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ANNUAL CLINICAL REPORT CLINICAL ANNUAL ANNUAL CLINICAL REPORT 2019 2019 No portion of this Annual Clinical Report may be reproduced or transmitted in any form or by any means, electronic or mechanical, including fax, photocopy, recording, or any information storage or retrieval system without the permission of the Master. ANNUAL CLINICAL REPORT 2019 Professor Sharon Sheehan Master/CEO Ms Ann MacIntyre Director of Midwifery Nursing Mr Patrick Donohue Secretary & General Manager Dr John Kelleher Director of Paediatrics & Newborn Medicine Professor Tom D’Arcy Director of Gynaecology Dr Terry Tan Director of Peri-operative Medicine Professor John O’Leary Director of Pathology & Molecular Medicine Research Acknowledgements Ms Laura Forde Ms Emma McNamee Ms Julie Sloan Ms Mary Holden No portion of this Annual Clinical Report may be reproduced or transmitted in any form or by any means, electronic or mechanical, including fax, photocopy, recording, or any information storage or retrieval system without the permission of the Master. ANNUAL CLINICAL REPORT 2019 Professor Sharon Sheehan Master/CEO Ms Ann MacIntyre Director of Midwifery Nursing Mr Patrick Donohue Secretary & General Manager Dr John Kelleher Director of Paediatrics & Newborn Medicine Professor Tom D’Arcy Director of Gynaecology Dr Terry Tan Director of Peri-operative Medicine Professor John O’Leary Director of Pathology & Molecular Medicine Research Acknowledgements Ms Laura Forde Ms Emma McNamee Ms Julie Sloan Ms Mary Holden ANNUAL CLINICAL REPORT 2019 Coombe Women & Infants University Hospital 1 Table of Contents Introduction from the Master 5 Medical Clinic 104 Multiple Birth Clinic 107 Awards 17 Options in Pregnancy Clinic 109 Outpatients Clinics (Adult) 111 Executive Summary 21 Parent Education & Antenatal Classes 112 Perinatal Day Centre 115 Hospital Overview 29 Members of the Board of Guardians and Directors 30 Preterm Birth Prevention Clinic 116 Organisational Chart 31 Severe Maternal Morbidity & High Dependency Unit 117 Members of Staff 32 Staff Retirements 41 Division of Gynaecology 121 General Gynaecology Report 122 Director of Midwifery and Nursing 43 Coombe Continence Promotion Unit 128 Director of Midwifery & Nursing Report 44 Colposcopy Service – Medical & Nursing Reports 130 Colposcopy Service – Nurse Colposcopists Report 132 Activity Data 49 Gynaecology Oncology Liaison Nurse 133 Dublin Maternity Hospitals – Combined Clinical Data 50 HyCoSy Service 134 Statistical Summaries 57 Outpatient Hysteroscopy 135 Perinatal Mortality and Morbidity 63 Operating Theatre Department 137 Division of Obstetrics 69 Division of Paediatrics & General Obstetric Report 70 Newborn Medicine 139 Addiction & Communicable/Infectious Diseases 82 General Paediatrics and Newborn Medicine – Medical & Midwifery/Nursing Reports 140 Community Midwife Service 85 Neonatal Transition Home Service 159 Delivery Suite 86 Registered Advanced Nurse Practitioner 160 Combined Service for Diabetes Mellitos 88 Early Pregnancy Assessment Unit 91 Fetal Medicine & Perinatal Ultrasound Department 92 Division of Peri-operative Medicine 163 Department of Peri-operative Medicine 164 Fetal Cardiology 96 Hemolytic Disease of Fetus and Newborn 97 Division of Laboratory Medicine 169 Infant Feeding 98 Department of Laboratory Medicine Report 170 Maternal Mortality 100 Biochemistry/Endocrinology/Point of Care Testing 172 Maternity Floors 101 2 Coombe Women & Infants University Hospital ANNUAL CLINICAL REPORT 2019 Cytopathology 174 Postgraduate Medical Training – Obstetrics & Gynaecology 229 Haematology/Transfusion Medicine 176 Postgraduate Medical Training Haemovigilance 178 – Paediatric Medicine 230 Histopathology and Morbid Anatomy 179 Postgraduate Medical Training – Pathology 231 Microbiology and Infection Prevention & Control 182 Trinity College Dublin 232 Pathology/Molecular Pathology 185 University College Dublin 234 Phlebotomy 191 Radiology Departments 193 Support Services 239 Human Resources 240 Adult Radiology 194 Hygiene Services 241 Paediatric Radiology 195 Information Communications Technology (ICT) 242 Allied Services 197 Bereavement 198 Friends of the Coombe 245 Friends of the Coombe 246 Chaplaincy/Pastoral Care 200 Clinical Nutrition & Dietetics 201 Liaison Perinatal Mental Health 202 Appendices 249 Medical Social Work 203 Appendix I: History 250 Pharmacy 205 Appendix II: Masters 251 Physiotherapy 209 Appendix III: Matrons and Directors of Midwifery and Nursing 252 Psychosexual Therapy 212 Appendix IV: Guinness Lecturers 253 Appendix V: Dr James Clinch Prize for Audit 2019 256 Quality & Patient Safety Division 215 Appendix VI: Glossary of Terms 259 Clinical Risk Management 216 Quality, Risk & Patient Safety 217 Academic Departments 223 Academic Midwifery Report 224 Biological Resource Bank 225 Centre for Midwifery Education 226 Midwifery & Nursing: Practice Development 227 Postgraduate Medical Training – Anaesthesia 228 ANNUAL CLINICAL REPORT 2019 Coombe Women & Infants University Hospital 3 4 ANNUAL CLINICAL REPORT 2019 Introduction from the Master ANNUAL CLINICAL REPORT 2019 5 6 Introduction from the Master ANNUAL CLINICAL REPORT 2019 Introduction from the Master Welcome to this year's The Hospital is governed by a Board of Guardians and Directors, chaired by Mr John Gleeson. Throughout Annual Clinical Report, 2019, they worked tirelessly, on a completely pro bono and my last as Master. basis, advocating for women, infants and families, and supporting the Hospital in too many ways to list. I wish As a tertiary-referral university- to extend my sincere thanks to each of them for their teaching hospital, in 2019 we cared support and their expertise. for 8434 mothers, 7746 of whom delivered 7929 infants weighing I also wish to acknowledge the huge support and ≥500g and we performed 5139 commitment of the Management Executive, the gynaecological operations. The Divisional and Departmental Heads and all of the corrected perinatal mortality rate was 3.9/1000. members who serve on the various committees (both internal and external) which are central to the running Our mission of "excellence in the care of women and of the Hospital. babies" remained central to all activity at the Coombe and I wish to acknowledge the tremendous efforts Throughout the year, a number of our wonderful of every member of staff throughout the year. We staff members retired and they will be greatly continued our focus on patient-centred care and our staff missed. In particular, I would like to acknowledge the worked tirelessly to deliver this. It was a year filled with outstanding commitment and dedication of a number challenges and opportunities, with increased demand for of our Department Heads and Senior Staff Retirees – care, greater patient complexity, ongoing staff shortages, Ms Frances Richardson, Assistant Director of Midwifery restricted budgets and a continued public focus on and Nursing, Ms Jacqui Barry O’Crowley, Chief Medical maternity and gynaecology services. I wish to express my Scientist, Ms Lucy More O’Ferrall, Night Superintendent, gratitude to our team of medical, midwifery and nursing, Ms Mary Sweeney, Chief Medical Scientist, Ms Rosemary allied health professionals, support and administrative Grant, Principal Medical Social Worker and Ms Rosena staff who worked together to ensure that we delivered Hanniffy, Assistant Director of Midwifery and Nursing safe, high-quality care to our women, babies and their (Infection Prevention and Control). They all witnessed families. huge changes in our services during their years at the Coombe and each was instrumental in advancing care The Senior Management Team once again played a for our patients. I would like to take this opportunity central role in ensuring the safe and smooth running to thank them for their enormous contribution to of the Hospital and I would like to thank them for their the Hospital over the years and to wish them every dedication, diligence and commitment; Mr Patrick happiness in their retirements. I would also like to offer Donohue, Secretary and General Manager, Ms Ann MacIntyre, Director of Midwifery and Nursing and Mr my congratulations to each of their successors. John Robinson, Financial Controller. I am so fortunate The recruitment process for the next Master was a to be surrounded by such a dedicated and hard-working key priority in the year and following interviews held team and I cannot thank them enough for their support, in May 2019, we were delighted that Professor Michael encouragement and energy. I would like to sincerely O’Connell was elected by the Board of Guardians and thank Ms Vivienne Gillen, Hygiene Services / Operations Directors to serve as the next Master of the Coombe Manager and Ms AnneMarie Waldron, HR Manager, for Women & Infants University Hospital. Professor their continued dedication and support throughout the O’Connell, a Consultant Obstetrician & Gynaecologist year. at the Coombe, will commence in post on January 1st I would like to express my gratitude to Ms Laura Forde, my 2020 and I look forward to working closely with him as PA, for her hard work and support throughout the year. we prepare for the handover. This Annual Clinical Report is only one part of the year’s We were delighted to welcome a number of new work that would not exist without Laura’s assistance and Consultant appointments to the Coombe during I would like to thank her most sincerely for her patience the year; Professor Nadine Farah (Obstetrics & and her commitment. I would also like to thank Ms Emma Gynaecology), a consultant already

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