ANNUAL REVIEW master Final3a - St Vincent's University Hospital

St. Vincent’s Healthcare Group Limited - Annual Review 2007
Department of Respiratory Medicine
Service Developments
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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