ANNUAL REVIEW master Final3a - St Vincent's University Hospital

Review 2007 

St. Vincent’s Healthcare Group Limited 

incorporating 

St Vincent's University Hospital 

St. Vincent's Private Hospital 

St. Michael's Hospital

St. Vincent’s Healthcare Group Limited - Annual Review 2007 

Contents 

Reports 

Mission Committee 6 

Ethics and Medical Research 8 

Health and Safety Review 10 

Report from Clinical Audit Department 12 

Education and Research Centre 14 - 73 

St. Michael’s Hospital Report 74 - 83 

St. Vincent’s Private Hospital 84 - 109 

St. Vincent’s University Hospital 110 - 299 

Report from the Director of Operations 112 

Reports 

Report from Chaplaincy/ Pastoral Care Department 116 

Report from Library and Information Service 120 

Report from Medical Records 123 

Allied Health Professionals and Support Services 

Medical Physics and Clinical Engineering Department 124 

Medical Social Work Department 126 

Nutrition and Dietetics Department 129 

Occupational Health Department 131 

Occupational Therapy Department 137 

Pharmacy Department 140 

Physiotherapy Department 145 

Preventive Medicine and Health Promotion Department 148 

Speech and Language Therapy Department 152 

Report from the Director of Nursing 158 

Bed Management 161 

Hospital Sterile Services Department 162 

Hospital Hygiene Services 163 

Report from the Professor of Medicine 168 

Report from the Chairman Physicians Subgroup 171 

Department of Anaesthesia, Intensive Care and Pain Medicine 172 

Department of Cardiology 181 

Department of Dermatology 185 

Department of Endocrinology and Diabetes Mellitus 187


Department of Medical Oncology incorporating 

Lios Aoibhinn Cancer Support Centre 194 

Department of Medicine for the Elderly 196 

Department of Nephrology 199 

Department of Neurology 200 

Department of Clinical Neurophysiology 205 

Department of Palliative Medicine 207 

Department of Respiratory Medicine 209 

Bone & Joint Unit 212 

Department of Rheumatology 213 

Department of Rehabilitation Medicine 220 

Report from the Professor of Surgery 224 

Reports from the Chairman Surgeons Subgroup 227 

Liver Transplant Programme and Liver Unit 228 

Department of Ophthalmology 229 

Operating Theatre Department 232 

Department of Orthopaedics 235 

Department of Plastic Surgery 238 

Department of Urology 240 

Department of Vascular Surgery 245 

Department of Medical and Surgical Gastroenterology 

incorporating the Centre for Colorectal Disease 250 

Report from the Emergency Department 256 

Report from the Pathology Department 258 

Report from the Radiology Department 262 

Report from the Clinical Director of Psychiatry 266 

Department of Old Age Psychiatry 267 

Report from the General Services Manager 272 

Department of Catering 274 

Department of Fire Safety 276 

Department of Household Services & Cleaning 277 

Department of Portering Services 278 

Department of Security 278 

Department of Technical Services 279 

Department of Telecommunications 281 

Report from the Human Resources Department 284 

Reports from Information and Communication Technology Department 289 

Report from Purchasing and Procurement Department 293 

Report from the Quality, Risk and Consumer Affairs Department 295 

2007 Healthcare Group Committees 297


Mission Effectiveness 

Mission & Values Committee 

As we face the many challenges today we maintain the philosophy of caring which is the very essence of 

our mission. 

Mission Committee 

Our thanks to all the members who gave so generously of their time and shared their creative ideas in 

seeking ways to promote the mission. The committee met every two months. 

Mission Education Programmes 

Units 1 & 2 of the Mission Effectiveness programmes were held on a regular basis throughout the year, all 

departments were represented with a total of 208 in attendance. 

It was evident from the responses from the groups that there was strong support for the mission and efforts 

made in all areas to integrate the values. 

Feedback was collated and presented at the Mission Committee and at Heads of Departments meetings. 

Mission Statement 

The new Group Mission Statement is now on display in the three hospitals. In addition laminated cards (credit 

card size) displaying our core values were prepared in-house and distributed to staff at Heads of 

Departments meetings. 

Accreditation 

In preparation for accreditation, quality standards based on evidence in relation to Mission Integration were 

prepared for the Leadership and Partnership Team who are working on “Developing the Organisation’s 

Culture”. With strong emphasis on the delivery of high quality care we realise that quality and mission have 

much in common and are the foundation for all the services we provide. 

Role of a Clinical Ethics Committee 

Meetings were held for all staff in the Group with the Professor of Health Care Ethics, RCSI starting a 

process of consultation, which hopefully will result in the setting up of a committee that would address ethical 

concerns. 

Return to Contents 

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Celebrations 

• There was a great attendance at the Mass celebrating our Foundation Day on the 23rd 

January. Many enjoyed the refreshments and the interactions afterwards. 

• On the feast of St Vincent de Paul, Mass was celebrated at 5.00pm for our deceased 

and bereaved staff. This celebration was much appreciated. 

Oratory 

The Oratory was refurbished this year. Staff from Health & Safety, Infection Control and Chaplaincy were 

involved. Thanks to all in Technical Services who completed a splendid job. 

Long Service Awards 

Long service awards were presented to staff from the three hospitals on 23rd October following the launch 

of the annual report. It is hoped that this celebration will now take place each year on Foundation Day. 

Hospital Choir 

The Choir performed in a wonderful and professional way at all our important celebrations. Staff provided 

the music playing - organ, violin, flute & viola. 

A wonderful selection of both carols and music was also performed for staff and patients for the Christmas 

season. Lunch breaks were given over to practice and recitals took place in the Atrium with excellent 

acoustics. It is indeed an event worthy of note in this report. Thanks to all who were so generous with their 

time and talents. 


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Ethics and Medical Research Committee 

The St. Vincent’s Healthcare Group Ltd., (SVHG) 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). 

In September 2007, the Department of Health & Children extended our recognition as a designated 

committee for a period of one year. 

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. The revised 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 July 2007. 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. 

Committee 

Throughout the year there were a number of changes in committee membership and new members were 

duly appointed. Dr. Brian Kirby was appointed Chairman of the committee in September 2007 following the 

completion of Professor Douglas Veale’s three year term of office. 

Meetings 

There were a total of 11 Committee Meetings held from 1st January 2007 to 31st January 2008 

Clinical Trials Reviewed 

Number of New Clinical Trial Proposals Considered: 14 

Number Issued a Favourable Opinion: 14 

Total 14 

SVHG EMRC are the responsible Ethics Committee for the following: 

Pharmaceutical Sponsored Trials 24 

Investigator Led Trials 11 

Pharmaceutical/Investigator Led, External Sites only 11 

Total 46 


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Research Studies 

Total Research Studies Reviewed 99 

Total Approved 99 

Amendments 

Total Number of Clinical Trial Amendments Reviewed and Approved 60 

Quarterly/Annual/Termination Reports 

Total Number of Reports Reviewed and Noted 110 

Copies of all application documents are available electronically and in hard copy from Ms Joan 

McDonnell/Ms Anna Brennan, Ethics Office, ext: 4117 (joan.mcdonnell@ucd.ie). (anna.brennan@ucd.ie). 


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Health and Safety Review 

St Vincent’s University Hospital recognises its obligations and duties as an employer, to direct, manage and 

ensure, as far as is reasonable practicable the safety, health and welfare of all employees, contractors and 

members of the public who may attend our premises as required under Safety, Health and Welfare at Work 

Act 2005. The goal of the hospital is not only to meet our legislative obligations but also to exceed them 

through the pursuit of best practices in all areas. 

Health & Safety is co-ordinated by Regina Rooney and is facilitated through a number of structures. The Health 

and Safety committee co-ordinates and monitors our safety management programme and acts as a platform to 

address matters pertaining to health, safety and welfare of all staff. It is representative of all major stakeholders. 

The Staff Safety Representative co-ordinates the process at local level and is further supported by a Safety 

Risk and Quality Improvement Group which reviews and address issues on a weekly basis. 

Training 

There is an ongoing and comprehensive mandatory training programme for Health and Safety. This was 

supplemented with department or role specific training for example Medical Gases, CPI training and Train 

the Trainer workshops during 2007. 

Two Dangerous Goods Safety audits were carried out this year and the department has implemented 

relevant staff training to address the audit recommendations. 

European Health and Safety Week 

In October the hospital participated in the European Health and Safety Week. The theme of this year’s event 

was" Lighten the Load", primarily targeting musculoskeletal disorders. The Annual Health and Safety 

Breakfast event was organized by Health and Safety and Ergonomics and Back Care with assistance of Risk 

Management, Preventive Medicine, Infection Control, Occupational Health, Security and Fire Safety. External 

partners represented were the Gardai, Dublin Fire Brigade, Oxigen and BOC Gases. This event is an 

excellent way for all staff to update themselves on topical issues in a relaxed and informal manner. It also 

helps to maintain the profile of Health & Safety within the hospital. 

During the event the hospitals Patient Handling Risk Assessment form “Easymove” was launched. The 

‘Easymove’ form aims to assist in providing the best care to patients in relation to manual handling and to 

minimize the risk to staff. Overall the event was a great success and thanks to all who participated. In 

particular, thanks to all who contributed to the stands and who assisted in making the day happen. 

The past year has seen a further roll out of safety statements and handouts including notification regarding 

the new General Applications regulations. 

The department is also progressing with General and Chemical Risk assessments in various departments. 

This programme includes training sessions for staff on how to complete assessments for their indiduvual 

areas. Other areas in which Health & Safety has been involved during 2007 are: 

• Accreditation • Working at Heights • Patient Restraint Policy 

• Internal Disaster Plan • Decontamination Audit • Health and Safety Module leader 

- FETAC HCA support Certificate 


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Clinical Audit Department 

2007 was a productive year, with more awareness of the principles of clinical audit across the three hospitals 

in the group. The department continues to support staff in the inclusion of audit within their daily practice. 

This necessary mindshift seeks to get away from the idea that audit is an add-on to our daily workload. 

Amassing evidence of good practice has been the central tenet of the audit function and we continue to 

successfully achieve this goal. Another 35 audits completed in the year highlight the excellent level of care 

and service that our hospitals provide to patients. Whether through surveys of patient satisfaction, measures 

of clinical outcomes or the adherence to national or international standards, these audits highlight an 

overwhelming level of excellence. Where issues for improvement have been identified at local level, the 

impetus that drove the staff to audit their work in the first place becomes the enthusiasm to make the 

necessary changes for the better. 

Concern centres on the blunt instruments enacted for control of expenditure and recruitment at national 

level. Such approaches can be detrimental to patient safety and excellence of care, where it has been clearly 

shown that additional resources would not just benefit organisational delivery of healthcare but would 

enhance efficiency or have a higher return on investment in the longer term. This blanket ban approach on 

expenditure has had an arresting effect on the closure of some audit loops in our hospitals. 

The Board of the hospital and the clinical governance committee continue to stand four square behind the 

rollout of clinical audit across the hospitals. In a new development, a book containing all the poster 

presentations at the audit masterclass was presented to each board member after the event. Copies of these 

posters were also hung in the foyers of the hospitals, where other staff, patients and visitors could witness 

examples of the high quality of healthcare being delivered across the group. 

The group chief executive’s support in funding summer projects by medical students has been very effective 

in driving forward the audit agenda. These students, some of which were at a very early stage in their medical 

training, produced clear and effective audits under the supervision of consultants with significant learning for 

the speciality and the organisation. This project had the added benefit of exposing undergraduates to the 

principles of clinical audit and adding to the skills of medical students in preparation for employment as 

qualified doctors. It is hoped to expand this project approach in following years, through greater linkages 

with the relevant schools of University College Dublin. 

Clinical audit is now established as a component of medical induction for junior doctors. This is very much 

due to the re-engineering of the induction process by medical HR. This new approach has been highly 

evaluated by our new medical staff and may serve as a model for other hospitals. 

We continue to explore newer, different and more effective ways of educating staff in the practice of clinical 

audit. We hosted another successful Clinical Audit Study Day and Masterclass with speakers from the 

National Indicator Project in Denmark sharing their experience of clinical indicators with us. National and UK 

leaders in quality and governance outlined possible ways forward for the group and helped set the scene for 

even more audits at even higher standards of achievement. In house, having presentations from Internal 


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Report from the Clinical Audit Department 

Audit, Clinical Audit and Library Services provided a basis for showing how these three functions could work 

in collaboration and this work enabled us to carry out joint audits subsequently. 

The attendance took us somewhat by surprise, exceeding our expectations by almost one third. The day was 

an enormous success with staff presenting posters of clinical audits conducted during the course of the year. 

Attendees voted for the winning posters with the conundrum of having a tie for first place being addressed 

by the CEO in providing two first prizes. 

The department had the pleasure of assisting the Pharmacy Department in organising a study day on 

medication safety. Again, attendance was more than expected and the format of having external and internal 

speakers, promoting excellence, is one that warrants repeating. 

Whereas we were unsuccessful in getting abstracts for national and international meetings accepted in our 

first year of existence, we had a much better return during 2007. More importantly, the high rate of 

acceptance for such conferences and peer- reviewed journals testifies to the learning that has been brought 

about by conducting such audits. Presenting at speciality meeting and ISQUA meetings offers the hospitals 

the opportunity to share our learning within wider international healthcare systems. Several audits were 

further recognised externally, winning awards at national and international conferences. 

Some of our audit findings relating to primary were published in Forum magazine, again emphasising the 

hospital’s goal of working closely with primary care and our local GPs. 

Our approach to clinical audit is not confined to the usual topics. Nursing practice development, as well as 

auditing the learning environment for student nurses at the behest of the university, also evaluated the 

optimal length of shift and preceptors attitudes for gaining the maximum effect for nursing education. The 

psychiatrist multidisciplinary meeting was evaluated for its effectiveness, using a variety of audit tools and 

the meeting format and structure has changed as a result. 

Likewise, a focus groups in cardiac rehabilitation lead to further enhancement of the printed literature 

provided to patients following their heart attack and allowed us to increase our experience in patient 

engagement. 

We delivered lectures on clinical audit practice, clinical governance and patient involvement to students on 

MBA courses, as well as masters in quality and diploma students and more general audiences throughout 

the year. 

Finally 2007 saw the launch of the clinical audit newsletter within the group where a synopsis of recent 

audits is shared with staff and public alike fostering a culture of openness, transparency and sharing of 

learning that we feel is a significant element of the mission of St Vincent’s Healthcare Group. 


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14 

Research

Education and Research Centre 

Reviews and Personnel 

Research Activities: 

Inflammation, Infection & Immunity 

Cancer 

Suicide & Depression 

Postgraduate Department 

Academic Activities 

Publications 

Grants Active 

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Contents 

Reviews and Personnel 

Review by E.R.C. Medical Director 17 

Principal Investigators - 2007 19 

Research Laboratories – Personnel 2007 20 

Research Activities: 

Translational Medicine Research Group Inflammation, Infection & Immunity 21 

Rheumatology 22 

Bioinformatics and Molecular Evolution 29 

Innate Immunity 31 

Liver Research 33 

Endocrinology & Diabetes Mellitus 38 

Thyroid Eye Disease 39 

Obesity 40 

Respiratory Sleep 40 

Neurology Research in Multiple Sclerosis 41 

Cancer 

Centre for Colorectal Disease 47 

Breast Cancer 51 

Suicide & Depression 

Psychiatry & Mental Health Research 52 

Postgraduate Department 53 

Academic Activities 57 

Research Course 58 

Workshops 58 

Lectures/Journal Club/Education & Outreach 59 

Prestigious Invitations/Honours 60 

Awards/Prizes & Degrees 62 

Publications 

Papers in International Peer Reviewed Journals 63 

Chapters in Books 69 

Grants Active 

Grants Active in 2007 70 

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Review by Medical Director, Education & Research Centre, 

Prof. Doug Veale & Director, Research Laboratories, Prof. Cliona O’Farrelly 

In 2007, we continued the significant momentum for development which had been 

established in 2006. This included a number of very positive developments in 

Translational Medicine research at SVUH, including: 

• Development of research strategy; & prioritisation; 

• Infrastructural Development 

• Funding 

• Administration 

which all involve and impact on the Education and Research Centre of St 

Vincent’s Healthcare Group, the Clinical Research Centre (previously known as 

the Genomics Research Unit), the Conway Institute at UCD, the broader 

academic community within UCD and its associated teaching hospitals. 

It is with great regret that Professor Cliona O’Farrelly was recruited by Trinity 

College, leaving the ERC after 16 years of complete dedication and loyal service, 

as the ERC’s Scientific Director to the students, researchers, PI’s and 

administration which undoubtedly made the ERC a vibrant and enthusiastic 

research institute. It is hoped by all that we can be inspired by her example and 

continue to ensure the ERC is active and successful as a leading research unit 

in Ireland 

Research Prioritisation and Strategy 

The 3 thematic areas of research prioritised through the Research Advisory Board/International panel review 

were endorsed at the final meeting of the Research Advisory Board: 

• inflammation and infection, • cancer • suicidal depression. 

The further development and outcome of this process has now led to the important and exciting step of the 

formation of the Dublin Academic Healthcare Centre - groups from the Mater University Hospital, St. 

Vincent’s University Hospital and UCD together in a single academic and clinical entity which will bring 

significant benefits for the organisation, infrastructure and governance and will allow for a clear and 

comprehensive research strategy. 

Infrastructural Development 

The third floor of the Education & Research Centre vacated in 2006 is now being refurbished with Research Laboratory 

Co-ordinator - Dr. Emer Bairéad, responsible for significant advances in this area. We have established dedicated 

research space with clearly defined functional areas – hypoxic laboratory, tissue preparation, immunohistochemistry, 

digital image analysis suite and PCR preparation laboratory. 

The combined ERC/CRC management team under the joint chairmanship of Risteárd Ó Laoide, Chairman of the 

Medical Board and Prof William Powderly, Prof of Medicine and Head of the School of Medicine & Medical Science, has 


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Education & Research 

made significant strides which are intimately interwoven with the establishment of the DAHC. We are pleased that Prof. 

William Powderly has been appointed as the interim Chief Academic Officer. Dr Peter Doran was appointed as the 

Scientific Director of the UCD Clinical Research Centre in November 2007. Significantly, the CRC received its first 

research participants on the 1st of March 2007, and now a number of research studies are underway. The 

Rheumatology group have commenced arthroscopic procedures in the unit as part of the Translational Medicine 

Programme study which was awarded by the HRB in 2006. 

Funding 

The new Translational Medicine Research group has been established with a Health Research Board award worth over 

€1.5 million. This multidisciplinary group brings together rheumatology, colorectal and the vascular biology researchers, 

based at SVUH and The Conway Institute has established a solid platform for collaborative and interdisciplinary 

translational research. Researchers from the ERC obtained further major funding for Translational Medicine €1.3 million 

entitled ‘Immune targeting strategies: improving the response rate to IFN-alpha/ribavirin therapy in chronic Hepatitis C 

Virus infection’ in 2007. In addition the colorectal group have been shortlisted for a prestigious HRB Health Research 

Centre Award worth up to €5 million over the next five years. 

All principal investigators, senior scientists, post-doctoral scientists, clinical fellows, post-graduate students and 

research assistants deserve huge congratulations as the Education and Research Centre have achieved over 70 

publications in peer reviewed journals and 6 higher degrees were awarded. This could not be achieved without the 

dedicated enthusiasm and hard work from each and every researcher, as well as the superb support of the Laboratory 

Co-ordinator, Dr. Emer Bairead; the administration team of Ger Lanigan Ryan & Louise McCormack; as well as the ever 

helpful Alan Garton. 

The future continues to provide significant challenges for our research community with further integration and 

rationalisation of space within the ERC and the CRC and the Conway Institute. We believe that there is currently a very 

positive momentum in this regard. This poses a number of challenges in terms of: 

• Permanent career track appointments for senior scientists in line with the International Review of Research 

remains an unresolved and urgent priority 

• Dedicated funding for research support and activities from the hospital and the University. 

• Coordination, space infrastructure and personnel. 

• Development of a DAHC research strategy 

• Establishment of core resources especially technical and IT/bioinformatics staff. 

These aspects are actively being reviewed and it is hoped that the PI’s, hospital management and UCD, through the 

DAHC will support a cohesive strategic plan within a realistic time frame. 

Prof. Doug Veale, 

Medical Director, 

E.R.C. 

Prof Cliona O’Farrelly. 

Director, Research Laboratories 

E.R.C. 


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Principal Investigators - 2007 

Prof. Barry Bresnihan 

Prof. Aongus Curran 

Prof. Joe Duffy 

Prof. Douglas Veale 

Prof. Oliver FitzGerald 

Dr. Charles Gallagher 

Mr. Justin Geoghegan 

Prof. John Hegarty 

Prof. Kevin Malone 

Dr. Donal O’Shea 

Prof. T.J. McKenna 

Prof. Walter McNicholas 

Dr. Hugh Mulcahy 

Prof. Diarmuid O’Donoghue 

Prof. Cliona O'Farrelly 

Mr. Denis Evoy 

Dr. Ursula Fearon 

Dr. Jacintha O’Sullivan 

Dr. Kieran Sheahan 

Dr. Tom Smith 

Dr. Niall Tubridy 

Mr Enda McDermott 


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Research Laboratories – Personnel 2007 

Director, Research Laboratories: Prof. Cliona O'Farrelly (until Aug 2007) 

Research Technology Facilitator: Dr. Emer Bairead 

Senior Scientists & Post Doctoral Fellows 

Jacintha O’Sullivan Andrew Lloyd Ursula Fearon 

Sinead Nic an Altaigh Kieran Meade Elizabeth Ryan 

Jean Fletcher Wei Gao Aisling Pierce 

Eadaoin McKiernan 

Nigel Stevenson 

Research Assistants 

Anna Kwasnik Emma McGrath Jennifer McCormick 

Sarah Cahalane Catherine Keogh Fernando Narciandi 

Miriam Tosetto Monika Biniecka Anna Maria McCrohan 

Jorge Ruiz de la Fuente Dermot Bowden 

M.D. 

Zaman M Badar Tariq Tajuddin Chin Teck Ng 

Juliette Sheridan Ceara Walsh Eliza Pontifex 

Gavin Rush Garret Cullen Joe Marry 

Dave Kevans Jean O’Connell Kavin Nanda 

Peter Barry Orla Young Bernadette Lynch 

Research Associates 

John Garvey Marion Rowland Silke Ryan 

PhD Students (Post Grads) 

Aisling Kennedy Lydia Lynch Patricia McGowan 

Ronan Shaughnessy Lucille Kavanagh Sheeona Gorman 

Paul Cormican Aoife O’Donovan Tom Cawood 

Martina Gogarty Ellen Moran Mary Connolly 

Eszter Nemeth 

Aspinas Chapwanya 

MSc. 

Julie Gorman 

MCh. 

Mohammad R. Zaman 

Chin Lim Hong 

Under Graduate Students 

Owen Sullivan Aoife Murphy Jannie Michielsen 

Research Nurses 

Blathnaid Nolan Catherine McEvoy Helen Vaughan 

Lisa Gribbin 


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Research Activities 2007 

TRANSLATIONAL MEDICINE RESEARCH GROUP 

INFLAMMATION, INFECTION & IMMUNITY 

• Rheumatology 

• Bioinformatics & Molecular Evolution 

• Innate Immunity 

• Liver Research 

• Endocrinology & Diabetes Mellitus 

• Thyroid Eye Disease 

• Obesity 

• Respiratory - Sleep 

• Cystic Fibrosis Research 

• Neurology Research in Multiple Sclerosis 

CANCER 

• Centre for Colorectal Disease 

• Breast Cancer 

SUICIDE & DEPRESSION 

• Psychiatry & Mental Health Research 


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Rheumatology 

Principal Investigators 

Professor Barry Bresnihan 

Professor Douglas Veale 

Specialist Registrar 

Registrar 

Professor Oliver FitzGerald 

Dr Ursula Fearon (Senior Scientist) 

Dr Ceara Walsh 

Dr. John Paul Doran 

Clinical Research Fellows Dr Chin Teck Ng Dr Laure Brulhart 

Dr Eliza Pontifex 

Dr Bernadette Lynch 

Dr Taj Saber 

Post Doctoral fellow Dr Sinead NicUltaigh Dr Wei Gao 

Dr Monika Biniecka 

Dr Emily Collins 

Research Assistants Jennifer Mc Cormick Jorge Lirola 

Graduate Students Mary Connolly Martina Gogarty 

Aisling Kennedy 

Ellen Moran 

Research Activities 

The coordinated Rheumatology Research group includes four Principal Investigators - Prof Barry Bresnihan, 

Prof. Doug Veale, Dr Ursula Fearon and Prof Oliver FitzGerald This truly translational research group has a 

primary clinical focus on early, inflammatory arthritis (RA, PsA and juvenile arthritis) and a scientific focus on 

mechanisms of inflammation and joint damage. The group has developed and established novel models of 

analysis using serum, synovial fluid, synovial tissue and cartilage to search for biomarkers of disease, examine 

mechanisms of angiogenesis, novel mediators/cytokines and cartilage destruction in the study of 

pathogenesis of arthritis. 

The research plan for the next five years is to develop the current expertise and extend our local, national 

and international collaborations to elucidate predictors of response to therapy, predictors of remission and to 

examine the mechanisms of disease. We have consolidated our use of novel human models of disease, in 

partnership with GlaxoSmithKline and Cambridge Antibody Technology, which funded drug development 

studies for novel monoclonal antibodies and small molecular inhibitors. 

We have in 2007 embarked on a major state-of–the-art clinical research programme to identify clinical 

biomarkers of therapeutic response, to identify therapeutic remission for early arthritis, to examine 

mechanisms of disease, and identify novel targets for new therapies for inflammatory disease. We have also 

developed our imaging techniques with MRI, Confocal and electron microscopy. We have established new 

collaborations with colleagues in SVUH, UCD (The Conway Institute, School of Public Health and 

Epidemiology) and the wider DMMC. Our vision, shared with our patients, medical and scientific colleagues, 

is to develop a centre of excellence for Inflammation and Immunotherapeutics Research funded through 

partnership with industry, HRB, SFI. 


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Specific ongoing projects 

(1) THERAPI Translational Medicine Group 

Hypoxia and altered mitochondrial bioenergetics in the inflamed joint. 

This major programme funded by a Translational Research Award from The HRB (2006-2011) to Prof Doug 

Veale, Dr Ursula Fearon, Dr Jacintha O’Sullivan and Dr Cormac Taylor, hypothesizes that vascular morphology 

and synovial invasiveness within the inflamed joint and response to therapy, may be dependent on activation 

of mitochondria-derived, hypoxia-induced transcriptional and non-transcriptional pathways and alterations in 

genome stability. By incorporating novel techniques, we are measuring for the first time the oxygen tension 

directly in lining membrane of inflamed synovial joints using a special probe to measure pO2 and 

temperature. We also record the macroscopic vascular changes, and we intend to measure blood flow and 

glucose metabolism by dynamic imaging (MRI and PET), while parallel cellular changes in mitochondrial 

respiration will be analysed. Dr Vincent Ng, clinical research fellow has successfully established a clinical 

protocol to recruit patients (n=29) commencing biologic therapy to undergo arthroscopic examination and 

hypoxic measures. He has demonstrated that tissue pO2 levels correlate with macroscopic synovitis and 

vascularity. Currently he is examining proliferation and apoptosis markers in paired synovial tissue (Ki67 and 

TUNEL) to examine correlations between tissue invasiveness, macroscopic assessments and in vivo hypoxia 

measurements. In future work, Vincent is going to examine the effects of graded hypoxia on proliferation, 

apoptosis and cell cycle using primary synovoa fibroblasts from patients undergoing arthroscopy. The results 

will be related back to the clinical status of the patient. 

In parallel, Aisling Kennedy, graduate PhD student, 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 synovial cell types. She has 

also shown strong expression of 8oxo-dG in the synovial tissue reflecting that of the in vivo environment. 

Staining is mostly localised to the lining layer and peri-vascular regions but varies depending on the severity 

of inflammation (Fig1A). Aisling has shown that exposure of cells to graded hypoxia induces VEGF and 

MMP-1 production, in contrast Ang 2 showed minimal change. Further studies have shown that Ang2 

sensitises synovial cells to TNF· induction of synovial cell proliferation and invasion, suggesting that adjuvant 

therapy may be a novel future approach. Synovial fibroblast cells have been isolated from six of the patients 

in this study and are currently growing. We plan to expose these cells to the same level of hypoxia as was 

measured in vivo in the patient’s synovial tissue at arthroscopy. Protein and mRNA levels of growth factors 

and their downstream targets NFκB, HIF1α, NOTCH and 8-oxodG will be measured. 


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Dr Monika Binecka started with us Nov 2007 as a post-doctoral fellow and is examining the role of genomic 

instability in the joint and the effect of hypoxia. She has demonstrated high oxidative damage in the synovial 

(A) 8-oxo DG Nuclear Staining 

(B) Anaphase Bridging 

Lining Layer 

Endothelial cells 

Fig 1: Demonstrates oxidative damage in the endothelial cells and lining layer in RA synovium (stained with 

8-oxo-dG) (A) and (B) demonstrates Anaphase Bridging in primary synoviocytes and chondrocytes 

tissue of patients with low pO2 levels. Currently she is examining the level of synovial infiltrate and blood 

vessel stability in the tissue and relating this to patient in vivo pO2 levels. In parallel, Monika is examining the 

effect of graded hypoxia on anaphase bridging, telomere lengths and proliferation in primary fibroblasts and 

chondrocytes (Fig 1B). 

2: Cytokines, angiogenesis and invasion 

Arthroscopy and dynamic imaging (MRI/PET) will be used to determine macroscopic vascularity, microscopic 

angiogenesis measures to predict cartilage degradation in arthritis patients - pre/post biologic therapy. 

Recent targeted biologic therapies, including anti-TNF and IL-1 blocking drugs are effective, but may not be 

effective in 30% or more patients. The increasing evidence shows that complex cytokine networks do not 

operate in isolation to promote new blood vessel formation, synovial hyperplasia and joint destruction. The 

effects of TNFα and IL-β‚ ?alone and in combination with novel cytokines and growth factors, including 

Oncostatin M (OSM), IL-17, acute serum amyloid A (A-SAA), IL-22, GMCSF, TLRs and Angiopoietins is 

being examined in the inflammatory process, lead by Dr Ursula Fearon and Dr Douglas Veale 

(i)Oncostatin M, IL-17, IL-22 

OSM and IL-17 work synergistically in human cells and co-culture models of disease, to promote 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) a dramatic 

synergistic reaction between OSM and IL-17 in promoting matrix degradation and cartilage degradation was 

found. Ellen Moran, a graduate PhD student is examining the role of IL-17 alone and in combination with 

TNFα and OSM on cartilage degradation and matrix turnover. Ellen has demonstrated high expression of IL- 

17 in the serums, synovial fluids and synovial tissue lysates of patients with inflammatory arthritis. 

Furthermore the expression of IL-17 in the inflamed joint was shown to correlate with disease activity and 

duration and to be regulated by anti-TNF therapy. IL-17 alone was shown to regulate MMP-1,-2, -9 and -13 

production and shift MMP/TIMP ratios in explants, RA fibroblasts, cartilage and chondrocytes and cause 

cartilage proteoglycan depletion. Furthermore Ellen has demonstrated that IL-17 synergistically acts with 

TNFα and OSM in the regulation of MMP production and proteoglycan depletion. Preliminary work carried 

out by Ellen has shown IL-17 up-regulates the production of chemotactic cytokines and chemokines by RA 

fibroblasts, explants and human endothelial cells. This will be investigated further to elucidate the role of IL- 

17 on cell migration in the arthritic joint. 


24



Dr Bernadette Lynch (Clinical fellow) is examining the role of IL-22 in the joint. She has demonstrated high 

levels of IL-22 in synovial fluid compared to serum. Currently she is examining IL-22 mRNA in synovial tissue 

pre/post biologic therapy and is examining the effect of IL-22 on cytokine production, cell proliferation and 

invasion and on downstream signalling pathways. Using synovial explant cultures Bernadette will examine 

the of anti-IL-22 in comparison to Humira, as a potential therapeutic target. Dr Taj Saber (Clinical Fellow) 

has only started with the group and will be examining the effects of IL-22 and OSM alone and in combination 

on synovial invasion. Using primary fibroblasts, explants and chondrocytes Taj will examine the effect of 

these two cytokines on MMP production, proteoglycan release and invasion. Furthermore she will examine 

the downstream signalling pathways involved, specifically the JAK-STAT pathway. 

(ii) Serum Amyloid A (A-SAA) 

The role of A-SAA in the pro-inflammatory response is an on-going project theme of the unit over the past 

10 years continued by Dr Ronan Mullan and Mary Connolly, graduate PhD student under the direction of Dr 

Ursula Fearon, Prof Doug Veale, Prof Barry Bresnihan. Dr Ronan Mullan’s paper demonstrating that A-SAAinduces 

adhesion molecule, angiogenesis and matrix metalloproteinase expression through the NFκB 

pathway was published in Arthritis and Rheumatism, January 2006 and won the best Rheumatology paper 

at the IJMS awards 2007. Furthermore Ronan has demonstrated increased matrix turnover in whole 

cartilage explants, along with correlation of A-SAA with serum biomarkers of cartilage breakdown in patients 

pre/post biologic therapy, suggesting that targeting A-SAA, or its signaling pathways, may represent a 

realistic therapeutic approach. Mary Connolly continues to progress this work, specifically examining the 

effect of A-SAA on cell migration and invasion, cartilage metabolism and the related transcriptional 

pathways. Currently we are examining GFP tagged monocyte migration in vivo using a novel human RA 

synovial tissue/SCID mouse chimera model. Mary has demonstrated high A-SAA levels in serum and 

synovial fluid of RA and PsA patients. In addition A-SAA and its receptor FPRL-1 mRNA was demonstrated 

in RASFC, chondrocytes, neutrophils, peripheral blood mononuclear cells, endothelial cells and synovial 

tissue. Mary has also shown that A-SAA upregulates a number of MMPs and GAG in human primary 

chondrocytes, synovial fibroblasts and synovial tissue. Furthermore, Mary has elucidated that A-SAA 

specifically alters cytoskeletal rearrangement in RA synoviocytes producing filopodia protrusion and 

migration. She has also shown that A-SAA regulates avB3, B1-integrins and viculin. Currently she is 

examining the effect of A-SAA on specific cytoskeletal proteins involved in cell migration and cartilage 

invasion such as PAX, FAK and the GTPases (RhoA, CDC42, RAC1). 

Intact Actin 

Filaments 

Disassembly of actin 

cytoskeleton and Induction 

of filopodia formation 

Fig 2 A-SAA induces disassembly of actin filaments in primary synovial fibroblast 

(iii) Endothelial cell survival and blood vessel regression. One of the main interests of the group is the role 

of angiogenesis in the pro-inflammatory response, with specific interest in the pathways of blood vessel 

maturity and survival. This work will provide novel insights into the complex mechanisms mediating growth 

factor activation within a synovial EC model. Dr Wei Gao, Jennifer Mc Cormick and Dr Catherine Sweeney 

have demonstrated expression of VEGF and Ang2 in the joint, and demonstrated they have synergistic 


25



effects on cell proliferation, MMP2/9 production and tubule formation. Furthermore Wei has demonstrated 

that VEGF +Ang2 synergistically induces NOTCH 1IC, 3IC and 4IC signalling pathways. Currently we are 

using an RA human synovial /SCID mouse model (in collaboration with Prof. Costantino Pitzalis, London) to 

examine the effect of blocking either the NOTCH signalling pathway or the Tie-2 receptor on blood vessel 

regression Wei was awarded Seed funding through the UCD scheme to travel to the American College of 

Rheumatology Boston to present his work. 

Fig 3: (above) Dual immunoflourescent staining with 

Factor VIII (red) and ·SMA (GREEN). Blood vessel 

staining red are immature and those staining for red and 

green are mature. This figure shows there is a mixture 

of immature and mature vessels in the joint. 

(iv) GMCSF and TLRs 

Dr. Sinead Nic An Ultaigh has been examining the role of Granulocyte-Macrophage Colony Stimulating 

Factor (GM-CSF) as part of our continuing work on cytokine networks in inflammatory arthritis. GM-CSF is 

found at higher levels locally in the joints of patients with inflammatory arthritis, while levels in serum were 

practically undetectable. Anti-GM-CSF may inhibit pro-inflammatory cytokines in our ex-vivo explant model 

from patients with inflammatory arthritis. Preliminary data also indicates that GM-CSF receptor alpha is 

expressed in the lining layer of the synovial tissue and in the endothelial cells of blood vessels of arthritis 

patients. Sinead is also examining the role of Toll-Like Receptors (TLRs) in inflammatory arthritis. TLRs have 

been implicated in autoimmune diseases, and TLR expression has been found in joint tissue and at the sites 

of invasion into cartilage/bone of patients with RA and PsA. Sinead has shown that cytokines and 

chemokines are increased in PBMCs, primary fibroblasts and novel ex-vivo synovial explants from patients 

with inflammatory arthritis when stimulated with TLR 2 and 4 agonists. Prelimiary data has also 

demonstrated induction of NOTCH 1 in synovial fibroblasts in response to TLR-2 and TL-4 stimulation. 

Future work will focus on the interaction of Notch and NFκB in response to TLR signalling. 

(v) Proof of Concept Studies 

Jennifer Mc Cormick is an integral part of the team and is involved in a number of projects in the group. In 

particular Jenny works on the signalling pathways and matrix invasion using zymography with Mary, Aisling 

and Ellen. She processes the tissue, cells, serums/ synovial fluids from all of the arthroscopies which are 

vital to all of the research carried out in the group. We have developed a number of partnerships with the 

drug discovery and translational teams within industry led by Prof Veale. Jenny, Ursula and Sinead carry out 

these studies using synovial explant cultures, MSD multiplex assays and transcriptomics to establish preclinical 

and ‘proof of concept’ drug development studies of novel bio therapeutics and small molecular weight 

candidates. 

(2) Remission study and Rituximab therapy for resistant arthritis 

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 


26

in patients with RA following withdrawal of their anti-TNFα 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-TNFα 

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. Loss of this expansion may predict disease 

relapse and therefore allow modification of dosing schedule with important health-economic and patient 

related benefits. 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 activated phenotype 

(upregulation of activatory CD69 and HLA-DR and inhibition of CD158 KIR and apoptotic CD57). This 

upregulation of CD56high NK cells has increased immunomodulatory function with a significant increase in 

proinflammatory cytokine release (interferon-gamma and tumour necrosis factor-alpha) from T cells and 

increased cytotoxicity of synovial fluid derived CD3+ cells against the leukaemia cell line K562 compared 

with matched peripheral blood. Furthermore we are also examining the immunological effects of kineret 

monotherapy and kineret in combination with anti-TNF· therapy (SPECTRA) and comparing this to anti-TNFα 

monotherapy. 

Rituximab is a recently licensed therapy, targeting CD20+ B cells, which is increasingly used in the treatment 

of refractory RA. We have demonstrated the presence of CD20+ cells in the synovium of patients with RA 

resistant to anti-TNFα therapies. Complete depletion of synovial B cells following treatment with rituximab is 

associated with an excellent clinical response. Early depletion of synovial B cells precedes a decrease in local 

inflammation leading to clinical improvement. 

Biomarkers and predictors of disease 

OMERACT project is an international study examining changes in synovial sublining CD68 in RA as a 

biomarker of treatment response. This work is being carried out by Dr Eliza Pontifex and lead by Prof Barry 

Bresnihan. 22 patients with RA have undergone synovial biopsies pre and post treatment with rituximab.The 

slides obtained from this tissue have been stained for CD68 and are being quantitatively scored by digital 

image analysis (DIA) in 2 different centres – AMC in Amsterdam (Prof PPTak) and SVUH in Dublin (Prof B 

Bresnihan). Each of these centres uses slightly different staining and DIA techniques.These same slides will 

then be swapped and sent to the centre in which they were NOT stained to be reanalyzed by DIA.The aim is 

to determine the degree of correlation between the results of the 2 different centres, and thus possibly 

validate the method of staining and quantification of sublining CD68 in RA despite the use of slightly 

different techniques in different centres. Eliza is also examining if change in CD3 positive cell infiltration in 


27



psoriatic arthritis (PsA) synovial tissue correlates with change in DAS28 following initiation of biologic 

therapy. Finally Eliza is examining the role of TLRs in patients with PsA. Eliza has demonstrated expression 

of TLR-2/4 in the endothelial and lining layer regions of the synovium. Currently she is stimulating primary 

fibroblasts from patients with PsA with TLR-2 and 4 +/- cJun inhibitors and assessing regulation of 

chemokines. 

(3) Psoriasis/Psoriatic Arthritis 

(i) Biomarkers of Biologic Treatment Response: As part of investigator-originated lead by Prof 

FitzGerald, 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 mini-arthroscopy pre-and post-biologic therapy) 

samples are available for study following infliximab (n=15), IL-1Ra (n=12) and etanercept (n=15,). 

Comparisons of immunohistochemical (IH) changes will be made with standard clinical measures and 

with MRI changes in the affected knee joint. The IH and semi-quantitative MRI (collaboration with Dr. 

Robin Gibney) analysis has now been completed and comparisons are being made with clinical 

response markers. In addition, with Prof Patrick Brennan’s group from Imaging UCD, a more 

quantitative measure of synovitis is being developed. Finally, funded by Abbott, a new post doctoral 

scientist has been appointed who will be analysing differential protein expression in these patientderived 

samples together with Prof Steve Pennington from UCD. 

(ii) Expression and Regulation of Transcription factors in Ps/PsA: This work is lead by Dr. Evelyn 

Murphy and Dr. Brian Kirby, the expression and regulation of NURR proteins pre-and post-treatment is 

being explored. Findings have established the aberrant expression and distribution of the orphan 

nuclear receptor NURR1 in psoriasis and suggest that clinical benefits of TNF-α inhibition may be 

mediated through altered NURR1 activity. In addition, a recent paper suggests a key regulatory role for 

the AP-1 transcription complex in Ps/PsA. 

(iii) 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. 

(iv) Synovial Proteomics Dr Emily Collins is examining proteomic profiles in PsA patients pre/post 

biologic therapy. We are aiming to identify molecular biomarkers which predict response to anti-TNF· 

therapy which are present in the synovium at an early stage of treatment. This project is led by Prof 

FitzGerald and Dr Ursula Fearon in collaboration with the P.P. Tak group in Amsterdam, and S. 

Pennington and M. Dunn of the Proteome Research Centre, UCD. Synovial tissue has been obtained 

via arthroscopy at baseline and 1 month from a cohort of patients, half of whom were receiving 

Adalimumab and half placebo injections, before beginning Adalimumab after 1 month. We are using 

proteomics technology (2D- DIGE and mass spectrometry) to analyse the proteome of these synovial 

tissue samples and identify differentially expressed proteins and potential biomarkers. These potential 

biomarkers will then be validated using various molecular biology methods. A pilot study on a smaller 

cohort has allowed us to optimise the experimental methodology and identify several interesting 

proteins. 


28



Student Awards and Oral Presentations: 

Dr Ronan Mullan; IJMS Awards Best Published Paper – Rheumatology 2007 Research Awards. Mullan RH, 

Golden Mason L, Markham T, O'Hara R, FitzGerald O, Bresnihan B, Veale DJ, Fearon U. A novel role for 

Serum Amyloid-A (A-SAA) in Angiogenesis and Adhesion Molecule expression through an NFÎB-dependent 

signal transduction pathway. 

Aisling Kennedy; SIAR Award/Oral presentation - American College of Rheumatology Boston 2007. 

Kennedy A, Ng C, Mc Cormick J, Fearon U, Veale DJ. Oxidative Damage and Hypoxia in Inflammatory 

Arthritis: Evidence from in vivo and ex vivo studies of Inflammatory Arthritis. 

Mary Connolly; SIAR Award - American College of Rheumatology, Boston 2007 

Mary Connolly, Jennifer McCormick, Ronan Mullan, Barry Bresnihan, Oliver FitzGerald, Douglas Veale, Ursula 

Fearon. Acute Serum Amyloid A Upregulates TNFα Expression in RA Synovial Tissue Explants & Induces 

Cell Migrational Processes 

Mary Connolly: Eular Travel Award– European Rheumatology Meeting, Barcelona 2007. M.C. Connolly, J. 

McCormick, R. Mullan, O. FitzGerald, B. Bresnihan, D.J. Veale, U. Fearon.Acute serum amyloid a stimulation 

of RA synovial tissue ex vivo upregulates chemokine expression, TNFα and MMP production via theNFÎB 

pathway 

Thesis Submission 

Dr Ronan Mullan submitted his PhD thesis (UCD) examining the role of A-SAA in the pathogenesis of 

inflammatory arthritis, under the supervision of Dr Ursula Fearon and Prof Douglas Veale 

Bioinformatics and Molecular Evolution 

Principal Investigator: 

Senior scientists: 

Graduate student: 

Professor Cliona O’Farrelly, PhD 

Andrew T. Lloyd PhD 

Paul Cormican M.Sc. 

The FIRM III project, funded by the Department of Agriculture, continues to investigate innate immunity in 

chickens by characterising the genes mobilised after Campylobacter jejuni infection. We have further 

developed the bioinformatic discovery pipeline for analysing the frequency of Single Nucleotide 

Polymorphisms (SNPs) in chickens and classifying SNP-rich genes in its genome. We have made a start at 

defining the Immunome (those genes that are involved in immunological processes) by comparing the 

contents of immunological gene lists. The two projects, started in 2006, investigating the response to 

Campylobacter infection in chickens and the response to the diseases of mastitis and metritis in cattle 

continue. We were centrally involved in a community project to sort out the nomenclature of avian defensins. 


29

The bioinformatics group moved with Professor O’Farrelly to Trinity College Dublin in September 2007. This 

means that collaborations with other SVUH groups and consultancy about bioinformatics matters will be 

difficult or impossible in the future. It has been a pleasure and a privilege to work in the dynamic environment 

of the ERC over the last 7 years. 

Invited talks 

May 2007 Bovine & Avian Immunogenomics Workshop. “Comparative Immunomics: Integrated approaches 

to analyzing immune reactivity to microbes” Cliona O’Farrelly 

May 2007 Bovine & Avian Immunogenomics Workshop. “Novel antimicrobial peptide discovery in chickens 

and cattle” Paul Cormican 

International Visits 

May 2007 Wellcome Trust, London. ImmunoGO consortium meeting. Cliona O’Farrelly and Andrew Lloyd 

June 2007 European Bioinformatics Institute, Hinxton, UK. ImmunoGO consortium meeting. Cliona 

O’Farrelly and Andrew Lloyd 

Posters 

September 2007. Irish Society of Immunology. Dublin. “β-defensin evolution – a broader perspective” Paul 

Cormican 

September 2007. Conway Festival of Research. UCD. “β-defensin evolution – a broader perspective” Paul 

Cormican 

Education and outreach. 

February 2007 We ran a half day course in Essential Bioinformatics for researchers at the ERC. Andrew 

Lloyd, Paul Cormican, Kieran Meade. 

May 2007. “Genetics key to healthy chickens” Relay eNewsletter (www.relayresearch.ie) Andrew Lloyd. 

Consultancy and collaboration 

The Bioinformatics Group was available to consult with and advise other research groups in the ERC about 

all aspects of bioinformatics and molecular evolution. Andrew Lloyd continued his collaboration with the 

Colon Cancer Group in analysing Microarray Comparative Genome Hybridisation (Array CGH) data. He also 


30



worked with Shay Fanning and the UCD Veterinary School on the bioinformatics analysis of artiodactyl 

viruses. Paul Cormican has helped the Rheumatology and Breast Cancer groups with DNA sequence 

analysis. The group has helped supervise undergraduate project students. Andrew Lloyd continued to 

develop and teach a 60 contact hour web-based course in bioinformatics at Carlow Institute of Technology, 

which is available for workers at SVUH. 

Innate Immunity 


Professor Cliona O’Farrelly, PhD 

Senior scientists: Andrew T. Lloyd PhD, Kieran Meade PhD 

Graduate students: Paul Cormican M.Sc. Aspinas Chapwanya, 

Ronan Shaughnessy, 

Cormac Whelehan 

(started October 2007) 

Research Associates: Sarah Cahalane, Fernando Narciandi. 

The FIRM III project, funded by the Department of Agriculture, continues to investigate innate immunity in 

chickens by characterising the genes mobilised after Campylobacter jejuni infection. We have further 

developed the bioinformatic discovery pipeline for analysing the frequency of Single Nucleotide 

Polymorphisms (SNPs) in chickens and classifying SNP-rich genes in its genome. We have made a start at 

defining the Immunome (those genes that are involved in immunological processes) by comparing the 

contents of immunological gene lists. The two projects, started in 2006, investigating the response to 

Campylobacter infection in chickens and the response to the diseases of mastitis and metritis in cattle continue. 

The Innate Immunity group moved with Professor O’Farrelly to Trinity College Dublin in September 2007. This 

marks a change in the nature of a long, stimulating and productive association with SVUH and the ERC. We 

will continue to collaborate with key personnel in the hospital. 

Awards and prizes 

November 2007. We were one of eight selected from the 200 funded under this measure to submit 

contributions to a display being prepared for the Minister of Agriculture at the Royal Iris Academy. We were 

awarded a €1000 prize for the best outreach presentation. At the same ceremony, Ronan Shaughnessy was 

awarded a €2000 travel bursary to progress his research. 

Invited talks 

March 2007. School of Veterinary Medicine, UCD entitled “The innate immunity pipeline; from receptors to 

effectors, and back again?”. Kieran Meade 

May 2007 Bovine & Avian Immunogenomics Workshop. “Comparative avian innate 

immune responses between commensal and pathogenic bacteria” Kieran Meade 

May 2007 Bovine & Avian Immunogenomics Workshop. “Comparative Immunomics: Integrated approaches 

to analyzing immune reactivity to microbes” Cliona O’Farrelly 


31



May 2007 Bovine & Avian Immunogenomics Workshop. “Novel antimicrobial peptide discovery in chickens 

and cattle” Paul Cormican 

September 2007. WCUR Plenary Session. “The Immune System as Enemy: how immune mechanisms 

contribute to pathology”. Cliona O’Farrelly. 

October 2007 Teagasc Ashtown. “Comparative immunomic responses to Salmonella and Campylobacter 

infection in chickens: Towards novel diagnostic aids and breeding tools” Kieran Meade 

October 2007 Teagasc Ashtown. “Commensal Campylobacter organisms stimulate specific and regulated 

innate immunity within hours of infection” Ronan Shaughnessy 

December 2007 Royal Veterinary College, London “Discovery and Immune Response Profiling of Novel 

Bovine Antimicrobial Peptides (AMPs)”. Kieran Meade. 

International Visits 

March 2007 VIDO, Saskatoon, Canada. Collaborative research visit. Kieran Meade and Fernando Narciandi 

May 2007 Wellcome Trust, London. ImmunoGO consortium meeting. Cliona O’Farrelly and Andrew Lloyd 

June 2007 EADGENE and SABRE joint meeting, Genomics for Animal Health, Utrecht. Kieran Meade. 

June 2007 European Bioinformatics Institute, Hinxton, UK. ImmunoGO consortium meeting. Cliona 

O’Farrelly and Andrew Lloyd 

December 2007 Royal Veterinary College, London. Collaborator meeting. Cliona O’Farrelly and Kieran 

Meade. 

Posters 

July 2007. NUIM Immunology Masterclass. Maynooth. “Comparative avian innate immune response between 

pathogenic and commensal bacteria” Ronan Shaughnessy 

July 2007. NUIM Immunology Masterclass. Maynooth. “Profiling innate immune genes for resistance to 

bovine metritis causing bacteria in post-partum dairy cows” Aspinas Chapwanya 

September 2007. Irish Society of Immunology. Dublin. “Directed alteration of a novel bovine antimicrobial 

peptide improves efficacy against Methicillin Resistant Staphylococcus aureus” Sarah Cahalane 

September 2007. Irish Society of Immunology. Dublin. “Profiling expression of bovine antimicrobial peptide 

(AMP) genes in response to post-partum uterine infection” Aspinas Chapwanya 

September 2007. Irish Society of Immunology. Dublin. “β-defensin evolution – a broader perspective” Paul 

Cormican 

September 2007. Irish Society of Immunology. Dublin. “Comparative innate immune gene expression in 

chicken intestine after in vivo challenges with commensal (campylobacter) & pathogenic (salmonella) 

bacteria” Ronan Shaughnessy 


32



September 2007. Conway Festival of Research. UCD. “Directed alteration of a novel bovine antimicrobial 

peptide improves efficacy against Methicillin Resistant Staphylococcus aureus” Sarah Cahalane 

September 2007. Conway Festival of Research. UCD. “Profiling expression of bovine antimicrobial peptide 

(AMP) genes in response to post-partum uterine infection” Aspinas Chapwanya 

September 2007. Conway Festival of Research. UCD. “β-defensin evolution – a broader perspective” Paul 

Cormican 

September 2007. Conway Festival of Research. UCD. “Comparative innate immune gene expression in 

chicken intestine after in vivo challenges with commensal (campylobacter) & pathogenic (salmonella) 

bacteria” Ronan Shaughnessy 

December 2007. School of Agriculture, Food Science & Veterinary Medicine Research Day, UCD. “Profiling 

expression of bovine antimicrobial peptide (AMP) genes in response to post-partum uterine infection” 

Aspinas Chapwanya 

Education and outreach 

May 2007. “Genetics key to healthy chickens” Relay eNewsletter (www.relayresearch.ie) Andrew Lloyd. 

October 2007. Introduction to Core Research Skills Conway, UCD. Talks: 1. Communicating Science, 2. 

Laboratory Work - Organisation & Management, 3. Good Laboratory Practice. Cliona O’Farrelly & Andrew Lloyd. 

November 2007. “Die Hard MRSA” The Irish Scientist. Sarah Cahalane. 

Liver Research 

The Liver Research Group operates a four-stranded research programme based on Liver Transplantation, 

Hepatic Malignancy, Hepatitis C Viral Infection and Basic Immunology of the Liver. 

Principal Investigators: 

Prof. Cliona O'Farrelly & Prof. John Hegarty 

Senior Scientists: Elizabeth Ryan Nigel Stevenson 

Margaret O'Brien 

Research AssistantS: Emma McGrath Catherine Keogh 

Research Fellows: Tariq Tajuddin, Kavin Nanda 

Postgraduate Students: 

Eszter Nèmeth 

Liver Transplantation 

The Liver Transplant team at St. Vincent’s hospital performs 50-60 transplants per year. A successful 

transplantation program depends on a steady supply of donor organs. Our research is focused on trying to 

find out ways of preventing damage to the donor organ due to a lack of oxygen. We have found that a 


33



transcription factor, NRF2 that regulates cytoprotective pathways is up-regulated in the livers of younger 

donors and that increased expression of this transcription factor means a better outcome post-transplant. 

Badar Zaman, Martin Leonard (Conway Institute, UCD), Elizabeth Ryan, Cormac Taylor (Conway 

Institute, UCD), Justin Geoghegan, Cliona O’Farrelly. 

Hepatic Malignancy 

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. The aim of this study is to investigate the role of CD1d isoforms in regulating immune responses 

to malignancy. 

Margaret O’Brien, Emma McGrath, Cliona O’Farrelly 

HCV & It’s effect on Bone Metabolism 

Does chronic HCV infection increase the risk for the development of Osteoporosis? 

Osteopenia (thin bones) and osteoporosis (brittle bones) are common among patients with chronic liver 

disease. The purpose of this study is to investigate the frequency of bone disease in a group of women 

infected with hepatitis C virus (HCV) via contaminated anti-D. The underlying mechanisms by which chronic 

HCV may cause osteoporosis are not fully understood, but individuals chronically infected with HCV have 

ongoing inflammation. We want to determine if this inflammation causes an increase in bone breakdown. 

Bone mineral density and markers of inflammation in individuals with persistent infection will be compared 

to those who have cleared the infection. 

Kavin Nanda, Elizabeth Ryan, Barbara Murray, Malachi McKenna, John Hegarty, Cliona O’Farrelly 

IL-10 and TGF-‚ mediated suppression of antigen-specific Th1 and Th17 responses during HCV infection 

We have shown that antigen-specific IL-10-secreting regulatory T (Treg) cells are induced in patients 

chronically infected with HCV. We found that HCV nonstructural protein 4 (NS4) induces IL-10, and inhibits 

IL-12 production by monocytes. We also found that PBMC from HCV infected patients secreted significant 

concentrations of IL-10, but low concentrations of IFN-γ and IL-17 in response to NS4. Addition of a 

neutrailizing antibody to IL-10 significantly enhanced NS4-specific IFN-γ, but not IL-17 production. In 

contrast, IL-17 was enhanced by neutralisation of TGF-β. Our findings suggest that HCV subverts virusspecific 

Th1 responses through the induction of IL-10 from monocytes and Treg cells and suppresses Th1 

and Th17 cells through TGFβ‚ production. This may in part explain the failure to clear the chronic infection. 

Aileen Rowan (TCD), Elizabeth Ryan, John Hegarty, Cliona O’Farrelly, Kingston Mills (TCD) 

Cytokine and chemokine signatures predictive of the response of HCV patients to therapy 

IFN-α in combination with Ribavirin is the current standard treatment for chronic HCV infection. However, 

more than 50% of patients do not respond to this combination therapy and suffer significant side effects 

unnecessarily. We propose to design an assay based on these characteristic signatures that will be used to 

predict the potential efficacy of IFNα/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 


34

targets for the rational development of novel therapies. Analysis of variations (polymorphisms) in the IFNα 

and IFNα 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. 

Tariq Tajuddin, Emma McGrath, Elizabeth Ryan, John Hegarty, Cliona O’Farrelly. 

Regulation of DC-SIGN by IFN-α 

DC-SIGN is a C-type lectin receptor expressed by dendritic cells (DC) that binds to a HCV envelope protein. 

DC-SIGN expression can be reduced following exposure to IFN-·. In this study we aim to determine the 

importance of the expression of this receptor to the outcome of IFN-·/Ribavirin therapy. 

Elizabeth Ryan, Cliona O’Farrelly, John Hegarty 

The characterisation of T cell subsets in normal and diseased liver 

T regulatory cells (CD4+CD25+FoxP3+) that secrete anti-inflammatory cytokines, such as IL-10 and TGFβ 

can prevent effective cellular responses. By carefully characterising this population in normal and diseased 

human liver tissue we aim to determine their importance in controlling the immune response in the liver. 

Previous work in Prof. Kingston Mills’ Laboratory has shown that Fasciola hepatica infection of mice can 

lessen the severity of Experimental Autoimmune Encephalitis (EAE). We aim to characterise liver T regulatory 

cells in this model to determine their role in mediating the suppression of inflammation. 

Eszter Nèmeth, Miriam Brady (TCD), Cliona O’Farrelly, Kingston Mills (TCD) 

How does HCV inhibit Interferon-alpha (IFN-·) treatment? 

A significant percentage of the Irish population are infected with HCV and IFN-· is the current standard 

treatment. However, more than 50% of patients do not respond to this therapy and suffer significant side 

effects unnecessarily. The anti-viral action of IFN-α depends on a cellular cascade of proteins known as the 

JAK/STAT pathway. We are investigating how HCV affects this pathway and the subsequent anti-viral 

response. Our initial results have discovered that a number of proteins of the JAK/STAT pathway are absent 

in patients who fail to respond to therapy. We plan to determine how this virus destroys such important 

proteins and in doing so we hope to provide clinicians with a predictive tool of response and identify potential 

targets of for future therapy. 

Nigel Stevenson, Catherine Keogh, Elizabeth Ryan, Tariq Tajuddin, John Hegarty, Cliona O’ Farrelly, 

Aideen Long (TCD), Christine Biron (Brown University), Jim Johnston (Queen’s University, Belfast), 

Charlie Rice (Rockefeller University) 


35



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 Research Consortium was established to conduct research into different aspects of HCV infection 

in this cohort. Profs O’ Farrelly and Hegarty coordinate the HCV Research Consortium; which includes Irish 

clinicians who have a research interest in HCV infection. 

Prof. Cliona O'Farrelly, Chairperson, Trinity College Dublin 

Prof. John Hegarty, St. Vincent's University Hospital 

Dr. John Crowe, Mater Misericordeae Hospital 

Dr. Orla Crosbie, Cork University Hospital 

Dr. Frank Murray, Beaumont Hospital 

Dr. Suzanne Norris, St. Jame’s Hospital 

Prof. Dermot Kelleher, St. James Hospital 

Dr. Aideen Long, St. James Hospital 

Dr. Lelia Thornton, National Disease Surveillance Centre 

Grants 

The group has been awarded a Translational Programme grant from the HRB of €1,302,467.40 for ‘Immune 

targeting strategies: improving the response rate to IFN-alpha/ribavirin therapy in chronic Hepatitis C Virus 

infection.’ With the help of HCV patients being cared for by the Irish HCV Research Consortium, a primary 

aim of this study is to develop a test for predicting responsive and non-responsive patients. We have 

preliminary evidence that the IFN-alpha activated JAK/STAT signalling pathway is compromised in nonresponsive 

patients and this defect can be detected in vitro prior to treatment. Using samples from our cohort 

of anti-D infected women, we propose to identify an IFN-alpha response gene signature predictive of 

treatment 

outcome. 

We have demonstrated that the envelope protein from HCV, E2, can inhibit the protein kinase C (PKC) 

signalling pathway. Inhibition of classical PKC has previously been associated with attenuation of IFN-alpha 

signalling. Thus, we will investigate the role of PKC in the molecular mechanisms of IFN-alpha resistance in 

HCV and the impact of G-CSF on these pathways. We thus aim to provide a rationale for its inclusion in the 

treatment regimen of the sub group of patients which demonstrate HCV induced inhibition of JAK/STAT 

signalling. 


36



We have also been awarded a grant from the HRB of €299,379 for “Suppressor Of Cytokine Signalling 

(SOCS) Protein Involvement In ChronicHepatitis C Virus (HCV) Infection and Failure to Respond to Interferon 

Alpha Therapy”. We have observed that PBMC’s from patients with sustained virologic response (SVR) 

produced higher levels of growth factors than non-responding patients after IFN-alpha/ribavirin treatment. 

These findings indicate that an intracellular blockade of IFN-alpha signalling occurs in PBMC’s from some 

HCV infected patients. We propose to define the molecular basis for this blockade. 

SOCS proteins control cytokine signalling and have been documented to regulate IFN-alpha signal 

transduction and be triggered by HCV infection. Therefore, plan to focus on SOCS proteins and their effects 

on ISG and growth factor expression levels. Using siRNA technology, we aim to identify the downstream 

molecular targets of SOCS interference. This will be the first study of its kind to compare the cellular 

response to IFN-alpha/ribavirin treatment using primary human haematopoietic cells in healthy, recovered 

and chronic HCV patients. We also aim to determine whether the failure to respond to IFN-alpha treatment 

is mediated primarily in hepatocytes or immune cells. A primary outcome of this study will be a novel 

signature of response to treatment, based on SOCS, ISG and growth factor expression by PBMC’s. 

Identification of non-responding patients prior to treatment will avoid unnecessary side effects 

Oral Presentations 

M. B. Zaman. Activation of the transcription factor NRF-2 in donor liver during ischemia reperfusion is 

associated with less inflammatory damage and lower trasaminase levels post-transplant. International Liver 

Transplant Society (ILTS) June 20-23 2007 – Brazil 

C. O’ Farrelly. The Liver: A Sentinel of Danger. International Liver Transplant Society (ILTS) June 20-23 2007 

– Brazil 

E. Ryan, J. Hegarty, C. O’Farrelly. GMCSF may modulate the response to IFN-alpha in Chronic Hepatitis C 

Virus (HCV) infection. Keystone Viral Immunity Conference Jan 20-25 2008 – Colorado. 

A. G. Rowan, E. J. Ryan, J. E. Hegarty, C. O’ Farrelly, K. H. G. Mills. IL-10 and TGF-β mediated suppression of 

antigen-specific Th1 and Th17 responses during hepatitis C virus infection. British Society of Immunology. 

Feb 20-23 2007 Glasgow 

Poster Presentations 

T. Tajuddin, E. Ryan, C. Keogh, S. Norris, C. O’ Farrelly, J. Hegarty. Suppressed Granulocyte Colony Stimulating 

Factor Production in Chronic Hepatitis C Patients on Interferon –Alpha (IFN-α) Therapy; Possible Role in 

IFN-· Induced Neutropenia. Irish Society of Gastroenterology Nov 29-30 2007 – Clontarf Castle, Dublin 

T. Tajuddin, E. Ryan, L. Gallagher, E. McGrath, J. Hegarty & C. O’ Farrelly. Expression of G-CSF in Chronic 

Hepatitis C Virus (HCV) infection; implications for the outcome of IFN-α/Ribavirin therapy. Irish Society of 

Gastroenterology April 19-20 2007 – Killarney, Kerry 

T. Tajuddin, E. Ryan, J. Hegarty & C. O’ Farrelly. GM-CSF may modulate the response to therapeutic IFN-· in 

Chronic Hepatitis C Virus (HCV) infection. American Association for the Study of Liver Diseases (AASLD) 

Nov 2-6 2007 - Boston 


37



E. Ryan, J. Hegarty, C. O’Farrelly. GMCSF may modulate the response to IFN-alpha in Chronic Hepatitis C 

Virus (HCV) infection. Keystone Viral Immunity Conference Jan 20-25 2008 – Colorado. 

M. O’ Brien, M. Exley, D. O’ Donoghue, J. E. Hegarty, C. O’ Farrelly. Alternative splicing of CD1d in colorectal 

cancer: implications for tumour surveillance. Irish Society of Gastroenterology Nov 29, 30 2007 – Clontarf 

Castle, Dublin 

K.S. Nanda, E. J. Ryan, L. Gallagher, M. Mc Kenna, B. Murray, C. O’ Farrelly, & J. Hegarty. Does chronic 

Hepatitis C Virus (HCV) infection contribute to bone disease by disrupting the OPG/RANKL/TRAIL 

pathway? Irish Society of Gastroenterology April 19-20 2007 – Killarney, Kerry 

Endocrinology & Diabetes Mellitus 

Consultants: Professor T.J. McKenna, Dr Malachi McKenna, 

Dr Donal O’Shea, 

Dr Ronan Canavan 

Lecturers: Department of Medicine, U.C.D.: Dr Gianluca Tamagno Dr Deirdre Blake. 

Specialist Registrars: Dr Eoin Noctor, Dr Conall Dennedy 

Registrars: Dr Tomás Ahern, Dr G Goawetse 

Research Registrar: Dr Jean O’Connell, Dr Mohammed Bashir, 

Dr Tom Cawood 

Endocrine Laboratory, Principal Biochemist: Dr. Tom Smith 

Research-Graduate Students: 

Lucille Kavanagh 

Research Projects 

Macroprolactin (Lucille Kavanagh, Prof TJ McKenna and Dr Tom Smith) 

Lucille Kavanagh is supported by a grant from the Health Research Board to support her elucidation of the 

nature of macroprolactin. Prolactin is a hormone which comes from the pituitary gland. High levels of 

prolactin is the underlying cause in approximately 25% of patients who present with failure of ovulation. This 

affects approximately 1-2% of all women. Our studies have highlighted the fact that the laboratory finding 

of approximately 10-20% of measurements indicating high levels or prolactin may be misleading. This is due 

to the presence of macroprolactin. Macroprolactin is a form of prolactin which, although measured in the 

assays, is not active in patients. This department has previously published extensively on laboratory 

techniques which may eliminate macroprolactin and also on the clinical consequences of failure to undertake 

routine screening for macroprolactin. While routine screening is generally undertaken in Ireland as a 

consequence of this laboratory’s research and in 80% of laboratories in the United Kingdom and to a lesser 

extent in Europe, screening is the exception rather than the rule in the United States. Further publications 

from this laboratory in the leading American laboratory and clinical journals is attempting to address this 

situation. The renowned Mayo Clinic laboratories have recently announced the provision of a service which 

screens for macroprolactin. In launching the service, the Mayo Laboratories Communique cited six scientific 

articles, four of which were from this department. 


38

Although clinical observations have been consistent with the concept that macroprolactin is not active in the 

body, laboratory bioassays have indicated that macroprolactin retains bioactivity. The classical bioassay for 

prolactin uses Nb2 cells derived from rat lymphoma which have been shown to multiply when exposed to 

prolactin. When macroprolactin was added to Nb2 cells, multiplication occurred over a period of 72 hours. 

Lucille Kavanagh has now demonstrated that during incubation with the cells, the prolactin/antibody complex 

dissociates freeing up prolactin in its active state, monomeric, and thus provides bioactive prolactin. This 

explains why macroprolactin appeared to be bioactive in the Nb2 cells and indiates that this bioassay is 

inappropriate for macroprolactin. 

In further studies, Lucille Kavanagh has demonstrated that while macroprolactin is usually due to a 

combination of prolactin and an antibody to prolactin, it is not associated with other disorders associated with 

the production of antibodies against normal body tissues i.e. autoimmunity. 

Dr Malachi McKenna is a member of the Editorial Board for the journal, Osteoporosis International. Professor 

TJ McKenna retired in August 2007, but continues with his research activities. 

Thyroid Eye Disease Research 

Personnel: 

Dr. Donal O’Shea & Dr. Tom Cawood 

Dr Cawood completed his studies on the potential role of anti-cytokine therapies in thyroid eye disease, and 

has also investigated the link between smoking and thyroid eye disease. This in vitro work, funded by a 

Clinical Research Training Fellowship from the Health Research Board, has suggested that Interleukin 1 may 

be an attractive therapeutic target as Interleukin promotes numerous pathological processes in thyroid eye 

disease (including inflammation, glycosaminoglycan production and adipogenesis). Interleukin 1 also acts in 

synergy with cigarette smoke extract to promote adipogenesis, which may help explain why smoking worsens 

thyroid eye disease. Dr Cawood was awarded the O’Donovan Medal by the Irish Endocrine Society, and the 

Novartis Endocrinology Registrar Research Medal for this work and was awarded his Ph.D. in 2007. In July 

2007 Dr Cawood moved to New Zealand to complete his specialist training. 


39



Diabetes & Obesity Research 

Personnel: Dr. Donal O’Shea, Dr. Jean O’Connell, Dr. Lydia Lynch, 

Dr Mohammed Bashir Dr MC Dennedy. 

Laboratory work is underway investigating the metabolic and immunological links between obesity and its 

consequences, such as type 2 diabetes and non-alcoholic fatty liver disease. A Newman Scholar post is 

being funded by Sanofi-Aventis, and the Diabetes Federation of Ireland and the Medical Research Charities 

group have recently awarded funding for a 3-year project entitled ‘Adipocyte size and type 2 diabetes; a study 

of patients undergoing bariatric surgery’. Dr.O’Connell has been awarded a HRB training fellowship to pursue 

this project. The group is increasingly focussing also on the link between obesity and cancer. Funding has 

been secured for another Newman Fellowship to start in early 2008. Dr Bashir is looking at novel urinary 

biomarkers and diabetes/obesity related kidney disease while Dr Dennedy plans to look at endocanabinoid 

regulation of adrenal and ovarian steroidogenesis. 

Respiratory Sleep Research 



Summary of Research Activities 

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 Prof. Cormac Taylor in the 

Conway Institute at UCD and the School of Electronic and Electrical Engineering (Prof. Conor Heneghan and 

Dr. Madeleine Lowery), also in UCD. Dr. John Garvey and Dr. David McSharry are the Research Fellows 

involved. 

Together with Prof. 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 utilising bovine aortic endothelial and HELA cells, we have 

demonstrated that IH selectively activates inflammatory over adaptive molecular pathways through the 

selective activation of the inflammatory transcription factor NFκB. NFκB has been shown to predispose to 

atherogenesis. We have also demonstrated that the NFκB-dependent gene TNF-α is elevated in patients 

with OSA and falls to control levels with nasal CPAP therapy. 

Currently we are engaged in characterizing the numbers and activation state of circulating neutrophils in 

OSAS patients. Our preliminary data has indicated a significant increase in the number of circulating 

neutrophils in OSAS patients when compared to controls. The current project includes collating the 

neutrophil counts of the patients (over 1200 patients) studied to date from the sleep laboratory database in 

St. Vincent’s University Hospital. Blood samples are being collected from OSAS patients and non-apnoeaic 

controls in a prospective fashion and the basal activation state and response to stimulation of circulating 


40



neutrophils is being assessed. We have established an in vitro model of intermittent hypoxia/reoxygenation 

to investigate molecular mechanisms by which intermittent hypoxia effects neutrophil activation. Finally we 

will correlate changes in neutrophil phenotype in OSAS patients with neutrophils exposed to IH to determine 

common molecular pathways which may represent novel therapeutic avenues. 

In collaboration with Prof. 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. The 

measurement of oxygen saturations and heart rate variability has been independently proposed as screening 

tools in the evaluation of patients with suspected OSAS. In collaboration with Prof. Conor Heneghan’s group 

we have evaluated a combined electrocardiograph and oximeter recorder in patients simultaneously 

undergoing polysomnography. Interim analysis of the data to date shows a high correlation (0.94) of the 

Apnoea-Hypopnoea index by the two techniques suggesting combined holter-oximeter monitoring may 

provide a suitable device for home screening of OSAS. 

In collaboration with Dr. Lowery, 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. 

Dr. David McSharry is carrying this project forward. 

Neurology Research in Multiple Sclerosis 

Consultant Neurologists Dr. Niall Tubridy, Prof. Michael Hutchinson 

Research Registrar 

Post Doc. 

PhD Student 

Dr. Roisin Lonergan, 

Dr. Jean Fletcher, 

Cheryl Sweeney, 

The Department of Neurology has an international reputation in the field of multiple sclerosis (MS) and 

research for many years thanks to the work of Professor Michael Hutchinson 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 (now of TCD). 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. Jean is working with Cheryl Sweeney who is helping with the human work 

but also working for her own PhD using animal models. 


41



To achieve this, of course, close co-operation is required with the clinical team. Dr. Lisa Costelloe was doing 

an MD in this area at the Dept of Neurology. Drs. Roisin Lonergan (MS research) and David Bradley 

(Dystonia) joined us in July 2007. A new clinic was set up in 2005 specifically for people with MS. In 18 

months, almost 500 patients with MS and 150 control subjects have been recruited. Lisa Costelloe, Roisin 

Lonergan, 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 work of Katie Doyle, 

MS Research Nurse, Sinead Jordan, Research Nurse, and Marguerite Duggan, MS Specialist Nurse, has 

been integral to the smooth running of this project and the ongoing care our patients. 

We have also undertaken work in collaboration with Dr. Margaret O’Brien looking at OAS in MS and plan 

further studies in vitamin D receptor genes in 2008. 

In addition to immunological research, we have a long-standing interest in the evaluation of clinical outcome 

measures for MS drug trials. In particular, the health related quality of life of MS patients and its quantification 

is being examined longitudinally in a large MS cohort attending this hospital. We have established a clinically 

useful and psychometrically valid “minimal change score” for one of the widely used MS self–report 

instruments. Doctor reported MS rating scales are also being evaluated for clinimetric characteristics that 

would make them effective outcome measures for RCTs). 

In 2007 and 2008 we plan a large scale study of the epidemiology of MS in Ireland based in Dublin, Donegal 

and Wexford. We aim to look at immunological, genetic and vitamin D markers in a large cohort of people 

with MS and controls in Ireland. 

Current MS Clinical Research Projects of the Neurology Research group 

1. Diffusion Tensor Imaging (DTI) of the Medial Longitudinal Fasiculus in Multiple Sclerosis patients 

with Internuclear Ophthalmoplegia 

To investigate the specificity of DTI, a novel MRI technique that provides information about the direction of 

white matter tracts, compared to conventional MRI for detecting disruption of the medial longitudina 

fasiculus in MS. 

Clinically, superior visualisation of new lesions and axonal loss may be of prognostic value and may 

enable us to monitor response to therapy in longitudinal studies. 

In collaboration with Jonathan Mc Nulty (Lecturer in Diagnostic Imaging, UCD), Professor Patrick Brennan, 

UCD, Professor Powderly, UCD, Dr. Risteard O’Laoide, SVUH 

2 Cognitive Functioning in Multiple Sclerosis: a longitudinal ERP analysis to quantify the degree of 

mpairment due to MS 

In collaboration with Dr. Robert Whelan, PhD Research Fellow Departments of Psychiatry and 

Neurology, SVUH. 

Cognitive impairment (CI) in MS represents a balance between destruction, repair and 

adaptivefunctional reorganisation. Contrast-enhanced MRI often fails to detect diffuse pathological 

changes in normal appearing brain tissue. Event Related Potentials (ERP), small fluctuations of the EEG 

related to the processing of a relevant stimulus, measure information-processing speed and are the 

most robust and sensitive markers of CI in MS. They are sensitive to subtle CI, which influences daily 

activities and quality of life, work performance, independent coping skills 


42

Electrophysiological characterisation of patterns and extent of cognitive impairment (CI) over time,and 

comparison with phenotype and MRI, may enable identification of disease pattern and progress. 

Clinically, this may predict disease course and guide therapeutic decisions. We are longitudinally 

correlating clinical and ERP findings in MS patients with findings in healthy controls. 

3. Epidemiology of Multiple Sclerosis in Ireland: prevalence study in Dublin, Wexford and Donegal 

looking at differences in clinical, genetic, immunological, and vitamin D status nationally. 

The aims are: 

a) To establish current prevalence of multiple sclerosis (MS) in three centres in Ireland. 

Studies suggest increasing worldwide prevalence of MS.This appears to be true in Ireland. 

Establishing prevalence, especially if increased, has important implications for health service 

planning. 

b) To determine any differences in vitamin D levels between people with MS in the North and 

South of Ireland, and controls. 

Vitamin D is generated in the dermal skin layer after exposure to sufficient ultraviolet radiation. During 

winter months at latitudes >45°, including Ireland, even prolonged sunlight exposure is inadequate to 

support adequate vitamin D synthesis. Past sun exposure and vitamin D supplementation have been 

associated with decreased risk of MS. In one study, MS patients had significantly lower serum 25(OH) 

D concentrations in June to September compared with controls. During MS relapses,levels were lower 

than in remission, suggesting that vitamin D could be involved in the regulation of the disease activity 

of MS. 

The metabolically active form of vitamin D, calcitriol (1, 25-dihydroxyvitamin D3), has potent 

immunological properties. Earlier studies have shown that in vivo treatment with vitamin D analogs 

ameliorates experimental allergic encephalomyelitis (EAE) in association with the inhibition of IL-12 

production and Th1 differentiation. 

Vitamin D status has not yet been examined in MS patients living in Ireland, an area of high latitude, little 

sunshine and high incidence of MS. Demonstration of suboptimal levels could have important 

implications for future trials of vitamin D therapy, an accessible, inexpensive oral medication. 

c) To determine the link between vitamin D and T regulatory (Treg) cells in MS, using CD39 as a 

marker of functional Treg, and attempting to correlate it witH vitamin D level and other clinical 

parameters. 


43



Vitamin D is thought to mediate its immunomodulatory effects via the induction of tolerogenic dendritic 

cells and regulatory T cells. IL-10 is also thought to play an important role in mediating the effects of 

Vitamin D3. CD39, a recently described marker that identifies a subset of Treg, converts ATP to 

adenosine, thereby mediating suppressive effects. 

We plan to use CD39 as a marker of functional Treg and to correlate %CD39 expressing Treg with 

vitamin D levels and other clinical parameters. 

We will also measure the concentrations of IL-10 and other cytokines in the serum and correlate these 

with Vitamin D levels. 

d) To determine any genetic differences between people with MS in the Northwest and the South of 

Ireland, and to compare with controls. 

HLA DRB1*1501 typing and examination of vitamin D receptor (VDR) polymorphisms, which have 

been associated with MS. 

Genetic susceptibility to MS is implicated on the basis of classical family and monozygotic twin studies. 

However the concordance rate in identical twins is only 25 to 30%, despite sharing 100% of DNA and 

family environment. MS does not follow a particular pattern of inheritance and is probably a 

multifactorial, polygenic disorder. 

Several reviews have discussed linkage and association studies of the well known multiple sclerosis 

candidate genes, the MHC, and specifically the HLA located at chromosome 6 (6p21), have long been 

known to be associated with MS but exact location of the locus within the HLA complex is still largely 

presumptive. In Northern European, and Ireland, carriage of DRB1*1501and the DQB2*0602 haplotype 

of the HLA class 11 molecule is associated with increased MS risk. 

Until recent association of IL2RA and IL7RA gene SNPs with MS, no definite links beyond MHC on 

chromosome 6 had been established. However, this explains only a small proportion (less than 0.2%) 

of the variance in the risk of the development of multiple sclerosis. As previously mentioned, vitamin D 

receptor gene polymorphisms may also play a role in development of MS. It is likely that susceptibility 

to MS probably consists of many risk alleles, each contributing a modest effect to overall risk. 

e) To assess the needs of people with MS in Dublin, Wexford and Donegal 

In collaboration with Dr. Malachi Mc Kenna, Consultant Endocrinologist; Dr. Barbara Murray, Principal 

Biochemist; Dr. Jennifer Brady, Senior Biochemist, Metabolism Laboratory, SVUH; Dr. M.O’Brien, PhD 

Genetics; Dr. J. Fletcher, Immunology, TCD; Dr. C. Dunne, IBTS; Dr. P. Fitzpatrick, UCD School of Public 

Health /Pop. Science; Dr. Howard Johnson, National Population Health Directorate, HSE, Dr Steevens 

Hospital; Dr. Peter Doran, CRC; MS Society 

4. Oligoadenylate synthetase (OAS) in Multiple Sclerosis: not just a haplotype association. 

MS is an autoimmune disease characterised by unregulated inflammation and subsequent 

neurodegeneration. Type 1 Interferon (IFN) therapy is effective in some, but not all, patients. Type 1 

interferons (endogenous and exogenous) exert anti-inflammatory effects by upregulating a number of 

proteins, including those of the OAS family. A number of single-nucleotide polymorphisms (SNPs) of the 

OAS 1 gene have been identified. A single nucleotide polymorphism (SNP) at exon 7 in the OAS 1 gene 

influences OAS enzyme activity. Allele ‘G’ at exon 7 is associated with highest, and Allele ‘A’ lowest, OAS 

activity. 


44



Thus, genotype may be associated with the development of MS. In addition, it may also determine 

response to interferon therapy. 

OAS genotype of 311 MS patients and 112 controls was determined using restriction fragment length 

polymorphisms (RFLP).A functional SNP at exon 7 in OAS1 was significantly associated with 

susceptibility to MS (the first study to demonstrate this). 

There was a significant difference in genotype distribution and allele frequency (higher levels of ‘A’ 

allele and lower ‘G’ allele) in MS patients compared to controls. 

The results also suggested that AA is more common in highly active disease (in a group of patients 

with suboptimal response to IFN therapy). As OAS is up regulated by IFN in vivo and in vitro, OAS1 

SNPs may also play a role in treatment response. The clinical and economic impact would be significant 

if genotyping, which is relatively inexpensive and accessible, could guide treatment choice. 

We now plan to genotype further subgroups (i.e. benign MS cohort/ patients with suboptimal response 

to IFN/ relatives of affected individuals), and to correlate genotype with MRI features and disease severity. 

Collaboration 

Dr. Margaret O’Brien, MB BChBAO, PhD Genetics, UCD; Dr. Jean Fletcher, PhD, Immune Regulation Research 

Group, TCD 

5. Does IL-17 play a role in MS? 

A number of recent studies in the EAE model for MS have identified a key role for IL-17 in 

neuroinflammation. It is not yet know whether IL-17 plays a similar role in the pathogenesis of MS. We 

are therefore comparing the cytokines (IL-17, IL-22, IL-10 and IFN-γ) produced in response to myelin 

proteins by T cells from MS patients and healthy controls. 

We have also measured the concentrations of cytokines in the serum of patients and controls and found 

that IL-17 and IFN-Á were elevated in a subset of patients. Furthermore, there was a strong correlation 

between the levels of IL-17 and IFN-Á. 

In collaboration with Prof. Kingston Mills, TCD; Dr Jean Fletcher, TCD 

6. A reduction in thymically-derived natural regulatory T cells in patients with multiple sclerosis 

CD4+CD25+ Foxp3+ naturally occurring regulatory T cells (Treg) play an essential role in maintaining 

tolerance and preventing autoimmune disease via suppression of autoreactive T cells. It has been 

shown that the suppressive function of Treg is defective in relapsing remitting (RR) multiple sclerosis 

(MS) patients when compared to healthy controls. However, we and others have shown that the total 

number of Treg in MS patients is similar to that found in healthy controls, thus the reason for the defect 

in regulatory function in MS is unknown. 

It is thought that Treg specific for self antigens are thymically derived, however Treg can also be 

generated in the periphery, which are likely to be specific for non-self antigens. In this study we sought 

to compare the number of thymically derived Treg in MS patients with that of controls, by measuring 

CD31 expression which has been described as a marker for recent thymic emigrants. 

A significantly decreased percentage of CD31+ naïve Treg was observed in MS patients compared to 

controls. 


45

In collaboration with Prof. Kingston Mills, TCD; Dr Jean Fletcher, TCD 

7. The effects of IFN-‚ on Toll-Like Receptor (TLR) induced cytokine production by dendritic cells 

IFNα‚ is currently the most commonly used immunomodulatory treatment for MS; however the 

mechanism by which it mediates these effects is still not well understood. Dendritic cells play a pivotal 

role in directing immune responses via their production of of cytokines, usually in response to infection 

via stimulation of TLRs. We are therefore investigating the ability of IFN-β to modulate the cytokine 

profile of dendritic cells stimulated with different TLR agonists. 

Treatment of DCs with IFN beta suppressed production of the pro-inflammatory cytokines IL-12p40 

and IL-23, following TLR2 activation, but not in response to agonists for other TLRs. We are currently 

investigating whether this effect is due to induction of IL-10. These data suggest that IFN-beta may 

exert its protective effect in MS patients by modulating production of innate inflammatory cytokines that 

promote the induction of pathogenic autoreactive T cells 

In collaboration with Prof. Kingston Mills, TCD; Cheryl Sweeney TCD; Dr Jean Fletcher TCD 

8. An examination of the response shift phenomenon in relation to quality of life assessment in Multiple 

Sclerosis. 

L. Costelloe, K.O’Rourke, C. McGuigan, C Walsh, N Tubridy, M Hutchinson 

‘Response shift’ describes a change in the patient’s measure of self-evaluation in relation to a target 

construct (e.g. quality-of-life measures). It may be a source of bias in self-report studies. This paper 

describes the occurrence of a ‘response shift’ in patients with MS of varying severity. 

From this cohort we plan to re-assess a group of 100 patients with significant disability, observing for 

further evidence of the ‘response shift’ phenomenon, comparing clinical findings with patient perception 

of the impact of MS on their physical and psychological well-being (MSIS-29 scale). 

Meetings attended 

ABN London 2007 ECTRIMS – Prague, October 11th-14th 2007 

AAN Boston 2007 


46



Centre for Colorectal Disease 

Personnel: 

Consultant Gastroenterologist 

Diarmuid O’Donoghue 

(Director of Centre for Colorectal Disease) 

Consultant Surgeon John Hyland Des Winter 

Consultant Pathologists 

Kieran Sheahan 

Consultant Gastroenterologists 

Hugh Mulcahy 

Consultant Oncologist 

David Fennelly 

Senior Research Scientist 

Jacintha O’Sullivan 

Consultant Pathologist 

David Gibbons 

Consultant Radiation Oncologists John Armstrong Michael Moriarty 

Genetic Nurse Specialist 

Denise Keegan 

Cancer Nurse Co-ordinator 

Anne White 

Nurse Specialists Nikki Smith Grace McEvoy 

Senior Medical Scientists 

Robert Geragthy 

Research Nurse 

Blathnaid Nolan 

Senior Scientists 

Dermot Leahy 

Research Assistant 

Miriam Tosetto 

Postdoctoral Fellow (joint fellow with Rheumatology) Monica Biniecka 

Postdoctoral Fellow (NCI/HRB fellow) 

Edward Fox 

MD research fellow Alan Coss Dave Kevans 

Garret Cullen 

Joe Marry 

Ph.D students Sheeona Gorman Juliette Sheridan 

Maciej Milewski 

MSc. Students 

Julie Gorman 

MCh fellow 

Chin Hong Lim 

Changes to our research team in 2007: 

In 2007, Maciej Milewski joined our group as a Ph.D student and is analysing the molecular features 

associated with familial colorectal cancer. Maciej is funded by a HRB project grant. Monika Biniecka has 

embarked on postdoctoral studies in collaboration between our group and the Department of Rheumatology, 

St Vincents Hospital. Monika is investigating how genomic instability events may be altered in the hypoxic 

joint and how this in turn may control disease progression and treatment sensitivity in rheumatoid arthritis 

patients. Monika is funded for 3 years by a HRB Translational research grant (PI: D. Veale, co-applicants: J 

O’Sullivan, U Fearon and C Taylor). Also in 2007, Edward Fox a postdoctoral fellow was awarded a prestigious 

joint HRB/NCI grant to spend one year in the Joesph Gottesin laboratory in Seattle with Prof. Larry Loeb 

and the second year in St Vincents Hospital. Edward is currently in Seattle learning new technologies to 

assess the levels of random nuclear and mitochondrial mutations in adenoma and colorectal cancer tissue. 

These technologies will be translated back to our laboratory later this year. 


47


Poster Presentations in 2007 

Fox E, Bielas J, Hyland J, O’Donoghue D, Sheahan K, O’Sullivan J and Loeb L. 

Mutator phenotype in colon cancer. AACR Special Conference in Cancer Research: Advances in Colon 

Cancer Research. Nov, 2007; Boston, USA. 

Cullen G, Tossetto M, Gorman S, Mulcahy HE, O’Donoghue DP, O’Sullivan J. 

Reduction of interleukin-1ß by cigarette smoke extract – a possible mechanism for disease protection in 

ulcerative colitis. Poster presentation, ISG Winter Meeting 2007 

Milewski M, Moss C, O’Donoghue DP, Sheahan K, Leahy DT. 

Detection of BRAF mutation in colorectal cancer. 7th Annual UCD Conway Festival of Research, Dublin, 

September, 2007. 

E Fox, D Leahy, R Geraghty, H Mulcahy, J Hyland, D Fennelly, D O’Donoghue, K Sheahan 

Transcriptomic profiling may be useful in predicting recurrence in Stage II colorectal cancer. Irish 

Association for Cancer Research Annual Meeting, Cork, March, 2007. 

Coss A, Sheahan K, Sullivan S, Fox E, Hyland J, O'Donoghue D, Leahy D, Mulcahy H, O'Sullivan J 

Alterations of the topoisomerase II alpha gene and protein in colorectal cancer. Irish Association for 

Cancer Research Annual Meeting, Cork, March, 2007. 

A Coss, K Sheahan, S Sullivan, E Fox, J Hyland, D O'Donoghue, D Leahy, H Mulcahy, J O'Sullivan. 

Amplification of Topoisomerase II· Occurs in Colorectal Cancer and Its Expression Is Associated with 

Aggressive Disease. (Poster Presentation), Annual Meeting of the American Gastroenterological 

Association Institute and Digestive Disease Week, Washington, May, 2007. 

Sheridan J, Wang L, Tosetto M, Dave Kevans, Hyland J, Sheahan K, O’Donoghue D, Mulcahy H & O’Sullivan 

J. High levels of 8-Hydroxyguanine, a marker of oxidative DNA Damage predicts overall survival in 

sporadic colorectal cancer. AACR conference on colorectal cancer, Boston, Nov, 2007. 

S. Gorman, M. Tosetto, H. Mulcahy, O. Howe, F. Lyng, D. O’Donoghue, J. Hyland, D. Fennelly, Gibbons D, Winter 

D, K. Sheahan & J. O’Sullivan. Gamma ray-induced bystander effects in colorectal cancer: a specific study 

on cell cycle alterations, cytokine release and early genomic instability events. AACR, Boston, Nov 2007. 

S. Gorman, M. Tosetto, H. Mulcahy, O. Howe, F. Lyng, D. O’Donoghue, J. Hyland, D. Fennelly, K. Sheahan & J. 

O’Sullivan. Radiation and chemotherapy bystander effects in ex vivo tumour and matching normal 

colorectal explants; possible role in secondary tumour formation. IACR, Cork, March 2007. 


48



S. Gorman, M. Tosetto, H. Mulcahy, O. Howe, F. Lyng, D. O’Donoghue, J. Hyland, D. Fennelly, Gibbons D, Winter 

D, K. Sheahan & J. O’Sullivan. Gamma ray-induced bystander effects in colorectal cancer: a specific study 

on cell cycle alterations, cytokine release and early genomic instability events. ISG, Nov 2007. 

J Marry, R O’Cearbhaill, J Mackarel, J Crown , D Fennelly. Increased Incidence in Gastrointestinal 

Perforation associated with Bevacizumab. Irish Association for Cancer Research, Cork, 2 March 2007. 

Joseph Marry and David Fennelly. Management of Metastatic Colorectal Cancer in a Dublin Teaching 

Hospital Irish Society of Gastroenterology Spring 2007. 

J Marry, M Tosetto, H. Mulcahy, J. Hyland, D O’Donoghue, K.Sheahan, D Fennelly, JO’Sullivan. Assessing the 

effects of monoclonal antibody therapies and telomerase inhibition on pro-angiogenic growth factor 

secretions in individual human colorectal cancer explants. AACR Special Conference on Advances in 

Colorectal Cancer, Boston MA, Nov 2007. 

LM Wang, D Kevans, DP O’Donoghue, HE Mulcahy, J Hyland, J O’Sullivan and K Sheahan. Tumour budding 

as a prognostic factor in Stage II, pT3N0 colorectal cancer. ISG, April 2007. 

Kevans D, Foley J, O’Donoghue DP, Hyland JH, Sheahan K, Mulcahy H, O’Sullivan J. High Clusterin 

expression is associated with poorer prognosis in a cohort of stage II Colorectal Cancer patients. AACR 

Special Conference “Advances in Colon Cancer Research”Boston November 2007 and Irish Society of 

Gastroenterology Dublin, November 2007 

Kevans D, Wang LM, O’Donoghue DP, Hyland JH, Mulcahy H, Sheahan K, O’Sullivan J. Epithelial- 

Mesenchymal Transition (EMT) protein expression and mismatch repair profiles in Stage II colorectal 

cancer with tumour budding status Irish Society of Gastroenterology, Dublin, November 2007. 

Published Abstracts 

A Coss, K Sheahan, S Sullivan, E Fox, J Hyland, D O'Donoghue, D Leahy, H Mulcahy, J O'Sullivan (2007) 

Gastroenterology 132: Suppl. 1, A-293 Amplification of Topoisomerase II· Occurs in Colorectal Cancer 

and Its Expression Is Associated with Aggressive Disease 

Cullen G, Keegan D, O’Donoghue DP. Infliximab in Crohn’s Disease: step-up or top-down? 

Gastroenterology 2007 April; 132:Supplement S1.Poster DDW Washington DC May 2007 

Invited Talks 

Jacintha O’Sullivan. Radiation induced bystander events in colorectal cancer. Irish Society of Radiology 

Annual Conference, Dublin. October 2007. 

Jacintha O’Sullivan. Oncologic Therapies for late stage CRC. International CRC meeting. St. Vincents 

Hospital, Dublin. Sept 2007. 

Juliette Sheridan. Levels of DNA damage in normal mucosa following radiation. Radiation Conference, 

Belfast. April 2007. 

Sheeona Gorman. Examination of Bystander effects using an ex vivo colorectal cancer explant model, ISG, 

April 2007. 


49



Joesph Marry. A Case of Reversible Cortical Blindness. Irish Society of Medical Oncology Education 

Meeting, Dublin, Feb 2007. 

Joesph Marry: Assessing the effects of monoclonal antibody therapies and telomerase inhibition on proangiogenic 

growth factor secretions in individual human colorectal cancer explants. Irish Society of 

Gastroenterology Winter Meeting Plenary Session, Dublin, December 2007 and at the Irish Society of 

Medical Oncology Education Meeting, Dublin, December 2007 

Alan Coss. Overexpression of topoisomerase II alpha in CRC is associated with resistance to etoposide 

and irinotecan. Irish Society of Gastroenterology Winter meeting, Dublin, November 2007 

Alan Coss. Medical management of inflammatory bowel disease. School of Nursing, Midwifery & Health 

Systems, University College Dublin, January 2007. 

Students Graduated in 2007 

Edward Fox, Ph.D. Thesis Title: Molecular analysis of colorectal cancer and its role in detecting familial cancer. 

Julie Gorman, MSc. Thesis title: The effect of telomerase inhibition in regulating treatment response in 

colorectal cancer cell lines. 

Current National & International Research Collaborators 

Prof. Peter Rabinovitch, University of Washington, Seattle, Prof. Larry Loeb, University of Washington, Seattle, 

Prof. Martin Tenniswood, Notre Dame, Indiana, Dr Oliver Zierau, Dresden, Dr. Cal Harley, Geron Co. Califormia, 

Dr. Walter Kloch, Glasgow, Dr Orla Howe, Dr. Fiona Lyng, DIT, Kevin Street, Dr. Cormac Taylor, Dr. Katrina 

Comerford, Amanda Mc Cann, Conway Institute, UCD, Prof. Kevin Malone, Dr. Douglas Veale, Dr. Ursula 

Fearon, St Vincents University Hospital, Dublin, Dr. Dermot Leahy, Conway Institute, UCD, Dr. Elizabeth Ryan 

and Prof. Cliona O’Farrelly, Trinity College Dublin, Prof. Alan Baird, Vet School, UCD, Dr. Paul Walsh, National 

Cancer Registry for Ireland, Cork. 

Our current translational research projects 

Role of genomic instability and hypoxia in governing response to therapies using in vitro and ex vivo explant 

models (Joe Marry & Miriam Tosetto) 

Role of oxidative stress and DNA damage in CRC (Juliette Sheridan). 

Molecular classification of familial colorectal cancer (Maciej Milewski &Dermot Leahy). 

Bystanders effects and tumour recurrence in colorectal cancer (Sheeona Gorman) 

Analysis of chromosomal instability patterns in non-metastatic and metastatic CRC using array comparative 

genomic hybridization, and validation of novel gene alterations using fluorescent in situ hybridisation 

(Alan Coss). 

Timing and rates of random nuclear and mitochondrial spontaneous mutations in colorectal cancer: 

implications for early detection and chemotherapy resistance (Edward Fox). 

Examination of prognostic gene signature in Stage II good and poor survivors (Dave Kevans). 

Cigarette smoking and genomic instability: factors controlling disease progression and treatment sensitivity 

in inflammatory bowel disease patients (Garret Cullen) 

Examination of Immune modulators involved in laproscopic and open colorectal cancer surgery 

(Chin Hong Lim) 


50



Breast Cancer Research 


Professor Joe Duffy 

Researchers: 

Patricia McGowan, Dr Aisling Pierce, Dr Eadaoin McKiernan, 

Dr Brid Ryan, 

Dr Neil O’Brien (currently visiting scientist in the lab of Drs Denis Slamon, University of California at Los Angeles) 

Collaborators (Local): 

Professor John Crown, Mr Enda McDermott, Mr Denis Evoy, 

Dr Liam Gallagher, Professor Steve Pennington, Professor F Martin (UCD), 

Dr Norma O’Donovan (DCU) 

Collaborators (International): 

Drs Denis Slamon/Gottfried Konecny, University of California at Los Angeles; 

Dr Stan Krajewski, Burnham Institute, La Jolla; Prof Fred Sweep, Nijmegen; 

Prof Nils Brunner, Copenhagen, Prof Manfred Schmitt, Munich. 

Research Focus 

The overall aim of the Breast Cancer Research 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. 

Patricia McGowan is working on TACE (ADAM17), a multidomain protein possessing both a protease and 

an adhesion domain. Using both breast cancer cell lines and human tumors, Patricia has shown that TACE 

is involved in the progression of breast cancer. TACE is thus a potential new target for the treatment of breast 

cancer. During 2007, Patricia also carried out research on a new breast cancer biochip 

Aisling Pierce is involved in using proteomics and glycomics for the early detection of breast cancer. She is 

also investigating the potential role of the breast-specific gene, mammaglobin, in the formation of breast cancer. 

Eadaoin McKiernan is attempting to identify new markers for predicting the metastatic potential of newly 

diagnosed breast cancers. This work is being carried out as part of a HRB-funded Programme Grant 

Recognition of Work 

In 2007, the American Society of Clinical Oncology recommended clinical use of uPA for determining 

prognosis in patients with newly diagnosed breast cancer. The first demonstration of the clinical value and 

indeed much of the early work on this biomarker was carried out in the Education and Research by 

researchers working under the supervision of Professor Duffy. These researchers included Pauline O’Grady, 

David Reilly and Catherine Duggan 

Higher Degrees/Fellowships 

Patricia McGowan received her PhD in 2007 for her research on “ADAM17 in Breast Cancer”. During the 

year, Brid Ryan began a Health Research Board/National Cancer Institute (USA) Fellowship in Preventative 

Oncology. This Fellowship will allow Brid to work at the world famous National Cancer Institute in the US. 


51



Mental Health Research 

The Department has established a leading National Programme on Suicide Research including projects in 

basic and applied clinical neuroscience, clinical epidemiology projects as well as leading national community 

projects in the area of new knowledge and understanding around the problem of suicide in Ireland. This work 

is being conducted in collaboration with the Department of Electronic Engineering in UCD as well as the 

Department of Radiology in St. Vincent’s. Other neuroscience projects include molecular genetic studies of 

patients with suicidal depression. This collaborative research project is being led by Dr Maria Ryan and 

includes a study of cases from all the Dublin Teaching Hospitals in collaboration with the Dublin Molecular 

Medicine Centre. Clinical epidemiology projects include a national study of all suicides by drowning as well 

as a ten-year study of all deaths on Irish railways over the past decade. This work is being conducted in 

conjunction with the Irish Water Safety Association and Iarnród Éireann respectively with significant 

consultation and collaboration with Professor Cecily Kelleher, UCD. New projects include a National Survey 

of Suicide in Ireland, which is being led by Professor Malone at St. Vincent’s. This project involves detailed 

interviewing of families who have been bereaved by suicide as well as the treating clinicians of those who 

have died. 

In addition to the suicidal depression projects we have established an exciting interdisciplinary collaborative 

research programme in psychobiology. The psychobiology group are currently engaged in a programme of 

research examining the relationship between depressive illness and physical health and are being conducted 

by Dr. Gavin Rush who is looking at the anti-inflammatory effects of some of our anti-depressant treatments. 

This research is based on the fact that recurrent depression is related to an increase in cardiovascular and 

cancer deaths. A further study examining the immune system in depression to explore the relationship 

between the immune system, stress and depression with a focus on exploring the mechanism of action of 

electroconvulsive therapy one of the strongest anti-depressant treatments we have. 

These projects are being led by the Multidisciplinary Psychobiology Research Group at SVUH. Members of 

MPBG include Dr Gavin Rush, Professor Kevin Malone and Ms. Aoife O’Donovan from the Department of 

Psychiatry, as well as Professor Cliona O’Farrelly and Dr Jacinta O’Sullivan from the ERC. 

Our collaborative partners in St. Vincent’s include Professor Cliona O’Farrelly, Professor Cecily Kelleher, Dr 

Jacinta O’Sullivan, Dr Douglas Veale, Dr Dónal O’Shea, Dr Hugh Mulcahy, Professor Michael Hutchinson from 

Neurology, and Dr Seán Connolly from Neurophysiology 

External and international collaborators include Professor Andy Seakin from Dartmouth Hitchcock Medical 

Centre, Professor John Mann from Columbia University, New York, Professor Annette Beautrais from the 

University of Otago in New Zealand, Professor Madelyn Gould from the Department of Public Health in 

Columbia University, New York, Dr Tom Foster and Dr Chris Kelly from Queen’s University Belfast, and 

Professor Richard Reilly from Electronic Engineering, UCD 


52

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 

It was agreed by the members of the GP Committee that the Annual Hospital Study Day be held this year 

on Saturday 3rd March on a trial basis as November and December are busy months for everybody. This 

proved to be very successful. The educational format was similar to that of 2005 and consisted of four 

Poster Sessions as follows: 

How to Manage the Patient with Palpitations - Dr. David Keane 

Common Endocrine Tests - Dr. Donal O’Shea 

The Full Blood Count - Dr. Gerry Connaghan 

Interpretation of Auto Antibody & Related Serology - Prof. Oliver FitzGerald 

There were 2 Interactive Sessions as follows: 

The GP and Radiology - Dr. Conor Collins 

Abnormal Liver Function Tests - Prof. P. A. McCormick 

There was also a Minor Surgery Workshop as follows: 

Common Dermatological Procedures in General Practice 

At 6.30pm there was a Panel Discussion on “Services in SVUH with New Developments” 

Later that evening the reception and dinner was held in the atrium of the New Ambulatory Care Centre and 

was attended by about 100 guests. This was the first time that the atrium was used for such a function and 

proved to be a very attractive option for the occasion. 


53



Medical and Surgical Meetings 

The Postgraduate Lunch Time Meetings include: 

Respiratory Gastroenterology Nephrology 

Rheumatology 

Intern Report 

The Breakfast Meetings include: 

Colorectal Meeting 

Surgical Audit 

Grand Rounds 

Respiratory SpR Conference 

Cardiology Meeting 

Tuesday at 7.30am 

Wednesday at 7.00am 

Thursday at 8.00am 

Friday at 8.00am 

Friday at 7.30am 

All of the above meetings are organised by the Postgraduate Department. Lunch or breakfast is provided. 

Intern Lunch Time Seminars 

Monday 

Lunch Time Seminars for Interns consist of Clinical Skills Sessions and Data Interpretation. 

Tuesday 

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. 

Wednesday 

Wednesday conferences can be either surgical or medical. 

Thursday 

Thursday Lunch Time Lectures are on matters relating to all aspects of Surgery and are given by Consultant 

Surgeons within the hospital. 

Friday 

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. 

SHO Teaching 

Formal Clinical Teaching 

We 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. These tutorials are all consultant provided and take place at 5.00pm to maximise attendance 

and to allow SHOs in peripheral jobs to attend. Consultants are asked to focus on a short case format (see 

page 8 of the Postgraduate Medical Training Booklet). 

At the end of the course feedback from 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. 


54



International Meeting 

In addition to the large number of in-house meetings, the Postgraduate Department helped organise the 

Centre for Colorectal Disease 14th International Meeting which was held on Friday 14th September 2007. 

The programme was as follows: 

Session 1 

Session 2 

Session 3 

Session 4 

Session 5 

The Past and the Present : Improved Outcomes 

Colorectal Cancer – The National Picture – Dr. H. Comber 

Colorectal Cancer – The Hospital Picture – Prof. D. P. O’Donoghue 

Colorectal Cancer Screening : Improving National Outcomes 

Screening Average Risk Individuals – The European Perspective – 

Prof. C. O’Morain 

Alternative Screening Modalities – Dr. P. MacMathuna 

Screening in Scotland – Prof. A. Mowat 

The Multidisciplinary Team Meeting – Improving Local Outcomes 

Introducing the Multidisciplinary Team – Mr. J. Hyland 

The Excelicare Database System – Mr. S. Thompson 

Case Presentations – Ms. A. White 

The Future : Improving Individual Outcomes 

Targeted Molecular Therapies – Dr. J. O’Sullivan 

State of the Art Lecture 

Colorectal Cancer : More than One Disease – Prof. J. Jass, 

St. Mark’s Hospital, London. 

There were 120 attendees at the meeting. 

A dinner was held afterwards in the Shelbourne Hotel and was attended by 70 guests. 

Sponsorship for this event was provided by the following pharmaceutical companies: 

Astra Zeneca Healthcare 21 Johnson & Johnson 

Merck Serono 

Sanofi Aventis 

“Get to Know you Function” for Incoming NCHDs 

In 2007 the welcoming lunch was held on Wednesday 11th July and as usual was very enjoyable. This event 

is an important opportunity to give incoming NCHDs the relevant information about ongoing lectures / 

conferences and welcome them to the hospital. It is now an annual event held every year in early July. 

The Student Summer Project 

As in other years this is an important part of the hospital’s academic year and in 2007 it was held on Monday 

12th November. As you are aware the aim of the project is for the student 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), Prof. Michael Keane, Prof. Ronan O’Connell, Mr. Enda 

McDermott and Dr. Cecily Quinn. The winner was A. C. McArdle whose project was entitled “The Effects of 

Nicotine on Atherogenesis in a Genetic Mouse Model”. 


55


Pharmaceutical Representatives 

The link for the pharmaceutical companies in St. Vincent’s University Hospital is the Postgraduate 

Department. The companies sponsor the medical and surgical lunch and breakfast meetings and in turn the 

representative meets the consultants and NCHDs to discuss their products. This link is important for both 

doctors and medical representatives. 

The Library 

The Library and Information Service (LIS) facilitates the staff of the three hospitals in St. Vincent’s Healthcare 

Group and all students, resident or on placement. The LIS supports the information needs of its users and 

therefore the clinical practice, education and research activities of the Group. 

The LIS collections comprise print and electronic resources including books, journals, reports, databases etc. 

The electronic resources can be accessed through the SVUH IT network and intranet and are also available 

remotely with an Athens account, which all staff may apply for. UCD’s electronic collections are available on 

the 17 PCs in the Library. These are strictly for research or hospital business (e.g. patient care) only. We 

offer basic and advanced training on all our electronic products, by appointment. 

Other services include: lending service, document delivery, photocopying, scanning and printing (b/w and 

colour). 

Postgraduate Medical Training Booklet 

This booklet is compiled and circulated bi-annually by the Postgraduate Department. It contains valuable 

information re conferences / meetings / tutorials that occur in the hospital. 


Co-ordinator of Postgraduate Education. 


56



Academic Activities 

DMMC/CONWAY INSTITUTE 

Immunobiology Course 2007 

10th January – 7th March 2007 

Venue: Education & Research Centre 

The aim of this course is to introduce students to the basic concepts and terminology required to understand 

immunology. At the end of the course, participants should be familiar with the terms and models of innate 

and adaptive immunity and be conversant with the names and functions of the organs, cells, molecules and 

genes involved in initiating and mediating immune responses. Participants should be able to explain 

fundamental immunological concepts and discuss the roles of key components of the immune system 

including acute phase proteins, complement, haematopoietic cells, immunoglobulins and cytokines in 

protecting against disease. The course will also provide an understanding of some basic concepts of 

immunological dysregulation seen in inflammatory and autoimmune diseases, allergy, malignancy and 

immunopathogenesis and appreciate genomic influences on these processes. 

Recommended Text 

Immunobiology (6th Ed). C.A. Janeway, P. Travers, M. Walport, M. Shlomchik (Garland / Churchill Livingstone). 

Course Leader 

Prof. Cliona O’Farrelly, Education & Research Centre, St. Vincent's University Hospital 

Contributors 

Prof. Denis Reen, Our Lady's Hospital for Sick Children 

Dr Elizabeth Ryan, E.R.C., St. Vincent's University Hospital 

Dr John Baugh, UCD Conway Institute of Biomolecular & Biomedical Science 

Dr Jean Fletcher, School of Biochemistry & Immunology, TCD 

Prof. Doug Veale, St. Vincent's University Hospital 


57



Careers Workshop 

A snapshot of some possible career paths for PhD graduates 

Chair: Professor Cliona O’Farrelly 

5.00pm Thursday 29th March 2007 

Venue: Lecture Hall, E.R.C. 

5.00 – 5.05 Welcome 

5.05 – 5.15 Patrick Corley Ph.D Cancer Research Officer, 

Cancer Research Ireland, 

Irish Cancer Society 

5.15 - 5.20 Questions 

5.20 – 5.30 Mairead O’Driscoll Ph.D Acting Director of Research 

Funding, Health Research Board 

5.30 – 5.35 Questions 

5.35 – 5.45 Mary O’Connell, Ph.D Lecturer, School of Biotechnology, 

Dublin City University 


5.50 – 6.00 Edel Healy Ph.D Head of the Hazardous Substances 

Assessment Unit, 

Health and Safety Authority 


6.05 – 6.15 Gordon Elliott Ph. D Head of Research & Development, Biotrin 


followed by RECEPTION 


58


Lecture Series 2007 

7th February 2007 

“Sharing Immunological Knowledge with Gene Ontology” Evelyn Camon, Senior Scientific Curator & Gene 

Ontology Annotation Database Co-ordinator, European Bioinformatics Institute, Hinxton, Cambridge, UK 

28th June 2007 

Translational Research Seminar: Update on current research by Obesity, Rheumatology and Innate 

Immunity Research Groups 

22nd November 2007 

Informal translational Research update with Respiratory, Rheumatology and Cardiology Groups on current 

research. 

ERC Journal Club 2007 

Schedule: 

Venue: 

Thurs mornings 9.00-10.00am 

Seminar Room, E.R.C. 

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. 

In 2007 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. 


59

Prestigious Invitations/Honours 

for E.R.C. Researchers 

Prof. Barry Bresnihan 

Co-Chairman, EULAR Synovitis Study Group 

Co-Chairman, OMERACT Synovial Tissue Analysis Study Group 

Chairman, Arthritis Ireland –October 2007 

Italian Society of Rheumatology, Catania 

Royal Society of Medicine, London, June 

Chairman scientific session, EULAR, June 

British Bone Society, Aberdeen, July 

Prof. Joe Duffy 

Invited Plenary Lecture, International Society for Oncology and Biomarkers Conference, Prague, 

Title of Presentation: “Personalised Treatment for Cancer: How Biomarkers Can Help”. 

Prof. Oliver FitzGerald 

Chairman, Arthritis Ireland (Oct-present) 

Member of HSE working group on Arthritis and Allied conditions representing the Irish Society of 

Rheumatology 

Steering committee member for GRAPPA (Group for Research and Assessment of Psoriasis and 

Psoriatic Arthritis) 

Member of Abbott International Immunology Advisory Board 

Steering committee member of OMERACT Biomarkers Group 

Scientific committee member 3e Initiative in Rheumatology 

Rochester University, Visiting Speaker 

Progress and Promise, Munich 


60




Visiting Professorship at University of Sydney, August 2007. 

Invited lecture at Seventh Annual Ludwig Engel memorial lecture. University of Sydney Aug 2007 

Invited lecture at World Sleep Conference, Cairns Australia Sept 2007 

Invited lecture at 10th International Sleep and Breathing Symposium Palm Cove Australia, Sept 2007. 

Invited lecture at ERS Research symposium on chronic co-morbidities Feb 2007 

Invited lecture at State of the Art Respiratory Symposium, University of Athens, April 2007 

Prof. Douglas Veale 

Adjunct Professor of Medicine, UCD awarded 2007 

Medical Director, Education & Research Centre, SVUH 

Chairman, SVGH Ethics & Medical Research Committee Vice-president, International Scleroderma 

Clinical Trials Consortium 

International Advisor, The Strategic Scientific Committee, Arthritis Research Campaign, UK 

Medical Director, Education and Research Centre, SVHG 

Director of THERAPI - Translational Medicine Research Group, SVUH 

HRB Infection & Immunity Grant Committee 

Irish Medicines Board, Medicines Committee 

Chairman, SVHG Ethics & Medical Research Committee 

Medical Executive, SVHG 

Seed Funding Committee, UCD 

Postgraduate Degree Programme Committee, UCD 

International Advisor to Wyeth (Global), Wyeth (Europe), Schering-Plough (Global), Centocor (Global) 

and GlaxoSmithKline (Global) 

IJMS Awards Best Published Paper – Rheumatology 2007 

Joint Irish and British Society of Rheumatology - Best Oral presentation 2007 

SIAR Award - American College of Rheumatology 2007 

Visiting Speaker 

Swiss Rheumatology Society 

British Society for Rheumatology 

University of Newcastle 


61



Awards & Prizes 2007 

Mr. Muhammad Badar Zaman: International Liver Transplant Society Rising Star Award 2007 at the 13th 

Annual Congress of the LITS (International Liver Transplantation Society) in Sheraton Rio Hotel, Rio do 

Janeiro, Brazil, June 2007. Zaman received this award on June 21st 2007 in recognition of his work 

investigating the activation of NRF-2 and other mechanisms of cytoprotection against reactive oxygen 

species and their clinical implications. 

Aoife O’Donovan: Rotary Ambassadorial Scholarship 2007-2008 to Dept. of Psychiatry, University of 

California, San Francisco. Fulbright Studentship 2007-2008 

Tom Cawood: Awarded the O’Donovan Medal by the Irish Endocrine Society and the Novartis 

Endocrinology Registrar Research Medal. 

Jane Foley (4th year medical student): HRB summer project fellowship 

David Kevans: Irish Cancer Society Oncology Scholars Travel Award 

David Kevans: ISG Poster presentation prize 

Sheeona Gorman: UCD Seed Funding Travel Award 

Juliette Sheridan: UCD Seed Funding Travel Award 

Dr. Ronan Mullan: IJMS Awards Best Published Paper – Rheumatology 2007 

Aisling Kennedy: SIAR Award/Oral Presentation – American College of Rheumatology, Boston 2007 

Mary Connolly: SIAR Award – American College of Rheumatology, Boston 2007 

Mary Connolly: EULAR Travel Award – European Rheumatology Meeting, Barcelona 2007 

Degrees Awarded 

PhD 

Lydia Lynch Tom Cawood Edward Fox 

Patricia McGowan 

Sinead Nic an Ultaigh 

MSc 

Julie Gorman 


62



Publications 

Published or Accepted for Publication in International Peer Reviewed Journals 2007 

Balcer LJ, Galetta SL, Calabresi PA, Confavreux C, Giovannoni G, Havrdova E, Hutchinson M, Kappos 

L, Lublin FD, Miller DH, O'Connor PW, Phillips JT, Polman CH, Radue EW, Rudick RA, Stuart WH, 

Wajgt A, Weinstock-Guttman B, Wynn DR, Lynn F, Panzara MA. 

Natalizumab reduces visual loss in patients with relapsing multiple sclerosis. 

Neurology. 2007; 68:1299-304. PMID 17438220 

Bresnihan B, Gerlag DM, Rooney T, SmeetsTJM, Wijbrandts CA, Boyle D, FitzGerald O, Kirkham BW, 

McInnes IB, Smith M, Ulfgren AK, Veale DJ, Tak PP. 

Synovial macrophages as a biomarker of response to therapeutic intervention in rheumatoid arthritis: 

Standardization and consistency across centres. J. Rheumatol 2007 Mar;34(3):620-6 PMID 17343309 

Brennan DJ, Kelly C, Rexhepaj E, Dervan PA, Duffy MJ, Gallagher WM Contribution of DNA and tissue 

microarray technology to the identification and validation of biomarkers and personalised medicine in breast 

cancer. Cancer Genomics Proteomics 2007 May-Jun;4(3):121-34 PMID 17878516 

Burgoyne CH, Field Sl, Brown AK, Hensor FM, English A, Bingham SL, Verburg R, Fearon U, Lawson 

CA, Hamlin JP, Straszynski L, Veale D, Conaghan P, Hull MA, van Laar JM, Tennant A, Emery P, Isaacs 

JD, Ponchel F. Abnormal T-cell differentiation persists in rheumatoid arthritis patients in clinical remission 

and predicts relapse. Ann Rheum Dis. 2007 Jul 20 PMID 17644540 

Cawood T, Moriarity P, O’Farrelly C, O’Shea D. Smoking and thyroid associated ophthalmopathy; a novel 

explanation of the biological link. J. Clin Endocrinol Metab 2007 Jan;92(1):59-64 PMID 17047020 

Chua CP, Garvey J, Redmond S, Heneghan C, McNicholas WT. 

Towards Automated Sleep State Estimation using a Holter-Oximeter. 

Conf Proc IEEE Eng Med Biol Soc. 2007;1:3998-4001. PMID: 18002876 

Colonna-Romano G, Akbar AN, Aquino A, Bulati M, Candore G, Lio D, Ammatuna P, Fletcher JM, Caruso 

C, Pawelec G. Impact of CMV and EBV seropositivity on CD8 T lymphocytes in an old population from West- 

Sicily. Exp Gerontol. 2007 Oct;42(10):995-1002. PMID 17611062 

Costelloe L, O’Rourke K, Kearney H, McGuigan C, Gribbin L, Duggan M, Daly L, Tubridy N, Hutchinson M 

The patient knows best: significant change in the physical component of the Multiple Sclerosis Impact Scale 

(MSIS-29 physical). J Neurol Neurosurg Psychiatry. 2007 Aug;78(8):841-4. PMID 17332049 

Costelloe L, O’Rourke K, McGuigan, C, Walsh C, Tubridy N, Hutchinson M. 

The longitudinal relationship between the patient-reported Multiple Sclerosis Impact Scale and the clinicianassessed 

Multiple Sclerosis Functional Composite. Mult Scler. 2007 Oct PMID: 17942522 


63



Costelloe L, Hutchinson M. Is a 20% change in MSFC components clinically meaningful? 

Multiple Sclerosis 2007; 13:1076. PMID 17895297 

Cullen G, O’Donoghue D. Constipation and pregnancy. Best Pract Res Clin Gastroenterol 

2007;21(5):807-18. PMID 17889809. 

Cullen G, O’Toole A, Keegan D, Sheahan K, Hyland JM, O’Donoghue DP. Long-term clinical results of 

iloececal resection for Crohn’s disease. Inflamm Bowel Dis. 2007 Nov;13(11):1369-73. PMID 17600379 

Culleton J, O’Brien N, Ryan BM, Hill ADK, McDermott E, O’Higgins N, Duffy MJ. Lipophilin B: a gene 

preferentially expressed in breast tissue and upregulated in breast cancer. Int J Cancer 2007 Mar 

1;120(5):1087-92. PMID 17163411 

Denton CP, Merkel PA, Furst DE, Khanna D, Emery P, Hsu VM, Silliman N, Streisand J, Powell J, 

Akesson A, Coppock J, Hoogen F, Herrick A, Mayes MD, Veale D, Haas J, Ledbetter S, Kom JH, Black 

CM, Seibold JR, Cat-192 Study Group: Scleroderma Clinical Trials Consortium. Recombinant human 

anti-transforming growth factor beta 1 antibody therapy in systemic sclerosis: a multicenter, randomized, 

placebo-controlled phase I/II trial of CAT-192. Arthritis Rheum 2007 Jan;56(1):323-33. PMID 17195236 

Doherty LS, Kiely JL, Deegan PC, Nolan G, McCabe S, Green AJ, Ennis S, McNicholas WT Late-onset 

central hypoventilation syndrome: a family genetic study Eur Respir J 2007;29:312-316 PMID 17264323 

Doherty LS, Cullen JP, Nolan P, McNicholas WT The genioglossus response to negative airway 

pressure:stimulus timing and route of delivery. Exp Physiol. 2007 Oct 19 PMID 17951328 

Duffy MJ, van Dalen A, Haglund C, Hansson L, Holinski-Feder E, Klapdor R, Lamerz R, Peltomaki P, 

Sturgeon C, Topolcan O. Tumour markers in colorectal cancer: European Group on Tumour Markers (EGTM) 

guidelines for clinical use. Eur J Cancer 2007 Jun;43(9):1348-60 PMID 17512720 

Duffy MJ Role of tumour markers in patients with solid cancers: A critical review. Eur J Intern Med 2007 

May;18(3):175-184. PMID 17449388 

Duffy MJ, O’Donovan N, Brennan DJ, Gallagher WM, Ryan BM Survivin: a promising tumour biomarker. 

Cancer Lett 2007 Apr28;249(1):49-60 PMID 17275177 

Fearon U, Veale DJ. Angiogenesis in arthritis: methodological and analytical details. 

Methods Mol Med 2007;135:343-57. PMID 17951670 

Fitzgerald DC, Meade KG, McEvoy AN, Lillis L, Murphy EP, Machugh DE, Baird AW. Tumour necrosis 

factor-alpha (TNF-alpha) increases nuclear factor kappaB (NFkappaB) activity inand interleukin-8(IL-8) 

release from bovine mammary epithelial cells. Vet Immunol Immunopathol. 2007 Mar 15;116(1-2):59-68 

PMID 17276517 

Flanagan E, Walsh C, Tubridy N. Neurophobia: attitudes of Irish doctors and medical student to teaching 

neurology. Eur J Neurol 2007; 14(10): 1109-12. PMID 17880566 


64



Galbraith S, Wells G. Definitions and Validation Criteria for Biomarkers and Surrogate Endpoints: 

Development and Testing of a Quantitative Hierarchical Levels of Evidence Schema. J. Rheumatol 2007 

Mar;34(3):607-15 PMID 17343307 Omeract 8 2006. In Press 

Garvey JF, McElwaine P, Monaghan TS, McNicholas WT Banning smoking: Confessions of an accordion 

cleaner. BMJ 2007 Sep 29;335(7621):630. PMID 17901481 

Gladman DD, Imman RD, Cook Rj, Maksymowych WP, Braun J, Davis JC, Landewe RB, Mease P, 

Brandt J, Vargas RB, Chandran V, Helliwell P, Kavanagh A, O’Shea FD, Khan MA, Pipitone N, Rahman 

P, Reveille JD, Stone MA, Taylor W, Veale DJ, van der Heijde D. International spondyloarthritis 

interobserver reliability exercise – the INSPIRE study: II. Assessment of peripheral joints, enthesitis and 

dactylitis. J. Rheumatol 2007 Aug;34(8):1740-5. PMID 17659754 

Gladman DD, Imman RD, Cook RJ, van der Heijde D, Landewe RB, Braun J, Davis JC, Mease P, Brandt 

J, Vargas RB, Chandran V, Helliwell P, Kavanagh A, O’Shea FD, Khan MA, Pipitone N, Rahman P, 

Reveille JD, Stone MA, Taylor W, Veale DJ, Maksymowych WP. International spondyloarthritis 

interobserver reliability exercise – the INSPIRE study: I. Assessment of spinal measures. 

J. Rheumatol 2007 Aug;34(8):1733-9. PMID 17611985 

Gladman DD, Mease PJ, Healy P, Helliwell PS, Fitzgerald O, Caula A, Lubrano E, Krueger GG, van der 

Heijde D, Veale DJ, Kavanaugh A, Nash P, Ritchlin C, Taylor W, Stand V. Outcome measures in psoriatic 

arthritis. J. Rheumatol 2007 May;34(5):1159-66. PMID 17477479. 

Gladman DD, Mease PJ, Strand V, Healy P, Helliwell PS, Fitzgerald O, Fottileb AB, Krueger GG, Nash 

P, Ritchlin CT, Taylor W, Adebajo A, Braun J, Cauli A, Carneiro S, Choy E, Dijkmans B, Espinoza L, van 

der Heijde D, Husni E, Lubrane E, McGonagle D, Qureshi A, Soriano ER, Zochling J. Consensus on a 

core set of domains for psoriatic arthritis. J. Rheumatol 2007 May;34(5):1167-70. PMID 17477480. 

Gogarty M, Fitzgerald O. Immunohistochemistry of the inflamed synovium. Methods Mol Med 2007;135:47- 

64. PMID 17951651. 

Golden-Mason L, Castelblanco N, O’Farrelly C, Rosen HR Phenotypic and Functional Changes of 

Cytotoxic CD56pos NT Cells Determine Outcome of Acute HCV Infection. J. Virol 2007 Sep;81(17):9292- 

8. PMID 17553896 

Goulding C, O'Brien C, Egan H, Hegarty JE, McDonald G, O'Farrelly C, White B, Kelleher D, Norris S. 

The impact of inherited prothrombotic risk factors on individuals chronically infected with hepatitis C virus 

from a single source. J Viral Hepat. 2007 Apr;14(4):255-9. PMID 17381717 

Greethan D, Ellis CD, Mewar D, Fearon U, Ultaigh SN, Veale DJ, Guesdon F, Wilson AG Functional 

characterisation of NF-{kappa} B inhibitor-like protein 1 (NR{kappa}BIL1), a candidate susceptibility gene 

for rheumatoid arthritis. Hum Mol Genet. 2007 Dec 15;16(24):3027-36. PMID 17855452 

Higgs R, Lynn DJ, Cahalane S, Alana I, Hewage CM, James T, Lloyd AT, O’Farrelly C. Modification of 

chicken avian beta-defensin-8 at positively selected amino acid sites enhances specific antimicrobial activity. 

Immunogenetics 2007 59(7):573-80. PMID 17483936 


65



Kenna T, O'Brien M, Hogan AE, Exley MA, Porcelli SA, Hegarty JE, O'Farrelly C, Doherty DG. CD1 

expression and CD1-restricted T cell activity in normal and tumour-bearing human liver. 

Cancer Immunol Immunother. 2007 Apr;56(4):563-72 PMID 16924493 

Kirwan JR, Minnock P, Adebajo A, Bresnihan B, Choy E, de Wit M, Hazes M, Richards P, Saag K, 

Suarez-Almazor M, Wells G, Hewlett S. Patient perspective: fatigue as a recommended patient centered 

outcome measure in rheumatoid arthritis. J. Rheumatol 2007 May;34(5):1174-7 PMID 17477482 

Lau TY, O’Connor DP, Brennan DJ, Duffy MJ, Pennington SR, Gallagher WM. Breast cancer proteomics: 

clinical perspectives. Expert Opin Biol Ther. 2007 Feb;7(2):209-19 PMID 17250459 

Low M, Nicholls K, Tubridy N, Hand P, Velakoulis D, Kiera L, Mitchell P, Becker G. Neurology of Fabry 

disease. Intern Med J. 2007 Jul;37(7):436-47. PMID 17547722 

Lynch L, Eogan M, O’Herlihy C Golden-Mason L, O’Farrelly, C. Cells with haematopoietic stem cell 

phenotype in adult human endometrium: relevance to Infertility? Human Reproduction 2007 Arp; 

22(4):919-26 PMID 17208945 

Lynn DJ, Higgs R, Lloyd AT, O’Farrelly C, Herve-Grepinet V, Nys Y, Brinkman FS, Yu PL, Soulier A, Kaiser 

P, Zhang G, Lehrer RI. Avian beta-defensin nomenclature: a community proposed update. 

Immunol Lett 2007 110(1):86-9. PMID 17467809 

Marzo-Ortega H, McGonagle D, Rhodes LA, Tan AL, Conaghan PG, O’Connor P, Tanner SF, Fraser A, 

Veale D, Emery P. Effcacy of infliximab on MRI-determined bone oedema in psoriatic arthritis. 

Ann Rheum Dis. 2007 Jun;66(6):778-81. PMID 17185324. 

McCormack O, Chung WY, Fitzpatrick P, Cooke F, Flynn B, Harrison M, Fox E, Gallagher E, McGoldrick 

A, Dervan PA, McCann A, Kerin MJ. Progesterone receptor B (PRB) promoter hypermethylation in sporadic 

breast cancer Breast Cancer Res Treat. 2007 PMID 17896177 

McHugh JC, Bradley D, Hutchinson M, Brett F, Heffernan J, Howley R, Farrell M, Tubridy N. Variant 

Creutzfeldt-Jakob disease: first two indigenous cases in Republic of Ireland. Case report and perspective. 

Eur J Neurol. 2007 Apr;14(4):467-9. PMID 17389001 

McGowan PM, Ryan BM, Hill AD, McDermott E, O’Higgins N, Duffy MJ. ADAM-17 expression in breast 

cancer correlates with variables of tumour progression. 

Clin Cancer Res. 2007 Apr 15;13(8):2335-43 PMID 17438092 

McNicholas WT, Bonsignore MR, Sleep Apnoea as an independent risk factor for cardiovascular disease: 

current evidence, basic mechanisms and research priorities 

Eur Respir J 2007 Jan;29(1):156-78 PMID 17197482 

McNicholas WT Cardiovascular outcomes of CPAP therapy in obstructive sleep apnea syndrome 

Am J Physiol Regul Integ Comp Physiol 2007 Oct;293(4):R1666-70 PMID 17634199 


66



McSharry DG, McElwaine P, Segadal L, McNicholas WT All that wheezes is not asthma. 

Lancet 2007 Sep1;370(9589):800. PMID 17765530 

Meade KG, Gormley E, Doyle MB, Fitzsimons T, O’Farrelly C, Costello E, Keane J, Zhao Y, Machugh DE. 

Innate gene repression associated with Mycobacterium bovis infection in cattle: toward a gene signature of 

disease. BMC Genomics 2007 Oct 31;8(1):400 PMID 17974019 

Morrissey C, Brown M, O’Sullivan J. Weathered N, Watson RW, Tenniswood M Epigallocatechin-3-gallate 

and bicalutamide cause growth arrest and apoptosis in NRP-152 and NRP-154 prostate epithelial cells. 

Int J Urol 2007 Jun;14(6):545-51 PMID 17593102 

Mullan RH, Mathews C, Bresnihan B, FitzGerald O, King L, Poole AR, Fearon U, Veale DJ 

Early changes in serum type II collagen biomarkers predict radiographic progression at one year in 

inflammatory arthritis patients after biological therapy. 

Arthritis Rheum 2007 Sep;56(9):2919-28 PMID 17763421 

Murphy AM, Meade KG, Hayes PA, Park SD, Evans AC, Lonergan P, Machugh DE. Transmission ratio 

distortion at the growth hormone gene (GH1) in bovine preimplantation embryos: An in vitro culture-induced 

phenomenon? Mol Reprod Dev. 2007 Oct 18. PMID 17948248 

Nolan G, Doherty LS, McNicholas WT Auto-Adjusting Versus Fized Positive Pressure Therapy in Mild to 

Moderate Obstructive Sleep Apnoea Sleep 2007 Feb 1;30(2):189-94 PMID17326544 

O’Brien SL, Fagan A, Fox EJ, Milikan RC, Culhane AC, Brennan DJ, McCann AH, Hegarty S, Moyna S, 

Duffy MJ, Higgins DG, Jirstrom K, Landberg G, Gallagher WM CENP-F expression is associated with poor 

prognosis and chromosomal instability in patients with primary breast cancer. 

Int J Cancer 2007 Apr 1;120(7):1434-43 PMID 17205517 

O’Connor CM, Lowery MM, Doherty LS, McHugh M, O’Muircheartaigh C, Cullen J, Nolan P, McNicholas 

WT, O’Malley MJ. Improved surface EMG electrode for measuing genioglossus muscle activity. Respir 

Physiol Neurobiol 2007 Oct 15;159(1):55-67 PMID17707698 

O’Rourke K, Walsh C, Hutchinston M. Bayesian analysis. J Neurol 2007 Nov;254(11):1547-1554. 

Outcome of beta-interferon treatment in relapsing-remitting multiple sclerosis: a Bayesian analysis. 

J Neurol. 2007 Nov;254(11):1547-54. PMID 17694348 

Patterson AM, Cartwright A, David G, Fitzgerald O, Bresnihan B, Ashton BA, Middleton JF. Differential 

expression of syndecans and glypicans in chronically inflamed symovium. 

Ann Rheum Dis. 2007 Jul 13. PMID 17545191. 

Plunkett FJ, Franzese O, Finney HM, Fletcher JM, Belaramani LL, Salmon M, Dokal I, Webster D, Lawson 

AD, Akbar AN. The loss of telomerase activity in highly differentiated CD8+CD28-CD27- T cells is 

associated with decreased Akt (Ser473) phosphorylation. J Immunol. 2007 Jun 15;178(12):7710-9. PMID 

17548608 


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Quinn A, Doody C, O’Shea D. The effect of a physical activity education programme on physical activity, 

fitness, quality of life and attitudes to exercise in obese females. J. Sci Med Sport 2007 Sept 12 PMID 

17869182 

Ralph J A, Zocco D, Bresnihan B, FitzGerald O, McEvoy A N, Murphy E P. A role for Type 1· CRH 

receptors in mediating CRH-induced vascular changes in chronically inflamed tissue. 

Am J Pathol 2007 Mar;170(3):1121-33 PMID 17322394 

Roberts K. Costelloe, D. Hutchinson, M. Tubridy N. What difference does a neurologist make in a general 

hospital? Estimating the impact of neurology consultations on in-patient care. 

Ir J Med Sci. 2007 176(3):211-214; PMID 17593329 

Rooney T, Bresnihan B, Andersson U, Gogarty M, Kraan M, Schumacher HR, Ufgren AK, Veale DJ, 

Youssef PP, Tak PP. Microscopic measurement of inflammation in synovial tissue: inter-observer agreement 

for manual quantitative, semiquantitative and computerised digital image analysis. 

Ann Rheum Dis 2007 Dec;88(12):1656-60. PMID 17604286. 

Rudick RA, Miller D, Hass S, Hutchinson M, Calabresi PA, Confavreux C, Galetta SL, Giovannoni G, 

Havrdova E, Kappos L, Lublin FD, Miller, DH, O’Connor PW, Phillips JT, Polman CH, Radue E-W, Stuart 

WH, Wajgt, A, Weinstock-Guttman B, Wynn DR, Lynn F, Panzara M, for the AFFIRM and SENTINEL 

Investigators. Health-Related Quality of Life in Multiple Sclerosis: Effects of Natalizumab. 

Ann Neurol 2007;62 PMID 17696126 

Ryan S, McNicholas WT, Taylor CT A critical role for p38 map kinase in NF-kB signalling during intermittent 

hypoxia/reoxygenation Biochem Biophys Res Comm 2007 Feb 9 PMID 17316568 

Ryan S, Nolan GM, Hannigan E, Cunningham S, Taylor C, McNicholas WT Cardiovascular risk markers 

in obstructive sleep apnoea syndrome and correlation with obesity Thorax 2007 Jan 24 PMID 17251313 

Ryan S, Ward S, Heneghan C, McNicholas WT Predictors of decreased spontaneous baroreflex sensitivity 

in obstructive sleep apnea syndrome. Chest 2007 Apr;13(4):1100-7 PMID 17426215 

Slattery E, Theyventhiran R, Cullen G, Kennedy F, Ridge C, Nolan K, Kidney R, O’Donoghue DP, Mulcahy 

HE. Intravenous proton pump inhibitor use in hospital practice. 

Eur J Gastroenterol Hepatol 2007 Jun;19(6):461-4. PMID 17489055. 

Smith T P, Kavanagh L, Healy M L, McKenna T J. Technology Insight: measuring prolactin in clinical 

samples. Nature Clinical Practice: Endocrinology & Metabolism 2007 (3); 279-289 PMID 17315036 

Smith FM, Fox E, Gallagher WM, Stephens R, Gaffney E, Hollywood, D, Whitely G, Petricoin E, Liotta L, 

Kennedy MJ, Reynolds JV. Combination of SELDI-TOF and data mining provides early-stage response 

prediction for rectal tumours undergoing multimodal neoadjuvant therapy. 

Ann Surg 2007 Feb;245(2):259-66. PMID 17245180 

Spain L, Tubridy N, Kilpatrick TJ, Adams S, Holmes A. Illness perception and health-related quality of life 

in multiple sclerosis. Acta Neurol Scand 2007; 116 (5): 293-9. PMID 17850407 


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Tuthill A, Quinn A, McColgan D, McKenna M, O’Shea D, McKenna T.J. A prospective randomized 

controlled trial of lifestyle intervention on quality of life and cardiovascular risk score in patients with obesity 

and type 2 diabetes. Diabetes Obes Metab 2007 Nov; 9(6):917-9 PMID 17451423 

Walsh CA, Minnock P, Slattery C, Kennedy N, Pang F, Veale DJ, Bresnihan B, FitzGerald O. Quality of 

life and economic impact of switching from established infliximab therapy to adalimumab in patients with 

rheumatoid arthritis. Rheumatology (Oxford) 2007 Jul ;46(7):1148-52. PMID 17478471. 

Walsh R, Hutchinston M. Molding the sensory cortex: Spatial acuity improves after botulinum toxin 

treatment for cervical dystonia. Mov Disord. 2007 Dec 15;22(16):2443-6. PMID 17960812 

Walsh R, O’Dwyer JP, Sheikh IH, O’Riordan S, Lynch T, Hutchinson M. Sporadic adult onset dystonia: 

sensory abnormalities as an endophenotype in unaffected relatives. 

J Neurol Neurosurg Psychiatry 2007; 78:980-983. PMID 17702779 

Waterhouse DF, McLaughlin AM, Walsh DC, Sheehan F, O’Shea D. An examination of the relationship 

between normal range thyrotropin and cardiovascular risk parameters: a study in healthy women 

Thyroid 2007 Mar;17(3):243-8 PMID 17381358 

Zaman M, Leonard M, Ryan E, Nolan N, Hoti E, Maguire D, Mulcahy Hugh, Traynor O, Taylor C, Hegarty 

J, Geoghegan J, O'Farrelly C. “Lower expression of Nrf2 mRNA in older donor livers: a possible contributor 

to increased ischemia-reperfusion injury?” Transplantation 2007 Nov 27;84(10):1272-8. PMID 18049112 

Zhao Y, Terron-Kwaitkowski A, Liao H, Lee SP, Allen MH, Hull PR, Campbell LE, Trembath RC, Capon 

F, Griffiths CE, Burden D, McManus R, Hughes R, Kirby B, Rogers SF, Fitzgerald O, Kane D, Barker JN, 

Palmer CN, Irvine AD, McLean WH. Filaggrin null alleles are not associated with psoriasis. 

J. Invest Dermatol. 2007 Aug;127(8): 1878-82. PMID 17410197 

Chapters in Books 

1. U Fearon, DJ Veale. Angiogenesis in arthritis. Humana Press, London 2007. 

2. DJ Veale, U Fearon. Angiogenesis in Arthritis: Potential for therapeutic targeting. In: Baillieres 

Rheumatology, New Perspectives. Eds. Buckley C & Bresnihan B. 2007 

3. Philip de Chazal, Conor Heneghan, Chern-Pin Chua, Redmond Shouldice, Liam Doherty, Silke Ryan 

and Walter T. McNicholas. Home-based assessment of sleep apnoea using simultaneous 

electrocardiogram and oximetry signals. In: Progress in Sleep Apnea Research. Editor: 

Robert T. Ferber, Nova Science Publishers, Inc. 2007; 115-139. 


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Grants Active in 2007 

P.I. Name of Study Source of Fund Start Finish 

Grant Amount Date Date 

Prof. Walter McNicholas Cell and molecular mechanisms of cardiovascular HRB Project Grant €220,000 2005 2008 

disease in obstructive sleep apnoea. 

Prof. Walter McNicholas Non-invasive low cost measurements of sleep, 

(with Prof C. Heneghan UCD) sleep disruption and sleepiness. Enterprise Ireland €300,000 2005 2008 

Prof. Walter McNicholas Research in sleep apnoea AstraZeneca €75,000 2007 2009 

Prof. Joe Duffy Clinical evaluation of a breast cancer chip Randox Laboratories €35,000 2007 2007 

Prof. Joe Duffy Breast Cancer Metastasis: Biomarkers Health Research Board €1,063,000 2005 2010 

(with W. Gallagher, F. Martin and Functional Mediators Programme Grant 2005 

& P. Dervan) 

Prof Cliona O’Farrelly/ Identification of genes responsible for natural host Dept. Agriculture FIRM €935,039 2006 2009 

Dr. Kieran Meade resistance to Campylobacter colonisation tools to Grant 2006 

identify and breed genetically resistant chickens 

Prof. Cliona O'Farrelly/ Structural and functional identification of candidate Research Stimulus Fund €770,735 2006 2009 

Dr. Kieran Meade immune genes for resistance to mastitis and metritis 2006 Dept. Agriculture 

Prof. Cliona O’Farrelly Immune targeting strategies: improving the response HRB Translational Research €1,331,820 2007 2012 

rate to IFN-alpha/ribavirin therapy in chronic Award 

Hepatitis C Virus infection 

Prof. Cliona O’Farrelly Suppressor of Cytokine Signalling (SOCS) Protein HRB Project Grant 2007 €299,379 2007 2010 

Involvement in Chronic Hepatitis C Virus (HCV) 

Infection and Failure to Respond to Interferon 

Alpha Therapy. 

Prof. Cliona O’Farrelly Functional immunogenomics in the chicken: Dept. Agriculture FIRM €691,286 2004 2007 

relevance to campylobacter jejuni infection. Grant 2004 


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Prof. Cliona O’Farrelly SFI Research Frontiers Programme 2005 Role of CD1d isoforms and €229,766 2005 2008 

reactive cells in regulating 

immune responses to 

malignancy 

Prof. Cliona O’Farrelly/ HRB Research Project Grant – General 2005 Investigation of KIR genotype €234,473 2005 2008 

Dr. Clair Gardiner 

in the resolution of HCV 

infection 

Dr. Jacintha O’Sullivan Genomic instability and severe depression UCD Seed Funding €9,000 2006 2007 

Dr. Jacintha O’Sullivan Establishment of a colorectal ex vivo biopsy UCD Seed Funding €15,000 2006 2007 

culture model to examine responses to neo-adjuvant 

radiation therapy in advanced rectal cancers. 

Dr. Kieran Sheahan/ Molecular characterisation of familial colorectal HRB €174,400 2006 2009 

Dr. Dermot Leahy cancers 

G Dr. Edward Fox The frequency of random mutations and genomic NCI/HRB €88,000 2006 2008 

instability in colorectal cancer progression 

Centre for Colorectal Disease HRB Project Grant €165,000 2006 2009 

Dr. Jacintha O’Sullivan/ The role of genomic instability in promoting Health Research Board €185,000 2004 2007 

Prof. Diarmuid O’Donoghue/ colorectalcancer development in Ulcerative 

Dr. Kieran Sheahan Colitis patients 

Dr. Jacintha O’Sullivan The role of telomeres and telomerase in colorectal Cancer Research Ireland €145,000 2004 2007 

cancer growth, progression and metastasis. 

Dr. Garret Cullen Cigarette smoking and genomic instability: factors Altana – Newman Fellowship €80,000 2006 2008 

controlling disease progression and treatment 

sensitivity in inflammatory bowel disease patients. 

Dr. Joseph Marry The effect of genomic instability on monoclonal Merck – Newman Fellowship €138,000 2006 2008 

antibody therapy response in colorectal ex vivo 

explants. 


71





Dr. Jacintha O’Sullivan & Frequency of random mutations and genomic HRB NCI Cancer €110,000 2007 2009 

Prof. L. Loeb (Seattle) instability events during colorectal Prevention Grant 

Post Doctoral Fellow cancer progression. 

Edward Fox 

Prof. D. O’Donoghue, Independent validation of a prognostic gene Almac Diagnostics €177,000 2006 2008 

Dr. Jacintha O’Sullivan, signature for Stage II colorectal cancer 

Prof Johnston & Prof. Harkin 

Dr. U. Fearon/ A-SAA regulates cytoskeletal rearrangement and HRB Project Grant 2005 €140,000 2005 2008 

Prof. D. Veale/ 

cell matrix interactions to promote cell migration 

Prof B. Bresnihan and cartilage invasion in inflammatory arthritis. 

Prof. D. Veale/Dr. P. Cahill/ The role of angiopoietins in driving angiogenesis Health Research Board €160,000 2004 2007 

Dr. U. Fearon 

in inflammation 

Prof. D. Veale/Dr. U. Fearon/ Hypoxia and altered mitochondrial bioenergetics HRB Translational €1,500,000 2006 2011 

Dr. J. O’Sullivan/ Dr. C. Taylor results in cellular transcriptional and metabolic Programme Award 

profiles to drive angiogenesis and the 

inflammatory response 

Dr. U. Fearon/Prof. D. Veale The mechanistic role of cytokines in regulating SFI €162,000 2004 2007 

angiogenesis and cartilage metabolism 

Prof. O. FitzGerald Differential expression of VEGF and PIGF and VEGF HRB Project Grant €165,000 2004 2007 

receptors in inflammatory arthritis 

Prof. D. Veale/ Biomarkers and Novel cytokines Wyeth €350,000 2006 2007 

Prof. O. FitzGerald/ 

Dr. U. Fearon/ 

Prof. B. Bresnihan 

Prof. D. Veale/Dr. U. Fearon Studies of novel cytokines using synovial/cartilage GSK €750,000 2006 2008 

explant cultures 

Prof. D. Veale/Dr. U. Fearon Proof of Concept Studies GSK €680,000 2006 2008 


72





Prof. B. Bresnihan/ Curing Autoimmune Disease – translational approach EU 6th Framework €800,000 2006 2011 

Prof. D. Veale 

Prof. O FitzGerald 

Prof. D. Veale Novel therapeutic antibody study Cambridge Antibody €100,000 2006 2007 

Technology 

Prof. D. Veale (co-applicant) Biopharmaceutical/Pharmaceutical PRTLI Cycle 4 €4,600,000 2007 2012 

Science Programme 

Prof. D. Veale A Cellmax Artificial Capillary System and UCD Research Support €35,000 2007 2007 

Flexercell Strain Unit 

Schemes 

Dr. U Fearon Hypoxia Chambers and Luminometer HRB Equipment Grant €75,000 2007 2007 

Dr. U. Fearon In vivo Hypoxic probes and monitor UCD Seed Funding €20,000 2007 2007 

Prof. O. FitzGerald Effcacy of switching anti-TNF therapies in patients Abbott €64,000 2007 2007 

with rheumatoid arthritis. 

Prof. O. FitzGerald Differential Protein expression in psoriatic arthritis Abbott €100,000 2007 2007 

synovial tissue following anti-TNF therapy 

Prof. O. FitzGerald Development of Inflammatory Arthritis database Abbott €240,000 2007 2007 

Dr. Donal O’Shea/ Clinical Research Training Fellowship Health Research Board €192,000 2005 2007 

Prof. Cliona O’Farrelly/ 

Dr. Tom Cawood 

Dr. Donal O’Shea Adipocyte size and type 2 diabetes; a study of Diabetes Federation of Ireland €180,000 2006 2009 

patients undergoing bariatric surgery. 

& Medical Research Charities 


73

74 

Quality

St. Michael’s Hospital 

Radiology 

Pharmacy 

I.C.T. 

Laboratory 

Library 

Human Resources 

Nursing 

75




I am pleased to report on the on-going developments in St. Michael’s Hospital during 2007. As part of the 

St. Vincent’s Healthcare Group the policy of developing and integrating services continued. The Health 

Service Executive continued to rollout its Transformation Programme in respect of service delivery. 

As in previous years, St. Michael’s Hospital prepared and submitted a Service Plan in conjunction with St. 

Vincent’s University Hospital to the Health Service Executive. The Service Plan detailed the Hospital’s 

projected expenditure, activity and Capital Funding requirements for 2007. The Service Plan and activity in 

the Hospital formed the basis for discussion at the Monthly Monitoring Performance Meetings held with the 

Health Service Executive. 

While the Budget position was difficult, the Hospital did maintain expenditure within allocation and is carrying 

forward a small deficit in respect of previous years. 

In 2007 the Hospital was allocated Capital Funding in respect of Phase II of Fire Safety Works and the 

upgrade of the water mains system. The upgrade of the water mains system was completed in September 

2007 and the Fire Safety Works will be completed in February 2008. Upgrading of the Hospital’s 

infrastructure, following the Hygiene Audit continued throughout the year. 

Following the Decontamination Audit it was agreed that the Hospital Theatres, Day Ward and TSSD Unit 

needed to be re-located. An application was submitted to the HSE for Capital Funding. The Hospital 

received sanction to proceed with the project. The tender process has commenced and is proceeding in 

conjunction with the Planning Unit of the HSE. 

Radiology 

In 2007 the RIS/PACS System, which links St. Vincent’s University Hospital and St. Michael’s Hospital 

radiology systems went live. Clinicians can view images from either Hospital as soon as the examination is 

completed. Another advantage for Clinicians is the ability to view C.T. and M.R.I. examinations performed in 

St. Vincent’s University Hospital. 

Rosaleen Walshe retired from the position of Radiography Services Manager in April and has been 

succeeded by Patricia Radebe who is warmly welcomed. Mary Hughes retired as Senior Radiographer and 

Gibson Gundidza is the new Senior Radiographer in charge of the DXA Service. We also welcomed 

Thushara Alias and Timea Zandoky to the Radiology Department. 

Pharmacy 

The Pharmacy department has continued to update its guidelines and processes aiming to provide a more 

efficient medication delivery service and prescription review service. The aim is to deliver medication in a 

timely way for patients and improve medication safety. 


76

A new drug kardex was designed, piloted and reviewed and will be introduced across the Hospital shortly. 

New guidelines on insulin storage and labelling were introduced, to improve safety and stability of insulin. 

The new medication policy is near completion. Pharmacy staff have had input into a wide array of new 

hospital policies/ guidelines with medication issues. 

Future plans include medication audits (e.g. another antibiotic audit) and further development of the 

temperature monitoring system. 

I.C.T. 

2007 was a busy year for the ICT Department in St Michael’s Hospital. The largest technological 

development undertaken in the hospital was the roll out of the Radiology Picture Archiving System commonly 

known as RIS/PACs. This system is a major departure from traditional radiology systems and has already 

proven to be of immense benefit to both patients and clinicians. Another major development in 2007 was 

the implementation of Healthlink online in St Michaels Hospital. 

Other projects included the rollout of a digital CCTV security system, the development of the hospital website 

and the rollout of the latest software for managing large groups of Windows-based computer systems. 

The year also saw the continuous improvement and consolidation of ICT in the hospital. This included 

updating the network infrastructure, updating servers and desktops, implementing improvements on ICT 

security and maintaining high-speed links to St Vincent’s University Hospital. These ongoing activities 

improve critical ICT services, which support the day-to-day activities of the Hospital. 

During the year the department bid a temporary farewell to David Hogan, who is currently on sabbatical for 

a year. In turn we were very happy to welcome John Ginanne to the team. 

Laboratory 

This was another busy year in the Pathology department. There were a total of 152,661 samples received 

in the laboratory over the year consisting of 1,305,815 individual tests. 

There were two retirements during the year. Betty White retired from the Clerical staff and Finan Hayes 

retired after 26 years service to the Hospital. Staff resignations during the year included Dr Mary Crowe, 


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Sarah Jane Slattery and Basker Sathiyanthan. We wish them all the best in their new careers. 

We welcomed Lindsay Jones and Maria Kane to Microbiology, Dr Lilian Rajan as locum Consultant 

Microbiologist and Sinead Impey to our Clerical staff. Congratulations to Geraldine Lunney who was 

appointed as our Quality Coordinator during the year. 

15 staff attended 25 training courses during the year. In addition Catherine Fitzpatrick trained as a manual 

handling facilitator. Nicola Flaherty successfully completed her traineeship and obtained full Academy 

membership. Orla Donaghue commenced a Masters programme and Sinead Impey commenced the Medical 

Records course in D.I.T. Catherine Doherty and Michael Carey completed their second year on the Skillvec 

program. 

A number of internal and external Audits were carried out in the department during the year. The external 

Audits included the H.S.A., The Hygiene Audit and the Dangerous Goods Advisor. Internal audits included 

an audit of equipment folders, horizontal audits of individual tests, armband audits and a complete audit of 

transfusion of a unit of blood. Every quarter a review of the incident book was presented at the Quality 

Meetings and Safety Meetings. 

Look-up facilities were rolled out throughout the hospital in January so that all Wards and Clinics can now 

view their pathology results electronically. The Healthlink software interface was purchased during the year. 

This enables the electronic downloading of results to GP practice management systems. 

Validation of the special software for the Warfarin dose monitoring was completed and the new system for 

running the warfarin clinic commenced. The system is similar to the one used in St. Vincent’s University 

Hospital. An average of 94 patients were dose-monitored at the clinic each week. This clinic has doubled in 

size in the last two years and is now at its maximum capacity. 

The Blood Transfusion department is preparing for the full implementation of the E.U. Directive on Blood, 

which comes into force in November 08. The first annual report from this department on behalf of the 

Hospital was submitted in January to the IMB. During the year the Blood Transfusion Department introduced 

a system for transferring units of blood to St. Vincent’s University Hospital, which are short dated and have 

not been transfused prior to expiry. The Strategic Planning group met to discuss how best the Blood 

Transfusion department in St. Michael’s Hospital could meet the ISO15189 standards, which is the 

requirement of the EU Directive. It was decided that because of the small volume of work and the lack of 

space in the department, the best option was to transfer the serology testing to St. Vincent’s University 

Hospital. A working group was set up to implement this. A Blood Transfusion Area Network group was set 

up during the year to include St. Vincent’s University Hospital, St. Michaels Hospital, Holles St Hospital and 

St. Columcilles Hospital for the implementation and auditing of the transfusion services. A Network Quality 

Officer was also appointed to work between the networked hospitals. 

Library 

In July 2007 the joint catalogue of St. Vincent’s Healthcare Group went live on-line. St. Michael’s Hospital 

library continues to provide a loan service, study space, Internet access, printing and copying facilities to all 

staff and students on placement in the hospital. The Librarian is involved in the Accreditation project, the 

Hospital Newsletter and orientation for new staff and students. 


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2007 was a difficult year for HR. As a Hospital we continued to experience increased demand for services 

while we still tried to operate within our tight employment ceiling. We also had the Nursing ‘campaign of 

action’, followed by a ‘recruitment pause’ imposed on us in September, combined with continuous and 

increased information demands from various sources for more reports and more information. All these 

factors contributed to a very difficult balancing act for the HR Dept given our limited resources and this 

challenged us throughout 2007. Thankfully we continued to experience a low turnover rate among our staff 

and low absenteeism, which mitigated the effects of the ‘recruitment pause’. 

In October the first SVHG Annual Service Awards were held in the ERC at St. Vincent’s University Hospital 

and 40 staff from St. Michael’s Hospital received an award for 20 years service. 

The HR Forum meetings with Department Heads and Line Managers continued to be popular and were well 

attended. These regular meetings take place throughout the year, are hosted by the HR Department and 

help managers to exchange information and to share experience in dealing with staff issues and to learn 

about and discuss best HR practice and HR developments within our Group. 

Our investment in Training and Development focused on extending Team Based Performance Management 

in line with national policy and in supporting Continuous Professional Development and training in People 

Management Skills. Over 250 staff participated in over 700 training and development days. 

We continued to monitor HR activity across a range of indicators. We also continued to collaborate with our 

HR colleagues at SVPH and SVUH on policy and practice development and in harmonising existing HR 

policies and practice. 

Some of our longer serving staff retired in 2007, including Rosaleen Walsh (Radiography Services Manager), 

Finian Hayes (Senior Medical Scientist), Betty White (Medical Laboratory Office) and Pat McNally (Nursing 

Manager). The Catering Department will miss Josephine Murphy and Hilda Denny who also retired, as did 

Ruth Matheson, our night-telephonist/receptionist and Angela O’Callaghan (Phlebotomy). To each and every 

one of them we say thank you for your service and dedication to St. Michael’s Hospital and to our patients 

and we wish you all a long, happy and healthy retirement. 


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Nursing 

The Nursing Staff at St Michael’s Hospital continue in their endeavours to give holistic care to the patient 

population from Dun Laoghaire, the surrounding areas and the many visitors that have crossed the threshold 

over the past year. 

Staff said a sad and fond farewell to Ms. Robyn Henderson who resigned following leave of absence. She is 

missed for her vibrant buzz but will remain an encouraging support. Pat McNally CNM 2, retired after 27 

years at the hospital as manager and person responsible for the establishment of the Diabetes Unit, which 

she has left in the capable hands of Ber Lynch CNM 2. 

There were many new Nursing initiatives during the year, including: 

Diabetes: 

Insulin Pump Therapy introduced, insulin treatment correction sliding scale cards, 

carbohydrate counting / insulin treatment sheets for the ward patients and the 

unit continues to work with a multidisciplinary team. 

Respiratory: The introduction and development of the Omalizumab/Xolair clinic and the research on the 

outcomes for these Xolair patients and the oxygen assessment clinic. There is a research / project planning 

for End of Life study for Lung Fibrosis and preparation for the development of Non Invasive Ventilation Study 

Day to start February 2008. 

Cancer Care / Urology: Male Urethral Catheterisation for nurses wishing to include male catheterisation in 

their scope of practice and facilitating the education of Public Health Nurses in the changing of Supra-pubic 

catheters in the community. 

Cardiac Rehabilitation: A conference was held for all past patients in the local Royal Marine Hotel at the end 

of 2007. Invited speakers from group such as Active Retirement contributed to the success of the day. Due 

to the overwhelming positive feedback, it was decided that this would be an annual event. 

Palliative Care: Funded by the National Council, a Palliative Care Facilitator for a period of one year has 

proved invaluable. Jeanette Barber not only educates but also takes an active part in Palliative Care. 

A Palliative Care folder was introduced in Clinical Areas which includes information and references on the 

various aspects of palliative care and relevant policies where updated including “Care of the Deceased” and 

information packs for relatives. 


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Infection Control: 2007 was a very busy year for the infection control team with the HIQA Hygiene Services 

Quality Review and the changes in National Hygiene Standards. Patient information leaflets and a comment 

section on hygiene were introduced into the patient satisfaction survey. 

The Nursing Staff in St. Michael’s Hospital continue to be advocates for our patients and strive to deliver 

efficient, effective and focused care. 

To conclude, I would like to thank Mrs. Ann Riordan, Chairperson of the Fund Raising Committee and all her 

team, for their dedicated work in organising functions and raising funds on behalf of St. Michael’s Hospital. 

Sadly, in 2007, the committee decided to disband. I would like to thank all members of the Fund Raising 

Committee and volunteers who participated on the Fund Raising Committee over the years. 

I thank the Religious Sisters’ Of Charity and the Board of Directors’ for their commitment to developing St. 

Michael’s Hospital. 

I acknowledge and thank the members of the Executive Council, The Medical Forum and members of the 

various other committees within St. Michael’s Hospital, for all their assistance and support during 2007. 

I would also like to thank the Group Chief Executive Officer and the HSE for their support during the year. 

Finally, I would like to thank St. Michael’s Hospital staff for their contribution in caring for our patients and 

their families. Their dedication and the professionalism shown in their work is acknowledged and highly 

appreciated. 


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Organisation Structure 


82

84 

Compassion


Consultant’s Forum 

Nursing Division 

Allied Health Division 

Support Services Division 

Human Resources Division 

Corporate Services Division 

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Overview 

St. Vincent’s Private Hospital increased it’s surplus from €2.6m in 2006 to €3.3m in 2007. Total income of 

€63.7m was 1% ahead of target for the year. The hospital continued to expand its day care activity which 

contributed to the overall financial outcome. I would like to thank our Heads of Departments, consultants and 

staff who contributed to the various improvements made during the year, which are outlined in this report. 

Agreements were successfully concluded with VHI, Quinn-Healthcare, Vivas and other medical insurers for 

2007. Negotiations took place with the Health Services Executive in relation to the provision of radiotherapy 

treatment for public patients. 

The hospital currently has 164 in-patient beds, 36 day care spaces (including day care 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 satisfaction with the 

hospital’s services remains high as evidenced by the results of the Patient Satisfaction Survey (Overall 

satisfaction rating of 98.8% for In-Patient and 99% for Day Care Services as outlined in the Corporate 

Services Report). Management continued to implement the strategic action plan, which contains a number 

of quality improvement initiatives. I would like to thank Professor Diarmuid O’Donoghue and the members of 

the Consultants Forum for their support in relation to a wide range of issues during the year 

Patient Activity 

In-Patient admissions for 2007 amounted to 9,517 an increase of 5.4% over 2006. However due to changes 

in clinical practice the average length of stay reduced from 5.32 to 4.88 days which is reflected in in-patient 

occupancy of 82.06%. Day cases were 13% up on 2006 as was day care oncology (6.2%). Radiotherapy 

activity is 1.3% higher than activity in 2006 and pathology tests are up 5.8% overall. A summary of the 

Patient Activity for the year is contained in the Report. 

General Improvements 

A number of infrastructural improvements were made in 2007 as follows: 

• Upgrading of Air Conditioning System in Radiotherapy and Day Care Oncology 

• New Air Conditional Unit in MRI Unit 

• New Sterilisers were installed in Hawthorn and Rowan Wards 

• A second Pulmonary Function Lab was established to meet growing demand. 

• Replacement of Endoscopy Sterilising Equipment 

• The Catering Department received their certificate for ISO 22000 (Food Safety Management System) 

in October. 


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A more detailed list of improvements is set out in the reports from the Divisional Managers. 

Management Team 

The Management Team continued to meet on a weekly basis throughout the year to review and monitor 

progress in relation to the budget and service plan. The Management Team also participated on the Best 

Practice Group, which is responsible for quality and risk management at the hospital. 

Regular meetings were held with the Heads of Departments and staff during the year. At these meetings the 

Management Team provided updates on the hospital’s clinical and financial performance and on relevant 

internal and external factors affecting the hospital. 

The Management Team also provides 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. 

New Private Hospital 

Work is progressing with the Design Team in relation to the design, construction and commissioning of the 

new 260 bed private hospital on the St. Anthony’s Site. Full Planning Permission was granted by An Bord 

Pleanala in 2007 and during the last quarter of 2007 those services which were based in St. Anthony’s were 

decanted to the main St. Vincent’s University Hospital site. Senior management participated on the user 

groups with the Design Team to finalise the detailed design aspects of the hospital. The Design Team 

comprises of Scott Tallon and Walker, Architects, Bruce Shaw, Quantity Surveyors, Buro Happold, Mechanical 

and Electrical Engineers and ARUP, Structural Engineers. Following a tender John Paul Construction was 

selected as the Main Contractor for the project. 

Michael Redmond 

Chief Executive 


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Consultant’s Forum 

The Consultants Forum met on a monthly basis throughout the year with hospital management. The Forum 

includes representation from Medicine (3), Surgery (3), Anaesthetics (1), Diagnostic Imaging (1), Pathology 

and Board nominations (3). Thanks are due to all of the consultants who participated on the Forum during 

the year and to Mr. Donal Maguire who resigned from the Forum in 2007. Among the issues considered by 

the Forum were the following: 

• Claims processing working group • Development of a New Private Hospital 

• Expansion of Radiotherapy Services • Development of New Consulting Rooms 

• Admitting Privileges • Radiology Reporting 

• Review of Hospital Activity Levels • Development of PACS 

• Report on Week End Pharmacy Services • Launch of Summer Bed Initiative 

• Theatre Survey undertaken • Revised Patient Consent Guidelines introduced 

• Guidelines re Peri-operative • Patient Medical Record 

use of Oral Medications 

• NTPF • Out of Hours Pathology Tests 

• Needle Stick Injury Policy 

Professor D. O’Donoghue, Dr. P. Quigley and Mr. D. Quinlan represent the Forum on the Executive Committee 

and Professor W. McNicholas and Mr. E. McDermott represent the Forum on the Best Practice Group. 

Thanks are also due to Ms. Yvonne Farnan who continues to provide secretarial support to the Forum. 

Professor Diarmuid O’Donoghue 

Chairman, Consultants Forum 


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Overview 

The Annual Review of Nursing Division encompasses the contributions of staff in all of the following areas: 

• Patient Care areas (8) • Operating Theatres 

• Day Care including Day Care Oncology • Endoscopy 

• Day Surgery • Urodynamics 

• Pastoral Care/Chaplaincy • Portering Service 

• Admissions • Nursing Education 

• Clinical Nurse Specialists 

Thanks to a high level of commitment and dedication of staff every effort was expended to continue providing 

quality patient care while facing the many challenges with vigour and enthusiasm. The New Hospital 

Development provided opportunities to review long term strategies while remaining true to our traditional 

values, knowing and believing that we must uphold these values in our new hospital. 

Activity levels in all patient care areas showed a steady increase in 2007 with a shift from inpatient to day 

case management occurring in certain specialties. Much effort was spent in Day Care Oncology to allow for 

increased patient throughput with a resulting decrease in waiting time from referral to first treatment. The 

Cardiac Step Down Unit on Redwood Ward proved a successful development with evidence of continuous 

efficient bed utilization. 

The nurses ‘work to rule’ in April provided a challenge to senior management and nurses in SVPH in terms 

of ensuring the safe provision of patient care, management of staff relations and the threat of revenue loss. 

Fortunately the organizational culture facilitated a smooth navigation throughout the course of the industrial 

dispute. 

We welcomed twelve new graduate nurses in July whose orientation to SVPH was facilitated by a 

comprehensive programme developed by Ms. Rita Leamy (Clinical Nurse Facilitator). Many of these graduate 

nurses were students of St. Michael’s Hospital. 


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Una Nicholson (Clinical Nurse Specialist – Infection Control) provided guidance on infection control issues 

and facilitated a Hygiene Audit, which took place in November. The audit tool was similar to that used by 

H.I.Q.A. for public service facilities. A multi disciplinary group with senior management membership has been 

formed to systematically carry out all report recommendations. 

Staff 

Much energy was expended on recruitment during the year. We were able to replace nurses resigning as 

well as fill some deficits. 

Staff Recruited: 

Staff Nurses 33 

Care Assistants 5 

TSSD Technicians 3 

Clinical Nurse Managers II 3 

Clinical Nurse Manager I 1 

Clinical Nurse Specialists 2 

Phlebotomist 1 

Porters 6 

Resignations 

In 2007 we said goodbye to a number of staff members 

Staff Nurses 23 

Porters 3 

Care Assistants 2 

Theatre Attendants 1 

TSSD Technicians 2 

Service Developments/Activities 

Committee Activities: 

The Mission Committee comprises of representatives of all divisions. Chaired by Ms. Orla Fitzgibbon 

(Assistant Director of Nursing) the Committee met monthly and engaged in many activities designed to 

incorporate the mission, philosophy and values of the Religious Sisters of Charity into our work practice. Fund 

raising events took place including: staff barbeque in July; quiz night in October and a very successful staff 

children’s party was held in December. 

The Staff Development Committee met throughout the year and developed a professional education and 

development programme consisting of a hospital based in- service education programme. Mr.Nelson Lebogo 


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was appointed Nurse Education officer in September and immediately carried out a skills and education 

needs analysis to predict any current staff training requirements as well as that needed for the new hospital 

development. 

Courses Undertaken in 2007 

• MSc in Nursing x 7 • MSc in Pain Management x 1 

• Maters in Clinical Practice x 1 • Graduate Diploma in Nursing Studies – Breast 

• MSc in Nursing Education x 2 Care x 1 

• Diploma in Management Studies x 1 • MSc in Healthcare Management x 1 

• Diploma in First Line Management x 2 • BSc in Information Technology x 1 

Staff members from Nursing Division participated in SVPH Committees including Health and Safety, 

Nursing/ Pharmacy /Finance, Bed Management, Best Practice, etc. 

Staff members from Nursing Division also participated in SVHG Committees including Clinical Audit 

Committee, Group Nutrition Committee, Drugs and Therapeutics Committee and Group Infection Control 

Committee. 

Outstanding/Significant Achievements 

In October ten of our Health Care Assistants graduated having successfully completed the FETAC Level 5 

Health Care Support course under the auspices of Dun Laoghaire College of Further Education. Justyna 

Pizytulska received the ‘Student of the Year’ accolade. 

Future Plans 

H.A.N.U. 

A quality improvement initiative was commenced on Hawthorn Ward with plans for the opening of the 

H.A.N.U. (Hawthorn Acute Nursing Unit) in early 2008. Refurbishment commenced in December of a fourbedded 

bay to allow for the cohorting of patients post major abdominal surgeries following return to SVPH 

from ITU and HDU. A nurse education programme was developed in collaboration with the Outreach 

Programme co-ordinator Denis Wedgwood. 

Multi disciplinary meetings took place clarifying roles and responsibilities. A trigger alert system together with 

a decision tree algorithm was developed to allow for appropriate and timely interventions to prevent patients 

returning to ITU with complications. 


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Introduction 

The Allied Health Division incorporates Administration, Cardiology, Dietetics, Diagnostic Imaging (Radiology), 

Medical Physics, Pharmacy, Physiotherapy, Radiotherapy, Respiratory, and Social Work. 

Departments provide clinical and/or non-clinical support services to in-patient wards and offer a range of 

outpatient services. 

The overall objective of the Division is to provide and develop services to meet the needs of patients and 

their relatives. 

The following contains a general overview of key issues, service enhancements and events that took place 

in 2007. 

2007 – An Overview 

Staff throughout the Division are to be thanked for their hard work, flexible attitude and overall commitment 

to meeting an increasing number and range of patient needs. This has been particularly challenging in some 

areas where there have been limitations in staff numbers and treatment facilities. 

A difficult time was also felt in September, with the loss of our colleague and Senior Pharmacist, Mary Cogan. 

Her contribution to services during her years at St. Vincent’s was significant and she is dearly missed. 

General 

The year presented various challenges and opportunities throughout the Division. An overview of key issues 

that affected Allied Health services are detailed below. 

Staff in all departments (with the exception of Radiotherapy) participated in User Groups with architects to 

work on the design of departments in the New Hospital. The project offers numerous opportunities and 

challenges for the development of services in the purpose built facility. 

Work continued with Accreditation as staff from across the Division joined with colleagues from St. Vincent’s 

University Hospital and St. Michael’s Hospital in the various care teams. 

Heads of Department from Allied Health and Support Services took part in Management Development 

training. Feedback on the course run by an external company was excellent and all departments gained from 

covering a range of subjects from goal setting to running effective meetings. 

In an effort to improve documentation for training, individual training cards were introduced for all staff in the 

Division. These allow staff to keep track of all training they have attended, including mandatory training such 

as manual handling and fire safety. 

CT activity increased by over 10%. A key factor in this rapid expansion in activity was as a result of a VHI 

agreement to reimburse oncology patients who require CT scans as part of a review of their condition. 


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National issues raised in relation to mammography led to a dramatic increase in demand for services towards 

the end of the year. Demand for ultrasound also rose with the ongoing development of the Triple Assessment 

Clinic (TAC) and symptomatic breast services. 

Chemotherapy activity rose by a further 18% in 2007 demonstrating an ongoing growth in demand for 

oncology services. This places particular pressures on staffing levels and the physical infrastructure/facilities. 

Service Enhancements 

In addition to the above, a number of service developments were delivered for the benefit of patients: 

• VHI agreed to direct payment for Echo tests, significantly reducing the financial burden on patients 

requiring this service. 

• MDA, night sedation and pre-medication stock management systems on the wards were changed, 

improving access without compromising security. 

• An improved satellite pharmacy was introduced on Redwood ward, comprising a drugs cupboard and 

fridge. Out-of-hours back up via an agreement with a local pharmacy was also put in place. 

• A laser machine was acquired in physiotherapy for the faster resolution of inflammatory response and 

reduction of pain. 

• Upgrade of CT Scanner (to 16 slice), which improves the standard of imaging in Radiotherapy and 

also provides a back-up facility for Diagnostic Imaging. 

• Revised Consent form introduced for Radiotherapy patient. 

• Further development work carried out on a new Radiation treatment – IMRT. 

• Successful negotiations with HSE for treatment of public patients requiring Radiotherapy treatment 

(first patients to be treated in Quarter 1, 2008). 

• Additional Social Work resources made permanent. 

• Development of a Patient Information Pack. 

• A second Pulmonary Function Lab was opened almost doubling capacity. 

• A new full-time Dietician Manager was appointed. 


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• In conjunction with Nursing, TPN guidelines were developed and several ward based training 

sessions carried out. 

• Introduction of Admission Medication Record – used to more accurately record patient medication. 

Summary Training/Education & Conference Attendances 

Education and training is key to the retention and development of staff. Some of the courses/events 

undertaken in Allied Health over the 12 months include: 

General – Induction, Manual Handling, Fire Safety and Fire Evacuations, CPR, Clinical Audit, European 

Safety Week, Management Development, Waste Management. 

Diagnostic Imaging – Certificate courses in Intravenous Administration, postgraduate certificate in 

Computed Tomography, ESGAR meeting in Lisbon, Cardiac MRI course, Annual Mater International Breast 

Imaging. 

Medical Physics – Irish Radiotherapy Physics Conference, Royal Marsden Radiotherapy training course, 

Varian Brachytherapy systems and advances in Treatment Planning Systems and Algoritms. One member of 

the department was invited to present at the European Elekta users Group. 

Physiotherapy – Breast research, Shoulder assessment and management, lymphodema, arterial blood 

gases, Acapella demonstration, Tracheostomy study day. 

Cardiology and Respiratory – junior staff completing compulsory Physiology Degree. 

Respiratory – Irish Sleep Society Conference. 

Pharmacy – Computer skills, clinical skills (HPAI), chemical risk assessment training. 

Dietetics – BAPEN conference, Diabetes Study Day, Annual Clinical Nutritions Seminar, Nutrition and Peak 

Performance Conference, Nephrotic Syndrome and Renal Stones. 

Radiotherapy – Postgraduate Diploma in Radiotherapy (Sheffield), Diploma in Management, CT anatomy 

course, Iview interpretation and matching. 

The above represents an overview of activities across Allied Health Departments during 2007. Further 

information is available within individual departmental action plans. 


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The Support Services Division incorporates Reception, Security, Hygiene Services, Household Services, 

Maintenance, Projects, Patient and Staff Catering. 

Reception 

Margaret English and a staff of nine provide reception and front of house services throughout the hospital. 

As reception is the first point of call for both patients and visitors the primary function is to promote a friendly 

and efficient environment. 

Some of the service improvements during the year were: 

A new shift is now in place on Saturdays to facilitate the checking in of day care patients. 

Security improvements included a new procedure for the registration of visitors and contractors and also our 

nightly surveillance and lock up procedures were updated. 

A system is now in place at reception for the dissemination of pathology reports. This system is working well 

since March of last year. 

In August a new system for contacting the cardiac team was put in place. There is also a tested contingency 

link with the switchboard team in St. Vincent’s University Hospital. 

A welcome is also extended to the new members of the team Andrew Reilly, Maureen Finnigan and Liz 

Murphy. 

Household Services 

Yvonne Gleeson, Household Services Officers has a team of 5 who provide a six-day service. The team 

provides support in relation to hygiene, laundry, and hotel services throughout the hospital. 

Some of the Improvements during the year were: 


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Laundry Service 

As part of improving the hygiene services throughout the Hospital there are now smaller trolleys in use to 

deliver linen to and from the ward areas. The linen contractor now washes the new trolleys each day. 

Household service staff in conjunction with infection control visited the linen company and reviewed the 

procedures in place. The linen delivery time has also been changed to 7.30am to facilitate congestion in the 

back yard delivery area. New scrub suits were rolled out to the required clinical areas in June. 

Recycling 

The household team also did some very good work in supplying recycling bins to 87 areas throughout the 

Hospital. There have been huge improvements in the level of recycling taking place. 

Cleaning and Hygiene 

A revised cleaning specification was issued in July. Additional hours were allocated to daycare and patient 

floors. 

A representative from BSAP Ltd carried out two audits during the year. The audits were in March and 

November and covered areas listed in the national hygiene services assessment scheme. Action plans were 

compiled to meet standards. 

The team continues to work closely with general refurbishment and facility enhancement projects that are 

carried out. 

Maintenance Department 

There are a total of 87 external contractors who service and maintain equipment on a regular basis. There 

are two on site personnel who work over six days. Non-routine work and projects are organised separately 

by using reputable outside firms who continue to complete the majority of our project work. Approximately 

2,684 requisition dockets were completed in 2007. In keeping with Health and Safety Regulations an 

External Contractors Form is completed by all contractors and kept in the relevant project files. 

Projects 

External contractors carried out a total of 17 projects. All projects are monitored through our maintenance 

administration office. 

Some of the projects completed last year include: 

• A new Dishwashing System was put in place in the tray room. 

• Air Conditioning Units installed in Admissions. 

• Newbridge Engineering installed a ladder to the lift motor room. 

• Gents changing room enhancement. 


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• Maple Unit room 136 refurbishment to PFT Lab. 

• Hawthorn Ward new sluice Sterilizer. 

• Rowan Ward new sluice Sterilizer. 

• External storage area in place for finance documentation. 

• CT upgrade in Radiotherapy. 

• Air Conditioning Units installed in Day Oncology. 

• Car park exit and entrance barriers replaced. 

• Refurbishment of Chaplains office, Pastoral care office. 

• New storage area put in place for BOC oxygen supply. 

• Air conditioning units installed in Radiotherapy. 

• In the MRI room new Air Conditioning Units were installed. 

• St Joseph’s Air Conditioning Units installed. 

• 4th Floor Air Conditioning Units installed in bedrooms and treatment rooms. 

• Extensive work was carried out in the coffee shop in January. The sandwich bar was relocated 

to enhance customer flow. 

• William Farrell & Co carried out exploratory work on the electrical board in the kitchen in July. 

Fire Prevention 

Apex Fire have completed the following upgrade works: 

The Fire alarm sound was checked to comply with the 65 decibels regulation. 

The Fire Register & Fire Service folders were reviewed and have been updated. 

Michael Slattery Associates Fire Advisor, Brendan Kavanagh assisted the Hospital in carrying out 4 

Fire Evacuations in patient areas, Theatre and Day care. 

Fire training sessions were available for all staff through the year. 

Catering Department 

The Catering Department services the needs of 162 in-patients, 30 day-care patients and approximately 

400 staff and visitors daily here in the Hospital. 

The Department also caters for various functions throughout the year as well as in-house meetings. The 

team consists of 68 staff lead by Yvonne Byrne and Geraldine O’ Nolan. 

The Catering Department has a fully implemented HACCP system and an ISO 22000: 2005 and IS 343 

accreditation. 

The Kitchen prepares and cooks the food on the day for all areas and is supervised by our Senior Chef 

Michele Pounch. The Coffee Shop opens from 7.00am – 5.00pm and seats 110 people. 

This department is very quality focused and promotes a culture of continuous improvements through out the 

year. 


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Some of last year’s activities: 

• The catering department held their Management Review Meeting’s in April and October. 

• A Healthy Eating week took place on the 4th June. 

• A New coffee machine was installed in the 2nd floor day room. 

• The 3 Marco boilers were serviced on the 9th July. 

• Gerard Kelly from CIR was on site on the 8th of August to verify corrective actions from last audit 

and then submit approval for certification to ISO 22000. 

• A coffee morning was held on the 19th September in the coffee shop and raised €286 for the Hospice. 

• The Catering Department received their certificate for ISO 22000 (Food Safety Management System) 

in October. 

• Complete Laboratory solutions carried out analysis on food products and hygiene swabs within 

the kitchen and coffee shop. 

• In December a raffle was held in the coffee shop for Focus Ireland and €3000 was raised. 

Audits 

ISO 22000 Stage 2 Audit was carried out by Centre for International Registration (CIR) out on the 9th 

January. 

Gerard Kelly from CIR was on site on the 8th of August to verify corrective actions from last audit and then 

submit approval for certification to ISO 22000. 

Michele Pounch and Denise Ryan carried out 5 supplier audit visits in August (Barbeque Foods, Old 

McDonnells, Traditional Cheese, Euro Frozen Foods and Pierres/Cusine de France). 

Michele Pounch and Denise Ryan carried out a follow up audit in November with Euro Frozen foods to close 

out an issue previously raised. 

Joe Carroll of QMS carried out a systems audit to ISO 22000 on the 16th October. 

Surveys 

Four surveys were carried out in the catering department two in the patient catering area and two in the 

coffee shop. 

Patient Catering: on the beverage service and on the sandwiches at evening mealtime. 

Coffee Shop: New layout as a result of moving the sandwich bar and on selection of breads available 

at the sandwich bar. 


98


Training 

Thornton’s Recycling Training took place from the 16th – 19th January. 

The Quantum training finished on the 2nd March. Ger O’Nolan, Denise Ryan, Michele Pounch attended from 

the catering department. 

Denise Ryan and Yvonne Gleeson attended a minute taking course with the Irish Times on the 27th April. 

Conor Devlin and Leona Dowd attended a Waste Minimisation course on the 14th June. 

Yvonne Byrne attended an Attendance Management course on the 26th June. 

In July there was ISO 22000 training for the Food Safety Team and the kitchen staff. 

7 people attended. 

Yvonne Byrne and Sinead Conroy attended Failte Ireland’s Training Techniques course during September. 

Failte Ireland Food costing training took place on the 15th and 27th November 10 staff attended from the 

kitchen, coffee shop and the patient area. 

Quantum Training carried out a management training programme March, May and November, Keith Wickham, 

Helen Dowd, Barbara McMullen, Jennifer Calton, Yvonne Byrne, Ger O’Nolan, Tina Purcell, Sinead Conroy, 

Denise Ryan, Margaret English, Siobhan Kelly and Michele Pounch attended. 

Yvonne Byrne attended Legal Framework 1&2 in SVUH during November. 

Waste Management training day took place on the 15th November for all staff. 

Janet Murray 

Support Services Manager 


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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; staff development and training; 

employee relations, implementation of policies and procedures, manpower planning, benefits administration, 

personnel administration and organisation development. The wide span of activities places an onerous 

burden on staff and I would like to thank Ms Erin Fitzgerald and Ms Barbara Power for their commitment and 

support during the year. Erin joined the staff of the HR Division in July 2007 and Barbara in December 2007. 

After nearly seven years service Ms Marian Murphy left the Department in September 2007. I would like to 

thank Marian for her major contribution to the Hospital during that time. Earlier in the year Ms Colette 

McNamara left the Department for pastures new and I would like to thank Colette for her service to the 

Department and the Hospital. 


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Occupational Health Service 

St Vincent’s Private Hospital has entered into an agreement with St Vincent’s University Hospital for the 

purchase of Occupational Health Services for Private Hospital staff. This service commenced on March 1st 

2005, and the main elements of the service are: 

• Treatment of inoculation injuries and risk management follow up 

• Immune status evaluation 

• Pre-employment assessment 

• Flu vaccination 

• Management referrals 

• Pregnancy Risk Assessments 

• Occupational Psychologist 

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. The feedback from staff has been very positive. 

During 2007 the service was expanded to include Pregnancy Risk Assessments and the services of the 

Occupational Health Psychologist (Ms Nuala Gannon). I would like to thank Nuala for her support to staff 

during the year. 

I would also 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. 

A Management Development Programme was provided for Department Heads in the Support Services and 

Allied Health Divisions. A total of 30 staff attended workshops in Feb / March, May & November. Feedback 

from staff that have participated in the programme is very positive This programme will continue in 2008. 

The Training was provided by Quantum Training. 


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The Management Team also undertook Management Development training in September and this 

programme will continue in 2008 Induction training was provided on five occasions during the year for new 

staff and 60 employees attended. Seminars were held in May on ‘Dignity at Work’, dealing with the whole 

area of bullying and harassment and 45 staff attended. It is planned to continue with this programme in 

2008. Four staff attended Retirement Planning courses. Customer Care training was provided in May and 

September and a total of 17 staff attended two courses. 

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. 10 Care Assistants completed the FETAC Level Five 

course. 

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. 

Below is a summary of HR activity in respect of Recruitment 

Detail Jan Feb March April May June July August Sept Oct Nov Dec TOTAL 

No. of Ads 

placed 5 11 4 4 3 6 3 1 3 1 6 1 48 

No. of 

Applications 60 140 63 27 10 28 15 22 7 1 29 10 412 

No of HR 

Interviews 2 3 7 3 3 3 5 4 6 1 6 1 44 

No. attended 

for interview 6 15 33 11 14 6 10 7 22 3 15 3 145 


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Personnel Administration 

In 2007 improvements were made in processes for measuring absenteeism and 

also for staff census / employment control 

The Chart illustrates the starters and leavers for each division 

80 

70 

60 

50 

40 

30 

20 

10 

0 

23 

29 

Number of Starters/Leavers by Division 

71 

49 

13 

9 

Allied Health Nursing HR Support Services Finance SVUH 

24 

20 

8 6 

Joiners 

Leavers 

3 2 

Employee Relations 

Discussions on various issues took place with trade unions and staff 

representatives throughout 2007. A work to rule was put in place by the INO as 

part of a dispute with the HSE. However, due to the high level of co-operation 

received from all staff the impact of this dispute was minimised as much as 

possible. 

• A number of individual staff grievances were resolved by agreement with the 

staff members concerned. 

• The HR Division represented the Hospital at various meetings with Rights 

Commissioners, the Labour Relations Commission and the Labour Court. 

Throughout the year we worked closely with our colleagues in the salaries office 

- Ms Dorothy Nolan and Ms Yvonne Casserly. I would like to thank Dorothy and 

Yvonne for their valued assistance. 

Medical Records 

The HR Division also has responsibility for Medical Records (including Floor 

Secretary staff), and Patient Focus. 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. Arrangements with ‘Medrex Systems Ireland Ltd’ continue to assist in 

providing solutions. Three new staff joined the Department in 2007. I would like to 

thank Ms Caitriona O’Connor, Ms Aoife O’Connor, Ms Phoebe Kenny O’Neill, Ms 

Mary Wolfe, 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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Corporate Services Division 

A number of key elements are encompassed in the Corporate Services Division brief. These include Quality 

& Risk Management, Information Technology, Capital Development and Statistics. During 2007 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. 

In 2007 the Best Practice Group received regular reports from the Group Clinical Audit Committee and the 

Hospital participated in a number of the audits undertaken through the year. 

The Best Practice Group membership comprises the senior management team and two representatives of 

the Consultants Forum. In 2007 the participation of an external advisor was interrupted but this element will 

be re-established in 2008. 

The work programme of the Best Practice Group for 2007 included: 

Development, review and approval of Hospital policies in conjunction with the Health & Safety Committee. 

BP003 

BP006 

BP007 

BP008 

BP010 

BP011 

BP014 

BP016 

BP017 

GH01 

VDU / DSE policy 

Smoke Free Policy 

Review of Existing Policies 

Incident Reporting Policy 

Facilities & Maintenance Safety Arrangements 

Fire Safety Policy 

Waste Management Policy 

Environmental Management Policy 

Pregnant Workers Policy 

Procedures for lone working 

The Hospital Safety Statement (BP000) is reviewed annually and was updated in December 2007. The 

Statement was approved by the Best Practice Group and distributed to staff. 


104


The Hospital Internal emergency and contingency plan was again reviewed, augmented and approved by the 

Best Practice Committee. The plan was tested with a programme of planned evacuations and desktop 

exercises. 

Incident Reporting system progress 

A report on incidents was presented monthly to the Best Practice Group, Team Leaders and Heads of 

Departments. 

A monthly report of all Medication Incidents was presented to the Best Practice Group. 

A monthly report of all incidents rated as medium or high risk by the Grading Group was presented to the 

Best Practice Group. 

Information sessions for staff were provided in October to raise awareness of the process and the 

importance of staff participation. 

Patient Satisfaction 

The ongoing satisfaction survey, for in-patients, continued in 2007 and was extended to include patients 

attending on a day basis. 240 in-patient submissions were received with an overall satisfaction rating of 

98.8%. 329 day care submissions were received with an overall satisfaction rating of 99%. A monthly report 

including statistical analysis and commentary was presented to the Best Practice group and actions taken 

where appropriate arising from patients comments. 

Complaints and Legal Cases 

The management of patient complaints consumed a considerable amount of the time and resources of the 

Corporate Services Division in 2007. Forty formal complaints were dealt with and concluded with a 

combination of letters, telephone calls and direct meetings with the complaining parties. At the 

commencement of 2007 seventeen legal cases were active. During the year nine cases were cleared and 

four new cases were initiated against the hospital, leaving twelve active cases at year-end. 


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Accreditation 

Due to the changes in the IHSAB and HIQA structures and system of accreditation, the scheduled 

accreditation survey did not take place in 2007. Staff members and accreditation teams continued to work 

on quality improvement plans through the year. At year end the Hospital is reviewing its strategy with regard 

to accreditation with a view to ensuring that the quality improvement programme continues and that a 

creditable external validation process is in place. 

Infection Control 

The Group Infection Control Committee provides infection control guidance for the three hospitals in the St 

Vincent’s Healthcare Group. The private hospital is well represented on the committee. A number of key 

infection control issues were actioned including two external audits of the transport of dangerous goods and 

a hygiene audit. Action plans were developed from the audit findings and the risk issues closed out or 

reduced. From Board level through the organisation a culture is fostered to control and reduce infection and 

this goal is driven through the Best Practice Group. During 2007 our Clinical Nurse Manager in infection 

control has worked closely with the Group and has made a formal presentation to the Group outlining the 

infection control programme and the education sessions for staff. 

Health & Safety Committee 

The Health & Safety Committee prepared a plan for 2007 and completed same during the year. Two key 

developments involved the establishment of a Waste Management Group and a Water Safety Group. These 

groups achieved a programme of work to ensure that the hospital complies with legislation and safeguards 

patients and staff. 

The Health & Safety Committee membership in 2007 was 

Ms Janet Murray 

Ms Annette O’ Neill 

Ms Una Nicholson 

Ms Catherine Mehigan 

Mr Vincent Lane 

Ms Jennifer Calton 

Ms Helen O’Hare 

Ms Yvonne Gleeson 

Ms Gerada Warnes 

Mr Neil Twomey 

Ms Mary Connolly 

Ms Ger O’ Nolan 

Mr Denis Scannell 

Mr Peter Sheehan 

Ms Barbara Power 

Ms Anne Carolan 


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Information Technology 

Major progress was achieved in the IT area in 2007. An IT users group was formed to steer the overall 

progression of IT and to approve and monitor the development of the service. The group comprises members 

of the senior management, staff from key departments and senior management from the ICT department of 

St. Vincent’s University Hospital. 

The Hospital entered a service level agreement with the ICT department of St. Vincent’s University Hospital 

during the year. An integral part of the agreement was the employment of three new staff to augment the 

pool of expertise in the ICT department. In this way both St. Vincent’s Private Hospital and the Healthcare 

Group have gained; the Private Hospital can now develop with the significant expertise of the department 

while the Group has gained new staff and skills in a time when such development has been restricted in the 

public sector. 

Considerable work has been achieved in bringing the infrastructure of ICT up to a new level and in providing 

a secure and robust platform for future development. This has enabled the hospital to develop the network 

and expand it to additional staff and departments – both clinical and non-clinical. Work has also commenced 

on introducing new applications in both clinical and financial areas. These projects will be completed in 2008. 

Planning for ICT in the new Hospital has commenced with plans being developed for hardware and 

applications. This work will continue to be refined in the next year. 

Capital Development 

Together with the other Divisional Managers, Corporate Services has embraced the planning and 

development of the new Hospital with enthusiasm. This exciting project has been progressed with the design 

team and the commitment will continue through the design and build stages to completion in 2009 / 2010. 

In 2007 capital expenditure continued on major and minor developments to ensure the continued high level 

of service in the period prior to the opening of the new hospital. 


107



Headline Statistics 

Jan to Jan to Variance Variance 

December December % 

2006 2007 

Patient Discharge 

Inpatients 9,033 9,517 484 5.4% 

Inpatient Occupancy 84.95% 81.83% -3.1% -3.7% 

Inpatient Bed days 48,038 46,336 -1,702 -3.5% 

Av. Length of stay(Days) 5.32 4.87 -0.45 -8.4% 

Day cases 5,592 6,320 728 13% 

Oncology Day cases 5,477 5,816 339 6.2% 

Operating Theatres 

SVPH Theatres 3,778 3,941 163 4.3% 

Theatre SVUH 810 779 -31 -3.8% 

Minor Operating Theatre 4,399 4,979 473 10.5% 

Endoscopy unit 5,417 5,760 343 6.3% 

Diagnostic Imaging 

No of Studies 30,393 29,397 -996 -3.3% 

Radiotherapy 

No of Treatments 14,570 14,764 194 1.3% 

Cardiology 

No of Procedures 6,688 6,478 -210 -3.1% 

Respiratory Medicine 

No of Procedures 2,749 3,029 280 10.2% 

Pathology Tests 

No of Procedures 441,053 466,476 25,423 5.8% 


108



Organisation Structure 

Group Chief Executive 

Chief Executive 


Director of Nursing 

Assistant Director of Nursing (3) 

Patients Floors 

Theatres (2) 

Endoscopy 

Daycare 

Minor Operations 

Pastoral Care/ Chaplaincy 

Portering 

Admissions 

Nursing Education 

Nurse Specialists 


Allied Health Manager 

Diagnostic Imaging 

Radiotherapy 

Pharmacy 

Dietetics 

Cardiology 

Medical Social Worker 

Physiotherapy 

Pulmonary Laboratory 

Other Allied Health Services 

Medical Physics 

Human Resource 

Human Resources Manager 

Administrative Assistant 

Recruitment 

Ward Clerks 


Staff Training & Development 

Employee Relations 

Medical Administration 

Finance Division 

Financial Controller 

Patients Accounts 

Debtors Accounts 

Creditors 

Salaries 

Materials Manager 


Management Accounts 


Support Services Manager 

Deputy Services Manager 

Reception 

Catering 

Coffee Shop 

Housekeeping 

Cleaning 

Maintenance 

Security 

Grounds 

Corporate Services 

Head of Corporate Services 


Risk Management 

Information Technology 

Accreditation 

Statistics 

Patient Complaints 

HIPE 

Capital Projects 


109

110 

Care

Report from the Director of Operations 

Reports 

Report from Chaplaincy/ Pastoral Care Department 

Report from Library and Information Service 

Report from Medical Records 

Allied Health Professionals and Support Services 

Medical Physics and Clinical Engineering Department 

Medical Social Work Department 

Nutrition and Dietetics Department 

Occupational Health Department 

Occupational Therapy Department 

Pharmacy Department 

Physiotherapy Department 

Preventive Medicine and Health Promotion Department 

Speech and Language Therapy Department 

111



I would like to thank all staff across the organisation for making me feel so welcome in my new role. Since 

taking up post in October 2007, I have been impressed by the hard work and dedication off all our staff in 

delivering high quality patient care in a challenging financial environment and under much public scrutiny. 

My approach has been to support our clinical services, reduce bureaucracy where we can, improve our 

processes and systems to support patient care, review and streamline our committee structures and meeting 

arrangements and empower staff at all levels – I hope you are starting to notice some differences. 

Hospitals are part of the broader healthcare system and cannot work in isolation. A significant part of my 

role, along with my senior management colleagues, is to liaise with the HSE and Primary Care to develop 

services, improve patient pathways and secure funding. I hope St Vincent’ University Hospital continues to 

play a leading role in modernising services and this will be a key area for me in 2008. 

This report gives a brief overview of key developments across a number of areas. I hope you find it both 

useful and familiar; the themes have formed a key part of our new communication strategy and are now 

being embedded in the organisation. 

Strategic Plans 

Development of Performance Management Approach and Systems 

In October 2007, and building on the foundations established through 2007 and previous, we introduced a 

new approach to performance management based on: 

• An agreed indicator set • Clear targets 

• Effective reporting • Providing staff with the tools and information 

to deliver such targets 

Effective indicators are those which can be measured, clearly understood, owned by the respective 

stakeholders and most importantly, are not merely monitored, but lead to improved performance. 

The agreed indicator set are integrated and have been compiled with regard to the key factors impacting on 

the efficiency and efficacy of the organisation in delivering its mission statement. This mirrors the HSE 

approach and provides consistency with our externally reported position, alerting the organisation to any 

areas of risk. 

The nine indicators below are deemed the most critical at present and as such their progress will be followed 

on a monthly basis. 

1. ED Waiting Time 2. In-patient Waiting List 3. Outpatient Waiting List 

4. Hospital Acquired Infections 5. Average length of stay 6. Day case rate 

7. Staffing levels 8. Financial Position 9. Delayed Discharge 

By tracking the progress of these nine indicators, we intend to stimulate discussion and agree the aspirations 

of the organisation. A simple traffic light monitoring system is used, showing red, amber and green lights to 

denote how close we are to delivering out identified target. 


112



Staff should now be familiar with the report we circulate on a monthly basis showing our current position and 

identifying actions needed to deliver our targets – see diagram 

Clearly there are a number of other 

indicators that could be considered, and 

indeed will be developed in time with 

reference to, and consultation with, 

appropriate internal and external 

stakeholders. 

Each Indicator is defined in turn, in terms of what is being measured, the proposed target and timescale, the 

context and interrelatedness with other indicators and the parameters that trigger the red, amber, green 

(RAG) status of the traffic light. 

This is consistent with the approach used by HSE and is likely to become a feature of HIQA’s reporting 

methodology. 

We have presented this approach at a number of staff and Heads of Department meetings and the feedback 

thus far has been very encouraging. I hope that all staff see this as a useful approach to keeping everyone 

informed of where we stand as an organisation and our key areas of focus. 

In 2008 I intend to roll this out across the organisation using the same methodology, to develop specific 

indicators relevant to each department. 

Review of our committee structures and communications 

As part of the communication’s strategy planned for 2008 and in line with the principles of Team Based 

Performance, we reorganised and reviewed our current committee structures and communications. 

Outlined below are some examples of how we evolved our current communication’s structures: 

• Replaced weekly management meeting with a Senior Management Meeting twice per month 

• Merged Executive Council Meeting with one of those senior management meetings per month 

• Moved monthly staff briefing to quarterly in order to drive high attendance 

• Re-launched the Heads of Department Meeting 

I hope you have found this new approach helpful and as always would welcome feedback. We have also relaunched 

Newsround – our monthly Newsletter. My thanks to Claire Finnan for this and all of her efforts on 

our Communication's Strategy. 


113



Estates Strategy 

The Estate Strategy Group was established in November 2007. This group has developed a structured and 

transparent process for future campus developments, ensuring where possible that the development is 

carried out in a planned, effective, efficient and progressive manner. 

Frank Smyth is the driving force behind this group and provides a monthly update on all projects. There is a 

considerable amount of building development underway to develop our services, improve our infrastructure 

and support patient care. Frank covers this more in his section of the annual review in terms of how projects 

are identified, proposed, evaluated and taken forward. 

A number of major capital projects have been completed in 2007 and further ones launched. The ADCC is 

now fully operational and is an impressive achievement, delivering 21st Century facilities for our patients and 

staff. 

Work has commenced on the New Private Hospital and should be complete in the first quarter of 2010. 

The new Day Care Ward is on track for delivery in June 2008 and we now have planning permission for a 

new 120 bed ward Block. 

2008 will be an exciting year for SVUH and a further example of our progressive approach to healthcare 

delivery. 

Services Initiatives 

Specialty Specific Admissions 

In order to improve utilisation of the St Vincent’s University Hospital bed base, provide consultant delivered 

integrated care to patients, enhance access to hospital services for primary care providers, create 

streamlined care pathways for local patients and reduce both attendance and waiting times in the 

Emergency Department (E.D.), we have developed a Speciality Specific Admissions policy. Developed by the 

Medical Executive Committee, this approach is now been rolled out across SVUH. 

In order to allow specialty specific admissions and a consultant provided service, work practices in the 

hospital are and have changed to follow the model outlined by Hanly (Hanly Report; DOCH 2003). It is 

particularly relevant that this proposal should stem from St Vincent’s University Hospital, as this was one of 

the core hospitals studied by Hanly and colleagues. 

Considerable progress has been made in establishing a protected bed base, which promotes effective clinical 

management and helps reduce length of stay. Coupled with a fundamental review of our discharge planning 

process, we are starting to see some benefits to this approach. We are also reviewing interfaces with Primary 

Care to provide whole system services. Respiratory, Neurology and Care of the Elderly multidisciplinary 

project teams have been established and have made significant progress in reengineering services in the 

short term and outlining a long-term vision for the service. 

This will continue to be a key part of our approach for 2008, with rollout across all specialties and a 

fundamental review of our catchment areas and bed base. 


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Future Plans 

Development of Effective Reporting Tool 

We are currently implementing a new Management Information System (MIS) called Health Diver. The 

system initially covers the Patient Administration System (in-patient, outpatients and waiting list), Emergency 

Department, HIPE and Social Work systems. While this data mining tool provides comprehensive reports and 

adhoc queries internally and externally one of its main advantages is its portal and dashboard capability. We 

are using this to deliver the SVUH Key Performance Indicator dashboard via the Intranet and Email. This 

currently consists of nine KPIs which Diver will automatically update from legacy systems. It uses thresholds 

to determine and illustrate (traffic lights) the status of these indicators. Users can then move beyond the KPI 

to see a detailed report, graph or speedometers giving further information on the indicator. Users with 

appropriate security access can then dive further into the data for example from KPI to specialty to 

consultant and patient level. Because Diver draws the information into a common pool you are not restricted 

to one silo of data but can explore information from a number of systems. 

This will be rolled out in 2008 and I hope staff find it useful and informative as a key part of our approach 

to Performance Management. 

GP Liaison 

We are currently in the process of developing links with our colleagues involved in local Primary Care. 

Communications initiatives such as a quarterly GP Newsletter and reformation of the GP Liaison Committee 

will be rolled out as part of the communication’s strategy 2008. 

Waiting List Management 

Waiting times for services are key from a patient’s perspective. 

Waiting times across outpatients, diagnostics and inpatients have all been reviewed in 2007 and continue to 

be an area of focus for the organisation and a key national target. 

We have made considerable progress in developing reporting systems and processes and further work is 

planned in 2008. 

We have also introduced more effective validation processes to ensure our waiting lists are accurate and 

made further use of the National Treatment Purchase fund to reduce the number of long-term waiters. 

A new Waiting List Policy was also introduced in 2007, outlining our aspirations, roles and responsibilities and 

improved processes to ensure waiting times are kept to a minimum within the financial constraints we 

operate. 

Summary 

2007 has seen a consolidation and review of all our major systems and processes, aimed at streamlining 

pathways and supporting patient care with the aim of providing clear and consistent approach and 

empowering staff at all levels. 

I hope you have felt part of this approach and that I can further count on your support. 

2008 has a number of challenges, it will see further developments and it will build on the foundations that 

we have laid. 

Bill Maher 

Director of Operations 


115

Chaplaincy/Pastoral Care Department 

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. 

Chaplaincy Staff 

Since the last annual review, there have been no changes in personnel. 


116

Department - Chaplaincy/Pastoral Care 

Service 

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, five part time priests, one Church of Ireland ordained 

Minister, three chaplains from the Religious Sisters of Charity and two lay chaplains. 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 at 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 pastoral visits made on a 

daily basis to the wards. 


117



Staff Support 

The members of the Chaplaincy Department work closely with the other health care professionals and are 

available to provide counsel and support to staff when the need arises. 


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 over seven hundred 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. 

On Friday 21st December, as most people were making their last minute preparations for the approach of 

Christmas, the Chaplaincy/Pastoral Care Department hosted the first official Pastoral visit of Bishop 

Raymond Field. Bishop Field is an Auxiliary to the Archbishop of Dublin and Diocesan representative for 

Healthcare. 

After his visit, in a letter of appreciation to the Hospital, Bishop Field said, “I was impressed to see the 

important spiritual and caring ministry which you bring to patients, relatives and staff throughout the hospital. 

The hospital facilities, along with the deep commitment and dedication of the nursing and ancillary staff, is 

most impressive”. 

Seminars 

During the year seminars on pastoral care were given to the student nurses at the in-service training 

programmes for Overseas Nurses and at 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. 


118



Clinical Pastoral Education 

There were three units of Clinical Pastoral Education in SVUH CPE Centre during 2007: January 15 through 

April 5; April 30 through July 20; September 17 through December 7. 

Eight students participated in the January – April programme. They were graduates of the Milltown Institute 

and of the Mater Dei Institute of Education. One was a CPE supervisor-in-training with a graduate degree 

from Boston College. Mr. Nicholas Jermyn presented certificates at the completion of the unit. 

Six students participated in the April – July programme. Four were graduates of the Milltown Institute and 

one a graduate of Mater Dei Institute of Education. Mr. Cormac Maloney presented certificates on behalf of 

Mr. Jermyn at the completion of the unit. 

Ten students participated in the September – December programme. They were graduates of the Milltown 

Institute, the Western Theological Institute and the Pontifical University at Maynooth. Mr. Nicholas Jermyn 

presented certificates at the completion of the unit. 

Students benefited from presentations by hospital staff and by presentations from visiting lecturers. Visiting 

lecturers included Fr. Michael Drumm, Monsignor Paul Tighe, and Mr. Alan Kearns, from Mater Dei Institute; 

Dr. Pat Walsh from the Granada Institute; and Dr. Patricia McCarthy. Visits to St. John of God Hospital, 

Childrens’ University Hospital, Temple Street, and The National Maternity Hospital, Holles Street, were also 

important curriculum events. 

One student was admitted to Supervisory training for Clinical Pastoral Education. 

One student completed her training as a CPE Supervisor and engaged the certification process. 

Seven graduates of the 2007 programme engaged the certification process with the Healthcare Chaplaincy 

Board. 

Sr. Pat O’Donovan gave the address at the presentation of certificates by the Healthcare Chaplaincy Board 

in December 2007. The address will be published in the April 2008 issue of Intercom. 

Graduates have become staff chaplains at The Mater University Hospital, St. Luke’s Hospital and the Royal 

Victoria Hospital in Belfast. One is doing further studies in the USA and others are doing mission work. 


119


Library & Information Services Department 


The staff complement in SVUH remained at 3 full time posts and 1 part time. Mary Flynn resigned her post 

of Evening Library Assistant in May and was replaced by Julia Christopher in September to provide late 

opening hours for the academic year 2007/8. 

Breda Bennett continued to provide a one-person-operated professional library and information service in St 

Michael’s Hospital. 


SVUH Library recorded 19,757 visits in 2007. The introduction of swipe-card access to the corridors of the 

ERC in September has reduced the number of visitors slightly but has provided secure access to the 

premises for authorised users. 

Update 

SVHG Libraries launched Update in March. This occasional newsletter aims to provide news and information 

about the library and information services to the Group and was published 3 times in its first year. Responses 

have been very favourable and a full review including customer satisfaction surveys will be carried out in 

2008. 

Heritage Library Management System 

The online public access catalogue was made available on the Intranet in July and formally launched by Mr 

Murtagh in St Michael's Hospital. Group staff are now able to search the joint SVHG catalogue, reserve items, 

extend their loans, gain electronic access to databases and journals and contact the library at their 

convenience. 

St Michael's Hospital 

Usage of the library was constant during the year. There are 456 library members. The Librarian participated 

in Orientation meetings for NCHDs and nursing students, the IHSAB Accreditation scheme and the hospital 

newsletter. She participated in Group Library & Information Services Committee and the Department Heads 

meetings. 

2 printers were upgraded. All PCs were upgraded and there are 6 available for public use. A binding machine 

and a scanner were acquired for the library. 

St Vincent’s Private Hospital 

Mr Peter Sheehan continued to represent the Hospital on the Group Library & Information Services 

Committee. 


120

Department - Library & Information Services 

Collection Development 

Print Journals: SVUH Library subscribed to 123 journal titles in the areas of medicine, surgery, nursing and 

allied health at a cost of €62,337.07. This is joint funded by the hospital and UCD. Over 60 titles were also 

received on donation. SMH Library subscribed to 57 journal titles at a cost of €30,000. Journals were 

donated by the Biochemistry Laboratory. 

Books: This year SVUH Library doubled its spend on new books to €8,023.20 and purchased some titles on 

leadership and management in support of HR and senior management initiatives. SMH spent €3826 and 

books were donated by the Respiratory Department. 

Electronic Resources: The main focus for the SVHG library service in 2007 was in developing its electronic 

resources. The SwetsWise system, which allows staff to log in to one website and then link out to all the 

Group’s electronic journals and databases, proved problematic over the year and was replaced in December 

with Ebsco AtoZ. The implementation of the Athens system in February was of much greater success and 

allows SVHG staff remote access to the electronic journals and databases. To date over 400 staff have 

registered for an Athens account. 

Library staff trialled a number of additional electronic resources in the summer and identified three new 

products which they hope to get funding for in 2008: MD Consult, Cinahl Full Text and UpToDate. Many 

thanks to all the clinical staff who participated in the trials. 

The Group provided access to over 80 electronic journal titles. The UCD/ERC server located in SVUH 

Library provided access to most healthcare databases and 15,000 fulltext journals. 

Interlibrary Loans 

SVUH Library: 565 journal articles and books were requested from other libraries: 65 were from the British 

Library; 332 were from Subito; and 168 from the network of Irish Healthcare Libraries (IHL). The Library 

supplied 285 to other Hospital libraries nationwide. The overall cost of ILLs for the year was €3,052.76. 

SMH Library requested 31 journal articles from various libraries. 18 were requested from members of the 

IHL network and 13 from the British Library. SMH supplied 12 articles to other libraries during the year. 


121


Department - Library & Information Services 

Library & Information Services Committee 

Due to significant changes in the membership, the Committee met only 3 times this year. The Committee 

wish to thank Professor Aongus Curran, who resigned as Chair for his hard work and support during his 

tenure and to welcome the new Chair, Dr Ed McKone, who took up the mantle in November. 

Niamh Lucey continued as joint Team Leader in the Information Management team for IHSAB’s 

Accreditation scheme. 


Training events: 

Advanced PubMed 

Evidence Based Practice for Library & Information Professionals (FOLIO Online Course) 

Getting to the Right Answer 

Heritage training (Dublin) and workshops (Oxford, UK) 

Identifying the Evidence for Systematic Reviews 

Library Advocacy (FOLIO Online course) 

Managing Electronic Journals 

Conferences/Seminars 

Electronic Resources Seminar – Buswell’s Hotel, Dublin 

Health Sciences Libraries Group Annual Conference – Hodson Bay Hotel, Athlone 

LIR Annual Seminar – Trinity College, Dublin 

European Association for Health Information and Libraries (EAHIL) Workshop – Krakow, Poland 

SVHG Clinical Audit Study Day - Niamh Lucey gave a short presentation entitled Information Sources 

for Clinical Audit 

Future Plans 

The following are projects the Library & Information Services Departments will be working on in 2008: 

• Provide additional electronic resources: Cinal with Full Text, MD Consult, UpToDate, HaPI 

• Review Collection Development Policy 

• Develop interactive medium for communication between staff and library in St. Michael’s Hospital 

• Pilot training and education programmes on information literacy skills (with HR Learning & 

Development unit) - April 

• Work with UCD in developing Adjunct Lecturer roles (and access to UCD E-Library) and in relation 

to Dublin Academic Healthcare 

• Participate in the development of the SVHG Intranet to prepare for prompt loading of content 

when completed 

• Marketing of Library & Information Services to Private Hospital staff 


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Allied Health Professionals 

Medical Records / Patient Services 

Staffing 

Two new Grade V posts were approved for the service, with the following appointments made in 2007: 

• Nicola Maddock, Supervisor, ADCC 

• Tadhg Keating, Supervisor, Filing Room 

Service Developments / Activities 

• The National Hospitals Office (NHO) launched a new Code of Practice for Healthcare Records 

Management in April. A review was carried out by the NHO in July and the overall audit score for 

SVUH was 77%. During the remainder of the year workshops were held by the NHO in preparation 

for introduction of a national Healthcare Record and implementation of the Code of Practice. 

Implementation of the Code of Practice will have a major impact on records management. 

• A Group Medical Records Committee was formed including representation from St. Michael’s 

Hospital and St. Vincent’s Private Hospital. 

• The move of outpatient clinics into the new Ambulatory Day Care Centre (ADCC), which began in 

2006, was completed during 2007. The new ADCC allowed for additional clinic sessions, introduction 

of sub-speciality clinics in some services and an overall increase of 9.6% in patient activity from 2006. 

• Collection of Day Case Activity was a focus during the year and a noteworthy increase of 103% 

was the result. This was made possible by the combined efforts of HIPE, Statistics & Registration 

staff in accurately capturing these attendances. 

• Phase 2 refurbishment of the filing room took place. Staff temporarily relocated to a portacabin to 

facilitate work being carried out. The mobile shelving unit was replaced and a much-improved 

working environment for staff was provided. 

• An audit of HIPE data was undertaken with results presented at the Clinical Audit day. Results 

showed a very positive outcome of a 94% accuracy rate for the recording of diagnoses and 

procedures by the HIPE Department. 

• A working group was formed to introduce a hospital wide Digital Dictation System. 

Future Plans 

During 2008 a major emphasis will be placed on introducing the new national Healthcare Record. This will 

be driven by Medical Records staff with involvement of clinical staff in all patient areas. 

Work will progress on action required from recommendations highlighted in reviews carried out by AON 

Healthcare & the National Hospitals Office in relation to Healthcare Records Management. 

Key Performance Indicators (KPIs) will be rolled out to all Senior Managers in the services early in the New 

Year. 


123

Medical Physics and Clinical 

Engineering Department 

Staff Members 

Chief Clinical Engineer 

Principal Clinical Engineering Technician 

Senior Clinical Engineering Technician 

Tom Smyth AENG, AMIEI 

Derek Farrell 

Frank Kelly AEng, AMIEI; IENG, MIHEEM 

David Farrell BSc 

John Harte 

Aidan O’Connor 

Declan Murray MSc 


• Preparation for forthcoming projects, equipping 

• Compiling comprehensive equipment 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, liaising with Irish Medicines Board 

• Technical Specifications for all new electro-medical equipment 

• We welcome the appointment of David Farrell as part of the team 

Academic Achievements 

Tom Smyth was awarded the title of Associate Engineer with Engineers Ireland. We currently have some 

members of staff registered with The Institution of Engineers which is the professional representative body 

for Clinical Engineering in Ireland and as such by act of the Oireochtas in 1969 are entitle to award the title 


124



of Chartered Engineer, Associate Engineer, and Engineering Technician of the Institution, confined to suitably 

qualified candidates. We also have applied for CPD Accreditation with The Institution of Engineers and are 

at an advanced stage of the award.. 

Publications: 

Poster 

“Poster Project Management of a New Dialysis Centre” BEAI Annual Scientific Meeting Tullamore. Frank 

Kelly, Derek Farrell 

“Profile of SVUH Clinical Engineering Department” BEAI Spectrum 

Tom Smyth et al. 

Meetings attended: 

Frank Kelly attended EDTNA/ERCA Florence Italy 

Aidan O Connor attended the Irish Cardiac Society Meeting Belfast. 

John Harte attended the Critical Care Meeting UK 

Tom Smyth attended Medica Düsseldorf 

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 when absolutely 

necessary. 

We plan to introduce a new I.T. solution to our method of equipment management. This will be in place by 

April 08 and will also serve to greatly assist the task of equipping all new projects. 

The Equipment Library is at an advanced stage and we hope to be in a position to offer this service soon. 


125



Medical Social Work Department 


Firstly, we have had a number of new personnel who joined the service during the year. The positive news 

was that there were 3 extra posts approved in the areas of Emergency Medicine, Old Age Psychiatry and 

Cystic Fibrosis. 

Rita Evrony took up a Senior Social Work part time position at the beginning of the year. Linda Groenewald 

began in the area of Cystic Fibrosis in May 2007. 

Nicola Flynn, Eimear Scahill and Jeanette Meany, all new graduates, joined the Department in the summer 

period. Jennifer Allen obtained a permanent position in the area of Old Age Psychiatry in August. Alina 

Popoescu also became a permanent member of the team the same month after being with us in a temporary 

capacity for over a year. She provides a service to Medicine for the Elderly. Emer Bissett came to us as a 

holiday locum for the months of June, July and August and got a temporary post in the Emergency 

Department in October. 

Enara Etxebarria Itaxso rejoined the department in March 2007 much to the delight of us all. Louise Morgan 

also resumed her work in the Emergency Department in January after being on maternity leave. Those who 

left for various reasons include Mary O’Connell, Eileen Ni Shulleabhain, Anne Marie O’Boyle and Ann 

O’Donoghue. Others who also contributed handsomely to the service during the year were Amy Walter and 

Olive Logan. We thank them for all the hard work and dedication given during their time with us. 


2007 was a very busy and challenging year for our service both in terms of demand and the impact of both 

internal and external factors. The provision of Delayed Discharge Initiative beds for most of the year enabled 

us to successfully place 143 elderly patients in approved private nursing home care. The availability of Home 

Care Grants also ensured that patients who needed a lot of care at home managed to leave the hospital. We 

also utilised the 13 Intermediate Care Beds that exist both in Kiltipper Woods Nursing Home and Our Lady’s 

Manor to maximum advantage both for “step down” from the acute hospital or diversion from the Emergency 

Department. There were 80 patients who benefitted from this arrangement in 2007. 

The role of the profession of Social Work was promoted extensively during the year in the hospital by all the 

staff after much work from a sub committee devoted to the topic .The educating of hospital staff about our 

role is vital in ensuring that we are used effectively in the care of patients. This work is ongoing. 

We also contribute to the Schools Programme that is run in SVUH and this is invaluable in alerting secondary 

students to opting for the profession as a career. 

The Bereavement Service delivered by the department to all relatives/friends of patients who died in SVUH 

continues to thrive. It is in its fourth year of operation and works very well. The feedback from the participants 

has been overwhelmingly positive. 


126


Allied Health Professionals - Medical Social Work Department 

Training in clinical supervision was undertaken in the year by 5 of the Senior Social Workers. At this stage 

all of the Senior Team have been trained in the Morrison Model which has been tried and tested in the NHS 

in the UK. 

The 3 Social Workers in Old Age Psychiatry have been holding information briefings for carers since the 

autumn of 2007. They plan to develop this model further by giving relatives an opportunity now and again, in 

a structured forum, to ventilate their feelings/frustrations etc and build mutual support. 

Several of the Social Work Team were involved in the pilot phase of the “Fair Deal” initiative for Older People 

in Dublin Mid Leinster. They provided valuable feedback about the clinical decision making process to the 

HSE. 

Eileen O’Donnell, Senior Social Worker, has played a key role in the “Care to Drive” project funded by the 

Irish Cancer Society in conjunction with our hospital. It will be directed at Cancer patients who because of 

their circumstances require someone to drive them to and from St Vincent’s University Hospital for treatment. 

It hopefully will be up and running in 2008. She has also been involved with a research project being 

operated by the National Cancer Registry Office on the “Financial implications of a diagnosis of cancer.” 


The graph shows the number of cases opened and closed in the social work department from 2005-2007. 

The nature of the referrals to Medical Social Work. 

As can be seen assessment is the predominant request with discharge planning coming second. Other can 

incorporate placement either short term or long term, housing issues and other practical help, child 

protection, elder abuse to name a few. 


127

Allied Health Professionals - Medical Social Work Department 

The Tasks of Medical Social Work 

As one can note from the chart “other” is the predominant piece which incorporates liaison and linkage work 

as well as reporting and recording. Direct work with patients and families combined comes to 47%. 

Future Plans 

Our first aim is to continue to improve upon our delivery of service to the patients and their families as well 

as stimulating and motivating the team. We shall be again rolling out the presentations concerning our role 

to all the relevant staff in the hospital. We will also be promoting our profession in the next edition of 

Newsround. This work coupled with the national launch of a position paper by the Head Medical Social 

Workers Group on our profession and its contribution to the development of the HSE transformation project 

should have a positive impact. 

We will also be utilising our new premises in 2008. There will be a family/conference room as well as 2 

interview rooms available for use. 

This will make a fundamental difference to our service delivery to patients and families. In the summer of 

2008 we plan to do a review of our clinical supervision process with an external facilitator both from the 

supervisees as well as the supervisors perspective. We intend to embrace the Team Based Performance 

model once more in order to refocus on targets. Finally we are planning a new training needs analysis in May 

2008 to be completed by the whole team. 


128



Nutrition and Dietetics Department 


There was 18% increase in in-patient consults and 15.5% increase in OPD consults. Day Care activity 

increased by 67% due to increased staffing in Haemodialysis. Patient group education grew significantly due 

to an additional staff member being appointed to Diabetes allowing expansion of our DAFNE programme. 


Total staff compliment at the end of 2007 was 16 WTE. Lynda O’Shaughnessy (Senior Dietitian in Cystic 

Fibrosis), Natalie Wallace (Entry-level Dietitian) and Aoife McFarlane, Jenny Caffrey and Yvonne Hickey 

locum Dietitians joined the Dept throughout the year. 


In 2005 a structured, accredited education programme for patients with Type 1 Diabetes (DAFNE) was 

introduced into SVUH. 2 accredited DAFNE tutors facilitated the programme. 8 patients participated in a 

weeklong intensive education programme learning about carbohydrate counting and matching insulin to the 

food consumed. 110 patients have participated in the programme with a further 145 on our waiting list with 

the capacity to include a maximum of 64 patients per year. 

The Department introduced a flexi-time policy in 2007. This has greatly facilitated the extended ambulatory day 

care clinics that run from 08.30 – 18.00 Monday – Friday. 

A pilot project of managerial professional supervision was undertaken in 2005 in association with our DATHs 

colleagues. 7 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. 6 members of the department have been 

trained and participate in peer supervision. In collaboration with our DATHs colleagues we hope to offer 

further training which is being financially supported by the HSE through our professional body. 


In May the Department facilitated the major examination for 14 final year B.Sc. (Human Nutrition and 

Dietetics) students. This undertaking was made possible with tremendous support and co-operation from our 

Medical and Nursing colleagues. The examination was co-ordinated by Orla O’Connor and Aisling Glynn, 

Dietitians. 


129


Allied Health Professionals - Department of Nutrition and Dietetics 

In 2007 the Department facilitated a final year thesis for a BSc. Human Nutrition and Dietetics. The student, 

Orla Brady completed her thesis entitled ‘Lactose Intolerance in Adults with Cystic Fibrosis’. Lactose 

Intolerance is frequently sited as a cause of gastrointestinal symptoms in patients with Cystic Fibrosis. 

Although Lactose Intolerance has been studied in paediatric patients with CF, prior to this it has never been 

investigated in adult patients with CF. Orla investigated Lactose Intolerance using a hydrogen breath test and 

completed a questionnaire to examine dairy product avoidance practices among adult CF patients. This study 

suggests that Lactose Intolerance is not more frequent in Irish adults with CF than in the normal Irish adult 

population. Small Intestinal Bacterial Overgrowth (SIBO) was suspected in 65% of the subjects. The 

presence of SIBO may be a contributing factor to gastrointestinal symptoms or discomfort in patients with 

CF and will require further investigation. A calcium rich diet is recommended in adults with CF with a 

recommended intake of 1300mg – 1500mg of calcium per day (Cystic Fibrosis Trust, 2007). The 

questionnaire revealed 83% of subjects include dairy products in their diet on a regular basis with an average 

dietary calcium intake of 1600mg and 1250mg in males and females respectively. 

A multidisciplinary pilot programme for cancer survivors was facilitated jointly by UCD and SVUH between 

February and May of 2007. The curriculum for the 8-week pilot-programme was developed based on the 

literature, interviews, focus groups and survey data. It is recommended that interventions should address 

multiple behaviours thus the programme combined a psycho-educational module (Hope Therapy) with 

physical activity and dietary modules. 39 survivors agreed to take part in the study (32 females; 7 males). 

The treatment group (22) consisted of one group of breast cancer survivors and a mixed gender group of 

breast, prostate and colorectal survivors (age range 47-65yrs). The comparison group (n=17) consisted of 

breast, prostate and colorectal cancer survivors (age range 46-65yrs). All participants were 2-10 years posttreatment. 

Analysis of the results is on going, but it is hoped that if the results are positive that long-term 

funding for such a programme could be secured. 

Significant Publications 

O’Reilly, M. Tully, O. Houlihan, G. Sugre, S. Gallagher, 

C. Percutaneous endoscopic gastrostomy in patients with Cystic Fibrosis. 

Proc Nut Soc 2007; Vol. 66:90A 

Catherine Lamont presented a poster on behalf of the Nutrition Sub-Committee entitled 

“Protected Mealtime: Does it Work?” at the Irish Gerontological Society Conference, September 2007. 

Edel Caples, Acting Senior Dietitian, presented at the UK and Ireland Liver Transplant Meeting, hosted by 

SVUH, at the SAS Radisson Hotel, Dublin. The title of her presentation was 

"The Role of the Dietitian in the Care of Liver Transplant Recipients" 22nd – 23rd November 2007. 

Lynda Parke submitted an article for the Irish Kidney Association (IKA) support magazine, summer 2007 

entitled “Cooking Al Fresco” 

Future Plans 

Having reviewed our pilot weight management clinic we have reverted to a general OPD clinic as objectives 

were not achievable within this clinic structure. 

We are exploring the feasibility of facilitating a structured education programme for patients with Type 2 

Diabetes to compliment the DAFNE programme for Type 1 patients. 


130



Occupational Health (OH) Department 

Staff members of the OH Department 

Staff members during 2007 

Occupational Physician 

Dr. Paul Guéret 

Dr. Jacintha More-O’Ferrall 

Dr. Robert Ryan 

Dr. Fiona Graham 

Occupational Psychologist 

Nuala Gannon 

Clinical Nurse Specialist (CNS) 

Siobhan Bulfin (Up to June 2007) 

Justine McGrane 

Orla Seale (Up to September 2007) 

Ann O’Reilly 

Aisling Purcell 

Administrative support 

Áine Yap Ciarán Reilly (Up to March 2007) 

Barbara Sheridan (From September 2007 part-time). 

Other hospital staff that contributed to OH included the Health and Safety Co- 

Ordinator and personnel from Risk Management, Infection Control, Preventive 

Medicine (Health Promotion), Ergonomics, Human Resources and Dietetics areas. 

OH continued to provide professional services to Health and Safety, Risk 

Management, Infection Control, Preventive Medicine (Health Promotion), 

Ergonomics, Human Resources and to UCD. 


Three thousand, nine hundred and fifty appointments were issued to staff in 2007, 

compared to 3150 appointments in 2006. Staff did not attend 628 appointments 

issued. 

There was an average of 44 documented telephone calls relating to client specific 

queries each month in 2007. This figure is not inclusive of general queries or 

queries relating to hospital departments. 


131


Allied Health Professionals - Occupational Health (OH) Department 

OHD appointment statistics 

3 % 3 % 1 % 

3 % 2% 

2 %2% 

5 % 

3 % 

9 % 8 % 12 % 47 % 

Vaccination = 1906 47% 

Infection Control = 487 12% 

Psychosocial = 318 8% 

Fitness to Work review = 350 9% 

Inoculation Injury = 119 3% 

Back = 181 5% 

Health surveillance (VDU/Skin) = 78 2% 

Occupational Injury = 116 3% 

Pre-employment Review = 64 2% 

Pregnancy Risk Assessment = 119 3% 

Alcohol = 104 3% 

Misc (GP/Musculoskeletal/Absenteeism) = 31 1% 

• There was further development of the OH webpage to aid the dissemination 

of information about OH services and activities; 

• Action has been initiated and developed in the following areas: 

i.) Policy matters: 

• A suite of policies and standard operating procedure’s (SOP) were 

approved and implemented in 2007. 

• The following policies were approved; 

- Hepatitis B: Protection of Patients and Staff Hospital Policy 

(Incorporating the Hepatitis B Vaccination Programme) 

- Management of staff exposed to potential Blood Borne Viruses by 

the Occupational Health Department and Emergency Staff. 

- Administration of the Influenza Vaccination to hospital staff. 

• The following SOP’s were approved; 

- The management of food handlers with symptoms of 

gastroenteritis. 

- The management of staff with symptoms of gastroenteritis. 

- Surveillance and screening of BSc nursing students for MRSA and 

the management of hospital staff who colonise MRSA in a Carrier 

Site. 

- A management protocol for the administration of Lyclear or other 

appropriate medication to hospital staff exposed to the Sarcoptes 

Scadei. 

- The management of the medication used in the treatment of 

hospital staff exposed to Pediculus Humanus Capitis 

- The Administration of Rifampicin or other appropriate medication to 

hospital staff exposed to the Meningococcal Meningitis Bacterium. 

- The management of staff exposed to the measles virus. 

- The management of staff exposed to the mumps virus. 

- The management of staff exposed to the rubella virus. 

- The management of staff exposed to the varicella zoster virus. 


132



- The management of individuals attending the OHD for Nicotine 

Replacement Therapy. 

- The management of individuals who attend the Occupational Health 

Department as part of the Working Backs Programme. 

- Pre-Employment Health Assessment. 

- The management of individuals attending the Occupational Health 

Department with a skin condition. 

- Vision Screening for users of display screen equipment. 

- Pregnancy and Work-Risk Assessment for pregnant employees. 

- The management of staff requiring the MMR vaccination in the Occupational Health 

Department. 

- The management of staff requiring the varicella-zoster virus vaccination in the Occupational 

Health Department. 

- Responsibilities of Clinical Nurse Specialist (CNS) in charge. 

- Management of a vaccination clinic in the Occupational Health Department. 

- Occupational Health Department managing clinic appointments. 

- Filing System for the Occupational Health Department. 

- Client confidentiality and Occupational Health information. 

- The management of complaints – OHD approach. 

- The response of Occupational Health Department staff in Emergency Situations. 

- Managing stress at work. 

- The Occupational Health Psychology service referral procedure. 

ii.) Evaluation matters: the following audits were undertaken: 

• An audit of the levels of verbal and physical assaults towards staff 

• An audit of the usage and uptake of the Working Backs Programme (WBP); 

• A study to investigate the role of interferon-gamma immunological testing in contact tracing of 

healthcare workers following significant exposure to TB in the course of their work. 

• An audit of the Hepatitis B immune status of the Dialysis Unit nursing staff 

• An audit of the Hepatitis B immune status of the research staff in the ERC 

• An audit of pregnant staff reporting to OHD. 

• An audit of staff attitudes towards awareness and practice of needlestick injuries in the acute 

areas within the hospital 

Significant Achievements 

The development and implementation of a comprehensive suite of OH clinical and psychological 

policies and SOP’s. 

The successful completion of MSc studies in Quality in Healthcare, Royal College of Surgeons Ireland 

by Ann O’Reilly. 

The delivery of post-graduate education to: 

• UCD post-graduates by J. McGrane; 

• TCD and UCD post-graduate by N. Gannon. 


133




Three thousand nine hundred and fifty appointments were issued to staff in 2007. 

This represents an increase of 800 appointments on 2006 

Needlestick injury prevention 

An ongoing educational campaign has continued into 2007 to encourage all staff 

to avoid and report inoculation injuries as early as possible. 

A number of “Be Sharp Be Safe” workshops were held and a total of 175 staff 

members attended. Specific sessions on the prevention and management of 

inoculation injuries were also provided for approximately 156 nursing staff as part 

of the cannulation and venepuncture study day. Informal sessions took place in 

the Emergency Department on the ‘Management of Blood Borne Virus exposure’; 

40 staff members attended. 62 medical staff attended education sessions. A 

special programme was given to general operatives as part of a safety initiative. 

Medical and psychological assistance was 

provided to the 103 staff members who 

sustained inoculation injuries in 2007. An 

additional 12 staff members sustained splash 

injuries. 

The prompt reporting of needlestick injuries 

was emphasised. This facilitated the OHD in 

monitoring and controlling associated risks. 

The incidence of such injuries has fallen steadily in recent years – however with 

the increase of acute procedures and the opening of the new acute facility within 

the hospital there has been a slight increase in the numbers reported this year. 

150 

100 

50 

0 

104 

83 

24 18 

Needlestick and splash injuries 

sustained by staff 2002-2007 

85 

28 

24 16 12 

2003 2003 2004 2005 2006 2007 

70 

85 

Series 1 

Series 2 

103 

‘Working Backs Programme’ (WBP) for staff 

WBP began in 2004. Staff who sustain a back injury are assessed by the OHD 

and followed up by a physiotherapist and/or orthopaedic referral if necessary. 

178 staff attended the OHD for this service in 2007. 

Information packs are provided on the intranet for managers and clinicians on the 

evidence-based management of Lower Back Pain (LBP). Information stands 

detailing the WBP was provided during the 2007 European Safety Week. 

Influenza vaccination programme 

Influenza vaccinations were provided to 543 staff in 2007. 

Infection Control activities 

Contact tracing procedures were carried out on the conditions listed on the next 

page: A total of 676 staff were contact traced. 


134



Contact Tracing 

• Brucella contact tracing: One case involving 10 staff in the microbiology 

laboratory, which necessitated follow up every 2 weeks for 3 months. 

• Meningococcal meningitis contact tracing: One case involving 16 staff. 

• Tuberculosis contact tracing: Two cases involving 110 staff. 

• Varicella-zoster virus contact tracing: This was the largest contact 

tracing done by the OHD in 2007, which included 19 clinical areas 

and 540 staff. 

• Norovirus: Eighty-nine staff contacted the OHD during 3 confirmed 

Norovirus outbreaks in 2007. 

• One hundred and ninety-eight staff contacted the OHD outside of 

Norovirus outbreaks with gastro-intestinal problems. Infection control 

advice was given. 

• A total of 306 appointments were offered to UCD student nurses for 

MRSA screening pre-placement, this is a significant increase since 

2006, 160 staff were offered appointments. 


1 % 2 % 16 % 

81 % 


TB = 10 

Varicella = 540 

Brucella = 10 

Meningoccoccal meningitis = 16 

Stress Management Activities 

Counselling support was provided to staff who are experiencing a range of 

emotional difficulties including stress as well as skills training in order to support 

ongoing personal and professional 

development. 

The aim of the Manager support service is to 

provide accessible, effective support to 

Managers in the management of their duties 

or if they have personal concerns. 

Staff Education and Training 

OHD contributed to and provided education and training in the following areas: 

• Induction to new staff members including general induction, overseas 

nurses and NCHD’s. 

• FETAC Programmes; 

• Safety Management programmes viz.: 

• ‘Be Sharp, Be Safe’; 

• Management of inoculation injuries presented to Emergency Department 

staff and NCHD’s and general operatives. 

• ‘The Management of Blood Borne Viruses’; 

350 

300 

250 

200 

150 

100 

50 

0 

• Blood Borne Virus, Cannulation and Venepuncture. 

28 

60 

17 

No of Appointments 

225 

1 2 3 4 5 6 7 

Individual Appointments 

Manager Appointments 

126 

171 

196 

52 49 

44 

55 

318 

2007 

No. of appointments = 318 

Provided to individuals = 89 

Provided to Managers = 131 

131 


135



St Vincent’s Private Hospital (SVPH) 

The service continues to expand. In excess of 200 staff availed of the following services in 2007: 

• Pre- Employment Health Assessments; 

• Immune status evaluation and vaccination– Hepatitis B, Measles, Mumps, 

Rubella, Varicella and Tuberculosis; 

• Management of inoculation injuries (15 needle stick injuries and 1 blood splash); 

• Management referrals; 

• OH Psychology; 

• Cytotoxic Surveillance. 

It is planned to expand the service further in 2008. 

Future Plans 

1. Strategic 

• Continuation of the implementation of a computerised software programme (Healthcare Manager) 

for OH data management; 

• Addressing the opportunities for improvement in the delivery of OH services highlighted in A) the HR 

strategy and B) the external review of OH services currently underway. 

• Continuation of the development of the policy and operational review process. 

• Continuation of the efforts to restore OH to its full staffing compliment. 

2. Information, training, education 

• To further develop the webpage designed to disseminate relevant information; 

• To extend and continue to develop a training and education plan in the light of HR and OH priorities; 

• To collaborate with Health & Safety about how best to influence health and safety behaviours and 

share good OH practice around the organisation. 

3. Quality Assurance 

• Use the Quality Assurance framework (Accreditation and Hygiene Services Assessment Scheme) to 

address common themes to ensure the provision of a safe and healthy work environment for staff. 

• Completion of a final review of the effectiveness of the Working Back’s Programme 

• Undertake audits in the following areas: 

• The OH process for managing work-related stress; 

• Needlestick injury statistics; 

• Flu vaccination uptake. 

• The pregnancy risk assessment process, ongoing audit for completion. 

• It is proposed to introduce the use of CORE (Clinical Outcomes in Routine Evaluation) in 2008. The 

CORE system is a standardised quality evaluation, audit and outcome benchmarking system for the 

psychological therapies. 


136




Overview 

St. Vincent’s Public and Private Occupational Therapy Services 

2007 was another busy year for the Department and the last quarter marked the merge of Saint Anthony’s 

Outpatient Occupational Therapy staff with the St. Vincent’s Inpatient staff to form a main Occupational 

Therapy Department situated on the first floor in the Allied Therapy Suite. 

In 2007 the Occupational Therapy staff continued to review communication methods with service users. 

Efforts concentrated this year on Patient Information. This resulted in the formation of two strands of patient 

information leaflets; one of which includes general service information and the second provides more 

detailed information on specific specialist Occupational Therapy services for example hands and plastics, 

adult mental health. 


St. Vincent’s 

We were fortunate to receive 1 pilot discharge facilitation post in Occupational Therapy in 2007. The aim of 

this post holder is to provide urgent Occupational Therapy (OT) intervention to those patients medically stable 

and only awaiting OT for discharge purposes. This resulted in our being able to access the particularly urgent 

cases in a more timely manner. 

Staffing remained relatively stable in the following areas 

- Medicine for the Elderly 

- Hands and Plastics 

- Stroke and Neurology 

- Pain Management 

There was some internal movement within the Department namely in the areas of Orthopaedics and Pain 

Management. We also had 1 successful staff member going from acting to permanent senior member of 

staff and one of the staff grades acting in a senior capacity . 

We also are very lucky to have recruited two senior therapists to Adult Psychiatry with strong mental health 

backgrounds and another senior Occupational Therapist to Orthopaedics with a strong acute and hands 

background. 

Service Developments/ Activities 

St. Vincent’s Occupational Therapy Department 

2007 was a very active time from an Occupational Therapy perspective. We achieved our service goal of 

reviewing our standards and commencing internal audits of our service. 


137

Occupational Therapy Statistics 

In reviewing our activity statistics from 2005 – 2007 some interesting trends have emerged. OT activity with 

regard to in-patients shows there are increases in the returns and attendances yearly whilst outpatient 

activity continues to show significant increases yearly. 

In-patients Totals 2005 - 2007 

Year New Return No. Of Units of 

Attend. 

Contact 

2005 1007 722 6147 21210 

2006 897 1065 8851 25742 

2007 993 917 9468 25806 

Outpatients Totals 2005 – 2007 

Year New Return No. Of Units of 

Attend. 

Contact 

2005 1385 1295 4351 18813 

2006 1296 1342 4931 14119 

2007 1548 1267 6399 20143 

138 

Units 

30000 

25000 

20000 

15000 

10000 

5000 

0 

Total Outpatients 2005 - 2007 

2005 2006 2007 

Return to Contents

Allied Health Professionals - Occupational Therapy Department 

Units 

30000 

25000 

20000 

15000 

10000 

5000 

0 

Total In-patients 2005 - 2007 

2005 2006 2007 


We had key members of staff acting as National Representatives and providing key pieces of work on behalf 

of our professional body (AOTI) on the following National Strategies; 

- Strategy to Prevent Falls and Fractures in Ireland’s Ageing Population. 

- National Stroke Audit and Strategy 

- Arthritis Needs assessment 

In terms of SVUH Accreditation one of the OT team is a team leader on the Bone and Joint team. In addition 

we have active input on the Neurology/ Care of the Elderly and Rehabilitation teams and the Adult and Old 

Age Psychiatry teams. 

Future Plans 

The Occupational Therapy Department has the following service plans for 2008 

- Audits to be completed in a number of key areas within the 


Working groups to actively target improved communication ideas between staff and Patients/ Clients. 


139



Pharmacy Department 


Major service developments and activities were: 

• Appointment of Medication Safety Co-ordinator 

• Clinical pharmacy service started in ED 

• 5th Edition of SVHG Medicines Guide published 

• SARI (Strategy for the Control of Antimicrobial Resistance in Ireland) pharmacist appointed 

• Dedicated CF clinical pharmacist appointed 

Dispensary Service 

There was a 13% increase in the number of items issued (average 28,737 items dispensed per month) as 

a result of increased service demands from clinical areas. 

Clinical Service 

The following appointments were made: 

Claire Keane, specialist CF clinical pharmacist and Zulema Gonzalez Sanchez, antimicrobial (SARI) 

pharmacist. 

A clinical pharmacy service commenced in ED. 

In 2007 clinical audits were completed on Antibiotic Use in General Surgery Patients and Venous 

Thromboprophylaxis in General Surgery Patients. 

Education 

Pharmacy staff provided lectures and workshops for undergraduate and postgraduate medical, nursing and 

pharmacy educational programmes. 

SVHG Prescriber’s Guide and Formulary 

The 5th edition of the SVHG Medicines Guide was circulated in September 2007. 

It includes Guidelines for the Peri-operative Use of Oral Medicines, Anticoagulant Guidelines and Clinical 

Nutritional Management Guidelines. It is also available on the hospital intranet and a PDF version was 

distributed to NCHDs. 

Aseptic Service 

In 2007 a total of 7956 items were prepared in the Aseptic Unit (ASU), a small decrease (~1%) on 2006. 

The number of chemotherapy items manufactured remained the same. Staff in the ASU dispensed medicines 

for 17 oncology research trials. 


140

Allied Health Professionals - Pharmacy Department 

Activity in the Aseptic Unit 2000-2007 

No. Units Manufactured 

9000 

8000 

7000 

6000 

5000 

4000 

3000 

2000 

1000 

0 

2000 2001 2002 2003 2004 2005 2006 2007 

No. of Items 5706 6023 7276 6777 6845 7845 8107 7956 

50 

% Change in Activity in the Aseptic Unit 2000-2007 

40 

30 

20 

10 

0 

2000 2001 2002 2003 2004 2005 2006 2007 

No. of Items (1,000’s) 5.706 6..023 7276 6.777 6.845 7.845 8.107 7.956 

% increase on 2000 0 6 28 19 20 37 42 32 

% annual increase 0 6 21 -7 1 15 3 -2 

-10 

2000 2001 2002 2003 2004 2005 2006 2007 

Medicines Information (MI) 

In August 2007, MI Databank®, a custom-built database package used in Medicines Information services in 

the NHS was implemented. 

The number of enquiries received increased (up to 1090 from 1049 in 2006). Enquiries, by source, are 

represented below. Figures are shown from August 2007 to the end of the year (from the time the new 

database was installed). 

Complex medication related enquiries increased to 69% (up from 62% in 2006). 

Most common types of enquiries received included administration/dosage (24%), adverse effects (17%), 

choice of therapy (11%), availability/supply (7.5%) and drug interactions (7%). 


141



No. Queries by Source Aug-Dec 2007 

St Agnes 

Microbiology/infection control 

Our Lady's Ward 

St Annes 

Emergency Dept 

Psychiatry 

HDU 

St Vincents 

Outpatients 

Pharmacy 

Lukes 3 

Dermatology 

CCU 

St Brigids 

St Michaels 

St Pauls 

St Annes Day Centre 

St Josephs 

St Johns 

St Laurences 

Dietetics 

ICU 

Theatres 

St Charles 

Other 

9 

5 

9 

22 

44 

16 

7 

5 

24 

53 

8 

10 

13 

22 

6 

22 

10 

27 

11 

5 

5 

42 

8 

5 

34 

0 10 20 30 40 50 60 

Medication Safety 

In August 2007, Niamh O’Hanlon was appointed as Medication Safety Co-ordinator for SVUH. The role 

involves working to ensure optimal patient outcomes from drug therapy by identifying risk in the medication 

management process and by making recommendations for process improvements designed to prevent or 

minimise error. 

The Medication Incident Report (MIR) database was interfaced with Diver®, a management information system, 

which enhanced information and feedback on drugs and processes involved in medication incidents. The MIR 

form was revised and the process of medication incident reporting was simplified. In addition to reporting via 

paper MIR form, e-reporting of incidents is now possible and is being undertaken in certain clinical areas. 


142


The SVHG Drugs & Therapeutics committee identified heparin and insulin as two high-risk drugs requiring 

priority attention. Multidisciplinary work is being undertaken to review, standardise and update guidance in 

relation to these drugs. 

The Irish Medication Safety Network (IMSN) was reconvened, facilitated by the Clinical Indemnity Scheme 

and SVUH is an active participant of this group. 

SVHG Drugs and Therapeutics Committee 

A multidisciplinary subcommittee developed a new in-patient prescription sheet for the hospital group. This 

is due to be launched in early 2008. The principal changes include a highlighted allergy section and inclusion 

of the intravenous fluids prescription. 

A subcommittee was also convened to facilitate the nurse prescribing initiative. 

Achievements 

Congratulations to staff who successfully completed the following courses: 

• Carmel Donnelly, MSc Hospital Pharmacy from TCD 

• Elizabeth Barry and Adele Flynn, Diploma First Line Management. 

• Claire Keane, Diploma Healthcare Management by the IPA 

• Elaine Hammond, Pharmaceutical Technician Course 

• Niamh O’Hanlon, Graduate Diploma Risk Management 

• Kathryn Feeley, Certificate Clinical Pharmacy 

• Maeve Moran, Diploma Clinical Pharmacy 

• Laura McCabe, American Health System 

Pharmacists (ASHP) patient care impact program: Introducing an 

Emergency Pharmacist into your institution. 

Publications and Posters 

McCabe L. Introduction of a Clinical Pharmacy Service into the Emergency Department, SVUH. 

Donnelly C, Fitzgerald S, McDermott E. Audit of Antibiotic Use in General Surgery Patients on a Surgical 

Ward. 


143



Kennedy F, Donnelly C. The Electronic Clinical Pharmacy Worksheet (Ecpw). 

O’Sullivan M. Development of Guidelines for the Peri-operative Use of Oral Medicines in SVUH. 

Crawford AM, Hammond E. An Audit of Supplier Errors in Deliveries to the Pharmacy Department of a 

Large Dublin Teaching Hospital. 

Hammond L, Kavanagh D, McDermott E. Audit of Venous Thromboprophylaxis in General Surgery Patients 

on a Surgical Ward. 

Walker SL, Kennedy F, McCormick PA. Drug-induced Fulminant Hepatic Failure Leading to Liver 

Transplantation. How Safe is Nimesulide? 

Flanagan M, O’Hanlon N, Strawbridge J. Documentation of Clinical Pharmacy Activity in St. Vincent’s 

University Hospital. 

Kennedy F, Kingston C, Marsden E. Survey of Clinical Pharmacy Services in the DATHs Hospitals. 

Conferences 

All Ireland CF Meeting, Killarney, February 2007. C. Keane. 

Update on Coagulation Study Day; SJH, March 2007. M. O’Sullivan 

HPAI Annual Educational Conference, Dublin, April 2007. 

British Renal Society Conference; London, June 2007. K. Feeley. 

Guide to Reducing Clostridium difficile, Manchester, July 2007. Z. Gonzalez Sanchez. 

UKCPA Critical Care Study Day; London, September 2007. M. O’Sullivan, K. Feeley. 

ECCO 14 (European Cancer Conference), Barcelona, September 2007. AM. Defrein. 

BOPA Annual Conference, Glasgow, October 2007. E. Marsden, L. Hammond. 

UKCPA Infection Management Group, Birmingham, October 2007. Z. Gonzalez Sanchez. 

UK & ROI Liver Pharmacists Group Meetings, Dublin and London. F. Kennedy. 

Joint Conference of the AMRAP and SARI Groups, Belfast, November 2007. Z. Gonzalez Sanchez. 

Hepatology Conference; Dublin, November 2007. K. Feeley. 

ASHP Mid Year Clinical Meeting; Las Vegas, December 2007. L. McCabe, N. O’Hanlon. 

RCPI Focus on Infection, Dublin, December 2007. Z. Gonzalez Sanchez. 

Future Plans 

• Review Intravenous Potassium Guidelines in 2008. 

• Review Unlicensed Medicines Policy. 

• Commence electronic ordering of medicines 


144



Physiotherapy Department 


Deputy Manager: Orla Daly commenced as Deputy Manager in November following successful Acting 

Deputy Manager terms by Karen Cradock and Martina Fitzpatrick. 

Cystic Fibrosis: an additional 2.5 WTE Senior Physiotherapists were assigned to the department as part of 

national developments in the provision of service to patients with cystic fibrosis. 

Tutoring: 0.5 WTE physiotherapy tutor was assigned to the department by the National Hospitals Office. This 

increased the department’s ability to accommodate undergraduates for their clinical practice training. The 

department is now committed to providing clinical placement to 12 UCD undergraduate physiotherapy 

students at a time from August to June each year. 

ITU: 0.5 WTE Senior was granted towards provision of service to expanding bed numbers in ITU. 


Cystic Fibrosis 

Increase in capacity to provide higher standards in in-patient and outpatient care was developed in 

accordance with increases in staffing to the service. In-patients are now treated twice daily in accordance 

with international standards. Patients on home IV therapy are reviewed twice following discharge and all 

outpatients are reviewed every three months. Two pieces of research were conducted for publication in 

2008. 

New Allied Therapy Suite 

With the close of St Anthony’s Rehabilitation Centre, a new treatment area was designed and built in 2007. 

Physiotherapy services in Rheumatology, Pain Management, GP Direct Access and outpatient neurology\ 

rehabilitation were re-housed in the Allied Therapy Suite in the main building. The move brings greater 

opportunities for combined care to be arranged for patients attending more than one therapy and allows 

therapists greater opportunities for collaborative work. Presence of the St Anthony’s physiotherapy team in 

the main hospital building enhances communication and teamwork within the Physiotherapy Department. 

IT / Statistics 

The existing package was upgraded to allow greater speed of input and importing of episode information 

from the PAS system. 

Critical Care 

Enhanced provision of early physical rehabilitation to ITU patients has resulted from increases in space 

available in the new unit. Joanne Barry presented on the role of physiotherapy in liver transplantation at the 

'U.K. and Ireland Liver Transplant Meeting' hosted by SVUH. 


145


Allied Health Professionals - Physiotherapy Department 

Multi-disciplinary Education 

In collaboration with Nursing Practice Development, Joanne Barry Senior Physiotherapist in Critical Care, 

commenced teaching a module in suctioning and humidification as part of the bi-annual the multi-disciplinary 

tracheostomy-training day. 

Ergonomics 

10 bariatric patients were admitted to SVUH in 2007. The small library of bariatric equipment maintained by 

ergonomics was extended and a bariatric policy was drafted for circulation in 2008. An evaluation of electric 

beds was completed to aid selection for purchase in 2008. Theresa Flynn is currently working with the HSA 

to develop FETAC standards for Manual Handling training and to develop video training clips on MH risk 

assessment for the HSA web site. An Eight day in-house course was provided in May to train 7 staff 

members to become Instructors in Moving and Handling. Course participants came from Nursing, Portering, 

Physiotherapy and Catering. A hospital wide patient handling risk assessment form (Easymove form) was 

launched in October 2007 after a gradual rollout process over the last few years. 

Management 

A 2 day course in business planning was developed and provided to seniors in September and October. 

Topics covered included the business planning framework in an Irish context, service and client analysis, 

process mapping, measuring throughput capacity, service evaluation and effective communication in the 

planning process. Each team developed a service plan for their area and identified changes that might 

enable a more streamlined provision of service. The aim with management training for seniors would be to 

enable them to implement modifications to their service as patient’s needs change. 


Martina Fitzpatrick, Clinical Specialist:. A literature review on Exercise in Ankylosing Spondylitis was awarded 

the Irish Rheumatology Health Professional Abbott Educational Bursary to fund attendance at the 2007 

American College of Rheumatology Conference in Boston, U.S.A. 

Keith Smart commenced his Health Research Board funded PhD at University College Dublin, entitled, 'The 

development and preliminary validation of a mechanisms-based classification of musculoskeletal pain'. 

Joanne Barry graduated from the National College of Ireland with a Diploma in Supervisory Management in 

November 2007. 

Significant publications 

Smart K, Doody C. The clinical reasoning of pain by experienced musculoskeletal physiotherapists. Manual 

Therapy 2007; 12:40-49. 

Brulhart L, Fitzpatrick Martina, Bresnihan B, FitzGerald O, Kane D, Veale DJ. Musculoskeletal ultrasound in 

the rheumatology outpatient clinic: Experience from a single centre in Ireland. Poster presentation at 

American College of Rheumatology Conference 2007. 

An Investigation Into The Factor Which Motivates Patients To Attend For Outpatient Physiotherapy. Eimear 

O'Sullivan, Riona Murtagh, Marese Cooney;Trinity College Dublin, School of Physiotherapy, Dublin, Ireland 

Presented at WCPT, Canada, June 2007 


146

Allied Health Professionals - Physiotherapy Department 

Ivers, M., Dooley, B., Bates, U., Barnes, E., Craddock, K., Reilly, C., Slevin, M., Toole, C., and Malone, K. (2007). 

The CANSURVIVOR Project Development and Evaluation of a Bio-psychosocial Rehabilitation 

Programme for Post-treatment Survivors to Maximise Quality of Life and Quality Cancer Care. Poster 

presented at 9th World Congress of Psycho-Oncology (IPOS), London, September 18th, 2007. Psycho- 

Oncology, 16(9) supplement:S273. 


Patient Referrals 

Patient Attendances 

12000 

11000 

10000 

9000 

8000 

7000 

6000 

5000 

4000 

3000 

2000 

1000 

2002 2003 2004 2005 2006 2007 

85000 

80000 

75000 

70000 

65000 

60000 

2002 2003 2004 2005 2006 2007 

Future Plans 

Investigate the feasibility of introducing a computerised out-patients scheduling system. 

• Develop definition of physiotherapy services for placement on SVUH Intranet. 

• Implement the use of KPIs within the department. 

• Develop outpatients services in neurology and respiratory. 

Catherine Toole, 

Physiotherapy Manager 


147



Department of Preventive Medicine and Health Promotion 


Head of Department 

Professor Cecily Kelleher MD, FRCPI, MPH, FFPHM, MFPHMI 

Health Promotion Officer Ms Jacinta Barnewell RGN, SCM, ADV. DIP. MONTESSORI ED (until Nov 2007) 

Dr. Anna Clarke LRCP&SI, MB, MPH, FRCPI, FFPHMI, FFPH 

Dr. Kirsten Doherty BSC, MPH, PHD 

Ms. Marion Fitzgerald BNS, RSCN, RGN (until December 2007) 

Ms Irene Gilroy BSc 

Ms. Carol Pye RGN, RM 

Ms. Tina Mooney RGN, DIP MGT, HDIP HP (until April 2007) 

Health Promotion Coordinator 

Ms. Denise Comerford RGN, RM 

Health Promotion Nurse Ms. Veronica O’Neill RGN, RM Ms. Brenda Whiteside RGN, RM 

Clinical Specialist Dietitian 

Secretary 

Ms. Vivien Reid MSC, DIP DIET. 

Ms. Frances Conlan 

Allied UCD staff 

Professor Leslie Daly, MSc, PhD, FFPH 

Dr. Patricia Fitzpatrick MD, MPH, FRCPI, FFPHMI. 

Service Developments/Achievements 

Service to Patients 

Cardiac Services 

• 24 Hour Ambulatory Blood Pressure Monitoring Service 

This service is provided for both in-patients and outpatients of hospital consultants and general practitioners. 

There has been a 15% increase in the number of referrals to the service in 2007. 

2500 

24 Hour Blood Pressure Monitoring Service 

Referrals and Total Attendances 

2000 

1500 

1000 

500 

0 

721 886 1022 1442 1772 2044 

2005 2006 2007 2005 2006 2007 


148


Allied Health Professionals - Department of Preventive Medicine and Health Promotion 

• Cardiac Rehabilitation 

This department’s involvement in cardiac rehabilitation continues. The monthly cardiac lifestyle information 

session is open to patients and the general public. 

Smoking Advice Service 

This service continued to be delivered to in-patients, outpatients and staff who were interested in stopping 

smoking. The increase in reviews seen in 2007 reflects the need to regularly reassess patients’ nicotine 

requirements for efficacy while in hospital. In July 2007, a pilot workshop was held for CNMs and Senior Staff 

Nurses to explore ways of dealing with patients and relatives who smoke in a smoke free campus 

environment. SVUH was awarded the European & National Network for Smoke Free Hospitals Silver award 

and the Tom Hurst Award from the International Network for Smoke Free Hospitals in recognition of its 

smoking cessation programmes. 

Smoking Advice Service Activity 2005 - 2007 

2500 

2000 

1500 

1000 

500 

0 

268 450 392 572 570 587 1699 1634 2189 

2005 2006 2007 2005 2006 2007 2005 2006 2007 

Group Attendance Initial Interventions Reviews 

Culinary programme for overweight cardiac patients: a randomised controlled trial. 

This programme is run by this department and is a co-operative initiative with the National Nutrition 

Surveillance Centre, UCD, Community Dietetic Services of the HSE, Dublin Mid-Leinster Bray and the 

Cardiac Rehabilitation Coordinator, SVUH. It is partially funded by a Noel Hickey Bursary which was awarded 

by the Irish Heart Foundation (IHF). 

Overweight and obese patients were invited into the study from a census of all cardiac patients who 

completed the rehabilitation programme in 2006/07 (n =172). To date 62% have agreed to participate. Half 

of these people have been systematically randomised into a cookery skills course, with an 80% participation 

rate. The first of three courses in this pilot phase of the study took place in autumn 2007. 


149



Nutrition 

The Clinical Specialist Dietitian provides an integrated clinical and health promotion service, including inpatient 

and outpatient services and group sessions. “Behaviour Change Skills (Level 2): Motivational 

Interviewing” training course was provided for Community Dietitians in association with the UCD School of 

Public Health and Population Science. 14 Dietitians attended in total with the majority from the HSE, Dublin 

Mid-Leinster area. 

Safe and Moderate Alcohol consumption (SMAC) Policy development. 

The multidisciplinary committee met to discuss the development of a comprehensive policy which would 

include staff education and training and the development of patient referral pathways, with community links 

being vital in this regard. As a result, the importance of accurate assessment and charting of patients’ alcohol 

consumption is now covered in the nursing and medicine induction days. A focus stand, “Pour yourself a 

drink”, was developed to provide education to patients, staff and visitors on what a unit of alcohol is. Alcohol 

workshops were facilitated by Denise Comerford at the International Health Promoting Hospitals (HPH) 

meeting and the All Ireland HPH meeting. 

Service to Staff 

• Bi-monthly health promotion education sessions were provided to departments, including medical 

interns, nursing and general staff induction programmes. 

• “Healthwise SVUH” was published with contributions from staff and distributed quarterly. 

• Launch of a “Slí na Sláinte” route for National HPH Hospital Challenge Day (HCD), focused on 

increasing physical activity. 736 people signed up to do 15 minutes physical activity, take part in the 

“DART Challenge” (how long it took to walk from the DART to SVUH) and guided walks on the day. 

A ‘No Chip Day’ continues now every Thursday. SVUH received an award for the highest number of 

participants taking part in HCD in an organisation of over 2,000 staff. 

• A smoking advice service was provided to the estimated 18% of staff who smoke. 

Service to the Community 

• 1,000 transition year students from schools in the catchment area of the hospital attended our 

seminars on alcohol awareness (x2), cancer awareness, smoking active and passive, bugs, 

superbugs and preventing infection and healthy eating. This year a session on “Road Safety 

Awareness”, in conjunction with the Road Safety section of An Garda Síochána, was also offered. 

• Four stop smoking courses were run in 2007, attended by patients and other members of the public. 

• A smoking awareness stand was set up in the hospital for “National No Smoking Day”. Carbon 

monoxide testing was offered to all who wanted to avail of it on the day. 

Health Promoting Hospitals 

Denise Comerford and Dr Anna Clarke are members of the Executive of the National HPH Network. 


150



Clarke A, Comerford D, Gilroy I, Fitzpatrick P, Tan LM, Pathmadevan R, Daly L, Kelleher CC, 

Mulcahy R. (2007). 

Secular trends in smoking in St. Vincent’s University Hospital 1977 – 2006 – Support for an outright 

campus wide ban? 

Proceeding of the International Health Promoting Hospitals Conference, Vienna, April 2007. 

Gilroy I, Tan LM, Pathmadevan R, Daly L, Clarke A, Fitzpatrick P, Ulmer H, Kelleher CC. 

How useful a predictor of gamma glutamyl transferase (GGT) is alcohol consumption in a hospital 

population?: Findings of a census survey at St. Vincent’s University Hospital. 

Proceedings of the Faculty of Public Health Medicine Summer Scientific Meeting, Dublin, May 2007. In Press. 

Reid V, McDonagh M, Moloney M, Quinn M, Clarke A, Daly L and Kelleher C. (2007) 

Are lifestyle changes maintained 5 years after participation in a cardiac rehabilitation programme? 

Journal of Human Nutrition and Dietetics, 20, p365 (abstract). 

Doherty K, Daly L. (2007) 

Irish tobacco legislation increases smoking cessation in hospital patients. 

Abstracts from the UK National Smoking Cessation Conference, 14-15 June 2007, London. 

Journal of Smoking Cessation, 2 Supplement p 12-27. 

Comerford D, Gilroy I, Doherty K, Clarke A, Conlan F, Daly L, Fitzpatrick P, O’Neill V, Kelleher CC. 

Smoking prevalence and attitudes to smoking among student nurses 10 years on: Cross-sectional followup 

study. 

Proceedings of the Faculty of Public Health Medicine Winter Scientific Meeting, Dublin, December 2007. In 

Press. 


151



Speech and Language Therapy Department 

1.Move to the Allied Therapy Suite 

In December’07, the Department moved from St. Anthony’s Rehabilitation Centre to the newly renovated 

Allied Therapy Suite on the first floor. It is a major development for the Department to have a base in the 

main hospital so close to many of our key service areas ENT, Neurology and the Stroke & Care of the Elderly 

services. This move has resulted in many positive benefits for our patients, staff and overall service. 

2.Staffing 

Eavan McSweeney joined the department on 08/01/07 as a staff grade therapist. In July 2007, Karen Kirke 

commenced working in the department after graduating from the University of Limerick with a postgraduate 

masters in Speech and Language Therapy. 

In September’07, Deirdre Kidney our senior therapist in Neurology went on maternity leave and Caoimhe 

McDermott took over this position in an acting capacity. 

3. Current Level of Service Delivery: 

The Speech and Language Therapy Department provides both an in-patient 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 2007. 

Clinical Specialities/Speech and Language Therapy Treatment units 2007 

3000 

2500 

2000 

1500 

1000 

500 

Medicine for the elderly 

ENT / Plastics 

Oncology 

Surgical 

Respiratory 

Gastroenterology 

Neurology 

Cardiology 

Endocrinology 

Rheumatology 

Nephrology/Psychiatry 

0 

1,928 1,541 359 803 1,235 1,176 2,411 159 208 382 645 


152


Allied Health Professionals- -Speech and Language Therapy Department 

Clinical Specialities 

Treatment Units 

Medicine for the Elderly 1,928 

ENT / Plastics 1,541 

Oncology 359 

Surgical 803 

Respiratory 1,235 

Gastroenterology 1,176 

Neurology 2,411 

Cardiology 159 

Endocrinology 208 

Rheumatology 382 

Nephrology / Psychiatry 645 

4. Specialised Clinics – Swallowing and Voice 

Digitalfluoroscopy 

This specialised clinic is run jointly by the Speech and Language Therapy Department and Dr. Dermot 

Malone, Consultant Radiologist. It continues to be the only digital fluroscopy service in the East Coast Area. 

Referrals are accepted from St. Michael’s Hospital, St. Vincent’s Private Hospital, the National Rehabilitation 

Hospital and the Royal Hospital Donnybrook. The clinic takes place in the Flursoscopy Unit on the 2nd floor 

of the Ambulatory Day Care building. Two weekly clinics are scheduled on Wednesday and Friday mornings. 

No. of patients 

200 

180 

160 

140 

120 

100 

80 

60 

40 

20 

0 

-25 % +12 % 

+40 % 

28 46 75 82 97 152 159 148 111 124 

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 


153



Fees 

The Fiberoptic Endoscopic Evaluation of Swallowing (FEES) assessment clinic is 

conducted jointly by the Speech and Language Therapy Department and the ENT 

team. This service commenced in July’04 and is completed either at the patient’s 

bedside or in the Voice Lab room in the ENT OPD suite on the first floor. 

50 

45 

40 

36 

38 

No of patients 

30 

20 

10 

12 

0 

2004 2005 2006 2007 

Digital Stroboscopy 

This service has been running for the past five years and is part of our weekly 

voice clinics. It provides accurate information on the shape, condition and 

functioning of the vocal cords. It also allows the team to make a permanent record 

of the vocal cords vibratory patterns, which may be used to monitor progress and 

treatment outcomes measures. 

No of patients 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

25 

78 

82 

71 

74 

53 

2002 2003 2004 2005 2006 2007 


154



Training and Development 

• Throughout 2007, the Department was involved in a number of presentations both within and outside 

the hospital. 

• We continue to provide input to nursing and physiotherapy students. 

• The Department provided several placements for speech and language therapy students. 

• We also continued our extensive in service training programme which was particularly useful given the 

number of new staff in the department. 

• In August’07 the department was also involved in the Tracheostomy Study Day organised in 

conjunction with the nursing practice development staff. 

Significant Courses/Conferences 

Fionnuala Duffy and Ruth Maxwell both graduated from TCD with their M.Sc. degrees. 

Caoimhe McDermott and Eavan McSweeney both successfully completed their postgraduate dysphagia 

training. 

Caoimhe McDermott also completed the Lee Silverman Voice Training (LSVT) Programme. 

Special Thanks 

I would like to thank all the staff in the Department for their support and help with our major move. I would 

also like to thank all the other staff throughout the hospital who helped to make our move so successful, 

hospital management, Mr. John McDonagh, portering and IT services. 


155

156 

Dignity

Report from the Director of Nursing 

Bed Management 

Hospital Sterile Services Department 

Hospital Hygiene Services 

157

Department of Nursing 

The Department of Nursing continued to demonstrate its commitment to the delivery of quality and safe 

patient care throughout 2007. It is important to acknowledge the continued contribution made by nurses to 

the provision of evidence based nursing care locally, nationally and internationally through poster 

presentations, journals and conference presentations. Many nurses have lead out on various projects and 

initiatives involving service developments, clinical audit, education and training developments. Welcome to all 

those who joined our nursing department and good wishes to all those who retired during the year following 

a long and dedicated service. It was with great sadness we report that one of our nurses passed away during 

the year. 

Service developments 

The following is an example of the many initiatives: 

• The nurse led ICU Outreach Service project, supported by the National Council for the Professional 

Development of Nurses and Midwives commenced in June 2007. 

• Management of patients with dermatological conditions were enhanced with the introduction of new 

nursing led services such as phototherapy, cryotherapy, nurse monitoring and skin surveillance 

clinics. The increased activity in the Cardiac Cath Lab presented many staffing challenges and a 

system of staff rotation between CCU and the unit was successfully introduced and supported with 

education and skills development. 

• Nurse led initiatives in cardiac rehabilitation included education sessions for newly diagnosed heart 

failure patients and a home follow-up by the Advanced Nurse Practitioner in Heart Failure for 

discharged low-risk heart failure patients. 

• Nursing staff facilitated the opening of the DXA Osteoporosis Unit in Jan 2007. 

• The colorectal and stoma care-nursing specialists continued to develop prevention and management 

educational strategies for patients with pelvic floor disorders. 


158


Department- Nursing 

• Nursing teams conducted audit within service areas, clinical practice and education with many 

quality improvements to be introduced locally and hospital wide. The Emergency Department staff 

focused on triage activity and nursing documentation. The Infection, Prevention and Control and the 

HSSD nursing teams actively participated in the two national audits conducted within the hospital: 

the National Hygiene Services Audit and the Decontamination Audit. The results demonstrated that 

the hospital featured as one of the top hospitals in the country in compliance with both sets of 

standards. Evaluations in Undergraduate BSc Nursing examined changes to nursing students shift 

patterns in the clinical settings and their impact on their learning experience. 

Education, Training and Skills Development 

The Nurse Education Centre continued its provision of education and professional development programmes 

for staff in St Vincent’s Healthcare Group and the East Coast Area. During the year, Intensive Care, Cardio 

Vascular, Emergency and Oncology Post Registration Diploma programmes were facilitated in partnership 

with University College Dublin. Foundation Skills courses in Intensive Care and Peri-Operative Nursing were 

developed in conjunction with the associated areas. In-service training programmes were provided for SVUH 

staff such as: nurse orientation, administration of intravenous medications, intravenous cannulation and 

venepuncture, intravenous assessors and preceptorship. LEO programme and FETAC programmes for 

Healthcare Assistants were provided to staff within the group and the East Coast Area. 

Nurse Practice Development (NPD) facilitated and lead numerous projects and initiatives. The management 

of patients with chest drains and tracheotomies were of particular focus, with NPD coordinating and 

developing a multidisciplinary tracheostomy study day in August. The Department’s development of a specific 

orientation programme for nursing students making the transition to qualified nurses continued to prove a 

huge success amongst participants as were the guidelines developed by NPD to support CNMs and 

registered nurses on conducting staff probation assessments. 

The National Nurse Prescribing initiative, which is being coordinated locally through NPD, is a major 

advancement for the delivery of quality patient care. Six nurses within the organization successfully 

completed the RCSI nurse-prescribing programme and graduated in October, which will facilitate the 

introduction of nurse prescribing. 

The Resuscitation Department provided in-service education and training for over 1,000 staff including a 

“hands free” defibrillation initiative in ADCC. 

Nurse Bank 

The Nurse Bank was established in July 2007 as part of a DATH’s two-year value for money project. All 

requests for additional registered nurse staffing resources are now centralised and managed through the 

bank office. The primary objective is to recruit bank only nurses who will be allocated to cover shifts that 

historically were covered by agency staff. 


159


Nursing Graduation 

The annual graduation ceremony took place on the 5th of July. Congratulations to all the BSc nursing 

students who graduated and to those who were presented with awards. All of the graduates took up 

employment in the hospital. 

Plans for 2008 

• Continue with the introduction of nurse prescribing. 

• Introduction of in-house hygiene audit tool. 

• Centralization of requests for additional HCA through the Nurse Bank office. 

• Clinical Learning Environments audit in line with An Bord Altranais Standards. 

• Participate in the implementation of integrated care models across the continuum of care. 

• Commence implementation of recommendations of An Bord Altranais Assessment (2007) 

• Preparation for the BSc nursing students new internship programme. 

• Roll out of the revised medication administration record designed for use across the organisation. 

• Launch of CPAP policy, and provision of CPAP education and training. 

• Establishment of a training programme for procedural sedation in line with policy development in areas 

such as Cardiac Cath lab and Radiology. 

• Introduction of Clinical Information System in ICU in line with planned “go-live” date. 

• Development of business cases for Advanced Nurse Practitioner posts in specialities based on patient 

and service needs. 

• Introduction of DNA CPR Guidelines. 

• Participate in the implementation of the National Report on Post Graduate Nurse Education. 

Mary Duff 


Ms. S. Brennan 

ADON Coordinator 


160


Department - Bed Management 

Bed Management 

The function of the Bed Management Department is to oversee all daily admissions, transfers and discharges 

to and from the hospital. In doing so we aim to balance the demands of the Emergency Department (ED) 

with those of urgent/ non-urgent elective work with available beds. 

St Vincent’s University Hospital’s in-patient bed capacity is currently 514. The focus of the Bed Management 

Department for 2007 was to move away from the traditional bed allocation role and to focus on a more 

strategic approach to capacity management. In doing so a number of new initiatives were introduced and 

are part of an on going approach: 

• Reconfiguration of St Raphael’s, St. Teresa’s Wards and the old I.C.U into a combined protected 

surgical unit, St Luke’s. This new arrangement facilitates speciality specific referral and admission 

from the ED. This area will also pilot documenting the Estimated Date of Discharge (EDD) on all 

patient’s notes. 

• Designated wards for all patients under the care of respiratory physicians allocated. The EDD 

will also be piloted here. 

• Escalation Policy revised. The key feature being that if there are in excess of 20 patients in the 

ED at 0730 hrs awaiting beds, a minimum of ten patients must move to the wards by 0930, to 

facilitate throughput. 

• Weekly Key Performance Indicators relating to Bed Management are now distributed (e.g. Length 

of Stay, Turn Over, Activity etc). 

• Collaboration with the Social Work Department to address delayed discharges. 

• On occasions 11 emergency beds opened on St Clare’s Ward (Former ED) to relieve pressure in 

the ED. 

• Task force group formed to address use of semi private beds resulting in optimising bed use on 

St Michael’s Ward and other designated semi-private areas. 

• Task force established to address discharge planning and work is ongoing. 

• IT systems up-dated within the department. 

• All policies updated relating to Bed Management 

• Comprehensive research on best practice in bed management (on-going) 


161



Hospital Sterile Services Department - HSSD 

Activities 

The National Hospitals Office has undertaken a national review of standards and practices for decontamination 

of reusable invasive medical devices in all public acute hospitals. 

The review was to be carried out by an independent company, Healthcare Science Ltd., who has vast 

experience in this field. The HSSD manager, Ms Ita Balfe, was the ‘link person’ between the NHO and the 

hospital, in order to facilitate a comprehensive consultation process throughout the organization. Prior to the 

official review Ita and the infection control team undertook an internal audit of all departments and wards 

using reprocessed medical devices. This proved very beneficial to all concerned as it highlighted areas that 

were meeting standards and those that needed some additional attention. The formal Decontamination 

review took place over 4 days It was intensive and thorough through out the organization. Congratulations to 

all involved in preparing staff and areas for the review. The organization scored highly and came in the top 5 

hospitals in the country. Well done to Ita and all concerned. 

Education 

Sinead Moran and Stephen Newman commenced their BSC, in Sterile Services; at the Institute of 

Technology; Tallaght. September 2007. 

Maribel Franco is undertaking a Masters in Sterile Services (distance learning) from The University of 

Scotland. October 2007. 

5 members of the technical staff are completing the skills programme in decontamination. 

It is proposed to look at competency based training for all technical staff in the year ahead. 


2007 saw further increases in activity levels for reprocessing medical devices in HSSD. The department has 

taken on the decontamination and reprocessing of flexible scopes from Theatre. This is a major undertaking 

and has been successfully integrated with only 5 additional staff. Thank you to all concerned for your 

cooperation in this transfer. 

Due to lack of capacity for sterilizing its own medical devices at St. Columcille's Hospital Loughlinstown the 

HSSD at SVUH has also taken on work from there. Each day sets are received, reprocessed and dispatched 

back sterile to St. Colmcille's Hospital. 

There are many positive projects happening in our HSSD, thanks to a dedicated and hard working group of 

people, nurtured and supported by their manager Ita Balfe. Unfortunately Ita leaves us at the end of January 

2008. She will be greatly missed by her friends in HSSD because that is what she is to each of them. Ita’s 

background is Theatre where she worked for most of her professional career .It was here she gained her 

knowledge and developed her interest in decontamination and sterilizing of medical devices. Her colleagues 

in theatre will miss her and wish her well in all her future undertakings’. Good luck and best wishes for a long 

and happy retirement Ita. 


162

Hospital Hygiene Services 

St. Vincent’s University Hospital continued its commitment to providing a clean and safe environment for 

patients, visitors, staff and members of the general public in 2007. 

St. Vincent’s University Hospital participated in the Annual National Hygiene Audit facilitated by the Irish 

Health Services Accreditation Board in 2007. A team of four assessors spent two and a half days in the 

Hospital and arrived unannounced on the 28th March 2007. The Assessment Team included two Directors 

of Nursing, an Environmental Health Officer and an Independent Food Hygiene Consultant. 

The Assessment team focused on issues such as hand hygiene, laundry management, contract cleaning, 

waste and facilities management. Members of staff and several patients were interviewed during the facility 

tours. A documentation review, including policies, training records, catering and waste management records 

was also undertaken. The Assessors also met with members of the Hospital Hygiene Quality Improvement 

Group and members of the Senior Management Team. 

No high-risk issues were identified during the survey and the general feedback to the hospital was good. 

They complimented staff on their friendliness and openness during the facility tours. St. Vincent’s University 

Hospital received an overall rating of ‘Good’. 60.71 % of scores were A ratings (Exceptional Compliance)and 

39.29 % were B Ratings (Extensive Compliance). 

The report identified a number of priority improvement plans regarding minor capital upgrade of clinical areas, 

improved storage facilities, greater input from patients/clients in hygiene issues and the identification and 

monitoring of Key Performance Indicators. 

An independent external hygiene audit was also carried out in March 2007. It covered clinical and nonclinical 

areas, kitchens, receptions, public areas and toilets. Departmental action plans were drafted as a 

result of the audit findings. 

Work began in the fourth quarter of the year to develop a Hygiene Audit Tool. The tool encompasses the 

seven core criteria within the service delivery section of the Hygiene Services Standards. The tool will be 

rolled out across the hospital early in 2008. 


163


Department- Hospital Hygiene Services 

The Infection Prevention & Control team continued a hospital-wide education and training programme in 

2007. The Infection Prevention & Control Liasion programme was evaluated and relaunched. A range of 

patient information leaflets were introduced and a web page on the SVUH Intranet was designed and 

launched. 

Ongoing refurbishment of exisiting facilities continued across the site, notably a new Allied Therapy suite was 

commissioned on the 1st floor of the main ward block. Redevelopment of the Emergency Department is also 

underway. A refurbishment programme was approved for toilet/bathroom facilities within the exsisting ward 

block, this work is due to commence in 2008. An Estates Strategy Group was established and will review all 

developmental requests. 

Household Services have developed a curtain changing procedure for all clinical areas, which will be be 

issued early in 2008. 

The waste management process has been consolidated and is now contracted to a single operator Oxigen 

Environmental Ltd. 

The Theatre Infection Control sub group continued to meet monthly to monitor hygiene standards in the 

theatre complex. 

The new Irish Standard I.S. 340: 2007 – ‘Hygiene in the Catering Sector’ published this year has been 

incorporated into the practices and procedures of the Catering Department. A range of food hygiene and 

HACCP training was delivered to both Nursing Students and clinical staff in clinical areas. An induction 

training package for part-time/locum staff was developed covering all aspects of hygiene in the catering 

department. 

St. Vincent’s University Hospital continued its partnership with Noonan Services Contract Cleaning Limited. 

The company introduced its own auditing system using a PDA tool, the new Clinical Services building was 

incorporated into this in July 2007. 

The Hospital Hygiene Quality Improvement Group continued to meet on a monthly basis, chaired by the 

Director of Nursing. The membership of the group was expanded early in the year to include 

Sheridans(Catering), Spring Grove(Laundry) and Cannon(Hygiene). The group reviewed and reissued a 

number of hygiene related policies and procedures and continue to address the requirements of the National 

Hygiene Standards. Many thanks to all staff for their participation and support in implementing the National 

Hygiene Standards. 


164

165

Health 

Report from the Professor of Medicine 

Report from the Chairman of Physicians Subgroup 

Department of Anaesthesia, Intensive Care and Pain Medicine 

Department of Cardiology 

Department of Dermatology 

Department of Endocrinology and Diabetes Mellitus 

166

Department of Medical Oncology incorporating Lios Aoibhinn 

Cancer Support Centre 

Department of Medicine for the Elderly 

Department of Nephrology 

Department of Neurology 

Department of Clinical Neurophysiology 

Department of Palliative Medicine 

Department of Respiratory Medicine 

Bone & Joint Unit 

Department of Rheumatology 

Department of Rehabilitation Medicine 

167


Department - Medicine 

Report from the Professor of Medicine 


Consultants Professor Michael Keane Dr Huzaifa Adamali 

Registrars Dr David O’Dwyer Dr Yusef Vapra 

Special Lecturers Dr Boon Beng Shu Dr Paul McElwaine 

Dr Ijaz Kamal 

Administration Manager/Student co-ordinator 

Barbara Cantwell 


Inpatients 

Admissions 453 Discharges 435 Day Care 54 

Outpatients 

New patients 121 Return visits 1382 

Service Developments 

Professor Michael Keane took up his appointment as Professor of Medicine and Consultant Respiratory 

Physician on September 1st. He replaced Professor Muiris FitzGerald who retired after many years of 

dedicated service to St Vincent’s University Hospital and University College Dublin (UCD). Dr Seery was 

appointed as a permanent College Lecturer/Consultant Physician. 

Curricular reform continues at UCD with significant changes being implemented in the undergraduate 

teaching programme as it moves towards a fully modular programme. 2007 was the last year when students 

would follow the old format of “Res Year” and they will also be the last group to follow the traditional Final 

Med structure. Graduate entry to Medicine was approved forUniversity College Dublin (UCD) and the first 

group of students will commence in 2008. 

The unit continues to provide a busy clinical service as evidenced by the in-patient and outpatient activities. 

The unit continues its tradition of providing a national referral centre for interstitial lung disease. The unit 

continues with its academic activities with both Professor Keane and Dr Donnelly being active investigators 

at the Conway Institute in UCD. Professor Keane is on the editorial board of the American Journal of 

Respiratory and Critical Care Medicine, American Journal of Physiology; Lung Cellular and Molecular 

Physiology, Fibrogenesis and Tissue Repair and is an Associate Editor for the Journal of Immunology. 

The Dublin Academic Health Centre (DAHC) was established to foster greater collaboration and interactions 

between the St Vincent’s University Hospital, Mater Misericordiae University Hospital and the Medical School 


168


at UCD. This follows the model of academic medical centres, which have been established internationally 

and will potentially represent a major advance in how health care is delivered in Ireland. 

UCD continues its links with Penang Medical College and Dr Donnelly travelled to Penang in June as an 

examiner in the Final Medicine Examination. 


Keane MP, Gomperts BN, Weigt S, Xue YY, Burdick MD, Nakamura H, Zisman D, Ardehali A, Saggar R, Lynch 

JP, Hogaboam C, Kunkel SL, Lukacs NW, Ross DJ, Grusby MJ, Strieter RM, Belperio JA. 

IL-13 is pivotal in the fibro-obliterative process of bronchiolitis obliterans syndrome. 

J Immunol. 178(1):511-9, 2007. 

Mehrad B, Burdick B, Zisman DA, Keane MP, Belperio JA, Strieter RM. 

Circulating peripheral blood fibrocytes in human fibrotic interstitial lung disease. 

Biochem Biophys Res Comm. 353(1):104-8, 2007. 

Mohsenin A, Burdick MD, Molina JG, Keane MP, Blackburn MR. 

Adenosine mediated CXCL1 production and angiogenesis in the lung. FASEB J. 21(4); 1026-36, 2007.. 

Strieter RM, GompertS BN, Keane MP. 

The role of CXC chemokines in pulmonary fibrosis. J Clin Invest. 117(3): 549-56, 2007. 

Gomperts BN, Belperio JA, Fishbein MC, Keane MP, Burdick MD, Strieter RM. 

Keratinocyte growth factor improves airway repair in injured tracheal epithelium. 

Am J Resp Cell and Mol Biol. 37(1): 48-56, 2007. 

Mehrad B, Keane MP, Strieter RM. 

Chemokines as mediators of angiogenesis. Thromb Haemostat. 97(5):755-62, 2007. 

Hong KM, Belperio JA, Keane MP, Burdick MD, Strieter RM. 

Differentiation of human circulating fibrocytes as mediated by transforming growth factor-beta and 

peroxisome proliferators activated receptor-gamma. J Biol Chem. 282(31): 22910-20, 2007. 


169



Zisman DA, Karlamangla AS, Ross DJ, Keane MP, Belperio JA, Saggar R, Lynch JP 3rd, Ardehali J, Goldin J. 

High resolution chest computed tomography findings do not predict the presence of pulmonary 

hypertension in advanced idiopathic pulmonary fibrosis. 

Chest. 132(3):773-9, 2007. 

Chappell S, Daly L, Morgan K, Baranes TG, Roca J, Rabinovich R, Millar A, Donnelly SC, Keatings V, Macnee 

W, Stolk J, Hiemstra PS, Miniati M, Monti S, O'Connor CM, Kalsheker N. 

Variation in the tumour necrosis factor gene is not associated with susceptibility to COPD. 

Eur Respir J. 2007 Oct;30(4):810-2. No abstract available. 

Gantier MP, Baugh JA, Donnelly SC. 

Nuclear transcription of long hairpin RNA triggers innate immune responses. 

J Interferon Cytokine Res. 2007 Sep;27(9):789-97. 

Cedervall T, Lynch I, Foy M, Berggård T, Donnelly SC, Cagney G, Linse S, Dawson KA. 

Detailed identification of plasma proteins adsorbed on copolymer nanoparticles. 

Angew Chem Int Ed Engl. 2007;46(30):5754-6 

Govender P, Baugh JA, Pennington SR, Dunn MJ, Donnelly SC. 

Role of proteomics in the investigation of pulmonary fibrosis. 

Expert Rev Proteomics. 2007 Jun;4(3):379-88. 

Bucala R, Donnelly SC. 

Macrophage migration inhibitory factor: a probable link between inflammation and cancer. 

Immunity. 2007 Mar;26(3):281-5. 

Martos R, Baugh J, Ledwidge M, O'Loughlin C, Conlon C, Patle A, Donnelly SC, McDonald K. 

Diastolic heart failure: evidence of increased myocardial collagen turnover linked to diastolic dysfunction. 

Circulation. 2007 Feb 20;115(7):888-95. 

Foley SC, Hopkins NO, Fitzgerald MX, Donnelly SC, McLoughlin P. 

Airway nitric oxide output is reduced in bronchiectasis. 

Respir Med. 2007 Jul;101(7):1549-55. Epub 2007 Jan 17. 

Plant BJ, Ghani S, O'Mahony MJ, Morgan L, O'Connor CM, Morgan K, Baugh JA, Donnelly SC. 

Sarcoidosis and MIF gene polymorphism: a case-control study in an Irish population. 

Eur Respir J. 2007 Feb;29(2):325-9. Epub 2006 Sep 27. 


170



Report from the Chairman Physicians Subgroup 

Chairman of Physicians Subgroup 

Honory Secretary to Physicians Subgroup 

Dr Martin Quinn 


This year was a busy year for the Department of Medicine in St Vincents University Hospital. The numbers 

of patients seen and treated continues to increase. The move to the new hospital building has been 

completed. The move to subspecialty admission has begun with the centralization of respiratory patients on 

St John’s and St Paul’s wards and gastroenterology medical and surgical patients on St Lukes 1 and 2. The 

formation of the Dublin Academic Health Centre has led to significant collaboration between the Mater 

Misericordiae University Hospital and Vincent’s University Hospital. 

New Developments 

Plans for the development of a dedicated high intensity medical observation unit have been agreed. It is 

hoped that work on this unit will start in the first half of 2008. This will provide significant improvements in 

the delivery of care to critically ill medical patients within the hospital. 

Retirements 

Professor T J McKenna and Dr Michael Moriarty retired in 2007 after many years of service to SVUH. 

Appointments 

Professor Michael Keane joined the consultant staff as Professor of Medicine and Consulant Respiratory 

physician. 

Dr Ronan Canavan joined the consultant staff in Endocrinology. 

Dr Seery was appointed as a permanent College Lecturer/Consultant Physician. 

Research and Teaching 

The research output of many departments is of the highest quality with many publications in international 

peer reviewed journals and numerous international distinctions. 


171



Dept. of Anaesthesia, Intensive Care & Pain Medicine 

2007 was characterised by ongoing shortages of consultant staff, which was particularly evident in the area 

of Intensive Care Medicine and the Liver On-Call rosters. Although the number of Consultant Anaesthetists 

working in the hospital had dropped slightly from 27 to 26, the number of full time permanent staff had 

increased slightly from 8 to 9 with the appointment of Dr Paul Murphy. The complement of staff at this time 

therefore consists of 9 permanent, fulltime consultants and 2 fulltime locum consultants. There are 15 parttime 

consultants. Of the 15 part-time consultants, 5 posts are currently filled by locums. The difficulty in 

advancing the respective consultant posts has been exacerbated by two main problems. Firstly, the ongoing 

negotiations for new contracts with consultants has resulted in an embargo on all posts, both new or 

replacement. The situation is likely to continue until the end of 2008. Secondly, the department has 

undergone an external review. Throughout this time we have been unable to advance any new permanent 

posts. 

The external review has brought about a number of changes. Articles of Association were formulated. An 

internal Implementation Body has been set up which oversees the day-to-day running of the department and 

answers directly to the full department. In time we will see the appointment of Clinical Directors who will 

have special responsibility and expertise in their particular area. Teaching and training has improved 

significantly and we had good success in recent exams. I would like to acknowledge the input of a number 

of individuals for their hard work in improving the teaching programme in the department. Dr Dara Breslin, 

our Senior Lecturer, was appointed in 2007. Dr John Boylan, Dr Ingrid Brown, Dr Juliette McAleese and Dr 

Kieran Crowley in the Intensive Care Unit. 

The external review has also resulted in the production of a new schedule and this will take into consideration 

additional areas of activity such as in the X-Ray Department. A pre-assessment clinic is due to begin in April 

2008. In addition to this an Acute Pain Service for post operative pain is also to be put in place by June 

2008. 

The number of operating theatres has remained as in previous years. Namely there are 15 theatres in all 

but this does not take into consideration the additional areas of activity outside of the operating theatre which 

have to be covered, namely acute pain, radiology, pre-assessment and ECT. 

I would like to welcome Dr Paul Murphy, Consultant Anaesthetist with a special interest in Pain Medicine, as 

a permanent member of staff. Dr Murphy is a replacement for Dr Vincent Hannon who retired. I would like 

to congratulate Dr Paul Murphy and extend to him our heartiest congratulations and welcome him into our 

department and wish him a successful and fulfilling career in St Vincent’s University Hospital. 


172



Department - Anaesthesia, Intensive Care & Pain Medicine 

Service Development /Activities 

Activity Report – Operating Statistics 2007 

Category SVUH St. Michael’s St. Michael’s St. Vincent’s 

Annexe Public Private 

Dental 29 1 

Dermatology 7 0 

E.N.T. 251 99 

Eswl (Lithotripsy) 

General 2373 719 483 

G.U. Endo 1459 89 

G.U. Open 161 15 

Gynaecology 262 1 

Local 316 

Nerve Block + Sedation 15 

Ophthalmology 369 0 

Orthopaedic 1800 62 

Pain 440 43 

Plastic 1154 68 

Thoracic 187 102 

Vascular 323 91 

TOTALS 8815 1050 1398 1054 

Outstanding / Significant Achievements 

Our congratulations are extended to Dr Juliette McAleese, Dr Mohd Attia, Dr Tom Owens, Dr Hugh Gallagher 

and Dr Pat Benson who presented a paper at the Association of Anaesthetists of Great Britain and Ireland 

which was held in Dublin in 2007. The paper won a medal which was well deserved. 


173



Resident Merit Awards 

The following residents received medals as follows: 

Dr Catherine Nix - Dr. Gerry Dorrian Award for best SpR in Anaesthesia 

Dr Caroline Larkin – Dr. Dick Nolan Award for best BST in Anaesthesia 

Dr Denise McCarthy - Dr Seamus O’Donnell Award for best SpR in ICU 

Intensive Care Unit 

Medial Director 

Dr. Kieran Crowley 

Consultants Dr. Pat Benson D. Caroline Hickey 

Clinical Nurse Manager III 

Ms Geraldine Carey 

Service workload 

628 patients were admitted to the ICU in 2007, a record number. 39% of patients stayed 1 day, while 45% 

stayed 3 days or more, similar to recent years. Average length of stay was 4 days. Average occupancy for 

the year was 91%. The ICU continued to provide the critical care component of the liver transplant 

programme. The year saw another equal record with 65 transplants. 

Organ failure rates and organ support rates were similar to recent years: 71% of patients received 

mechanical ventilation. Overall ICU survival was 77%, with hospital survival of 76%. There is a continuing 

trend of increasing post-ICU discharge hospital survival. 

St. Vincent’s University Hospital supplied an ICU nurse and registrar to staff the transfer of critically ill 

patients by MICAS (mobile intensive care ambulance service) on a 1:4 roster. The ICU is contributing to a 

national HSE study on organ procurement (the link nurse for organ donation is Mary Galligan). 


The ICU ran two Foundation Courses, 8 nurses having completed the first course (all remaining on staff) with 

11 on the current course. This course promises to greatly assist in providing adequate numbers of suitably 

trained nursing staff, which remains an issue. Maureen Flynn left her post as DNM to work with the HSE, 

Maureen Darcy filling the DNM position. Anne Donegan and Mark Jeffrey were appointed CNM2; Aisling 

Vickers was appointed Acting CNM2. 

There are two attendants, one shared orderly, one shared technician and three secretaries. The ICU is staffed 

by a registrar or specialist registrar rotating from the Department of Anaesthesia. The aim of achieving outof-hours 

cover by consultant intensivist staff has not yet been met: this is now achieved for 2/4 of weekends. 


Of the total of 16 beds in the new ICU initially 8 were opened, increasing to 10 in July, with overflows to 13 

beds at times. Efforts are being made to open further beds. Edwina Beirne was appointed to oversee the 

introduction of a Clinical Information System, with a planned “go-live” date mid 2008. Edwina previously 

oversaw such a project in Amsterdam. After a successful application to the National Council for the 

Professional Development of Nurses, Dennis Wedgeworth took up a post studying the feasibility of an 


174



Outreach Service for patients after ICU discharge. Thanks to the work of Liam McGann and Joey Gormly, 

the Purchasing Department took over stock management in ICU, freeing up ICU staff time for patient care 

and saving money. As part of the commitment to continuing education, the ICU Nursing Staff hosted their 

annual educational conference in February 2007 with an attendance of over 100. Intermittent Haemodialysis 

is now available to patients in the ICU with the support of the Renal Service. The ICU marked its first year 

in the new premises with an international lunch. 

Significant achievements 

At the SVUH poster competition on “Quality in Healthcare” Dr. Hani and Dennis Wedgeworth won 1st and 

2nd prizes respectively. 

ICU ACTIVITY 

2007 2006 2005 2004 2003 2002 2001 2000 1999 

Admissions 628 595 613 516 450 471 421 469 556 

Average length 

of stay (days) 4 2 4 6 6 6 5 5 3.4 

Average occupancy 91% 91% 92% 93% 90% 85% 89% 85% 64% 

Elective surgical 29% 34% 38% 36% 27% 30% 32% 35% 36% 

Emergency surgical 25% 25% 30% 30% 39% 31% 31% 35% 31% 

Medical 46% 43% 32% 34% 34% 39% 37% 30% 33% 

Mechanical ventilation 71% 80% 82% 69% 70% 75% 68% 67% 58% 

Central venous access 77% 73% 77% 64% 73% 81% 69% 78% 75% 

Vasoactive infusions 31% 19% 24% 20% 18% 25% 33% 33% 26% 

Acute renal failure 18% 14% 10% 10% 17% 25% 23% 24% 14% 

Continuous renal 

replacement therapy 18% 14% 10% 10% 16% 21% 16% 14% 10% 

Tracheostomy 10% 7% 6% 6% 13% 11% 13% 6% 6% 

Unplanned ICU 

discharge - 17% 21% 21% 25% 1.5% 11.4% 6% 5% 

Readmissions 9.7% 8.1% 12% 8.3% 2.9% 0.9% 6.3% 

ICU survival 77% 78% 80% 79% 82% 75% 73% 75% 81% 

Hospital survival 78% 76% 78% 75% 78% 70% 68% 70% 71% 


175



Liver Transplantation 

2007 was a very busy year for the Liver Transplantation Group. 59 Orthotopic Liver transplants took place. 

The results for 2007 were very good. Transplantation is demanding work for all concerned. All credit to the 

Anaesthesia Team: 

Consultant Anaesthetists Liver Fellows Anaesthetic Nurses 

Dr Neil McDonald Dr Mohammad Zafruddin Sr. Jean McCarthy 

Dr. John Boylan Dr. Shaikh Subani Billie Stafford 

Dr. Aly Karim Aly 

Karl Perocillo 

Karen Ann Keating 

The transplant anaesthesia group provided coverage for 59 liver transplants, including 52 primary elective 

transplants during 2007. The 60-day survival for primary isolated elective transplants was 96%, with median 

ICU stay and hospital stay of 1 and 21 days, respectively. Outcome for primary elective liver transplantation 

at SVUH continues to be one of the best in the UK and Ireland. 

Peer-reviewed papers 

J.J. Magner, K.J. Crowley, J.F. Boylan. Fatal fibrinolysis during orthotopic liver transplantation in patients 

receiving solvent/detergent-treated plasma (Octaplas®). 

Journal of Cardiothoracic & Vascular Anesthesia 2007; 21: 410-3 

Abstracts 

A.D. Nichol, F. Naughton, D. Ó Cróinín, J.F. Boylan, P. McLoughlin. 

Buffered hypercapnia worsens lung injury in endotoxin induced pneumonia. 

American Journal of Respiratory & Critical Care Medicine 2007 A785 

A.D. Nichol, D. Ó Cróinín, F. Naughton, J.F. Boylan, P. McLoughlin. 

Hypercapnic acidosis attenuates oxidative reactions in endotoxin induced acute lung Injury. 

American Journal of Respiratory & Critical Care Medicine 2007 A785 

Three former Conway research fellows, Dr. Finola Naughton, Dr. Ahtsham Niazi and Dr. Alistair Nichol, took 

up posts as staff anaesthesiologists at the University Hospital Network, Toronto, Canada (Drs. Naughton and 

Niazi), and as Senior Lecturer at Monash University, Australia (Dr. Nichol). Dr. John Boylan was a contributing 

author for the Irish Critical Care Trials Group (ICCTG), and a manuscript reviewer for Chest. 

Vascular Access 

Director 

Consultant 

Dr. Alan McShane 

Dr. Neil McDonald 

The Vascular Access service continues to meet the constants demands from a variety of healthcare groups. 

The requests include placement of a variety of vascular access devices, and increasingly, the provision of a 

consultation service. While the oncology and haematology services continue to be frequent users of the 

service, the number of referrals of patients with cystic fibrosis for portacath placement also continued to rise. 


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Training in the use of ultrasound devices to aid the placement of central venous access devices has 

continued, and there is increasing willingness of all to embrace this technology. 

Formal training in central vascular access is now a training requirement of the College of Anaesthetists. Drs 

McShane and McDonald again organized the Vascular Access Study Day in the College. This course 

continues to be popular and oversubscribed. It provides didactic lectures, live and cadaveric demonstrations 

and tuition in the use of ultrasound. 

South East Dublin Department of Anaesthesia 

Again in 2007 consultant recruitment to the SEDDA hospitals was severely curtailed. This was due to a 

combination of reasons but mainly to uncertainty about the new consultant contract and uncertainty about 

what hospitals were to be built up. Consequently, we again relied, heavily on locum consultant services. 

These enabled the comprehensive anaesthesia services in the group to be maintained. We are again grateful 

to the contribution made by these doctors. We were happy to welcome one new Consultant to the SEDDA 

group, Dr. Paul Murphy, who will be joining the liver transplantation anaesthesia team and will also work with 

the Pain Service. We wish him well in his career here. 

The SEDDA training scheme retains its popularity, with a constantly increasing number of applications. This 

reflects on the individual teaching done by consultants and the facilities and varied clinical experience 

available in the constituent hospitals. 

Pain Medicine 

2007 was another year of immense development in the Pain Service in St. Vincent's University Hospital with 

the appointment of a new Consultant in Pain Medicine, Dr Paul Murphy. Dr Murphy did his Pain Fellowship 

training in the world famous North Shore Hospital in Sydney, Australia, under the guidance of Prof Michael 

Cousins. We also had the project of planning a new pain suite, and the commencement of the transfer of 

our clinical activities from St Anthony’s Rehabilitation Centre to the main SVUH building. 

Outpatient Activity 

Number New Return Total 

Of Sessions Patients Patients 

Tues 51 250 2,244 2,494 Dr O'Keefe 

Tues 46 23 264 287 Dr Victory 

Wed 51 112 886 998 Dr O'Keefe 

Pain Unit 148 3 370 373 

Total 296 388 3,764 4,152 


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The Wednesday Clinic has been taken over by Dr Paul Murphy as his basic OPD assessment access for new 

patients, this commences at 3 p.m and finishes at 6 p.m . We have continuted with the initiative which was 

introduced in 2006, of the Wound Clinic and the Walk In OPD Service for emergencies and urgent referrals. 

This had a huge impact in emergency admission avoidance and prolonged stay at St. Vincent's University 

Hospital. 

Publications and Presentations 

Presentations 

National 5 

International 4 

Publications 1 

2 Papers were presented by Dr Zuberi and Dr Hannsman. INSUKI Meeting in York in October 2007. 

There were 5 poster presentations at the Irish Pain Society Meeting in UCD in October 2007, which were 

jointly authored by Dr O’Keeffe and Dr Murphy. With presentations from Dr Zuberi, Dr Hannsman, Dr Idrees, 

Dr Kamraj on a variety of topics, including Audits of Electronic Neuromodulation Practice, and the use of 

Pharmacologic Neuromodulation using a novel new drug, Ziconatide. 

There were also 2 presentations from the Unit at the North American Neuromodulation Society in Acapulco, 

Mexico, in December 2007, given by Dr Zuberi. One of which was a case report and the second was an audit 

of our Electronic Neuromodulation Practice. 

Dr Philip Hu commenced and successfully completed a year in the Dept of Functional MRI and the University 

of Oxford, under the guidance of Prof Eileen Tracey, where he is investigating the ‘Impact of Subcutaneous 

Electrical Stimulation on Brain psycho-physics.’ 

The Pain Programme, under the joint Clinical Directorship of Dr. Rosemary Walsh and Dr Declan O’Keeffe, 

continued with its cognitive behavioural therapy programme, 3 week programme for patients with chronic 

pain and new innovations including tailored programmes for patients with special needs. 

Publications 

Audit of Neuromodulation: Our Experience of 83 Implanted Systems. 

Hu P, Majedi Max P, Illynski O, Al Majedi A, O’Keeffe D. 

Neuromodulation Vol 10 Issue 2. Page 195-201 

April 2007. 


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Finally the total patient interaction in the department was over 5,200 for 2007 

Director Dr. Declan O’Keeffe 11 sessions 

Consultants Dr. Paul Murphy 7 sessions 

Dr. Ray Victory 

2 sessions 

Dr Oleg Illynski 

4 sessions 

Pain Fellows 

Senior Clinical Psychologist 

Dr. Michael Hannsman 

Dr. Aamir Zuberi 

Dr Kamraj 

Dr. Rosemary Walsh 

0.5 WTE Physiotherapist Miss Aoife Caffrey 

1.0 wte Occ Therapist Miss Shannon Barr 

Pain Management Co-ordinator/ 

PA to Director 

Neuromodulation Co-ordinator Locum 

Niamh Clohessy 

Activity 

Outpatient Clinics 

Day Consultant Total No. of Patients 

to visit OPD Pain Clinic 

Tuesday Dr. O’Keeffe 2492 

Wednesday Dr. Victory 287 

Tuesday Dr. O’Keeffe 998 

St. Clare’s Pain Unit 

Procedure Room 

Wound Clinic 1319 

Extramural Theatre 

Bone&Joint Unit 

Pain Management Programmes 

Type Programme No. of Courses in 2007 Total Number of Patients on Course 

3 week 9 81 

1 Day 2 8 


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Distinguished Guests 

The department was honoured by the presence of the world famous Pain Physician / Scientist, Prof Michael 

Cousins of the University of Sydney in October 2005. Prof Cousins visited the unit and delivered the 

Anaesthesia grand round lecture on Chemotherapy Analgesia. Given Prof Cousins’ background, this was a 

view into the future of pain medicine and he explained to us the new goal of attempting to achieve periods 

of remission from pain of patients with unrelenting chronic pain. Prof Cousins was also accompanied by Dr 

Damian Finess, (Chairman of the IASP Group on Placebo), who is attached as a Physiotherapist / 

Neuroscientist to the famed North Shore Hospital facility in Sydney, Australia. 

Prof Cousins also gave an address on Pain Relief as a Human Right at the Royal College of Physicians as 

part of the Irish Pain Society’s Annual Scientific Meeting. It was a great pleasure to have Prof Cousins visit 

our unit and I on behalf of the MDT in St Vincent’s University Hospital Pain Clinic would like to thank our new 

colleague Dr Paul Murphy for facilitating this wonderful experience for our group. 


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Department of Cardiology 

The demand for outpatient based clinical cardiological services continues to increase. A total of 6,965 

patients were seen at cardiology clinics during 2007 – an increase of 10% over the previous year. This was 

also reflected in the 13% rise in non-invasive investigative tests (ECG, echocardiography, stress testing, 

rhythm monitoring) to 19,266 procedures – almost 400 per week. In-patient activity as evidenced by 

admissions / discharges / bed days used remains generally unchanged (~1% rise) understandably due to 

saturation of available resources. For similar reasons the number of invasive cath lab based procedures were 

unchanged at 2,453 however there was clearly an increase in the need for emergency out-of-hours 

procedures – particularly direct coronary angioplasty / stenting for evolving acute myocardial infarction – a 

need which is certain to continue to grow and place a substantial extra burden on already strained resources. 

Cardiac Arrhythmia Service 

The Cardiac Arrhythmia Service now provides the following services: 

Implantation of Cardiac Arrhythmia Devices: 

Implantable loop recorders, use of selective Para-Hisian high septal pacing in order to reduce cardiac 

dysynchrony for patients with bradycardias, ICD therapy, and biventricular cardiac resynchronization therapy. 

The development of the cardiac arrhythmia services at St. Vincent’s University Hospital has been facilitated 

by the subspecialisation of cardiac technicians with dedicated arrhythmia interests. The follow-up of 

implantable loop recorders, pacemakers, implantable cardioverter defibrillators and resynchronization therapy 

devices has been greatly enhanced by the high level of expertise by our cardiac technicians and has allowed 

the service become less dependent on technical support from industry for the interpretation of error 

messages, alarm signals and optimization of programmable features. 2007 has seen a grown concern for 

device advisories and recalls. Such problems require increasing vigilance for adverse trends in electrical 

parameters (impedance, voltage, high frequency noise) on follow-up visits and subsequent communications 

with patients, referring physicians, device extractions (in selected patients in conjunction with our cardiac 

surgical colleagues) and replacements. The more sophisticated implantable device technology becomes the 

greater the potential for technology defects and device recalls. 


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Department - Cardiology 

Catheter ablation of atrial fibrillation, ventricular tachycardia and SVT’s: Catheter ablation is performed by 

endocardial ablation and in selected patients by percutaneous epicardial ablation. The development of 

catheter ablation services of both complex as well as common tachycardias at SVUH has been facilitated by 

the acquisistion of 3-D electroanatomical mapping systems (Carto, Navex, Ensite and Loca-Lisa) and by the 

use of customised pulmonary vein isolation catheters such as the 36 strand mesh ablation catheters. 

Cardiac Rehabilitation 

The Cardiac Rehabilitation Service continues to offer four phases to patients recovering from a Myocardial 

Infarction, Angioplasty and Coronary Artery Bypass Surgery/Valve Surgery. 

463 patients received Phase 1, at Phase II, all patients were phoned after their event and 227 patients 

attended group meetings throughout the year. Some were also seen individually. One hundred and forty one 

patients attended the six-week Phase III programme. Approximately seventy patients attended our Phase IV 

refresher sessions. 

Heart Failure Service 

The Heart Failure Unit continues to provide in-patient and outpatient services. At outpatient level there were 

in excess of 4,000 patient contacts last year. Services include a dedicated clinic for potential new diagnoses 

of heart failure, annual review for those with established heart failure to ensure continued optimal 

management, same day review for clinical deterioration as well as in-patient care and immediate post 

discharge care. In 2007 three new services were established: 

a) Outreach services for those patients not capable of attending St. Michael’s Hospital for clinical 

review. This service is provided by Mary Ryder, the first Advanced Nurse Practitioner in 

heart failure in Ireland. She maintains close contact with the General Practitioner and 

the hospital heart failure unit where required. 

b) Home Telemonitoring. In conjunction with the HSE the Heart Failure Unit has developed 

an I.T. based interactive program for general practitioners in helping to facilitate referral 

and clinical opinion. 

c) The Hypertension Unit was established in late 2007 to provide specialist services for 

Hypertension and to co-ordinate with the Heart Failure Unit in formulating optimal 

strategies for prevention of heart failure. 


182

Papers Published & Accepted 

Ponikowski P, Anker S, Szachniewicz J, Okonko D, Ledwidge M, Zymlinski R, Ryan E, Wasserman S, Baker 

Nigel, Rosser D, Rosen S, Poole-Wilson P, Banasiak W, Coats A, McDonald K. 

Effect of Darbepoetin alfa on exercise tolerance in anaemic patients with symptomatic Chronic Heart 

Failure: a randomized, Double-Blind, Placebo-controlled trial. 

J Am Coll Cardiol. 2007. 49:7: 753 – 762. 

McDonald K, Conlon C, Ledwidge M. 

Disease management programs for heart Failure: Not just for the ‘sick’ heart failure population. 

Eur J Heart Fail. 2007. 9: 113 – 117. 

Travers B, O’Loughlin C, Murphy N.F., Ryder M, Conlon C, Ledwidge M, McDonald K. 

Fluid restriction in the management of decompensated heart failure: no impact on time to 

clinical stability. 

J Card Failure 2007. 13: 2: 128 – 132. 

O’Hanlon R, O’Shea P, Ledwidge M, O’Loughlin C, Lange S, Conlon C, Phelan D,Cunningham S, McDonald 

K. J. 

The biological variability of B-type natriuretic peptide and N-Terminal pro-B-type natriuretic peptide in 

stable heart failure patients. 

J. Card Failure 2007. 13: 1: 50 - 55 

Martos R, Baugh J, Ledwidge M, O’Loughlin C, Conlon C, Patle A, Donnelly S, McDonald K. 

Diastolic Heart Failure: Evidence of increased myocardial collagen turnover linked to diastolic 

dysfunction. 

Circulation 2007.115: 888 –8 95 


183

184


Department of Dermatology 


Consultants Dr Paul Collins (9+2 sessions) Dr Brian Kirby (11 ) 

Dr. Sarah Rogers (11 ) 

(31 sessions at St Vincent’s University Hospital , 2 at St Michael’s Hospital) 

NCHDs 

Sp Registrar 

Dr Jane Barry 

Registrar Dr Maeve Mc Aleer Dr Catriona Ryan 

SHO 

Dr Aisling Ryan 

Research Registrar Dr Agnieszka Zawirska 

Nursing Staff 

CNS Ms Sheila Ryan Ms Nicola Mahon (acting) 

CNM2 

Ms Nora Tracey 

Nurses 11 (full and part-time) 

Care assistant 

Ms Maria del Pillay 

Nurses 

13.39 WTE 

Administrative Ms Caroline Lehane Ms Eileen Cusack 

Ms Maria Pongraz 

Ms Brenda Harte part time 

Ms Niamh Spain part time WTE 3.8 

Patients seen and treated 2007 St Vincent’s University Hospital + (St Michael’s Hospital) 

New patients 

Return patients 

Clinics 2345 + (292)=2637 6,163 + (443)= 6606 

Total patients = 8508 + (735) 

Phototherapy unit 15,491 Patch tests 283 Skin biopsies 635 + (33) 

Skin excisions 429 


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Department - Dermatology 

Inpatient consults 434 + (62) 

Consult review not measured but most reviewed at least once 496 

Nurse led services have increased this year and full details are contained in the annual Nursing Report. 

Outpatient waiting list February 2008 combined St Vincent’s University Hospital and Michael’s Hospital 

New patients 

Return patients 

758 2,154 

Publications 

Narrowband UVB and psoralen UVA in the treatment of mycosis fungoides:A retrospective study. 

Ahmed K, Rogers S, McNicholas P, Collins P. Acta Dermatologica Venereologica 2007;87:413-417. 

Randomised, double-blind, prospective study to compare topical 5- aminolaevulinic acid methylester with 

topical 5-aminolaevulinic acid photodynamic therapy for extensive scalp actinic keratosis. 

Moloney FJ, Collins P British Journal of Dermatology 2007;157:87-91. 

Two years experience with etanercept in recalcitrant psoriasis. 

Ahmad K, Rogers S. Br J Dermatol 2007 ; 156 : 1010-1014 

Filaggrin null alleles are not associated with psoriasis. 

Zhao Y, Terron-Kwiatkowski A, Liao H et al. J Invest Dermatol 2007; 127 : 1878-82. 

A retrospective review of azathioprine treatment for recalcitrant atopic dermatitis. 

Hughes R, Collins P, Rogers S. Accepted Clinical and Experimental Dermatology 

The department has presented over 20 presentations at national and international meetings 


A once monthly multidisciplinary team meeting for melanoma has been started. This incorporates specialists 

from Dermatology, Plastic and Reconstructive surgery, General surgery, Oncology and Histopathology. 

Achievements 

Dr Paul Collins was appointed Chairman of the Southern Group of the IAD. 

Dr Brian Kirby has been appointed Chairman of the St Vincent’s University Hospital Research Ethics 

Committee 

Nurse Eimear Ennis and Nurse Sheena Killarney have completed their BSc degrees in nursing. 

Acting CNS Ms Nicola Mahon completed the Higher Diploma in Dermatology course at Stirling University 

CNS Sheila Ryan is Honorary Secretary of the Irish Dermatology Nurses Association and the British 

Dermatology Nursing Groups. 


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Department of Endocrinology & Diabetes Mellitus 

Personnel 

Consultants: Professor T.J. McKenna, Dr Malachi McKenna, Dr Donal O’Shea, 

Dr Ronan Canavan 

Lecturers: 

Department of Medicine, U.C.D.: Dr Deirdre Blake Dr Gianluca Tamagno 

Specialist Registrar: 

Dr Conall Dennedy 

Registrars: Dr Maeve Hutchinson, Dr Gadintshware Gaoatswe, 

Dr Eoin Noctor 

Research Registrars: Dr Tom Cawood, Dr Mohammed Bashir, Dr Jean O’Connell 

Secretary: 

Geri Daly 

Diabetes Centre 

Nurses: Deirdre Gleeson, Nora Collis, Moira Haran, 

Joanne Kildunne, Jean O’Brien, Claire Dingle 

Dieticians: Maeve Moran, Carmel Quinn, Natalie Wallace 

Primary Care 

Liaison Team: Deirdre Hall, Diabetes Nurse Specialist Yvonne Ryan, Dietician, 

Secretarial Staff: Fiona Whelan, Patricia Sinnott, Joyce Doyle, 

Maura Mahony, 

Florence Mhandu 

Endocrine Laboratory 

Principal Biochemist: 

Dr. Tom Smith 

Senior Medical Scientist: Anne Dickinson 

Acting Senior 

Medical Scientists: Martina Cassidy, James Connolly, Nicola Faherty 

Laboratory Aide: 

Amy Wallace 

Research-Graduate 

Students: 

Lucille Kavanagh 

Weekly Departmental Academic Events 

Diabetes Team Meeting - Monday lunchtime 

Endocrine Conference - Tuesday 1pm 

Multi-Disciplinary Thyroid Cancer Group Meeting (Quarterly) 

Departmental Journal Club - Friday – 8.00am 


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Out-patient Clinics 

3 Diabetes Clinics per week 

1 Endocrinology Clinic 

Weekly multi-disciplinary group education sessions for newly diagnosed patients with type 2 diabetes. 

Monthly Patient Group Education Session on cholesterol management and diet. 

Quarterly Group Education Sessions for patients with newly diagnosed impaired glucose tolerance. 

Endocrine Clinical Services 

The Endocrine Team provides a comprehensive outpatient and in-patient consultation service. By its nature, 

the combined Endocrinology/Diabetes Service is predominantly outpatient orientated with the essential goal 

of avoiding hospital admission and this is particularly the case in avoiding the long-term complications of 

diabetes mellitus. 

In the field of thyroid cancer, the development of a quarterly Multi-Disciplinary Team Meeting, (Medical 

Endocrinology, Surgical Endocrinology, Histopathology, Radiotherapy and Radiology) ensures the provision of 

a co-ordinated service working to approved international guidelines. At this conference patients who have 

been reviewed by any of the groups are presented and their management discussed and presentations and 

key aspects of the management of thyroid cancer are reviewed. A similar multi-disciplinary team approach to 

the management of gut endocrine tumours was established in September 2007. This meeting occurs quarterly. 

The Endocrine Team provides a national consultation service in the areas of reproductive endocrinology, 

adrenal disease, obesity, hypoglycaemia, gut endocrine tumours, gender identity disorder, calcium metabolism 

and metabolic bone disease. 

Endocrine Laboratory 

Overall workload in the Endocrine Laboratory remained relatively static during 2007. However, this overview 

masked a significant increases in the number of manual tests requested and a fall in the automated 

workload, particularly from the Coombe Hospital as they expanded in-house endocrine testing. 

The laboratory was again inspected during the course of a two day surveillance visit from Clinical Laboratory 

Accreditation UK Ltd. in 2007. The inspector’s report was very positive and the laboratory maintained its 

accreditation status. 

Dr. Tom Smith is the Association of Clinical Biochemist’s representative on the Irish EQA Steering Committee. 

James Connolly has been promoted to acting Senior Medical Scientist in place of Anne Dickinson who is 

currently on maternity leave. 

Martina Cassidy resigned her post in 2007 to take up a Medical Scientist position in Temple St. Children’s 

Hospital. She was replaced by Nicola Faherty. 

Gordon Dixon took up a position as trainee Medical Laboratory Scientist in June 2007. 


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Diabetes Service 

The official opening of the Diabetes Centre was held on the 21st April 2007. Special guests included Dr 

Garret FitzGerald and Mr Albert Reynolds. The opening ceremony was preceded by a seminar for healthcare 

professionals and a patient workshop for patients and their families. 

The goal of the Diabetes Service is to keep well patients well through the linked processes of information, 

education, counseling and empowerment. The Diabetes Service is probably unique in the extent to which 

the patients play the central role in the management of frequently complex situations. This service is 

supported by time committed to telephone contact with patients and the provision of various individual and 

group educational sessions. 

For insulin dependent patients, there is the “Dose Adjustment For Normal Eating” (DAFNE) programme. This 

is a detailed continuous five day course for small groups of patients to empower them to tightly link insulin 

adjustment with carbohydrate intake, exercise and general health status to ensure tight blood glucose levels 

with the aim of avoiding long-term diabetes complications, while at the same time avoiding the serious 

consequences of low blood glucose levels, hypoglycaemia. Detailed training and accreditation in DAFNE for 

doctors, nursing staff and dietitians continues as resources allows. 

Cystic Fibrosis (C.F.) related Diabetes Mellitus 

As we in St Vincent’s University Hospital are the national referral centre for adults with Cystic Fibrosis and 

allied with medical advances in treatment, we have seen a large increase in the number of patients 

presenting with cystic fibrosis related diabetes mellitus as their life expectancy increases. The treatment and 

education of this group form a complex and demanding facet of the caseload of the Diabetes Nurse 

Specialist and Endocrine Medical Team. 

A further aspect of the Diabetes service in St Vincent’s University Hospital is Liver Transplantation related 

Diabetes, which continues to increase our expertise and workload. 

The Shared Care Programme in which a group of General Practitioners work in partnership with the Diabetes 

Centre to agreed treatment protocols and facilitated by Liaison Diabetes Nurse Specialists and Dieticians 

has expanded further this year. This programme at once expands the base and the provision of expert 

diabetes care, facilitates the provision of that care nearer to the patient’s home and relieves demands on the 

hospital based Diabetes Service. 


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Research Projects 

Thyroid Eye Disease Research Group 

Personnel: 

Dr Donal O’Shea and Dr Tom Cawood 

Dr Cawood completed his studies on the potential role of anti-cytokine therapies in thyroid eye disease, and 

has also investigated the link between smoking and thyroid eye disease. This in vitro work, funded by a 

Clinical Research Training Fellowship from the Health Research Board, has suggested that Interleukin 1 may 

be an attractive therapeutic target as Interleukin promotes numerous pathological processes in thyroid eye 

disease (including inflammation, glycosaminoglycan production and adipogenesis). Interleukin 1 also acts in 

synergy with cigarette smoke extract to promote adipogenesis, which may help explain why smoking worsens 

thyroid eye disease. Dr Cawood was awarded the O’Donovan Medal by the Irish Endocrine Society, and the 

Novartis Endocrinology Registrar Research Medal for this work and was awarded his Ph.D. in 2007. In July 

2007 Dr Cawood moved to New Zealand to complete his specialist training. 

Diabetes & Obesity Research Group 

Personnel: Dr Donal O’Shea, Dr Jean O’Connell, Dr Lydia Lynch, 

Dr Mohammed Bashir Dr Conall Dennedy. 

Laboratory work is underway investigating the metabolic and immunological links between obesity and its 

consequences, such as type 2 diabetes and non-alcoholic fatty liver disease. A Newman Scholar post is 

being funded by Sanofi-Aventis, and the Diabetes Federation of Ireland and the Medical Research Charities 

group have recently awarded funding for a 3-year project entitled ‘Adipocyte size and type 2 diabetes; a study 

of patients undergoing bariatric surgery’. Dr. O’Connell has been awarded a HRB training fellowship to 

pursue this project. The group is increasingly focussing also on the link between obesity and cancer. Funding 

has been secured for another Newman Fellowship to start in early 2008. Dr Bashir is looking at novel urinary 

biomarkers and diabetes/obesity related kidney disease while Dr Dennedy plans to look at endocanabinoid 

regulation of adrenal and ovarian steroidogenesis. 

Clinical Studies (Dr Eoin Noctor, Dr T Smith) 

For the last ten years that Endocrine Laboratory has screened all blood samples with an elevated prolactin 

level for the presence of macroprolactin. When macroprolactin was found to account for 

hyperprolactinaemia, the interpretation was made that when corrected for the presence of macroprolactin, 

the prolactin level was normal. We have now commenced a study to review the subsequent clinical course 

of patients whose doctors received this result and interpretation. Questions to be addressed include what 

additional investigations were undertaken for these patients? What treatments did they receive? What were 

the final diagnoses? What was the diagnosis? 

Achievements and Distinctions 

Professor T J McKenna retired in August 2007 having been associated with St Vincent’s University Hospital 

since the 1960’s and on the staff as a Consultant since 1978. His retirement was marked by a day given 

over to reviewing the developments in Diabetes and Endocrinology over that time, with a particular emphasis 


190



on his areas of interest. Former colleagues in St Vincent’s including Professor Frank Muldowney and Dr 

Andrew Heffernan were among the speakers as was Dr Frances Hayes, who has been appointed to take up 

Professor McKenna’s position in July 2008. Professor McKenna will maintain his academic links with the 

department. He has been appointed Chairman of the Irish Committee for Higher Medical Education and is a 

member of the Editorial Boards for the journals Clinical Endocrinology (Oxford) and The Endocrinologist 

(United States). 

Dr Donal O’Shea completed his four year term as Secretary of the Irish Endocrine Society. He was 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. He received a UCD Premier Award for Undergraduate Teaching 

Excellence in 2007. 

Dr Malachi McKenna is a member of the Editorial Board of Osteoporosis International. 

Dr Ronan Canavan joined the staff as Consultant Endocrinologist in July 2007. 

Conferences/Courses/Meetings Attended 

National Cystic Fibrosis Meeting. Killarney, 21st February 2007. 

Annual Abracadabra Diabetes Nursing Conference. London, 2nd March 2007. 

International Society for Clinical Densitometry. Tampa, USA, 14th– 7th March 2007. 

Diabetes Federation of Ireland Multi-disciplinary Diabetes Study Day. Croke Park, 9th March 2007. 

American Endocrine Society. Toronto, Canada. 2nd-5th June 2007. 

American Diabetes Association Annual General Meeting and Conference. Chicago, USA, 

22nd–26th June 2007. 

DAFNE Collaborative Meeting, Manchester. 5th-7th July 2007. 

DAFNE Peer Review and Quality Assurance. Kings College, London. 13th September 2007. 

Insulin Pump Therapy Training Programme. Mater Misericordiae University Hospital, 

27th-28th September 2007. 

American Society for Bone and Mineral Research. Honolulu, Hawaii, 16th–19th September 2007. 

Irish Diabetes Nurses Association Annual General Meeting. Dublin, 12th-13th October 2007. 

Irish Endocrine Society 31st Annual Meeting. Belfast, 2nd-3rd November 2007. 

DAFNE Ireland Collaborative Meeting. Galway, 1st December 2007. 


191



Publications 

Abuzakouk M, Barnes L, O'Gorman N, McKenna MJ, Freaney R, Feighery C. 

Dermatitis herpetiformis: no evidence of bone disease despite evidence of enteropathy. 

Dig Dis Sci 2007; 52: 659-64. 

Cawood T, Moriarty P, O'Farrelly C, O'Shea D. 

Smoking and thyroid associated ophthalmopathy; a novel explanation of the biological link. 

J Clin Endocrinol Metab 2007; 92(1): 59-64. 

Cawood TJ, McKenna MJ. The harms of risks. 

Brit Med J 2007; http://www.bmj.com/cgi/eletters/334/7591/437. 

Fahie-Wilson MN, McKenna TJ, Ahlquist JA, Smith TP. 

Macroprolactin and the Pituitary Society guidelines for the diagnosis and management of prolactinomas. 

Clin Endocrinol 2007; 67(4): 638-639. 

Hutchinson M, McKenna MJ. When bone strength fails – what next? 

Forum Focus 2007; 7(7): 35-8. 

Kelleher FC, McKenna M, Collins CD, Crown JP. 

A potential anatomic cause of mandibular osteonecrosis in patients receiving bisphosphonate treatment. 

Mayo Clinic Proceedings 2007; 82: 133-135. 

Kelleher FC, McKenna M, Collins C, Brady G, Collins I, Crown J. 

Bisphosphonate induced osteonecrosis of the jaws: Unravelling uncertainty in disease causality. 

Acta Oncologica 2007: 46: 702-4. 

Quinn A, Doody C, O’Shea D. 

The effect of a physical activity education programme on physical activity, fitness, quality of life and 

attitudes to exercise in obese females. 

J Sci Med Sport. 2007; 12. 

Smith TP, Kavanagh L, Healy ML, McKenna TJ. 

Technology insight: measuring prolactin in clinical samples. 

Nature Clinical Practice Endocrinology and Metabolism 2007, 3(3):279-289. 

Tuthill A, Quinn A, McColgan D, McKenna M, O’Shea D, McKenna TJ. 

A prospective randomized controlled trial of lifestyle intervention on quality of life and cardiovascular 

risk score in patients with obesity and type 2 diabetes. 

Diabetes Obes Metab. 2007; 9(6): 917-919. 

Tuthill A, McKenna MJ, D. O’Shea, T. J. McKenna. 

Weight changes in type 2 diabetes and the impact of gender. Diabetes Obes Metab, 2007; (doi: 

10.1111/j. 1463-1326. 2007. 00800.x). 

Waterhouse DF, McLaughlin AM, O’Shea D. The correlation between normal range TSH concentrations 

and cardiovascular risk parameters – a study in healthy women. Thyroid 2007; 17(3): 243-248. 


192


Abstracts 

Gaoatswe G, McKenna MJ, Van der Kamp S, FitzGerald O. 

Higher Prevalence of osteoporosis at spine than femur: Preferential bone loss or reference range 

variance. 

Ir Med J 2007; 76: 378. 

Noctor E, Dennedy MC, Tamagno G, O’Shea D. 

Effects of Rimonabant induced weight loss in Polycystic Ovarian Syndrome (PCOS) patients. 

Ir Med J 2007; 76: 357. 

Noctor E, McKenna MJ. 

Teriparatide treatment for osteoporosis: Superior benefit in spine compared to femur. 

Ir Med J 2007; 76: 371. 

Tamagno G, Sheahan K, Dennedy MC, Gaoatswe G, King R, Noctor E, O’Shea D. 

Retrospective analysis of gastroenteropancreatic neuroendorine tumours histologically diagnosed in a 

single Irish centre: a 14 year long experience. 

Ir Med J 2007; 76: 368. 

Tamagno G, Simo A, Celik Y, Lee BI, Murialdo G. 

Clinical manifestations, follow-up and outsomes of patients with Graves’ disease and encephalopathy 

associated to autoimmune thyroid disease. 

Ir Med J 2007; 76: 363. 


193



Department Of Medical Oncology 

2007 was a highly successful year in the academic, clinical and educational activities of the Medical 

Oncology department in St. Vincent’s University Hospital. 

The year saw a major and welcome re-development of the inpatient facility in St. Anne’s Ward. The everincreasing 

move of Oncology from the outpatient to the ambulatory setting continued with increasing 

numbers of patients treated in our day centre. 

On the personnel front, Dr. Dimitrios Tryfonopoulos took up duties as Consultant Medical Oncologist and at 

the end of 2007 was appointed to the new Health Research Board Investigator/Consultant post in the unit. 

We wish Dr Tryfonopoulos, who was a medical oncologist on the staff of the St. Savas Cancer Centre in 

Athens, one of Europe’s leading cancer centres, every success for a happy and productive time here in 

Dublin. Another major transition in the unit was the retirement of Sr Patricia Goodwillie after many years of 

sterling service as the Clinical Nurse manager of St. Anne’s Ward. We wish Sr. Goodwillie all the best for 

many years of a healthy and happy retirement. 

The clinical research team underwent further development. Susan Cairney and Mary Doyle joined the unit 

as research assistants and Ms Trish Carroll has joined as administrative assistant to the Research 

Department. 

Professor Crown lectured extensively during 2007. In addition, he presented the results of the Lapatinib/ 

Capecitabine randomised trial at the Annual Conference of Clinical Oncology in Barcelona. 

Professor Crown was awarded a Health Research Board Clinician Scientist award. This scheme is designed 

to free up academically focused consultants from full time patient care work, to facilitate the development of 

research programmes. Professor Crown will take up these duties in January, 2008. 

Publications 

Martinez V, Kennedy S, Doolan P, Gammell P, Joyce H, Kenny E, Prakash Mehta J, Ryan E, O'connor R, 

Crown J, Clynes M, O'Driscoll L. Drug metabolism-related genes as potential biomarkers: analysis of 

expression in normal and tumour breast tissue. Breast Cancer Res Treat. 2007 Sep 27; 

Doolan P, Clynes M, Kennedy S, Mehta JP, Crown J, O'driscoll L. Prevalence and prognostic and 

predictive relevance of PRAME in breast cancer. Breast Cancer Res Treat. 2007 Jul 12; 

O'Donovan N, Crown J. EGFR and HER-2 antagonists in breast cancer. 

Anticancer Res. 2007 May-Jun;27(3A):1285-94. Review. 

Kelleher FC, McKenna M, Collins C, Brady G, Collins I, Crown J. Bisphosphonate induced osteonecrosis of 

the jaws: unravelling uncertainty in disease causality. Acta Oncol. 2007;46(5):702-4. 

Kelleher FC, McKenna M, Collins CD, Crown JP. 

A potential anatomic cause of mandibular osteonecrosis in patients receiving bisphosphonate treatment. 

Mayo Clin Proc. 2007 Jan;82(1):134; author reply 134-5. 


194

Lios Aoibhinn Cancer Support Centre 

2007 was a year of challenge, innovation and development for Lios Aoibhinn Cancer Support Centre. Much 

was achieved and targets were met. However more work is required to continue the development of Lios 

Aoibhinn Cancer Support Centre. Solid foundations based on the highest standards are in place upon which 

future services can be developed. 

Service Activity 

2007 was a time of movement within the Cancer Support Centre. In January we welcomed Paul D’Alton as 

Psychologist to the Oncology service. We bade farewell to Ann Marie McGrath, Complementary Touch 

Therapist at the end of September and wish her well with her continuing education and degree programme 

in Complementary Therapies . In December we said goodbye to Art Therapist, Wendy Marlatt. Wendy had 

facilitated 8 week courses in Creative Arts Therapies since the Centre opened in June 2004. Mary Hennigan, 

Administrative Assistant relocated to the hospital in March and in April we welcomed Caroline Livingstone in 

her place. Caroline had previously worked in the Project office. 

We welcomed 3 new volunteers. Stephen Dollard in May and Fiona Hedigan and Anne Douglas in October. 

We now have 9 volunteers who provide an invaluable “meet and greet” service to people who use Lios Aoibhinn. 

551 people (including 358 new clients) used the service on 4595 occasions in the first 3 years of service 

(2005 – 2007). This represents a steady increase in both the number of clients registering and attending 

and service activity. Two new courses were developed and facilitated in 2007: Men and Prostate Cancer: 

Keeping the Focus and Mindfullness Based Cognitive Therapy. Such was the response that these courses 

will now continue to be offered as part of the centre’s programme of services. 

Challenges 

At year end the challenge is to relocate the Centre. This has been necessitated by the planned construction 

of the new St. Vincent’s Private Hospital on the grounds of St. Anthony’s. Lios Aoibhinn Cancer Support 

Centre was set up in Herbert House in St. Anthony’s in 2004 and since then there has been a steady 

increase in the numbers of people using the centre. Client’s experiences tell us that as well as being a space 

to help them cope with and make sense of what is happening to them, the work of Lios Aoibhinn goes 

beyond that, beyond their experience of just being a “cancer patient”. So while the past four years have been 

busy and challenging they have also been very worthwhile and have afforded us the opportunity of setting 

up and developing a truly credible service which all of us will be working hard to transfer to our new abode. 

The recent announcement that St. Vincent’s University Hospital has been designated one of the cancer 

treatment centres of excellence confirms the vision and commitment by St. Vincent’s Healthcare Group to 

specialist cancer care. However this adds to the urgent need to commit to the parallel development of Lios 

Aoibhinn Cancer Support Centre in line with the development of other oncology services in the hospital to 

take account of increased activity. 


195



Department of Medicine for the Elderly 


Consultants Dr. Morgan Crowe Dr. Diarmuid O’Shea 

Dr. J. J. Barry 

Dr. Rachael Doyle 

Nursing 

Ms Sinead Brennan, Divisional Nurse Manager 

Ms. Imelda Noone, Advanced Nurse Practitioner in Stroke 

Ms. Hilda Markey, CNM II Our Lady’s Ward 

Ms. Therese Carey, CNM II, Carew House Day Hospital 

Ms. Mary Ann Furigay, CNM1, Our Lady’s Ward 

Ms. Hepsy John, CNM1, Our Lady’s Ward 

Registrars Dr. Eugene Wallace Dr. Niamh O’Regan 

Dr. Kit Mun Tan (SpR) 

Dr. Declan Byrne (SpR) 

Social Workers: Ms. Alina Popescu Ms. Margaret Cagney 

Administrative Staff: Ms. Lorraine Murray Ms. Joan Magera 

Ms. Cherryle Millo 


2005 2006 2007 

Inpatients 

Admissions 445 456 414 

Discharges 451 503 503 

Outpatients 

New 221 282 293 

Review 498 602 828 

Carew Day Hospital 

New 594 487 536 

Review 804 799 603 

Stroke Inpatient Service 316 256 251 

Total Attendance 

New 815 771 829 

Review 1302 1401 1431 


2007 was a busy year for the Department of Medicine for the Elderly, which continues to provide an inpatient 

and outpatient consultation service, treatment and rehabilitation primarily for elderly patients from the 

hospital’s catchment area in South East Dublin and East Wicklow. 


196

Issues continuing to challenge the service include the lack of resources to maintain people in their home and 

in hospital with dignity. There is an increase in the number of people awaiting long-term continuing care. 

Great credit is due Ms Hilda Markey, CNM II, and the staff for their continued dedication to the patients on 

Our Lady’s Ward and meeting the ongoing challenges. 

The number of inpatients treated is gradually increasing, as are the outpatient attendances. New patient 

attendance is up from 665 in 2001 to 829 in 2007. This is reflected in the throughput in both outpatients 

and Carew House Day Hospital. Great credit is due to Ms Therese Carey, CNM II, and her multidisciplinary 

team for the quality of work there. 

In Patient Consultations 

In 2007 over 800 inpatient consultations were seen in St Vincent’s University Hospital by the Elderly Care 

Team. Meetings are held weekly between Dr. O Shea, the elderly medicine registrars and the Medical Social 

Work Department to facilitate planning of discharge of those elderly patients on whom consultant colleagues 

have requested advice. 

Orthopaedic Liaison Service 

Dr. Rachael Doyle is leading the continued development of this service with our consultant orthopaedic 

colleagues. 

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. 

The recent National Audit on Stroke report will guide development in this area. Ms. Imelda Noone, Advanced 

Nurse Practitioner in Stroke, is involved in further development of this unit and the introduction of set 

guidelines and protocols. An active stroke follow-up clinic is now up and running in Suite 4 in the new ADCC. 

A once weekly-dedicated TIA (Transient Ischaemic Attack) clinic continues to facilitate assessment and 

treatment of patients with TIAs, who do not require hospital admission. This service requires further 

investment for both improved infrastructure and staffing levels. 

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 130 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. Carew Day 


197


Department - Medicine for the Elderly 

Hospital developments in the future will help provide a more seamless service with the Emergency 

Department and the community in order to reduce or prevent hospital admission with this 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 and 12 are now dedicated to stroke rehabilitation. The 

Day Hospital at the Royal in Donnybrook continues to provide outstanding care and outpatient rehabilitation 

services to those with multidisciplinary needs. The long established links with long-term care facilities 

continue to evolve through the dedicated work of Dr Mary Deane, Medical Director. 


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 J.J. 

Barry. Additional consultant posts are being looked for, to improve the service delivery in St. Vincent’s 

University Hospital. 

Welcome to Ms Hilda Markey CNM II on Our Lady’s Ward and Ms Therese Carey, CNM II in Carew Day 

Hospital who were appointed during the year. We look forward to their contribution and work in the ongoing 

development of these services. 

Achievements / Conferences Attended 

Congratulations to Ms. Imelda Noone who has been accredited as an Advanced Nurse Practitioner in Stroke 

Care and has also has had the position of Clinical Nurse Specialist in Stroke sanctioned. 

Dr. Kevin McCarroll won 2nd place for his poster presentation at the 55th Annual Irish Gerontological Society 

meeting in Croke Park – “Acute Hospital Readmission Rates for Elderly following Discharge from Hospital”. 

The multidisciplinary team members attended The 2nd UK Stroke Forum in Harrogate, Annual Care of the 

Elderly Study Day, The Irish Gerontological Society Conference, Irish Heart Foundation Stroke Study Day and 

the Annual British Geriatric Society Meeting. 

The Fifth Annual Care of the Elderly Study Day took place in March 2007 in the Education & Research 

Centre, St. Vincent’s University Hospital. This year it focused on more general topics and was attended by 

90 people. This is now be a regular study day in the teaching calendar. 

Publications / Abstracts 

Presented at Irish Gerontological Society Meeting 2007 and published in Irish Journal of Medical Science 

1. Acute hospital readmission rates for elderly following discharge to long-term care facilities. 

2. Mortality of patients discharged from hospital to long-term care. 

3. Role of telecare & assistive technology in facilitating home living. 

4. An audit on the prevalence of incontinence in the acute hospital setting. 

5. Atrial fibrillation as a major risk factor for stroke in patients over 80 years of age. 

6. Stroke Activity in the acute hospital setting. 

7. What happens to stroke patients discharged to extended nursing care. 


198



Consultant Nephrologist: Dr. Alan Watson 

Specialist Registrar: 

Dr. Gearoid Mc Mahon 

Registrars: Dr. Mohammad Faisal Khan Dr. James Lineen 

CNM I: 

Michelle Mc Quaid 

Newman Scholar: 

Dr. Simon Curran 

Principal Clinical Engineer: Frank Kelly 

Clinical Nurse Specialists in 

Peritoneal Dialysis: Bairbre Moynihan Emer Kenny 

Department Secretary: 

Jeni Messitt 

Significant publications 

Acute renal disease, as defined by the RIFLE criteria, post liver transplant: O’Riordan A, Wong 

V, McQuillan R, McCormick PA, Hegarty JE, Watson AJ. 

American Journal of Transplantation, 7, 168 – 176, 2007 

The effect of calcimimetic therapy and serum bone biomarkers: Curran S, O’Riordan A, Murray B, Brady 

J, Watson A. Journal of the American Society of Nephrology 18,922a 2007. 

Comparison of the dosage regimens and achieved clinical targets between haemodialysis patients treated 

with Epoetin Beta and Darbepoetin Alpha: Curran S, O’Riordan A, Watson A. 

Proceedings of the Irish Nephrology Society, Irish Journal of Medical Science* 2007. 

Squamous cell carcinoma of the renal pelvis after curative retro peritoneal radiotherapy for seminoma: 

Daly BJ, O’ Brien F, Dowling C, Crotty B, Watson A, Moriarty M, Mulvin D. Journal of Urology 70:812 2007. 

Future Service Developments 

Chronic Kidney Disease Programme. This programme has progressed and a new Clinical Nurse Specialist 

has been appointment. 

The Central Reverse Osmosis Unit has been installed in the St. Peter’s Dialysis Unit replacing individual units 

to allow for sufficiently pure water to be provided to enable online haemodiafiltration to be provided as a 

further modality of treatment of end stage renal disease. 

Outpatients Clinics: there are now three Outpatients Clinics a week allowing for development of speciality 

clinics eg: transplantation, peritoneal dialysis. 


Total HD Treatments in 2007: 9,800 Total PD patients in 2007: 27 


199



Department of Neurology 

The Department of Neurology has continued to substantially expand in 2007. We still have only two 

Consultants, Professor Michael Hutchinson and Dr. Niall Tubridy and we have applied for at least two more 

to continue the progressive service development. 

Marguerite Duggan, our Multiple Sclerosis Nurse Specialist, continues to provide an excellent service for 

people with MS and has been joined by our CNM, Heather Kevelighan, as Parkinson’s Nurse Specialist. 

Heather is running the new Parkinson’s Clinics and is providing a great service for our patients in this area. 

Dr Graham Hughes, Consultant in Care of the Elderly with a special interest in Parkinson’s Disease, has also 

joined the Clinic recently and is a most welcome addition to our expanding service. 

Paula Halpin (Departmental Secretary) has helped bring a greater deal of cohesion and deals with a huge 

amount of phone calls from concerned patients and relatives daily. 

Katie Doyle joined us in 2007 and has done a huge amount of background work in addition to her regular 

work as the Neurology Research Nurse. She has been integral to our studies in epidemiology in MS and in HSP. 

Sinead Jordan also joined the Team in 2007 and has continued the work in MS Treatment Trials and in 

organisation of our research in MS. We are now participating in a number of new trials with oral therapies in 

MS and have gradually increased the numbers of people with MS who have access to Tysabri as a result of 

her work. 

Drs. Roisin Lonergan (MS Research) and David Bradley (Dystonia Research) have been an integral part of 

the Neurology Service and without them the twice-daily clinics would not have been feasible. In addition, both 

have been extremely productive in their first year of research with numerous presentations at National and 

International meetings. 

Dr. Margaret O’Brien has also played a critical role in developing the clinical research in MS and her work 

on OAS in MS has already received many plaudits. 

Dr. Jean Fletcher is working on a joint project in Multiple Sclerosis with the Department of Immunology at 

Trinity College under the supervision of Professor Kingston Mills. She has funding from the SFI for the next 

three years 

The Neurology Ward (in-patients) 

Eilish Funge, the Clinical Nurse Manager continues to run a great ward and shares our aims to improve all 

aspects of the in-patient services. Only patients with the most complex problems are admitted to the ward. 

These patients require skilled, high-intensity nursing and multidisciplinary care from Physiotherapy, 

Occupational Therapy and Speech and Language Therapy. Many can no longer be managed at home or 

need special advice about aids at home from these team members and from the Social Work Department. 

There is a great team spirit in the Department of Neurology with regular multidisciplinary meetings, radiology 

meetings, the Journal Club and up-date meetings about recent advances, new therapies and techniques. 


200


Neurology in the Ambulatory Day Care Centre (ADCC). 

The move to the new ADCC allowed the development of a new rota of Neurology Outpatient services in 

2006. This involves public neurology clinics twice a day and has already improved the service dramatically. 

In 2008 we will see over 6000 outpatients. We have reduced the waiting times substantially as part of our 

continued waiting list initiative. 

400 

Total Number of Sessions 

400 



300 

200 

100 


300 

200 

100 

0 2003-2004 2004-2005 2005-2006 2006-2007 

0 2003-2004 2004-2005 2005-2006 2006-2007 

400 


400 



300 

200 

100 


300 

200 

100 

0 2003-2004 2004-2005 2005-2006 2006-2007 

0 2003-2004 2004-2005 2005-2006 2006-2007 

We now have Specialist Clinics for Parkinson’s Disease, Multiple Sclerosis, Neuroinflammation, and a 

Dystonia/Botulinum Toxin Clinic. 

We are running Special Therapy Clinics to facilitate patients who otherwise might require hospitalisation. We 

saw over 1000 people in the ADCC for procedures such as lumbar punctures and for administration of 

therapies that would previously have required the sue of Day Ward facilities and thus have contributed to 

huge savings for the hospital and the Health Service as a whole. 

We have a dedicated secretary (Orla Bannon) to (always cheerfully!) check patients in and we have a number 

of other initiatives planned to make sure that attendance at the clinics are less stressful. Orla has worked 

hard with Radiology and Niamh Gaffney to deal with the long waiting list for outpatient MRIs and we are 

employing the NTPF currently to obtain MRI scans for those outpatients waiting more than 3 months for a 

scan with great success. 


201


Department - Neurology 

All of this has been made possible only with the help of a wide variety of people but we would like to thank 

especially Bernadette Howard, Margaret Boland and Breege Screene. 

Our e-mail neurology service (called ‘Neurolink’) continues to work well and we hope to expand it. St James’ 

Hospital has now adopted the project too which is encouraging and we are grateful to Healthlink for all of 

their support. We are most grateful for the co-operation of the GPs who use it and it has been a successful 

venture in that it has helped further reduce the burden on the Emergency Department, in-patient beds 

required and, of course, our patient waiting times. We have now expanded the project to allow access to over 

120 GPs in the South Dublin area. 

We have also introduced a new in-patient referral service that is intranet-based and allows us to expedite 

review of people with neurological issues under the acre of colleagues in the hospital. This has had a great 

impact particularly in the Emergency Department where patients are seen rapidly and a management plan 

formulated to facilitate early discharge. 

The Neurology web-site is being developed over 2007/8 and will soon have information not just on our 

department, but also links regarding research in MS and clinical information on Parkinson’s, Epilepsy, 

Migraine and other common neurological problems. 

Tysabri is being administered by an intravenous infusion every month and so the amount of work required to 

administer this has greatly increased the demands on our service, particularly our MS Specialist Nurse. We 

expect the numbers to gradually increase over the next 12 months. We have already reached maximum 

capacity for this after three months (i.e. >50 people get a monthly infusion and each takes 2-3 hours). To 

continue to offer this treatment we will need another MS Specialist Nurse. 

We are now trying to establish an infusion unit in conjunction with other specialities to improve access for 

patients throughout the day. 

Significant Achievements in 2007 

Dr. Roisin Lonergan won Best MS paper at the Diaspora Meeting in Dublin in October 2007. 

Dr. Lisa Costelloe won Best MS paper at the INA in Belfast in 2007 

Other papers presented by the Team at the INA in Belfast (2007) included those by Drs. Tubridy, Eoin 

Flanagan, Michael Murnane, and Grainne Gorman. 

Significant Recent Publications 

Walsh R, Hutchinson M. 

Molding the sensory cortex: spatial acuity improves after botulinum toxin treatment for cervical dystonia. 

Mov Disord 2007 Dec;22(16):2443-6. 

Spain LA, Tubridy N, Kilpatrick TJ, Adams SJ, Holmes AC. 

Illness perception and health-related quality of life in multiple sclerosis. 

Acta Neurol Scand 2007 Nov;116(5):293-9. 


202


Department - Neurology 

O'Rourke K, Walsh C, Hutchinson M. 

Outcome of beta-interferon treatment in relapsing-remitting multiple sclerosis: a Bayesian analysis. J 

Neurol. 2007 Nov;254(11):1547-54 

Flanagan E, Walsh C, Tubridy N. 

'Neurophobia'--attitudes of medical students and doctors in Ireland to neurological teaching. Eur J Neurol 

2007 Oct;14(10):1109-12. 

Calabresi PA, Giovannoni G, Confavreux C, Galetta SL, Havrdova E, Hutchinson M, Kappos L, Miller DH, 

O'Connor PW, Phillips JT, Polman CH, Radue EW, Rudick RA, Stuart WH, Lublin FD, Wajgt A, Weinstock- 

Guttman B, Wynn DR, Lynn F, Panzara MA; AFFIRM and SENTINEL Investigators.The incidence and 

significance of anti-natalizumab antibodies: results from AFFIRM and SENTINEL. Neurology. 2007 Oct 

2;69(14):1391-403. 

Rudick RA, Miller D, Hass S, Hutchinson M, Calabresi PA, Confavreux C, Galetta SL, Giovannoni G, Havrdova 

E, Kappos L, Lublin FD, Miller DH, O'Connor PW, Phillips JT, Polman CH, Radue EW, Stuart WH, Wajgt A, 

Weinstock-Guttman B, Wynn DR, Lynn F, Panzara MA; 

AFFIRM and SENTINEL Investigators.Health-related quality of life in multiple sclerosis: effects of 

natalizumab. Ann Neurol 2007 Oct;62(4):335-46. 

Costelloe L, Hutchinson M. Is a 20% change in MSFC components clinically meaningful? 

Mult Scler 2007 Sep;13(8):1076. 

Roberts K, Costelloe D, Hutchinson M, Tubridy N. 

What difference does a neurologist make in a general hospital? Estimating the impact of neurology 

consultations on in-patient care. Ir J Med Sci 2007 Sep;176(3):211-4. 

Walsh R, O'Dwyer JP, Sheikh IH, O'Riordan S, Lynch T, Hutchinson M. Sporadic adult onset dystonia: 

sensory abnormalities as an endophenotype in unaffected relatives. 

J Neurol Neurosurg Psychiatry 2007 Sep;78(9):980-3. 

Low M, Nicholls K, Tubridy N, Hand P, Velakoulis D, Kiers L, Mitchell P, Becker G. 

Neurology of Fabry disease. Intern Med J 2007 Jul;37(7):436-47. 

Hutchinson M. Natalizumab: 

A new treatment for relapsing remitting multiple sclerosis. Ther Clin Risk Manag 2007 Jun;3(2):259-268. 

Miller DH, Soon D, Fernando KT, MacManus DG, Barker GJ, Yousry TA, Fisher E, O'Connor PW, Phillips JT, 

Polman CH, Kappos L, Hutchinson M, Havrdova E, Lublin FD, Giovannoni G, Wajgt A, Rudick R, Lynn F, 

Panzara MA, Sandrock AW; 

AFFIRM Investigators. MRI outcomes in a placebo-controlled trial of natalizumab in relapsing MS. 

Neurology 2007 Apr 24;68(17):1390-401. 

O'Rourke K, Walsh C, Antonelli G, Hutchinson M. 

Predicting beta-interferon failure in relapsing-remitting multiple sclerosis. 

Mult Scler 2007 Apr;13(3):336-42. 

Balcer LJ, Galetta SL, Calabresi PA, Confavreux C, Giovannoni G, Havrdova E, Hutchinson M, Kappos L, 


203



Lublin FD, Miller DH, O'Connor PW, Phillips JT, Polman CH, Radue EW, Rudick RA, Stuart WH, Wajgt A, 

Weinstock-Guttman B, Wynn DR, Lynn F, Panzara MA. 

Natalizumab reduces visual loss in patients with relapsing multiple sclerosis. Neurology 2007 Apr 

17;68(16):1299-304. 

Beetz C, Zuchner S, Ashley-Koch A, Auer-Grumbach M, Byrne P, Chinnery PF, Hutchinson M, McDermott CJ, 

Meijer IA, Nygren AO, Pericak-Vance M, Pyle A, Rouleau GA, Schickel J, Shaw PJ, Deufel T. 

Linkage to a known gene but no mutation identified: comprehensive reanalysis of SPG4 HSP pedigrees 

reveals large deletions as the sole cause. Hum Mutat 2007 Jul;28(7):739-40. 

McHugh JC, Bradley D, Hutchinson M, Brett F, Heffernan J, Howley R, Farrell M, Tubridy N. Variant 

Creutzfeldt-Jakob disease: first two indigenous cases in Republic of Ireland. Case report and perspective. 

Eur J Neurol 2007 Apr;14(4):467-9. 

Costelloe L, O'Rourke K, Kearney H, McGuigan C, Gribbin L, Duggan M, Daly L, Tubridy N, Hutchinson M. 

The patient knows best: significant change in the physical component of the Multiple Sclerosis Impact 

Scale (MSIS-29 physical). J Neurol Neurosurg Psychiatry 2007 Aug;78(8):841-4. 

Future Plans 

GP-led Migraine Clinic – we plan to have a weekly GP-led migraine clinic for the many thousands of people 

with migraine in our area and require funding for the GPs sessions, a migraine registrar and a migraine nurse. 

Such an investment would substantially reduce attendances at the Emergency Department and thus hospital 

admissions. It would have a major impact for our patients in terms of waiting times and overall economic 

savings would be substantial. 

Audit 

Consultation service for in-patients of all services 

The Neurology service sees 10-20 in-patients with neurological problems each week. Over a 6-month period, 

254 referrals were seen. There was a significant change in diagnosis in 55%, and in management in nearly 

70%. Neurological referral facilitated earlier discharge for 65% patients. 

Neurology in the Emergency Department (ED). We previously performed an audit of the ED admissions at 

SVUH that had a neurological problem. Between 13and 15% of all ED admissions had a neurological 

problem. The most common conditions were headaches (19%), post-traumatic neurological signs (16%), 

seizures (10%), stroke (17%), loss of consciousness (6%), and dizzy/syncope (6%). 

Teaching 

The Department has an excellent reputation in teaching under-graduate and post-graduate students 

Department runs the MRCP examinations three times a year 

We also run an annual MRCPI course in Neurology as well as in hospital MRCP teaching sessions there 

times a year. 


204


Clinical Neurophysiology Department 

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 Children’s Hospital (AMNCH) at Tallaght. As this service is currently run by one Consultant, it is 

best to consider this service as a whole. 

The range of investigative/diagnostic services provided include routine Nerve Conduction Studies (NCS), 

Needle Electromyography (EMG), Quantitative Sensory Testing (QST), Electroencephalography (EEG) and 

Evoked Potentials (EPs). 

Research, currently being carried out mainly at the AMNCH and St Vincent’s University Hospital 

Departments, includes 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. 

Clinical Neurophysiology Staffing 

Consultant, and Head of Department: 

Dr Sean Connolly, MD, FRCPI 

[Voicemail: 2094541; E-mail: sean.connolly@ucd.ie] 

Neurophysiology Measurement Technologists: 

There are two senior technologists, one permanent (Ms Brigid Clark) 

and one on a fixed term contract (Ms Anne Bjerke). 

SVUH departmental secretary/manager: 

Ms Lesley Bergin 

Recent Developments 

Efforts are continuing to appoint more technologists and to provide additional departmental space. 


205


Recent Publications 

Stephen Faul, Gregor Gregoraia, ˇ ˇ Geraldine Boylan, William Marnane, Gordon Lightbody and Sean Connolly. 

Gaussian Process Modelling of the EEG for Detection of Neonatal Seizures, 

IEEE Transaction on Biomedical Engineering 2007;54:2151-62 

Murray DM, Boylan GB, Ali I, Ryan CA, Murphy BP, Connolly S. Defining the gap between electrographic 

seizure burden, clinical expression, and staff recognition of neonatal seizures. 

Arch Dis Child Fetal Neonatal Ed. 2007 Jul 11 (Epub ahead of print) 

McHugh JC, Murray B, Renganathan R, Connolly S, Lynch T. 

GAD antibody positive paraneoplastic stiff person syndrome in a patient with renal cell carcinoma. 

Movement Disorders 2007;22(9):1343-6 

Greene BR, de Chazal P, Boylan G, Reilly RB, Connolly S. 

Electrocardiogram based neonatal seizure detection. IEEE Transaction on Biomedical Engineering 

2007;54(4):673-82 

Greene BR, Boylan GB, Reilly RB, de Chazal P, Connolly S. 

Combination of EEG and ECG for improved neonatal seizure detection. 

Clinical Neurophysiology 2007;118:1348-59 

Recent Contribution to a book: 

Sean Connolly is a co-author of the Oxford Handbook of Neurology (Oxford University Press). [Authors: Hadi 

Manji, Sean Connolly, Neil Dorward, Neil Kitchen, Amrish Mehta and Adrian Wills] 


206




Staff: 

Consultant: 

Dr Eoin Tiernan 

Clinical Nurse Specialists: 

St. Vincent’s University Hospital: 

Ms Millie Devenish 

Ms Siobhan Hollingsworth 

St. Vincent’s Private Hospital: 

Ms. Carmel Houlihan 

Olga Price 

Ms Barbara Whyte 

Ms. Rachel Algar (part-time) 

Specialist Registrars: Dr Carol Stone- 01/01/07 to 30/06/07 

Dr Ashling O’Gorman – 01/07/07 to 31/12/07 

Registrars: Dr Brenda O’Connor – 01/01/07 to 30/06/07 

Dr Tim Price – 01/07/07 to 31/12/07 

Principal Psychologist: Ms. Ursula Bates (2 sessions per week) 

Senior Social Worker: Ms Aine Canny 

Care of the Dying Project 

Facilitator: Ms. Pauline Ui Dhuibhir (until Nov ’07) 

Administrative Support: Ms Joan Stokes Mr Olajide Ogidan 

2007 was another busy year for the Palliative Medicine Department seeing the total number of referrals 

across St. Vincent’s University Hospital and St. Vincent’s Private Hospital exceed 1000 for the first time 

(1,038 referrals in total) – this represented an increase of 12% in the total number of referrals compared 

with 2006. 18% of total referrals had a non-cancer diagnosis. 

The “Link Nurse” programme, established in 2006, was continued in 2007 supported by nursing 

administration. It includes a programme of monthly meetings set up for nurses interested in becoming 

palliative care link nurses. The role of the link nurses is to develop their knowledge in palliative care issues 

and to share that knowledge with other ward staff via formal and informal teaching. The aim of the 

programme is to promote the hospice model of excellence in end-of-life care throughout SVUH by fostering: 

• Knowledge about symptom management; 

• Skills in communicating with the dying patient, the family and the multi-disciplinary team; 

• Awareness of ethical issues regarding interventions and patient preferences; 

• Excellence in spiritual and psychological care. 

This programme identifies 2 nurses from each ward who act as local “champions”/resources for palliative 

care issues in general. 

The “Care of the Dying Project”, which was launched in 2004, was completed in November, with the Liverpool 

Care Pathway operational across all general wards in St. Vincent’s University Hospital. 


207



Education 

Two very successful study days titled “A Framework for End of Life Care” were facilitated by the clinical nurse 

specialists in conjunction with the Department of Preventive Medicine and Health Promotion. 

The team continues to contribute to a wide range of educational programmes for doctors, nurses and other 

professionals both in-house and at national meetings, as well as facilitating clinical placements for nurses 

undertaking the Higher Diplomas in Palliative Care Nursing and Pain Management from UCD. 

Courses and Conferences attended by members of the team 

A selection of the external educational events attended by members of the team: 

• Care of older people in the last days of life: A pathway to excellence. Jo Hockley, Croke Park Fri 

26th January 

• Irish Care Pathway Network Meetings: January 31st Great Southern Hotel, Dublin Airport 

• 7th Annual IAPC Education & Research Seminar. 1st Feb, Law Society, Dublin. 

• Palliative Care & Oncology-‘the odd couple?’ 23rd February 2007 Dublin Castle 

• St Francis Hospice. Multi disciplinary course in Palliative Care. The care pathway. March 29th 2007 

• Nadur/ Meitheal,Milford Hospice, Limerick April 20th 

• St. Francis Hospice. Palliative Care for Elderly Care Pathway. April 26th 2007 

• Our Lady’s Hospice, Palliative Care Update for nurses. Sedation at the end of life: whose needs? 

May 3rd 2007 

• Kaleidoscope May 2007. Dublin Castle. 

• EAPC Conference, Budapest, June 2007. 

• ‘Hope and Opportunity-Putting Hospice Principles into Hospital Practice’ Hospice friendly hospitals 

programme. Clontarf Castle Hotel. 14th November 2007 

• I.A.P.C. A.G.M. 30th November Blackhall Place, Dublin. 

Achievements 

During 2007, Ms. Barbara Whyte, Clinical Nurse Specialist, was chairperson of the Nursing Advisory Forum 

of the Irish Association for Palliative Care. She also sat on the steering group for the development of a 

Strategic Plan for the IAPC, and on the Irish Hospice Foundation group looking at ways of expanding 

palliative care to patients with dementia. 

Publications 

Peer-reviewed publications - 

O'Leary N, Tiernan E, Walsh D, Lucey N, Kirkova J, Davis MP. The pitfalls of a systematic MEDLINE review 

in palliative medicine: symptom assessment instruments. Am J Hosp Palliat Care. 2007 Jun-Jul;24(3):181-4. 


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Prof. W. McNicholas, Dr. Tim McDonnell. 

Statistics period: January – December 2007 

In-patient & Day Care Activity 

Prof. W. McNicholas Dr T.McDonnell Total 

Admissions 473 1 474 

Sleep Laboratory Admissions 375 - 375 

Total 848 1 849 

Discharges 773 18 801 

Day Care 53 15 68 

Outpatient Activity 

Outpatients No of sessions New Return Total 

Dr W. McNicholas (Tues Respiratory) 51 179 921 1100 

Dr W. McNicholas (Wed Sleep Apnea) 52 233 696 929 

Dr T. Mc Donnell 49 68 345 413 

Pulmonary Function Laboratory: 

Total pts SMH 441 Total no. tests 925 

Total pts SVUH 3250 Total no. tests 6607 

Overall total 3,691 7,532 

Sleep Laboratory: 

Total Admissions: 375 

CPAP commencements: 110 


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The pulmonary function laboratory continues in its temporary location but clear deficiencies are evident, 

particularly the lack of adequate space to perform patient testing and the lack of a patient waiting area. Patients 

are obliged to wait for testing in an open main hospital corridor, which has generated numerous complaints. 

The acute Non Invasive Ventilation (NIV) unit in St. John’s Ward, which opened in late 2005, has provided a 

designated base to concentrate the skills related to managing patients in acute respiratory failure requiring 

pressure support. The unit is the first such dedicated facility in Ireland and has been visited by representatives 

from other acute hospitals in Ireland. However, an audit of activity during 2007 indicated that the majority of 

patients requiring NIV were started on NIV outside the unit, which reflects the lack of any protected beds in 

the unit to allow the immediate transfer of a patient requiring NIV to the unit. 

The move to the new Ambulatory Day Care Centre has allowed an expansion of outpatient services. In 

addition to the existing Tuesday morning clinic (which is now exclusively respiratory), there is a weekly sleep 

apnoea clinic on Wednesday morning, which has considerably improved the ability to assess and follow 

patients with sleep apnoea. 

Respiratory Education Centre 

The Respiratory Education Centre received a total of 1635 consults during 2007, which reflects an annual 

increasing trend. There has been a 25% increase in our involvement with Non Invasive Ventilation. Staff 

education re Bi Level NIV continues. 236 staff nursing and physiotherapists have been trained to date. 

Several audits were undertaken; 

Patient satisfaction survey ADCC. 

RNS response times to telephone enquiries. 

Appropriateness of calls to telephone advice line. 

Annual audit RNS clinical input. 

An evaluation of a formal referral system to the RNS Service. 

HF CPAP equipment audit 

RNS Poster Presentation at audit masterclass 

“How to catch……... a Respiratory Nurse! 

A survey of referrals to the Respiratory Nurse Service. 

The Respiratory Nurse Specialists attended the Irish Thoracic Society Annual Conference. 

Summary of Research Activities: 

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 Prof. Cormac Taylor in the 

Conway Institute at UCD and the School of Electronic and Electrical Engineering (Prof. Conor Heneghan and 

Dr. Madeleine Lowery), also in UCD. Dr. John Garvey and Dr. David McSharry are the Research Fellows 

involved. Together with Prof. 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 collaboration with 

Prof. Heneghan, we have studied the ability to identify sleep apnoea from digital signal processing of the 


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ECG signal, based on characteristic changes in the ECG that accompany apnoea. In collaboration with Dr. 

Lowery, 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. 

Honours and Distinctions 

Professor McNicholas continues as Chair of a EU COST Action (B26) on obstructive sleep apnoea and as the 

founding President of the Irish Sleep Society. Geraldine Nolan continues as Secretary of the Irish Sleep Society. 

Visiting Professorship: Prof McNicholas at the University of Sydney, August 2007. 

Invited Lectures 

Prof. McNicholas: 

Seventh Annual Ludwig Engel memorial lecture. University of Sydney Aug 2007 

World Sleep Conference, Cairns Australia Sept 2007 

10th International Sleep and Breathing Symposium Palm Cove Australia, Sept 2007. 

ERS Research symposium on chronic co-morbidities, Rome Feb 2007 

State of the Art Respiratory Symposium, University of Athens, April 2007 

Joint COST/ERS Research symposium on interactions of obesity and sleep apnoea, Düsseldorf , Nov 2007 

Dr. Silke Ryan: European Respiratory Society, September. 

Presentations of original research were given by members of the research team at the annual meeting of the 

American Thoracic Society in San Francisco in May (Dr. John Garvey), and the annual meeting of the 

European Respiratory Society in Stockholm in September (Dr. John Garvey and Dr. Silke Ryan). 

Selected Publications 2007 - Prof. McNicholas (see ERC report for complete list). 

McNicholas WT, Bonsignore MR; Management Committee of EU COST ACTION B26. Sleep apnoea as 

an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research 

priorities. Eur Respir J. 2007 Jan;29(1):156-78. Review. PMID: 17197482 [PubMed - indexed for MEDLINE] 

Doherty LS, Kiely JL, Deegan PC, Nolan G, McCabe S, Green AJ, Ennis S, McNicholas WT. Late-onset 

central hypoventilation syndrome: a family genetic study. Eur Respir J. 2007 Feb;29(2):312-6. PMID: 

17264323 [PubMed - indexed for MEDLINE] 

McSharry DG, McElwaine P, Segadal L, McNicholas WT. All that wheezes is not asthma. Lancet. 2007 Sep 

1;370(9589):800. PMID: 17765530 [PubMed - indexed for MEDLINE] 

4. Ryan S, McNicholas WT, Taylor CT. A critical role for p38 map kinase in NF-kappaB signaling during 

intermittent hypoxia/reoxygenation. Biochem Biophys Res Commun. 2007 Apr 13;355(3):728-33. Epub 

2007 Feb 9. PMID: 17316568 [PubMed - indexed for MEDLINE] 

Ryan S, Nolan GM, Hannigan E, Cunningham S, Taylor C, McNicholas WT. Cardiovascular risk markers in 

obstructive sleep apnoea syndrome and correlation with obesity. Thorax. 2007 Jun;62(6):509-14. Epub 

2007 Jan 24. PMID: 17251313 [PubMed - indexed for MEDLINE] 


211

Bone & Joint Unit 

The St. Vincent’s Healthcare Group (SVHG) Bone and Joint Unit is comprised of specialities of Orthopaedic 

Surgery, Rheumatology and of Rehabilitation Medicine. The Bone and Joint Unit is the only such unit in 

Ireland and the Mission of the Bone and Joint Unit is fourfold. 

1. To provide an evidence based, multidisciplinary care programme to all patients presenting to 

SVHG with musculoskeletal and rehabilitation related clinical related problems. 

2. By linking closely with community care to devise programmes of patient management, which are 

designed to offer speedy access, early intervention and discharge back to the community where 

appropriate. 

3. By coordinating teaching programmes to provide a unique, educational programme for medical 

undergraduates, post-graduate trainees and for nurses, physiotherapists and occupational 

therapists wishing to develop specialist musculoskeletal expertise. 

4. By promoting interdisciplinary cooperation to further develop and expand the academic and 

research infrastructure relating to musculoskeletal disease. 

The Bone and Joint Unit has been operational since the summer of 2006. Clinics are provided within the 

Unit operating on the basis of three by three clinics per day in addition to daily fracture clinics. Members of 

the Bone and Joint Unit meet on a monthly basis to help plan and develop the service and to improve the 

delivery of care to our patients. 


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Department of Rheumatology 


Consultant Staff: Professor Barry Bresnihan Professor Oliver FitzGerald 


Dr. Orla Killeen 

Specialist Registrars: Dr. Shafeeq Alraqi Dr. Ceara Walsh (July-present) 

Registrars: 

Dr. John Paul Doran 

Research Registrars: Dr. Ceara Walsh (January-June) Dr. Laure Brulhart 

Dr. Bernadette Lynch 

Dr. Eliza Pontifex 

Dr. Chin Teck Ng 

Dr. Taj Saber 

Nursing Staff: Ms Catherine Slattery Mrs. Miriam Molloy 

Mrs. Phil Gallagher 

Mrs. Alexia Grier 

Mrs. Marie O’Rourke 

Mrs. Eileen O’Flynn 

Mrs. Susan van der Kamp 

Ms Imelda Corcoran 

Ms Bincy Varghese 

Administration Staff: Ms. Jenni Cross Ms. Mary White 

Mrs. Linda Collins 

Ms. Frances Dwyer 

Ms. Ann Sharkey 

Ms. Saibh Kelley 


Specific programmes, which are operational within the Bone and Joint Unit, include the Early Arthritis Clinic, 

the Adolescent Transitional Clinic, the clinic designated for patients on biologic therapies and the nurse-led 

Methotrexate Clinic. The Fracture Liaison Nurse service (FLS) position has been in place throughout 2007 

funded by Eli Lilly. An audit of this service by FLS nurse Annette Whelan has confirmed that patients with 

low trauma fracture are being identified, fully assessed including DXA scanning and are being commenced 

on appropriate treatment to prevent further fracture. It is hoped that the funding of this position will be taken 

up by the hospital in 2008. 

Other significant achievements, within 2007, include the following: 

The Bone Density Department has expanded with two DXA scanners on site within the Bone and Joint Unit. 

The further coordinated development of DXA scanning within the St. Vincent’s Healthcare Group is planned. 

Coordinated by Dr. Bernadette Lynch and Specialist Physiotherapist Martina Fitzpatrick, musculoskeletal 

ultrasound continues to be available within the Bone and Joint Unit. A new state-of-the-art musculoskeletal 

ultrasound machine will be installed early in 2008. 

Work is well on the way to develop a database for inflammatory arthritis patients. It is hoped that the 

database will be operational by mid-2008. Significant support to develop this database has been obtained 

through a grant received from Abbott Immunology. 


213


Department - Rheumatology 

Needle arthroscopy continues to be available within the department. The arthroscopies are now being 

undertaken in the Clinical Research Centre. Professor Douglas Veale is coordinating this programme. 


Consultant achievements 

Prof Barry Bresnihan 

• Co-Chairman, EULAR Synovitis Study Group 

• Co-Chairman, OMERACT Synovial Tissue Analysis Study Group 

• Chairman, Arthritis Ireland –October 2007 

• Chairman scientific session, EULAR, June 

• Invited Speaker 

Italian Society of Rheumatology, Catania 

Royal Society Medicine, London 

British Bone Society, Aberdeen 

Prof Oliver FitzGerald 

• Chairman, Arthritis Ireland (Oct-present) 

• Member of HSE working group on Arthritis and Allied conditions representing the Irish 

Society of Rheumatology 

• Steering committee member for GRAPPA (Group for Research and Assessment of Psoriasis 

and Psoriatic Arthritis) 

• Member of Abbott International Immunology Advisory Board 

• Lead Consultant Bone & Joint Unit, SVUH 

• Steering committee member of OMERACT Biomarkers Group 

• Scientific committee member 3e Initiative in Rheumatology 

• Invited speaker at the following: 

Rochester University, New York 

Progress and Promise Meeting, Munich 

Ulster Internal Medicine Association, Belfast 

Prof Douglas Veale 

• Adjunct Professor of Medicine, UCD awarded 2007 

• Medical Director, Education & Research Centre, SVHG 

• Chairman, SVGH Ethics & Medical Research Committee 

• Vice-president, International Scleroderma Clinical Trials Consortium 

• International Advisor, The Strategic Scientific Committee, Arthritis Research Campaign, UK 

• Director of THERAPI - Translational Medicine Research Group, SVUH 

• HRB Infection & Immunity Grant Committee 

• Irish Medicines Board, Medicines Committee 

• Medical Executive, SVHG 

• Seed Funding Committee, UCD 

• Postgraduate Degree Programme Committee, UCD 


214



• Chairman, Bone and Joint Accreditation committee 

• Medical Director, Rheumatology Rehabilitation Unit, Our Lady’s Hospice, Harold’s Cross 

• International Advisor to Wyeth (Global), Wyeth (Europe), Schering-Plough (Global), 

Centocor (Global) and GlaxoSmithKline (Global) 

• IJMS Awards Best Published Paper – Rheumatology 2007 

• Joint Irish and British Society of Rheumatology - Best Oral presentation 2007 

• SIAR Award - American College of Rheumatology 2007 

• Visiting Speaker 

Swiss Rheumatology Society 

British Society for Rheumatology 

University of Newcastle 

Grants 

Efficacy of switching anti-TNF therapies in patients with rheumatoid arthritis. 

Abbott: €64,000 (PI-Oliver FitzGerald) 

Etanercept in Psoriasis and Psoriatic Arthritis: A pilot study in 15 patients. 

Wyeth: €120,000 (PI-Oliver FitzGerald) 

Differential expression of VEGF, PIGF and the VEGF receptors in Inflammatory arthritis. 

HRB Project Grant: €165,000 (PI-Oliver FitzGerald) 

Differential Protein expression in psoriatic arthritis synovial tissue following 

anti-TNF therapy. (PI-Oliver FitzGerald) 

Abbott: €100,000 

Development of Inflammatory Arthritis database. 

Abbott: €240,000 (PI-Oliver FitzGerald) 

Hypoxia-induced mitochondrial signalling pathways in inflammatory arthritis. 

HRB Translational Award 2006-2011, €1.5m (PI-Douglas Veale) 

Autocure EU 6th Framework Grant (PI-Barry Bresnihan) 

‘Curing Autoimmune Disease – translational approach’ €212,500 over 5 years 

Biopharmaceutical/Pharmaceutical Science Programme 

PRTLI Cycle 4, €4.6 million (Co-applicant – Douglas Veale) 

A CELLMAX® Artificial Capillary System and Flexercell Strain Unit 

UCD Research Support Schemes. €35k (PI - Douglas Veale) 

Hypoxia-induced mitochondrial signaling pathways in inflammatory arthritis promote 

angiogenesis and synovial invasiveness and may predict response to therapy. 

HRB Translational Award €1.4 million (PI - Douglas Veale) 


215



Hypoxia Chambers and Luminometer 

HRB Equipment Grant Award €75k (PI - Ursula Fearon) 

In vivo Hypoxic probes and monitor. 

UCD Seed Funding €20k (PI - Ursula Fearon) 

Proof of concept studies of novel biopharmaceutical and small molecular 

weight inhibitors using whole tissue explant cultures. 

GlaxoSmithKline €680k (PI - Douglas Veale) 

Cytokine Regulation in Synovial explant cultures and pre/post biologic therapy. 

Wyeth Pharmaceuticals €350k (PI - Douglas Veale) 

Publications: 

Fearon U, Veale DJ. 

Angiogenesis in arthritis: methodological and analytical details. 

Methods Mol Med. 2007;135:343-57. PMID: 17951670 [PubMed - indexed for MEDLINE] 

Greetham D, Ellis CD, Mewar D, Fearon U, an Ultaigh SN, Veale DJ, Guesdon F, Wilson AG. 

Functional characterization of NF-kappaB inhibitor-like protein 1 (NFkappaBIL1), a candidate 

susceptibility gene for rheumatoid arthritis. Hum Mol Genet. 2007 Dec 15;16(24):3027-36. Epub 2007 

Sep 12. PMID: 17855452 [PubMed - in process] 

Mullan RH, Matthews C, Bresnihan B, FitzGerald O, King L, Poole AR, Fearon U, Veale DJ. 

Early changes in serum type II collagen biomarkers predict radiographic progression at one year in 

inflammatory arthritis patients after biologic therapy. 

Arthritis Rheum. 2007 Sep;56(9):2919-28. PMID: 17763421 [PubMed - indexed for MEDLINE] 

Gladman DD, Inman RD, Cook RJ, Maksymowych WP, Braun J, Davis JC, Landewé RB, Mease P, Brandt 

J, Vargas RB, Chandran V, Helliwell P, Kavanaugh A, O'Shea FD, Khan MA, Pipitone N, Rahman P, Reveille 

JD, Stone MA, Taylor W, Veale DJ, van der Heijde D. 

International spondyloarthritis interobserver reliability exercise--the INSPIRE study: II. Assessment of 

peripheral joints, enthesitis, and dactylitis. 

J Rheumatol. 2007 Aug;34(8):1740-5. PMID: 17659754 [PubMed - indexed for MEDLINE] 

Burgoyne CH, Field SL, Brown AK, Hensor EM, English A, Bingham SL, Verburg R, Fearon U, Lawson CA, 

Hamlin JP, Straszynski L, Veale D, Conaghan P, Hull MA, van Laar JM, Tennant A, Emery P, Isaacs JD, 

Ponchel F. Abnormal T-cell differentiation persists in rheumatoid arthritis patients in clinical remission and 

predicts relapse. Ann Rheum Dis. 2007 Jul 20; [Epub ahead of print] PMID: 17644540 [PubMed - as 

supplied by publisher] 

Walsh CA, Minnock P, Slattery C, Kennedy N, Pang F, Veale DJ, Bresnihan B, FitzGerald O. 

Quality of life and economic impact of switching from established infliximab therapy to adalimumab in 

patients with rheumatoid arthritis. Rheumatology (Oxford). 2007 Jul;46(7):1148-52. Epub 2007 May 3. 

PMID: 17478471 [PubMed - indexed for MEDLINE] 


216



Rooney T, Bresnihan B, Andersson U, Gogarty M, Kraan M, Schumacher HR, Ulfgren AK, Veale DJ, Youssef 

PP, Tak PP. Microscopic measurement of inflammation in synovial tissue: inter-observer agreement for 

manual quantitative, semiquantitative and computerised digital image analysis. 

Ann Rheum Dis. 2007 Dec;66(12):1656-60. Epub 2007 Jun 29. PMID: 17604286 [PubMed - indexed for 

MEDLINE] 

Bresnihan B, Gerlag DM, Rooney T, Smeets TJ, Wijbrandts CA, Boyle D, Fitzgerald O, Kirkham BW, 

McInnes IB, Smith M, Ulfgren AK, Veale DJ, Tak PP. Synovial macrophages as a biomarker of response 

to therapeutic intervention in rheumatoid arthritis: standardization and consistency across centers. 

J Rheumatol. 2007 Mar;34(3):620-2. PMID: 17343309 [PubMed - indexed for MEDLINE] 

Denton CP, Merkel PA, Furst DE, Khanna D, Emery P, Hsu VM, Silliman N, Streisand J, Powell J, Akesson 

A, Coppock J, Hoogen F, Herrick A, Mayes MD, Veale D, Haas J, Ledbetter S, Korn JH, Black CM, Seibold 

JR; Cat-192 Study Group; Scleroderma Clinical Trials Consortium. Recombinant human antitransforming 

growth factor beta1 antibody therapy in systemic sclerosis: a multicenter, randomized, 

placebo-controlled phase I/II trial of CAT-192. 

Arthritis Rheum. 2007 Jan;56(1):323-33. PMID: 17195236 [PubMed - indexed for MEDLINE] 

Marzo-Ortega H, McGonagle D, Rhodes LA, Tan AL, Conaghan PG, O'Connor P, Tanner SF, Fraser A, 

Veale D, Emery P. Efficacy of infliximab on MRI-determined bone oedema in psoriatic arthritis. Ann Rheum 

Dis. 2007 Jun;66(6):778-81. Epub 2006 Dec 21. PMID: 17185324 [PubMed - indexed for MEDLINE] 

Ralph JA, Zocco D, Bresnihan B, Fitzgerald O, McEvoy AN, Murphy EP. 

A role for type 1alpha corticotropin-releasing hormone receptors in mediating local changes in chronically 

inflamed tissue.Am J Pathol. 2007 Mar;170(3):1121-33. PMID: 17322394 [PubMed - indexed for 

MEDLINE] 

Gogarty M, Fitzgerald O. 

Immunohistochemistry of the inflamed synovium. 

Methods Mol Med. 2007;135:47-63. PMID: 17951651 [PubMed - indexed for MEDLINE] 

Patterson AM, Cartwright A, David G, Fitzgerald O, Bresnihan B, Ashton BA, Middleton JF. 

Differential expression of syndecans and glypicans in chronically inflamed synovium. 

Ann Rheum Dis. 2007 Jul 13; [Epub ahead of print] PMID: 17545191 [PubMed - as supplied by publisher] 

Gladman DD, Mease PJ, Strand V, Healy P, Helliwell PS, Fitzgerald O, Gottlieb AB, Krueger GG, Nash P, 

Ritchlin CT, Taylor W, Adebajo A, Braun J, Cauli A, Carneiro S, Choy E, Dijkmans B, Espinoza L, van der 

Heijde D, Husni E, Lubrano E, McGonagle D, Qureshi A, Soriano ER, Zochling J. 

Consensus on a core set of domains for psoriatic arthritis. J Rheumatol. 2007 May;34(5):1167-70. PMID: 

17477480 [PubMed - indexed for MEDLINE] 

Gladman DD, Mease PJ, Healy P, Helliwell PS, Fitzgerald O, Cauli A, Lubrano E, Krueger GG, van der 

Heijde D, Veale DJ, Kavanaugh A, Nash P, Ritchlin C, Taylor W, Strand V. Outcome measures in psoriatic 

arthritis. J Rheumatol. 2007 May;34(5):1159-66. PMID: 17477479 [PubMed - indexed for MEDLINE] 


217



Zhao Y, Terron-Kwiatkowski A, Liao H, Lee SP, Allen MH, Hull PR, Campbell LE, Trembath RC, Capon F, 

Griffiths CE, Burden D, McManus R, Hughes R, Kirby B, Rogers SF, Fitzgerald O, Kane D, Barker JN, 

Palmer CN, Irvine AD, McLean WH. Filaggrin null alleles are not associated with psoriasis. J Invest 

Dermatol. 2007 Aug;127(8):1878-82. Epub 2007 Apr 5. PMID: 17410197 [PubMed - indexed for 

MEDLINE] 

Giles JT, Mease P, Boers M, Bresnihan B, Conaghan PG, Heald A, Maksymowych WP, Maillefert JF, Simon 

L, Tsuji W, Wakefield R, Woodworth T, Schumacher HR, Bingham CO 3rd. Assessing single joints in 

arthritis clinical trials. J Rheumatol. 2007 Mar;34(3):641-7. PMID: 17343312 [PubMed - indexed for 

MEDLINE] 

Kirwan JR, Minnock P, Adebajo A, Bresnihan B, Choy E, de Wit M, Hazes M, Richards P, Saag K, Suarez- 

Almazor M, Wells G, Hewlett S. Patient perspective: fatigue as a recommended patient centered outcome 

measure in rheumatoid arthritis. J Rheumatol. 2007 May;34(5):1174-7. PMID: 17477482 [PubMed - 

indexed for MEDLINE] 

Lassere MN, Johnson KR, Boers M, Tugwell P, Brooks P, Simon L, Strand V, Conaghan PG, Ostergaard 

M, Maksymowych WP, Landewe R, Bresnihan B, Tak PP, Wakefield R, Mease P, Bingham CO 3rd, Hughes 

M, Altman D, Buyse M, Galbraith S, Wells G. Definitions and validation criteria for biomarkers and 

surrogate endpoints: development and testing of a quantitative hierarchical levels of evidence schema. 

J Rheumatol. 2007 Mar;34(3):607-15. PMID: 17343307 [PubMed - indexed for MEDLINE] 

Sokka T, Kautiainen H, Toloza S, Mäkinen H, Verstappen SM, Lund Hetland M, Naranjo A, Baecklund E, 

Herborn G, Rau R, Cazzato M, Gossec L, Skakic V, Gogus F, Sierakowski S, Bresnihan B, Taylor P, 

McClinton C, Pincus T; QUEST-RA Group. QUEST-RA: quantitative clinical assessment of patients with 

rheumatoid arthritis seen in standard rheumatology care in 15 countries. Ann Rheum Dis. 2007 

Nov;66(11):1491-6. Epub 2007 Apr 5. PMID: 17412740 [PubMed - indexed for MEDLINE] 

Chapters 

Professor Oliver FitzGerald, co-editor for new textbook on “Psoriatic and Reactive Arthritis”. 

Dr. Eliza Pontifex, Professor Barry Bresnihan for “In Palliative Medicine” on “Musculoskeletal disorders”. In 

Press. 

Future Plans 

To make additional appointments in Rheumatology, in particular at consultant and clinical nurse specialist 

levels. 

To continue with development of closer links with primary care services with a view to improving interface 

between primary and secondary care. 

To further develop care pathways in collaboration with Bone and Joint colleagues in Orthopaedic Surgery 

and Rehabilitation Medicine. 


218



Department Statistics 

7 Day 5 Day Day Care ED Other Urgent Total 

3 4 497 386 25 915 

Discharges 

Total 320 

Admissions, Our Lady’s Hospice, Harold’s Cross 

Total 762 

Day Care 

Bone & Joint Unit 440 

Extra Mural Theatre 57 

Total 497 

OPD New Patients Return Patients Total 

Monday Clinic 284 744 1,028 

Adolescent Clinic 15 37 52 

Tuesday Clinic 19 1,308 1,327 

Wednesday AM Clinic 249 910 1,159 

Wednesday PM Clinic 171 763 934 

Thursday AM 101 417 518 

Biologic Clinic 0 720 720 

Nurse Led 10 46 56 

Grand Total 849 4945 5794 


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Department of Rehabilitation Medicine 

A rehabilitation consultation provides an expert opinion, offers education to staff, patients and carers/families 

and improves patient care. It facilitates appropriate management of individuals with complex disabilities, 

preventing many complications and facilitating patients’ care pathways. Typically, consultation leads to a 

significant contribution in the management of clinical cases in several ways: assessment and management 

of complex disabilities (spasticity management, splinting and special seating and 24hr positioning advice) 

pain management, management of agitation and altered behaviour post-acquired brain injury, pre-amputation 

consultations and prosthetic rehabilitation, spinal injury rehabilitation and musculoskeletal rehabilitation. 

In 2007, the Rehabilitation Medicine Department received 58 inpatient referrals. The most common reasons 

for referral are usually stroke (approx. 30% cases), traumatic brain injury (approx. 20% cases), amputation 

(approx. 10% cases) and the remainder various neurological and miscellaneous diagnoses. Approximately 

60% of referrals were from medical teams and 40% from surgical teams. There was a 60:40 ratio of male: 

female referrals with 51-70 year olds representing approximately 1/3 of the referrals. Approximately 50% 

of the patients were transferred to the National Rehabilitation Hospital (NRH) for a programme of 

rehabilitation, 10% went on to be followed-up in the SVUH Rehabilitation outpatient clinic and 10% attended 

the Prosthetic Rehabilitation Clinic at the NRH. Advice on complex disabilities was given on almost 20% but 

they were unfit/unsuitable for further transfer to the NRH, while the remainder were either transferred 

elsewhere, expatriated to home countries or died. 

58 new patients attended the rehabilitation outpatient clinic with 93 return patients attending. These patients 

included follow-up from inpatient admissions, new GP referrals and past SVUH patient who have undergone 

the NRH rehabilitation programme. 

Staff within the Department: 

Consultants in Rehabilitation Medicine Dr. Nicola Ryall, FRCPI Dr. Aine Carroll, MD, FRCPI 

Specialist Registrars in Geriatric Medicine Dr. Mary Martin Dr. Kit Mun Tan, 

The Department provided training, six months each, for two Specialist Registrars from Geriatric Medicine. 

There was particular emphasis on training in the areas of spasticity management, assessment and 

management of complex disabled patients, amputee rehabilitation, stroke and neurocognitive rehabilitation. 

This proved highly successful. 

All members of the departments were involved with undergraduate and post-graduate teaching and 

education of medical and allied health professionals. The team members also participated in clinical audit and 

research. Dr Kit Mun Tan was awarded with a distinction for her presentation on ‘Peripartum and puerperial 

stroke’ at the XVI European Stroke Conference, Glasgow 29/05/2007. 


220



Department - Rehabilitation Medicine 

The following outlines the various invited presentations: 

1. Carroll, A. Peri-partum Stroke. Stroke Physicians Meeting, RCPI, Dublin. 02/02/2007 

2. Carroll, A. Whiplash Injuries – A Mild brain Injury or just a pain in the neck? Minor Brain Injury - 

The Complex Presentation, Catalis Conferencing Centre, Derby. 13/03/2007 

3. Carroll, A. Byrne, P. The Effect of Peripartum and Puerperial Stroke on Attachment in Mothers. 

Irish Heart Foundation Stroke Study Day. 11/05/2007 

4. Carroll, A. Rehabilitation in the 21st Century. Royal College of Physicians Ireland. 06/11/2007 

Dr. N Ryall was invited to participate in national and regional debate on the issue of Road Safety and Drink- 

Driving, including a live television debate on RTE’s Six-One News and The Late Late Show, as well as to 

provide expert advise and opinion on the Pat Kenny radio show, the Gerry Ryan radio show, and various other 

radio shows, and National and regional newspaper ineterviews. 


221

222 

Justice

Report from the Professor of Surgery 

Report from the Chairman Surgeons Subgroup 

Liver Transplant Programme and Liver Unit 

Department of Ophthalmology 

Operating Theatre Department 

Department of Orthopaedics 

Department of Plastic Surgery 

Department of Urology 

Department of Vascular Surgery 

223


Department - Surgery 

Report from the Professor of Surgery 

Professor P. Ronan O’Connell 

Surgical Professorial Unit 


Head of Subject: 

Professor P. Ronan O’Connell 

Senior Lecturer: 

Mr Enda W McDermott 

Adjunct Professor: 

Professor M Joe Duffy 

Special Lecturers: Ms Mary Dillon Mr Farrukh Naseem 

Senior Research Associate: Dr Neil Docherty 

Research Fellows: Dr Colin Pierce Dr Michael Cunningham 

Dr Fiachra Rowan 

Ms. Karen Griffen 

Ms. Paulina Wojciechowska 

Senior Laboratory Technician: Mr Dermot Carty 

Clinical Research Nurse: Ms Helen Vaughan 

Executive Assistants: Mrs Patricia O’Shea Ms Hannah Carpenter 

Ms Maureen Mulhall 

Ms Elaine O’Sullivan 

2007 saw the retirement of Professor Niall O’Higgins. A Festschrift was held in January to 

celebrate the many achievements of his 29 years as Professor of Surgery. The keynote 

address was given by Professor Irvine Taylor from the Royal Free and University College 

Medical School, London. He paid tribute to Professor O’Higgins as an educator, a scientist, an 

administrator and a surgeon. The meeting was attended by many former trainees, research 

fellows and colleagues. 

Professor P. Ronan O’Connell took up post as Professor of Surgery and Head of Subject in September. Prof 

O’Connell had been consultant surgeon at the Mater Misericordiae University Hospital since 1990 and 

Newman Clinical Research Professor at UCD since 2002. His appointment brought a reconfiguration of the 

Surgical Professorial Unit to reflect his clinical interest in colorectal surgery while maintaining the Unit’s well 

established interest in breast and endocrine surgery under the academic leadership of Mr Enda McDermott, 

Senior Lecturer. 


224



The Final Medical Year students of 2007 did spectacularly well in their Final Surgical Examination, 35% 

achieved honours and 5% were awarded First Class honours in surgery. The following Prizes in Surgery were 

awarded in 2007 - The O’Farrell Gold Medal in Surgery Dr. Romaine King, McArdle Prize in Surgery Dr. Niall 

Breen, Gallagher Prize in Orthopaedics Dr. Stephen Kearney, and Tobin Prize in Surgery Ms. Rebecca Fry 

(Resident Year). 

In 2007 research from the Surgical Professorial Unit was recognised by several national and international 

awards. Dr Ciaran Healy was awarded the ASCRS Research Prize for the best research paper presented to 

the American Society of Colon and Rectal Surgeons Annual Meeting in St Louis. Dr John Burke won the 

British Journal of Surgery Prize for best paper presented to the Association of Coloproctology of Great 

Britain and Ireland Annual Meeting in Glasgow. Dr Burke also won the Sir Peter Freyer Medal for best 

research presented to the Sir Peter Freyer Surgical Symposium in Galway. 

Professor O’Connell was invited to speak at several national and international meetings. The highlights for 

2007 were delivery of the Sir Peter Freyer State of the Art Lecture in Galway, the ESR Hughes Lecture to 

the Colorectal Surgical Society of Australia and New Zealand in Adelaide and the Sir Alan Parks’ Lecture at 

St Mark’s Hospital London. 

2007 was a productive year in terms of publications. Representative articles are listed below. In addition 

numerous presentations were made at national and international scientific meetings. 

Books Edited 

1. EUROPEAN MANUAL OF COLOPROCTOLOGY, Herold A, Matzel K, Lehur PA, O’Connell PR eds. 

Springer, Frankfurt (publication, summer, 2008) 

2. BAILEY and LOVE’S SHORT PRACTICE OF SURGERY (25th Edition) Bulstrode C, O’Connell PR, 

Williams NS eds. Arnold, London (publication, autumn 2008) 

Book Chapters 

1. O’Connell PR 

ANAL CANCER in Herold A, Matzel K, Lehur PA, O’Connell PR eds, 

EUROPEAN MANUAL OF COLOPROCTOLOGY, Springer, Frankfurt, (in press) 

2. Shields C, O’Connell PR 

ELECTROCAUTERY in Trimbos JB, Trimbos-Kemper TC eds 

BASICS OF SURGERY:tools, techniques, attitude and expertise. 2007 Elsevier, Maarssen, pp67-77 

3. Joyce M, O’ Connell PR 

ANO-RECTAL STENOSIS: in Clavien JC, Mortensen NMcC eds 

ANORECTAL SURGERY, A PRACTICAL GUIDE TO MANAGEMENT. Springer, Frankfurt (in press) 


225



Significant Publications (Colorectal) 

1. Burke JP, Mulsow JJ, O’Keane C, Docherty NG, Watson WG, O’Connell PR 

Fibrogenesis in Crohn’s disease. Am J Gastroenterol 2007; 102: 439-48 

2. Mahoney RT, Behan M, Daly L, Kirwan C, O’Herlihy C, O’Connell PR 

Internal anal sphincter injury influences continence outcome following obstetric anal sphincter injury. 

Am J Obstet Gynecol 2007; 196: 217.e1-217.e5 

3. Brennan DJ , Moynagh M , Brannigan AE , Gleeson F , Rowland M , O’Connell PR 

Routine mobilization of the splenic flexure is not necessary during anterior resection for rectal cancer. 

Dis Colon Rectum 2007; 50: 302-7 

4. McGuire BB, Brannigan AE, O’Connell PR 

Ileal pouch-anal anastomosis. Br J Surg 2007; 94: 812-23 

5. Eogan M, Daly L, Behan M, O’Connell PR, O’Herlihy C 

Randomised clinical trial of a laxative alone versus a laxative and a bulking agent after primary repair 

of obstetric anal sphincter injury. BJOG. 2007;114:736-40. 

Significant Publications (Breast Endocrine) 

1. Murphy IG, Dillon MF, Doherty AO, McDermott EW, Kelly G, O'Higgins N, Hill AD. 

Analysis of patients with false negative mammography and symptomatic breast carcinoma. 

J Surg Oncol. 2007;96:457-63. 

2. Dillon MF, Mc Dermott EW, O'Doherty A, Quinn CM, Hill AD, O'Higgins N. 

Factors affecting successful breast conservation for ductal carcinoma in situ. 

Ann Surg Oncol. 2007; 14:1618-28. 

3. Brennan DJ, Kelly C, Rexhepaj E, Dervan PA, Duffy MJ, Gallagher WM. 

Contribution of DNA and tissue microarray technology to the identification and validation of biomarkers 

and personalised medicine in breast cancer. 

Cancer Genomics Proteomics. 2007;4:121-34 

4. Dillon MF, McDermott EW, Hill AD, O'Doherty A, O'Higgins N, Quinn CM. 

Predictive value of breast lesions of "uncertain malignant potential" and "suspicious for malignancy" 

determined by needle core biopsy. 

Ann Surg Oncol. 2007; 14:704-11 

5. O'Daly BJ, Sweeney KJ, Ridgway PF, Quinn C, McDermott EW, O'Higgins NJ, Hill AD. 

The accuracy of combined versus largest diameter in staging multifocal breast cancer. 

J Am Coll Surg. 2007; 204:282-5. 


226



Report from the Chairman Surgeons Subgroup 

Chairman of Surgical Subgroup 

Secretary to the Surgical Subgroup 

Mr Sean Dudeney, 

Mr Denis Evoy, Hon 

2007 was an interesting year for the Department of Surgery. In addition to the usual workings of the group 

a great deal of time and effort was spent looking to the future of surgery at St Vincent’s and the future needs 

of our patient population, the latter increasing in both age and total number. The numbers of patients seen 

as outpatients and treated surgically continues to increase across the subspecialties. Much of our vision of 

the future revolves around increasing the available operating room space to fully accommodate current and 

future consultant staff to allow them to do the best they can for patients. A great deal of enthusiasm was 

generated by the completion of further new operating rooms in the New Hospital Building, and considerable 

effort has been put into preparing for the move from all parties involved. 


The New Theatre project continues. We continue to move toward expansion in operating room numbers from 

our present ten operating theates to an increased compliment of twelve. This has been an important project 

over many years and continues to be so. 

The move of outpatient services to The New Building was completed, resulting in significant improvements 

for patients. 

Future developments include the New Bed Block, the construction of a new private hospital and the 

formation of the Dublin Academic Health Centre between St Vincent’s and The Mater Hospital. 

Retirements 

Professor Niall O’Higgins retired in January 2007 after many years of distinguished service. We wish him 

well for the future. 

Appointments 

Prof Ronan O’Connell was welcomed to the surgical staff as Professor of Surgery in September 2007. 

Research and Teaching 

Research and undergraduate teaching continue to remain key areas in the group, with many departments 

being highly productve with regard to their research interests. The undergraduate teaching programme was 

updated under the guidance of Professor Ronan O’Connell. 


227



Liver Transplant Programme and Liver Unit 

The year 2007 was another very successful year for the National Liver Transplant Programme. A total of 59 

transplants were performed on 49 patients. This number was slightly lower than 2006 but still represents a 

significant increase in activity compared to previous years. During 2007, we celebrated two very important 

milestones in the history of the National Liver Transplant Programme. In September 2007, we performed our 

500th liver transplant operation and at the end of the year we celebrated the 15th anniversary of the 

commencement of the liver transplant programme. The overall success rate of our programme is in keeping 

with the best rates achieved in large liver transplant units throughout Europe and the United States. 

Organ donation continued at a very satisfactory level during 2007. A total of 80 livers were donated in Ireland 

during the year, a slight decrease from the 85 in 2006. However, the organ donation rate in Ireland still 

compares very favourably against most other countries in Europe. We are extremely fortunate to have a 

population who are well disposed to the concept of organ donation and who understand the great benefits 

of organ transplantation. 

The success of the National Liver Transplant Programme continues to result in an increasing pattern of 

referrals of patients with complex medical and surgical problems which do not necessarily require liver 

transplantation. Many of these patients can be treated non surgically or by types of surgery other than 

transplantation. This referral pattern has had highly beneficial effects on training for doctors, nurses and para 

medical staff at St Vincent’s University Hospital. However, it has also stretched the resources of many other 

departments in the hospital, including the Intensive Care Unit, the Department of Diagnostic Imaging and the 

Allied Heathcare Departments. Furthermore, this has placed great strain on the bed availability in St Brigid’s 

ward. 

During 2007, the National Liver Transplant Programme hosted the Annual UK and Ireland Liver Transplant 

Meeting. This was a great success and attracted medical and nursing staff from all of the liver transplant 

units in the United Kingdom, who came to Dublin for the two day meeting. 

It was with great sadness that we note the departure of Professor Cliona O’Farrelly from her post as 

Scientific Director of the Education and Research Centre. Cliona has been appointed to the prestigious 

Chair of Immunology at Trinity College Dublin and we wish her every success in her future role there. Cliona 

has made a most outstanding contribution to the research programme of the National Liver Transplant 

Programme over the past 15 years. 


228


Department of Ophthalmology 


Consultants: Mr P Barry, Mr W Power, 

Dr E Chacko 

St James Ward: Sandra Murphy CNM2 Esther McCarthy CNM1 

Ophthalmic Theatre: 

Medical Research Ophthalmologist: 

Ms Annette Cullen CNM2 

Dr Aideen Hogan 

Surgical Registrars: Mr Tarik Saddiq Dr Princeton Lee 

Medical Registrar: 

Dr Magdy Nasralla 

Lecturers in Ophthalmology: Dr Jan Shotveld Dr Ruaidhri Kirwan 

Orthoptist: 

Unit Secretary: 

Vacant Post 

Ms Jane Caulfield 

The tables below summarise the department’s activity for the year 2007. 

Due to pressures from the Emergency Department, unfortunately some of the Ophthalmology cases have 

been cancelled or postponed but with the help of the National Treatment Purchase Scheme we hope to see 

this number diminish over the coming months and years. 

To challenge these erosions we have a day care cataract surgery but unfortunately a majority of our patients 

are in an age group with co-morbidities which makes it impossible. 

Our day care activity continues to expand and the provision of laser photocoagulation for diabetic retinopathy 

is now extremely busy. We have commenced intravitreal injection of drugs to retard exudative age related 

macular degeneration and hope to develop a clean room delivery service for this on the ward itself rather 

than utilising the operating theatres as at present. 


229


Department - Ophthalmology 

This is now the 10th year of participating in the European Audit network for cataract surgery, European 

Cataract Outcome Study. This audit provides excellent benchmarking for the procedure. 

As last year, the consultant staff would like to express their appreciation of the heroic nursing efforts 

provided by Sr. Sandra Murphy, Sr. Esther McCarthy and their nursing team. We understand the stress of 

their jobs in today’s world. Their patient care is superb. 

We would also like to thank Ms. Jane Caulfield for her dedicated secretarial role in a world where 

administration is becoming progressively more time consuming. Finally, our lecturer Dr Jan Shotveld has 

returned to a consultant’s post in Holland and is replaced by Dr. Ruaidhri Kirwan Ph.D. 

Dr. Aideen Hogan is in her second year developing the services as a medical research ophthalmologist and 

Mr. Princeton Lee is our current surgical registrar. The many years experience of Dr. Magdi Nasralla as 

medical registrar is also much appreciated. 

In a changing world of care delivery, education and research we hope to continue the development of the 

department. 

Finally, Mr. William Power was elected Chairman of the Medical Board of the Royal Victoria Eye and Ear 

Hospital and Mr. Peter Barry delivered the Choyce Medal Lecture to the United Kingdom and Ireland Society 

of Cataract and Refractive Surgeons in Harrogate, U.K. 

St. Jame’s Ward Inpatient Admissions 2007 (including transfers) 

Ophthalmology Other Specialities Total 

ELECTIVE 339 71 410 

VIA EMERGENCY DEPARTMENT 0 175 175 

OTHER URGENT 3 8 11 

TRANSFERS (from other wards) 2 32 34 

TRANSFERS (from other hospitals) 0 4 4 

TOTAL 344 286 634 


230


Department - Ophthalmology 

Ophthalmology: St. Jame’s Ward 

1992 1993 1994 1995 1996 1997 1998 1999 2000 

ISt James In-Patients 

Ophthalmology Admissions 694 845 790 738 587 488 496 487 443 

Ophthalmology Discharges 701 843 787 732 583 484 491 482 436 

St James In-Patients 

Cataract Procedures 283 527 396 353 374 278 333 345 308 

St James Day Care 

Admissions 188 449 788 878 1196 1406 1708 1491 1526 

Discharges 188 449 788 878 1196 1406 1708 1491 1526 

St James Day Care Orthoptic 

Total Attendances Done in OPD Done in OPD 611 667 598 563 575 551 573 

St James ED Ophthalmic Patients 

Total Attendances Accounted for Accounted for 

In ED Dept In ED Dept 754 617 746 888 1268 1229 1130 

St James In-Patients Referrals 

Total Attendances 503 462 479 437 439 388 392 325 361 

Ophthalmology Out-Patients 

New 879 821 967 965 1045 1018 928 897 702 

Total Attendances 2948 3360 4118 3302 3120 3015 3180 3121 2651 

2001 2002 2003 2004 2005 2006 2007 

ISt James In-Patients 

Ophthalmology Admissions 461 458 458 442 365 366 344 

Ophthalmology Discharges 457 456 451 434 363 362 344 

St James In-Patients 

Cataract Procedures 330 324 310 299 300 331 321 

St James Day Care 

Admissions 1611 1846 1994 1729 1647 1536 1649 

Discharges 1611 1846 1994 1729 1647 1536 1649 

St James Day Care Orthoptic 

Total Attendances 607 502 927 777 973 283 0 

St James A/E Ophthalmic Patients 


St James In-Patients Referrals 


Ophthalmology Out-Patients 

New 745 773 781 729 836 742 825 



231



Operating Theatre Department 


Welcome to the twenty-eight new nursing staff and 6 theatre aides who joined the Operating Theatre staff 

during the year. 

Sadly on April 13th our nursing colleague and friend Liz Tully lost her fight for life, she is greatly missed by 

all who had the fortune to know her. 

Promotional appointments; Ms. Natasha Keaty, CNM1 PACU; Ms. Maura McEvoy, CNM 1, Theatres 1 & 2. 

Three of our senior portering staff were promoted to other posts in the hospital. One porter was appointed 

to a supervisory position in theatre. 

Retirements 

Two of our most senior Clinical Nurse Managers retired at the end of the year, Ms. Bernadette Farrell and 

Ms. Breda O’Donoghue. Ms. Maureen Flynn Assistant Director of Nursing resigned her post in September. 

Maureen moved to the HSE where she is coordinator for nurse prescribing for the East Coast Area. Ms 

Maureen D’Arcy is currently ADON for critical care areas Theatre, ICU and HSSD. 

Education / Conferences 

A series of workshops were introduced to support overseas nurses in their orientation to Irish operating 

department nursing, practices in anaesthetics, recovery and surgery. Six staff attended the Operating 

Theatre National Conference, three presenting scientific posters and one oral presentation. One staff 

member also attended the Anaesthetic Nursing conference in Waterford, and workshops and study days on 

Surgical Stapling, Breast Implants Reconstruction, Wound Care and Orthopaedic Implants Regular in-service 

education continues in the department every Wednesday morning. The nursing journal club was further 

developed and each speciality group meet simultaneously on a monthly basis. 

Support for students (nursing and medical) is a fundamental activity for the operating team. During the year, 

11 staff nurses completed preceptorship training. Nursing students, 88 pre-registration students undertook 

four weekly placements in the department. Feedback from students on placement identified theatre as a 

positive experience and a good educational environment. 

Developments/ Activities 

The inaugural foundation course in perioperative nursing commenced in Nov 2007 and postgraduate 

students are undertaking this programme. This programme was initiated by the theatre staff and formulated 

in collaboration with the School of Nursing. 

Theatre Commissioning 

A multidisciplinary steering group is being formed to co-ordinate the transfer of services to the Clinical 

Services Building, which is anticipated in the second part of 2008. 


232

Department - Operating Theatre 

Decontamination/ Infection Control 

The decontamination and hygiene audits took place during the year. Theatre is now in the process of 

implementing recommendations from the audit and review. The Health and Safety and Infection Control 

Groups met on a regular basis throughout the year. 

Product Evaluation 

The Operating Department Product Committee continued to meet to streamline the introduction of new 

products and equipment to the department 


During 2007 9,869 surgeries were performed, of this 7,550 were planned cases. 23.5% (2,319) of all 

surgery performed in the department were emergency of this 13% (1285) were performed after hours. 

CATEGORY SVUH SVPH TOTAL 

Dental 29 1 30 

Dermatology 7 0 7 

E.N.T. 251 99 350 

General 2,373 483 2,856 

G.U. Endo 1,459 89 1,548 

G.U. Open 161 15 176 

Gyncaecology 262 1 263 

Ophthalmology 369 0 369 

Orthopaedic 1,800 62 1,862 

Pain 440 43 483 

Plastic 1,154 68 1,222 

Thoracic 187 102 289 

Vascular 323 91 414 

TOTALS 8,815 1,054 9,869 

Fifty-nine liver transplant operations were performed during the year, with 75 donor retrievals. 


233

Future Plans 

It is hoped that the year 2008 will be an exciting one for the Operating Department team with the planned 

move to the new Clinical Services Building. The key activities will involve: 

• Working with the Project Team in commissioning the new facilities. 

• Developing and agreeing the Theatre Schedule. 

• Commissioning, training and introducing new equipment to the service. 

• Developing a detailed training and education plan for all members of the multidisciplinary team. 

• Completing the Standard Operating Procedure for the service in the new Clinical Services Building 

• Agreeing the Nurse Management Structure for services in the new facility. 

• Developing a detailed Workforce Plan for the Operating Department. 

Planning is underway for the 2nd Foundation Course in Perioperative Nursing in the autumn. 


234


Department Orthopaedics 

Orthopaedic Dept. Mr. Sean Dudeney Mr. Brian Hurson 

Mr. Eamonn Kelly 

Mr. William Quinlan 

Mr. Garry O’Toole 

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 

Nurse Specialist CNM2: Ms. Natalie Landers CNS: Ms. Ann Camlin 

SN: Ms. Josephine Ubas SN: Ms. Deirdre Kelly 

Fracture Liason Nurse CNS Ms. Annette Whelan 

The Orthopaedic Department provides elective orthopaedic and trauma services to South Dublin , South 

County Dublin, Co. Wicklow and parts of Co. Wexford. In addition some services are provided on a national 

basis. 

Trauma Services 

Major trauma is delivered by ambulance direct to the Emergency Department of St Vincent’s University 

Hospital. The Three Emergency Depts. of St. Vincents University Hospital, St. Columcilles Loughlinstown and 

St. Michaels Hospital in Dun Laoghaire all serve as portals of entry for the ambulant, and less severely injured. 

From there the patients are referred either directly to the Trauma Unit of St. Vincent’s University Hospital for 

operative treatment or to one of the fracture clinics for further management. 

There are daily fracture clinics in The Bone and Joint Unit of St. Vincent’s University Hospital and further 

outlying clinics in St. Michael’s Hospital and St. Columcilles Hospital. 


235



Elective Services 

There are daily elective orthopaedic clinics in The Bone and Joint unit. These include subspecialty clinics in 

Upper Limb and Joint Replacement. There are further specialty elective clinics in Cappagh National 

Orthopaedic Hospital, which includes Joint Replacement and The Bone Tumour Clinics. The Bone Tumour 

Service provides a national service in this area. 

The majority of the patients seen in the elective clinics at both St. Vincent’s University Hospital and Cappagh 

Hospital have the surgery carried out in Cappagh Hospital. 

Activity 

Clinics 

No. Sessions New Return Total 

SVUH 380 3266 9367 12633 

SMH/SCUH 2743 4879 7622 

Combined 6099 14246 20255 

Admissions/Op 

SVUH 1790 

CNOH 725 

SMH 577 

Total 3092 

Nurse specialist Area 

They are based in the plaster area of the Bone and Joint Unit. Throughout the year the staff provide support 

to the fracture and orthopaedic clinics. This caters for all aspects of orthopaedic nursing including: wound 

management, plaster services and fracture splinting. A total of 3159 patient episodes were recorded. 

In addition to being a point of contact for patients under the departments care on an ongoing basis, the 

Plaster Service also provide educational support for other areas that use or require this type of service. 


236



Publications 

Zuboviç A, Cavanagh M, Hurson B. 

Value of measuring subpopulations of T and B lymphocytes in patients with musculoskeletal tumours. 

Arch Orthop Trauma Surg. 2007 Aug 15; [Epub ahead of print] 

PMID: 17701188 [PubMed - as supplied by publisher] 

Related Articles 

Vioreanu M, Dudeney S, Hurson B, Kelly E, O'Rourke K, Quinlan W. 

Early mobilization in a removable cast compared with immobilization in a cast after operative treatment of 

ankle fractures: a prospective randomized study. 

Foot Ankle Int. 2007 Jan;28(1):13-9. 


Related Articles, Links 

Flavin R, Gibney RG, O'Rourke SK. 

A clinical test to avoid sural nerve injuries in percutaneous Achilles tendon repairs. 

Injury. 2007 Jul;38(7):845-7. Epub 2007 Jan 22. 


Byrne AM, Morris S, McCarthy T, Quinlan W, O'byrne JM. 

Outcome following deep wound contamination in cemented arthroplasty. 

Int Orthop. 2007 Feb;31(1):27-31. Epub 2006 Apr 4. 


Related Articles, Links 

Macgiobain S, Quinlan JF, O'Malley N, Brophy D, Quinlan WR. 

Isolated Proximal Tibio-Fibular Joint Dislocation In An Elite Rugby Union Player. 

Br J Sports Med. 2007 Nov 29; [Epub ahead of print] 


R. Steffen, K. O’Rourke, H. S. Gill, and D. W. Murray 

The anterolateral approach leads to less disruption of the femoral head-neck blood supply than the 

posterior approach during hip resurfacing 

J Bone Joint Surg Br, Oct 2007; 89-B: 1293 - 1298. 


237



Department of Plastic Surgery 


Consultants Mr Tom O’Reilly Mr Sean M Carroll 

Ms Margaret O’Donnell Dr Catriona Lawlor 

Registrars Ms E Fitzgerald Ms T Laing 

Mr P O’Sullivan 

Occupational Therapist 

Hand Therapist 

Unit Secretary 

Aine O’Reilly 

Catherine Cradock 

Alison Kelly 

Service Development and Activities 

The Department of Plastic Surgery provides a general plastic surgery service within the St. Vincent’s 

Healthcare Group 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. 

St Agnes' 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 being admitted for elective procedures on 

to our ward. We never the less acknowledge the dedication and hard work of the highly competent ward staff. 

Out patient clinical activity increased further this year. We recognise the expertise and continued positive 

attitude of the OPD nurses. 

The hand surgery clinic has now become too busy and we need more occupational and hand therapy hours 

to cover the increase in patients seen. 

There has been a significant increase in waiting lists for skin cancers due to our inability to admit patients 

but a new Friday morning list run in St Michael’s Hospital by Ms O’Donnell has helped this immensely. 

An additional Wednesday afternoon list has been added and run by our Registrars and this has also helped. 

A new booking system for Minor Op Theatre has made the allocation of operating slots more efficient and 

was introduced by Ms E Fitzgerald. 

Unfortunately due to this high level of activity, sometimes clinical procedures have to be postponed at short 

notice due to inevitable unforeseen circumstances. 

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. 


238

Department - Plastic Surgery 

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 Breast Check and many patients now undergo breast 

reconstruction at the time of their mastectomy. The majority of patients, however, are reconstructed 

sometime after their surgery. 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 (NRH) by Mr 

Carroll. An outpatients and ward round at NRH is provided on alternative weeks. Agreement was reached 

during the year that 2 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 numbers of complex micro-vascular reconstructions performed over the last year has increased 

significantly over previous years. We have been delighted to perform these and have been gratified by the 

excellent results obtained but feel that in the medium term the unit cannot continue to expand without the 

addition of a permanent fourth consultant. 


239



Department of Urology 

Staffing: 

Consultants Mr David Quinlan Mr David Mulvin Mr Gerald Lennon 

Senior Registrars Mr Gordon Smyth Mr Rowan Casey 

(from 01/01/07) (from 01/07/07) 

Registrars Dr Kevin O’Connor Mr Ivor Cullen 

(from 01/01/07) (from 01/07/07) 

Senior House Officers Dr Aisling Hogan Dr Rosemarie Fitzgerald 

(from 01/01/07) (from 01/07/07 

Interns Dr Lillian Smyth , Dr Eoin Judge, Dr Sinead Barry, 

Dr Mark Doherty, Dr Elizabeth Ryan, Dr Barry Hutchinson, 

Dr Ferdia Bolster, Dr Claire Gibson 

Ward Sisters Sr Mary Nevin Sr Denise Murray (St Charles') 

Theatre Sisters Sr Linda Mullen, Antoinette Guthrie Sr Breda O'Donoghue 

Urology Cancer Nurse Coordinator 

Urodynamics/Urology Nurse Practitioner 

Inpatient Clinical Coordinator 

St Charles Ward Secretary 

Helen Forristal 

Siobhan Gardner 

Nuala Kennedy 

Krystle Finnegan 

Urology Secretaries Louise Bradbury Margot Hennigan 


The year 2007 was again a busy year for the Department of Urology. As in previous years 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. Between the 1st of January and the end of February, St 

Charles’ Ward is available to the Emergency Department for direct admission of patients from other 

disciplines. This 10-month protection is invaluable in permitting orderly and timely admissions of patients on 

Urological and Gynaecological waiting lists. From a Urological perspective, this permitted the treatment of 

patients with: 

• Urological malignancies, 

• Need of complex urological surgery 

• A requirement for complex urological reconstruction or other intervention 

• Urological complications of other malignancies (including gynaecological and colorectal malignancies). 

This would all not be possible without the invaluable dedication of our Admissions Coordinator, Nuala 

Kennedy, who has her office opposite the nurses station on St Charles’ Ward and makes herself ever 

available to patients on waiting lists for inpatient care. 


240

Cancer remains a significant focus for the Urology Department in St Vincent’s University Hospital and has 

done so for the last 4 decades. The 2005 Irish National Cancer Registry figures (the latest figures available) 

show that nationally prostate cancer was the commonest solid organ cancer with 2407 cases, breast cancer 

was second at 2379 cases and colorectal cancer third at 2184 cases. If one adds in cancers of the kidney 

(375), bladder (504) and testis (162) the total number of Urological Cancers numbers 3,448 cases. This 

figure does not include less common Urological cancers such as cancer of the ureter, urethra, penis and 

scrotum (Table 1). 

Table 1: Common Cancers in Ireland 2005 (National Cancer Registry) 

Cancer 

Number of New Cases 

Prostate 2407 

Bladder 504 

Kidney 375 

Testis 162 

Total Urological 3448 

Breast 2379 

Colorectal 2184 

St Vincent’s Urology has had a sizeable contribution to these figures. On average over the past five years 

434 Urological Cancers were diagnosed and treated at St Vincent’s University Hospital. This comprises 

15.1% of all newly diagnosed Urological Cancers in Ireland. On average 300 prostate cancers are 

diagnosed and treated each year at St Vincent’s University Hospitals. This comprises 12.96% of all newly 

diagnosed prostate cancers in the Republic of Ireland. On average 91 radical prostatectomies are performed 

per annum by St Vincent’s University Hospital Urologists with an almost similar number being referred for 

radiation therapy. These figures do not reflect the large numbers of ongoing Urological Cancer patients 

undergoing continuing care at St Vincent’s. These patients require outpatient appointments and admissions for 

ongoing care. This group of ongoing patients are a large proportion of the patients attending outpatient clinics. 

Surgically 2007 has also seen the further development of Laparoscopic Urology under the direction of Mr 

David Mulvin. Laparoscopic nephrectomies and pyeloplasties are now a weekly occurrence with more 

laparoscopic nephrectomies now being performed for renal cell carcinoma. This is providing significant 

improvements in hospital stay and early return to work for patients. Mr Lennon has continued to expand 


241


Department - Urology 

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. 

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 in order to obtain protection for inpatients on St Charles’ Ward). Its fiveday 

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, St Michael’s theatre and, for the first time in 2006, the Ambulatory Day 

Care Unit (ADCC). Twelve patients per week are undergoing flexible cystoscopies in the ADCC. 

Urodynamics remains very active. 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. An MSD trial on the overactive 

bladder continues. Urodynamics also provides a tremendous service for male patients presenting for the first 

time to the outpatients with Prostate symptoms. These men undergo a pre-assessment with Siobhan 

Gardner consisting of urinalysis, renal profile, prostate specific antigen, symptoms score, uroflow and 

estimation of post void residual prior to seeing their consultant in the ADCC. This provides for instant 

decision making at the patient’s first consultation and has been invaluable. 

As in 2006, the purpose built Urology Unit in the new Ambulatory Day Care Centre provides an ideal 

environment in which to treat Urological patients in a private and confidential setting. As has been the case 

now in Urology for the past five years, patients are given timed appointments for their clinic visits and every 

effort is made to see patients in a timely, courteous and professional manner. This provides a significant 

challenge for urology with only three clinics per week and the time constraints of three hours per clinic. The 

numbers of patients seeking Urological appointments now far outstrips the number of available 

appointments. For the first time, 2007 saw the referral of some new patients with lower acuity clinical 

problems to the National Purchase Treatment Fund for first time outpatient appointments. 


During 2007 there were 9045 patient presentations calculated from presentation to outpatients, admissions 

(includes theatre, urodynamics and inpatient consults) which included: 

Outpatients 

• A total of 5,083 outpatients were seen by the Urology Department. Three Urological Outpatients 

occur per week on the St Vincent's Campus with 4,274 outpatient attendances. Of these 896 were new 

patient attendances. There were 809 outpatient attendances in St Michael's Hospital seen in one weekly 

outpatients of which 275 were new patient attendances. 

Theatre 

• Surgical procedures totaled 2,713 with 1,811 surgical procedures performed on the St Vincent's 

Campus, 358 performed at St Michael's Hospital and a further 544 procedures performed in the 

St Michael's Annexe. 


242


Consults 

• 394 inpatient consultations in 2007. 

Urodynamics 

There were 855 urodynamic procedures performed. 

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 MMUH and SVUH) 

• Irish Society of Urology Clinical Case Conference (Monthly Wednesdays 7:00PM) 

Ongoing Clinical Trials 

• Atrasentan for prostate cancer (Abbott) 

• Merck Sharpe & Dohme Overactive Bladder Study 

Publications 

Magill P, Jacob T, Lennon GM: A rare case of segmental testicular infarction. Urology 69:983, 2007. 

Floyd MS Jr, Dowling CM, Power RE, O'Bien A, Gibney RG, Quinlan DM: Ectopic splenic tissue presenting 

as a scrotal mass. Ir J Med Sci 176(2):141-2, 2007. 


243



Healy CE, Leonard DS, Cahill R, Mulvin D, Quinlan D: Primary endourologic realignment of complete 

posterior urethral disruption. Ir Med J 100(6):488-9. 2007. 

Quinlan MR, Teahan S, Mulvin D, Quinlan DM: Is digital rectal examination still necessary in the early 

detection of prostate cancer? Ir J Med Sci 176(3):161-3. 2007. 

Lim CH, Quinlan DM: Are doctors examining prostates in university hospital? Urology: 70(5):843-5, 2007. 

Connolly SS, Mulvin DW, Quinlan DM, Lennon GM: Painful hydronephrosis of pregnancy. Eur J Obst Gynecol 

Reprod Biol, Dec 2007 

O'Daly BJ, O'Brien MF, Dowling CM, Crotty TB, Watson AJ, Moriarty MJ, Mulvin DW: 

Squamous cell carcinoma of the renal pelvis after curative retroperitoneal 

radiotherapy for seminoma. Urology 70(4):812, 2007. 

Future Plans 

The plans for 2008 must again emergently focus around improvements in ward accommodation for inpatients 

on St Charles’ Ward, 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. Plans have been 

drawn up for improvements to St Charles’ Ward but, unfortunately, we again anticipate their implementation. 

Urology has the potential to take advantage of its new outpatient setting with 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) 

• Dysfunctional Voiding / Incontinence Clinics (with same day urodynamics and flexi-cystoscopy) 

For the first time in 2007 the Ambulatory Day Care Unit started its service for patients undergoing flexible 

cystoscopies. The plans for 2008 are for this to occur during outpatient clinics to facilitate a “one stop shop” 

for patients with haematuria and voiding dysfunction. 

The application for a fourth Urological Consultant has now been submitted following the resolution of the 

new consultants’ contract. 

Outpatient numbers pose a difficult problem. The numbers per clinic must be reduced to provide a higher 

quality service to each individual patient. Demand far outstrips supply of appointments. A fourth Urological 

appointment would certainly help. Novel solutions such as private practice Urologists being contracted for 

outpatient sessions may need to be looked at to cope with the growing volumes of patients. 

Unfortunately, the Post Graduate Diploma in Urology Nursing was stalled this year by University College 

Dublin due to a lack of candidates. Discussions are afoot to plan the future of the course. 

2008 will see the introduction of an annual “Visiting Professor” with Dr Alan Partin, Chief of Urology at Johns 

Hopkins arriving in July 2008. 


244





Consultants: Mary Barry Denis Mehigan Stephen Sheehan 

Hugo Prins (Locum) 

Senior Registrars: Tony Moloney Graham Roche Nagle 

Registrars: Mo Atie Bunmi Esam John McCormack 

Senior House Officers: Joe Baker Danielle Collins Lange Nqwena 

Interns: Lucy Belton Claire Leonard Elysha McGovern 

Mark Owens Aileen Rogers Alison Whelan 

Rory Whelan 

Assistant Director of Nursing: Margaret Cullen Maureen Flynn 

Clinical Nurse Managers: Mary Leamy Fionnuala McCusker Sandra Shea 

Theatre Sisters: Bernadette Farrell Annette Hughes Maura McEvoy 

Plethysmographist: 

Tissue Viability Nurse: 

Catherine Kelly 

Deirdre Cornally 

The Vascular Surgery Unit at St. Vincent’s University Hospital had another busy year in 2007. The department 

serves a population of up to 700,000 in our catchment area of Dublin and also the south east of the country. 

Bed shortages remain a major problem but effective cooperation with our referral hospitals has helped to 

maintain turnover of a satisfactory volume of elective as well as urgent and emergency work. The High 

Dependency Unit continues to be central to the throughput of complex and critically ill patients. The role of 

protected beds and their management by the ward staff cannot be overstated in the delivery of the service. 

Close cooperation between the departments of Vascular Surgery and Interventional Radiology has further 

developed the endovascular programme particularly in the area of aortic stent grafting. To date 28 

procedures have been successfully performed. 2007 has also seen a significant change in the management 

of symptomatic deep venous thrombosis through collaboration with Dr Brophy, Interventional Radiologist, 

producing very good results. There is an ongoing programme of haemodialysis vascular access covering the 

local needs of SVUH and the south east region. 

In March 2007 we finally moved into the new Ambulatory Day Care Centre (ADCC) facility which places the 

out patient clinic area in close proximity to the Vascular Laboratory and the Vascular Ulcer Clinic. The great 

success of the latter has already posed its own strains on resources and plans to extend its hours of 

operation are under consideration. The centralisation of the services in the ADCC has also allowed a certain 

amount of streamlining of patient attendance. 


245



Department Activity 2007 

Admissions 2007 

Elective 244 

7 day 242 

5 day 2 

Urgent/Emergency 267 

Day Care 95 

Total 606 

Out Patient Attendances 2007 

Outpatient sessions 146 

New Patients 764 

Return Patients 2696 

Total 3460 

Operative Procedures 2007 2006 2005 

Elective 317 273 276 

Emergency 97 51 71 

Total 414 324 347 

Meetings Attended 

Meetings attended by members of the department during the year were: 

Cerebrovascular Meeting, RSM. January 2007 

Carotid Stenting Course, RCSI. February 2007 

Pre-operative Evaluation for Endovascular Aortic Aneurysm Repair, London. April 2007 

Charing Cross Meeting, London, April 2007 

Venous Forum, London, June 2007 

European Society of Vascular Surgery, Madrid, Sept 2007 

Vascular Society, November 2007 

Mr. Denis Mehigan is a member of the executive of the Irish Association of Vascular Surgeons and represents 

that body on the Vascular Advisory Committee. He is also a member of the Court of Examiners (FRCSI). 

Mr. Stephen Sheehan is an instructor on the Basic Surgical Skills Course and is an examiner of the 

European Board of Vascular Surgery. He is a member of the executive of the Irish Association of Vascular 

Surgery and represents the RCSI on the Vascular Division of the UEMS. 

Ms. Mary Barry is Secretary of the Basic Surgical Training Committee, RCSI and a faculty member on the 

Care of the Critically Ill Surgical Patient (CCRISP) Course. 

Academic Activity 

Guest Lectures 

Surviving High Risk Vascular Surgery. M. Barry, Charter Day RCSI Feb 2007 

Major Lower Limb Amputations. M. Barry, Annual Physiotherapy Study Day, AMANCH, Feb 2007 


246


Presentations 

Doctor's attitudes about prescribing and knowledge of the costs of common medications. 

C McGuire, S King, G Roche-Nagle, MC Barry, S Sheehan. 

Sylvester O’Halloran Surgical / Scientific Meeting March 2007. 

Elastic Compression Stockings to Prevent the Post-thrombotic Syndrome – Patient and physican 

practices and perceptions. G Roche-Nagle, F Chambers, MC Barry, D Mehigan, S Sheehan. 

Sylvester O’Halloran Surgical / Scientific Meeting March 2007 

Publications 

Roche-Nagle G, Barry MC, Ryan R, Brophy DP 

Considerations in the diagnosis and therapy for deep venous thrombosis Am J Emerg Med 2007 860-4 

Roche-Nagle G, Ryan R, Barry M, Brophy DP Effort thrombosis of the upper extremity in a young 

sportsman: Paget-Schroetter syndrome Br J Sports Med 2007 540-1 

Hughes FM, Kavanagh D, Barry M, Owens A, MacErlaine DP, Malone DE Aorto-enteric fistula: a diagnostic 

dilemma Abdom Imaging 2007; 398-402 

Neary P, Hurson C, Briain DO, Brabazon A, Mehigan D, Keaveney TV, Sheehan S. 

Abdominal aortic aneurysm repair and colonic infarction: a risk factor appraisal. 

Colorectal Dis 2007;9:166-172 

Roche-Nagle G, O'Donnell DH, Brophy DP, Barry MC. Primary aortoenteric fistula. 

Am J Surg. 2008 Apr;195(4):506-7. 

Roche-Nagle GM, Barry MC, Ryan R, Brophy DP. 

Considerations in the diagnosis and therapy for deep vein thrombosis. 

Am J Emerg Med. 2007 Sep;25(7):860. 

Roche-Nagle G, O'Donnell D, O'Hanrahan T. 

Visceral artery aneurysms: a symptomatic aneurysm of the ileocolic artery. 

Vascular. 2007 May-Jun;15(3):162-6. 


247

248 

Advocacy

Reports 

Medical and Surgical Gastroenterology 

incorporating the Centre for Colorectal Disease 

Report from the Emergency Department 

Report from the Pathology Department 

Report from the Radiology Department 

Report from the Clinical Director of 

Psychiatry 

Report from the Department of Old Age Psychiatry 

249



Medical and Surgical Gastroenterology 

incorporating Centre for Colorectal Disease 

Consultant Medical and Surgical staff 

Medical Gastroenterology: Professor DP O’Donoghue, Dr HE Mulcahy 

Colorectal Surgery: Mr J Hyland, Mr D Winter, Professor R O’Connell 

GI Pathology: Dr K Sheahan, Dr D Gibbons 

GI Diagnostic Imaging: Dr C Collins, Dr R Gibney, Dr D Malone. 

Dr D Brophy. 

Medical Oncology: 

Dr D Fennelly 

Radiation Oncology: Dr M Moriarty, Professor J Armstrong 

Non-Consultant Medical and Surgical staff 

Specialist Registrars: Dr E Slattery: Dr J Sheridan: Mr D Beddy: 

Mr F Fleming: 

Ms A Hanley 

Clinical Nurse Managers 

St. Luke’s Ward Ms A Smyth, Ms G O’Neill 

Endoscopy Unit Mr R Marshall, Ms F Kavanagh 

Research Staff 

Senior Research Scientist Jacintha O’Sullivan 

Senior Medical Scientist Robert Geraghty 

Research Nurse 

Blathnaid Nolan 

Senior Scientist 

Dermot Leahy 

Research Assistant Miriam Tosetto 

Postdoctoral Fellow 

(joint fellow with Rheumatology) Monica Biniecka 

Postdoctoral Fellow 

(NCI/HRB fellow) 

Edward Fox 

MD research fellow Alan Coss Dave Kevans Joe Marry 

Garret Cullen 

Ph.D student Sheeona Gorman Juliette Sheridan Maciej Milewski 

MSc. Student 

Julie Gorman 

MCh fellow 

Chin Hong Lim 


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Department - Medical and Surgical Gastroenterology 

Dieticians 

Medical Gastroenterology 

Surgical Gastroenterology 

Ms M Doyle 

Ms N Bates 

Specialist support staff 

Cancer Nurse Co-ordinator Ms A White 

Colorectal Nurse Specialists Ms G McEvoy: Ms J McCarthy: Ms W Hillery 

IBD & Genetics 

Nurse Specialist 

Ms D Keegan 

IT/Excelicare Mr S Thompson; Mr K Curran; Ms M Ward. 

Secretary 

Ms G O’Neill 

Clinical 

In 2007 Medical and Surgical Gastroenterology completed the move to a single department with the 

opening of St Luke’s wards 1 & 2. Patients with acute gastrointestinal illnesses are admitted to these wards 

either via the Emergency Department or off the waiting lists. This relative protection has greatly improved the 

functioning of the unit and allows for a more rapid throughput of patients. Thus Medical and Surgical 

Gastroenterology now encompasses combined outpatient clinics, weekly clinical and audit meetings and a 

shared ward. Close to one third of all hospital admissions fit into the category of acute or chronic 

gastroenterological disease and these integrated services, unique in the country, are clearly appropriate. The 

move to the Ambulatory Day Care Centre in the new building continues to bear fruit with greater numbers 

undergoing procedures each year under the excellent management of Mr Richard Marshall and his team. The 

appointment of a half time Registrar to the unit has been of major benefit to the Endoscopy Unit but more 

specifically to the Emergency Department. We are now in a position to offer almost immediate endoscopy 

facilities to patients in the Emergency Department such that many are able to go home on the same day and 

thus free up badly needed beds. 

The dedicated St Luke’s Ward and the additional staff has allowed the early development of specialty referral 

whereby many patients arriving in the Emergency Department are now seen and taken over by Medical 

Gastroenterology, again ensuring a quicker and more focused admission. The weekly Radiology and 

Pathology conferences run with our colleagues in Diagnostic Imaging and Pathology allow for best practice 

in patient care and provide an excellent source of teaching for junior staff. We wish to acknowledge the close 

clinical and scientific support we receive from our colleagues in Medical and Surgical Oncology and Palliative 

Care. 

We welcomed Ronan O’Connell as Professor of Surgery at St Vincent’s University Hospital in 2007. Professor 

O’Connell has an international reputation in colorectal surgery and, in particular, in disorders of the pelvic 

floor. His arrival further strengthens the reputation of the Gastroenterology Division in the hospital. 

We also wish to put on record our thanks to our nursing colleagues on St. Luke’s and St. Patrick’s Wards who 

manage our gastroenterology patients despite major involvement in general medical and surgical call. We 

wish to express our thanks to Ms Nuala Donnelly and staff in St. Mark’s Day ward for all their magnificent 

work throughout the year. We look forward to the opening of a new and expanded St. Marks in 2008. 


251



Research and Education 

The Centre for Colorectal Disease (CCD) 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, Denise Keegan and Grace McEvoy who 

lead patients through the varied and complex pathways of diagnosis, treatment and postoperative stoma care 

in a way that appears seamless. Joanne McCarthy has joined the team as a nurse specialist. The Excelicare 

database system is now the backbone of the weekly Colorectal Cancer audit organised by Anne White, 

Marian Ward, Stewart Thompson and Ken Curran. 

The research arm of the Centre for Colorectal Disease continues to flourish under the guidance of Dr 

Jacintha O’Sullivan, Senior Research Scientist. The main research goals of the Centre for Colorectal Disease 

are to achieve a more complete understanding of which biological factors that 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. The goal of these translational research projects based 

on unique and exciting explant work is to determine which cancers require additional treatment and what 

therapies might be most effective. Such work has the potential for huge financial savings in the management 

of Colorectal Cancer. The large and detailed databases for patients with Bowel Cancer and Inflammatory 

Bowel Disease enable many of the projects to be achieved. The unit has very productive collaborations with 

both national and international institutions. 

Along with our colleagues in the Mater Misericordiae University Hospital and University College Dublinunder 

the umbrella of Dublin Academic Health Care- the Centre has received recommendation for a 5 

million euro grant that, at the time of writing, awaits funding confirmation from the HRB. This grant is centred 

on the management of bowel cancer in the elderly. 

Professors O’Donoghue and O’Connell represent the Hospital on the National Colorectal Cancer Screening 

Committee. 

Our Annual International Colorectal Meeting in the Education and Research Centre each September 

continues to draw large numbers of attendees and is an ideal platform to display the various strengths and 

activities of the unit. 

We wish to record our thanks to the many individuals and groups who raise funds for our research. In 

particular we would like to acknowledge foundations to the memory of Ellie Brady, Susie Byrne and 

Darragh Gibbons. 

Papers 

Selected papers : (21 in total 2007) 

O’Sullivan J, Sheridan J, Mulcahy H, Tenniswood M and Morrissey C. The effect of green tea on oxidative 

damage and tumour formation in Lobound-Wistar rats. 

(accepted Dec 2007, currently in press). 


252



Cullen G, O'Toole A, Keegan D, Sheahan K, Hyland JM, O'Donoghue DP. Long-term clinical results of 

ileocecal resection for Crohn's disease. Inflamm Bowel Dis. 2007 Nov;13(11):1369-73. 

Hanly AM, Winter DC. 

The role of thrombomodulin in malignancy. 

Semin Thromb Hemost. 2007 Oct;33(7):673-9. Review. 


Feighery LM, Cochrane SW, Quinn T, Baird AW, O'Toole D, Owens SE, O'Donoghue DP, Mrsny RJ, Brayden DJ. 

Myosin Light Chain Kinase Inhibition: Correction of Increased Intestinal Epithelial Permeability In Vitro. 

Pharm Res. 2007 Dec 27; [Epub ahead of print] 


Burke JP, Mulsow JJ, O'Keane C, Docherty NG, Watson RW, O'Connell PR. 

Fibrogenesis in Crohn's disease. 

Am J Gastroenterol. 2007 Feb;102(2):439-48. Epub 2006 Dec 11. Review. 


McGuire BB, Brannigan AE, O'Connell PR. 

Ileal pouch-anal anastomosis. 

Br J Surg. 2007 Jul;94(7):812-23. Review. 


Book Chapter 

Shields C, O’Connell PR 

ELECTROCAUTERY in Trimbos JB, Trimbos-Kemper TC eds BASICS OF SURGERY:tools, techniques, 

attitude and expertise. 2007 Elsevier, Maarssen, 67-77 

Presentations in 2007 

16 abstracts were presented during 2007 at various international and national meetings. These included the 

American Association for Cancer Research, American Gastroenterology Association, Irish Association for 

Cancer Research and the Irish Society of Gastroenterology. 


253



Invited Talks 

INVITED PRESENTATIONS 

Professor Ronan O’Connell 

INTERNATIONAL SURGICAL GROUP 

Fibrogenesis in Crohn’s Disease 

London, August, 2007 

SIR PETER FREYER MEETING 

“Publication in an electronic era” 

Sir Peter Freyer State of the Art Lecture 

Galway, September, 2007 

COLORECTAL SURGICAL SOCIETY OF AUSTRALIA AND NEW ZEALAND 

and SECTION OF COLON AND RECTAL SURGERY, ROYAL AUSTRALASIAN COLLEGE OF SURGEONS 

“Obstetric injury to faecal continence mechanisms” Adelaide, Australia, October, 2007 



“How to get published” Adelaide, Australia, October, 2007 



“Strictures in Crohn’s Disease” ESR Hughes Lecture, Adelaide, Australia, October, 2007 

FRONTIERS IN COLORECTAL SURGERY MEETING 

“Why are research and publication important to the modern surgeon” 

Sir Alan Parks’ Lecture St Mark’s Hospital, London, November 2007. 

Sir Alan Parks Visiting Professor 

St Mark’s Hospital, London (November 2007) 

INVITED PRESENTATIONS: 

Mr John Hyland 

(Sept) Modern Management Colorectal Cancer 

Faculty of Radiology/Radiotherapy Annual Meeting Royal College of Surgeons in Ireland 

Laparoscopic surgery for colorectal cancer. Prof Peter Lee Lecture. University of Hull United Kingdom 

The Evidence for Laparoscopic Colorectal Surgery 

International Laparoscopic Course RCSI/AMANCH Keynote Speaker 

Laparoscopic Surgery for Colorectal Cancer European Surgical Institute Hamburg. Keynote Speaker 

Students Graduated in 2007: 

Edward Fox, Ph.D. Thesis Title: Molecular analysis of colorectal cancer and its role in detecting familial cancer. 

Julie Gorman, MSc. Thesis title: The effect of telomerase inhibition in regulating treatment response in 

colorectal cancer cell lines. 


254



Grants Active in 2007 involving members of CCD amount to approx 1.75 million euro 

Health Research Board 2006-2009. Co-Investigator. €174,400. 

Almac Diagnostics 2006-2008. Principal Investigator. €106,000. 

Altana Newman Fellowship 2006-2008. Principal Investigator. €80,000. 

Health Research Board 2004-2007. Co-Investigator. €185,000 

Cancer Research Ireland 2004-2007. Co-Investigator. €145,000. 

HRB Translational Research Grant 2006-2011. 

€1.5 million. 

HRB NCI Cancer Prevention Fellowship 2006-2008 €110,000 

UCD Seed Funding Multidisciplinary Funding 2006-2007 €9,000 

UCD Seed Funding Multidisciplinary Funding 2006-2007. €15,000 

Almac Diagnostics 2006-2008. €106,000. 

Altana Newman Fellowship 2006-2008. €80,000 

Merck Newman Fellowship 2006-2008 €138,000. 

Health Research Board 2004-2007 €185,000 

Cancer Research Ireland 2004-2007 €145,000 

Health Research Board 2002 – 2008 €630,000 



RSCI / RCS Edinburgh Research Fellowship. 2007- 2009 €160,000 


255

Department of Emergency Medicine 

Introduction 

Department overcrowding due to admission delay continues to be the main challenge to improving efficiency 

and patient care. We are grateful to our in house colleagues and Bed Management for their efforts to assist 

us. This is a country wide problem and strong central action is required urgently. Locally we continue with 

innovative pathways of care and improved efficiency. 


Our priority continues to be streamed pathways of care while concentrating on key performance indicators. 

Early assessment of patients by a health care professional is pivotal and over 90% of our patients have had 

an assessment carried out within 10 minutes of arrival. Increasingly this is being combined with a medical 

assessment in an overall Rapid Treatment and Assessment programme. Alan Doyle is taking the nurse lead 

in this area. A proportion of patients can be directed to more appropriate care outside the Emergency 

Department, within the department they are directed to the most appropriate area for their care. 

Pathways of care continuing into the hospital are not possible without extensive cooperation with our inhouse 

colleagues and we are particularly grateful to Cardiology, Respiratory Medicine, Neurology, 

Gastroenterology, Care of the Elderly and Haematology in this regard. These links are essential if we wish to 

progress to Speciality Specific Admissions with emphasis on enhancement for care of the elderly and the 

further development of a stroke unit with a stroke neurologist and adequate rehabilitation facilities. Many 

pathways start in other hospitals in our region such as trauma bypass, suspected aortic rupture and fractured 

neck of femur and close cooperation as part of the regionalised plan for emergency care is essential. 

Audit related to risk management continues with emphasis on hygiene and infection prevention and control. 

Recent audits of clinical notes and patient satisfaction have been very valuable. We audit clinical incident 

reporting, patient recall, did not waits, drug related incidents and all aspects of communication that often 

underlie adverse incidents. A recent audit of the Chest Pain Evaluation Unit has shown results in keeping 

with the best international standards. There have been a number of international presentations based on the 

Deep Vein Thrombosis protocol and Exit Clinic and following this a Pulmonary Embolism protocol is being 

developed. During the year there were two activations of the Major Emergency plan. There has been 

extensive debriefing and audit of our response to this plan. We are very grateful to the hospital auditor Mr. 


256


Department - Emergency Medicine 

Sean Kingston for his role in preparing the debriefing audit with recommendations. Based on this internal 

and external trials of the plan on a regular basis are planned. We would also like to thank Ian Callanan with 

his audit help throughout the year. 

Publications and presentations 

“Should you play sport with a congenital or acquired abnormality of a solid abdominal organ” 

J Ryan 

Evidence Based Sports Medicine (2nd edition) 

Authors: Prof D MacAuley, T Best 

BMJ Publications 2007 ISBN 978 1 4051 3298 5 

“Adolescents Attending an Adult Emergency Department: Their utilisation Characteristics and Self- 

Reported Opinions of Care provided” 

Fry R, Ryan J, Salter N, Murrin C, Kelleher CC 

Ir Med J 2007 100(7): 525-529 

“Evaluation of a novel electronic algorithm for the management of paracetamol overdose” 

Presented at the 2007 Mediterranean conference on Emergency Medicine 

J Horan, A Nayeem, J Ryan 

“Treating Pain in the Emergency Department” 

Presented at the 2007 Mediterranean Conference on Emergency Medicine 

S Kuan, N Collins, S Kuan, J Ryan, M Boland, I Callinan 

"The effects of night-time closure on an urban district emergency department" 

Presented at the European Emergency Medicine Conference (EUSEM), Italy 

M Rochford, R Drew, St. Michael’s Hospital 


The total number of patients attending the Emergency Department was 41,531 (new 37,840). 

The total number of patients admitted through the Emergency Department was 9,676 (320 more than 

previous year). 

The total admission to the Clinical Decision Unit was 1,205. 

Future plans 

The emphasis for the coming year is to concentrate on our Key Performance Indicators and our Quality 

Improvement Plans as part of the hospital accreditation programme. This is to be combined with 

strengthening regionalisation with the objective of achieving efficient specialty specific admissions from the 

emergency departments throughout the region. 


257


Reports 

Department of Pathology & Laboratory Medicine 


During 2007 there was a further major emphasis on quality initiatives and audit. Clinical Pathology 

Accreditation UK Ltd. (CPA) carried out an inspection of the new facilities in conjunction with surveillance 

audits in Biochemistry, Haematology, Blood Bank, Nuclear Medicine, Endocrinology, Metabolism and 

Histopathology. The outcome of the visit was that Haematology/Blood Bank and Histopathology retained 

their CPA accreditation and that the other laboratories listed above were granted full CPA accreditation status. 

The Microbiology laboratory applied for CPA assessment in April 2007 and an assessment visit is scheduled 

for March 2008. 

In meeting the requirements of the EU Blood Directive, the Blood Bank applied for ISO15189 accreditation 

in November 2007 with an assessment scheduled for January 2008. 

In conjunction with ICT a major hardware upgrade of the laboratory information system was implemented in 

September 2007, which resulted in a significant improvement in the operational performance of the system. 

The laboratory quality management system Q-Pulse was upgraded to Version 5.0 in November and it is 

planned to train all staff on the new system in 2008. 

The level of achievement in the above projects could not have been achieved without the commitment and 

team effort of all the Pathology staff. 

Significant Developments 

Other significant developments in 2007 include the following: 

A programme to assist the management and usage of blood and blood products between St. Vincent’s 

University Hospital and St. Michael’s Hospitals commenced in October. In 2005 a similar programme had 

been set up with St. Columcilles Hospital, which was successful in improving the utilisation of blood. 

The appointment of a blood bank network quality officer has facilitated the establishment of links between 

the hospital blood banks in the region. In particular, the initiative has enabled SVUH blood bank to provide 

support to the hospitals in the region in their efforts to achieve compliance with ISO15189 by the EU Blood 

Directive deadline of November 2008. 

Following the commissioning of new analysers and pre-analytical automation in the Biochemistry laboratory 

in 2006, Roche Diagnostics have now identified the laboratory as the Irish “Showcase Site” for visitors. 

There has been considerable expansion of the role of Biochemistry staff in the quality management of both 

blood gas and glucose monitoring at point of care. The number of glucose meters and gas analysers has 

increased and staff were involved in the validation of two new blood gas analysers for Theatre and the 

training of over 100 Theatre nurses. 

Testing for Her2 in-situ using a Fluorescence Hybridization technique was launched in Histopathology. The 

test is used to determine treatment in breast cancer. 


258



In Microbiology and in collaboration with UCD, molecular typing of cystic fibrosis pseudomonas was 

introduced as per the recommendations of the Pollock Report. 

To enhance communication with GPs a twice yearly Microbiology newsletter was launched as a quality initiative. 

In Haematology a new protocol was introduced for the administration of Heparin throughout the hospital. In 

response to requests from the Drugs and Therapeutics Committee and to facilitate the introduction of a new 

Heparin monitoring protocol, the APTT ratio has been added to the haematology profile. 

A significant new development was the instigation by the Metabolism Laboratory and Dr Malachi McKenna 

of joint paediatric meetings to be held quarterly with consultants and medical staff from OLHSC, Crumlin and 

Temple Street Children’s Hospital and AMNCH Tallaght. The inaugural meeting was held on 7th September. 

The format consisted of case presentations, including bone biomarker results at baseline and on treatment, 

followed by interactive discussions. 


Professor McKenna retired as Consultant Endocrinologist and Director of the Endocrinology and Metabolism 

Laboratories in August, 2007. His career, his contribution to medical research and thirty years of clinical 

service to St. Vincent’s University Hospital was marked by tributes from friends and colleagues who attended 

a scientific meeting to mark his retirement. 

Staff who achieved promotion to higher grades in 2007 included the following: 

Acting Senior Medical Scientist 

Ms. Sandra Doyle 

Specialist Medical Scientist (Training) 

Ms Jean Kavanagh 

Senior Phlebotomist 

Ms. Gay Wright 

Senior Phlebotomists 

Ms. Miriam Hogan 

Acting Senior Clinical Biochemists 

Ms. Laure McAleavey 

Acting Senior Clinical Biochemist 

Ms. Catherine Higgins 

Senior Medical Scientist (Breastcheck) 

Ms. Louise Flanagan 

Acting Senior Medical Scientist (Endocrinology) Mr. James Connolly 

Job Sharing Microbiology Consultant 

Dr. Kirsten Schaffer 

Senior Medical Scientist 

Ms. Maura Reynolds 

Grade IV Secretary 

Ms Chie Borlongan 

New staff who joined the department included: 

Mr Ger Noone, Mr Alan Byrne and Ms Sinead Bradshaw.(Phlebotomists). 

Ms. Alison Breslon, Ms. Aoife Prendergast, Ms. Sarah Carroll, Ms. Nicola Faherty, Mr. Gordon Dixon, Ms. 

Deirdre O’Shea, Ms. Helena Duggan, Ms. Amanda Lynch, Ms. Margaret Ann Connaughton, Ms. Aoife 

O’Sullivan (Medical Scientists). 

Ms. Mary Walsh, Ms. Ursula Fox (Senior Medical Scientists). 

Ms. Fiona Tamas, Ms. Mireia Giralt Cubi (Admin). 


259



Ms. Michelle Cox, Vivian Cullen, Ms. Julie Rogers, Ms. Sharon Clifton, Mr. Joji Matthews, Ms. Juliette Griffin, 

Mr. Simon Smyth, Mr. Tom Nelluveilli, Ms. Eva Sadlier, Mr. Ben Glendon (Laboratory Aides). 

Ms. Elizabeth Kehoe, Ms. Susan Brady (Transfusion Surveillance Officers). 

Outstanding Achievements 

Prof. Dr. Joe Duffy continues to act as Focus Group Leader of the gastrointestinal group of the European 

Group on Tumour Markers (EGTM). EGTM is a European Expert Group involved in preparing guidelines on 

the use of tumour markers in different malignancies. 

Dr. Eoghan O’Neill was successful in the MRCPath. 

Ms Carmel Wren, Medical Scientist, presented a poster on the validation of a VRE screening medium and 

VRE epidemiology in SVUH at the Federation of Infection Societies in Cardiff. 

Ms. Deirdre Keating, Medical Scientist, gave a presentation of CF work and presented two posters at the 

Annual Cystic Fibrosis Conference in Killarney. 

Ms. Elaine O’Shea, Medical Scientist, took leave of absence from March – September to work with 

underprivileged children at the Sara Fox Hospital in Cape Town, South Africa. 

Dr. Karen Murphy, is Deputy National Specialist Director for Haematology and Education to the IMS/HAI. 

Mr. Ivan Shirley, is Vice Chairman of the Steering Committee of the Irish External Quality Assessment 

scheme. 

Ms. Geraldine Collier, continued her role as Chairman of the Association of Clinical Biochemistry, Republic 

of Ireland region. 

Dr. Sean Cunningham, is Chairman of the Clinical Biochemists Registration Board. 

Mr. Rowland Reece, continues his role as member of the Irish Expert Body on Fluoride and Health. 

Ms. Colette Hatton gave a presentation on “Stress in the Workplace” at the Phlebotomists Association of 

Ireland Conference. 

Dr. Tom Smith, is the Association of Clinical Biochemists’ representative on the Irish EQA Steering committee. 

Ms. Sheila McKeon, Grade IV Admin, successfully completed her Diploma in First Line Management. 

Ms Rhona Barry, Ms Marie Cantwell, Ms Miriam Hogan, Ms Ursula Keenan successfully completed the 

Certificate in Phlebotomy programme. 

Ms Miriam Hogan and Ms Sheila Fallon completed the Assessors and Mentors programme in Phlebotomy 

Ms Gay Wright completed the Tutor’s programme in Phlebotomy 


Pathology activity increased by 15.5% in 2007. 


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Department - Pathology & Laboratory Medicine 

Publications 

Cullen, G., A. O'Toole, D. Keegan, K. Sheahan, J. M. Hyland and P. O'Donoghue D (2007). "Long-term clinical 

results of ileocecal resection for Crohn's disease." Inflamm Bowel Dis 13(11): 1369-73. 

Cumiskey, J., P. Whyte, P. Kelehan and D. Gibbons (2007). "A detailed morphologic and 

immunohistochemical comparison of pre and postmenopausal endometriosis." J Clin Pathol 

Roe, B., S. Coughlan, J. Hassan, A. Grogan, G. Farrell, S. Norris, C. Bergin and W. W. Hall (2007). "Elevated 

serum levels of interferon- gamma -inducible protein-10 in patients coinfected with hepatitis C virus and 

HIV." J Infect Dis 196(7): 1053-7. 

Schaffer, K., S. F. Fitzgerald, A. Flynn, F. Fitzpatrick and L. E. Fenelon (2007). "Newly qualified doctors' 

knowledge about MRSA: uncertainty regarding management in the community." J Hosp Infect 66(2): 190- 

2. 

Zaman, M. B., M. O. Leonard, E. J. Ryan, N. P. Nolan, E. Hoti, D. Maguire, H. Mulcahy, O. Traynor, C. T. Taylor, 

J. E. Hegarty, J. G. Geoghegan and C. O'Farrelly (2007). "Lower expression of Nrf2 mRNA in older donor 

livers: a possible contributor to increased ischemia-reperfusion injury?" Transplantation 84(10): 1272-8. 

Future Plans 

Transfer of St. Michael’s Blood Bank laboratory to SVUH ensuring compliance with the EU requirements for 

the Healthcare Group. 

Achieve GMP accreditation for the tissue bank. The validation of the tissue bank clean room and preparation 

for further assessments by the IMB in order to fulfil our requirements under Tissue Directive 2004/23/EC 

will be undertaken. 

Establish CF Pseudomonas typing in the molecular laboratory in SVUH. 

Achieve compliance with new CPA standards. 

Introduce BNP test for evaluation of heart failure and sweat testing for the adult Cystic Fibrosis Unit. 

Audit activity in Histopathology will be further developed in line with HSE, CPA and Royal College of 

Pathologist’s recommendations. 


261


Reports 

Radiology Department 

Radiology Management Team 

Clinical Director of Radiology 

Radiography Service Manager 

Clerical Supervisor Grade VI Officer 

Clinical Nurse Manager II 

Dr Conor Collins 

Sharon Simpson 

Helen O’Reilly 

Sara Nicholson 


Over the last year the service delivered by the Radiology Department has continued to expand and improve. 

The state-of-the art equipment available throughout the department has facilitated the development of a 

wide range of exciting new procedures such as Cardiac CT Angiography and CT Colonoscopy. 

Rapid advances have occurred in Interventional Radiology resulting in a large increase in the number and 

variety of examinations being performed. 

The introduction of Enterprise Wide PACS has greatly improved clinical access throughout the hospital group. 

New Technology 

Throughout 2007 the learning curve continued for radiology staff with the introduction of a large number of 

previously unperformed procedures. 

Specialist training in a wide range of new examinations and applications presented a huge challenge for 

Radiologists, Radiographers and Nurses in the department. 

All of the staff in Radiology have shown great commitment to providing the best service possible by 

embracing the new technology installed and adapting to the changes in workflow, which have occurred as a 

result. 

Staff Movement 

Radiology 

There were no changes to the Consultant staff during 2007. 

Dr Amjad Iqbal returned to work as Locum Consultant during 2007. 

Fifth Year specialist registrar Dr. Abdul Nasser Alhajeri departed having successfully completed his fifth year 

of training. We wish him well in his future career. 

We welcome Drs. Ingrid Hesalip and Deirdre Moran as first year specialist registrars. Dr David O’Donnell 

commences his appointment as a fifth year specialist registrar. 


262

Department - Radiology 

Radiography 

We were delighted to have the following Radiographers join us during 2007: 

Patrice Power Victoria Vatsvag Marie Hickey 

Maxwell Mkhandawire James Vincent Noble Abraham 

Sony Koshy Rebecca Kelly Eva Dowling 

Edel O’Hanlon Karen Purcell Anne Walsh 

Selina Nic Airt Sarah O’Connor Shauna Finnerty 

Nile O’Hagan 

In 2007 we said goodbye to the following group of Radiographers. We were very sad to see them go but 

wish them all the best for the future. 

Ciara Sweeney Marina Ventor Hilary Eustace 

Patricia O’Loughlin Lea Farrell Emma Canniff 

Louise Venables Emma Flanagan Angela O’Sullivan 

Nursing 

We welcomed the following new staff nurses who joined the team in 2007 

S/N Henry Hibaler S/N Nisha Bin Kurian S/N Ajitha Joseph 

S/N Cynthia Tamario 

Healthcare Assistants Ana Moreno Carmen Garnes 

We said goodbye and thank you to the nurses & hca who left in 2007 

S/N Janeth Ceria 

Laura Kenny 

Clerical 

Lindi Phakoe was successful in obtaining an Acting Grade IV in CT, which commenced in August 2007. 

Brendan Foy was successful in obtaining a Grade IV in Interventional Radiology, which commenced in 

September 2007. 

Angela Ormonde was successful in obtaining an Acting Grade IV position in Nuclear Medicine and 

commenced in December 2007. 


263



The following staff joined us during 2007: 

Brendan Foy Celeste Kelly Petrutchka Jack 

Sander Quadros 

Breda Mullins 

The following staff left us during 2007: 

Emer Timony Nolan Marie Louise Kilty Eileen Mc Ginley 

Ann Sharkey Mary Gaughan Gillian Harmon 

Ann Marie Leahy 

Mary Peare 

Ancillary Staff 

The Radiology Aides have continued to contribute significantly to the workflow of the Radiology Department. 

Outstanding Achievements 

Administrative and Academic achievements by consultant radiologists in 2007 

Dr Conor Collins was elected Hon. Secretary of the International Cancer Imaging Society and delivered the 

keynote lecture on PET-CT in Oncology at the 7th annual meeting of the Society in Bruges, October 2007. 

He also delivered a state of the art lecture on PET-CT in Oncology at the European Congress of Radiology 

in Vienna, March 2007. 

Dr O Laoide was elected Dean-elect of the Faculty of Radiologists and continues as Hon. Secretary. 

Dr Skehan was appointed examiner to the part II Fellowship. 

Specialist Registrar achievements 

Drs Victoria Chan, Shauna McDermott, Chris Hegarty and Carol Ridge were successful in the primary 

examination for the Fellowship. 

Drs David O’Donnell and Ronan Killeen were successful in the FFRRCSI examination. 

Selected Publications 

PET CT in Oncology – for which tumours is it the reference standard? 

Collins CD. Cancer Imaging 2007; 7; 77- 87. 

Sheehan JJ, Ridge CA, Ward EV, Collins CD, Skehan S, Malone DE.. The process of evidence-based 

practice in radiology: an introduction. Acad Radiol 2007;14:385-388 

Sheehan JJ, Ridge CA, Ward EV, Collins CD, Skehan S, Malone DE. FDG PET in preoperative assessment 

of colorectal liver metastases combining "evidence-based practice" and "technology assessment" 

methods to develop departmental imaging protocols: should FDG PET be routinely used in the 

preoperative assessment of patients with colorectal liver metastases? Acad Radiol 2007;14:389-397 

O'Connor R, O'Leary M, Ballot J, Collins CD, Crown JC. A phase I clinical and pharmacokinetic study of 

the multi-drug resistance protein-1 (MRP-1) inhibitor sulindac, in combination with epirubicin in patients 

with advanced cancer. Cancer Chemother Pharmacol 2007;59:79-87 


264



Moran DE, Smith MJ, O'Sullivan MJ, Collins CD, Evoy D. Sentinel lymph node biopsy in elderly irish patients 

with malignant melanoma. Ir Med J 2007;100:422-424 

Kelleher FC, McKenna M, Collins CD, Brady G, Collins I, Crown J. Bisphosphonate induced osteonecrosis 

of the jaws: Unravelling uncertainty in disease causality. Acta Oncol 2007;46:702-704 

Evidence-based practice in radiology: an introduction to the series. Malone DE. Radiology 2007: 

242(1):12-4. 

A clinical test to avoid sural nerve injuries in percutaneous Achilles tendon repairs. Flavin R, Gibney RG, 

O'Rourke SK. Injury. 2007 Jul; 38(7):845-7. 

Conferences 

All of the major national and international radiology conferences were attended and presentations, such as 

the following, were made at several of these. 

Dr Conor Collins delivered the keynote lecture on PET-CT in Oncology at the 7th annual meeting of the 

Society in Bruges, October 2007. He also delivered a state of the art lecture on PET-CT in Oncology at the 

European Congress of Radiology in Vienna, March 2007. 


Statistics for the Radiology Department for 2007 are as follows: 

IR Rooms 8796 

CT 18421 

DR 83332 

Mammo 4973 

MRI 3965 

RNI 3200 

US 11989 

Total 134676 

This figure represents an 8% increase compared with 2006 (total no. 124653) 

Future Plans 

2008 will see further upgrades to the PACS in Radiology in addition to the introduction of electronic 

requesting. A review of services provided by interventional radiology will also be undertaken. 


265


Reports 

Report from the Clinical Director of Psychiatry 

Elm Mount Psychiatric Unit 

Elm Mount Unit continued to provide a high standard of psychiatric care during 2007. It was the first full year 

under the new Mental Health Act. There were 59 patients admitted involuntarily to the unit during the year 

(7% of total admissions), 16 had their orders revoked within 21 days. There were 36 tribunals held on the 

unit in relation to admissions and renewal orders, three of which were revoked. The Act had considerable 

impact on the running of the unit. In addition to the tribunals, all detained patients had independent second 

opinions from Consultant Psychiatrists and Legal Representation by Solicitors provided by the Mental Health 

Commission. 

An Advocate from the Irish Advocacy Network visits the ward on a weekly basis. His priority is to detained 

patients, but he is available to all patients in Elm Mount and his input is valued by staff and patients alike. 

In order to maintain the high standards among the staff, the unit was part of the refocusing acute psychiatry 

initiative in the HSE Dublin Mid Leinster Region. 

Refocusing is a practice development and change management model sponsored by the Nursing/Midwifery 

Planning and Development Unit. The aim is to: 

• Foster effective team work amongst staff 

• Collaboration with service receivers (patients/carers) 

• Whole team staff training to share ideas and good practice. 

• Have clear targets for change 

• Strong leadership to manage and maintain the changes made. 

Refocusing began in October 2007 and the positive impact has been noted by staff and patients and we 

look forward to completing this exciting project. 


266

Department of Old Age Psychiatry 

The increase in clinical activity of the Department of Old Age Psychiatry year on year since the inception of 

the service followed the same pattern in 2007 with over 845 new referrals seen by the service. There is an 

ever increasing demand for and increased pressure on the service reflecting the increasing elderly 

population in our catchment area reaching 34,000 people over 65. The multi-disciplinary team is preparing 

a plan for the service to be completed in 2008 which will outline a strategy to deal with planned 

developments for the service. 


The department welcomed a number of new staff to the unit including Clare Flanagan, Mental Health Nurse 

in the community, Gaye Robinson, Social Worker, Jennifer Allen, Social Worker, Sinead O’Brien, Senior 

Occupational Therapist and Desiree Letlhake, Occupational Therapy Assistant. Dr Deirdre Jackson took up 

post as Senior Registrar in Old Age Psychiatry. Congratulations to Dr Emma Unoh who passed her 

Membership of the Royal College of Psychiatrists. 

Service developments and Activities 

845 new referrals were seen in 2007, of which 245 (29%) were hospital consults. In addition there were 

1460 outpatient visits by doctors and 4170 visits by community mental health nurses. 

The day hospital continues to play a pivotal role in the assessment and management of patients and provides 

a very valuable support for patients recently discharged from hospital. There has been greater multidisciplinary 

team approach to the Healthy Ageing Course following an evaluation in 2007. Jennifer Allen, 

Social Worker and Sinead O’Brien, Senior Occupational Therapist have been involved in developing the 

programme with the day hospital staff. The Anxiety Management Group facilitated by the Senior 

Occupational Therapist and various members of the multidisciplinary team and Active Rehabilitation Group 

are run alongside the acute day hospital services. 

A model for a Rapid Response service for nursing home referrals has been developed by the Clinical 

Psychologists working with the multidisciplinary team. Aspects of the service have been put in place over 

2007. These include multi-element needs-based assessments (including newly designed assessment forms) 

and treatment plans for behavioural and psychological problems in dementia, formulation meetings with staff 


267


Department - Old Age Psychiatry 

and relatives to discuss assessments and treatment plans. Research and audit of this initiative are planned 

to be an integral part of this programme and additional staff will be required to implement it in full. 

The database, developed by the Health Research Board and introduced into the Department in 2006 under 

the supervision of Dr. Aideen Freyne, has been successfully generating data regarding service activity. Ms 

Antoinette Copley has played a major role in the organisation of the programme and Ms Debbie Connolly 

has been trained in its use. It is planned that additional staff will be trained to manage this data base. 

The social workers on the team are developing a carer support programme in addition to the existing carer 

information groups which are run 4 times per year. They are continually updating the information document 

on services for older people so that it represents a comprehensive guide to community support services, 

long-term care options and legal issues relevant to older persons. 

The community mental health nurses play a pivotal role in the assessment and follow-up of our patients 

across the whole spectrum of the service. They are involved also in co-ordinating the effective running of the 

specialist Lithium Clinic with a specific nurse allocated to the service, involvement in the Anxiety and Healthy 

Ageing Groups and providing clinical input to the Nursing Homes of the catchment area and teaching input 

in the Nursing Home education programme. They have also been actively involved in training in dementia 

care mapping and training in the management of enduring mental illness. 

Dr Aideen Lewis Principal Psychologist with the team has been a member of the HSE steering group on 

Elder Abuse. 

Publications, Research 

Meehan, T. MacLachlan, M. (in press) Self construction in schizophrenia: a discourse analysis. 

Psychology and Psychotherapy: theory, research and practice. 

Dolan, M. Freyne A and Cooney, C. Needs Assessment of older people with dementia has been submitted 

to Irish Journal of Psychological Medicine. 

Deirdre McNally (Clinical psychologist in training) has completed her research for the Masters in Applied 

Psychology 2007. Her research entitled “Getting rid of demons: Older adults experiences of therapy” involved 

interviewing older adults about their experiences of therapy. 

An evaluation of the lithium clinic is being conducted with emphasis on the assessment of the potential 

benefits of lithium on cognitive function in older patients. 

Conference Presentations 

Meehan, T. Mental Health in late life. Paper presented at the Gerontology conference (Mental Health issues 

in Later Life), Our Lady’s Hospice Harold’s Cross, Dublin 6 28th September 2007 

Abidin Z and Jackson D. “Cognitive function in attendees at Dublin South East Lithium Clinic”. Winter meeting 

of the Irish College of Psychiatrists, November 2007 


268


Department - Old Age Psychiatry 

Continuing Professional Development and Teaching 

Dr. Trudy Meehan (Clinical Psychologist) attended an intensive training course on Narrative Therapy and is 

offering Narrative therapy as part of her therapeutic repertoire for patients in the Department of Old Age 

Psychiatry. 

Jennifer Allen is undertaking professional training in Play Therapy and Psychotherapy. She is currently in first 

year of the four-year course accredited by HETAC. 

Dr Aideen Lewis continues to develop and manage the Nursing Home Education Programme which is held 

annually at the Education and Research Centre of the Hospital and involves multi-disciplinary teaching input. 

In addition, Dr Lewis and Dr Trudy Meehan co-ordinated a week-long teaching block (Older Adult Specialist 

Week) for doctoral students of Clinical Psychology from UCD and TCD. Feedback from the course attendees 

was very positive. 

A Challenging Behaviour Workshop for all team members was held in June 2007, presented by a nurse 

specialist and clinical psychologist from the Newcastle Challenging Behaviour Service. 

Sinead O’Brien, Senior O.T., completed a three year advanced course in group analytic psychotherapy with 

the Institute of Group Analysis, Dublin (The School of Psychotherapy, St. Vincent’s University Hospital). 

Dr Aideen Lewis and Dr Cooney have given lectures at the “Adult Education and Information Course for Non 

Clinical Professionals with an Interest in Health Care”. 


269

270 

Excellence

Report from the General Services Manager 

Catering 

Fire Safety 

Household Services & Cleaning 

Portering Services 

Security 

Technical Services 

Telecommunications 

271


General Services 

The General Services department is responsible for managing the delivery of the non-clinical support 

services to the hospital. 

In early 2007 the portfolio was restructured to include Catering and Technical Services. In February 2007 

Mr. Frank Smyth was appointed as General Services Manager. The General Services portfolio consists of 

the following departments: 

Catering 

Fire Safety 

Health & Safety 

Household Services & Cleaning 


Security 


Telecommunications 

The overall aim of the department is to ensure that the above support services are delivered in an efficient, 

effective and customer focused manner. 

General Services took the lead in setting up the Estates Strategy Group in late 2007. The Estates Strategy 

Group is responsible for reviewing all requests for development work in order to assess the impact on 

business and clinical operations, and to determine if and how projects should proceed. It is also responsible 

for ensuring that developments are planned in a manner that does not undermine or prohibit future 

developments. 

The department was also involved in developing a Transport Strategy for the hospital that would encourage 

more sustainable methods of travelling to and from the hospital. Initiatives will include the establishment of 

a Bicycle User Group to promote cycling, improvements in showering and changing facilities, installation of 

cycle friendly stands and greater awareness of public transport opportunities. 

Planning permission for the new Private Hospital was received in November 2007. General Services was 

actively involved in the planning and enabling works to decant and relocate the existing services provided in 

St. Anthony’s from the proposed site for the new hospital. Projects included: 

• Sourcing and refurbishing alternative accommodation for the Cancer Support Service. 

• Sourcing alternative accommodation for transplant patient’s families. 

• Co-ordinating the move of Occupational Therapy, Physiotherapy and Speech & Language Therapy 

services to the newly refurbished Allied Therapy Suite. 

• Relocation of Pain Management service to a purpose designed location within the main campus. 


272



It is expected that 2008 will bring many more challenges as several major redevelopment projects are to 

commence including the construction of the new 120 bed ward block and a major refurbishment programme 

which already includes: 

• St. Camillus - replacement of ceilings and lighting. Upgrading of linen room and installation of a 

high density storage system. 

• St. Monica’s – installation of a high density storage system in the store room. 

• Day Ward – conversion of old Radiology department into a new 23 bed day ward. 

• St. Monica’s – refurbishment of ward kitchen. 

• Outpatient’s Department – refurbishment work to improve Social Work Dept; create HIPE Offices 

and a refurbished Clinic Room. 

• Emergency Dept. modifications to create an additional 4 bedded Clinical Decision Unit. 

• St. Luke’s 2 modifications to improve patient environment. 

• St. Patrick’s – creation of a new seven bedded Medical Observation Unit. 

• St. Mark’s Ward modification to create an eight en-suite bedded unit. 

• Professor of Medicine Suite to be developed with support from UCD 

• Professor of Surgery Suite to be developed with support from UCD 

• Ward Kitchens – upgrade programme across all kitchens. 

• Ward Bathrooms – upgrade programme with new showers and toilets 

• Signage – provision of permanent external signage across campus. 

Each of the departments within the General Services portfolio has had a productive year. The following is a 

brief outline of their role and activities. 


273



Catering 

We would like to welcome all new staff who joined the catering department in 2007 and hope they will enjoy 

being part of our team. In particular we would like to welcome Barbara Grogan who joined the hospital as 

Director of Catering Services. 

We would also like to send our good wishes to all our staff who retired in 2007 and thank them for their hard 

work and commitment during their employment with the hospital. 

Peggy Lowry, Director of Catering Services retired in November 2007 and we would like to wish her well in her 

retirement and acknowledge her dedication and commitment to the department during her time in the hospital. 


A number of service developments and quality improvement initiatives were introduced in 2007. Key 

developments were: 

• An extended out of hours vending service for patients and visitors providing a 24hr food service. 

• Provision of a continental breakfast and a hot or cold main course to patients awaiting admission in 

the Emergency department. 

• Provision of Halal, Kosher and other Ethnic or religious meals on the patient menus and in the 

cafeteria. 

• Introduction of a “made to order” sandwich bar in the cafeteria with an independent cash point in 

order to provide a greater choice and reduce queuing time during peak periods. 

• Training of senior members of the catering staff to deliver the primary food hygiene course and the 

manual handling course ensuring that all staff can be trained and re-trained in these areas at 

departmental level. 


The Catering Department achieved the Irish Heart Foundation – “Happy Heart at work – Healthy Eating at 

Work Award” in 2007. We would like to thank all catering staff members for their efforts in achieving this 

award for the hospital. 


The Catering Department provides a full meal service to over 500 patients and in excess of 2,500 hospital 

staff and visitors. All meals are prepared fresh using the best choice ingredients from recommended and 

audited suppliers who are monitored to adhere to HACCP regulations, standard specifications and pricing 

structures. 


274


The HACCP system in place in the Catering Department ensures that all hygienic and safety standards are 

fulfilled during the storage, preparation, cooking and service of food to patients and customers. 

Healthy eating is encouraged by catering services throughout the hospital and reflected in the use of lower 

fat option spreads, yogurts, dressings etc in the cafeteria. High calorie and full fat items, as well as special 

diets, are of course also included in our patient catering service. 

Restaurant volumes have increased significantly in the past years with greater numbers of staff using the 

service. 

Catering services have also provided for many functions, seminars and meetings throughout the year and 

have put much effort into the organisation and presentation of such events for the hospital, particularly at 

festive periods where great creativity and innovation comes into play in terms of decoration, variety and 

displays. 

Future Plans 

The following key service developments and quality improvement initiatives are planned for 2008. 

• A programme is in place to upgrade and modernise all ward kitchens in line with HACCP regulations 

and standards. 

• The coffee and tea service in the cafeteria will be upgraded and have an extended range of 

beverages. 

• A Healthcare Food award has been planned. 

• The introduction of a departmental induction booklet. 

• A waste recycling system is due to be launched in the cafeteria in early 2008. 

• Team ~Based Performance will be developed further in the Catering Department reaching out to all 

members of staff in terms of communication and progress. 

• The re-introduction of a moulded food service for patients with dysphasia providing a modified 

consistency diet. 

• We hope to provide some organised food theme days in the cafeteria during 2008 taking input and 

ideas from staff members with a view to boasting morale and interaction. 


275



Fire Safety 

Fire safety in the hospital has been further enhanced with the appointment of Clive White as a dedicated 

Fire Safety Coordinator. The function is responsible for overseeing the development of the fire safety 

management system through conducting fire risk assessments, housekeeping audits, fire equipment 

inspections and fire safety training. 

The number of fire training sessions carried out in 2007 was: 

General Fire Training – 20 sessions 

Fire Marshal Training – 6 sessions 

A major drive was initiated to help promote the importance of fire training and evacuation drills. 

Improvements were made in the availability and quantity of training sessions to help minimise any disruption 

to departmental resources. Additional drills were incorporated to facilitate the staff transfer to the new 

ADCC building. 

Fire evacuation sheet audits were conducted on all wards with the kind assistance of the Clinical Nurse 

Managers. 

The fire safety register was revamped with a “real-time” live register to allow for continuous works 

improvements occurring throughout the hospital. A contract was awarded for the design and project 

management of a new fire alarm system for the ward block area. This also encompassed the commissioning 

of new fire detection systems in areas such as the Allied Therapy Suite. Systematic fire risk assessments 

are being conducted to identify hazards and help improve fire prevention and control. 

Further developments in fire safety included the development of a fire alarm incident procedure to help clarify 

the roles and responsibilities of the key members of the fire team who respond to fire activations. The SOP 

lists the action plan switchboard staff will immediately initiate on the report of a fire; the preliminary details 

of the incident in which security will record; and the follow-up investigative report that the Fire Safety 

Coordinator will pursue. 

Weekly fire safety meetings are held and place a strong emphasis on improving and implementing fire safety 

controls. One such initiative involved the reduction of nuisance fire activations by identifying their causes 

and implementing strategies to help reduce or prevent re-occurrences. A complete ban on aerosols being 

used within the hospital was agreed as one such measure of reducing nuisance activations. 

Type of Activation 2007 2006 

Real/Actual 9 13 

Nuisance Activations 32 31 

Totals 41 44 


276



The main causes of fire alarm activations are categorised as follows: 

Cause of Activation 2007 2006 

Dust 12.2% 13.6% 

Accidental Human Activation – BGU/Panel 17.1% 22.7% 

Aerosol 4.9% 9.1% 

Steam 26.8% 6.8% 

Unknown 4.9% 6.8% 

System Fault 12.2% 11.4% 

Actual Activation* 21.9% 29.6% 

*Fire / Toaster / Microwave / Hot Work / etc. 

Cleaning, Hygiene and Household Services 

The hospital acknowledges its requirement to maintain the highest standards of cleaning and hygiene in the 

support of patient care. All cleaning and hygiene activities are guided by best infection control practices and 

national guidelines. The majority of cleaning activities are provided under a contracted service and the 

hospital endeavours to ensure the services provided continue to meet our ever-changing needs. 

Following the introduction of new recommended cleaning standards by the NHO the department undertook 

a total review and update of the hospitals cleaning specifications with the launch of the first phase to clinical 

areas completed in October. 

The household function also co-ordinates the management of rest, welfare and the accommodation facilities 

for the staff and patient relatives and is responsible for co-ordinating and monitoring contracted household 

services. In 2007 the department initiated many minor refurbishment projects including the relatives room 

and was a key stakeholder in planning the refurbishment of the hospital’s linen rooms. 

Household Services continued to work in conjunction with Noonan Services Group, the hospital’s cleaning 

service providers. The department monitors cleaning outcomes and participated in quality improvement 

initiatives. 

The staff compliment in 2007 was 4. Finally, congratulations to Ms Kathleen Gill the department’s supervisor 

who celebrated her 30 years of service to the hospital and also successfully completed the FETAC Level 6 

in Management programme. Theresa Burke completed Fetac Level 5 in Household Services and also 

celebrated along with her colleague Jane Purcell 20 years of service in the hospital. 


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The department manages the provision of Portering services to a broad spectrum of hospital departments. 

Departments serviced include complex areas such as Theatres, Laboratories, Pharmacy, Radiology and 

Ambulatory Day Care Clinics. The department continues to develop its responsibility for the provision and 

co-ordination of whole hospital activities such as waste management, post and patient transport. 

Waste management continued to be a major focus and in 2007 the department was instrumental in 

implementing a consolidated waste contract across all non-clinical waste streams. This saw a diverse 

number of waste streams such as food, domestic, paper, building, WEEE, etc being consolidated under one 

service provider. The new contractor Oxigen Limited had been working closely with the department in 

developing initiatives such as recycling at source and the segregation of food waste. 

The staff compliment in 2007 was 93. The Portering Services Manager is Gerry Noone. Gerry is in his 38th 

year of service with the hospital. Finally congratulations to Dominic Loughlin for successfully completing 

Fetac Level 5 and Anthony Walsh for completing Fetac Level 6 in Skills Vec. 

Security 

It is the intent of the St Vincent’s University Hospital to provide a safe and secure environment for all 

employees, patients, visitors and contractors. Our security department plays a key role in the co-ordination 

and delivery of our safety and security activities and operates on a 24-hour basis with particular focus on fire 

and emergency response procedures. 

Security was a key stakeholder in the development and implementation of a number of policies such as 

Visiting Hours Policy, Patient Property Policy and a Restraint Handling Policy. The department participates 

in a number of quality improvement committees such as the Safety, Risk and Quality Improvement Group, 

Fire Safety Group and the Health & Safety Committee. 

The department continued its roll-out programme for Access Control / ID cards with extra departments 

coming on stream. To date all current employees have been issued with the new ID cards. This has 


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necessitated in excess of 3,000 cards being programmed. In 2008 it is planned to integrate the issue 

process into the Human Resources induction programme for new employees. 

Key areas of the campus continue to be risk appraised for conversion to access control and it is planned to 

roll-out the system to all staff car parks in 2008. 

The department is managed by Jim Mitchell and the staff compliment in 2007 was 16. 


Technical Services is responsible for the management, design, installation and maintenance of engineering 

services within the hospital. It is also involved in the broader areas of energy management and sustainability 

planning. Four key areas of activity in 2007 were: 


Due to the amount, complexity and cost of building services in new developments, systematic inspections 

and routine maintenance were devised to ensure continuity of good service and economy of resources. New 

maintenance schedules were planned using the manufactures specifications with O&M manuals. As most 

of the equipment was on a first year schedule, isolation and hazards had to be identified to ensure continuous 

support to the hospital. All plant equipment was identified and ranked to ascertain the impact of a failure to 

the hospital. Planned preventative maintenance was introduced to avoid disruption to the activities of the 

various areas covered, i.e. chillers were maintained in off peak hours. The new Allied Health Department 

Refurbishment came on stream in 2007. The process of integrating new developments into the campus has 

been a demanding, challenging and interesting one and we look forward to implementing the lessons learned 

as future projects come on stream during 2008. 

Estates Strategy Technical Services Projects 

Technical Services was a key stakeholder in the development of the Estates Strategy Group. Its Projects 

Team completed a substantial number of new projects with the combination of in-house technical services 

staff and outside contractors. 


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A summary of these is: 

• Catheterisation Laboratory Recovery Room Refurbishment 

• Window replacement included ward isolation cubicles and ancillary areas 

• Cardiology ECG Offices 

• Medical Records Filing Room Refurbishment & Mobile shelving Replacement 

• Dryer & Cleaning Room Refurbishment 

• Clinical Services Building Air Conditioning 

• Roof repairs on Ancillary Buildings 

• Numerous office upgrades were completed around the campus. 

• Bone & Joint Treatment Room 

• Ward Courtyard Drainage Revamp 

• HSSD Reverse Osmosis Plant Upgrade 

• St. James Ward Room Conversions. 

• Catering Department new main kitchen flooring and window replacement. 

Planned & Reactive Maintenance 

Day-to-day operational maintenance continued within the department, the online helpdesk - PEMAC 

received over 10,000 requests. All reactive maintenance was prioritised to achieve a quicker and more 

streamlined response. With the help of our online helpdesk all requests can be logged & tracked 

electronically to allow for more positive feedback. Planned preventative maintenance programmes were 

implemented for engineering plant and building services to eliminate failure and break downs, a brief outline 

of areas maintained is as follows. 

• Asset Plant Management • AHU’s and air conditioning 

• Central Plant Operations • Cleanroom validation 

• Carpentry Repairs • Emergency Lighting Test & Repair 

• Environmental Testing • Events Set-up – indoor 

• Electrical Maintenance & Repairs • Fire Alarm Testing/Management 

• Fire Hydrant & Sprinkler Testing • Flooring Repairs 

• Generator Maintenance • Glazing Repairs 

• Infection Control wall washing • Landscape maintenance 

• Lock Repairs & Key Replacements 

Energy & Utility Management 

Operating data recorded through a Building Management System is monitored and corrective action was 

initiated to ensure an efficient energy usage policy. Areas were identified for control upgrades which will 

allow for more automated control and decreases energy expense. Water management continued with the 

sampling and testing across various areas on the campus to ensure the services comply with the relevant 


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standards and decrease the risk of legionella. The impact of new developments led to increased loads, 

notably electrical which was 2.25 KWT max demand and water which was 430,000litres daily. 

The Technical Services Manager is Peter Mortell and the department has a complement of 46 staff. Staff 

changes in 2007 were: William Hanlon, Deputy Technical Services Manager and John Hickey, Electrician 

who left to pursue new career paths and we wish them success. Also we would like to welcome Ciaran Ryan, 

Facilities Engineer, Robert Coffey and Derek Kelly, Electricians to the Department 

Telephone and Communication Services 

The telephone service provides switchboard and other communication services to internal and external 

customers. In 2007 a total of 3500 internal and external calls were handled per day. This figure is a 

decrease of 12.5% on the previous year’s figures and is part of a programme to reduce the amount of 

unnecessary calls handled by the switchboard staff. The objective of this is to allow the staff more time to 

focus on external calls thereby improving answer response times. 

The department is responsible for co-ordinating all internal emergency communication protocols and is 

responsible for maintaining the key internal telephone and paging system directories. 

The department continues to offer technical assistance for all departmental moves, and 2007 saw 

involvement in two main refurbishment projects – Allied Therapy Suite and Medical Records. The service 

provided in excess of 100 new extensions and numerous moves and repair faults in 2007. 

The Major Emergency Plan was activated in June 2007 with two major emergency alerts called on a single 

day. One was to standby level and another to full alert following a second unrelated incident, creating one of 

the busiest and most testing days in the department’s history. The department was pivotal in ensuring the 

deployment of the Emergency Plan went as planned. 

An Internal Audit review of the department recommended a number of quality and risk improvement 

initiatives. These have been incorporated into its 2008 service plan. A new monthly bleep testing Policy has 

been implemented as a result of the audit. 

The Telecommunications Supervisor is Bernie Deignan. The service operates on a 24-hour basis and is 

staffed by a team of 14 full and part time members. 

Finally 

General Services would like to express our thanks to staff in all its departments for their hard work and 

commitment to the team over the past year. Also to acknowledge the other departments that work in 

association with us in helping us to deliver a quality service in a customer focused manner. 


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282 

Mission

Reports 

Report from the Human Resources 

Department 

Report from the Information and 

Communication Technology Department 

Report from the Purchasing and 

Procurement Department 

Report from the Quality, Risk and 

Consumer Affairs Department 

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Reports 

Report from the Human Resources Department 

Introduction 

The development of a Human Resources Strategy for the Health Care Group was one of the key goals in 

the St Vincent’s Health Care Group’s strategic plan, ‘Framework for Development 2006 - 2010’. Prior to this, 

Human Resources Management in the hospital was guided by a number of key HR management plans. 

These were the result of engagement in a range of activities such as quality improvement through 

Accreditation, Modernisation and Change linked to the Performance Verification process under the Social 

Partnership Agreements, Partnership Service Plans, focused risk management and the development of new 

systems and processes to improve HR service delivery. 

A high level Group HR Strategy was agreed by the HR functions of the three hospitals in the Healthcare 

Group early in 2007. As part of a project plan agreed by the three hospitals each of them committed to 

developing a site specific Action Plan. St. Vincent’s University Hospital engaged an independent facilitator 

to assist in an extensive consultation process and preparation of an Action Plan. This consultation process 

was undertaken during 2007 to ascertain those areas which were important to staff and managers across 

the Hospital and the plan was finalised by year end. A launch event is planned for early 2008. 

Organisational Development 

In line with its ethos of continually improving the organisation in support of its mission a series of projects 

were initiated or focussed by the hospital’s senior management at the beginning of 2007 to deliver alignment 

of purpose throughout the hospital. Previous initiatives were incorporated and throughout the year a format 

for using individual, team and organisational objectives to ensure delivery of the appropriate services and 

service quality aligned to the governing strategies of the Board were developed. Management development, 

the development of a performance culture in support of the mission, team development, communications 

strategies and measurement communication systems were put in place. The current dashboard of metrics 

and board report, the “10+5” objective setting and performance review system, the management 

development program, the roll-out of performance management through all functional teams and the 

focussing of managers onto 1:1 communications and performance feedback with their direct staff are some 

of the outcomes to date. 

Partnership 

Management and trade unions in the hospital had agreed a 2007 Partnership Service Plan, in conjunction 

with the Heath Services National Partnership Forum and supported a number of key initiatives throughout 

the year. Principle among these was the 2-year project “Partnership Communication and Partnership 

Management in SVUH”. This successful project had strong backing from the committee and financially from 

the HSNPF and has had a very effective foundational year as can be seen in the implementation of Team 

Based Performance Management, in the supporting training and in a new internal communications strategy. 

The planned, extensive programme to support the HSE Trust in Care policy, which upholds the dignity of 

patients / clients, and which outlines a procedure for managing allegations of abuse, was rolled out in 2007. 


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Department - Human Resources 

The committee and the wider partnership constituency also played a role in continuing to maintain a positive 

industrial relations climate in the hospital during some challenging times and played a valuable role in fulfilling 

the hospitals obligations in the Performance Verification Process, which forms part of the national social 

partnership agreement (Sustaining Progress). 

Learning and Development Division 

2007 has been a year of intensive growth and development in the provision of Learning and Development 

within the hospital and also to a group wide audience. The, by now, ongoing financial and operational support 

for an extensive range of developmental qualifications was continued and progressed through the year and 

the M.Sc. in Creative Leadership with the Royal College of Surgeons (with the support of the other Dublin 

Academic Teaching Hospitals) is a significant augmentation. The M.Sc. is a focussed tool to develop leaders 

for the future of the hospital and for the health service. It fills a developmental need as a part of succession 

planning and represents a considerable visionary investment for the hospital. This is backed up internally with 

a consistent focus on Developing our Managers. 2008 will see the development of a “How to” series of short 

workshops on the skills of managing people. 

Courses throughout the year have included Team Based Performance Management, Interest Based 

Bargaining, Trust in Care, The Legal Framework for People Management, Presentation Skills, The 7 Habits 

of Highly Effective People, internationally accredited Crisis Intervention Training ( for which we have now 

trained a team of internal trainers) and IPA Interviewing and Recruitment workshops. The hospital continues 

to support the national SKILL programme for support grades and support managers, which is run in 

conjunction with the VEC’s. Over 30 staff were on release last year to attend courses aimed at furthering 

the continuous improvement of professional practises in the support areas. The next stage of development 

of the SKILL roll-out is to move to a delivery method focussed just on the participants from our own hospital 

in line with the national drive for focussed “critical mass” roll-out to increase the uptake among support 

grades. 

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 advising on the provisions of 

employment legislation, managing performance, employee grievances and managing attendance. 

Key activities for the Division during 2007 were: 

• Enhancing, promoting and maintaining good employment relations at local level through extensive 

communication with employees and their representatives regarding impending/ongoing change. 

Also, in this context, ensuring compliance with the provisions of Towards 2016. 

• Supporting and enhancing the competence of line managers and supervisors in employee relations 

with a view to enabling them to resolve employee problems quickly and informally whenever 

possible. 

• Promoting the use of mediation as a means of resolving contentious issues. 

• Responding to expanding body of legislation regarding employment rights. 


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• Developed and implement models for workplace investigations in line with relevant policies and 

emulating best practice. 

• Conduct restructuring initiatives at departmental level 

• Respond on behalf of the hospital to referrals involving Equality Tribunal, Labour Court, LRC, and 

Rights Commissioner Services. 

• Developed and implemented an Employee Relations database for tracking issues 

• Participation in initiatives such as HR Strategy development, Partnership, Accreditation and Smoke 

Free Campus. 

• Involvement at both local and national level with issues such as Nurses Work to Rule, introduction of 

37.5 hour week for nurses and benchmarking. 

• Delivery of the reports for the Performance Verification Process Phase 2 and 3 under the terms of 

Towards 2016. 

• Monitoring and review of attendance records in line with national guidelines for Health Service 

Employers on Managing Attendance. 

• Participation in the delivery various training initiatives, e.g., FETAC programme for Health Care 

Assistants, People Management -The Legal Framework, Mission Effectiveness and less formal 

departmental workshops. 

Resourcing and Retention Division 

2007 was a very demanding year for the Resourcing & Retention Division despite the HSE recruitment 

restrictions which were initiated in September 2007. A total of 357 clinical (excluding medical and nursing), 

administrative and general support staff were recruited throughout the year filling a wide variety of temporary, 

permanent and locum roles. 

A new advertising corporate image ‘Combining Tradition and Innovation’ was launched aimed at more 

effective recruitment campaigns in the contest to attract quality staff. Advertising was changed from a 

weekly to a monthly cycle and text was also significantly reduced, which helped reduce expenditure on 

advertising. 

A significant body of work aimed at standardising recruitment activity across the hospital was commenced 

in conjunction with Medical and Nursing HR Divisions. A new competency framework which significantly 

draws on the Office for Health Management competencies was also rolled out. Feedback questionnaires to 

recruiting line managers were introduced in order to get their suggestions and recommendations on 

improvements that could be made to the recruitment process. 2007 also saw the introduction of Garda 

Vetting of all new employees. 

Nursing HR Division 

It has been a very busy and challenging year for the Nursing Division of the HR Department. During 2007 

the division worked closely with the Senior Nurse Management team to deliver on significant goals and 

objectives, which were designed to support the provision of high-class healthcare by all nursing staff. 


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One such objective was to continue to reduce absenteeism and to achieve an overall reduction of 12% by 

the end of 2007 (from 2005). This target was achieved and in fact exceeded in 2007. A number of initiatives 

aimed at improving attendance were taken during the course of 2007 including the roll out of a revised 

absence-recording model. 

The Nurse Bank was formally established in October 2007 with the appointment of Liz Tuohy, Nurse Bank 

Manager and her team. This is a two-year Value for Money Initiative that aims to achieve cost savings of up 

to 20% and higher quality care provision through the establishment of an efficient Nurse Bank. 

This was a challenging year for recruitment in nursing with almost 205 appointments in 2007 including 28 

management level positions. A total of 38 nurses joined us from abroad following three overseas intakes 

during 2007. 

A number of key recruitment and retention initiatives took place during the year such as the following: 

• Two six-month foundation level courses in Critical Care and Peri-operative courses were developed 

by the respective specialist areas in conjunction with the Nurse Education Centre to assist with 

recruitment, development and retention of specialist nurses. 

• The Nurse Graduate Recruitment Drive was reviewed resulting in a 25% increase in applications; 

increase in places on the graduate programmes and the enhancement of the programme by formally 

offering an additional 6-month specialist placement to graduates to stimulate an interest in specialist 

nursing. 

• The Department of Enterprise, Trade and Employment launched new employment permit 

arrangements on 1st February 2007 and over 180 employees attended an Information Session by 

Nicky Egan, Nursing HR, on 9th March 2007 to explain the new model. 

Medical HR Division 

This was another busy year for the Medical HR Division. As always the main goal of the division is to ensure 

the hospital has a full complement of appropriately qualified and experienced medical staff at all times in 

order to provide the necessary services to our patients. In relation to recruitment 2007 saw the seamless 

appointment of over 250 Non Consultant Hospital Doctors, which in turn saw 250 leaving the hospital in 

order to pursue training elsewhere. 4 permanent consultants were also appointed. This is less than previous 

years, as early 2007 saw the suspension nationally of permanent consultants posts being approved due to the 

negotiations in relation to a new consultant contract. This obviously caused challenges for the division and 

resulted in the appointment of additional temporary and locum consultants. The division continued to provide 

comprehensive support to the Chair of the Medical Board and Medical Executive Committee of the Hospital. 

Considerable developments were made in the area of electronically recording working hours of NCHDs and 

reducing them as required by the European Working Time Directive, whilst working in collaboration with 

Hospital Consultants. This related to a reduction in associated overtime costs. 

The division undertook a complete review of standard operating procedures, which also resulted in the 

streamlining, and strengthening of processes. As well as being audited by both internal and external auditors 

the division developed a continuous self-audit process of employee files. 


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A review of the NCHD induction process took place and a new induction programme was implemented that 

received positive feedback from contributors and participants alike. Provisions were put in place and 

supported by the Medical Board in order to facilitate attendance by NCHDs. This resulted in a significant 

increase in attendance of approximately 50%. An induction programme was also implemented for newly 

appointed permanent consultants, which has received positive feedback. 

HR Services Division 

This was another active year for the HR Services Division. The division continued to develop management 

information on absences provided to department heads as part of managing attendance. The management 

of the probation review process was also implemented. 

There was an increase in the requirement from staff for work / life balance services such as flexible working, 

parental leave and leave of absence. The volume of work permit / visa renewals reflected the increase in the 

diversity of nationalities and cultures within the hospital. 

The division continued to make significant progress on an electronic document archiving project, which is 

allowing for more efficient retrieval of archival records. 

HR Services took a lead role in the development of Human Resources Policies and Procedures and these 

will be launched in early 2008. Staff information / standard forms continued to be set up on the SVUH 

Intranet. 

Pensions 

A dedicated HR Benefits Unit was established in the first quarter of 2007 to provide a comprehensive 

service to all current/former members of the Hospital’s Pension Schemes and its establishment has been 

well-received by employees. Substantial progress was made in prioritising initial key tasks and clearing 

historical backlogs, as well as providing a more proactive service to new and existing members. On the 

external front, the Unit had to contend with the challenging transfer of the management of the Pension 

Schemes from the Department of Health & Children in Dublin to a brand new team in the HSE HR Shared 

Service Division in Manorhamilton, Co Leitrim. 

Feedback from consultative sessions as part of the HR Strategy Review has re-confirmed that employees 

generally place a very high value on receiving information on their Pension Scheme entitlements. For the 

first time, in 2007 c. 3000 members were issued with updated Scheme Member Booklets and Annual Grade 

Statement, which provided invaluable summary information of potential member benefits and entitlements, 

complemented by a Pensions Open Day. 

In addition to day-to-day work and an ongoing project to assess eligibility to reckon prior part-time service 

for pension purposes, the unit completed preparatory work for the possible introduction of a new Pensions 

Management System to complement the deployment of the new Payroll System (Northgate) within the 

hospital. By year-end, the newly established Benefits Unit was well placed to meet ongoing challenges and 

to further develop the service offered at a time of growing interest and media coverage on the true value of 

Public Sector Pensions. 


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ICT Department 


In 2007 we were glad to welcome Colin Bogle to our support team. This year we also commenced the 

provision of IT services to develop, support and sustain the ICT infrastructure and systems of St Vincent’s 

Private Hospital. We have recruited three additional staff to facilitate this service. They are Louise Allman 

(Project manager), Niall Currid (Operations) and Brian Lenihan (Service desk). 

Service Development/Activities 

A number of projects were completed in 2007: 

It was a busy year for the ICT department with the completion of existing projects and the commencement 

of new projects. Our strategy in recent years was to focus on consolidating our infrastructure creating a 

stable platform on which to build our clinical application portfolio. Having largely completed this process we 

are now focused on implementing and enhancing new and existing systems. 

We are implementing phase two of the Regional Cancer System. This cancer clinical repository is located in 

St. Vincent’s University Hospital but interfaces to a number of hospitals in the region. It uses the Excelicare 

application from Axsys Technology and has links to the Patient Administration System as well as diagnostic 

systems e.g. Pathology. 

We have successfully migrated our Pathology iLAB system onto an AIX and Cache environment. This new 

clustered hardware system operates simultaneously between two separate computer rooms. The Pathology 

system is now considerably more responsive and resilient with a much more advanced database backend. 

We commenced the extension of the Healthlink Pathology system to St Michael’s Hospital go live January 

08. We have also implemented a Neurology requesting protocol and are testing with Siemens the provision 

of Radiology reports. We implemented a seamless link between the Virus Reference laboratory and Our 

Pathology system using a product called Medibridge. This delivers a much more efficient service to areas 

such as microbiology. 


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Department - ICT 

The Siemens Picture Archiving and Communications system and a Radiology Information system (PACS/RIS) 

was extended to St. Michaels Hospital. In essence this system provides a film-less radiology solution. 

We worked with Media One, a subsidiary of Eircom, to develop a new SVUH and Group Website. Media One 

has also been selected to create a new Group Intranet which is due to be completed in June 2008. 

We completed a review and significant upgrade of the Emergency Department and Social Work systems, the 

migration of the Tomcat Cardiology system and the development in-house of a number of database systems: 

• Accreditation database 

• Neurology referral form 

• Medication incident reporting 

• Nurse Bank System 

In cooperation with the EmotionMedia group we have developed a patient information channel on which we 

can transmit presentations and educational videos via the hospitals television network 

In progress since 2007 

DI DIVER - We are currently implementing a new Management Information System (MIS) called Health Diver. 

The system initially covers the Patient Administration System (inpatient, outpatients and waiting list), 

Emergency Department, HIPE and Social Work systems. While this data-mining tool provides comprehensive 

reports and adhoc queries internally and externally, one of its main advantages is its portal and dashboard 

capability. We are using this to deliver the SVUH Key Performance Indicator dashboard via the Intranet and 

Email. 

In early 2008 we will go live with our Endorad Endoscopy system. This not only digitally captures and stores 

endoscopy studies but also has a web client for image distribution and tracks the patient journey from 

scheduling to reporting. 

We will also complete the implementation of an integrated ICU Clinical Management system. 

Digital Dictation - we procured the TA+ application from DictateIT/CBay Systems this year to replace our 

analogue dictation system. This system is fully integrated to our Patient administration system and can 

therefore associate voice files with the patient record. It offers greater flexibility in terms of recording and 

accessing dictated records as well as higher quality digital functionality. 

We have developed a menuing facility add on to the Catering System in support of an initiative stemming 

from a recent patient satisfaction survey 


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Planned Initiatives for 2008 

Departmental Systems 

We plan to develop a suite of integrated clinical departmental systems commencing in areas such as Arthritis, 

Cystic Fibrosis and Dermatology. These applications will form a clinical data repository with interfaces to the 

Patient Administration System (PAS) and diagnostic systems such as Pathology and advanced reporting 

tools. 

PAS enhancements: 

We will implement a number of PAS developments covering functional changes and increased data integrity 

measures. It will also include Patient Wristbands, a bar-coded patient wristband system. This will produce 

wristbands with typed rather than handwritten patient details thus reducing the risk of incorrect identification. 

The wristband will also include a code 39 and 2D barcode, which will be a cornerstone of initiatives in areas 

such as Phlebotomy, Pharmacy and Haemovigilance. 

iCM Clinicals and Pathology Order Communications 

This is a patient centred portal for clinicians and a solution for clinician requesting of Pathology 

investigations. OCM provides for the electronic raising/transmission of orders and the gathering/receipt of 

results between patient based departments or locations and ancillary departmental systems. 

We intend to create a Bed Management module as an add-on application to our existing patient 

administration system to improve patient flow from admission to discharge. This system will help to achieve 

this by accurately deriving bed availability by improving bed occupancy and automating key elements of bed 

turnaround. 

Infrastructure and Support 

2007 was a very busy year for our helpdesk; we upgraded our Touchpaper Helpdesk System to an ITIL 

standard to include an end user satisfaction response, end user web portal, integrated reporting, detailed 

auditing and remote management of all computers. There were 12,258 calls logged to our helpdesk 

throughout 2007 with 82.26% of them closed within the agreed SLA. This has continuously improved 

throughout the year. In Q4 we closed 89.1% of all calls within the agreed SLA. 

We continued to upgrade our Network that is now complete. We also upgraded our link to the Internet to 

100Mb with a second 100Mb planned for installation by the start of 2008. Our network has also been fully 

extended to include SMH and SVPH. Our links to other hospitals have also expanded with fast links to 

Beaumont, National Maternity Hospital, Our Lady’s Hospice to name but a few and these links are now being 

fully used for systems such as PACS. We started a campus wide Wireless Network rollout which will be 

finished by the end of Q2 2008. 

We implemented a new SAN 11Tb (Storage Area Network) with a second one being implemented in 2008 

for full DR/BCP. We focused heavily on designing robust systems installing two VM Servers and two Blade 

Server Chaises. This has allowed us to offer truly highly available solutions including LABS, Ensemble, File 

& Print, Regional Cancer System, SQL, Tomcat, HR Wiztec, QPulse and DI Diver to name but a few. 


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Other Projects Completed Include 

• Audio Visual System in NEC 

• Eight Day Security Audit 

• Improved Communications 

• Citrix Farm 

• Citrix Access Gateway 

• Improved Central Backup Solution 

• Link to UCD 

• Installed & Upgraded over 300 Computers 

• Network Management 

• AV & Malware Removal System 

Projects Planed for 2008 

• Single Sign On 

• Computer logon using ID Cards 

• New E-mail System 

• E-mail & File Archiving 

• Second SAN with real time replication 

• Emergency Department Upgrade 


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Purchasing & Procurement Department 


There was a change of staff in the Purchasing Department during 2007. Mr. Joey Gormly took up the 

position of Supplies Officer A and Mr. John Byrne also joined the Purchasing team as Supplies Officer A, 

while Mr James Byrne has taken overall responsibility for the C.S.S.D. Supplies area. Anthony Donohoe was 

appointed to the position of Grade C Supplies officer. 


The C.S.S.D. department was transferred from the St. Anthony’s site into the Main Stores. This entailed a 

rigorous reduction in some stock items to successfully accommodate the move. All stock items, both Main 

Stores and C.S.S.D. are now available from the one Warehouse located on the main Hospital campus. 

Over 280 line items were relocated and are expected to be fully integrated into the Main Stores inventory 

management system in 2008. 

Activities 

The Supplies Department placed approximately 21500 orders during 2007 amounting to a spend of 

42.5million which includes the Purchase of Capital Equipment as well as consumable supplies. All tenders 

for the procurement of goods, services and capital equipment are tendered using the Irish Government 

“e-tenders” website, which enables staff to upload tender documents for suppliers and eliminates the need 

to send out tender packages. The department also takes part in joint tendering procedures with the Hospital 

Procurement Services Group which covers a wide range of product categories to secure contract pricing for 

the coming years. 

While activity continues to increase for the Supplies Department, staff are performing well and continue to 

achieve best value for money for products within their remit in conjunction with user departments and 

suppliers. 


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Department - Purchasing & Procurement 

The Top Up System was rolled out to the new Intensive Care Unit. This system has allowed members of the 

Purchasing & Procurement team to directly manage the inventory held in the I.C.U. Optimum stock holding 

has been achieved and maintained throughout 2007. Savings continued to be the primary goal of the Stock 

Management team in 2007 and savings of €428,072 were achieved through new product introduction, 

supplier price renegotiation and other VFM initiatives. 

Department Statistics 

Purchase Orders Placed 

Total number 21,455 

Gross Value of Purchases placed 

Non-stock €34,451,276 

Stock €5,656,660 

Project €1,850,019 

Total €41,957,955 

Value For Money Savings 2007 

New Product Introduction €223,065 

Renegotiated Price Increases €58,372 

Credit Notes €146,635 

Total €428,072 

Future Plans 

The Supplies Department continue to expand the amount of pre-printed requisition books to areas not 

presently using them. This makes it more efficient for departments to request products for purchase, as all 

the information required will appear on the requisition. Staff also continue to expand the use of web based 

ordering and Microsoft Outlook to email orders, as it provides a more efficient ordering service with our 

suppliers and speeds up delivery timescales for user departments. 

We hope to expand the use of direct deliveries in order to reduce lead times, improve service and reduce 

congestion in the Goods Inwards Area. The Main Stores continues to improve our stock fill ratio in 

conjunction with stock control by tight management of all stock items. 


294


Reports 

Quality, Risk and Consumer Affairs Department 

Introduction 

The Quality, Risk and Consumer Affairs Department was developed in 2007 and has evolved throughout the 

year in an effort to meet the needs of patients and staff and ensure compliance with relevant statutory and 

best practice requirements. The main components within the division are: Quality and Accreditation, 

Insurance, Risk & Legal Affairs, Communications and Consumer Affairs. 

Significant Developments 

In 2007, there was a significant change nationally with regard to the accreditation process. The Irish Health 

Services Accreditation Board (IHSAB) was integrated into the Health Information and Quality Authority 

(HIQA). St. Vincent’s Healthcare Group accreditation teams through monthly meetings completed selfassessment 

against the national acute care accreditation standards in October 2007. The teams identified 

a number of team specific and organisation wide strengths and areas for improvement. The external survey 

planned for November 2007 was postponed until clarification was received with regard to the status of the 

national accreditation scheme. A number of teams continued to meet throughout the rest of 2007 to identify 

opportunities for improvement and local quality improvement initiatives. 

The Hospital Hygiene Quality Improvement Group (HHQIG) continued to meet in 2007 to ensure compliance 

with the national hygiene assessment scheme. A peer review survey was carried out in March 2007 resulting 

in an overall score of ‘good’ for St. Vincent’s University Hospital. 

Insurance, Risk & Legal Affairs staff strived to deliver a cohesive and collaborative risk management culture 

to ensure the structures are directed towards the effective management of incidents with the aim of 

constantly improving patient safety. By continuing to develop and expand the level of compassionate and 

coordinated support offered, effective compliance with risk management was ensured by implementing a 

number of local and organisational quality improvement initiatives. The latter quarter of 2007,a Management 

and Governance Review was carried out. 

Equally, the Communication’s division continued to grow and expand. In late 2007, the a robust and 

comprehensive communication’s strategy was developed that outlines St. Vincent’s Healthcare Group’s main 

communication projects, in line with its mission and values, for the next two years. All current communication 

pathways and processes were evaluated and an all inclusive action plan was then devised in conjunction with 

the Senior Management Team to improve and expand these practices. 

The Consumer Affairs division continued to facilitate the development of positive and proactive consumer 

engagement. This included aiming for best practice in complaints management, ensuring that complaints are 

investigated thoroughly and impartially, while ensuring compliance with the relevant legislation, HSE policies, 

and the hospital’s mission and philosophy. Quality improvement and learning are an integral component of 

effective complaints management and greater emphasis is now placed on quality improvement, aiming to 

address the issues highlighted through complaint investigation. 

: 


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Department - Quality, Risk and Consumer Affairs 

Plans for 2008: 

• To develop and implements a Quality Strategy for SVUH and undertake external validation of the 

selfassessment completed in 2007. 

• Participation in national accreditation/quality improvement schemes and review of the accreditation 

/quality improvement team structure. 

• To develop organisation – wide quality improvement initiatives 

• To develop and implement a hospital Policy for the Management for Complaints and develop a 

Customer Care standard and programme for staff 

• To develop a Complaints Database – which can help us provide more meaningful reports for 

stakeholders 

• To promote Staff & Public awareness of the complaints process– posters / leaflets / internet & 

intranet information 

• To enhance Patient / Consumer engagement through patient feedback groups 

• To develop new patient information packs and expand the amount of patient and visitor information 

available via our website and other external vehicles and ensure they are accurate and up-to date 

at all times. 

• To design, develop and launch a new Intranet for St. Vincent’s Healthcare Group 

• To develop and foster strong links and relationships with our Primary Care colleagues. 

• To organise and co-ordinate a showcase of quality improvements. 

• To deliver Root Cause Analysis Train the Trainer Programme and a Falls Assessment Project 


296


Healthcare Group Committees 

Board Membership 

Professor Noel Whelan 

Chairman 

Mr. Nicholas C. Jermyn 


Mr. Edmond J. Bergin 

Sr. Eugene Butler 

Ms. Louise English 

Mr. Stewart Harrington 

Mr. Joe Leydon 

Mr. Patrick Meade 

Mr. Michael Meagher 

Ms. Gemma McCrohan 

Professor 

Diarmuid O’Donoghue 

Dr. Ristard O’Laoide 

Professor Bill Powderly 

Mr. William R. Quinlan 

Mr. Conor Sexton 

Dr. Michael Somers 

Professor MX Fitzgerald 

until October 2007 

Sr. Anne MacEneaney 

In Attendance: 

Ms. Mary Duff 

Mr. Bill Maher 

Mr. Cormac Maloney 

Mr. Seamus Murtagh 

Mr. Michael Redmond 


Membership of the 

Group Executive 

Mr. N. Jermyn 

Chairman 

Mr. Ken Bale 

Ms. Josephine Barrett 

Ms. Mary Connelly 

Mr. James Crowe 

Mr. Dermot Cullinan 

Ms. Mary Duff 

Mr. Donal Kelly 

Mr. Sean Kingston 

Mr. Donal Maguire 

Mr. Ian Maguire 

Mr. Bill Maher 

Mr. Cormac Maloney 

Mr. John Mc Phillips 

Mr. Seamus Murtagh 

Professor 

Diarmuid O’ Donoghue 

Dr. Risteard O’Laoide 

Mr. Michael Redmond 

Mr. Peter Sheehan 

Ms. Mary Shore 

Mr. Frank Smyth 

Members of the Medical 

Executive 2007 

Dr. Risteard Ó Laoide 

Chairman 

Dr. Hugh Mulcahy 

Honorary Secretary 

Mr. Sean Dudeney – 

Chairperson of the Surgical Division 

Ms. Margaret O’Donnell 

Consultant Plastic Surgeon – Elected Member 

Dr. Donal McCarthy 

Director of Pathology 

Mr. Enda McDermott 

Oncology Committee Representative 

Dr. Declan O’Keeffe 

Chairman of the Anaesthetic Division 

Professor. Diarmuid O’Donoghue 

Consultant Gastroenterologist – Chair of Medical 

Forum SVPH 

Mr. Donal Maguire 

Chairman of Medical Forum, St. Michael’s 

Hospital 

Dr. Malachi McKenna 

Consultant Endocrinologist – SMH REP 

Dr. Martin Quinn 

Chairman of Division of Physicians 

Professor. Kevin Malone 

Consultant Psychiatrist 

Dr. Doug Veale 

Consultant Rheumatologist – Elected Member 

Dr. Conor Collins 

Chairman of the Division of Radiology 

Mr. John Ryan 

Consultant Emergency Department - Elected 

Member 

Professor Michael Keane 

Chair of Medicine & Therapeutics 

Professor Ronan O’Connell 

Chair of Surgery 

297



Mission Committee 

Sr Eugene Butler 

Chairperson - Board of Directors 

Ms Theresa Ward 

Secretary - Pathology 

Member of Finance 

Committee 

Conor Sexton (Chairman) 

Ms Gemma McCrohan 

Board of Directors 

Mr Nicholas Jermyn 


Sr M Angela 

Director of Mission 

Rev Ted Ardis 

Church of Ireland Chaplain 

Mr Ekundayo Badmus 


Ms Margaret Barry 

Admissions Officer, SVPH 

Ms Barbara Cantwell 

Medical Student Co-ordinator 

Dr Michael Casey 

Principal Physicist, Nuclear Medicine 

Ms Sarah Cusack 

CNM 1 Theatre 

Ms Phil Pyne Daly 

Psychotherapist, Cardiac Unit 

Audit Committee 

Dr Michael Somers 

Mr Conor Sexton 

Ms Siobhan Devane 

Catering Supervisor 

Mr Sean Dudeney 

Consultant Orthopaedic Surgeon 

Ms Orla Fitzgibbon 

Assistant Director of Nursing, SVPH 

Ms Nicola Geoghegan 

Secretary to General Manager, SMH 

Mr John Harraghy 


Sr Margaret Hilliard 

Chaplaincy Department, SMH 

Ms Tanya King 

Assistant Director of Nursing 

Dr Diarmuid O’Shea 

Consultant in Geriatric Medicine 

Ms Sheila O’Toole 

Clinical Nurse Specialist 

Mr Patrick Meade 

Mr Michael Meagher 

Patrick Meade 

Louise English 

All above named are external members 

(board directors) 

Nicholas C. Jermyn 


Cormac Maloney 

Sean Kingston 

Bill Maher 

Director of Operations 

Seamus Murtagh 

General Manager, St. Michael’s Hospital 

Ken Bale 

Financial Controller, St. Michael’s Hospital 


CEO, St. Vincent’s Private Hospital 

James Crowe 

Financial Controller, St. Vincent’s Private Hospital 

Prof. Diarmuid O’Donoghue 


In attendance are 

Nicky Jermyn 

Cormac Maloney 

Ken Bale 

James Crow 

Bill Maher 

Seamus Murtagh 


Sean Kingston 


298

St. Vincent’s University Hospital - Annual Review 2007 


Group Clinical 

Governance Committee 

Membership 

Health and Safety 

Committee 


Chair, Director 

Sr. Anne MacEneaney, 

Director 

Mr. Eddie Bergin, 

Director 

Mr. Joe Leyden, 

Director 

Mr. Nicky Jermyn, 

Group CEO 

Ms. Mary Duff, 


Dr. Donald McCarthy, 

Director of Pathology 

Mr. John Ryan, 

Consultant in Emergency Medicine 

Dr Ken McDonald 

Consultant Cardiologist/ Honorary Secretary 

Medical Board 

Professor Kevin Malone 

Professor of Psychiatry, 

Dr Conor Collins 

Director of Radiology 

Chairman: 

Ms Mary Shore (Jan - Oct) 

Mr Bill Maher ( Oct - Dec) 

Members: 

Ms Elizabeth Barry 

Ms Eithne Culinan 

Mr Donal Murphy 

Ms Liz Barnes 

Mr John O'Grady 

Ms Denise McDonnell 

Mr Peter Mortell 

Ms Paula McNally 

Mr Frank Smyth 

Mr Anthony Walsh 

Mr Clive White 

Dr Lynda Fenelon 

Ms Theresa Flynn 

Ms Nuala Gannon 

Dr Paul Gueret 

Ms Sarah Mansfield 

Mr Jim Mitchell 

Ms Maragret Brittain 

Ms Regina Rooney 

Ms Gillian Lesware 

Ms Karen Clerkin 

Ms Sinead Brennan 

Mr Donal Kelly (April - Dec ) 

In attendance 

Mr Peter Sheehan 

Mr Peter Mansfield 


299

Elm Park Dublin 4 Ireland 

Tel +353 1 221 3422 Fax + 353 1 269 1264 

Web www.stvincents.ie

ANNUAL REVIEW master Final3a - St Vincent's University Hospital

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