AJ, Ryan M.
Poster presentation: Irish Nephrological Society, 2005.
Conway Institute, Festival of Science, 2005.
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Department of Nephrology
A Prospective study of ambulatory blood pressure monitoring in the haemodialysis patient.
M. Kiely, M Mc Quaid, F Kelly, A Watson.
Poster presentation.
EDTNA, Vienna, Austria, September 2005.
Conferences
Dr. Watson attended the Cinacalcet Masterclass in Barcelona in December 2005.
Dr. Mc Quillan attended the Comprehensive Clinical Course in Nephrology at Harvard University in
November 2005.
Dr. Niamh Kieran attended the American Society of Nephrology in Philadelphia in October 2005.
Dr. Aisling O'Riordan attended the European Dialysis and Transplant Association meeting in Istanbul in
June 2005.
Grants and Awards
May 2005:
Amgen/ Irish Nephrological Society research grant. Dr. A. O' Riordan
May 2005:
Irish Nephrological Society. Best oral clinical presentation. Dr. A. O' Riordan
Staff
Consultant Nephrologist:
Consultant Nephrologist:
Specialist Registrar:
Registrar:
CNM II:
CNM I:
DNM III:
Newman Scholar:
Clinical Engineer:
Dr. Alan Watson
Professor Keogh
Niamh Kieran
Rory Mc Quillan
Martina Kiely
Michelle McQuaid
Therese Carey
Dr. Aisling O' Riordan
Frank Kelly
Clinical Nurse Specialists in Peritoneal Dialysis:
Bairbre Moynihan & Emer Kenny
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Review 2005
Department of Neurology
The Department of Neurology has continued to substantially expanded over the last year. We now have two
Consultants, Professor Michael Hutchinson and Dr. Niall Tubridy, and have applied for at least another one (in
conjunction with the National Maternity Hospital) for 2006.
The department moved to their new offices in Carew House where we are able to offer a faster referral for
patients who are having difficulties and cannot get an early clinic appointment and see patients as part of
clinical trials. The department Secretary is Paula Halpin who has helped bring a greater deal of cohesion and
is appreciated for her help in dealing with the many phone calls from concerned patients and relatives on a
daily basis.
We have spent much of the year planning the move from the 'old' out-patients to the new Ambulatory Day
Care Centre. Nearly 3,000 people were seen in the Neurology Out Patient Clinics in 2005 (1,000 new
patients and 2,000 review patients) but another 1000 failed to attend underlining the intense demands on the
service. The Department is due to begin a new rota of Neurology Outpatient Department (OPD) Services
from March the 6th 2006. Initially this will involve clinics twice a day, and will improve the services to our
patients dramatically. We aim to reduce substantially the waiting times as part of our continued waiting list
initiative. This was successfully started by the new patient clinics twice a week at St Michael's Hospital in
2005, and we are most grateful to all of the staff there who helped make this possible.
The new clinical set up will have a dedicated secretary to check patients in and we have a number of other
initiatives planned to make sure that attendance at the clinics are less stressful. For example, we plan to try
and make sure patients' MRIs are block-booked so that they can have their date for return visit to coincide
with their scan result all arranged before they leave the hospital. We will also have specialist clinics for
Parkinson's Disease, for Multiple Sclerosis, for new patients only, a rapid access clinic and a Dystonia
Botulinum Toxin Clinic. We will be running Special Therapy Clinics to facilitate patients who otherwise might
require hospitalisation. All of this has been made possible only with the help of a variety of people but we
would like to thank especially Bernadette Howard and Julija Meirane in OPD, Margaret Boland, Breege
Screene, John McDonagh, June O'Shea (Pharmacy).
Lisa Gribben has done a huge amount of background work in addition to her regular work as the MS Research
Nurse and we are most grateful to her for going above and beyond what she was employed to do. We are
very near the point of starting an e-mail neurology service that will start as a pilot project for a selected group
of enthusiastic GP practices from April 2006. We are most grateful for their co-operation in what we hope
will be a successful venture and might help further reduce the burden on the Emergency Department, inpatient
beds required and, of course, our patient waiting times.
Drs John O'Dwyer and Killian O'Rourke finished as Research Registrars in Dystonia and Multiple Sclerosis
respectively, are writing up their MDs and have been succeeded by Drs. Richard Walsh and Lisa Costelloe.
Jean Fletcher is working on a joint project with the Department of Immunology at Trinity College under the
supervision of Professor Kingston Mills. We have set up a special clinic for people with Multiple Sclerosis and
are collecting blood samples to look at immunological and genetic aspects of this condition. We are most
grateful to all of our patients and their carers for their support in these efforts and would encourage anyone
else who may be interested either as a patient or a 'control subject' to contact the department.
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Department of Neurology
Marguerite Duggan the Multiple Sclerosis Nurse Specialist provides an excellent service for the Multiple
Sclerosis patients and has been joined by our CNM, Heather Kevelighan, as Parkinson's Specialist Nurse with
the financial support from the Parkinsons' Disease Society of Ireland. Heather will be running the new
Parkinson's Clinics and is already providing a great service for our patients in this area.
The Neurology Ward (St Vincent's Ward) continues without “protected” beds which unfortunately results in
a long waiting list for admissions. Neurology patients may wait many months, or even up to a year, to be
admitted because of the pressure of the Emergency Department admissions. The management of the
majority of patients with neurological problems is almost entirely based on the out-patient clinic and the day
ward; only patients with the most complex problems are admitted to the ward.
These patients require the input of multiple disciplines, for example, the insertion of intrathecal baclofen
pumps for spasticity by the Pain Control Team lead by Dr Declan O'Keeffe. These markedly disabled patients
require skilled, high intensity nursing and multidisciplinary paramedical care from Physiotherapy,
Occupational Therapy and Speech and Language Therapy. Many patients are no longer able to manage at
home or need special advice about aids at home from these team members and from the Social Work
Department. We work closely with the Neuro-rehabilitation and Palliative Care Teams throughout the year and
they both provide an excellent service.
There is a great team spirit in the Department of Neurology with regular multidisciplinary meetings, radiology
meetings, the Journal Club, and a six-monthly up-date meeting about recent advances, new therapies and
techniques to keep everyone up-to-date.
Publications in peer-reviewed journals in 2005
McGuigan C, Dunne C, Crowley J, Hagan R, Rooney G, Lawlor E, Hutchinson M.
Population frequency of HLA haplotypes contributes to the prevalence difference of MS in Ireland.
J Neurol 2005;252:1245-1248.
O'Dwyer JP, O'Riordan S, Saunders-Pullman R, Bressman SB, Molloy FM, Lynch T, Hutchinson M.
Sensory abnormalities in unaffected relatives in familial adult onset dystonia.
Neurology 2005;65:938-940.
Ryan A, Molloy FM, Farrell MA, Hutchinson M.
Fatal toxic leukoencephalopathy: clinical, radiological, and necropsy findings in two patients
J Neurol Neurosurg Psychiatry 2005;76:1014-16.
William J, O'Rourke K, Hutchinson M, Tubridy N.
The Face-Symbol Test and the Symbol-Digit Test are not reliable surrogates for the Paced Auditory Serial
Addition Test in multiple sclerosis.
Multiple Sclerosis (in press).
Martin C, Tubridy N, Butzkueven H, Kilpatrick TJ.
Gait analysis in multiple sclerosis.
Multiple Sclerosis (in press).
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Review 2005
Department of Neurology
O'Rourke KET, Hutchinson M.
Stopping beta-interferon therapy in multiple sclerosis.: an analysis of stopping patterns.
Multiple Sclerosis 2005;11: 46-50.
Papers presented at international meetings.
World Congress of Neurology, Sydney, November 2005.
Tubridy N. JJ Billings: An Australian Neurologists Story.
Association of British Neurologists, Torquay, September 2005.
Platform
K. O'Rourke, M. Hutchinson.
The ABN relapse based multiple sclerosis beta interferon stopping criterion is not clinically useful.
American Academy of Neurology, Miami, April 2005
Platform
O'Dwyer JP, O'Riordan S, Saunders-Pullman R, Bressman SB, Molloy FM, Lynch T, Hutchinson M.
Sensory abnormalities in unaffected relatives in familial adult onset dystonia.
ECTRIMS, Thessalonica, Oct, 2005
Platform
K. O'Rourke, M. Hutchinson Defining beta-interferon treatment failure in relapsing-remitting multiple
sclerosis: clinical predictors of progressive disability.
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Department of Clinical Neurophysiology
Staff
Consultant:
Neurophysiology Measurement Technicians:
Departmental secretary:
Dr Sean Connolly, MD, FRCPI
Ms Brigid Clark (full-time senior)
Ms Lesley Bergin
Service Developments/Activities
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 Meath & Adelaide Hospitals, incorporating the
National Childrens' 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).
Research, currently being carried out mainly at the AMNCH and St Vincent's University Hospital, includes a
transcranial magnetic stimulation study in dystonia. There are also research collaborations with the
Department of Electrical and Electronic Engineering at UCD and with Dr Geraldine Boylan in the Department
of Paediatrics and Child Health, UCC.
Recent Developments
Efforts are continuing to appoint more technologists and to provide additional departmental space.
Publications
Kinirons P, O'Dwyer JP, Connolly S, Hutchinson M. Paraneoplastic limbic encephalitis presenting as lingual
epilepsia partialis continua, Journal of Neurology 2006;253:256-7, Epub 2005 Aug 24
Kavanagh D, McDermott E, Connolly S. Meralgia paraesthetica, Irish Medical Journal, 2005;98(6):183-5
Faul S, Boylan G, Connolly S, Marnane W, Lightbody G. A
Method for the Blind Separation of Sources for use as the First Stage Of a Neonatal Seizure Detection
System. Int. Conf. Acoustics, Speech, and Signal Processing (ICASSP-2005), Philadephia, PA, March 19-23,
2005, Vol 5, pp 409-412
Beck RB, O'Malley MJ, Stegeman DF, Houtman CJ, Nolan P, Connolly S, Zwarts MJ. Tracking motor unit
potentials in the tibialis anterior during fatigue, Muscle Nerve 2005;32:506-514
Faul S, Boylan GB, Connolly S, Marnane L, Lightbody G.
An evaluation of Automated neonatal seizure detection methods,
Clinical Neurophysiology 2005 116(7):1533-41
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Department of Nursing
Introduction
It gives me great pleasure to present my first Annual Review for the Nursing Department, which includes
Healthcare Assistants, Ward Orderlies, Ward Secretaries and the nursing student population. In preparing for
this report, I have taken the opportunity to reflect on my first year in St Vincent's University Hospital. I am
most impressed with how the mission and values of the Religious Sisters of Charity are evident in all aspects
of care provided to patients and their families.
I would like to express my gratitude to all those who made me feel so welcome here in the Healthcare Group.
I extend my personal thanks to the Religious Sisters, Board of Directors, Group CEO and to colleagues on
the Group Executive team for their support and help.
I acknowledge the support received from the senior nurse managers and I would like to thank them for their
leadership and professionalism throughout the year. I now am in the fortunate position to have a full team in
senior nurse management with the appointment of Mr. M. Hollywood Divisional Nurse Manager (Theatre,
CSSD, Xray, Cath Lab and Endoscopy.) and Mr. J Gormly Head of HR Operations (Nursing).
The nursing teams experienced many challenges during the year, both in the clinical managerial and in the
educational arenas. Patients continued to receive high quality nursing care and I am very pleased to report
that this was due to staff's commitment towards innovative and creative approaches to the delivery of care
and education programmes.
I am very pleased that Ms Mary Murray was appointed as the first Advanced Nurse Practitioner in Breast
Care in Ireland. This heralds the introduction of a new step to the clinical career pathway for nurses within
St. Vincent's Healthcare Group. (SVHG)
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Review 2005
Department of Nursing
Work continued on implementing quality improvement plans, following the outcome of the Irish Health
Service Accreditation Board's survey in 2004. The organisation will participate in the mid cycle review in
January 2006. All participants in the accreditation teams and their colleagues are to be commended for their
commitment and contribution to all aspects of quality and risk management throughout the hospital.
The nursing graduation ceremony marked the end of the undergraduate diploma programme and fifty-nine
graduates received their hospital badges. Special awards were made to seven nurses for their nursing
achievements.
Ms. Mary Murphy, Out of Hours CMN 3, Ms. Louise Hederman CNM2 and Ms. Colette Kingston retired after
a long and committed service to the organisation. I wish them good health to enjoy their retirement. I extend
the warmest welcome to all new staff that took up employment in the hospital during the year.
For the first time, a nurse, Ms. Imelda Noone (Clinical Nurse Specialist) was appointed to the Executive
Committee of the Irish Gerontological Society.
The Department of Mental Health moved into the new Elm Mount Unit and the services of St. Vincent's
University Hospital merged with the HSE Mental Health Services in Area 2. The feedback from both clients
and staff was positive and full integration of the services is ongoing.
A Clinical Decision Unit (CDU) was established to provide an effective and safe alternative to inpatient
admission for patients who require short-term diagnostic or therapeutic intervention. A Rapid Assessment
Treatment (RAT) service, staffed by senior nursing and medical personnel, was introduced for patients
attending the Emergency Department.
The nursing department witnessed other service developments, including:
• A multidisciplinary Non-invasive Ventilation Unit.
• An improved access scheme to the Tissue Viability service.
• The Daphne Programme for diabetics.
• Patient information booklet, developed by the Cardiac Rehabilitation Team.
• A Biologic Clinic for arthritis patients receiving specialised medication
Nursing Practice
Policies on Administration of Intravenous Medications by Nurses and the administration of intravenous
opiates were introduced. This provides for the administration of first dose of IV medications by nursing staff,
therefore expanding their scope of practice, and ensuring more timely delivery of medications to individual
patients.
The Clinical Nurse Specialists in Palliative Care led a unique pilot study of the Liverpool Care Pathway for the
dying patient.
Protected meal and rest times were introduced on a pilot basis in Our Lady's and St. Joseph's wards. This
initiative will ensure that patients receive appropriate assistance at mealtimes and that only appropriate
interruptions are made during this time. It is planned that this quality improvement will be extended to all
patients.
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Department of Nursing
The Clinical Nurse Specialists in Infection Control introduced an infection control link nurse system of care.
This programme enables nurses to create and maintain an environment that will ensure safety of the patient,
relatives and staff. The national hygiene audit result created further momentum to continue to improve the
quality of the hygiene services at all levels within the organisation.
A welcome development for nursing was the introduction of a Clinical Nurse Specialist service for patients
with Parkinson's disease. This new service will have a strong patient focus, providing direct and indirect
clinical care, access to expert knowledge and advice, along with education and service evaluation.
Centre of Education
The Director of the centre and her team continued to provide a wide range of postgraduate and continuing
educational programmes in line with service and staff's needs. A welcome development will be the
introduction of modularisation for post-graduate nursing students in 2006. However, this change will present
some challenges for the clinical areas. The current emphasis on clinical competency must be maintained in
any changes introduced and every effort will be made to ensure that this happens in collaboration with the
academic staff.
Conference Presentations
• “Rapid Assessment Treatment” Boland M., Doyle A., ISQSH Conference
• “Bringing it all together”. Poster Presentation by the Clinical Placement Coordinator for the
National Council for the Professional Development of Nursing and Midwifery Annual Conference.
• “Perspective study on ambulatory blood pressure in haemodialysis” Kiely M., Mc Quaid
M., Kelly F.,Watson A.European Dialysis Transplant Nephrology Association (EDTNA).
• “Nurse Led Clinics” Murray M. M&K Conference
• “Evaluation of a risk assessment tool for the prediction of falls in an acute hospital setting”
Noone I., Furigay A. Irish Gerontological Society Conference.
• “ The Outcome of Stroke in the Very Old” Noone I. Irish Gerontological Society Conference.
• “Mortality, length of stay and discharge destination of stroke patients: A comparative study”
Noone I. Irish Gerontological Society Conference.
• “Stroke risk factor management: A comparative study” Noone I. Irish Gerontological
Society Conference.
• “Nurse Specialists in Breast Care” Murray M., National Council for the Professional Development
of Nursing and Midwifery Study Day.
• Advanced practise in Oncology Nursing” Murray M. Dublin City University.
Nurse Practice Development
Third year BSc Nursing Students were on rostered placement for the first time as members of the nursing
team, augmenting their clinical experience while being supported by working with formally prepared
preceptors. This “internship” is a significant aspect of the new degree programme that aims to marry the
best of traditional nurse training with an academic qualification.
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Review 2005
Department of Nursing
Human Resources
There were no graduates available this autumn as a result of the changes in the undergraduate education
programme for nursing students. A workforce plan was developed to proactively manage this deficit and a
number of initiatives were introduced in order to avoid any disruption to service delivery.
Bed Management
Nurses played a very important role in leading and managing the complex task of optimising the use of beds
and responding to the increased demand on the overall bed capacity within the hospital. There was
continued pressure on the limited number of ICU beds in the hospital with the requirement to establish a
temporary emergency bed in the Post-Anaesthesia Care Unit on 49 occasions during the year. This practice
was less than optimal and will have to cease. Increasing acuity level of patients places additional pressure on
the need to access inpatient beds more speedily.
The following initiatives were introduced to try and address the increasing demand for emergency and
elective admissions:
• Additional nine inpatient beds were opened
• A discharge lounge was created for patients to wait in for transport home.
• Beds were contracted in St Vincent's Private Hospital to assist in reducing medical and
surgical waiting lists
• Waiting list for liver biopsies was reduced tenfold by year-end.
• The establishment of a chronic pain service in St Michael's Hospital significantly reduced the
number of patients awaiting treatment
• An intermediate care service in the community was introduced for patients whose acute
phase of treatment had been completed
Future Developments
The Department of Nursing will continue to provide a high quality nursing service through the continued
provision of evidenced-based nursing care and support for professional development.
The following list indicates the range and breadth of developments that are planned to improve patient care:
• Continue the standardisation of nursing practice across SVHG
• Establishment of a pre-dialysis renal service at the outpatient level
• Creation of nurse led specialist services in Rheumatology and Dermatology
• Accreditation of A.N.P. posts in Stroke Care, Chest Pain Evaluation, Dermatology and Heart Failure.
• Introduction of a critical care outreach service.
• Introduce, in partnership with UCD and other health care providers, the first post-graduate programme
in Ireland for nurses in Stroke Care and Acquired Brain Injury.
• Introduction of team based performance management.
As we approach 2006, I am very proud that I lead such a dynamic and committed team of professional staff
within the Nursing Department. Once again, I thank them for all that they do to ensure our patients receive
the highest quality care in a healing, compassionate and safe environment.
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Review 2005
Department Of Ophthalmology
Staff
Consultants:
St James Ward:
Ophthalmic Theatre:
Surgical Registrar:
Medical Registrar:
Lecturer in Ophthalmology:
Orthoptist:
Unit Secretary:
Dr G Kelly, Mr P Barry, Mr W Power
Ms Colette Kingston CNM2, Sandra Murphy CNM1
Ms Maeve Williams CNM2
Dr Susan Kelly, Dr Ismail Tuwir
Dr Magdy Nasralla
Dr Moji Oshodi
Ms Nanno Fitzsimons
Ms Jane Caulfield
The Table below summarises the department's activity for the year 2005.
Elective cataract admissions continued to be curtailed by the ever-present A&E crisis.
However, our day-care unit continues to thrive with an ever-increasing number of patients for elective
ophthalmic day-care assessment and treatment e.g. chronic glaucoma, diabetic retinopathy and laser
photocoagulation together with medical investigation of retinal or vascular disease.
Our ophthalmic emergency attendances continue to rise as does the number of new patients in our
Outpatient Department (OPD).
For the unit, the most difficult problem is the cancellation of elective cataract patients in favour of nonophthalmic
emergency admissions. With all the inconvenience this causes to patients, relatives and staff. We
regret the resulting difficulty of reducing our cataract waiting list and the involvement of the NTPF.
On a happier note we continue to participate in the European Cataract Outcome Study. This unique study,
involving 50 European clinical centres, anonymously analyses the quality of the surgery performed in an
anonymous fashion and thus identifies benchmarks of clinical excellence.
As a result of the above, we have been invited to participate in another study comparing quality of surgery
amongst a number of European centres compared with centres in the United States.
Sadly the year has been marked by staff retirements.
Dr Geraldine Kelly retired after 30 years of consultant service at the Royal Victoria Eye & Ear Hospital and St
Vincent's University Hospital and this represents almost 40 years of continued service to both.
Ms Colette Kingston also retired and we all miss her professional, kind and caring approach to patients, staff
and their families. Colette's commitment and dedication was exemplary and we wish her all the best in her
retirement.
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Department Of Ophthalmology
Ms Maeve Williams has taken a leave of absence and we look forward to her return.
Ms Sandra Murphy was appointed CNM2 and we wish her every success in taking over from Colette.
She is assisted by Ms Esther McCarthy appointed CNM1 later in the year.
Staff nurse Sheila Querubin completed her diploma in first line management at SVUH in conjunction with the
National University of Ireland and we congratulate her. We express our appreciation of the service provided
to the ward by all our superb staff nurses in these difficult times.
We look forward to the future developments at SVUH and hope to participate in them.
We must tackle the problem of continuing to provide cataract surgery for the very elderly with multiple
systemic illnesses and at the same time try to develop Day-Care Cataract Surgery for those who can avail of
it.
I finally, personally thank Ms Jane Caulfield for her constant and total dedication to the unit. The
administrative smoothness she achieves is almost impossible to match.
Ophthalmology
St. James Ward
2001 2002 2003 2004 2005
St James In-Patients Admissions 461 458 458 442 365
Discharges 457 456 451 434 363
St James In-Patients
Cataract
Procedures 330 324 310 299 300
St James Day Care Admissions 1611 1846 1994 1729 1647
Discharges 1611 1846 1994 1729 1647
St James Day Care Orthoptic Total Attendance's 607 502 927 777 973
St James A/E
Ophthalmic Patients Total Attendance’s 1153 1261 1016 1064 1157
St James In-Patient Referrals
Total
Attendance's 299 309 327 342 312
Ophthalmology Out-Patients New 745 773 781 729 836
Total Attendances 2372 2398 2475 2245 2262
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Review 2005
Department of Orthopaedic Surgery
Orthopaedic Dept.: Mr. Sean Dudeney Mr. Brian Hurson
Mr. Eamonn Kelly
Mr. William Quinlan
Mr. S. Kieran O'Rourke
Admin. Staff: Ms. Jenni Cross Ms. Frances Dwyer
Orthopaedic Ward: CNM2 Ms. Gillian Fields CNM1 Ms. Rachel Hayden
CNM1 Ms. Andrea Marnell
Orthopaedic Theatre: CNM2 Ms. Katrina Lennon CNM1 Ms. Anna Marie Bos
CNM1 Ms. Sarah Cusack
The Orthopaedic Department is part of the South East Department of Surgery. It is based in St Vincent's
University Hospital. The service is provided for the South Eastern area through the facilities at St Vincent's
University Hospital, St Columcille's Hospital and St Michael's Hospital.
The trauma and orthopaedic service is provided locally for the areas covered by South Dublin, Wicklow and
North Wexford. There is an estimated population of between 350,000 and 400,000 people. However, with
reference to the sub-speciality interests in the Unit, there is a nationwide referral pattern.
Currently the Outpatient clinics are divided between the three sites of activity in the area. Daily clinics are
held in St Vincent's University Hospital. Subspecialty clinics in joint replacement and upper limb surgery are
held in St. Anthony's on the St Vincent's University Hospital campus. Mr W. Quinlan, Mr B. Hurson and Mr
S. Dudeney attend St Michael's Hospital where there are three clinics a week. And similarly Mr K. O'Rourke
and Mr E. Kelly attend St Columcille's Hospital, where a further two clinics per week are conducted.
Mr Hurson and Mr Dudeney currently deal with the oncological referrals of bone tumours and much of this
is dealt with through the elective facility in Cappagh National Orthopaedic Hospital.
The Outpatient activity on the St Vincent's University Hospital campus caters for 12, 978 patients during the
current year. A further 9, 040 patients attended the other clinics. Therefore a total of 22, 018 patients attended
the unit overall.
The surgery catered for in St Vincent's University Hospital is mainly trauma. Trauma presents to the units with
the three portals of entry: the Emergency Department of St Vincent's University Hospital, St Columcille's
Hospital and St Michael's Hospital. Daily fracture lists endeavour to provide prompt treatment of fractures
and therefore the early rehabilitation of the patients. It is therefore the main trust of the unit to have all the
areas involved in the service co-ordinated to allow the access to treatment with the greatest facility. In
addition to the long-bone trauma of young and middle aged associated with sport, road traffic accidents and
domestic accidents, the increasing age profile results in an increasing number of infirmed patients who are
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dependent. Such circumstance makes huge demands on the medical, geriatric and social services to
reintegrate them into the community.
Overall approximately 2,000 patients were admitted within the region for surgery during the year.
For elective orthopaedic services, once the patients have been seen in the Outpatients within the region,
their surgery is dealt with at Cappagh National Orthopaedic Hospital, which allows for the planned scheduling
of regular protected orthopaedic operating lists. Approximately a further 1,000 patients had surgery in
Cappagh National Orthopaedic Hospital from the South-East region.
Mr. Quinlan is currently a Director on the Board of Management of St. Vincent's Healthcare Group Ltd.
Mr. Dudeney is Secretary of the Arbeitsgemeinschaft fur Osteosynthesefragent (A.O.) group Ireland. He was
chairman of the A.O. instructional course in March. He was a member of the visiting faculty for the A.O.
instructional course in fracture management in Portugal. He currently sits on the Ethics Committee of the
hospital. He was the Coordinator of the Intercollegiate Fellowship Exam held in Cappagh National
Orthopaedic Hospital. Mr Kelly is currently the Unit Director, is the Hospital representative to the training
committee and is a member of council of the Institute of Orthopaedics
Presented Work
'CT guided radiofrequency ablation of intra-articular osteoid osteoma of the hip'.
Cantwell CP, Scanlon T, Dudeney S, O'Byrne J, Eustace S.
'Epidural abscess causing cauda equna syndrome'.
Lenehan B, Sullivan P, Street J, Dudeney S.
'Impaction allografting and the Kerboull acetabular reinforcement device: 35 hips followed for 3 - 7 years.'
Lunn JV, Kearns SS, Quinlan W, Murray P, Byrne JO.
'Revision of the Sheehan total knee arthroplasty'.
Hurson C, Boran S, Synnott K, Powell O, Quinlan W.
'Diagnosis of thoracic neurilemoma incidental to a traumatic clavicle fracture'.
Cleary M, Mullett H, Tolan M, O'Rourke K.
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158
Review 2005
Department of Palliative Medicine
Consultant:
Dr Eoin Tiernan
Clinical Nurse Specialist: Ms Millie Devenish, Ms Olga Price
Ms Siobhan Hollingsworth, Ms Barbara Whyte
Ms. Carmel Houlihan (St. Vincent's Private)
Care of the Dying Project Facilitator:
Ms. Pauline Ui Dhuibhir (Nov '05)
Specialist Registrar: Dr Ita Hartnett - 01/01/05 to 30/06/05
Dr Joan Cunningham - 01/07/05 to 31/12/05
Registrar: Dr Aoife Gleeson - 01/01/05 to 30/06/05
Dr Gill Gormley - 01/07/05 to 31/12/05
Senior Social Worker: Ms Aine Canny
Administrative Support: Ms Joan Stokes & Mr Olajide Ogidan
2005 was another busy year for the Palliative Medicine Department with a total of 917 referrals to the service.
This represented an 11.6% increase in referrals in St. Vincent's University Hospital and a 39% increase in St.
Vincent's Private over the previous year. The proportion of non-cancer referrals increased significantly from
8% to 16.7%.
The team also made significant progress in the “Care of the Dying Project” which was launched in 2004. Its
purpose was to review the standards of care given to dying patients in St. Vincent's University Hospital with
the aim to improve all aspects of care to patients and families around time of death. A survey of the
experiences of staff nurses in caring for dying patients and their families, and a survey of bereaved next-ofkin
(including focus groups) on their experiences of care given around the time of death were completed. In
addition, a pilot project implementing the Liverpool Care Pathway for the Dying was completed in St. Anne's
Oncology Inpatient Unit. A report on these projects will be presented to the Group Executive and Board of
Directors in early 2006. The Project received a further boost when joint funding was secured from the HSE
Eastern Region and the Irish Hospice Foundation to support a Project Facilitator. Pauline Ui Dhuibhir was
appointed to the post in November 2005. This appointment will facilitate the “roll-out” of the Liverpool Care
Pathway (LCP) throughout the hospital over a two-year period. The team hosted a national meeting for other
hospital specialist palliative care teams interested in the LCP in November 2005, with Professor John
Ellershaw from Liverpool speaking.
Education
The team hosted the second annual international palliative medicine symposium in early November. A
capacity attendance of approximately 180 professionals attended at the Education & Research Centre for the
half-day symposium entitled “Cancer Pain Management - Latest Developments”. The international faculty
included Dr. Mike Bennett (Leeds), Dr. Marie Fallon (Edinburgh), Dr. Columba Quigley (London), and Dr. Kathy
Redmond (Milan), with the local faculty comprising of Dr. Ray Victory (SVUH), Dr Norma O'Leary, (Blackrock
Hospice), and Dr Peter Lawlor, (St. James Hospital).
The Nursing Team facilitated their Annual Palliative Care Study Day for registered nurses in December. The
team continues to contribute to a wide range of educational programmes for nurses and other professionals
both in-house and at national meetings, as well as facilitating clinical placements for nurses undertaking the
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Higher Diplomas in Palliative Care Nursing and Pain Management from UCD, and undergraduate medical
students.
Olga Price completed the Higher Diploma in Nursing Studies (Palliative Care). Siobhan Hollingsworth and
Pauline Ui Dhuibhir undertook a one-week training programme on Integrated Care Pathways (Venture Training
and Consulting). Millie Devenish & Aine Canny commenced the Certificate in Children and Loss (Irish Hospice
Foundation).
Courses and Conferences attended by members of the team
A selection of the educational events attended by members of the team
• Irish Association for Palliative Care Education and Research Seminar, Feb 2005
• Anaemia and Cancer Therapy: Rome, Apr 2005
• 9th EAPC Congress, Aachen, Germany, Apr 2005
• Finding A Better Way: A National Conference on Care for People Dying in Hospitals, May 2005 (IHF)
• Irish Lung Cancer Nurses Group 1st Annual Conference, May 2005
• 4th Annual Kaleidoscope Conference (St. Francis Hospice), May 2005
• 17th Annual Symposium of the Multinational Association of Supportive Care in Cancer, Geneva, June 2005
• LCP Annual Conference: Meeting the challenges in care of the dying. RSM London November 2005
Presentations at international meetings
Posters presented by the team at LCP National Conference, RSM London, Nov 05:
“Nurses” perspectives on quality of care provided for dying patients in an acute hospital
setting - questionnaire survey”.
“Liverpool Care Pathway: Our experience of establishing a care of the dying project in a
university teaching hospital”.
“Survey of bereaved relatives of patients who died in an acute hospital setting”. Ursula Bates also
made an oral presentation at that meeting entitled “Good practice in Palliative Care Research -
A systematic approach”.
Publications
Abstracts -
Conroy M, Tiernan E, Cunningham J, Gleeson A, & Ryan J, Palliative Care in the Emergency Department,
European Journal of Palliative Care, Abstracts of the 9th Congress of the European Association of Palliative
Care, Aachen, Germany, 8-10 April 2005, Abstract No: 304, p.64
O'Leary N & Tiernan E, Specialist Palliative Care in Non-malignant Disease in an Acute Hospital, European
Journal of Palliative Care, Abstracts of the 9th Congress of the European Association of Palliative Care,
Aachen, Germany, 8-10 April 2005, Abstract No: 484, p.105
O'Leary N, Tiernan E et al, Symptom Assessment Instruments - A Systematic Review - Pitfalls and
Shortcomings, European Journal of Palliative Care, Abstracts of the 9th Congress of the European
Association of Palliative Care, Aachen, Germany, 8-10 April 2005, Abstract No: 553, p.120
Stone C & Tiernan E, Prospective validation of the Palliative Prognostic Index in palliative care patients,
European Journal of Palliative Care, Abstracts of the 9th Congress of the European Association of Palliative
Care, Aachen, Germany, 8-10 April 2005, Abstract No: 655, p.145Department of Pathology
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Review 2005
Department of Pathology
Service Developments/Activities
The Clinical Pathology Accreditation (UK Ltd.) (CPA (UK)) accreditation process was ongoing in Pathology in
2005. In June, CPA assessors visited the Biochemistry, Nuclear Medicine, Endocrinology and Metabolism
laboratories over a six-day period. The visit was very successful with favourable comment being made by the
assessors and the laboratory User's Group. A report of 'conditional approval' was awarded to the
Haematology and Blood Transfusion laboratories in relation to their assessment visit, which was carried out
in November 2004. The award of conditional approval for the Histopathology Laboratory was extended to
January 2006. It is anticipated that awards of full accreditation will be awarded to the above laboratories as
facilities issues are addressed with the transfer to the new department in 2006.
We would like to thank all laboratory staff for their enthusiastic participation in the accreditation process,
which has resulted in a very positive outcome.
The procurement process for the new laboratories was the other major emphasis for Pathology in 2005.
While the above work has been time consuming for laboratory staff, everyone is in agreement that it
represents a great opportunity to further modernise the pathology service. The procurement process has
been greatly facilitated by the expertise and commitment of the Project Office staff.
Healthlink a project to provide results electronically to GP practices, progressed to the testing and validation
phase.
Other development in 2005 included the following
• The implementation by Haematology of a new Warfarin Information Booklet and identification card for
attending the Anticoagulant Monitoring Service.
• The evaluation and introduction by Biochemistry of an assay for transferrin and inclusion of this in the
Iron Status Profile; further evaluation of assays for theophylline and phenytoin; increased involvement
in quality management of Point-of-Care Testing, now including the St. Brigid's Ward Blood Gas Analyser
and an increased number of ward based blood glucose meters (now over 50). In collaboration with the
Emergency Department and the Cardiology Department/Heart Failure Unit, the Biochemistry
Laboratory has been involved in an ongoing evaluation of ischaemia modified albumin, an early marker
of cardiac ischaemia and ≤-natriuretic peptide (BNP), a diagnostic test for heart failure.
• The Blood Transfusion Laboratory developed a blood inventory strategy, which reduced the number of
scheduled blood deliveries to the hospital to one per week. The net benefit of this initiative was a
reduction in blood shortages and outdating with considerable cost savings.
• The new diagnostic cytology liquid-based ThinPrep TM system is now operational.
• The major development in Phlebotomy in 2005 was the introduction of the National Certificate in
Phlebotomy Programme. This nationally recognised course has been developed by the National
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Ambulance Training Centre in association with the School of Nursing in Dublin City University, following
lengthy deliberation by a working group. In 2005 St. Vincent's University Hospital along with other
hospitals around the country facilitated clinical placement of students undergoing a pilot programme.
The course is now being rolled out nationally and will initially standardise the training of existing
experienced phlebotomists. It is hoped however to develop the programme to include the training of
new entrants. The plan for 2006 includes Mentorship, Assessor and Tutor Training Courses, along with
development of I.V. Cannulation and Advanced Paediatric modules. St. Vincent's University Hospital is
pleased to have been chosen and accredited as a site to deliver the course on an ongoing basis and is
one of six hospitals nationally which has undertaken to do so. The course is accredited by Dublin City
University and funded by the Health Services Executive. It will enable phlebotomists to conform to a
national standard, thus enhancing both the delivery of the service and the status of the profession.
• The Infection Control Liaison Nurse Programme was established with SVHG.
Significant Achievements
Dr. Donald Mc Carthy is the President of the Haematology Association of Ireland. Dr. Karen Murphy is the
National Specialist Director for Haematology and Education Secretary to the IHS/Haematology Association of
Ireland. Mr. Ivan Shirley is a member of the Steering Committee of the Irish External Quality Assessment
Scheme.
Dr Gerard Connaghan, Consultant Haematologist took up an appointment position in August. His post is
shared with St Michael's Hospital and St Columcille's Hospital.
Ms Orla Maguire was promoted to Principal Biochemist and was also successful in the final examination of
the Membership of the Royal College of Pathologists (MRCPath). Ms Anne Kirwan and Ms Geraldine Collier
were promoted to Senior Biochemist. Geraldine Collier was successful in the Examination for Part 1 of the
MRCPath and became Hon. Secretary of the Association for Clinical Biochemistry, Republic of Ireland Region.
Dr Sean Cunningham is Chairman of the Clinical Biochemists Registration Board. Ms Myra O'Keane is Chair
of the Safety Advisory Body of the Academy of Medical Laboratory Scientists.
Professor Dr Joe Duffy continued to act as Chairman of the National Academy of Clinical Biochemistry (USA)
Panel for the preparation of new guidelines on the Clinical Use of Tumor Markers in Breast Cancer. During
2005, Professor Duffy was also appointed Focus Group Leader of the Gastrointestinal Group of the European
Group on Tumor Markers (EGTM). EGTM is a European Expert group involved in preparing guidelines on the
use of tumor markers in different malignancies. Prof. Duffy was an invited speaker at a number of
International Conferences in Europe and USA.
Dr. Ciaran O'Riain, Specialist Registrar (Histopathology), was awarded the Registrar's Prize of the Pathology
Section of RAMI for his presentation entitled “Generations of GISTs”.
Laura Conroy, Grade IV Officer (Biochemistry) successfully completed Year 2 of the Diploma in First Line
Management and was awarded a Distinction. She was also presented with Merit 1 Certificate in Health and
Safety
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Review 2005
Department of Pathology
Mary Pilkington, Grade IV Officer (Microbiology) retired after many years of dedicated service to SVUH.
Sheila McKeon, Grade III was promoted to this position. The following Officers were also promoted to Grade
IV posts: Niamh Devereux (ECG Department), Maria Lawlor (Rehab Medicine) and Siobhan O'Grady
(Cardiology Department).
Colette Devlin and Gay Wright were graduates of the 1st Certificate in Phlebotomy Programme.
Marion Commane joined SVUH as Clinical Nurse Specialist in Infection Control.
In July, Dr Fidelma Fitzpatrick joined the Microbiology Staff in a job sharing capacity with Dr Lynda Fenelon.
Dr. Mary Crowe was co-convenor of Infection Control Session at the Intersciences Conference of
Antimicrobial Agents and Chemotherapy (ICAAC) Washington DC.
Toni Cronly (Blood Bank) was promoted to Senior Medical Scientist.
Deirdre McMahon (Histopathology) was appointed as Senior Medical Scientist with special responsibility in
the Symptomatic Breast Service.
Ms Brenda Larkin was appointed as Senior Phlebotomist.
Publications
Dillon, M. F., C. M. Quinn et al.
"The accuracy of ultrasound, stereotactic, and clinical core biopsies in the diagnosis of breast cancer, with an
analysis of false-negative cases."
Ann Surg 242(5): 701-7.
Gautier, V. W., W. W. Hall et al. (2005).
"Direct interaction of the human I-mfa domain-containing protein, HIC, with HIV-1 Tat results in cytoplasmic
sequestration and control of Tat activity."
Proc Natl Acad Sci U S A 102(45): 16362-7.
Krajewska, S. Kennedy, M. J. Duffy, et al. (2005).
"Tumor-associated alterations in caspase-14 expression in epithelial malignancies."
Clin Cancer Res 11(15): 5462-71.
Ryan, R., D. Gibbons, D. Treanor, K. Sheahan et al. (2005).
"Pathological response following long-course neoadjuvant chemoradiotherapy for locally advanced rectal
cancer." Histopathology 47(2): 141-6.
Smith, D., B. F. Murray, E. McDermott, D. O'Shea, M. J. McKenna and T. J. McKenna (2005).
"Hungry bones without hypocalcaemia following parathyroidectomy."
J Bone Miner Metab 23(6): 514-5.
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Department of Pathology
Departmental Statistics
Pathology activity increased by 7% in 2005. The increase in activity was driven by the increase in inpatient
workload (5% increase) and general practitioner workload (11% increase). Blood usage was up 8% over the
previous year.
Future Developments
The major event of 2006 will be the move to the new laboratories. This will involve installation, commissioning
and training on new equipment and moving existing equipment to the new facilities.
There is also a requirement to implement the EU Blood and Tissue Directives. The implications of the Blood
Directive will be accreditation of the blood transfusion service to ISO 15189 and 100% traceability of all blood
products. The implications of the Tissue Directive, which will pass into law in April 2006, are as yet unclear.
The Tissue Directive will apply to all tissues stored in the hospital. We are fortunate that the directive
coincides with the move to the new building where we will have adequate clean room facilities to comply
with this directive.
In 2006, it is anticipated that the Biochemistry Laboratory will be required to take responsibility for the
maintenance and quality assurance of additional blood gas analysers, e.g. in ICU and the Emergency
Department.
Staff training is at an advanced stage in the Histopathology Laboratory to introduce fluorescence in situ
hybridisation (FISH) testing for Her2-neu, an important test for patients with breast cancer.
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Review 2005
Department of Plastic Surgery
Staff
Consultants:
Registrars:
Occupational Therapist:
Hand Therapist:
Unit Secretary:
Mr Tom O'Reilly, Ms Margaret O'Donnell, Mr Sean M Carroll
Dr. Catriona Lawlor
Mr M Allam, Mr H Ali Shah, Mr Adnan Gull
Ms Aine O'Reilly
Ms Catherine Cradock
Ms Rachel Boyle
Service Development and Activities
The Department of Plastic Surgery provides a general plastic surgery service within St Vincent's Healthcare
Group (SVHG) for the southeast of the country. We provide specialised services in breast reconstruction,
hand surgery, skin cancer, pressure sore surgery and head and neck reconstruction.
In June 2005, Ms O'Donnell began a two year leave of absence from her full time clinical duties to spend
more time with her growing family and we wish her well during this period. She continues however in a part
time capacity and is currently setting up a new breast reconstruction unit. As a result, Dr Catriona Lawlor was
appointed as a temporary Consultant Plastic Surgeon to SVUH. Dr Lawlor is a Canadian graduate and has a
special interest in breast reconstruction and microsurgery. We warmly welcome her to Dublin.
St Agnes's Ward remains the nominal plastic surgery ward but unfortunately, due to the pressure of
emergency work, we see little increase in the numbers of patients been admitted for elective procedures to
our ward. Never the less, we acknowledge the dedication and hard work of the Senior Nurses, Ms Dolores
O'Neill and Ms Josephine Ryan and the other highly competent ward staff.
Out patient clinical activity increased further this year. We recognise the expertise and continued positive
attitude of the OPD nurses. An additional out patient's clinic on a Thursday morning, has been agreed upon
and will commence in the New Year. Therefore a total of four OPD clinics are held per week in SVUH, three
of which are general plastic surgery, and one hand clinic. A further OPD clinic is held on Monday afternoons
in St Michael's hospital.
Over the last year there has been an increase of over 100% in new patient referrals to the hand clinic. We
are hugely indebted to the dedication and expertise of Aine O'Reilly and Catherine Craddock who enable us
to see the numbers of patients we do and who work with these patients for months on end ensuring an
optimum outcome. We sincerely thank the outstanding hard work of our unit secretary Rachel Boyle who
enables us to increase our clinical activity.
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Department of Plastic Surgery
Mr O'Reilly continues to provide a general plastic surgery service with a special commitment to skin cancer
surgery as well as participating in the paediatric plastic surgery service in Crumlin Children's Hospital. Dr
Lawlor and Ms O'Donnell continue to provide a busy breast reconstruction service and it continues to expand
with over one hundred and twenty reconstructions being performed during the year. We have a close working
relationship with the Surgical Professorial Unit from where a significant number of patients are referred. We
also provide a reconstructive service to BreastCheck and many patients now undergo breast reconstruction
at the time of their mastectomy. The majority of patients, however, are reconstructed sometime after their
reconstruction. The service is complimented by the participation of the Breast Care Nurses and encompasses
a Micro-pigmentation (Tattooing) Clinic to complete Nipple-Areolar reconstruction.
A plastic surgical service continues to be provided for the National Rehabilitation Hospital. An outpatients and
ward round at NRH is provided on alternative weeks. Agreement was reached during the year that two
protected beds were to be made available for pressure sore reconstruction in the NRH and this has been an
invaluable asset over the last year.
The unit received a very complimentary report from the Joint Committee for Higher Surgical Training (JCHST)
and are now accredited for higher surgical training. This will enable us to attract even higher quality trainees
thus further improving our service potential, increasing out research output and contribute to the training of
future plastic surgeons for Ireland.
Future Developments
The future of the unit has been mapped out for the medium term. There is increasing demand, and need, for
head and neck reconstruction, breast reconstruction and sarcoma surgery reconstruction. The aging
demographic and increasing incidence of skin cancer means that the pressures on this speciality will become
even greater. It is apparent that the appointment of a fourth consultant remains both appropriate and
necessary.
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Review 2005
Department of
Psychiatry and Mental Health Research
2005 was a momentous year for the Department of Psychiatry and Mental Health Research. On the 31st
May, the new Psychiatric Unit named Elm Mount incorporating the services of St. Camillus' Ward, Elm Park
and the catchment area services at Vergemount Clinic opened.
Initially 41 of the 54 beds were commissioned with plans to open the remaining beds on a phased basis as
funding allows. The dedicated 6 beds for Psychiatry of Old Age should be functioning in March 2006 without
increasing the bed complement of 41.
As a result of the amalgamation, the staffing numbers are:1 Professor, 1 Clinical Director, 7 Consultant
Psychiatrists, 2 Senior Registrars, 2 Lecturers, 12 NCHD's, 2 Assistant Directors of Nursing, 1 CNM III,
5 CNM II, 3 CNM I and 35 Nursing staff, 3 Psychiatric Social Workers, 9 Community Nurses, 3 OT's and 1 / 2
time OT assistant, 9 Clerical staff and Catering staff attached to the service. There is also input from the
Nutrition and Dietetic Department and Pharmacy.
The department is jointly managed by St. Vincent's University Hospital and the HSE.
The move took place in an efficient manner with minimum disruption to the patients and maximum cooperation
from all staff. Since the move, the two services have been working towards full integration. The
medical staff under Clinical Director Dr. Freda O'Connell have been working the one rota since the move and
this is serving the needs of St. Vincent's University Hospital and the Community Psychiatric Service. The
nursing staff under the direction of Kay Beggan, Chief Nursing Officer of Area 2 Mental Health Service, are
now working on an integrated roster. The aim of the unit is to integrate into the life of St. Vincent's University
Hospital and provide a seamless service to all out patients.
Psycho-oncology Service
In the year 2004/5, 102 people have used the service from SVUH hospital and the Cancer Support Centres.
The 102 clients came for 303 sessions and average of 3 sessions per person. 40.9% were assessed and
counselled once, the majority of these were patients seen in the hospital setting who were returning home,
some were relatives who came for one session to get advice on managing their loved ones' reactions to
cancer. Some 65.9% of patients referred to the Psycho-Oncology Service had an adjustment disorder with
either depression or anxiety. The majority attended for brief Cognitive Behavioural Therapy (CBT), and 5% of
the clients with multiple difficulties required ongoing supportive work.
Research
Cancer Rehabilitation Project
The SVUH Psycho-Oncology Service is in receipt of a research grant from the East Coast Area Health Board
(ECAHB) to research and develop a Cancer Rehabilitation Pilot project. Focus groups with survivors and
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Department of Psychiatry and Mental Health Research
carers are complete and three pilot Mindfulness Based Cognitive Therapy (MBCT) groups assessed. Results
have been accepted for presentation at the Second International Cancer Survivors Conference in Vancouver
Canada in March 2006. This is a joint project with SVUH the HSE and the Department of Psychology UCD.
Psychological Distress Screening
The Psychological Distress Screening Project was completed in 2005, comparing the efficacy of the Hospital
Anxiety Depression Scale (HADS) with the National Comprehension Cancer Network (NCCN) visual analogue
scale. This project is in collaboration with the Department of Psychology Trinity College Dublin.
Mental Health Research
The Department has over 10 active research projects running at present. These include the Suicide in Ireland
Survey in association with the charity Turning the Tide of Suicide at UCD. This project is interviewing families
who have been bereaved by suicide over the past two years in Ireland (Ms. Sharon Bolger, Research
Coordinator, s.bolger@st-vincents.ie). Other major projects include a study of all near-miss suicides
presenting to intensive care units in the DATHs hospitals to understand more about high lethality suicidal
behaviour (Dr Maria Ryan). The department is also commencing a study of death on all Irish waterways for
the past ten years in collaboration with the Irish Water Safety Association. Following a research grant from
the American Foundation for Suicide Prevention, the Department is conducting a Functional Neuroimaging
Study of Suicidal Depression (Dr Rob Whelan). Through the UCD Newman Scholar Programme we are
conducting a study on Immune Surveillance, Oxidative Stress and Depression (Ms. Aoife O'Donovan) as part
of an Inter-Disciplinary Research Programme on PsychoNeuroImmunology with Prof. Cliona O'Farrelly, ERC
at St. Vincent's University Hospital.
On the educational development side, the department is developing an interactive web-based training
product for psychiatry (Dr Allys Guérandel).
The Department of Mental Health Research said goodbye to Ms. Niamh Ní Ghafraidh and welcomed
Ms. Olwyn Ní Chróinín to the administrative staff working with Prof. Malone and Dr McCarthy.
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168
Review 2005
Department of Old Age Psychiatry
The Department of Old Age Psychiatry has had a very busy year. A key development was the move to the
new Psychiatric Unit at Elm Mount (Unit) in the main hospital. There has been very welcome feedback from
our elderly patients about he new setting. We are looking forward to the opening of the 6 bedded purpose
built unit for the elderly with mental health problems within the Elm Mount Psychiatric Unit.
Staff
The service welcomed a number of new staff to the unit including Dr. Eithne Bolger, Specialist Registrar in
Old Age Psychiatry, Antoinette Copley who joined us to work on the data base for the service, Deborah
Connolly who has taken up a secretarial post in September 2005 and Catherine Moore who has taken up a
post as Community Mental Health Nurse.
Service Developments/Activities
2005 has been the busiest year to date with 680 new referrals seen and 1,451 patient reviews carried out.
The Day Hospital had another very busy year and continues to provide a very important service to prevent
patient admissions to hospital and to facilitate their discharge.
There have been a number of important health service initiatives for patients in Old Age Psychiatry including
the Healthy Ageing Programme, which was developed by our Senior Occupational Therapist, Catherine Keogh
together with nursing staff from the Day Hospital, Ann Hutton and Mairead McDonnell. The programme
promotes the development of mental and physical well being in older patients with a variety of functional
psychiatric problems. The first programme took place in August 2005 and the second programme was held
in November 2005. Initial feedback from participants has been very encouraging.
A Family Focus Group has been set up to provide support for the families of patients who are long stay
residents of the service at Units D and E at Vergemount Hospital, Clonskeagh and Cois Ceim at Tivoli Road
Dun Laoghaire. It is intended to hold these meetings every 3 months.
There are a number of other programmes, which have been running successfully at the Day Hospital
including the Active Rehabilitation Group and the Anxiety Management Programme. The Senior Occupational
Therapist, Catherine Keogh, has developed an anxiety management information pack for patients on the
waiting list for the Anxiety Management Programme.
In terms of educational and outreach work, Dr. Freyne gave a public talk on the subject of “Managing
Dementia at Home and Supporting the Carer” in February 2005 and facilitated an educational session for the
Carers Association.
Dr. Aideen Freyne together with Antoinette Copley for the department is currently designing a database with
the assistance of the Health Research Board. The database aims to capture all the statistical information that
the department currently provides through manual data collection systems, onto one central database. This
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Department of Old Age Psychiatry
will facilitate the provision of statistics for the Mental Health Commission and the HSE and should provide
useful statistics for service related mental health research. The database should be operational by April 06.
The Senior Registrar set up a Lithium Clinic. All patients who attend the Old Age Psychiatry service and who
are prescribed lithium are monitored by the clinic every 3 months. A key feature of the service is the close
follow-up of all patients on lithium by their community mental health nurse to ensure that those who cannot
physically attend the clinic have the appropriate investigations carried out under the supervision of the Senior
Registrar.
Significant Achievements
Catherine Keogh completed and was awarded a Masters of Science in Occupational Therapy. As part of her
thesis she carried out research in the catchment area on “Nursing home staff's perceptions of the factors
influencing the implementation of person-centred care in nursing homes”. She also gave a presentation on
“Occupational Therapy and Dementia Care” at the 15th Alzheimer Europe conference held in Killarney, 2005.
Antoinette Copley was awarded a BA degree in Psychology from Open University.
Dr. Cooney was an invited speaker at the annual meeting of the Irish Gerontology Society September 2005
and the Winter Meeting of the Irish College of Psychiatrists November 2005 and on “Abuse of the elderly
with dementia by carers”. In addition he continued to chair the Accreditation Group in Psychiatry, Old Age
Psychiatry, Medicine for the Elderly and Neurology.
Dr. Aoife Ni Chorcorain, Registrar in Old Age Psychiatry, presented a poster on “Psychotropic Medication in
Delirium” at the winter meeting of the Irish College of Psychiatrists.
Dr. Leona Judge attended special interest sessions in the Department of Medicine for the Elderly and
obtained the Diploma in Geriatric Medicine.
Publications
Freyne A. Neuropsychiatric complications of steroids in older people.
Ir J Psych Med. 2005; 22(1): 22-25
Freyne A, Fahy S, McAleer A, Keogh F, Wrigley M.
A longitudinal study of depression in old age I: outcome and relationship to social networks.
Ir J Psychol Med 2005; 22: 87-93.
Hally O, Cooney C. Delirium in the hospitalised elderly: An audit of NCHD prescribing practice.
Ir J Psych Med 2005; 22(4): 133-136.
Cooney C. Diogenes syndrome - a review. Irish Psychiatrist. 2005; 6(1):19-22.
Keogh C. Nursing homes and person centred care.
Oasis (Alzheimer's Society of Ireland). 2005; December.
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Review 2005
Department of Radiology
Management Team
Clinical Director of Radiology:
Radiography Service Manager:
Clerical Supervisor Grade VI Officer:
Clinical Nurse Manager II:
Dr Stephen Skehan
Sharon Simpson
Helen O'Reilly
Sara Nicholson
Staff
Radiology
Dr James Masterson retired at the end of June after more than 30 years service in the department. Dr
Masterson's outstanding career included election as Dean of the Faculty of Radiologists and as President of
the IHCA. He will be greatly missed in the department and we wish him well in his retirement.
Dr David Brophy took up a new post as a Consultant Radiologist with a special interest in vascular
interventional radiology. Dr Brophy has already expanded the range of procedures performed, including such
procedures as carotid stenting and uterine fibroid embolisation.
Dr Tarek Sinan and Dr Jean Doyle both worked as locum consultants during 2005.
Drs Ronan Ryan, Simon Walsh and Rowland Okello joined the department in 2005. Dr Okello, from Kenya,
is the second recipient of a scholarship donated by the family of the late Dara O'Halpin-Linders, a radiologist
who trained in St Vincent's University Hospital.
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Department of Radiology
Radiography
The following Radiographers joined us during 2005:
Adrienne Heffernan Hilda Msango Joanne Collins Sharon Conaghan
Teresa Mearon Thomas Dodd Joanne O'Sullivan
The following Radiographers left the Radiology Department in 2005:
Catherina Boyle Dominic Gormley Claire O'Donnell Sarah Cullen
Liam Chawke Lynette Idas Mary Hinch Lorna McEntee
It is with great sadness that we record the passing of Deirdre Scott-Hayward (ex-RSM) in July 2005. Deirdre
will be sadly missed by her numerous colleagues within SVUH and throughout Ireland and the UK. A
memorial service was held in Deirdre's honour in the Hospital Chapel at which her colleagues both past and
present spoke in her honour.
Nursing
S/N Rivera completed a Radiation Protection study day.
We welcomed the following new staff nurses who joined the team in 2005:
S/N Lucile Rivera S/N Preethy Thomas S/N Smitha Sukumaran
S/N Molly Arackaparambjl
We said goodbye and thank you to the nurses who left in 2005:
S/N Alex Ong S/N Mira Sta Ana S/N Loida Macalinao
Clerical
Debbie Connolly and Antoinette Copley (Grade IV job sharers) transferred to Medical Records in February and
March respectively. Mary Peare was appointed to this position in April.
We welcomed back Donna Pili from Maternity Leave in April.
Ismay Crowley, Grade IV Officer (Out-Patient Clinics), resigned in June and Anne Marie Leahy was appointed
to this post in September.
Anne Sharkey was appointed to the permanent position of Grade IV Symptomatic Breast in July.
Louisa Murphy was appointed to the new position Grade V “RIS Housekeeper” to manage the data on the
existing RIS in order to prepare, manage and update the existing RIS database in advance of data migration
to the new RIS/PACS.
Dorothy Murray replaced Louisa Murphy as Grade IV Officer (A&E and In-Patient Services) in December
Ancillary Staff
The Radiology Aides have continued to contribute significantly in the workflow of the Radiology Department.
Their rota ensures that an aide is present to assist a radiographer 24 hours a day.
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Department of Radiology
Service Developments/Activities
New Development
The focus of the department in 2005 was on equipping of the new building, which was handed over by the
builders in 2005. Tenders underwent detailed evaluation with multiple visits to other hospitals by a team from
Radiology, Hospital Administration, ICT and Medical Physics to enable informed decisions to be made
regarding equipment purchase for the new Radiology Department. Installation of equipment began in
October 2005 with a target date for opening in early 2006.
New Technology
A steep learning curve was faced late in 2005 with the introduction of the first three direct digital X-Ray
systems and a 64-slice CT in the ground floor of the new building. Training on the new equipment proved to
be a lengthy process but one which the radiographers took on with eagerness.
Significant Achievements
Administrative and Academic achievements by Consultant Radiologists in 2005
Dr Skehan became President of the Irish Nuclear Medicine Association.
Dr O' Laoide continued as Chairman of the Medical Board. Dr Gibney continued as Chief Examiner for the
Final FFR(RCSI) examination.
Dr. Dermot Malone was appointed as interim Academic Lead Between UCD and SVUH, with many
important new initiatives including a rejuvenation of undergraduate radiology teaching with the assistance of
Honorary Lecturers, Dr Eric Heffernan and Dr Amjad Iqbal. Dr Malone was appointed Editor of a series on
Evidence-Based Practice in Radiology (11 articles to be published 2006-2007).
Drs O Laoide and Malone both continued to serve on the Board of the Faculty of Radiologists, RCSI.
Specialist Registrar achievements
Dr Lorna Browne and Dr Colm McMahon obtained the FFRRCSI. Dr Susannah Harte and Dr Ronan Killeen
were successful in the primary examination for the Fellowship.
Selected Publications
O'Mahony M, Skehan S, Gallagher C.
Percutaneous stenting of the superior vena cava syndrome in a patient with cystic fibrosis.
Ir Med J 2005;98(3):85-6.
Collins CD. The sentinel node in breast cancer: an update. Cancer Imaging 2005;5 Suppl:S3-9
Staunton M, Dodd JD, McCormick PA, Malone DE.
Finding evidence-based answers to practical questions in radiology: which patients with inoperable
hepatocellular carcinoma will survive longer after transarterial chemoembolization?
Radiology 2005;237(2):404-13
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Department of Radiology
Staunton M, Malone DE.
Can diagnostic imaging reliably predict the need for surgery in small bowel obstruction? Critically appraised
topic. Can Assoc Radiol J 2005;56(2):79-81
Collins CD. Problems monitoring response in multiple myeloma. Cancer Imaging 2005;5 Suppl:S119-26
Conferences
All of the major national and international radiology conferences were attended and presentations, such as
the following, were made at several of these.
Double Contrast MRI of focal lesions in the cirrhotic and non-cirrhotic liver: A problem-solving technique.
Sheehan JJ, Harte SE, McKenna C, Malone DE. Presented in the ECR 2005 electronic (EPOS) poster
exhibition.
Departmental Statistics
Statistics for the Radiology Department for 2005 are as follows:
Statistics 2005
In-patients 35616
Out-patients 34147
Emergency Department 30658
General Practitioner 12048
Other 10870
Total 123,339
This reflects an increase of approximately 3.3% on the figures from 2004.
Future Developments
2005 saw the plans for the new Radiology Department begin to become a reality. Installation, commissioning
and implementation of new equipment began in August. This will continue up to the 'go live' date of
Radiology set for early 2006.
The commitment to further education of Radiographers, Radiologists and Nursing staff within the department
will continue, to ensure that the Radiology Department will be in a prime position to offer the best possible
service to the community.
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Review 2005
Department of Respiratory Medicine
Consultant Staff
Prof. W. McNicholas and Dr. T. McDonnell.
Service Developments/Activities
A dedicated 6-bed acute Non-Invasive Ventilation (NIV) unit was developed in St. John's Ward to provide
expert medical and nursing care for patients in acute respiratory failure requiring assisted ventilation.
The Chronic Obstructive Pulmonary Disease (C.O.P.D.) Unit in St. Michael's Hospital continues to accept
patients directly from the Emergency Department of St. Vincent's University Hospital when appropriate.
Some difficulties in providing this service have been noted over the past year due to increasing pressure and
utilisation of beds in St. Michael's Hospital. A nurse led C.O.P.D. clinic has been initiated in St. Michael's by
Ms. Mary Frances O'Driscoll, Respiratory Nurse Specialist, in conjunction with the regular respiratory
outpatient session in St. Michael's Hospital.
Prof. McNicholas completed a 3-year term as President of the European Respiratory Society. He was also
appointed Vice-Chair in 2005 of an EU-funded Concerted Action on sleep apnoea which includes experts from
15 European countries. He gave invited lectures at many international conferences including the European
Respiratory Society (Copenhagen, Denmark), American College of Chest Physicians (Montreal, Canada) and
Asia Pacific Society of Respirology (Guangzhou, China). He was also awarded a project grant by the HRB to
investigate cell and molecular mechanisms of cardiovascular disease in obstructive sleep apnoea.
Statistics for 2005
SVUH SMH
Admissions: 410 442
Discharges: 377 418
Daycare admissions: 53 31
Outpatient Clinics (SVUH)
New Patients Returns Total
Prof. McNicholas (Respiratory) 335 977 1312
Prof. McNicholas (Satellite Sleep) 1 309 310
Dr. McDonnell 81 394 475
Total 417 1680 2097
Outpatient Clinics (SMH) 181 684 865
Pulmonary Rehabilitation (SMH) 70 1915 1985
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Department of Respiratory Medicine
Pulmonary Function Laboratory
SVUH SMH
Total Patients 3122 519
Total Tests 6101 1157
Sleep Disorders Unit (SVUH)
Sleep Studies 496
CPAP initiations 170
The Pulmonary Function Unit continues to accept student placements from the degree course in clinical
measurement at DIT. Lynda Hayes graduated with BSc Hons in this course during 2005; Geraldine Nolan was
awarded the MPhil in Physics, also from DIT and both Paul Byrne and Jeanette Lane graduated from the parttime
course at DIT. Courses attended by various staff of the Unit: ITS, ERS and an ATS course in London.
Members of the Sleep Disorders Unit played a prominent role in the formation of the Irish Sleep Society,
whose objective is to promote and support the specialty of sleep disorders in Ireland. Prof. McNicholas was
elected President and Geraldine Nolan, as Secretary.
Respiratory Education Centre
Consultations 2005: 1650
The Respiratory Nurse Specialists were closely involved in preparing for the opening of the new acute NIV
Unit in St. John's Ward, particularly in the delivery of an educational programme for nursing staff and the
development of an operational policy document for the new unit.
Selected Full Paper Publications
Doherty LS, Nolan P, McNicholas WT.
Effects of topical anesthesia on upper airway resistance during wake-sleep transitions.
Journal of Applied Physiology 2005; 99:549-555 (e-pub March 24, 2005). PMID: 15790683
Ryan S, Taylor CT, McNicholas WT.
Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnoea
syndrome.
Circulation. 2005; 112(17): 2660-7. PMID: 16246965.
Doherty LS, Kiely JL Swan V, McNicholas WT.
Long-term effects of nasal CPAP therapy on cardiovascular outcomes in the sleep apnoea syndrome.
CHEST 2005; 127(6): 2076-84. PMID: 15947323.
Martial FP, Dunleavy M, Nolan P, McNicholas WT, O'Regan RG, Bradford
A. Simultaneous recording of breathing and respiratory related neuronal activity in the brainstem of
conscious rats. Respir Physiol Neurobiol. 2005; 145(2-3): 301-6. PMID: 15705544
McNicholas WT. Sleep apnea in adults. IN:
Encyclopedia of Respiratory Medicine. Editors: Geoffrey Laurent and Steven Shapiro. Elsevier 2005.
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Review 2005
Department of Rheumatology
Staff
Consultant Staff: Professor Barry Bresnihan Professor Oliver FitzGerald Dr Douglas Veale
Senior Scientist:
Specialist Registrar:
Registrar:
Dr Ursula Fearon
Dr Chin Teck Ng
Dr Eliza Pontifex
Research Staff: Dr Waleed Al-Shehhi Ms Mary Connolly Dr Adrian Gibbs
Ms Felicitas Froelich-Grimm Ms Martina Gogarty Ms Laura Greenan
Ms Aisling Kennedy
Ms Jennifer McCormick
Mr Keith McQuillan Dr Julia Martin Mr Gerard Moloney
Ms Ellen Moran Dr Ronan Mullan Ms Marie O'Rourke
Dr Bea Radovits
Dr Catherine Sweeney
Dr Ceara Walsh
Ms Connie Walsh
Advanced Nurse Practitioner: Ms Patricia Minnock
Clinical Nurse Manager:
Ms Catherine Slattery
Clinical Nurse Specialists: Ms Alexia Grier Ms Miriam Molloy Ms Louise Moore
Ms Madeleine O'Neill Ms Karen Reid Ms Susan van der Kamp
Staff Nurses: Ms Imelda Cormican Ms Deirdre Kelly Ms Marie Magner-Ryan
Ms Eileen O'Flynn Ms Rachel Varghese
Hospital Care Assistant:
Ms Cara Drumgoole
Secretarial Staff: Ms Louise Byrne Ms Yvette Collins Ms Eithne D'Arcy
Ms Anne Duff Ms Jeanine Fagan Ms Patricia Garvey
Ms Dympna Mc Gann Ms Katie Murphy Ms Chris Walsh
Ms Mary White
Service Developments/Activities
The existing Biologics Clinic has expanded to 3 clinics weekly supported by the medical and nursing staff.
The development of a musculoskeletal ultrasound service proceeded. The Rheumatology Team was at the
forefront of the accreditation process for the Bone and Joint Unit/Pain & Rehabilitation. Further integration of
rheumatology services across the 2 sites, St Vincent's University Hospital and Rheumatology Rehabilitation,
Harold's Cross has continued. Preparations are in hand for the move to expanded Bone & Joint Unit in the
main hospital in early 2006 with development of multidisciplinary patient care pathways for back pain, early
arthritis, urgent rheumatology problems and low trauma fracture assessment.
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Department of Rheumatology
Departmental Statistics
There were 419 acute medical admissions to St Vincent's University Hospital. In addition, 812 patients were
admitted for evaluation and treatment to the Rheumatology Rehabilitation Unit, Harold's Cross. A total of
5775 patients were seen in the Rheumatology clinics at SVUH, including the Early Arthritis (462), Juvenile
Arthritis Clinic (44), the Biologic Clinic (545) and Rheumatoid Arthritis Clinics (4724). In total there were 869
new referrals.
Significant Achievements
Professor Bresnihan was an invited speaker at the Advances in Targeted Therapies Meeting and the BA
Festival of Science in Dublin. In May, he was invited to speak in Australia on anakinra by Amgen. He was
also an invited speaker at the Latin American MabThera Event in Guatemala and the Chilean Rheumatology
Congress. Professor Bresnihan continues to co-chair the European Synovitis Study Group. He is chairman
of the Subcommittee for Academic Support, Arthritis Research Campaign (UK) and of Arthritis Ireland and a
member of the Oliver Bird Programme Section Committee. Professor Bresnihan continues to serve on the
Editorial Board for the Journal of Rheumatology, Annals of the Rheumatic Diseases, Joint Bone and Spine
and Bailliere's Clinical Rheumatology.
Professor FitzGerald was guest lecturer at the Welsh Society for Rheumatology and at the EULAR AGM in
Vienna in June. He was an international speaker at Abbott/Wyeth sponsored meetings in Marrakech, Vienna,
Dublin and London. He attended the Irish Society for Immunology as a keynote speaker. Professor FitzGerald
is a Council Member for Arthritis Ireland and a member of the Editorial Board of Rheumatology and of Current
Rheumatology.
Dr Veale was an invited speaker at the University of Zurich, the combined Irish/ Scottish Societies for
Rheumatology and the American College of Rheumatology Annual Meeting. Dr Veale is the Clinical Research
Director (Rheumatology), National Speciality Director (Rheumatology), Chairman SVHG Ethics and Medical
Research Committee, Medical Director Department of Rheumatology at Our Lady's Hospice, and Chairman
of Arthritis Action Ireland.
Prizes
ISR Best Oral presentation: Awarded to Dr Ronan Mullan, Research Fellow, at the ISR AGM in October 2005.
Ronan won the prize for 'Acute-phase serum amyloid A stimulation of angiogenesis, leukocyte recruitment
and matrix degradation in rheumatoid arthritis through an NF-kappaB-dependent signal transduction pathway.'
The ISR Ely Lilly Bursary was awarded to Dr Adrian Gibbs, Specialist Registrar at the ISR AGM in October.
Adrian won the bursary for his proposed study entitled 'Comparison on bone mineral density measurements,
bone and cartilage biomarkers in rheumatoid and psoriatic patients receiving biological therapy'.
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Department of Rheumatology
Significant Publications
Kee F, Sheehy N, O'Hare L, Bane C, Bell A, Dempster M, FitzGerald O.
Rheumatologists' judgements about the efficacy of anti-TNF therapy in two neighbouring regions.
Rheumatology (Oxford). 2005 Nov;44(11):1407-13.
Benito MJ, Veale DJ, FitzGerald O, van den Berg WB, Bresnihan B.
Synovial tissue inflammation in early and late osteoarthritis.
Ann Rheum Dis. 2005 Sep;64(9):1263-7.
Smith MD, Baeten D, Ulfgren AK, McInnes IB, Fitzgerald O, Bresnihan B, Tak PP, Veale D; OMERACT synovial
special interests group.
Standardisation of synovial tissue infiltrate analysis: how far have we come? How much further do we need
to go?
Ann Rheum Dis. Epub 2005 June 23.
Ralph JA, McEvoy AN, Kane D, Bresnihan B, FitzGerald O, Murphy EP.
Modulation of orphan nuclear receptor NURR1 expression by methotrexate in human inflammatory joint
disease involves adenosine A2A receptor-mediated responses.
J Immunol. 2005 Jul 1;175(1):555-65.
Manzo A, Paoletti S, Carulli M, Blades MC, Barone F, Yanni G, Fitzgerald O, Bresnihan B, Caporali R,
Montecucco C, Uguccioni M, Pitzalis C.
Systematic microanatomical analysis of CXCL13 and CCL21 in situ production and progressive lymphoid
organization in rheumatoid synovitis.
Eur J Immunol. 2005 May;35(5):1347-59.
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Surgical Professorial Unit
Staff
Consultants:
Senior Registrars:
Special & College Adjunct Professors:
College Lecturers:
Special Lecturers:
Registrar in Breast Diseases:
Research Fellows:
Professor N. O'Higgins, Mr. J.J. Murphy
Mr. E.W. M. McDermott, Mr A.D.K. Hill
Mr R. Mascarenhas
Mr M. O'Sullivan, Ms Louise Kelly
Professor M J Duffy
Dr P. P. A. Smyth, Dr. Leonie Young
Mr. Steve Richards, Ms Usha Shan
Mr. Athar Sheikh
Dr Claire Davidson, Dr Mary Dillon,
Dr Dhafir Alazawi
Clinical Research Associate:
Ms Trudy Roche
Clinical Nurse Manager:
Ms Gillian Webster
Advanced Nurse Practitioner:
Sr Mary Murray
Clinical Nurse Specialists in Breast Care: Ms Marina Nolan, Ms Gillian O'Donnell
Breast Cancer Co-ordinator:
Senior Executive Assistant:
Executive Assistant:
Senior Laboratory Technician:
Ms Catherine Masterson
Ms Aine Bergin
Ms Elaine O'Sullivan
Mr Dermot Carty
New Academic Structure
Sweeping organisational and administrative changes in University College Dublin have seen the introduction
of five Colleges and thirty five schools replacing the faculty structure of the past. The College of Life Sciences
includes the School of Medicine and Medical Science, the School of Nursing, Midwifery and Health Systems,
the School of Public Health and Population Science, the School of Physiotherapy and Performance Science
and the School of Biomolecular and Biomedical Science. Each of the schools has a Head of School replacing
the system of Deans. Changes are occurring with the methods of organisation and delivery of the medical
school curriculum with the advent of modularisation. Additionally, the biomedical research programmes of
the University are now co-ordinated in the Conway Research Institute and much of the basic research carried
out in the University Department of Surgery at SVUH in now taking place in the Conway Institute.
Undoubtedly, such a concentration of scientific expertise will facilitate the development of all research
programmes.
Service Developments/Activities
Professor O'Higgins was appointed by the Minister for Health and Children to be chairman of the National
Quality Assurance Group for Symptomatic Breast Disease Services with a remit to provide advice and
guidance on the Performance Indicators required in Specialist Breast Units in the Country. He was named
to receive the Honorary Fellowship of the American College of Surgeons and is to be awarded the President's
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Surgical Professorial Unit
Medal from the Royal College of Surgeons of Edinburgh. He continues as President of the Royal College of
Surgeons in Ireland. Professor O'Higgins and Professor T J McKenna (President of the Royal College of
Physicians of Ireland) were awarded the Honorary Fellowship of the College of Medicine of South Africa in
Cape Town in October 2005.
Mr A D Hill was appointed Professor of Surgery at the Royal College of Surgeons in Ireland. He has
contributed greatly to the success of the Department of Surgery at SVUH both in clinical activity and in
research. In addition, as the Lead Surgeon of the Breast Check programme in the hospital he has been highly
effective and we wish him continued success in his new and important position.
Professor Joe Duffy continued to act as Chairman of the National Academy of Clinical Biochemistry (USA)
Panel for the preparation of new guidelines on the Clinical Use of Tumor Markers in Breast Cancer. During
2005, Professor Duffy was also appointed Focus Group Leader of the Gastrointestinal Group of the European
Group on Tumor Markers (EGTM). EGTM is a European Expert group involved in preparing guidelines on the
use of tumor markers. He was invited speaker at the following International Conferences:-
• 16th IFCC/FESCC European Congress of Clinical Chemistry and Laboratory Medicine:
Glasgow, Proteseases as Markers for the Formation of Metastasis
• XIX International Congress of Clinical Chemistry: Orlando, National Academy of Clinical Chemistry
Guidelines for Clinical Use of Tumor Markers in Breast Cancer
• ISOBM Meeting, Rhodes, Secretoglobins: potential markers for breast cancer.
• Strategic Consensus Conference on Biomarker Research in Breast Cancer, Philadelphia
We were very pleased to welcome Mr. Des Winter as consultant surgeon to the hospital Mr. Winter has a
special interest in Colorectal diseases and has just spent a period of time at the Department of Surgery at
the renowned Mayo Clinic.
Mr Richard Mascarenhas was appointed consultant surgeon at The Cavan-Monaghan Hospital Group and
has taken up his duties there.
We were pleased to welcome Mr Martin O'Sullivan and Ms Louise Kelly as Specialist Registrars in Surgery
and Dr Myles Smyth and Dr Diarmuid O Malley as Surgical Lecturers.
The National Breast Screening Programme, BreastCheck continues to provide an outstanding service and the
object measurements of quality, which have been established internationally, have been surpassed in this
programme. Great credit is due to the team of clinicians, radiologists, pathologists and, nurses and
administrative staff who deserve great credit and thanks for running this successful programme in such an
outstanding fashion.
The Symptomatic Breast Clinic at SVUH continues to develop and, being the first breast clinic ever to be
established in the country, is providing a leadership role in the development of the much-needed Specialist
Breast Units in the Country.
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Surgical Professorial Unit
Significant Publications
The following are representatives of the twenty publications in peer-reviewed journals produced by the
department during the year.
Dillon MF, Hill AD, Quinn CM, O'Doherty A, McDermott EW, O'Higgins N.
The accuracy of ultrasound, stereotactic, and clinical core biopsies in the diagnosis of breast cancer, with
an analysis of false-negative cases.
Ann Surg. 2005 Nov;242(5): 701-7
Myers E, Hill AD, Kelly G, McDermott EW, O'Higgins NJ, Buggy Y, Young LS
Associations and interactions between Ets-1 and Ets-2 and coregulatory proteins, SRC-1, AIB1, NCoR in
breast cancer.
Clin Cancer Res. 2005 Mar 15; 11(6): 2111-22
Ryan B, O'Donovan N, Browne B, O'Shea C, Crown J, Hill AD, McDermott E, O'Higgins N, Duffy MJ
Expression of survivin and its splice variants survivin-2B and survivin-deltaEx3 in breast cancer
Br J Cancer. 2005 Jan 17;92(1): 120-4
O'Brien N. O'Donovan N, Ryan B, Hill ADK, McDermott E, O'Higgins N, Duffy MJ.
Mammoglobin in breast cancer: existence of multiple molecular forms. Int J Cancer 2005 2005; 114:623
Kelly LM, Buggy Y, Hill A, O'Donovan N, Duggan C, McDermott EW, O'Higgins NJ, Young L, Duffy MJ.
Expression of the breast cancer metastasis suppressor gene, BRMSI, in human breast carcinoma: lack of
correlation with metastasis to axillary lymph nodes.
Tumour Biol.2005 Jul-Aug; 26(4): 213-6. Epub 2005 Jul 6.
Professor T J McKenna and Professor Niall O' Higgins
after their conferring as Honorary Fellows of the
Colleges of Medicine of South Africa.
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Surgical Professorial Unit
Departmental Statistics
Professor N. O'Higgins, Mr. JJ Murphy, Mr.McDermott, Mr. Hill, Mr. Evoy
Admissions
7 Day 5 Day A/E Other Urgent Sub-total Day Care Total
207 62 735 82 1086 1,161 2,247
Discharges (excluding Day Care)
Total 1,083
Outpatients Department
Total
Sessions 203
New Patients 3,046
Return Patients 7,632
Grand Total 10,678
Breast Clinics
Sessions New Return Total
Patients Patients
General Breast Care Clinic 53 1,788 2,020 3,808
Triple Assessment Clinic 50 497 179 676
Follow-up Breast Care Clinic 51 117 1,834 1,951
Grand Total 154 2,402 4,033 6,435
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183
Department of Urology
Staffing
Consultants:
Mr David Quinlan, Mr David Mulvin, Mr Gerald Lennon
Senior Registrars: Richard Power and Frank O'Brien (from 01/07/04)
Registrars: Michael Floyd and Catherine Dowling (from 01/07/04)
Senior House Officers: Helen Stunnell (from 1/01/05), Chin Hong Lim (from 1/7/04)
Interns:
Clinical Nurse Manager 2:
Clinical Nurse Manager 2:
Clinical Nurse Manager 1:
Clinical Nurse Manager Theatre:
Urology Cancer Nurse Coordinator:
Judith Lyons, Aoibhlinn O'Toole, Carol Traynor, Emily Monks,
Edel McDermott, Lisa Smyth, Colin McCarthy, Paul Carroll
Ms Louise Hederman (St Charles’)
Ms Mary Nevin (St Charles')
Ms Denise Murray (St Charles')
Ms Linda Mullen, Ms Breda O'Donoghue
Angela Kissane, Lisa Cullen
Urodynamics/Urology Nurse Practitioner: Siobhan Gardner
Inpatient Clinical Coordinator:
St Charles Ward Secretary:
Urology Secretaries:
Nuala Kennedy
Adelah O'Brien
Fiona Whelan, Kirsty Whaley
Service Developments/Activities
The single most important event in 2005 was the early retirement of Sister Louise Hederman, Ward Sister
on St Charles' Ward. The entire hospital would agree that she was a most outstanding Ward Sister, leader in
clinical nursing, a great colleague and a wonderful friend. Over three decades she has been Ward Sister in
the Neurosurgical Unit in St Teresa's ward (until its transfer to Beaumont Hospital), the Surgical Five Day Ward
in St Catherine's and, finally, Ward Sister for Urology and Gynaecology in St Charles' Ward. The innovations
that have occurred in St Charles's Ward and in Urology in general are in no small part attributable to her
valuable input, insight and perseverance. Her kindness and interest in others was her trademark and because
of this she was revered by her patients, her nurses, her NCHDs and her consultants. Indeed, consultants
from other disciplines envied the fact that St Charles was not their ward and Sr Hederman was not their Ward
Sister. As a result of her efforts, the level of Urological expertise in St Charles' ward is of the highest standard
and it is clear that her stamp will continue to be impregnated on the running of Urology in St Vincent's for
decades to come. She has been replaced by Sr Mary Nevin with Sr Denise Murray as Junior Ward Sister
who will no doubt not only continue this tradition of excellent nursing but develop it further it into the future.
The year 2005 otherwise remained a busy year for the Department of Urology. As in 2004 St Charles' Ward
continues to have a major throughput mainly due to its protection from admissions from other disciplines
from the 1st of March to the 31st of December. This permitted patients on Urological waiting lists, particularly
those with Urological malignancies, to be given a date for admission which in the majority of cases is
honoured. Indeed, there were 1,054 inpatient admissions in 2004 for urology through St Charles' Ward.
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Department of Urology
Many of these patients require complex urological surgery, reconstruction or other intervention for urological
cancers or urological complications of other malignancies (including gynaecological and colorectal
malignancies).
One day and five day activity remains vibrant. It must be remembered that the Department of Urology has
no dedicated 5 day beds on the campus of St Vincent's University Hospital (having relinquished St Kevin's
Ward for five day activity in 2000). Its five-day activity continues to occur off site in the Annexe of St
Michael's Hospital. One day activity occurs via St Mark's Ward, St Michaels Annexe and St Michael's theatre.
Total one day and five day activity for the department stands at 1,929 procedures.
Urodynamics remains very active with 817 procedures. As in previous years, male patients presenting for
the first time to the outpatients with lower urinary tract symptoms undergo a pre-assessment with Siobhan
Gardner consisting of urinalysis, renal profile, prostate specific antigen, symptoms score, uroflow and
estimation of post void residual. This provides for instant decision making at the patient's first consultation.
Complex urodynamics under the expert guidance of Mr Lennon continue for patients with incontinence and
difficult voiding problems. This has been a major advance for the department greatly improving the care of
this challenging group of patients.
Surgically 2005 has seen the further development of Laparoscopic Urology under the direction of Mr David
Mulvin. Laparoscopic nephrectomies and pyeloplasties are now an almost weekly occurrence with
improvements in hospital stay and early return to work for the patient. Mr Lennon has continued to expand
Urodynamics and Female Urology. Surgery for female incontinence remains strong with use of sling
procedures and transobturator tape procedures for stress incontinence and injection of botulinum toxin for
refractory detrusor instability.
Unfortunately, the Urology Nurse Diploma programme at University College, Dublin and St Vincent's
University Hospital which was well established in 2004 was not in a position to continue in 2005. This was
a significant disappointment as it is the only programme of its type in the country and a most coveted
development by the Department of Urology. It is hoped that it will be re-established in 2006.
Mr David Quinlan was elected to the Council of the British Association of Urological Surgeons in 2005 and
also became a Board Member of the British Journal of Urology International.
Departmental Statistics
During 2005 there were 9,631 patient presentations (calculated from presentation to outpatients, admissions
{includes theatre}, urodynamics and inpatient consults) which included:
• Outpatients: A total of 4,716 out patients were seen by the Urology Department. Three Urological
outpatients occur per week on the St Vincent's campus with 3,954 outpatient attendances. Of these 971
were new patient attendances. There were 762 outpatient attendances in St Michael's Hospital seen in
one weekly outpatients of which 224 were new patient attendances.
• Admissions: Total admissions were 3,177 patients. There were 2,116 admissions in the year 2005 on the
St Vincent's Campus with an additional 450 in St Michael's Hospital and 611 daycare and 5-day patients
through the St Michael's Annexe.
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• Theatre: Surgical procedures totaled 3,250 with 1,784 surgical procedures performed on the St Vincent's
Campus, 450 performed at St Michael's Hospital and a further 611 procedures performed in the St
Michael's Annexe. It is important to note that 535 cases were performed in the extramural theatre…..this
level of activity will need to continue in the new theatre and outpatient building.
• Consults: 921 inpatient consultations in 2005.
• Urodynamics: There were 817 urodynamic procedures performed.
If one were to look at this activity per consultant sessional commitment, it can be seen that this is a very
busy department. A patient presentation can be an out patient visit or it could be a prolonged hospital stay
or a complex surgical procedure. SVUH Healthcare Group has 25 consultant sessions (Mr Mulvin 7 SVUH
and 4 St Michaels, Mr Quinlan 10 SVUH and 1 St Lukes and Mr Lennon 4 SVUH and 7 St Columcilles). If one
divided the 9,631 patient presentations to St Vincents Healthcare Group Urology by its 25 consultant
sessions, this equals 386.24 presentations per consultant session.
Looking at the budget for SVUH (not including St Michaels) this means that looking after 7,808 patient
presentations to St Vincents alone (not St Michaels) at a total cost for GU surgery of €2,905,800 equals
€372.16 per patient. Again, these presentations range from outpatient visits to prolonged hospitalizations for
complex urological procedures.
Teaching
For the urological trainees there is a major emphasis placed on teaching with academic conferences,
teaching in the operating room and research endeavours. Each day starts with an organised teaching session
with weekly conferences on:
• Research Conference and Journal Review (Monday 8:15am)
• Irish Society of Urology Teaching Conference (Monday 7:00pm)
• Uroradiology Conference (Tuesday 8:15am),
• Surgical Conference (Wednesday 8:15am),
• Uropathology Conference (Thursday 8:15am)
• Audit (Friday 8:15AM)
Monthly meetings occur as below
• Multi-Disciplinary Team Meeting (Monthly, Monday 8:15 AM)
• University College Dublin Urology Conference (Bi-Monthly on Thursdays 6:30PM between
Mater and Vincent's)
• Irish Society of Urology Clinical Case Conference (Monthly Wednesdays 7:00PM)
Ongoing Clinical Trials
• Casodex 150mg for non metastatic prostate cancer (Zeneca)
• Atrasentan for prostate cancer (Abbott)
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Department of Urology
Publications
Kavanagh DO, Fanning N, Heffernan E, Malone DE, Mulvin DM, Quinlan DM.:
Management of gestational nephrolithiasis in the presence of a bicornuate uterus and pelvic kidney.
Int J Urol. 2005 Feb;12(2):211-3.
Howe O, O'Malley K, Lavin M, Gardner RA, Seymour C, Lyng F, Mulvin D, Quinlan DM, Mothersill C.:
Cell death mechanisms associated with G2 radiosensitivity in patients with prostate cancer and benign
prostatic hyperplasia. Radiat Res. 2005 Nov;164(5):627-34.
Walsh CA, Quinlan DM.
Oncocytoma and synchronous urothelial carcinoma in same kidney: previously unreported association.
Urology. 2005 Jul;66(1):194.
Casey RG, Galvin D, Bouchier-Hayes D, Lennon G: Fractured penis: a clinical misnomer!
Ir J Med Sci. 2005 Jan-Mar;174(1):55-7.
Future Plans
The plans for 2006 will again focus around continued improvements in ward accommodation for inpatients,
particularly regarding privacy, shower and toilet facilities. This is an ongoing problem for the two specialties
affecting women and men (Gynaecology and Urology) where the highest levels of privacy, hygiene and
access to toilet and bathing/showering facilities are required.
Urology is greatly looking forward to its new outpatient setting and have been preparing for the last three
years for a seamless transition into the new Ambulatory Day Care Unit. Over that time frame Urology has
moved to timed appointments and improved pre-assessment. It is the Urological aim, that the facilities in
the new outpatient setting will facilitate the development of “one stop shops” for:
• Haematuria Clinics (with same day renal ultrasound and flexi-cystoscopy)
• Prostate Clinics (with same day urodynamics, PSA testing etc)
• Testis Clinics (with same day ultrasound to rule out testis cancer)
• Dysfunctional Voiding / Incontinence Clinics (with same day urodynamics and flexi-cystoscopy)
Information technology and secretarial infrastructures will need to be improved to provide a better interface
with both referring doctors and their patients. Secretarial support still remains an issue for development.
A fourth Urological Consultant has been applied for.
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Department of Vascular Surgery
Staff
Consultants: Denis Mehigan Stephen Sheehan Mary Barry
Senior Registrars: Eoghan Condon Daragh Moneley
Registrars: Mashood Ahmed Tariq Cheema
Senior House Officers: Tony Stafford Miriam Byrne
Interns: Catriona Ryan Claire Rock Elyce McGovern
Zac Johnson Audrey Diffely Sinead Feeney
Division Nurse Manager:
Maureen Flynn
Clinical Nurse Managers: Fionnuala McCusker Brid Murphy Mary Leamy
Theatre Sisters: Bernadette Farrell Carmel Kelly Annette Hughes
Plethysmographist:
Tissue Viability CNS:
Department Secretary:
Catherine Kelly
Deirdre Cornally
Lisa Naughton
The Vascular Surgery Unit at St. Vincent's University Hospital continues to be a busy surgical department with
good throughput of work despite restrictions imposed by bed shortages. The High Dependency Unit (HDU),
in particular, continues to be invaluable in improving throughput in the department and has reduced the
cancellation of moderate and major vascular surgical procedures.
Staff
The Unit is happy to welcome our new nursing colleague, Fionnuala McCusker (CNM2) to St. Joseph's Ward
and HDU. All nursing vacancies were filled during the year and we now have a waiting list of staff wishing
to transfer to St. Jospeh's Ward. In 2005 all staff in HDU were given the opportunity to complete the
Advanced Cardiac Life Support (ACLS) and Non-invasive Ventilation (NIV) training programmes. Three staff
nurses moved from HDU to ICU to complete the Higher Diploma in Critical Care Nursing, we wish them well
in their studies. Mary Leamy, successfully completed the Management Development programme for
CNM1s. Mary Leamy and Sandra Shea also completed the Infection Control Link Nurse programme and
Deridre Cornally completed a BSc in Nursing Management.
Some infrastructural changes were introduced - a storage room was created on the ward; and an onsite blood
gas analyser and new haemodynamic monitors were installed for the HDU. St. Josephs Ward / HDU were
very pleased to participate in the pilot of protected meal times and rest for inpatients. The team also
contributed to the pilot of nursing documentation for recording the care of short stay patients.
With the opening of the new hospital and improved imaging equipment we expect to be able to provide an
expanded endovascular service, a more comprehensive non-invasive vascular laboratory service and a fiveday
nurse-led leg ulcer and wound
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Department of Vascular Surgery
management clinic. The leg ulcer clinic is expected to make a big difference to the running of out-patient
clinics and allow for more speedy and efficient management of these patients. In 2005, 55 new patients with
leg ulcers were referred and a total of 526 out patient visits were related to management of leg ulcers.
Service Developments/Activity
Admissions 2005 2004 2003
Elective 221 227 245
7 day 217 216 191
5 day 4 11 54
Urgent/Emergency 206 228 197
Day Care 100 91 71
Total 527 546 513
Out Patient Attendances 2005 2004
Out patient sessions 120 117
New Patients528 625
Return Patients 2117 2335
Total 2645 2960
Operative Procedures 2005 2004 2003
Elective 276 316 222
Emergency 71 78 87
Total 347 394 309
Meetings attended by members of the department during the year were:
February 2005:
March 2005:
April 2005:
June 2005:
November 2005:
November 2005:
An Introduction to Laser Treatment of Varicose Veins, London
The Venous Forum, Brighton
Vascular and Endovascular Meeting, Charing Cross, London
Society of Vascular Surgery, Chicago
The Vascular Society of Great Britain and Ireland
Veith Vascular and Endovascular Meeting, New York
Mr. Denis Mehigan as co-ordinator of the Basic Surgical Training at St. Vincent's University Hospital and is
also a member of the Court of Examiners (FRCSI).
Mr. Stephen Sheehan is a Member of the Court of Examiners (FRCSI), is an instructor on the Basic Surgical
Skills Course and on the Advanced Trauma Life Support Course.
Ms. Mary Barry is Chairperson of the South East Dublin Division of Surgery, Secretary of the Basic Surgical
Training Committee, RCSI and a faculty member on the Care of the Critically Ill Surgical Patient (CCRISP)
Course.
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Department of Vascular Surgery
Academic Activity
Guest Lectures
The Occluded Graft. MC Barry
Charter Day Meeting, Royal College of Surgeons in Ireland, February 2005
Gender and Peripheral Vascular Disease. MC Barry
Irish Association of Cardiac Rehabilitation, Dublin, November 2005
Thesis
Public Awareness of Peripheral Arterial Disease
MSc in Nursing awarded to Mary Hayden, CNM ll, St. Vincent's Private Hospital
Presentations
Prospective implementation of a risk-adjusted audit in a vascular unit - a model for quality assurance.
Byrne J, Condon E, Mehigan D, Sheehan S, Barry MC.
Sylvester O'Halloran Meeting, Limerick, March 2005
An audit of inferior vena caval filters.
Ahmed M, Sheehan S, Mehigan D, Barry MC
Sir Peter Freyer Memorial Meeting, Galway, September 2005
The effect of peri-operative beta blockade on the pulmonary function of patients undergoing
major vascular surgery.
Kieran SM, Cahill RA, Sheehan SJ, Mehigan D, Barry MC
Society of Vascular Surgery, Chicago, June 2005
Academic award
Paradoxical Embolus causing upper limb ischaemia.
Murphy I, Moneley D, Diffley A, Barry MC.
Winner of the Case Report Competition, Royal Academy of Medicine December 2005
Published Papers
Malignant fibrous histiocytoma masquerading as a pseudoaneurysm of the profunda femoris.
Waterhouse DF, Cahill RA, Sheehan SJ.
Eur J Vasc Endovasc Surg 2005;30(3):267-9
Prediction of the exact degree of internal carotid artery stenosis using an artificial neural network based on
duplex velocity measurements.
Mofidi R, Powell TI, Brabazon A, Mehigan D, Sheehan SJ, MacErlaine DP,
Keaveny TV
Ann Vasc Surg 2005;Nov:19(6):829-37
Optimisation of peri-operative beta-blockade in patients undergoing operation for peripheral arterial disease.
Cahill RA, Kieran S, Brown I, Barry MC
Vascular Disease Management, Sept-Oct 2005:139-142
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Chaplaincy & Pastoral Care Department
Allied Health Professional and Support Services
Chaplaincy Department
The Chaplaincy Department like every other department within the hospital represents a very specific and
professional discipline. It works with other professional disciplines in providing an overall or holistic service
that is geared to total patient care and ministry to the family.
The Department is interdenominational in character and all members are professionally trained for their work.
The Department has two main functions:
• To provide pastoral & sacramental service to patients, their families and staff.
• To provide educational programmes for the 'In-Service Training' of student chaplains.
Staff
Since the last annual report, there have been changes in personnel. Sr. Fiona Corway was appointed in a
temporary capacity to the Chaplaincy team in December and will take up her position early in the new Year.
Sr. Fiona is a Religious Sister of Charity and trained for nursing in St. Vincent's University Hospital. After her
training Fiona worked as a staff nurse and later as a ward manager in the hospital. Fiona trained in C.P.E. at
the Regional Hospital in Cork and was accredited by the Healthcare Chaplaincy Board of Ireland. Fiona has
worked as a chaplain in Our Lady's Hospice, Harold's Cross, for the past nine years and is a welcome addition
to the Chaplaincy team.
Service Developments/Activities
When patients are admitted to hospital in need of healing for a physical or emotional illness, they often bring
with them other concerns that range over the psychological and spiritual dimensions of their lives. Being
aware of their many concerns the Chaplaincy Department responds at different levels:
• In the administration of the sacraments and in providing appropriate spiritual care and counselling
to patients.
• The need for this care is acutely felt at times of great anxiety such as major surgery and especially
terminal illness.
• Much time is spent with families of patients, supporting those shattered by the terminal illness
of those closest to them, and later in consoling the bereaved.
• The Chaplaincy Department continues to provide a twenty-four hour service in the hospital. The
team consists of three full time Roman Catholic priests, two part time priests, one Church of
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Chaplaincy & Pastoral Care Department
Ireland ordained Minister, one Lay Minister, and three Chaplains from the Religious Sisters of Charity.
The department is very fortunate to have over forty lay volunteers who serve as Ministers of
the Eucharist and assist in bringing the Blessed Sacrament to patients on a daily basis.
During the past year the chaplains attended to over seven hundred deaths and made 60-80 pre-operation
visits per week to patients who had requested a visit. Added to these were the informal visits made on
wards when time permitted.
Staff Support
The members of the Chaplaincy Department work closely with the other health care professionals and are
available to provide counselling and support to staff when the need arises.
Religious Services
The Chaplains provide liturgical services in the main hospital chapel, on the wards, and in the oratory during
Advent, Lent and on special occasions. One memorable occasion was the special Mass in February to
commemorate the World Day of the Sick. A large number of patients attended with the kind assistance of
many staff and volunteers. The Sacrament of the Sick was administered during a very prayerful and moving
liturgy.
Five Masses were held during the month of November for deceased patients. The next of kin and family
members of patients who died during the past year were invited and it gave bereaved families an opportunity
to come together and remember their loved ones in a 'Candle Ceremony of Remembrance'. There was a
very large attendance at the Masses and bereaved families were very appreciative of the support and
consolation they received. For many families, it was their first time back in the hospital since the death of
their loved one and they found it brought a sense of closure to their experience. Bereaved staff, and
deceased members of staff and their families were particularly remembered at a special Mass organised by
the Mission Effectiveness Committee on the Feast of St. Vincent De Paul in September.
Seminars
During the year, seminars on pastoral care were given to the student nurses, and was part of the in-service
training programme for overseas nurses and the induction programmes for new nurses, and for new
employees.
The chaplains attended the Annual Conferences of the National Association of Hospital Chaplains and of the
Dublin Diocesan Committee of Hospital Chaplains as well as other relevant study days.
Professional Bodies
At present, a member of our Chaplaincy Team sits on the Executive Committee of the Dublin Hospital
Chaplains' Association.
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Chaplaincy & Pastoral Care Department
Clinical Pastoral Education (C.P.E.)
The primary focus of the C.P.E. course is the spiritual needs of the patients. The course aims at enabling the
student develop a better understanding of patients' needs and how to respond to these. The participant's
personal ministry is enhanced through interpersonal group experience and other methods of reflection on
how one relates to patients (people in crisis). Attention to the participant's personal development and
supervision of the individual's pastoral work promotes a greater self-assurance and effectiveness in ministry.
Formal lectures focus on areas such as the theory of pastoral care, loss and bereavement and personal
development.
Participants are welcome from all religious denominations. While these courses were originally aimed at
providing practical pastoral training to clergy, seminarians, and members of religious orders, in recent years
there has been a growing interest in this area among lay people.
In January 2005 Fr. Joe Cahill retired from his duties as Director of Pastoral Care. Joe has been running the
CPE programme at St. Vincent's University Hospital since 1981 and has contributed to the training of
hundreds of hospital chaplains who are now working in hospitals all over Ireland and overseas. Joe is widely
respected as an incisive, skilful teacher of CPE and will be greatly missed by his colleagues in chaplaincy and
by the staff of the hospital. Joe graciously agreed to come out of retirement to supervise the CPE
programme in September and January while we await the appointment of a new CPE Director. We wish Joe
success and happiness in his retirement.
Sr. Dervilla O' Donnell (Supervisor in Training) shared leadership with Fr. Joe Cahill in directing the unit of CPE
from September to December.
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Information and Communication Technology
(ICT) Department
Allied Health Professional and Support Services
Staffing
Dermot Cullinan was confirmed Director of ICT. We were sorry to say goodbye to Nicola Newcombe and
Stephen Kelly two valued members of staff, but were also very pleased to welcome Trevor Flynn, John
Maguire and Aidan O' Sullivan to our team.
Service Developments/Activities
It was a busy year for the ICT department with the completion of existing projects and the commencement
of new projects. Our strategy in 2005 was to focus on consolidating our infrastructure, having made
significant progress we expect to have largely completed this initiative in 2006. We will then continue to
focus on building our application portfolio.
A number of projects were completed and some additional projects commenced in 2005:
In conjunction with a multidisciplinary team headed by Radiology we completed the procurement and
commenced the implementation of a Siemens Picture Archiving and Communications system and a
Radiology Information system (PACS/RIS). In essence this system will provide a film-less radiology solution.
We have procured a new Ascribe Pharmacy system. This system offers improved functionality to the
Pharmacy Department, has links to the Patient Administration and Finance System and will provide a platform
on which in the future we will build a ward prescribing solution.
We are implementing a Document Scanning system in the Emergency Department (ED). This will be live in
the first quarter of 2006. It will be used to scan emergency cards and their contents, associating the scanned
images with the patients ED system record.
Commissioning of New Development
Our level of involvement with the new building project has continued to grow. We have procured and
implemented a leading edge Cisco network. This network is fast, resilient, secure and scalable providing a
stable platform on which to build applications such as the PACS/RIS system. It is based on three core Cisco
Catalyst 6509 and forty-six edge cabinets with a mixture of Cisco Catalyst 3750's, 3650's and 3550's. This
gives us a core backbone of 10 gigabytes.
We have also procured a number of PCs and peripherals, which will be rolled out in line with the
commissioning programme. We are working closely with the project office on the procurement of a number
of clinical systems.
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Information and Communication Technology (ICT) Department
We have embarked on phase two of our Intranet and Website development. The Intranet improves
communications, allowing departments to share information, reduce and eliminate paper and provides
access to policies and procedures, manuals and forms online. The Intranet incorporates links to current
systems for enquiry, reporting and result reporting.
Nursing and Medical Administration: The Nursing Personnel system went live in 2005. It records information
about nurses, relating to their demographics, nursing registration, nurse contacts, external and internal career
history, education, staff development activities, research, membership, skills and some details relating to
leavers. A nurse-scheduling module will also be incorporated which will aid staff management and skill mix
on the wards. The scope of this system has been extended to include Personnel and Medical Administration,
which will go live in the first quarter of 2006.
We are supporting the implementation of the East Cost Area Regional Cancer System. This will be based in
St. Vincent's University Hospital Coast and will interface to a number of hospitals in the area such as the
National Maternity Hospital, St. Luke's Hospital and St. Columcille's Hospital.
We are replacing the current Occupational Health System with a bespoke development more tailored to the
departments' specific requirements. This system will be linked to the Wiztec HR system.
This year we continued to develop Management Information System (MIS) and Data Warehouse completing
the inpatients and outpatients modules and starting the addition of cardiology and the Emergency
Department Systems data. The MIS system draws and purifies information from clinical and non-clinical
systems into a single repository incorporating systems Integration tools, on line analytical processing (OLAP),
business intelligence software and desktop decision support. The system also contains a data-mining tool
capable of providing comprehensive reports and adhoc queries. The solution enables the hospital to maximise
the value of data already stored in our current IT systems, building an infrastructure that allows us to meet
the current and increasing demands for management and clinical information. It is now envisaged that it will
not only provide management and clinical reports, but will also help to support essential functions such as
clinical audit
We have carried out substantial upgrades of the PAS, Radiology and HIPE systems.
In 2005 we made a concerted effort to consolidate our infrastructure and enhance our security, below is a
list of our infrastructural and security projects:
The Exchange/Outlook e-mail system was implemented in order to improve internal and external
communications. The inclusion of a legal disclaimer on all out going e-mails helps to confirm their origin. With
e-mail security being of ultimate importance to St Vincent's Healthcare Group as a whole we have upgraded
SurfControl SMTP e-mail filtering system to include a Virtual Image Agent and a user interface called End User
Spam Management Tool. As identity theft is on the increase we will be continuing to ensure e-mail security,
we will be testing Digital Certificates and encryption tools.
In 2005 we continued to make a concerted effort to consolidate our infrastructure and enhance our security.
Below is a list of our infrastructural and security projects:
• Upgraded the network to a 10gb backbone with 1gb to the desktop
• Opening of a new custom built computer room
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Information and Communication Technology (ICT) Department
• SurfControl Enterprise Threat Shield
• SurfControl Virtual Image Agent
• SurfControl End User Spam Management
• IP structure rationalization with a new design incorporating DHCP
• Started installation of an Enterprise Storage Solution
• Full integrated St Michaels Hospital into our single group Domain Structure
• 100mb Microwave link between St Michaels and St Vincents
• EPolicy Orchestrator intrusion detection system
• Tendered for two Virtual Servers
• Tendered for a campus wide Wi-Fi solution
• Improved our backup strategy to include on line disk backup
• Improved our fibre infrastructure
• Continued our Server Consolidation programme
• Implemented Microsoft SMS which will facilitate remote application installation, security
and product updates and remote management of all PCs
• Have standardised PC operating system for simplified support
• Increased security throughout hospital
• Upgraded our Helpdesk System
• Installed Netilla Web Portal
• Carried out consolidation of databases
• Implemented Citrix Secure Gateway
• Included a legal disclaimer on all out going e-mails.
• Expanded communication mechanisms between hospitals
Future Developments
Our new purpose built Computer Room will come on stream in early 2006, this will allow us the capacity to
customise how we manage all computerised systems. We will have three dedicated Computer Rooms
including a Production Room, Disaster Recovery Room and a Backup/Security Room. With the delivery of
our new Enterprise Storage Solution and two Virtual Servers we will be starting the consolidation of all critical
systems. We will also be greatly improving our disaster recovery / business continuity solutions using these
new systems. With our new Backup/Security Room we can now ensure all systems are being backed up to
disk and tape library to ensure data degradation while improving restore times.
We will be upgrading and expanding our Citrix servers creating a full Citrix Farm for improved access with no
single point of failure. This will greatly improve the functionality and scope of what ICT can provide to St
Vincent's Healthcare Group.
We will be starting a Campus wide Wi-Fi Solution offering a secure method of access to critical systems on
the move. With this system we will also be able to offer patients access to the Internet.
We have greatly improved communication methods and connectivity between St. Vincent's University
Hospital and other hospitals in the past year. We will be continuing this with upgrading links to St Vincent's
Private Hospital (1gb Fibre), St Michael's Hospital (1gb Fibre) and Our Lady's Hospice (2mb). With the usage
of the eGovernment Interagency Link we have also connected to the National Maternity Hospital and St
Luke's Hospital for sharing of systems and data. We will be continuing this with more hospitals over the
coming 12 months.
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Library & Information Service
Allied Health Professional and Support Services
The Library & Information Service (LIS) facilitates all staff of the three hospitals in St Vincent's Healthcare
Group and all students from UCD who are resident in the hospitals.
Library and Information Services are located on two sites: at St Vincent's University Hospital, in the Education
& Research Centre (ERC); and at St Michael's Hospital, in the Annexe.
Staff
After four years of service, Greg Sheaf resigned from his post of Senior Library Assistant in October to take
up a professional post in Trinity College Library. John O'Grady joined the Library from Portering Services in
November and Anne Madden was recruited as Assistant Librarian to take up her post in January 2006.
Service Developments/Activities
Work continued on developing a library and information service across St Vincent's Healthcare Group. One
of the most challenging projects has been to establish the Heritage library management system on both
library sites. Late in the year a link was made between the Group and ERC's servers which will allow the
merge to go ahead and library staff are looking forward to “going live” in early 2006.
St Michael's Hospital (SMH)
In July 2005 Heritage was activated in SMH. Breda Bennett, Librarian, added 1374 item records, and 182
library members to Heritage by the end of 2005. Loans, reservations and overdues were operational. A
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Library & Information Service
number of surveys were carried out: on library users' needs; print journal subscriptions and electronic journal
subscriptions. The Financial Controller of St Michael's Hospital, Mr Ken Bale, joined the Group Library &
Information Services Committee and funding was provided for a number of projects including the installation
of new shelving, additional journal subscriptions and an annual budget for book purchases.
St Vincent's Private Hospital (SVPH)
Mr Peter Sheehan continued to represent the hospital on the Group Library & Information Services
Committee and donated €3000 for the development of electronic journal resources that will be made
available to all three hospitals in 2006.
Collection
Journals: SVUH Library subscribed to 117 journal titles in the areas of medicine, surgery, nursing and allied
health, at a cost of €56,000. This is joint funding by the Hospital and UCD. Over 60 titles were also received
on donation.
St. Michael's Hospital subscribed to 47 journal titles at a cost of €25,000. The library collection was
augmented by the relocation of some major journal titles, which until now were stored in the Reading Room.
A small number of titles were donated to the library.
Books: €9859.98 was spent on 149 new books for SVUH Library.
SMH Library purchased 52 new books in 2005 at a cost of €3560.
Electronic Resources
Through the UCD server SVUH Library had access to a number of databases including, Web of Science and
Medline. Over 15,000 journal titles are available through this server and other online resources for healthcare
staff includes Clinical Evidence, Books@Ovid and MD Consult.
In September, remote access to the UCD server, which had been available to consultants and staff involved
in training UCD students, was temporarily withdrawn. Negotiations got underway to restore access and it is
hoped to have this service back as early as possible in 2006.
The Library subscribed to three databases: CINAHL, PyscINFO and BNI Plus and provided online access to
60 of its journals. PubMed and the Cochrane Library continue to be freely available on the Internet.
A number of groups and individuals availed of the free tutorials provided by library staff on searching the
electronic databases at both sites.
SMH Library with the cooperation of SVUH and UCD was able to offer access to almost the same electronic
resources as in SVUH. The UCD resources were limited to those available off campus and provided access
to password holders only.
Interlibrary Loans
SVUH Library: 725 journal articles and books were requested from other libraries: 84 were from the British
Library; 392 were from Subito; and 249 from the network of Irish Healthcare Libraries (IHL). The Library
supplied 570 to other hospital libraries nationwide. The overall cost of ILLs for the year was €2,445.80.
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Library & Information Service
SMH Library requested 38 journal articles from various libraries. 28 were requested from members of the
IHL network and 10 from the British Library. SMH supplied 28 articles to other libraries during the year.
Library & Information Services Committee
The Committee met 6 times this year and was chaired by Professor Aongus Curran.
Significant Achievements
The long awaited second edition of Standards for Irish healthcare library and information services, which was
co-edited by Niamh Lucey, was finally published and launched by the Library Association of Ireland in
September. This important document is a blueprint for the development of library and information services
throughout Ireland over the coming years.
Staff attended the following conferences and training days:
Cochrane Collaboration in Ireland Conference - DCU
EAHIL Conference - Palermo, Sicily
Introduction to HTML training - St James's Hospital
Financial Management - Trinity College Dublin
Departmental Statistics
There were 22,562 visits to the Library in 2005.
Future Developments
The addition of a third staff member in SVUH Library has necessitated the redevelopment of the existing
Library space and provides an opportune moment to increase the complement of study spaces to
accommodate the growing number of library users, in particular undergraduate medical students. A full
refurbishment is planned for August 2006. The Library will close for that month.
With the creation of a second professional post in Vincent's comes a wonderful opportunity to expand the
provision of library and information services to the Group over the coming years. New services to be
developed will include: access to the Heritage catalogue for staff on all three sites; development of a
structured training programme on information literacy; development of electronic resource availability and
accessibility; and the launch of the Library's pages on the Group intranet.
The provision of an integrated library service in St. Michael's Hospital is moving slowly and quietly, but
positively forward. Half of the Inter Library Loan requests in 2005 came from consultants. Donations,
previously directed to the Reading Room, are now coming to the Library. Access to electronic resources is a
very important library service, and the cooperation of the two libraries in expanding access appears to be
much appreciated, especially by those people who rarely visit the library in person.
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Medical Physics and Clinical Engineering
Department
Allied Health Professional and Support Services
Staff
Chief Clinical Engineering Technician:
Principal Clinical Engineer:
Senior Clinical Engineering Technician:
Senior Clinical Engineer:
Senior Clinical Engineering Technician:
Senior Clinical Engineering Technician:
Principal Clinical Engineering Technician:
Senior Clinical Engineering:
Tom Smyth
Richard Bergin AEng AMIEI
Derek Farrell
Frank Kelly IEng.MIHEEM
John Harte
Aidan O'Connor
Declan Murray MSc
Stephen McGrath
Service Developments/Activities
• Actively participating in all aspects of project development, equipping, compiling comprehensive
equipment technical specifications
• Advising on and evaluating new equipment purchases
• Continuously updating information on EEC Directives
• Continuous liaison with health and safety including product alerts
• Quality control and compliance with international standards
• Project decommissioning programme
• John Harte developed valuable additions to the current database
International Meetings
T. Smyth: Clinical Engineering, a patient focused service, Stuttgart 2005
J. Harte, D. Farrell: Surgical enhancements from an equipment perspective Versailles 2005
J. Harte: Patient Monitoring, Edinburgh 2005
T. Smyth: Medica equipment meeting, Düsseldorf 2005
F. Kelly: EDTNA/ERCA Vienna 2005
Significant Achievements/Presentations
Declan Murray with project colleagues, developed an automated equipment tender adjudication model. This
has been used on the majority of project related tenders and approved by the Department of Health &
Children (DOH&C)
Aidan O'Connor introduced new safety procedures in the area of cardiology transoesophageal (TOE) and
defibrillator safety.
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Medical Physics and Clinical Engineering Department
Tom Smyth fully equipped and assisted in the successful opening of the new Pain Management Unit at St.
Michael's Hospital
Academic Achievements
In April of 2005 Richard Bergin was awarded the title of Associate Engineer with the Institution of Engineers
of Ireland.
In September 2005 Frank Kelly achieved the title of Associate Engineer with the Institution of Engineers of
Ireland.
Subsequently Tom Smyth is endeavouring for the title of Associate Engineer with Engineers Ireland.
Declan Murray is endeavouring for the title Full Member Chartered Engineer with Engineers Ireland.
John Harte has undertaken management studies with the National College of Ireland.
Publications
EDTNA/ERCA Vienna September 2005
“A prospective study of ambulatory blood pressure monitoring in the haemodialysis patient”.
Frank Kelly et. al.
Departmental Statistics
The department has continuously succeeded in producing considerable savings in equipment repairs and
planned preventative maintenance by adopting the policy of only outsourcing maintenance unless absolutely
necessary. The department continues with a full equipment management programme.
Future Plans
We have introduced a new I.T. solution to our method of equipment management. This will be fully in place
by the end of April and will also serve to greatly assist the task of equipping the new building.
Also an operational policy has been put in place for the establishment of an equipment library.
We will endeavour to maintain the current level of service within the new project.
Medical Physics
2005 was a challenging year for the Medical Physics Team. Although the staff compliment has remained
unchanged in 2005, the workload has considerably increased. While maintaining our routine service
commitments, staff members have been very much involved in the new project.
Routine service commitments include the provision of scientific support to the Radiology, Dermatology and
Pathology departments in SVUH and St. Michael's Hospital. These include the performance of quality
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Medical Physics and Clinical Engineering Department
assurance testing on all equipment and the provision of radiation protection advice. In addition to these duties
in Radionuclide Imaging, physics staff routinely perform image processing, laboratory tests and radionuclide
therapies. Physicists have been instrumental in setting up a new scanning protocol structure and
documentation system.
The department has been heavily involved in drawing up equipment specifications, and in both the tender
evaluation and equipment selection processes for new radiology equipment, as well as for radiopharmacy
and quality assurance equipment.
Acceptance testing was carried out for the new cardiovascular laboratory, the OEC C-arm and the 64 slice CT
scanner and three digital systems in the hospital's new Emergency Department. The new CR system and
Fluoroscopic system in St Michael's Hospital have also been tested. Associated with each installation, the
physics staff have been involved in licensing equipment with the Radiological Protection Institute of Ireland
(RPII), specifying and checking the integrity of the room's shielding and the drafting of radiation risk
assessments. All these tasks must be performed prior to equipment being used clinically.
During the year, staff participated in lecturing programmes in affiliated organisations such as UCD Physics
Department, UCD School of Diagnostic Imaging and the Faculty of Radiology of the Royal College of
Surgeons. Dr Michael Casey has acted as an external examiner for the Northern Irish Medical Physics
Training Scheme. Ms Elaine Tyner successfully undertook and completed her training modules in diagnostic
imaging and nuclear medicine in SVUH as part of the SVUH- St. Lukes Hospital Rathgar Joint Medical Physics
training scheme. Ms Eileen Seymour has been elected as the Irish Representative for the European Nuclear
Medicine Association Radiopharmacy subgroup.
Staff members are committed to professional development and appreciated the opportunity
to attend the following meetings:
British Nuclear Medicine Society Annual Meeting, Manchester
European Nuclear Medicine Association Annual Meeting, Istanbul
IPEM Optimisation Meeting of the tender process, London
KCARE DR and CR QC, London
KCARE Digital Imaging and Technology Study Day, London
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Review 2005
Medical Social Work Department
Allied Health Professional and Support Services
Staff
In the past year there have been a number of changes of personnel in the Department.
Firstly, Enara Etxebarria took up a 2 year locum for Mary O'Connell who is on leave of absence until 2007.
Kelle Mason resigned her post in August of 2005 to do childcare work and was replaced by Fiona Byrne
Cathy Neagh who was a part time Senior since January 2005 resigned a few months later in April.
Moira Campbell also resigned in January of this year after going on maternity leave in September 2005.
Ann Donohoe is currently the Locum Social Worker for the post since Moira left last autumn.
Ann Marie O'Boyle has been with the team since July 2005 when she started a part time position which
evolved in to a full time Locum Social Work position for Rita Delaney who is currently on maternity leave until
May 2006.
Martina Dolan is back with us since October 2005 after she went on maternity leave in April of the same year.
Fina Doyle was the Locum Social Worker for the post until she got a full time external position in September
2005.
Finally Victoria Richardson got a permanent position in Adult Psychiatry in June of 2005 and became Senior
Social Worker as the role was re graded.
On a sad note Kay Hennigan, the former Head of Social Work died in November 2005 after a long illness
borne bravely. She served from 1987 until 2002 and under her stewardship the Department grew from a few
to a team of 19 people.
Service Developments/Activities
The team undertook a one-day training in Solution Focused Therapy in May 2005 under the guidance of John
Sharry, a facilitator from the Irish based Brief Therapy Organisation in Ranelagh.
This proved to be a very practical and yet important development in refocusing practitioners minds to
listening to what the patient/client wants and helping set realistic targets and goals with people from a
strengths based perspective. Too often we can stereotype patients and families before we ever engage with
them.
Later in November/December 2005 we met as a group on two occasions to look at team development and
set up the following projects; (a) Raising the Profile of the Profession within the hospital, (b) Self Care for
team members, (c) Information Technology and Social Work and (d) Accommodation for the Department.
We are currently one of the “pilot” sections in St Vincent's University Hospital for Team Based Performance
Management. This has given us the added incentive to work towards certain goals and targets for the rest of
the year.
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Medical Social Work Department
The Bereavement Service again ran two series of seminars during 2005 in the Education and Research
Centre for relatives/friends of deceased patients.
Finally this past year has been a very challenging one for the Social Work Team primarily because of the large
number of patients who remain in hospital despite being medically stable and need practical
support/placement.
We are in the primary position to facilitate discharge because of our psycho-social role in negotiating with
patients and families. Significantly there have been resources set aside by the HSE to deal with the issue
both from the residential/nursing home care option including intermediate care as well as domiciliary
services.
Thus we have been involved in the placement of over 80 patients in long term care in 2005 as well as 53 in
Intermediate Care and significant numbers of Home Care Packages.
Significant Achievements
Victoria Richardson, Aine Canny and Eileen O'Donnell completed a poster presentation on the workings of
the service at the European meeting of Preventive Medicine held in Dublin in May of 2005. We were greatly
facilitated in this work by Denise Comerford from the Department of Preventive Medicine.
With regard to training for team members Eileen O'Donnell did the Psycho Oncology course in DCU in the
autumn. Also she and Aine Canny completed a 2 day workshop in Communication Skills in Cancer Care as
well as a 2 day course in Anticipatory Grief run by The Hospice Foundation. Aine is presently doing a
certificate course in grief work with children also run by the same body.
Louise Morgan attended a Critical Incident Stress Management Course and will also receive a certificate. This
course was of particular benefit to the Emergency Department, as she can support those patients who have
experienced a trauma, but may not have had a major physical injury. She is also very keen to implement some
key procedures in our department in order to deal effectively with a major incident.
Victoria Richardson completed the foundation year in Family Therapy. She also attended a North-South
Conference on Mental Health in October. She is presently due to embark upon a year and half's work of
research focusing on suicide and its effects with Professor Kevin Malone. Hopefully she will be returning to
her post when that valuable piece of work is finished. Both she and others in the team e.g. Martina Dolan
and Margaret Cagney as well as Eileen O'Donnell and Aine Canny, are very involved in various National Social
Work Speciality Groups such as the Special Interest Group in Aging (SIGA).
Teresa Mc Donnell attended the HIV and AIDS Multidisciplinary Course in St James's Hospital in March 2005.
Margaret Hunter attended a major international conference on Cardiac Rehabilitation held in Dublin last May.
Finally a number of staff attended “The Dignity at Work” Seminars which were run in conjunction with the
Human Resource Department during the year.
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Medical Social Work Department
Future Developments
We are focusing on a number of areas agreed by the team in terms of increasing effectiveness.
In general we as a profession are not always good at explaining what we do in our work to other professionals
in the hospital. Therefore the group dealing with the issue are planning various strategies including giving
presentations to hospital staff, compiling a brochure, focusing on counselling skills and putting realistic
boundaries on our role etc. Accommodation and increasing the amount of space at our disposal is also a key
target for the team.
We are committed to achieving more adequate interview space for meeting with patients and families. With
increased demands for the social work service, we will have to become more creative in staff utilization.
The area of policies and guidelines needs to be constantly updated and is another task that has to be
progressed in 2006.
Finally it is imperative that we hold the ground that we have achieved up to now and given the current
pressures on the health system we need to have a supportive and caring atmosphere at work. The “self care”
working group are reflecting on this important issue at present.
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Department of Nutrition and Dietetics
Allied Health Professional and Support Services
Staff
The staff compliment of the Department is 12 Whole Time Equivalent (WTE) dietitians and one administrator.
Emer Cannon, Marie Sheahan and Naomi Bates joined the department in 2005.
Service Developments/Activities
In collaboration with the Nutrition Committee, the Annual Nutrition Seminar was held in March 2005 with final
year medical students as part of the target audience. A total of 73 staff and students attended. Evaluation
was very positive. The Nutrition Committee has been working with key stakeholders to update our policy on
confirming the position of NG feeding tube. This will be implemented in 2006.
Maeve Moran, Senior Dietitian in Diabetes trained as Dose Adjusted For Normal Eating (DAFNE) educator.
This is an accredited structured education programme for type 1 diabetic patients. The first course was
facilitated in SVUH in November 2005. If resources are made available, a further 6 courses will be facilitated
in the hospital in 2006.
In collaboration with dietitians involved in diabetes management in the east coast area, a formal structured
programme for patients with impaired glucose tolerance has been developed. This is facilitated quarterly for
groups of 20 - 40 patients. One programme was held in SVUH in 2005.
A successful Coeliac Information evening was held in March 2005. Patients with coeliac disease who had
attended our service in the previous two years were invited to attend with their families. Three dietitians, Orla
O'Connor, Cathy Monaghan and Margaret Doyle spoke on different aspects of the management of coeliac
disease. Prof O'Donoghue gave the opening address. The feedback from patients was so positive we are
considering facilitating this on an annual basis.
Rehab Groups for Heart Failure patients was delivered in a new format in the summer of 2005, prior to that,
the group did exercise only. Patients with heart failure are invited to participate in an eight-week exercise and
update programme. They attend the gym twice a week for eights weeks. They also receive education from
the dietitian, the heart failure nurse and a cognitive behavioural therapist.
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Department of Nutrition and Dietetics
Departmental Statistics
There was a 4% increase in inpatients and OPD consults in 2005.
Significant Achievements
Under the auspices of the Nutrition Sub Committee a pilot project of implementing a 'Protected Meal and
Rest Time' in St. Vincent's University Hospital was undertaken in 2005. The committee is a multidisciplinary
group with the objective of ensuring optimal nutritional care for patients on hospital diet or a specific
therapeutic diet. The aim of the project is to:
1. Protect mealtimes from unnecessary and avoidable interruptions.
2. Provide an environment conducive to eating.
3. Assist staff to provide patients with support and assistance with meals.
This initiative was piloted on two wards in September 2005. This involved protecting an agreed particular time
on these wards. To date nursing staff have had very favourable reports of the pilot project. Patients seem to
benefit from the quiet time on the ward. Ward Catering staff report that there is less wastage of meals.
Concerns however have been raised over the length of the 'Protected Meal and Rest Time'. The Allied Health
Professionals have expressed concern that patients may miss out on therapy time. The next steps in this
project include surveying patients' satisfaction with it, and determining how best to implement it throughout
the hospital.
A very successful seminar on Nutrition and Liver Disease was held in St Vincent's University Hospital in
October 2005. This was organised by Orla O'Connor, Senior Dietitian in the Liver Unit. This is part of the
ongoing links we maintain with the main UK liver transplant centres to ensure best practice. Speakers
included Prof. Aiden McCormick, Consultant Hepatologist and senior dietitians from the UK and Ireland.
Twenty Six dietitians from various hospitals across the country attended. The feedback from the evaluation
was very positive.
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Department of Nutrition and Dietetics
Significant Publications/Presentations
Presentations
Catherine Lamont, Reflections on Dietetic Practice in Heart Failure. The British Dietetic Association UK
Heart Health and Thoracic Dietitians Group, Birmingham, Nov 2005.
Maeve Moran, Diet and Lifestyle in the Management of Diabetes. The Diabetes Federation of Ireland,
public meeting, Dublin, Nov 2005,
Julie Dowsett, Nutrition in Critical Care, British Association for Parenteral and Enteral Nutrition (BAPEN)
first satellite meeting. Belfast, Feb 2005
Poster presentation
Cathy Monaghan and Clare Kingston (Pharmacist), The Use of Probiotics in Clostridium Difficile.
Gerontological Society of Ireland, 53rd Annual conference. Dublin, Sept 2005.
Publications
Sheahan, M., Tully, O. Cystic Fibrosis - Related diabetes. Diabeteswise 2005; 2(3); 18 -23.
Dowsett, J & Tully, O. (2006). Nutritional Management of Cystic Fibrosis.
Encyclopaedia of Human Nutrition (2nd Ed). Academic Press (Eds. Prentice, A. et al)
Dowsett, J & Tully, O (2005). Cystic Fibrosis. Clinical Nutrition.
The Nutrition Society textbook series (Ed. Gibney, M. et al)
Future Developments
In collaboration with the Speech and Language Therapy Department, Catering Department and Nursing
Practice Development, we intend to explore the possibility of developing moulded foods for patients with oropharyngeal
dysphagia. Training of chefs will be undertaken in February 2006. We plan to audit the outcome
of the project.
A pilot project of professional supervision was undertaken in 2005 in association with our DATHs colleagues.
Seven members of the department were involved in this process. However the model of supervision has had
to be revised due to the structure of the departments. Two members of staff have been trained in peersupervision.
If funding is made available we hope to roll this process out through 2006 - 2007. This project
has been part funded by Action Plan for People Management (APPM)
A specific weight management clinic has been established as part of our general OPD service. This clinic is
for patients for whom weight management is the primary intervention. A pre-appointment questionnaire will
be sent to each patient in order to determine their readiness to change within the stages of change cycle. An
audit will be carried out to assess if the dedicated clinic results in an overall improvement in attendance rates
by this population group.
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Review 2005
Occupational Health Department
Allied Health Professional and Support Services
Staff
Members of the Occupational Health Department during 2005 were:
Occupational Physician:
Occupational Psychologist:
Clinical Nurse Specialist (CNS):
Administrative support:
Dr. Robert Ryan, Dr. Paul Guéret
Dr. Jacintha More-O'Ferrall, Dr. John Walsh
Ms Nuala Gannon
Ms Siobhan Bulfin, Ms Ann O'Reilly, Ms Justine McGrane
Ms Aisling Purcell , Ms Orla Seale
Ms Áine Yap, Ms Ciara McCarthy
Other hospital staff that contributed to the department include the Health and Safety Co-coordinator, Risk
Management, Infection Control, Health Promotion, Ergonomics, and HR Department.
Significant achievements
Expansion of OHD Service
In 2005 the OHD extended its opening hours from 07:30hrs-18:00hrs Monday -Friday. The services of the
OHD were extended to Breast Check, Elm Mount Unit, and SVPH.
Needlestick injury prevention activities
Medical and psychological assistance was provided for the 94 staff members who sustained inoculation
injuries in 2005. This compares with 113 staff members who sustained similar injuries in 2004.
Needlestick injury prevention workshops continued throughout the year. 18 “Be Sharp Be Safe “ workshops
were provided by the OHD, and a total of 238 staff members attended these sessions. Hourly sessions took
place in the E/D on a daily basis over a weeklong period in April and October for nursing staff in E/D, on the
Management of Blood Borne Virus Exposure by Emergency Staff. Thirty five staff members attended these
information sessions.
A concerted effort was made to include all categories of staff, including medical staff. Sessions were
provided for medical staff incorporating prevention and management of inoculation injuries. One hundred and
four medical staff attended these sessions.
Specific sessions on prevention and management of inoculation injuries were also provided for ISS cleaning
staff, radiography staff in Breast Check, pathology staff and phlebotomy staff. Specific training was provided
to phlebotomy staff on correct tray usage.
A needlestick injury prevention information stand was displayed regularly in different locations in the hospital.
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Occupational Health Department
'Working Backs Programme' for staff
A multidisciplinary care pathway continued for staff members who require treatment for their back. Education
sessions were provided for line managers by physiotherapy. Promotion stands were also held to advertise
the programme to staff. The programme commenced in April 2004 and has been successful to date. From
January to December 2005, one hundred and one staff members attended a total of 125 appointments. There
were 71 referrals to Physiotherapy. The programme was presented by Caitriona Cunningham (Research
Physiotherapist UCD) at the 13th International Health Promoting Hospitals Conference.
Influenza Vaccination Programme
All hospital staff were encouraged to avail of the influenza vaccination programme. Out-of-hours clinics were
provided to staff resulting in 856 SVUH staff employees receiving the vaccine, this compares with 588 in
2004. The following is a breakdown of the staff that received the vaccine in 2005:
• 264 Nursing staff.
• 91 Medical staff.
• 129 Allied healthcare professionals.
• 190 General services staff.
• 182 Administration staff.
This implies that 524 clinical staff received the vaccine in 2005.
Infection Control
Follow up precautions were taken by the OHD following exposure of staff to 4 cases of TB, 1 case of
measles, 1 case of scabies, 3 cases of mumps, 2 cases of meningococcal meningitis 14 cases of varicella
compared to 3 cases of varicella in 2004. Each follow-up required extensive OHD resources.
SRSV: 152 staff contacted the OHD during 3 outbreaks in 2005, a considerable number of additional staff
telephoned the department seeking advice.
MRSA: Student nurses attended the OHD for MRSA screening and ward staff were advised and screened as
requested by infection control.
St Vincent's Private Hospital (SVPH)
On March 1st the OHD took over responsibility for a limited service provided to SVPH staff. a) Preemployment
health assessments b) Immune status evaluation c) Needlestick injuries and d) Management
referrals. 120 staff attended the vaccination clinic and the department dealt with 17 needlestick injuries. It has
been very well received and it is hoped that the service will be widened to include all of the OHD services
in 2006.
Stress Management
1. Individual -focus
One hundred and seventy three appointments were provided to 54 staff members who attended the
confidential staff support service for direct psychological support. A further 30 staff members used the
managers advisory service.
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Review 2005
Occupational Health Department
2 Organisation - focus
Education
15 seminars (170 participants) were provided on “Managing work-related stress”.
Based on a 91% response rate, 81%of participants scored the workshop as” useful” or as “extremely
useful.”
The seminars now run twice annually and additionally sessions are delivered at ward level as requested by
ward managers.
Other seminars and workshops provided during the year included:
• Psychological response to critical incidents at work;
• Well-being at work;
• Facilitating behavioural change;
• Dealing with verbal and physical assault and aggression.
Three information leaflets were published:
1) Occupational health department services offered.
2) Work-related stress- what managers need to know.
3) Coping with stress.
Policy -development
The introduction of the HSEA Dignity at Work Policy and the selection and recruitment of contact support
persons made an important and complementary role to other hospital services in supporting cultural change.
An evaluation of the benefits and effectiveness of the contact support person's role will commence in 2006.
Outreach activities
• Psychological services were provided to staff members in St. Michaels Hospital in collaboration
with the occupational health department there;
• Workshops and addresses were provided to professional groups;
• Ongoing contributions were made to academic programmes in occupational health & safety at
TCD and UCD.
Education
The following seminars were provided:
• Induction seminars
• Infection control link programme.
• Prevention and management of inoculation injuries at the ground medical round.
• Talk on BBV as part of the cannulation programme.
The department contributed to many other educational activities including:
• Health and safety week;
• Smoking cessation programme;
• Moving and handling.
• Health promoting Hospitals Conference.
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Occupational Health Department
The OHD is continuing to update all policies and initiate setting up of standard operating procedures (SOPs)
to standardise all our activities.
Audit & Research Activities.
In the latter end of 2005 the OHD inititated two significant research activities
1) A pilot study to examine the occupational needs of staff in relation to current service provision and
expectations. It is envisaged that on completion of the pilot study the results of the service will be
used to further enhance the delivery of the OHD service to staff.
2) The SVUH Partnership Committee provided funding to contract the services of UCD to design and
develop a staff survey research tool. We are enormously grateful to staff members who responded
to the pilot staff survey. The responses received will be analysed independently by UCD and a report
will be produced mid-2006.
It is proposed this year that a research study investigating the efficacy of interferon-gamma immunological
testing compared to mantoux testing. The research proposal has been submitted to the Ethics and Medical
Research Committee for approval.
The following audits were carried out:
a) An evaluation of the needlestick injury prevention programme (“Be sharp, Be safe”)
b) Needlestick injury rates
c) Time lost from work due to back pain
d) Hepatitis B immune status of theatre staff.
To comply with the accreditation process, the OHD staff continues to monitor and improve the quality of its
services.
St Vincent's Private Hospital
On March 1st The OHD commenced supplying some services to SVUH
1 Immune status Evaluation
2 Management referrals
3 Management of needlestick injuries
4 Pre employment health assessments
There has been 120 attendance at the vaccination clinic and the OHD managed 17 Needlestick injuries
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Review 2005
Occupational Health Department
Department Statistics
A total of 3,156 people attended the OHD in 2005. A minimum of 900 staff members availed of telephonic
consultations from OHD staff pertaining to Occupational Health advice.
Reasons for attendance
Occupational Injuries 2005 2004 2003 2002 2001
Sharps/Inoculations 70 85 83 104 106
Blood splashes 24 28 18 24 9
Other injuries 250 245 189 252 235
OHD attendance for certain occupational infections
2005 2004 2003 2002
SRSV 254 450 98 182
Visits to the OHD for non-vaccine consultations
2005 2004 2003 2002
Seen by Occupational Nursing Team 477 1627 1247 993
Seen by Occupational Medical Team 588 1038 463 782
Seen by Occupational Psychologist 203 171 144 55
The core activities of the staff support service continued to expand with the overall
statistics as follows:
54 staff members attended the occupational psychologist representing an increase of 5% on 2004.
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Occupational Health Department
Reasons for attendance at occupational psychologist 2005
An additional 30 Managers sought advice and support in 2005.
Reasons for Managers consultation 2005 (n=30)
Breakdown by gender (n=55)
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Occupational Health Department
Future Plans
Priorities for 2006 are
• The provision of an extended service to St.Vincent's Private Hospital and development of closer
links with the St. Michael's Hospital Occupational Health Department.
• The completed review and implementation of all the OHD operational policies.
Focus 2006.
• The implementation of the recently acquired Healthcare Manager occupational health software package
over the three sites. This package will facilitate a number of functions, including diary and time
management, holding and retrieval of client information, production of statistical and audit information,
production of statistical and audit information thereby allowing for the planning of future service activities.
• A series of information sessions on the role of the manager in relation to health and safety will be provided
to managers / heads of departments advising them of their responsibilities to staff members. This
programme will be developed in conjunction with health and safety.
• It is planned that an obesity management programme will be instigated similar in format to the working
backs programme.
• The completion of the two undergoing research projects:
1) A pilot survey to examine the occupational needs of staff in relation to current service
provision and expectations.
2) An evaluation of the staff support service.
It is envisaged that the results of the pilot study will be used to further enhance the delivery
of the OHD service to staff and to promote the services of OHD to hospital staff.
• An evaluation of the OHD services by examining:
- The impact of the workshops on needlestick injury rates.
- The effectiveness of 'managing work-related stress' seminars.
Continuing Professional Development
Clinical nurse specialist (CNS) J. McGrane successfully completed a MApplSc degree programme in
Safety Health and Welfare at Work.
C.N.S. A. Purcell successfully completed an M.B.s. degree in Safety Health and Welfare at Work.
C.N.S. A. Purcell successfully completed the Manual Handling Instructors Course.
C.N.S. O. Seale commenced a Diploma in Safety, Health & Welfare at Work.
C.N.S A.O'Reilly successfully completed a Higher Diploma in Quality in Health Care.
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Occupational Therapy Department
Allied Health Professional and Support Services
Service Developments/ Activities
SVUH
The stability achieved in personnel, particularly towards the latter part of the year, enabled some positive
developments within the department, which included a review of our referral card system and patient
information pertaining to the role and services provided by the Department.
Department Wide Objectives Think Tank
With commitment from all service areas within our department we set a number of key objectives
for the year ahead.
Team Based Performance November 2005
Our department took part as one of the hospital pilot sites in the hospital wide roll out programme.
May 2005: Computerised Statistics
The department commenced this method of recording our monthly activity levels. This has aided
the ease with which service areas can be analysed.
It is hoped this will also help facilitate staff in service audits and research.
St. Michael's and St. Vincent's Occupational Therapy sites
Slan Abhaile Equipment initiative
This initiative continued for both St. Michaels and St. Vincent's sites.
Action Van Man Project Initiative February 2005
This initiative was set up through the Slan Abhaile Equipment steering group whereby Occupational
Therapists in what were the East Coast area hospitals can access a person in the provision of rails, fitting of
equipment etc to expedite discharges for the over 65 population from hospital.
A review also took place in both sites of the Benefits v's Impact on caseload took place.
As a result Ms. Fionnuala Sheehan has commenced working full time.
St. Michaels and St. Vincent's Occupational Therapy Departments - Network 8
Meetings as a Network 8 group in conjunction with Loughlinstown were commenced.
In addition to exploring our commonalities, we have, as a group, reviewed and our Occupational Therapy
Policies and Procedures with a view to amalgamating these. We also plan to utilise this group as a way of
exploring educational possibilities for both staff and O.T students.
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Review 2005
Occupational Therapy Department
SVUH: Individual Developments / Achievements for Occupational Therapy Service areas
Adult Psychiatry
Jayakumar Seetharman was secured as a Senior into post December 2005 (vacant x 16 months)
We had a successful move to the Elmmount Unit and a smooth transition of the Vergemont Occupational
Therapy staff to the Unit.
Polices and procedures were reviewed and criteria were formed for referrals to the service.
Group Interventions have commenced weekly in addition to intensive individual interventions.
Hands and Plastics
Multidisciplinary meetings are now held fortnightly to facilitate the development and updating of existing
programmes.
Mirror Therapy commenced for Complex Regional Pain Syndrome (C.R.P.S) patients.
Mrs. Aine O' Reilly (Senior Occupational Therapist) continues as active committee member of the Irish
Association of Hand Therapists.
Old Age Psychiatry:
Anxiety Management Information Packs were developed as a solution in direct response to the gap identified
for those patients on a waiting list.
A Healthy Ageing Programme (in conjunction with day hospital colleagues) audited and trailed August 2005.
Second programme began November 2005.
Ms. Catherine Keogh (Senior Occupational Therapist) was invited to lecture at TCD and UL schools of O.T
Rheumatology
Ms. Carol O' Donnell successfully completed Level 2 of British Association Of Hand Therapists (BAHT).
Audit completed of Rheumatology Footwear Service.
Fibromyalgia relaxation group commenced.
Pain Management
This post became WTE effective December 2005. It is hoped this will facilitate development of this service
area and increase the possibility of formal service analysis /research.
Stroke/ Neurology
A Locum post secured in September to work on outpatient waiting list. In December 05, we initiated a review
of the effectiveness of this post.
Significant Achievements
Ms. Catherine Keogh (Senior Occupational Therapist) was awarded Masters of Science in Occupational
Therapy.
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Occupational Therapy Department
It involved research in the catchment area on “Nursing Homes' Staff Perceptions of the factors influencing
the implementation of person centered care in Nursing homes”.
Ms. Keogh also attended and represented St. Vincent's Hospital at the 'Alzheimer Europe' conference in June
2005.
Panel member on discussion surrounding future developments in O.T and dementia.
Departmental Statistics
The stability we experienced in staffing towards the last two quarters of the year was reflected in a positive
upturn in our activity levels, this was especially noticeable in terms of Inpatient activity levels (see table).
Numbers of Inpatients' treated in Occupational Therapy 2005
Numbers of Home Visits completed by the Occupational Therapy Department 2005
Future Developments
For 2006, we have set two Department Goals
(i) The provision of increased education for all users, that is those patients' and health professionals alike
are aware of our services and our role within the organisation.
(ii) We aim to review our practices in a number of service areas, with a view to implementing
improvements where possible and monitor our effectiveness overall.
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Review 2005
Pharmacy Department
Allied Health Professional and Support Services
Service Developments / Activities
From the start of 2005 the development project presented challenges to the pharmacy service in terms of
planning and managing change. In May 2005 acute mental health services relocated from Vergemount to the
Elm Mount Unit. Pharmacists worked with staff in the Elm Mount Unit to successfully integrate
pharmaceutical services for both inpatients and outpatients. A lot of work also went into planning for the
relocation of the Emergency Department and the other departments, as part of the hospital development
project.
Dispensary Service
Indicators of the increase in activity in the dispensary in 2005 include an increase of 3% in the total number
of items dispensed and a 25% increase in the number of emergency trays and rolls supplied to clinical areas.
There was a large increase in the number of prescriptions dispensed for patients in the Emergency
Department, CDU and St. Camillus' Annexe.
Clinical Service
The clinical pharmacy service was affected by increased activity notably in the following areas:
Hepatology
• the number of liver transplant operations, 56, was the highest annual total
• the number of HDU beds in St. Brigid's ward increased from 2 to 5
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Pharmacy Department
Cystic Fibrosis
• Increased activity in the CF service (304 CF patients attending SVUH by December 2005)
Seamless Care
• Increase in the workload of clinical pharmacists organising discharge medication and continuity
of pharmaceutical care in the community
Education
Pharmacy staff delivered:
• Lectures, workshops and presentations for undergraduate and postgraduate medical,
nursing and pharmacy programmes
• Training for pre-registration pharmacists, MSc students as well as pharmacy undergraduates
from other EU countries
SVHG Prescriber's Guide and Formulary
The 4th edition of the SVHG Prescriber's Guide and Formulary (2005/2006) was circulated in July. It contains
additional prescribing guidelines and is colour - coded to facilitate access to different sections of the guide.
Aseptic Service
In 2005 the total number of items prepared in the Aseptic Unit (ASU) was almost 8000, an increase of 15%
on the previous year. The ASU provides an aseptic service to a wide range of specialties including Oncology,
Haematology, Urology, Neurology, ENT, Diagnostic Imaging, Respiratory Medicine, Renal Medicine,
Ophthalmology and Critical Care.
Activity in the Aseptic Unit
Medicines Information
Although the number of enquiries dealt with in Medicines Information over the past year remained static
(N=1080), the time spent undertaking enquiries (1000 hours), and the complexity of the enquiries has
increased.
The percentage of enquiries from senior medical staff has increased. Support to the SVHG Drugs and
Therapeutics committee was substantial.
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Pharmacy Department
Breakdown of enquiries by speciality for the organisation, in 2005 are given below.
Number of Enquiries by Directorate 01/2005 to 12/2005
Risk Management/ M.I.R. Database
The Pharmacy and ICT Departments worked together to develop the Medication Incident Report (MIR)
Database. The database was showcased at a meeting of the National CIS IT Steering Committee in July. Work
is continuing to further develop the functionality of the software.
Achievements
Laura McCabe was awarded an MSc in Hospital Pharmacy by the University of Dublin.
Kathryn Feeley completed the UK National Introductory Medicines Information Residential Training Course.
Dora Mulvihill and Ciarán Muldowney graduated in November after completing their pre-registration year.
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Pharmacy Department
Ciarán Muldowney won first prize in the poster competition at the Annual Conference of the Pharmaceutical
Society of Ireland in October 2005.
Carmel Bogue won first prize in the pharmaceutical technician's category of the poster competition at the
HPAI Educational Conference and first prize at the Annual Conference of the Pharmaceutical Technicians
Association of Ireland.
Posters
Keane C.
The Administration of Aminoglycosides to Patients with Cystic Fibrosis : Current Practice.
Gonzalez Z, Schaffer K, O'Sullivan S, Fitzgerald S, Fenelon L.
Community Acquired Pneumonia: Evaluation of Diagnostic Studies and Antibiotic Treatment on Admission to
St. Vincent's University Hospital.
Mulvihill D.
How can Advances in Pharmacy Information Technology Improve Patient Care and Clinical Practice in St.
Vincent's University Hospital (SVUH).
(Poster and thesis for pre-reg training programme)
Kennedy F.
Patient Controlled Analgesia: an Audit.
Muldowney C.
The Introduction of Once Daily Tobramycin Dosing in the National Referral Centre for Adult Cystic Fibrosis at
St. Vincent's University Hospital.
(Poster and thesis for pre-reg training programme)
O'Shea J, DeFrein AM, Gaughran N.
Capacity Planning for Aseptic Services.
Broderick M.
Medicines Information: Results from a Users' Survey.
Murray S.
The Use of Infliximab and Etanercept in the Treatment of Rheumatoid Arthritis.
Bogue C, Keane C, Tyrrell M.
The Role of the Pharmaceutical Technician in Improving Medication Safety in Theatre through a Risk
Assessment of Pharmaceutical Packaging.
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Pharmacy Department
Publications
Thesis
McCabe, L. Activated Protein C (Drotrecogin alfa (activated)): An Audit of Use in SVUH. MSc thesis.
Presented at SVUH ICU Study Day, September 2005.
Conferences
All Ireland Cystic Fibrosis Meeting, Killarney, February 2005. C. Keane.
HPAI Annual Educational Conference, Dublin, April 2005.
European Cystic Fibrosis Conference, Crete, June 2005. C. Keane.
UK Pharmaceutical Technicians Conference, June 2005. C. Bogue, A.Cahill.
UKCPA study days in Critical Care, Emergency Medicine. C. Keane, M. O'Sullivan L. McCabe, C. Bogue.
BOPA Annual Conference, Glasgow, October 2005. C. Browne.
Facilitation Skills Workshop, SVUH, November 2005. C. Browne, N.O'Hanlon.
UKCPA Cystic Fibrosis Pharmacists Group meeting, London, November 2005. C. Keane.
UK & ROI Liver Pharmacists Group Meetings, Dublin and London. F. Kennedy.
ASHP Mid-year Clinical Conference, Las Vegas, December 2005. N. O'Hanlon, J. O'Shea.
Future Developments
New IT Project
Install new computer system and “go live” in summer 2006.
Risk Management
Develop the MIR Database to facilitate electronic reporting.
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Physiotherapy Department
Allied Health Professional and Support Services
Service Developments/Activities
2005 has proved a significant year in terms of service and professional development, clinical audit and
research.
Service developments in 2005 included the Non Invasive Ventilation (NIV) Unit on St Johns Ward, the Back
Education Programme, the Osteo Arthritis (OA) Knee Programme and the Rehabilitation Programme for
patients post cardiovertor defibrillator implant.
Two professional development programmes were introduced in 2005, the DATHs Continuing Professional
Development Competency Programme for staff grade physiotherapists and the piloting of the Office of
Health Management Personal Development Planning Programme for senior physiotherapists.
The most significant development in clinical auditing has been the integration of the ICD 10 as a component
of the physiotherapy data management system.
In research the organisation of a collaborative, strategic and structured approach to clinical research has
served to link clinical practice and research in a practical way.
The Physiotherapy Department is organised under three core specialities, which encompass the scope of
physiotherapy practice and education namely:
• Cardio Respiratory Care
• Musculoskeletal Care/Rheumatology
• Rehabilitation
Physiotherapy Cardio Respiratory Service
The development of the NIV Unit has been a significant development in the terms of best practice and
improved patient care. The collaboration of the medical, nursing and physiotherapy staff in developing the first
multidisplinary operational policies and competency training programme has proved to be an innovative
model of collaborative care and competency training.
The initiation and implementation of a rehabilitation programme for patients with implant cardiovertor
defibrillators, which involves the multidisplinary team is in line with the Department's progressive approach
to rehabilitation.
Activity within the Cystic Fibrosis Service continues to exceed the physiotherapy staffing levels.
Physiotherapy Musculoskeletal Service
Developments in the Musculoskeletal Care include the development of a Back Education Programme and an
OA Knee Rehabilitation Programme. The appointment of 0.5 whole time equivilant (WTE) staff grade
physiotherapist to the Emergency Departmentcommenced in 2005. The need to establish a fully integrated
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Physiotherapy Department
physiotherapy team within Emergency Medicine is in line with HSE's 'whole system' approach to care.
Activity in the Hand Therapy Service as identified last year continues to rise. There were 97 referrals in 2001
and 406 referrals in 2005.
Data collated on the Working Backs Programme, which offers a streamline evidenced based management
pathway for staff with low back pain, is currently being analysed.
Physiotherapy Rehabilitation Service
The Neurology Outpatient Service continues to expand with referrals increasing by 100% in 2004 and a
further 25% in 2005. Referrals for stroke rehabilitation have increased by 18%.
Undergraduate Programme
The appointment of 1.5 wte clinical tutors by HSE has been a significant development in undergraduate
education. Eighty four physiotherapy undergraduate clinical placements were provided in 2005.
Research
The tripartite approach to research is based on the implementation of a collaborative research model at
undergraduate level, the organisation of a structured programme to facilitate and promote research at
graduate level, and the development of SVUH as a site for clinical placements at postgraduate level.
Clinical Audit
The inclusion of the ICD 10's diagnostic and procedural codes, as a component of the Physiotherapy
Department's data management system, is a significant step towards an integrated auditing approach. The
system is currently being piloted on:
a) Fractured neck of femurs
b) Cardiovascular accidents
Significant Achievements
Martina Fitzpatrick, Clinical Specialist was awarded a prize for poster at the Irish Rheumatology Health
Professional Society Conference, Autumn 2005
Martina Fitzpatrick was awarded the Chartered Physiotherapists in Manual Therapy Research Project Award
2005 for her research on Ankylosing Spondylitis.
Theresa Flynn, Senior Physiotherapist-Ergonomics, Chairperson, DATH's Minimal Handling Advisory Group
and editor of “Towards Safer Patient Handling-Agreed Core Practical Patient Handling” December 2005
Pauline Leahy, Physiotherapy Manager was awarded honorary lectureship by the School of Physiotherapy &
Performance Science, College of Life Sciences, UCD.
Pauline Leahy is a member of ISCP Executive, the Chartered Physiotherapists in Management Executive
Committee, the ISCP Undergraduate Education Board & the ISCP Research & Development Committee.
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Physiotherapy Department
Postgraduate Degrees
• Aoife Caffrey, MSc (Sports Physio.) UCD 2003/05.
• Karen Cradock, MSc (Med Science) TCD 2003/05
• Ruth Gibson, MSc (Sports Physio) UCD 2003/05
• Grainne O'Hara, Deputy Physiotherapy Manager, completed 1st year Leadership Programme
• Three Physiotherapy Education Bursaries were awarded by Physiotherapy Departments Educational
Fund to staff undertaking postgraduate degrees.
Significant Publications/Presentations
Reilly C.
“ Hand held Dynamometry as a tool in Clinical Practice”
Physiotherapy Ireland 2005 June; 26(1): 34-37
Smart.K
“ The clinical reasoning of pain by experienced musculoskeletal physiotherapists”.
Accepted for publication by Manual Therapy.
Oral Presentations.
Irish Cardiac Society Conference. October '05
“The Effects of an eight week exercise programme on exercise capacity and activity levels in patients with
Heart Failure” Cradock K
Joint Irish & Scottish Rheumatology Health Professional Society Conference May '05
“The demographic profile of patients with Rheumatoid Arthritis attending for Physiotherapy treatment.”
Fitzpatrick M
Poster Presentations
Irish Thoracic Society Conference 2005.
“The Reproducibility of Peripheral Muscle Strength Testing in Adult Cystic Fibrosis Patients” Reilly C
11th World Congress on Pain, Sydney, Australia. August 2005
“Mechanisms-based Clinical Reasoning of Pain by Experienced Musculoskeletal Physiotherapists. Smart K
Conferences attended 2005
Physiotherapy staff attended a variety of national and international conferences
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Review 2005
Physiotherapy Department
Departmental Statistics
Patient Referrals
.
Patient Attendances
.
Future Developments
Develop the Physiotherapy Service in Emergency Dept & ADC.
Collaborate with the multidisplinary team on the new Cystic Fibrosis development
Further development of ICD 10 data management system
Develop computerised OPD appointment system
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Department of
Preventive Medicine and Health Promotion
Allied Health Professional and Support Services
Staff
Head of Department:
Professor Cecily Kelleher MD, FRCPI, MPH, FFPHM, MFPHMI
Health Promotion Officer: Ms Jacinta Barnewell RGN, SCM, Adv. Dip. Montessori Education
Dr. Anna Clarke LRCP&SI, MB, MPH, FRCPI, FFPHMI, FFPH
Health Promotion Coordinator: Ms. Denise Comerford RGN, RM
Secretary:
Ms. Frances Conlan
Health Promotion Officer: Ms. Kirsten Doherty BSc, MPH, Ms. Hilda Gallagher RGN, RM
Ms Irene Gilroy BSc (from September 2005), Ms. Carol Pye RGN, RM
Ms. Brenda Whiteside RGN, RM
Health Promotion Nurse: Ms. Veronica O'Neill RGN, RM
Clinical Specialist Dietitian: Ms. Vivien Reid MSc, Dip Diet.
Allied UCD staff:
Professor Leslie Daly, MSc, PhD, FFPH
Dr. Patricia Fitzpatrick MD, MPH, FRCPI, FFPHMI.
Service Developments/Activities
Service to Patients
Cardiac Services
24 Hour Ambulatory Blood Pressure Monitoring Service
This service is provided for both inpatients and outpatients of hospital consultants and general practitioners.
Cardiac Rehabilitation
There is dietetic and health promotion support for the multidisciplinary Cardiac Rehabilitation Team. The
monthly Cardiac Lifestyle Information Session is open to patients and the wider community and is subject to
ongoing review.
24 Hour Blood Pressure Service Activity
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Department of Preventive Medicine and Health Promotion
Aspirin Study
The Eastern Regional Health Authority (ERHA)-funded Heart Health Bursary, comprising an audit of aspirin
administration to 500 patients presenting to the Emergency Department over 2 months, was completed and
presented at peer scientific meetings (Gallagher et al 2005).
Smoking Cessation Services
There has been an increase of 29% in the number of initial interventions carried out with ward and OPD
patients between 2004 and 2005. Including interventions with staff members, 572 people received an initial
intervention. One thousand six hundred and ninety nine reviews were carried out, mainly on an outpatient
basis. The patient service was extended to the Elm Mount Unit patients in June 2005. Five Stop Smoking
courses were provided, with an average smoking cessation rate of 55%. Staff education sessions took place
in most wards, in several departments, at the CCU Diploma Nurse course and at staff and intern induction
days to increase awareness of smoking and the service available.
Smoking Cessation Service Activity
*2004 Special EU-funded follow-up
The EU-funded study of the impact of a nurse-led smoking cessation service was completed and the report
submitted (Clarke et al 2005). Work continued on the six-month follow-up study of 1100 smoking in-patients,
funded by the Cardiovascular Health Strategy. A major qualitative evaluative study, in light of the tobacco
legislation, was completed and presented (Kelleher et al 2005). Smoking cessation support and free nicotine
replacement therapy are offered to staff, in conjunction with the Pharmacy and Occupational Health
Departments.
A smoking education DVD was developed and evaluated, in association with Dun Laoghaire College of Art
and Design, for effectiveness in attracting self-referrals to a smoking cessation service. This is part of a
hospital-wide communications strategy with the Communications Executive, the Library, ICT and hospital
management.
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Department of Preventive Medicine and Health Promotion
Nutrition
The Clinical Specialist Dietitian provides an integrated clinical and health promotion service. This includes
inpatient and outpatient services (430 interventions) and group sessions (475 attendances).
A skills training day on Cognitive Behavioural Therapy approaches to patient management was provided for
Community Dietitians in association with the Health Promotion Unit, DOHC. In response to the launch of the
Report of the National Task Force on Obesity, 150 pedometers were distributed to interested staff members
as motivators to encourage exercise.
Health promotion information stands
Health promotion information stands were provided e.g. Smoking Cessation at the launch of the hospital's
Health and Safety Policy Heart Health Awareness stand was co-ordinated by the Cardiac Rehabilitation
Department and a Chronic Obstructive Pulmonary Disease (COPD) Awareness stand was co-ordinated by the
Pulmonary Department.
Service to Staff
By-monthly health promotion training sessions were provided to departments, including medical interns and
general staff induction programmes.
“Healthwise SVUH” was published quarterly with contributions from interdisciplinary staff.
Participation in the National Health Promoting Hospital Challenge Day initiative encouraged staff to participate
in physical activity.
A smoking cessation service was provided to the estimated 10% of staff who smoke.
Service to the Community
Education and Training Days for health professionals
Training days were run in conjunction with hospital departments. Topics were:
• Colorectal Cancer
• Palliative Care
• Smoking Cessation, in conjunction with the Irish Cancer Society
Student Health Promotion
• Student seminars
Six seminars were held, each attended by approximately 100 transition year students; topics covered
were alcohol awareness, cancer awareness, smoking cessation and healthy eating.
Teacher training
A Smoking Cessation training course was developed specifically for those working in education, e.g.
teachers, school counsellors and school nurses.
Information stand
A Smoking Awareness stand was provided in UCD for “World No Tobacco Day”.
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Department of Preventive Medicine and Health Promotion
Media
Brenda Whiteside appeared on 'The Afternoon Show' to assess the smoking cessation status of participants
in a stop smoking project, while Hilda Gallagher contributed to a panel discussion on 'The Big Bite', both on
RTE 1.
Health Promoting Hospitals
Denise Comerford and Dr Anna Clarke are members of the National Executive of the National Health
Promoting Hospital (HPH) Network. The international meeting was held in Dublin in 2005, with two sessions
chaired by department members and three presentations made by hospital staff.
A government delegation from the Danish Parliament visited on the 25th of October, to examine the
development and success of the smoking ban in Ireland. They attended presentations and met senior staff.
In conjunction with the Department of Medicine for the Elderly, we participated in a pilot project to evaluate
the use of diagnostic-related group (DRG) codes for health promoting procedures in HPH hospitals
throughout Europe. The Clinical Unit of Health Promotion, WHO Collaborating Centre for Evidence-Based
Health Promotion in Hospitals, coordinates this project.
Significant Publications
Clarke A., Daly L., Herity B., McEwen J.
Impact of providing a nurse specialist in smoking cessation in a hospital setting.
Report to the EU Commission. 2005
Comerford D., Bimpeh Y., Fitzpatrick P., Clarke A., O'Neill V., Daly L., Kelleher C.
Longitudinal follow-up of smoking prevalence and attitudes among three cohorts of nursing students.
Proceedings of the Faculty of Public Health Medicine Winter Scientific Meeting, Dublin, December 2005.
IJMS in press.
Fry R., Ryan J., Salter N., Murrin C., Kelleher C.
Adult Emergency Departments: adolescent utilisation characteristics and self reported perceived care.
Proceedings of the Faculty of Public Health Medicine Winter Scientific Meeting, Dublin, December 2005.
IJMS in press.
Gallagher H., Clarke A., Fitzpatrick P., Daly L., Kelleher C.
Early administration of aspirin to patients with suspected acute myocardial infarction: effects of admission
source, sex and final diagnosis. Proceedings of the Jacqueline Horgan Prize Presentations of the Royal
Academy of Medicine in Ireland, Section of Epidemiology. November 2005
Kelleher C., Corradino D., Doherty K., Clarke A., Fitzpatrick P., Comerford D., Whiteside B., Pye C.,
Barnewell J., Daly L. Attitudes of Staff and Patients to the Total Smoking Ban in Indoor Hospital Facilities in
Ireland. Proceedings of the Faculty of Public Health Medicine Winter Scientific Meeting, Dublin, December
2005. IJMS in press.
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Speech and Language Therapy Department
Allied Health Professional and Support Services
Current Level of Service Delivery
The Speech and Language Therapy Department provides both an inpatient and outpatient service to over 60
consultants, 23 wards, Carew House, and St. Michael's Hospital. The following is a breakdown of the speech
and language therapy treatment units by clinical specialities for 2005.
Clinical Specialities
Treatment Units
Clinical Specialities
Treatment Units
A Medicine for the Elderly 1,746
G Neurology 1,931
B ENT/Plastics 1,112
H Cardiology 124
C Oncology 184
I Endocrinology 709
D Surgical 788
J Rheumatology 901
E Respiratory 1,154
K Nephrology/Psychiarty 604
F Gastroenterology 1,384
1 x unit = 15 mins.
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Speech and Language Therapy Department
Staff
Staffing - Current = 6 full time posts
SLT Manager:
Fionnuala Duffy
Senior SLT - Care of the Elderly & Stroke Team:
Ruth Maxwell
Senior SLT - St. Michael's Hospital and Neurology Service SVUH:
Deirdre Kidney (funded by SMH but 5 sessions to SVUH Neurology service)
Senior SLT - ENT Team:
Susan McElwee
Basic Grade SLT:
Sharon McNulty
Basic Grade SL: Caoimhe McDermott (Sept 05)
Successful recruitment of basic grade posts - vacated by Una Deane (Aug' 05) who took up a senior post in
the Mater Hospital and Claudia Schafer (Jul. 05), who resigned following a 1-year career break.
Summary of Service Development 2005
Expanded neurology service:
1) Attendance/presentations at Journal Club
2) Parkinson's Group
3) Parkinson's Booklet
4) Increased outpatient service
5) Commenced Lee Silverman Voice Programme
Increased use of Fiberoptic Endoscopic Evaluation of Swallowing (FEES) Clinic. This is another type of
objective swallowing assessment, cost effective (equipment already in ENT Deep.), no radiation exposure
and can be completed at the bedside.
Commence July 2004 Figures for 2005
12 Inpatients 36 (200% increase)
34 Inpatients /2 outpatients
Commenced a major research project with Dr. Dermot Malone (Radiology Dept.), Professor L. Daly (UCD)
and the neurology team on 'Developing and Standardising a Pharyngeal Retention Scale using
Videofluroscopy. Commenced formal work on scale following ethical approval in Jnue'05.
Continued development of ENT service - now running three joint voice clinics per week.
The department started using a computerised statistical database in line with the other Allied Health
Departments.
The department was a pilot site for the team performance project.
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Speech and Language Therapy Department
Videofluroscopy Service
The Speech and Language Therapy Department and Dr. Dermot Malone, Consultant Radiologist, run this
specialised clinic jointly. It continues to be the only videofluoroscopy service in the East Coast Area Health
Board. Referrals are accepted from St. Michael's Hospital, St. Vincent's Private Hospital, St. Colmcille's,
National Rehabilitation Hospital, and Royal Hospital Donnybrook.
Data from St. Michael's Hospital
• Number of new referrals 2005 = 242 (2004 =216)
• One of our aims for 2006 is to install the same database system from the main department to
include St. Michael's patients.
Training and Development
Throughout 2005, the department were involved in a number of presentations within and outside the hospital
group.
Three members of the department successfully completed the first year of their Masters programmes.
Sharon McNulty completed her postgraduate training in Dysphagia at the Manchester Metropolitan
University - June -December 2005.
Significant Courses /Conferences
Various members of the department attended a number of courses and conferences throughout the yea
including:
• Advanced Swallowing Training- 2nd & 5th June 2005
AMNCH, Tallaght.
Professor J. Logemann
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Speech and Language Therapy Department
• 6TH Pan European Voice Conference- 31st August -3rd September
Royal Academy of Music, London.
• Lee Silverman Voice Training Course - 14th & 15th November
Mater Hospital, Dublin.
Presentations at conferences included
'Swallowing Problems in the Older Person' - Ruth Maxwell, Senior Speech and Language Therapist, Annual
Care of the Elderly Study day, E.R.C., St. Vincent's University Hospital -28TH January
Poster Presentation ' Development of an Effective Group Therapy Programme for Dysarthria in Parkinson's
Disease' - Deirdre Kidney, Senior Speech and Language Therapist, Annual Conference of the Irish
Gerentological Society, UCD - 12th September
Plans for 2006
Nurse Training and Education - Jointly with the Department of Nutrition & Dietetics regarding swallowing
disorders, modified diets, thickened fluids and 'moulded' foods (scheduled for February 2006).
NCHD'S Education on Screening for Swallowing Problems
Working with the Catering Department to introduce new type of modified diet
'Moulded' foods - date for planned introduction 22nd of February 2006.
Continue collecting data for Dysphagia Research Project commenced in June'05
Expanding our service to include St. Vincent's Private Hospital - covering St. Vincent's Healthcare Group
Expanding service to neurology patients - continued group sessions and commencement of Lee Silverman
Voice Programme for Parkinson's patients.
To increase videofluoroscopy service to include a second clinic to cover our increasing number of outpatient
referrals.
Longer Term Service Aims
To provide a fully integrated speech & language therapy service to all of St. Vincent's Healthcare Group -
SVUH, SMH & SVPH.
To provide a speech & language therapy service encompassing all treatment models - inpatients, OPD,
individual & group treatment, specialised clinics, and domiciliary.
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Speech and Language Therapy Department
Summary
7 Full time posts
1-In-charge III /Manager
1- Clinical Specialist = Neurology
3- Senior posts = ENT/Care of the Elderly & Stroke/General Medical &
St. Michael's Hospital
2- Basic grade posts
Service Provided
To provide a fully integrated SLT service to all of St. Vincent's Healthcare Group - SVUH, SMH &
SVPH.
Encompassing all treatment models - inpatient, OPD, individual and group treatment, specialised
clinics, domiciliary etc.
IMPORTANT NOTE:
While SLT may only be viewed as having involvement with certain medical teams, neurology,
ENT, care of the elderly, stroke and general medical. It is important to note that due to the nature
of acute care, chronic illness (implicated in the use of 60% of hospital bed days) and the age
profile of patients admitted to SVUH, we do provide a service and are involved with most of the
medical teams, specialities and wards in the hospital.
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Catering Department
Service Departments
Staff
2005 was a very successful year in recruiting catering staff. We welcome all new members who joined us
this year. Teresa Mc Fadden (Chef), Ward Catering Assistants: Bernie Smith, Catherine Wright, Terry Townley,
Leona Delaney, and Patrick Walsh. Cafeteria and Kitchen Staff: Sinead Nugent, Abraham Baisel, Marie
Kennedy and Symon Talaga.
Mr. Frank Dowling, Kitchen Porter, celebrated 40 years working for St. Vincent's University Hospital on the
5th December 2005. We wish Frank much success in the future.
Service Development/Activities
The Staff Restaurant introduced a full carvery service which is the focal point of the new layout and an
acknowledged hit with staff and visitors. Menu choices have once more been extended with emphasis on
“healthy eating options”. Our customers are now enjoying the added benefit of “al fresco” dining space
which reduces demand for seating inside the restaurant, and affords a welcome fresh air/sunshine break for
staff cooped up in enclosed ward and office spaces.
The food service to patients was updated in 2005 by the provision of new food trolleys which meet the
temperature standards required by food safety regulations (HACCP). The food presentation and palatability
is also greatly enhanced.
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Catering Department
At “The Best of Health” conference on the 15th November 2005 in the Europa Hotel in Belfast, a
presentation on “Catering for Diversity and Ethnicity in our Hospitals” was delivered by Mr. Rick Wilson,
Director of Nutrition and Dietetics, King's Hospital, London and Peggy Lowry, St. Vincent's University
Hospital. The day seminar was organised and sponsored by the North South Health Service Partnership and
coincided with the launch of a new book “Ethnic Catering in Hospitals” for which St. Vincent's University
Hospital was one of the case studies.
Members of our own catering staff contributed recipes to the book with the exception of the Filipino recipe,
which was provided by Nurse Sheila Querubin. It is intended to feature these recipes on ethnic theme days
at regular intervals.
Departmental Statistics
The Catering staff provide a full meal service which is cooked and served fresh daily to over 500 in patients
and 2,000 hospital staff.
The Out-Patients Snack Bar has a throughput of 500 customers daily where a deli service is provided.
Catering facilities are also provided for functions, seminars and meetings throughout the hospital. Demands
on the staff restaurant have increased by over 33% since 2001.
The five “Top Spends “ for one-month period are
July 2004 July 2005
Dispenser Napkins €1,646.00 €1,748.86
Long Grain Rice 1,166.93 1,839.25
Disposable 9” plates 1,023.23 1,061.03
Cooking Oil 812.88 1,264.48
Baked Beans 752.46 1,372.68
Future Plans
At the top of the list for future planning for 2006 is the modernisation of all ward kitchens. These have
remained unchanged for many years.
Next in order of urgency will be the provision of an out-of-hours snack food service for patients. It is also
planned to provide a “full menu” for patients to inform them of the comprehensive range of choices available
to them. The printed menu will be provided to patients on a weekly basis, allowing them adequate time to
browse and make a selection.
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General Services Department
Service Departments
Telephone and Communication Services
The Telephone Service provides switchboard and other communication services to approximately 3,500
internal and external callers per day. The department also co-ordinates our internal and external fire and
emergency communication protocols, and is responsible for maintaining internal directories for the telephone
and paging systems. The service operates on a 24-hour basis, and is staffed by a team of 14 full and part-time
staff members.
During 2005 the hospital commissioned a significant new telephone system as part of the planning for the
commissioning of new facilities. This additional infrastructure will deliver increased functionality, capacity,
resilience and redundancy across the entire campus, and enable departments moving to our new facilities to
do so in a manner that creates minimal disruption to internal and external callers.
Security Department
The hospital is committed to providing a safe and secure environment for patients, relatives and staff. Our
security department plays a key role in the co-ordination and delivery of our safety and security activities, with
a particular focus on fire safety management and emergency response procedures.
The hospital continued to invest in the service in 2005, with the addition of new staff members, which will
enable us to improve the service to key departments on a 24-hour basis.
Portering Services Department
The department provides portering services to a broad variety of hospital departments through the provision
and supervision of portering staff. The areas serviced include Theatres, Laboratories, Radiology and Patient
Clinics. The department is also responsible for the provision and co-ordination of whole-hospital activities
such as waste management, post and patient transport. The staff compliment was 68 in 2005.
During 2005 the hospital commissioned and equipped a new waste marshalling facility as part of our
redevelopment programme. The management of waste will receive further attention in 2006 by way of a
review of our process with the intention of ensuring compliance with regulations and adherence to best
practices.
In November 2005 Mr John O'Grady, Portering Services Officer moved to a new position in the organisation,
after 12 years within the Portering Department. We wish him well in his new appointment.
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General Services Department
Cleaning, Hygiene & Household Services
The hospital acknowledges it's requirement to maintain the highest standards of cleaning and hygiene in
support of patient care. We also acknowledge that the creation of a clean and hygienic environment requires
commitment and teamwork from every discipline within the organisation. All such cleaning and hygiene
activities and priorities are guided by best Infection Control practices.
The majority of cleaning activities are provided under a contacted service, and the hospital endeavours to
ensure that the services provided continue to meet our ever-changing needs. Following a comprehensive
review of our cleaning specifications in 2004, the hospital sought revised proposals from the market for the
provision of our contracted service. This process led to the appointment of a new service provider, and we
look forward to working in partnership with Noonan Services over the coming years.
Our household function co-ordinates rest, welfare and accommodation facilities for staff and patient relatives,
and is also responsible for co-ordinating and monitoring various contracted household service
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Human Resources Department
Service Departments
2005 was a very active year for the Department, with a range of new initiatives and re-organisation of the
Department itself.
Re-organisation
John McPhillips was appointed in December 2004 as the Director of Human Resources. This role is intended
to assume a new strategic importance both within the University Hospital and the Healthcare Group. The
General HR Department was re-organised, with 4 Divisions now established each headed up as follows;
Head of Resourcing and Retention, Head of HR Services, Head of Learning and Development and Head of
Employee Relations. Further internal restructuring and strengthening of the functions is on going.
In the latter part of 2005, the Nursing HR area was re-configured and is part of the HR Department. A new
role of Head of HR Operations (Nursing Division) was advertised and Jared Gormly was appointed in
December 2005. A similar re-organisation is taking place in the Medical Administration Department, which
will become an integral part of the HR Department. A Head of HR Operations (Medical Division) is being
recruited. The integration of the 3 areas is part of the strategic development of the HR function and this
process had commenced in 2005.
Group HR Strategy
A significant recommendation, which followed from the Accreditation Process was the development of a
Group HR Strategy and this was also underlined in the Strategic Plan for the Healthcare Group. The terms of
reference and establishment of a steering group got underway towards the end of 2005 and external funding
was successfully secured under the “Improved Working Lives programme: Becoming an Employer of Choice
in the Health Service” to allow the engagement of an external consultant / facilitator. The strategy should be
delivered in 2006.
Accreditation:
On the broader HR accreditation agenda, meaningful progress was made on a range of Quality Improvement
Plans and recommendations in preparation for a mid cycle review visit in January 2006. These involved:
• Introduction of Personal Development Planning;
• Revised policies and procedures around registration with An Bord Altranais and the Medical Council;
• Revised Probationary Review system;
• Introduction of Exist Questionnaires;
• Enhanced staff communications;
• Revised Employee Handbook, HR policy manual and HR templates / Standard Operating Procedures;
• Enhanced Occupational Health services;
• Initiatives relating to enhanced integration of the Group on HR matters.
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Human Resources Department
Partnership
Partnership activity in SVUH is part of a national initiative under the leadership of senior management and
trade unions, coordinated through the Health Services National Partnership Forum.
Now entering a fourth year of formal partnership activity in SVUH, management and trade unions moved this
year to integrate much of their partnership activity with mainstream service provision within the Hospital
Provider Plan, supporting the programme of work in the St. Vincent's Healthcare Group. At the same time,
the parties are looking at how management, staff and unions can, together, identify and work the common
ground that meets the needs of all stakeholders, with the interests of patients and service users at the
centre.
Management and trade unions in the hospital agreed a partnership service plan for the year and sponsored
or supported a wide range of activities including the Dignity at Work programme, the Accreditation
programme, a major staff survey, a range of training initiatives and the publication of Occupational Health
leaflets. Partnership also played a role in maintaining a positive industrial relations climate and fulfilling the
hospital's obligations under the Performance Verification process in Sustaining Progress.
Resourcing and Retention Division
The recruitment section was involved in a high volume of recruitment of staff throughout the year. The
hospital continued to experience shortages in certain specialised areas and successful efforts were made to
recruit these staff shortages from at home and abroad. The recruitment-advertising budget increased from
approximately €295,000 in 2004 to €380,000 this year. This was reflective of the higher level of activity
required to fill posts during the year.
General HR conducted over 190 competitions throughout the year, Nursing HR conducted over 90
competitions and Medical HR conducted over 70 competitions. This is indicative of the very tight labour
market in which the hospital is competing.
Learning and Development Division
In 2005 the hospital continued to actively support staff who wished to further their education by providing
financial assistance towards fees for courses which ranged from one day seminars to degrees and post
graduate degree programmes.
The Corporate Induction day, which occurs in the Education and Research Centre every second month,
continues to receive positive feedback. In 2005 a total of 109 new staff attended
The hospital progressed the roll out of the nationally agreed “Dignity at Work” policy for the Health Service
with a number of Initiatives. External training providers were commissioned to provide a one-day workshop
on 'Dignity at Work' and this was run 39 times during 2005 and a total of 569 staff attended. The hospital
advertised for Designated Support Contact Persons and were delighted with the level of interest shown by
staff. 13 Designated Contact Persons were identified and are operating, as planned, to deal with issues within
their remit.
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Human Resources Department
The hospital is committed to ensuring that all staff, patients and visitors are treated with respect at all times
and management will support the roll out of this policy during 2006 with additional workshops and awareness
sessions.
External training providers were commissioned to present a two-day facilitation workshop on-site and a total
of 71 mangers, staff and union representatives attended. This workshop ran 6 times during 2005.
Other one-day courses, which were delivered for managers this year, included Recruitment and Selection
skills, Employment Law and People Management - The Legal Framework.
Team Based Performance Management was introduced in 7 pilot areas and feedback from this initiative has
been positive. It is expected that other departments will be invited to adopt this approach during 2006.
The National College of Ireland continued to provide their “Diploma in First Line Management” two-year
course on site. This is a very popular course with 14 graduating in October 2005, 17 participants progressing
to second year and 34 joining the first year of the programme.
Employee Relations Division
The Employee Relations Division of the HR Department had a particularly demanding year. The Employee
Relations Division continues to work closely with department heads in providing advice and support on the
provisions of employment legislation, managing performance, employee grievances and managing
attendance and representation in Union / Management meetings, 3rd party industrial relations fora. Important
activities for the Division during 2005 included:
• The opening of the new integrated mental health unit took place in May 2005 following a favorable
recommendation by the Labour Court.
• Discussions with Trade Unions on the relocation of services to the new building.
• The approach of promoting and maintaining good employee relations at local level continued and
resulted in a reduction of referrals for third party intervention.
• Regrading claims in Finance, Purchasing & Procurement, Medical Records and Clerical Admin areas.
• Satisfactory Performance Verification Reports for Phase 4 and 5
• Continued compliance with Industrial Relations provisions of Sustaining Progress.
• Completion of satisfactory discussions with Craft Group of Unions in relation to change and
modernisation agenda.
• Review of Attendance records in line with national guidelines for Health Service Employers on
Managing Attendance, which was launched in September 2005.
• The policy for Health Service Employers on upholding the Dignity and Welfare of Patient/Clients and
the procedure for Managing Allegations of Abuse against staff Members known as “Trust in Care” was
launched in May 2005.
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Human Resources Department
HR Services
The delivery of general HR services was particularly demanding in the year. The Division was also heavily
involved in a range of projects with the HR Accreditation process, aimed at enhancing customer service. The
review of and strengthening of HR systems and processes, in the context of Internal Audit standards, was
advanced in the period under review.
The HR Department continued to administer of the Voluntary Hospitals Superannuation Scheme and provide
an advisory service to current and former staff. The HR Department was also involved in the implementation
of on-going legislative changes to the scheme.
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Medical Records / Patient Services Department
Medical Records / Patient Services Department
Service Departments
Staffing
It is with great sadness to note that a long serving member of our staff, Myles Yeates, passed away in August.
We really miss Myles - may he rest in peace.
Throughout the year recruitment and training of staff was on-going. A total of 9 Grade IV posts were filled
and 12 Clerical Officers joined our organisation. In addition, many of our summer locums returned and new
temporary relief staff were introduced into the department. Internally, many staff availed of temporary acting
positions. A strong team of our long-term staff remain committed to working hard and thus making it
possible to keep the essential support services covered.
The following Grade V appointments were made:
• Al Janneh, Grade V Supervisor, Emergency Department Reception
• Julija Meirane, Temporary Grade V, Project Development Assistant, Ambulatory Day Care
Centre (ADCC)
• Alex Coulahan, Acting Grade V, Supervisor, Clinic Secretaries
Staff participated in the following courses on offer:
• Dignity at Work
• Equality and Diversity Training
The PDP (Personal Development Programme) was rolled out extensively due to the commitment of Jenni
Cross and Cecily Dawson. Many thanks to the Supervisors in different sections who dedicated their time
and efforts to ensure this was shared with staff appropriately.
As a result of the completion of a job evaluation exercise, the following positions in our department were
merited a higher grade:
• Statistics Officer, Marian Moran, Grade VI
• Medical Records Filing Room Supervisor, Ekundayo Badmus, Grade VI
• Medical Records Release of Information, Bernard Byrne, Grade V
• Medical Secretary, Department of Surgery, Marguerite Murphy, Grade IV
This is a positive acknowledgement of the importance of our work and recognition of the associated
responsibilities and duties that apply. Congratulations to all above.
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Service Developments / Activities
Hospital In-Patient Enquiry (HIPE) and Case Mix Department :
The introduction of a new coding system was effective from January 1st 2005
ICD 10 AM (Australian Modified) which involved significant changes and training for coding staff. Both coding
deadlines were met successfully on 30th June 2005 and 30th September 2005
National Patient Treatment Register - in conjunction with the Waiting List Office and ICT, staff from
Admissions, Medical Records, Outpatients and HIPE dedicated considerable expertise and time to assist in
setting up codes for the development of a national register. There was considerable data input work involved
and the system went live on June 9th
Admissions -many changes took place during the year, which resulted in revised work practices and
acceptance of additional work. New wards were introduced - Clinical Decision Unit (CDU), Elm Mount Upper,
Elm Mount Lower and the re-opening of beds in the vacated St. Camillus's Ward. Coordination of efforts
between staff in Admissions, Patient Accounts, Statistics and Ward Secretaries, along with the cooperation
of Administrative staff in the Emergency Department, Psychiatry and HIPE made collection and tracking of
information possible
Changes in the registration of deaths - effective from December 5th - resulted in reorganisation of workflow
and changes in notification to families of the deceased
Medical Records Filing Room - work commenced in December to refurbish the old pharmacy area for
accommodation of patient records. There is great anticipation from staff for the completion of this project,
which will allow for general improvement of working conditions in the main filing room area. All staff working
in this area are to be commended for their patience and perseverance - there is a light at the end of the
tunnel!
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Purchasing and Procurement Department
Purchasing and Procurement Department
Service Departments
Service Developments/Activities
Activity increased in 2005 as a result of improvement in funding made available to the Hospital late in the
year. All staff performed well to deal with the increased workload in the department, which is ongoing.
2002 2003 2004 2005
Total Purchase Orders 18,783 17,166 18,217 20,137
Total Value €21,787,514 €23,943,843 €29,857,219 €44,783,265
( Note : Includes Project Office Procurement for New Hospital Development)
Top Up System
Within existing resources, the “Top Up” stock control system was rolled out to include St. Paul's Ward and
Theatre General Ad Hoc gowns and drapes. This service includes review / replenish stock on a daily basis,
stock rotation and supplier expediting.
Medical Gas Supplies
In 2005 the control of medical / industrial gas was transferred from manual spreadsheets to the hospital
Purchasing Stock Control (Integra) system.
This year the Medical Gas replenishment system was rolled out to include Clinical Decision Unit (CDU)
(Camillus), Elm Mount Upper, and Elm Mount Lower.
Savings
There has been a saving of €460,730 to the hospital this year. There have also been savings in Centre Sterile
Supplies Department (C.S.S.D) of €12,000 following tenders and new product inclusion for user departments.
Total Hospital Savings 2004 2005
€204,000 €460,730
Procurement
The introduction of the new 'Outlook' e-mail system has enabled the department to further utilise electronic
means with suppliers so as to reduce paper transactions.
The Purchasing Department is now using the Irish Government e -Tendering website on a continuous basis
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for all tendering and this has proved to be extremely efficient. All tenders being produced for the
procurement of goods, services and capital equipment, as well as project procurement requirements are
published on this site. Supplier rationalisation is ongoing for 2005 and will continue throughout 2006.
Project Procurement
2005 saw the completion of 19 local and 17 European tenders, which generated 260 purchase orders with a
total spend of €16.5 million. Some of the major equipment packages completed were: Diagnostic Imaging,
PACS, Pathology Analysers, Physiological Monitoring and Ventilation & Anaesthesia.
The first six months of 2006 will see the remaining equipment requirements going to Tender on a phased
basis.
Central Supplies
The activity of the Main Stores continued to grow year on year, with the opening of Elm Mount and the
imminent opening of the new building especially having an impact. It is envisaged that in conjunction with
the “top up system” and the merging of the C.S.S.D. departments we will roll out an on-line Stock
Requisitioning System which will provide advantages to both user departments and the supplies function,
helping us to provide an improved service. The department has recently taken over the distribution of C.S.S.D
daily and weekly supplies to the wards. This has resulted in an enhanced and more efficient service.
CSSD continues to work with the Hospital Procurement Services Group (HPSG) and are currently examining
and evaluating the Dressings & Bandages Tender, which was first realised back in Spring 2005.
Capital Equipment
On behalf of the hospital, the Purchasing Department tendered and purchased over €1.5 million worth of
equipment this year, many areas throughout the hospital benefited from receiving new equipment.
Future Developments
It is envisaged to introduce Web Based Requisitioning to certain areas of the hospital throughout 2006. This
will eliminate the need for paper requisitions, as departments will request goods from Purchasing and Stores
via the Internet.
It is planned to introduce Custom Procedure Trays (CPT) in the first quarter of 2006. This will improve pre-op
activity efficiency and achieve value for money.
Ongoing stock count will be continued in 2006 for all departments. It is also proposed to streamline the
current method of ward stock counting by use of Pareto analysis.
A new system based report will be developed to improve the current method of amending supplier price
changes. This will considerably reduce the number of Purchase Orders / Invoice mismatches.
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Technical Services Department
Technical Services Department
Service Departments
Staff
The Technical Services Department provides the engineering and maintenance service for the hospital facility.
The department is responsible for providing the following services:
• Maintenance of existing building and facilities
• Maintenance of grounds, plant and equipment
• Management of fire protection, emergency lighting systems
• Energy management
• Refurbishment of existing accommodation
• Engineering and technical advice on the installation of new equipment
• Provision and upgrading of infra-structural services such as water, electricity, steam, heating,
ventilation, medical gases, telephony etc. within the hospital
• Project management
The current compliment of staff is 40. Bobby Bateson, foreman electrician and John Byrne, shift fitter, retired
during the year. We wish them well in their retirement. Two new staff members joined the department during
2004, John Whelan, Foreman electrician and Aidan Conroy, Facilities Engineer.
Service Developments/Activities
The main hospital project reached practical completion stage during February. The remainder of the year was
occupied with compiling and checking snag lists, organising staff training and getting familiar with the building
and all of the building services.
Projects
In addition to the above, many minor capital projects were completed. This was achieved through a
combination of our own in-house staff of electricians, carpenters, plumbers and painters and external
contractors. A summary of these projects is as follows:
• Upgrade and conversion of 6 bed ward in St. John's Ward to create a specialised non invasive
ventilation (NIV) Unit.
• Major upgrades to Mortuary Chapel and pastoral areas to provide a compassionate area for bereaved
relatives and friends
• Replacement of old windows to improve building energy efficiency and enhance comfort for patients
and staff including Our Lady's Ward, St. Camillus' Ward and the Doctors' Residence
• Office upgrades to create more efficient working environments including Gastroenterology, Nursing
Education and Catering
• Upgrade of domestic hot water system to improve efficiency, quality and reliability of service
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Maintenance
This year saw the introduction of a web based Help Desk maintenance system known as Pemac. This system
enables staff to log their maintenance requests directly onto our maintenance management system via the
hospital intranet. Staff can check on progress of individual requests or all requests for their department. The
web based system was introduced in September and has yielded efficiencies in terms of more accurate
reporting of problems, less duplication and more overall visibility of the workload which greatly assists
planning of future works.
The maintenance staff were kept busy with the increasing demands of routine and preventative maintenance
and ongoing breakdown maintenance in both the existing and new hospital buildings.
Future Plans
The year ahead will be challenging for the Technical Services Department as various departments move into
the new building. The department has to become familiar with the new systems within the new building,
check that the building performs to specification, establish planned maintenance programmes and set up
maintenance contracts with external providers.
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Theatre Sterile Services Unit (TSSU)
Service Departments
Staff
During the year we said “au revoir” to two members of staff, Aileen Byrne and Linda Finn. We congratulate
Stephen Newman who was appointed to Supervisor in November and Michelle Rankin and David McCleery
who were appointed as acting senior technicians. New recruits Patrick Mahon and Andrew Fields have joined
the team as sterile services technicians.
Ms Ita Balfe attended the European Forum for Hospital Sterile Services in London in April and with Stephen
Newman attended the annual Irish Association of Sterile Services Managers conference which was held in
Malahide in October.
Ms Ita Balfe was an invited speaker at the National Operating Theatre Nurses Conference in Killarney on the
subject of “Surgical Instrument Traceability - myths and realities”.
Service Developments/Activities
The service activity levels of the department have again increased but despite the limitations of the current
working environment and with great effort and commitment of the staff, a high quality service continues to
be provided.
2005 will be remembered for the time and effort spent in preparation for the move to our new department.
Equipping lists, operational policies and gap analysis have become an integral part of our lives. It is anticipated
that the move will take place early in 2006. The new department will be renamed HSSD (Hospital Sterile
Services Department)
Future developments
We look forward with great anticipation to moving to the new state of the art facility next year. No doubt
many new challenges will present themselves in the form of new technology and practices but we will
endeavour to take these challenges in our stride and continue to deliver a high quality service to the hospital
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2005 Healthcare Group Committees
Board of Directors
Group Executive
Finance Committee
Membership
Chairman
Professor Noel Whelan
Members:
Mr. Edmond J. Bergin
Sr. Eugene Butler
Ms. Louise English
Mr. Stewart Harrington
Mr. N. C. Jermyn
Professor M. X. FitzGerald
Mr. Joe Leyden
Sr. Anne MacEneaney
Dr. Brian Maurer
Ms. Gemma McCrohan
Mr. Patrick Meade
Mr. Michael Meagher
Dr. Risteárd Ó Laoide
Mr. W. R. Quinlan
Mr. Conor Sexton
Dr. Michael Somers
In Attendance:
Sr. Therese Culhane
Ms. Mary Duff
Mr. Eamonn Fitzgerald
Mr. Cormac Maloney
Mr. Michael Redmond
Chairman
Mr. N. C. Jermyn (Chair)
Chairman
Mr. Conor Sexton
Members:
Mr. Ken Bale
Members:
Ms. Marianne Byrne
Ms. Louise English
Ms Josephine Barrett
Mr. Stewart Harrington
Ms. Gretta Colbert
Mr. Patrick Meade
Mr. James Crowe
Mr. Dermot Cullinan
In Attendance:
Ms Mary Duff
Dr. Brian Maurer
Mr. Eamonn Fitzgerald
Dr. Risteard O'Laoide
Mr. Ian Maguire
Mr. Nicholas C.Jermyn
Mr. John McPhillips
Mr. Eamonn Fitzgerald
Mr. Cormac Maloney
Mr. Cormac Maloney
Dr. Brian Maurer
Ms. June Stanley
Mr. Seamus Murtagh
Mr. Michael Redmond
Dr. Risteárd Ó Laoide
Mr. James Crowe
Mr. Michael Redmond
Mr. Seamus Murtagh
Mr. Peter Sheehan
Mr. Ken Bale
Ms. June Stanley
Mr. Neil Twomey
Audit Committee Membership
Chairman
Dr. Michael Somers
Members:
Mr. Patrick Meade
Mr. Michael Meagher
Mr. Conor Sexton
In Attendance:
Mr. Ken Bale
Mr. James Crowe
Mr. Eamonn Fitzgerald
Mr. Nicholas C.Jermyn
Mr. Cormac Maloney
Mr. Seamus Murtagh
Ms. June Stanley
Mr. Michael Redmond
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2005 Healthcare Group Committees
Group Medical Executive
Chairman
Dr. Risteárd Ó Laoide
Honorary Secretary:
Dr. Ken McDonald
Members:
Dr. Tom Crotty
Chairman Department of Pathology
Dr. Seamus Donnelly
Rep Academic Department UCD
School of Medicine
Ms. Margaret O'Donnell
Elective Representative
Dr. Doug Veale
Elected Representative
Mr. John Ryan
Elected Representative
Ms. Mary Barry
Chairperson South Eastern Dublin
Division Surgery
Professor Kevin Malone
Department of Psychiatry
Professor Niall O'Higgins
Chair of Surgery
Dr. Hugh Mulcahy
Chairman Sub Committee
Dr. Declan O'Keeffe
Chairman Division of Anaesthesia
Dr. Stephen Skehan
Chairman Division of Radiology
Mr. Donal Maguire
Chairman St Vincent's Private
Hospital Forum
Mr. Enda McDermott
Chairman Oncology Sub Committee
Mission Committee
Chairman
Sr. Eugene Butler
Secretary:
Ms. Theresa Ward
Pathology
Ms. Gemma McCrohan
Mr. Nicholas Jermyn
Sr. M Angela
Rev. Ted Ardis
Mr. Ekundayo Badmus
Ms. Barbara Cantwell
Ms. Therese Carey
Dr. Michael Casey
Fr. Liam Cuffe
Mr. John Harraghy
Mr. John Hickey
Dr. Risteard O'Laoide
Dr. Diarmuid O'Shea
Ms. Sheila O'Toole
Ms. Phil Pyne Daly
Sr. Margaret Hilliard
Ms. Nicola Geoghegan
Ethics and Medical
Research Committee
(June 2005)
Chairman
Dr. Doug Veale
Expert Members
Dr. Michael Moriarty
Deputy Chairman
Dr. Kieran Crowley
Alt. Chairman
Dr. Kieran Sheahan
Dr. Dermot Malone
Mr. Eamonn Fitzgerald
Ms. June O'Shea
Dr. Eoin Tiernan
Ms. Tanya King
Dr. John Ryan
Mr. S. Dudeney
Mr. Michael Redmond
Co-Opted Member
Lay Members
Mr. Joe Leyden
Ms Ciara Murray
Ms. Siobhan Reynolds
Mr. L. Newcombe
Mr. Frank Smith
Mr. C. Diamond
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2005 Healthcare Group Committees
Project Team
Chairman
Mr. Nicholas C. Jermyn
Group Chief Executive
Members:
Mr. Eamonn Fitzgerald
Group Deputy Chief Executive
Mr. Gary Wright
Boyd Creed Sweett
Mr. Paul Marlow
Director, Boyd, Creed, Sweett
Mr. Peter Kerruish
Director, Boyd Creed Sweett
Sr. Anne MacEneaney
Sister Superior
Ms. Mary Duff
Director of Nursing
Mr. Pat McDonnell
Technical Services Manager
Dr. Risteárd Ó Laoide
Chairman, Medical Executive
Dr. Lynda Fenelon
Consultant Microbiologist
Professor
Diarmuid O'Donoghue
Consultant Gastroenterologist
Dr. Mary Barry, Consultant
Surgeon, Division of Surgery
Mr. Justin Geoghegan
Consultant General Surgeon
Mr. William R. Quinlan
Consultant Orthopaedic Surgeon
Mr. Wilf Higgins
Engineering Advisor, Department
of Health & Children
Mr. Paul de Freine
Deputy Chief Architectural
Advisor, Department of
Health & Children
Mr. Terry Woulfe-Flanagan
Principal Quantity Surveyor,
Department of Health & Children
Mr. Brendan McGrath
Structural Engineering Advisor,
Department of Health & Children
Ms. Louise McMahon
Network Manager, HSE
Health Promotion
Committe
Chairman
Dr. Diarmuid O'Shea
Secretary:
Ms. Denise Comerford
Members:
Ms. Margaret Boland
Ms. Maeve Broderick
(to Feb.05)
Dr. Anna Clarke
Mr. Ronan Clancy
(from March 05)
Ms. Yvonne Connolly
Ms. Margaret Doyle
Ms. Elaine Hammond
Ms. Ann Donohoe
Ms. Peggy Lowry
Ms. Barbara Murray
Ms. Anne McFadden
Ms. Catherine Toole
Ms. Ann O'Reilly
Ms. Vivien Reid
Ms. Orla Seale
Ms. Mary Shore
Health & Safety Committee
Chairman
Mr. Eamonn Fitzgerald
Members:
Ms. Elizabeth Barry
Ms. Eithne Culinan
Mr. Donal Murphy
Ms. Liz Barnes
Mr. Gerry Gorey
Ms. Emma Curry
Mr. Peter Mortell
Ms. Peggy Lowry
Mr. Pat Gargan
Mr. Donal Sheeran
Mr. Larry Clancy
Dr. Lynda Fenelon
Ms. Theresa Flynn
Ms. Nuala Gannon
Dr. Paul Gueret
Mr. John Heal
Mr. Pat McDonnell
Ms. Maragret Brittain
Ms. Regina Rooney
Ms. June Stanley
Ms. Catherine Toole
In Attendance:
Ms. Eleanor Scully SMH
Mr. Peter Sheehan SVPH
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