ANNUAL REVIEW master Final3a - St Vincent's University Hospital

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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 Return to Contents 210
St. Vincent’s Healthcare Group Limited - Annual Review 2007 Department of Respiratory Medicine 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] Return to Contents 211
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Review 2007 St. Vincent’s Healthc
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Celebrations • There was a great
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Research Studies Total Research Stu
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Education & Research Pharmaceutical
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74 Quality
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Report from the Director of Nursing
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General Services The HACCP system i
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General Services necessitated in ex
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ICT Department Staffing In 2007 we
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St. Vincent’s University Hospital
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