St Vincent's Hospital annual report 1996
Item Type Report
Authors St Vincent's Hospital
Publisher St Vincent's Hospital
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Ar ______Mission Statement ______St.
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We strive for excellence in meeting the holistic needs of our patients in a caring and healing environment in which the essential contribution of each member of staff is valued. 1 The values of human dignity) compassion) justice) quality and advocacy) rooted in the mission and philosophy of the Religious Sisters of Charity) guide us in our work.
We will) within the foregoing context) make every effort to maintain excellence in clinical care) teaching and research.
Comh mheas) comh bha) comh phartaiocht agus comh oibre bunsraith ar gcuid saothar uile.
(Mutual respect) empathy) partnership and co-operation are the foundation of all our work.) St. Vincent's Hospital Elm Park Annual Report 1996 Contents
Annual General Meeting Agenda ...... 2 St. Vincent's Hospital Board of Management ...... 3
Executive Reports Report from the Chairman of the Board of Management ...... 4 Report from the Chief Executive Officer ...... 6 Report from the Chairman of the Medical Board ...... 1 0 Finance Department Report for the Year 1996 ...... 12 Summary Financial Statement ...... 1 3 Highlights of the Statement of Accounts ...... 14 Comparisons for the last 5 years ...... 15 Organisational (Service) Chart ...... 16 Goverance and Management Strucnlre ...... 17 Departmental Statistics ...... 18
Departmental Reports Report from the Department of Nursing ...... 24 Department of Philebotomy ...... 68 Orthopaedic Surgery Report ...... 25 School of ursing ...... 69 Surgical Proffessorial Unit - St. Raphael's Ward ...... 26 Department of Diagnostic Imaging ...... 71 General Surgical Unit - St. Teresas Ward ...... 31 School of Diagnostic lmaging ...... 73 Plastic Surgery ...... 32 Outpatient Department ...... 75 Department of Anaesthesia ...... 33 Personnel Department ...... 76 Department of Cardiology ...... 35 Pharmacy Department ...... 76 Medical Oncology Department ...... 37 Physiotherapy Department ...... 79 Gastroenterology / Liver Unit /National Medical Social Work Department ...... 81 Liver Transplant Programme ...... 38 Department of Occupational Therapy ...... 82 Department of Respiratory Medicine ...... 39 Speech & Language Department ...... 83 Department of Nephrology ...... 41 Department of Nutrition and Dietetics ...... 83 Department of Neurology ...... 42 Project Department ...... 85 Department of Clinical europhysiology ...... 43 Teclmical Services Department ...... 86 Dermatology ...... 45 Purchasing Department ...... 88 Department of Endocrinology Medical Records Department ...... 88 & Diabetes Melli tus ...... 45 Catering Department ...... 89 Department of Metabolism ...... 48 Portering Service Department ...... 89 Department of Rheumatology ...... 50 Central Sterile Supplies Department (CSSD) ...... 89 Department of Medicine for the Elde rl y ...... 52 Health & Safety Report ...... 90 Department of Psychiatry ...... 54 Report from the Chairperson of the Department of Old Age Psychiatry ...... 56 Management Committee ...... 91 Department of Nuclear Medicine ...... 58 Report from the Medical Director ...... 91 Department of Preventative Medicine Report from the Director of Research Laboratories .... 92 / Cardiology ...... 60 Report from the Director of Fundraising ...... 93 Palliative Care Service ...... 62 The Postgraduate Department ...... 94 Pathology Department ...... 64 St Vincent's Hospital Library ...... 95 Haematology Department ...... 64 Mission Committee ...... 96 Clinical Biochemistry Department ...... 64 St. Vincent's Private Hospital ...... 97 Department of Histopathology General Practitioners Liasion Committee ...... 98 (including Cytopathology) ...... 65 Pri ze Winners - Tuesday, 20th February 1996 ...... 99 Blood Transfusion ...... 66 Hospital Com mittees ...... 1 00 Department of Microbiology ...... 66 Pathology Professorial Unit ...... 67 Department of Immunology ...... 68 St. Vincent's Hospital
St. Vincent's Hospital
Annual General Meeting
Monday 26th May 1997 at 17. 00 hours
Lecture Hall Education & Research Centre) St. Vincents Hospital.
1. R eport of the Chairman of the Board of Management
2. R eport of the Chief Executive and Chairman of the Executive Council
3. Report of the Chairman of the Medical Board
4. Accountsfor the Year ended 31st December 1996
5. Appointment of Hospital Auditors
6. Any other Business
Annual Report 1996 St. Vincent's Hospital •••• . " . c ... ,. Board of Management •
Professor Noel Whela .. Cbairman Vice President and Dean, UniJ1crsity of Limerick
Mr. Cathal McAllister Mr. De ..is Bergi .. Mrs. Joyce A ..drews Sr. J oseph Gyri/ Manager witb the Bank of Partner, Art/mr Cox & Co. Member o/Governing Body, Sister Superior, Sisters of Ire/and Solicitors University Col/ege Dub/it) Charity, St. Vincenrs Hospital
My. Gerald B. Sca ..la .. Sr. Joa .. O'Co.mor Ex. Group Chief Executive, Sisters of Charity, Oil Y lAdy's Allied Iris" Banks Ltd. Hospice, Harolds Cross
Sr. Joseph Bug... e Mrs. Patricia Maguire My. Stewart Harrington Prof Muiris FitzGerald Provincial, Sisters of Charity Commu11ity R epresmtative Managing Director, Consultant Rtspirlltary Phyrician/ ProJ Dlm/oe HOltse Gro up pLc. of Medicine, St. Vincent's Hospital
Sr. Agnes ReY'JOlds Sr. MaNe Peter Mr. Da.. iel G. Kelly Dr. Caroli.. e Hussey Director of Mission Sisters of Charity, Consultant Urologist, R egistrar, Effectiveness, Sisters of Charity Cappagb Orthopaedic Hospital St. Vincenrs Hospital U"iversity Col/ege Dublin
AmlUal R eport 1996 ····· St. Vincent's Hospital :. "" ... dJ("..... 1
anI ad, op Report from the Chairman of int the Board of Management ______St. Vi H pu reI ex I have pleasure in presenting the Annual Report of St. the Executive Council of the hospital, chaired by re' Vincent's Hospital for 1996. This annual report reviews Mr. Nicholas C. Jermyn, Chief Executive Officer, and th the year just past and looks to the future. the Medical Board, chaired by Consultant Surgeon 15 Mr. Willianl Quinlan. The year 1996 has been a busy and fruitful one for St. s; Vincent's Hospital, and there is much to report. Detailed The two General Managers recruited during 1996 were: information relating to the past year is contained in the various sections of this annual report and I shall not Mr. Robert Martin and Mr. Eamonn Fitzgerald. C reiterate it here. te V I wish to look to the future and focus on three important While no organisational and managerial structure should be aJ issues which, I am sure, will shape that future to the benefit considered as 'cast in stone' and suitable for all time, tile U of St. Vincent's fi.lture development. The issues are: Board of Management is happy that tile consolidation and p rationalisation which it has effected during 1996 does, and First, the effective governance and management of the wi ll continue to form the basis for the effective governance hospital lll1der the aegis of the Board of Management; and management of St. Vincent's Hospital for the critical 11 1 Second, the development of the hospital into the new years aI1ead. Millennium; Developmmt of the Hospital illto Third, the contribution made to the public interest by St. Vincent's. the New Millennium ______
Governance and Managemmt ______St. Vincent's Hospital is a major 500 bed tertiary referral hospital with both medical teaching and research as vital ingredients. The aim of the Board of Management is to During 1996, the Board of Management has developed develop the hospital further from the perspectives of charity further the organisational and managerial arrangements for (as witnessed by the foundation source of the hospital - the effective governance and management of the hospital. It Religious Sisters of Charity), and the public service (as has finalised a carefi.illy focused Board committee system witnessed by the major financial and public policy which devolves key responsibilities to Board committees investnlent made in the hospital by successive Governments while, at the same time, strengthens the capacity of the and Ministers for Health). Board to chart the strategic development of the hospital. And it has approved and overseen the recruitment of two It is a source of great pleasure for tile Board to report that general managers, thus strengthening greatly tile internal tile development plan for the hospital which the Minister management of the hospital and supporting tile Chief for Health announced in May 1996 has been developed Executive Officer of the hospital in his overall management significantly further during tile period May 1996 to present. of St. Vincent's. This has been done under the guidance of the joint The Board committee system is as follows: Department of Health/St. Vincent's Hospital Project Team. The multi-million £ major investment being made in tile hospital, under this development plan, will position Finance & Statistics Committee, chaired by Board tile hospital so that it will be of major importance and member Mr. Catllal McAUister; relevance to national health policy and operations, and to Education & Research Centre Committee, chaired by excellence in medical research and teaching well into the Board member Mrs. Joyce Andrews; new Millennium. Specific details relating to the Mission Committee, chaired by Board development plan and its realisation are contained in tile member Mr. Cathal McAllister; report of the Chief Executive Officer in this annual report. Fund Raising Committee, chaired by Board member Mr. Denis Bergin. Because of the major research and teaching dimensions of St. Vincent'S, and the increasing importance of these for the This Board committee system, and of course tile Board future, the hospital's Board of Management has been itself, both provide the strategic policy context and reviewing, witll University College Dublin, both the background for: agreement underpinning tile present relationships between UCD and St. Vincent's and how tllis should be deepened
A1I1mal Rep01"t 1996 St. Vincent's Hospital : ··.....·· ·.. ec..,.,,,
and developed for the future. Discussions are at an continuing, selfless dedication to tile development of the advanced stage, and it is hoped that a new strategic and hospital - often in frustrating circumstances and with not operational agreement wi ll be incorporated an d brought enough resources. My special thanks are due to Mr. into being during 1997. Nicholas Jermyn, Chief Executive Officer of the hospital and Chairperson of tile hospital's Executive Council and to St. Vincent's Hospital pursues its mission through both St. Consultant Surgeon Mr. William Quinlan, Chairperson of Vincent's Public Hospital and St. Vincent's Private the Medical Council of the Hospital. Behind Mr. Jermyn Hospital. A close symbiotic relationship exists between the and Mr. Quinlan there are many dedicated persons who public and the private hospitals. In order to ensure that this simpl y are too numerous to mention by name here. Our relationship continues to be of maximum effect in the sincere thanks go to them, nevertlleless. exciting fi.lture which lies ahead for St. Vincent's, a major review of it was commenced during 1996. It is hoped that I tllank tile many friends of the hospital and my colleague this review will be completed and implemented during members of the Board of Management for their 1997. commitment and dedication to the hospital's development. They give generously of tlleir time and energies on a St. Vincent)s and the Public Interest ___ _ voluntary basis.
Charity and serving the public interest are the two key Our tllanks are due to the President, the Registrar, the tenets which shape the polices and operations for St. Dean of the Medical Faculty and tile many faculty members Vincent's Hospital. They pervade all that we do, and they and staff of University College, Dublin who have been so supportive of St. Vincent's during 1996 and earlier. They be are pursued in the context of medical excellence and continued to give their support in the context of the many :he underpinned by far·reaching research and teaching fa r-reaching demands made upon a major third level nd programmes. education institution such as UCD. nd ICe In order to consolidate and develop fi.lrther the public Our special thanks are due to the Minister for Health, Mr. cal interest dimension of St. Vincent's, the hospital has, during 1996, engaged in a major rationalisation programme, both Michael Noonan, T.D. and to Department Secretary, Mr. managerial and medical, between itself and St. Luke's/St. Jerry O'Dwyer and the officials of the Department of Anne's Hospital. This was done, willingly, at the request of Health for their continuing support during 1996, and for the Minister for Health. The Chairpersons of the Boards of their active commitment to and support of the joint Management of both St. Luke's/St. Anne's and St. Department of Health/ St. Vincent's Hospital Vincent's hospitals signed, on behalf of their respective Development Plan. 'al boards, a major joint co· operation agreement during 1996. :al This agreement is being implemented during 1997 and will As is customary for me, I leave tile last thanks for the :0 bear rich fruit in the years ahead. Superior General of tile Religious Sisters of Charity, Sr. Una ty O'Neill, and the Order of the Religious Sisters of Charity. le St. Vincent's Hospital has also been involved, actively, in I do so because of the very special contribution they make lS helping to clarifY and shape the South Eastern Health to St. Vincent's. They are the umbrella under which St. :y Strategy espoused by the Minister for Health and the Vincent's pursues its mission and tlley are indeed an organic ts Department of Health, and the Chief Executive Officerof part of tile etllos and operations of St. Vincent's. As is the Hospital serves on the Ministerial Task Force on the usual, they have (again in 1996) been a tower of strength Eastern Health Authority. for all involved in the welfare of St. Vincent's Hospital. It May tlley have continued success and effectiveness in their The hospital has also managed its financial affairs during Mission of Charity in the tinle mead. 1996 such that optimal and cost-effective returns have accrued from the investment fi.lI1ds provided by the To conclude: let me pledge, once more, the continued Government and the Minister for Health during 1996. commitment of the Board of Management of St. Vincent's And, as referred to earlier in my report, St. Vincent's has Hospital to tile twin aims of charity and public service as the responded actively and positively to the stated wish of the foundations for the hospital's fi.mlre development. Minister for Health and his Department to invest significantly in St. Vincent's Hospital so that it will be a major source of tile development and delivery of public health policy in the years ahead. Professor Noel Whelan Thanh ______Chairman Board of Management, St. Vincent's Hospital. Nothing of which I have reported o n above happened by accident. It is the result of dedication and hard work by many persons and groups.
Our special thanks are due to all the staff - medical, nursing, health service professionals and managerial - of the hospital for their renewed achievements during 1996, and for their
Annual R eport 1996 •••• St. Vincent's Hospital ~ .c ... " • Executive Reports
In Report from the Chief Executive Officer_ m3 mi 191 Ea pn COl IS:
As Chief Executive Officer, I am pleased to report 1996 was The Project Team has identified a number of areas that T~ another very successful year in the life of St. Vincent's require urgent attention in 1997. These have been W Hospital. In a report like this it is practically impossible to discussed by dle Project Team and there are a number of B( adequately reflect the achievements of our hospital staff. I proposals which have been forwarded to the Department sa' can only mention in a summary way some of the of Health for consideration. The areas involved are: m outstanding work. C. Intensive Care / High Dependency Unit I Project Development ______A cohort unit for Infection Control su Pharmacy V: Dialysis Unit The Minister for Health, Mr. Michael Noonan, visited dle in hospital on 16dl May 1996 when he announced the Mortuary General Accommodation Department of Healdl's commitment to me development S( of St. Vincent's Hospital. m The Project Team is confident progress will be made in dle rr short term on specific areas requiring attention in 1997. I The Joint St. Vincent's Hospital/Department of Health aJ would like to dlank all the members of dle Project Team for Project Team submitted dle hospital's project development d their support in 1996. brief to dle Department of Health. The hospital has f. appointed a Design Team which will be led by Architects, [ Scott TalIon Walker in association with anomer fir:n of Mr. J. J. Cummins, Technical Services Officer, was appointed Project Manager and Ms. Phil Shovlin, ational Architects, YRM. We are now awaiting dle Department of SI Healm's audlOrisation to advertise for building contractors Liver Transplant Co-ordinator, was appointed Nurse who we anticipate will be on site before dle end of 1997. PlaJlIling Officer to dle project. This is a multi-million pound development which, when completed, will ensure St. a Vincent's Hospital will be one of the most modern and The hospital's development will, more man likely, take c purpose built hospitals in Ireland and Europe. place over a seven year period. The project will be p organised into duee phases for practical reasons which at ( present have been prioritised as follows. This project development has given us dle opportunity to redesign the infrastructure of the hospital to facilitate a Priority 1 more patient focused environment. Pamology Radiology Mission Effectiveness ______Accident & Emergency Outpatients - (Ambulatory Day Care to incorporate tlVO In my report last year I mentioned dle launch of Mission Theatres and a Recovery area, Cystic Fibmsis Unit and Effectiveness in me hospital. I am pleased to say dus Breast Cancer Unit and many other ambulatory day initiative is growing and gaining considerable support care services suited to ambulatory care) duoughout me hospital. In dle latter half of 1996 dle Intensive Care Unit hospital's Mission Committee, following consultation wim Psychiatric Unit - (Development to accommodate the staff from a large number of departments, developed a transfer of acute psychiatric ser vices from Ve'E'cmoullt Mission Statement wluch encompasses me essence of what Hospital) St. Vincent's Hospital is all about - "The Patient comes Concourse. first."
Priority 2 May I take dus opportunity of manking me various Theatre members of the hospital's Mission Committee and Physical Medicine particularly Sr. Angela Kelly and Ms. Geraldine McSweeney, Pharmacy who are dle Missions Liaison representatives. CSSD I would also like to mank Sr. Agnes Reynolds, Director of Priority 3 Mission Effectiveness, and her team and wish mem well in Ward areas including an Isolation Unit dleir work. Geriatric Day Hospital Clinical Sciences complex
AlIlIual Repol·t 1996 St. Vincent's Hospital OO . ~ . dIJ!S;,
Organisational Development ______while maintaJnll1g the respective autonomies of both hospitals. A major objective of this agreement is to In 1995 I reported that the hospital was reviewing its enhance patient care and ensure that the most effective management structures. I am pleased to report that part of delivery of health services is achieved. The association is this work has been completed with the appointment in in line with the general trend of closer links being formed 1996 of two General Managers, Mr. Robert Martin and Mr. between specialist institutions and major acute hospitals. Eamonn Fitzgerald. They both bring qualities from their This agreement takes account of the proposals contained in previous working environments which I know will the National Cancer Strategy which will be launched in complement and add value to the management team which 1997. is already in place. An Agreement was signed by Professor Noel Wbelan, lat Chairman of St. Vincent's Hospital with Mr. Brian Slowey, en The Medical Executive, under the Chairmanship of Mr. Chairman, St. Luke's/ St. Anne's Hospitals. As part of this of William Quinlan, Chairman, Meclical Board, and Hospital association, I was appointed Chief Executive Officer of St. nt Board member, has evolved structures and I am pleased to say Consultants are actively participating in the Luke's and St. Anne's Hospital while still remaining Chief management of the hospital. This involvement of Executive Officer of St. Vincent's Hospital. Consultants in the management of the hospital is essential. I would like to express my sincere appreciation for their St. Vincent's Hospital continues to develop its links and support without which I do not think a hospital like St. network with hospitals in the region in line with the Vincent's could develop, grow and deliver care to patients Department of Health's policy that the various hospitals in in the way it does. the region set up joint departments of Medicine, Surgery, Radiology, Pathology and Anaesthesia. The purpose of Senior Nursing staff, Allied Health Professionals and many these departments is to improve the efficiency and delivery of a comprehensive range of health care services to patients le more are involved in the management of the hospital. We must continue to develop our staff to manage themselves in the catchment areas serviced jointly by all the hospitals. and with this in mind 1996 saw the participation of over 40 The establishment of clinical departments in these areas is )r department managers in a joint St. Vincent's almost complete. Hospital/ Institute of Public Administration Management Development Programme. The hospital is committed to In 1996 the hospital continued to meet and develop its IS continuing this investment in training and educating its service links with the following hospitals in the South East tI region: e staff. n As part of the reorganisation of services, the hospital looked St. Michael's Hospital, Dun Laoghaire St. Columcille's Hospital, Loughlinstown :l at the work practices and procedures in a number of patient oriented service areas. Patient administration process and St. Luke's and St. Anne's Hospitals planning systems have been reorganised in both the Royal Victoria Eye and Ear Hospital Operating Theatres and Racliology Department.. This has City of Dublin Skin and Cancer Hospital, Hume Street resulted in the inlproved utilisation of the present facilities National Rehabilitation Hospital, Dun Laoghaire and it has created capacity for further service increases when The Royal Hospital, Donnybrook resources permit. The hospital intends to continue this Leopardstown Park Hospital patient process review in 1997. It is proposed that a similar Our Lady's Hospice, Harold's Cross exercise will take place in the Intensive Care Unit as a Our Lady's Hospital for Sick Children, Crumlin priority in 1997. I would like to thank everybody involved in these projects during the year. The hospital has met regularly throughout 1996 with General Practitioners in the region and I would like to In 1996 a number of Consultant staff were appointed to the thank the various representatives on the G.P. Liaison hospital, which the Chairman of the Meclical Board refers to Committee. Progress has been made on a number of in his report. Compared to previous years, I think you will matters which has improved services and communications agree the numbers involved indicate the hospital is in a between the G.P.s and the hospital which ultimately major development cycle. benefits our patients. Please see report from Dr. Tiernan Murray, G.P. representative, which speaks for itself. I am pleased to say that 1997/1998 will also see additions to the list of Consultant staff employed by the hospital. It would be remiss of me not to mention two major The hospital now employs in excess of 100 Consultant developments which took place in 1996 in Nursing which medical staff covering a large number of specialty and sub will have a major impact on the way we will deliver care to specialty interests. the patients in St. Vincent's Hospital in the future. The hospital was granted permission by the Department of The hospital's Board of Management, at the request of the Health to introduce a Registration/Diploma Course for Minister for Health and the Secretary for Health entered student nurses linked to University College Dublin. This into discussion and developed an association agreement development is the result of hard work and commitment with St. Luke's and St. Anne's Hospitals. The purpose of from a number of people over the last four years and I the association is to develop a closer relationship between would like to congratulate everyone involved. The hospital St. Vincent's Hospital and St. Luke's/ St. Anne's Hospital introduced, on a project basis, a new approach to nursing
A ,Jnuat R eport 1996 St. Vincent's Hospital
practice at ward level which involves a patient's care being separately from tile public hospital. Th allocated to a specific team of nurses for the duration of wh their stay in hospital. I am pleased to say that this process, St. Vincent's Public Hospital provides the following 25 from everybody's point of view, has been very successful. services to St. Vincent's Private Hospital : adl Of At this point I should mention the hospital's Director of Pathology Ac Nursing, Sr. Agnes Reynolds and Principal Tutor, School Radiology (interventional) err of Nursing, Sr. Ann Curry. Both of these Sisters are Mortuary members of the Religious Sisters of Charity who resigned Intensive Care Unit n from the hospital's staff in 1996. I speak for everybody Theatre (complex sm;gery) D( when I say they will be missed and I would like to take this Cardiology (Catheterisation Laboratory) wa opportunity of thanking them for their years of dedicated Rehabilitation (1 ' service to the hospital. Allied professional support ou Medical staffing lII' I do not intend outlining in my report details concerning 3] service developments as these are covered in the various St. Vincent's Private Hospital provides MRI and departmental reports which form part of tllis annual report. Radiotherapy facilities to public hospital patients. A special Tl I feel tile individual reports speak for themselves but I think group has been formed to explore and propose how the co it is obvious from the reports that considerable progress has relationship between the two hospitals can add value to WJ been made in 1996. each other, avoid duplication of expensive technology and re at the same time offer what is best for all patients. It is w' Teaching ______hoped a report on this matter will be completed by the middle of 1997. T The hospital continues to have close links with University ar College Dublin. Negotiations are still on-going concerning Witll tile introduction of tile proposed new Dublin Health in a formal teaching agreement between St. Vincent's AutllOrity planned for 1999 it is important that the two Hospital and University College Dublin. However, hospitals continue to develop relationships witll the otller following a meeting between the President of University hospitals in the region. College Dublin, Dr. A .. Cosgrove, and tile Chairman of the T hospital's Board of Management, Professor oel Whelan, an understanding was reached in principle that the Information Technology ______h University would contribute in excess of £2m to tile re development of a Health Sciences complex on the hospital The hospital in 1996 followed tllrough on the development 1 campus. The hospital's Education & Research Centre and completion of its Information Technology Strategy. tI continues to flourish under the Medical Directorship of The hospital's mainfranle, operating systems and personal Professor Barry Bresnihan. The hospital places great computer systems were upgraded. The hospital is in tile emphasis on teaching and research which I think you will process of reviewing and preparing specifications for the agree is evident from tile Education & Research Centre's following systems: e report and the various lists of publications incorporated t under tile different departments and tile distinctions gained Pathology by members of hospital staff which arc indicators of tile Radiology continuing commitment to research and teaching at the Patient Administration systems (incorporating OPD, hospital. The development of tile Registration/ Diploma Admissions and Patient Master Index) Course in Nursing linked to University College Dublin has been a tremendous boost for all concerned. Activity & Expenditure ______I would like to take tllis opportunity of thanking the following people from UCD for their help and support in It is essential the hospital reviews and monitors its daily 1996 - operations so tllat it can continue to improve the quality and delivery of care in the most effective and efficient way Dr. G. Wright, Secretary; possible. Obviously it is essential that we review everything Professor R. O'Regan, Dean, Faculty of Medicine. we are undertaking during tile design stages of the new Dr. P. Tracey, Department of Nursing SUldies hospital development to ensure that we build an economic Ms. J. Halley, Marketing and Development Officer. and efficient hospital.
I would also like to express my appreciation to the As I have already indicated, the 1996 analysis of activity consultant professorial staff in St. Vincent's Hospital. patterns and financial returns cannot, no matter how impressive, really indicate the dedication and St. Vincent)s Private Hospital ______professionalism of tile hospital staff. However, figures are important and I am sure you will agree when you have read The hospital continues to develop its close association Witll the following statistical information and activity review, that St. Vincent's Private Hospital which is managed and funded you cannot but be impressed.
A,mllal Report 1996 St. Vincent's Hospital • ··V ··· dJC"""'1S1I
The hospital had a total of 27,080 admissions in 1996 support and help. On a personal note I appreciate Sr. which was an increase of 1,333 over the 1995 figures of Joseph Cyril's ongoing support.and I know that many of 25,747, (5.2 % increase). The breakdown of these my colleagues would share my views. Sr. Joseph Cyril's admissions were 7-day/5-day - 17,543 and I-day - 9,537. fundraising achievements over the last number of years have Of the 27,080 admissions, 8,056 were through the been outstanding and the debt on the Education & Accident & Emergency Department (46 %) Other Research Centre, which was over £2m three years ago will emergency admissions accounted for 2,050 or (11.7%) . be cleared by the end of 1997.
The hospital received £1 ,075 ,000 as part of the On behalf of the hospital and on my own behalf I would Department of Health's waiting list initiative to deal with its like to thank the Department of Health officials who have waiting lists. I am pleased to report that 1326 patients supported and helped us over the last number of years. We (1076 inpatients and 250 outpatients) were removed from look forward to their continued support. Too often we our waiting lists as a result of this initiative. The hospital's forget that our colleagues in the Department of Health in-patient waiting lists were reduced to a figure of 998 on have pressures and problems to deal with as well and they 31/12/ 96 compared with 1,536 at 31/12/95. too want patients to get the best care possible. d d The Hospital's financial affairs have continued to be The hospital acknowledges and appreciates the e controlled effectively. The hospital has managed to stay commitment of all who continue to support us and who ) within its revenue allocation by £3,180. The hospital's total generously give their time to serve voluntarily on hospital revenue expenditure amounted to £55,975,805, details of committees. which are outlined in the financial report. On behalf of the hospital's Executive Council and Board of The hospital's original revenue allocation in 1996 Management I would like to thank you, the members of amounted to £43,849,000. At tlle end of 1996 this had staff for your continued support and dedication in the increased by £3,326,000 as a result of special initiatives and interests of the hospital's patients and their families. grants made available by the Department of Health for specific projects ete. I thank the Bank of Ireland, our Auditors - Oliver Freaney & Co, Legal Advisors - Arthur Cox & Co, Insurance The hospital continues to develop its use of activity and Brokers - Sedgwick Dineen, Insurers -Church and General, costing systems. The information produced by the the Garda Siochana in Donnybrook and all the other hospital's HIPE system has been invaluable in helping us to organisations and personal friends of St. Vincent's Hospital review and control the level of activity in the organisation. for their continued support and help over the year. The hospital, as a priority in 1997, will continue to educate the clinical staff in the use of this management information tool. Nicholas C.Jermyn I would like to thank Mr. Sean Fagan, Financial Controller, Chief Executive everyone on his team, and all the other staff involved for their support in achieving the results we did in 1996.
Mai1ttenance and Expenditu1'e ______
The hospital continued its ongoing investment in the maintenance and re-equipping of the hospital in 1996. £2,135,000 was spent, mainly on the refurbishment and purchasing of equipment in patient service areas.
1996 has been a year in which hospital management has tried to consolidate and build a platform for the hospital's redevelopment. The next few years are going to be difficult but rewarding where we will see a new St. Vincent's Hospital emerging which will allow us deliver quality care in surroundings our patients expect and deserve.
Thanks ______
On behalf of my colleagues I would like to thank Professor Noel Whelan, Chairman, Board of Management, and the members of the Board of Management for their support which is voluntary. My thanks to Sr. Joseph Cyril, Sister Superior, and the community of Sisters for their continued
A1lnllal Report 1996 St. Vincent's Hospital
Pub higi for Report from the Chairman of noti the Medical Board ______Ow the tl1e
1996 has been a very eventful year for the Medical Board of During the past year Mr. Tom O'Reilly and Dr. Margaret St. Vincent's Hospital and for the hospital in general. O'Donnell were both appointed to consultant posts in Plastic Surgery. Mr. David Charles was appointed to a In May 1996 the Minister for Health, Mr. Michael consultant post in Ear, Nose & Throat surgery. In tl1e Noonan, visited St. Vincent's Hospital and announced the future all three surgeons will deliver a service to the South government's support for the revamping and East Dublin Department of Surgery. dis modernisation of the hospital which he said was long mu overdue given that planning for the present facilities began In addition to the above, considerable progress has been almost fifty years ago. made over the past year towards the development of T Departments of Medicine, Radiology and Pathology for ho The Minister indicated that the modernisation programme South East Dublin. Pr< should be carried out in three phases over a period of SL,{ - the seven years. He hoped that building work for the first During 1996 Dr. Shaun O'Keeffe was appointed as a re! phase, for which his department gave a financial consultant in Geriatric Medicine and he commenced commitment of more than £30 million, would begin before practice in ovember. Dr. Sean Connolly was appointed I 1 the end ofl997. to tl1e post of Consultant Neurophysiologist and he took up et his post in July. Dr. Charles Gallagher was appointed as a Following the Minister's announcement the Project Team, Respiratory Physician with an interest in Cystic Fibrosis and which had been meeting on a regular basis, stepped up he will take up his post in early 1997. Dr. Paul Collins was activity and for much of the second half of 1996 met at least appointed Consultant Dermatologist and he plans to join once a week and often more frequently. In the Autumn of St. Vincent's in November 1997. 1996 Architects, Engineers, Quantity Surveyors and other allied building industry professionals were appointed and they will play a major and important role in the In 1996, as in the previous year, individual departments modernisation programme. were allocated specific operational budgets. Despite the very best of intentions, by mid 1996 many departments had A broad based consultative process was pursued in the sustained significant overruns on budget activity and at tl1at preparation of the Development Brief which was submitted time patient admission figures had increased by more tl1an to the Department of Health in late November 1996. 9% in comparison with mid 1995. Some measures were Ministerial approval for the commencement of work is now introduced to bring the level of activity back into line with awaited. budget allocations. However, towards the year end there were indications that activity was again running well mead In a major re-development programme, although of budget allocation and were it not for some extra and everyone's ambitions cannot be totally achieved, it is hoped special grants from the Department of Health, a further that the end result will represent balanced discussion and waiting list initiative and prolonged reduction of activity ideas providing much improved patient care facilities and prior to Christmas, there would have been major financial that it will not be perceived as "some winners and some overruns for the year. losers". When compared to the activities of 1994 and 1995 there Throughout 1996 careful but slow steps were taken to were in fact no actual cutbacks during 1996 but rather the enable the Department of Surgery for South East Dublin introduction of measures to bring activity back into line begin its activities. In this context approval has been given \vith that of 1995 - the level of activity for which the for access to St. Vincent's Hospital for those surgeons in hospital was funded in 1996. south-east Dublin not already attached to this hospital. At present we are awaiting approval from Comhairle na It now appears that for the next few years budgeting will be nOspideal for restructuring of the relevant posts. based on the activity levels which were approved in 1995. With this advance knowledge it is hoped that all staff Comhairle approval for the appointment of a Consultant members \ViU work even harder in an effort to remain Surgeon with a special interest in vascular surgery under the within budget levels and thus avoid autumn activity umbrella of the Department of Surgery for South East reducing measures being introduced. Dublin is expected in the near future. The excellent level of co-operation between St. Vincent's
A1lnual Report 1996 St. Vincent's Hospital ••••• ~ •.c-.. ",. Public Hospital and St. Vincent's Private Hospital was courtesy and co-operation during 1996. highlighted by the provision of beds in the private hospital for the waiting list initiative which was introduced at short In conclusion I also wish to thank all members of the notice in the latter part of the year. Executive Committee of the Medical Board for their continuing help and support during 1996. In particular, I Our senior citizens, and in particular the senior citizens of wish to express my appreciation to Dr. Waiter McNicholas the area served by St. Vincent's Hospital, rightly deserve who has come to the end of his term as a hardworking the best of medical care, delivered in pleasant and Honorary Secretary. I would like to welcome Dr. Oliver comfortable surroundings. However, because of the lack FitzGerald who has now taken over this onerous task and I of adequate facilities in soutll Dublin tile past winter in wish him well in this role during the coming years. My particular saw a huge influx of medically ill elderly patients thanks are also due to all of my medical colleagues for their et resulting in overcrowding of hospital facilities and tile help and co-operation throughout the year. Ln serious curtailment of many other areas of activity in an a effort to comfortably accommodate and treat these elderly le patients with dignity. This ever increasing problem :h warrants our careful and considered attention and discussion Witll the Department of Health in an effort to w.R. Quinlan minimise the problem before tile onset of next winter. Chail'man of the Medical Board
The Board of Management continues to safely steer the )r hospital through difficult times. Our tllanks are due to Professor Noel Whelan, Chairman of tile Board , and all of tile Board members for their continued commitment in this a regard. d d I would like to express my appreciation to the hospital's p Chief Executive, Mr. Nicholas Jermyn, for his openness, a j Minister for Health)s visit 1996 ------
Mr. D01lal Devitt Professor Noel Whela11 Mr. MiclJael Noo/lan T.D. Mr. William Q;t.inlan Mr. Nicholas Jermyn Department of Health Chairman Minister for Health Chairman Chief Executive Officer St. Vincent's Hospital Medical Board
Annllal R eport 1996 St. Vincent's Hospital
Finance Department Su Report for the year 1996 for Re We are continuing to develop a number of areas in the bar code labeUed.This will allow filture reviews to be done Finance Department. much more efficiently by scanning the bar codes.
Specialty budgeting is now in its third year and covers all Grants received during the year allowed us to install a Pa special ties within the hospital. Combined Heat & Power system and an energy monitoring Ot Pathology and radiology costs and activity analysis by & targeting system. This will yield annual savings of up to specialty are being incorporated into the budgets iss llcd. £80,000. Gr.
Wc can also analyse the source of external pathology and Casemix funding is becoming an increasing part of tlle radiology requests. This has proven helpful in controlling Deparmlent of Health allocation process. the volumes of these requests. The specialty costing unit and the HIPE Coding Department are working to develop and improve the A theatre operation costing system is now in place. This analysis of hospital activity.The furtller development of this allows us to cost each operation and analyse the workload unit is seen as a priority if tlle hospital is to get fiLii credit for in theatre by surgical specialty. the work being done here. It is hoped to incorporate this into the budgeting system in the future. This theatre database is proving a useful source of information for clinical research as well as financial analysis. A similar system is now being developed for the Sean Fagan Deparmlent of Diagnostic Imaging and this should be Financial Controller completed in the first quarter of 1997.
The weekly and formightly wages are now being processed internally on a McKeowns software package. TillS has worked well and provides a better database of information for the salaries department. Ex The Fixed Assets register was reviewed and a new software Rt package is being installed which will allow all assets to be Su
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A
Mr. Robert Martin Mr. Eamom. Firegerald General Mallager General Ma11ager
Annual Report 1996 St. Vincent's Hospital ······ • V dJc .... l$"1.
Summary Financial Statement
for the year ended 31st December 1996
Results for the year 1996 1995 ne Income £ £
a Patients Income 2,453,453 2,475,670 Ig Other Income 3,260,898 3,125,191 to Grants Amortised
Buildings & Equipment 3,089,634 2,761,569 le 8,803,985 8,362,430 Ig le is Expenditure )r Salaries & Wages 35 ,276,585 32 ,872,819 Surgery & dispensary 10,897,015 10,420,232 Provisions 871,211 788,946 Domestic 1,975,782 1,903,898 Administration 1,093,409 1,108,9 36 Maintenance of Builillngs etc 820,049 1,333,278 Bank Interest & Charges 24,886 (7,348 ) Miscellaneous 1,956,480 1,885,053 Depreciation etc - Buildings & Equipment 3,089,634 2,761 ,569 Exceptional I terns (29,246) 0 55,975,805 53,067,383
Excess of Expenruture over Income (47,171,820) ( 44,704,953) Refundable from the Department of Health 47,175,000 44,709,000 Surplus (Deficiency) transferred to Balance Sheet 3,180 4,047
Balance Sheet as at end of year
Assets
Fixed Assets 80,633,952 78,832,086
Current Assets 8,383,665 7,399,366
Total Assets 89,017,617 86,231,452
Liabilities / Reserves / Capital
Creditors 8,447,766 7,465,230
Capital - Sisters of Charity 68,336,383 67,305,376
Capital Accounts 12,177,516 11 ,408,674
Accumulated Surplus (Deficiencies) 55,352 52,172 89,017,017 86,231,452
Amlllai R eport 1996 St. Vincent's Hospital
Cl Highlights of the Statements of Accounts ------A~
Expenditu1'e ______shows that increased medical and surgical costs of £476,783 were offset in 1996 by a substantial saving in maintenance costs due to a number of exceptional items incurred in The net expenditure for 1996 was £47,171 ,820. This respect of maintenance during 1995. represents an increase of £2,466,867 (5.5%) over 1995.
The allocation received from the Department of Health for I'lcome ______1996 was £47,175,000 resulting in a nominal saving on allocation of £3,180. The overall income for 1996 generated by the hospital was £5,714,351. This compares with £5,600,861 in 1995 and Cost per Patient represents an increase of £113,490 (2.0%) .
The cost per inpatient week increased by £107 (5.5%) from £1 ,935 in 1995 to £2,042 in 1996. Balance Sheet ------
Capital purchases of £2.2 million have been added to the Activity Levels ______hospitals assets in respect of equipment acquired during the year and this sum is reflected in the Balance Sheet after disposals of old assets and depreciation. Stocks totalling Overall patient admissions were up 1,334 (5.18%) from £397,175 held in the hospitals theatres have been 25,738 in 1995 to 27,072 in 1996. The increase in introduced into the balance sheet under current assets for admissions occurred principally in one day and fIve day the fIrst time in accordance with Department of Health plarmed admissions which increased by 1,031 in total. accowlting practice standards. Heretofore it had been the Accident and Emergency admissions reduced by 89 practice to treat these stocks as expended once issued from admissions between the two years. Notable increases in the central stores. The bank overdraft (included under diagnostic services occurred in Pathology tests which were current liabilities) stood at £3,166,713 at the end of the up 141 ,905 (6.18%), Theatre operations increased by 322 year compared with £996,994 at the end of 1995. (2.02%) and CT scans by 915 (18.39%) .
Pay costs ______
Salaries and Wages costs were £35,276,585 ill 1996 and £32,872,819 in 1995 an increase of £2,403,766 (7.31 %) . The average number of employees on the payroll increased by 61 (3.9%) from 1583 in 1995 to 1644 in 1996. National Pay awards and increased staff numbers contributed to the higher pay costs in 1996.
Non-Pay costs ------
The cost of goods and services used by the hospital in 1996 cost £17,647,882 and in 1995 £17,442,045 an increase of £205,837 (1.2%) . An analysis of the non-pay cost increase
A,mllal Report 1996 St. Vincent's Hospital ~ ~ Comparison of Defici ts/Expendi tu res/Inco me/ Admissions for the last 5 years ______
783 nee Excess Expenditure O1'er Income for last jil1e years ____ lin
.vas md
the Total Expenditure for last jil1e years ______the ter ng :en for lth :he lm ler he
Income for last jil1e years ______
Inpatient Admissions for last jil1e years ------
Actual :-lumbers lIi iil 1992 1993 1994 1995 1996
Ammat Report J 996 ". St. Vincent's Hospital ...... :;; $C'~lS t'
Organisational (Service) Chart
'1' ".. ~\ ..... - ~ l"~ Patients ~alld Relatives , .
, Board of Mallagelllellt
: Superior Gmeml Sisters ofClmrity
Department of Health
Patient Focused Care-______
Primary Service Provitiet"S Hospital Management Executive Council
Departmental Managen Board of Management
General Managers Superior General Sisters of Charity
Chief Executive Officer Department of Health
Annual R ~port 1996 St. Vincent's Hospital "· • v lBC!t4',,,. Governance & Management Structure Hospital Board Structure------
Missioll CO/ll/ll;ttrCi
FIIIldmisillg C01ll1llitue
Operational Structures--
Service Finance Departments Huma1~ ResOtlrces Allied Health Professionals Information Technology General Corporate Managers Functions
School of Nursing Director Departments of Chairman of Nursing Medical Medicine Board Unit Nzming Stlrgery Managers Radiology Ward Sisters Pathology Staff Nurses Anaesthetics Professorial Unit
Anmtal Report 1996 St. Vincent's Hospital
Statistics
Bed Days ______Discharges ______
Admissions ___ Average Stays (DaysJ------
%Occupancy ______OPD Attendances ___
A&E Attendances ______Cost per Patient per Week ____
Amllta/ Report 1996 St. Vincent's Hospital ····~ e.c~"" Statistics
DiagnosticfI'reatment Departments ______
1995 1996
Pathology Tests 2,241,809 2,382,405 X-Rays 93,667 94,657 Nuclear Medicine Tests 53,069 54,378 Nuclear Medicine Scans 9,248 11,137 Dialysis Treatments 1,803 1,887 Pulmonary Lab. Attendances 4,000 3,387 Pulmonary Attendances 74,915 70,372 Social work Cases 10,488 10,386 Dietetics - Attendances 24,284 21,281 Diabetes Centre 2,024 2,094 Vascular Lab. Tests 2,042 1,762 E.C.G. Recordings 16,468 17,593
Theatres: Main theatre 10,914 11,012 Cardiovascular Theatre 1,187 1,256 Endoscopy Unit 3,852 4,007
E.E.G./E.M.G. Tracings 1,034 1,295 Pain Management Programme Attendances 2,509 2,300
Pathology Tests------
1995 1996 %Varia1lce
Biochemistry 1,036,444 1,088,355 5.0 Microbiology 302,222 347,352 14.9 Haematology 808,630 852,966 5.5 Blood Transfusion 42,337 40,454 -4.4 Histology 44,051 44,551 1.1 Cytology 8,125 8,727 7.4
Biochemistry Includes: Metabolic, Immunology and Endocrinology Tests
All/mal Report 1996 St. Vincent's Hospital :. ..., .. e'''' , Department Statistics
Cardiology 1994 1995 1996
Inpatients Admissions 1,527 1,472 1,538 Discharges 1,530 1,471 1,550
Outpatients New patients 703 690 742 Total attendances 3,713 3,616 3,933
Nephrology 1994 1995 1996
Inpatients Admissions 492 623 539 Discharges 472 591 513
Outpatients New patients 144 148 167 Total Attendances 1,025 1,150 1,285
Oncology 1994 1995 1996
Inpatients Admissions 1,154 1,048 1,166 Discharges 1,163 1,048 1,145
Outpatients New patients 167 175 215 Total attendances 1,640 1,691 1,807
Haematology 1994 1995 1996
Inpatients Admissions 159 138 120 Discharges 165 155 132
Outpatients New patients 113 116 121 Total attendances 1,251 1,265 941
St. Anne)s Day Centre (Oncology & Haematology) 1994 1995 1996
Admissions 2,608 2,681 3,295 Discharges 2,608 2,681 3,295 PLUS ward patients treated in centre 605 497 618
Psychiatry 1994 1995 1996
Inpatients Admissions 263 260 271 Discharges 272 262 283
Outpatients New patients 419 378 441 Total attendances 2,924 3,109 3,295
Day Centre Attendances 2,687 2,516 2,667
Neurology 1994 1995 1996
Inpatients Admissions 241 240 269 Discharges 270 261 290
Outpatients New patients 915 969 909 Total attendances 3,372 3,516 3,484
Annual Report 1996 St. Vincent's Hospital a ~···· - ec~ ".
196 Dermatology 1994 1995 1996
38 Inpatients Admissions 6 9 6 50 Discharges 10 12 7
42 Outpatients New patients 486 499 582 33 Total attendances 1,501 1,487 1,821
'96 Rheumatology 1994 1995 1996
39 Inpatients Admissions 405 499 384 13 Discharges 403 417 372
57 Outpatients New patients 1,035 1,258 940 ~5 Total attendances 4,770 5,130 5,283
96 Respiratory & General Medicine 1994 1995 1996
i6 Inpatients Admissions 1,530 1,68 1 1,760 ~ 5 Discharges 1,467 1,625 1,717
5 Outpatients ew patients 618 626 647 17 Total attendances 4,017 4,088 3,961
16 Endocrinology 1994 1995 1996
0 Inpatients Admissions 409 399 357 2 Discharges 420 416 344
1 Outpatients New patients 274 331 331 1 Total attendances 2,040 2,366 2,375
6 Diabetes Clinic 1994 1995 1996
5 New patients 234 276 217 Total attendances 2,915 2,926 2,892
Diabetes Centre 1994 1995 1996 6 Attendances 2,171 2,024 2,094
Geriatric Medicine 1994 1995 1996
Inpatients Admissions 429 445 448 Discharges 460 504 509
o II tpa ti ents New patients 254 226 261 Total attendances 1,044 988 1,018
Gastroenterology & General Medicine 1994 1995 1996
Inpatients Admissions 2,042 2,104 2,246 Discharges 2,017 2,080 2,222
Outpatients New patients 927 945 932 Total attendances 3,379 3,369 3,432
Amlllai Report 1996 St. Vincent's Hospital
General Surgery 1994 1995 1996
Inpatients Admissions 5,327 5,152 5,000 Discharges 5,275 5,091 4,990
Outpatients New patients 3,382 3,501 3,548 Total attendances 13,067 14,111 13,587
Liver Clinic 1994 1995 1996
New patients 17 36 56 Total attendances 431 620 842
Colorectal Clinic 1994 1995 1996
New patients 20 25 37 Total attendances 386 440 517
Pain Clinic 1994 1995 1996
Inpatients Admissions 329 357 566 Discharges 328 356 566
Outpatients New patients 155 165 174 Total attendances 1,352 1,188 1,199
Vascular Surgery 1994 1995 1996
Inpatients Admissions 677 620 669 Discharges 695 633 683
Outpatients New patients 629 623 629 Total patients 2,738 2,699 2,709
Orthopaedic Surgery 1994 1995 1996
Inpatients Admissions 1,849 1,870 2,012 Discharges 1,850 1,872 2,016
Outpatients New patients 2,370 2,619 2,797 Total attendances 10,489 10,305 10,689
Urology 1994 1995 1996
Inpatients Admissions 2,535 2,423 2,513 Discharges 2,536 2,407 2,516
Outpatients New patients 1,403 1,491 1,400 Total attendances 5,626 5,120 5,426
Plastic/Maxillofacial Surgery 1994 1995 1996
Inpatients Admissions 742 884 775 Discharges 747 897 775
Outpatients New patients 679 800 811 Total attendances 2,882 3,098 2,882
Annual Report 1996 St. Vincent's Hospital
96 Thoracic Surgery 1994 1995 1996
)0 Inpatients Admissions 192 202 169 )0 Discharges 210 225 181
1,8 Outpatients ew patients 114 141 105 l7 Total attendances 616 658 537
P6 Gynaecology 1994 1995 1996 i6 Inpatients Admissions 574 476 503 :2 Discharges 577 481 507
Outpatients New patients 752 761 767 )6 Total attendances 2,295 2,378 2,240 -7 7 Ophthalmology 1994 1995 1996
Inpatients Admissions 790 738 587 '6 Discharges 787 732 583 6 Day-care Admissions 788 878 1,196 6 Discharges 788 878 1,196 4 Outpatients New patients 967 965 1,045 9 Total attendances 4,118 3,302 3,120
6 Orthoptics 1994 1995 1996 "} Total attendances 611 667 598 3 A&E Patients treated in Ophthalmology Dept. Total attendances 754 617 746
1994 1995 1996 5 ENT Surgery Inpatients Admissions 599 589 663 Discharges 600 594 663
Outpatients New patients 796 821 867 Total attendances 2,080 2,151 2,297
Dental Surgery 1994 1995 1996
Inpatients Admissions 31 24 25 Discharges 30 24 25
Outpatienst New patients 28 20 15 Total attendances 88 57 56
Chiropody 1994 1995 1996
Outpatients ew patients 25 13 5 Total attendances 733 639 675
Annual R eport 1996 St. Vincent's Hospital
Report from the Department of Nursing ______
I am pleased to report that in 1996 St. Vincent's Hospital Paula Craig - Bachelor of Nursing Studies in UCD was granted sanction from the Department of Health to Noeleen O'Connor - Oncology Diploma Course in UCD introduce a Registration/ Diploma Course for Student Eleanor Quill - Oncology Diploma Course in UCD Nurses. Since January 1992, together with the Department of Nursing Studies in University College Dublin, we have Twenty registered nurses are pursuing degree courses and a worked diligently to prepare for this course. Sixty students large number are undertaking diploma courses in the started this course on 30 September 1996 and will start Nursing Studies Department in UCD, the Faculty of their clinical placement on 10 March 1997. Six Clinical Co Nursing in the Royal College of Surgeons and many other Ordinators have been appointed and are currently colleges. undertaking a course in U.C.D. They will guide and support the students in the clinical areas by addressing their Inservice Staff Development------educational requirements. This advance in nursing education has been welcomed with enthusiasm. On-going inservice training and education was maintained throughout the year. Since July 1996 the School of ursing has been under tile 38 registered nurses completed courses in Accident & direction of Miss Geraldine McSweeney, Acting Principal Emergency, Anaesthetics, Coronary Care, Intensive Care Tutor. and Theatre Nursing. All courses are approved by An Bord Altranais During the year four Sisters of Charity resigned from their posts in the nursing department to pursue congregational The acquisition of CINAHL and the effective training duties: - programme in its use by Miss Mary Shore has been beneficial to a large number of nurses. Sr. Agnes Reynolds - Director of Nursing Sr. Anne Curry - Principal Tutor Nut'sing Practice Developmmt ______Sr. Philomena Farrell - Unit Nursing Officer Sr. Ignatius Killeen - Ward Sister - Our Lady's Ward Under the direction of Miss Heather Kevelighan, this project commenced in St. Teresas and St. Vincents wards. I wish to acknowledge the immense contribution these four This development is an evaluation system of improving the sisters have made to the Nursing Profession in the past, and standard of patient care and nurse education. wish them success and happiness in their new roles. Appreciation ______Senior Nzming Appointments made in 1996
The sadness and loss at the untimely death of Muireann Ni Miss Philomena Shovlin Mhuirithe was deeply felt by all who knew her. Muirearm urse Planning Officer appointed in September was killed on the 11 August in a road traffic accident near Miss Marian Quinn her home in Helvic, Co. Waterford. Muirearm was 22 years urse Tutor appointed in September old. She qualified in May 1996, with her friends from the Miss Regina Joye March 1993 group. We extend our sympathy to her parents - Nurse Tutor appointed in December Breda and Bill, her four brothers and all family members Miss Anna Maria Lynch and friends. "Ar dheis De go raibh an anam dilis ". - Palliative Care Sister appointed in August 1996 Miss Deirdre O 'Doherty In conclusion I would like to express my sincere thanks and - Junior Ward Sister St. Paul 's Ward appointed appreciation to all my colleagues for their excellent care and in ovember 1996 service to patients. Miss Ann Dwyer - Junior Ward Sister St. Teresa's Ward appointed in December 1996 Miss Pauline Doyle Acting Director of Nursing The appointment of Miss Shovlin to the Project Team is of immense value to the future development of St. Vincent's Hospital.
Staff Development ______
Congratulations to the following nurses on their achievements:-
Annual Report 1996 St. Vincent's Hospital ! ···· • W dJc"'4,,-,,
Orthopaedic Surgery Report
During 1996 activity levels within the Orthopaedic Conferences and Courses Attended: Department continued to expand. Since 1991 it has in fact acted as the Department of Orthopaedic Surgery for South Member of Faculty AO Fracture Management Course, East Dublin, although it has not had the facility of being London, England 30/ 06/ 96. Id a able to make joint non-consultant staff appointments. the Faculty Member of North European Surgeons Meeting, of In 1996, 20,548 outpatients were seen at orthopaedic Nottingham, England 01 / 09/ 96 to 05/ 09/ 96. her clinics in St. Vincent's Hospital, St. Colmcille's Hospital and St. Michael's Hospitals. The development of the fi.llly Faculty Member of AO International Fracture Meeting, fledged South East Dublin Department of Surgery will Davos, Switzerland 9/ 12/ 96 to 14/ 12/ 96. enable joint appointments of non-consultant staff and make for more streamlined delivery of service. led Mr. Brian J. Hurson ______
& Mr. William Quinlan ------During the year Mr. Hurson was elected to the panel of are reviewers for the Journal of Bone & Joint Surgery and was xd MrWilliam Quinlan 's five year term as the Irish invited to join the programme committee of the representative on the Orthopaedic SAC finished in International Society of Arthroscopy, Knee Surgery, and December 1995 and he has been replaced by Mr. Kieran Orthopaedic Sports Medicine. ng O'Rourke who was recently elected by the Irish Institute of :en Ormopaedic Surgeons to fill this position for the coming five years. We wish him every success in this increasingly busy position.
Mr. Quinlan continues as a member of the Court of his Examiners for the Intercollegiate Board Fellowship in :Is. Ormopaedic Surgery. He participated in these he examinations in Glasgow and London during 1996.
Conferences attended:
Faculty member / skeletal trauma conference - Valbella, Ni Switzerland, March 1996. 1n :ar Irish Orthopaedic Association Conference - Limerick May Irs 1996. he Its Revision Hip and Knee Replacement Surgery Symposium - :rs Gleneagles, Scotland September 1996.
Publications:
Risks of radiation exposure to Orthopaedic Surgeons. O'Rourke P., Crerand S., Harrington P., Casey M., and Quinlan W. Journal of tile Royal College of Surgeons, Edinburgh. 41(1 ). 40-43. 1996
The consultant staff of the Orthopaedic Department would like to thank the members OftllC Board of Management and me Hospital Administration for the continuing upgrading and improvement of facilities at the hospital.
Mr. Kieran O'Rourke ______
Mr. O'Rourke is a member of SAC in OrtllOpaedic Surgery and he is also a member of the U.K. AO Education Committee.
Anllual Report 1996 St. Vincent's Hospital ~
Surgical Professorial Unit - St. RaphaelJs Ward ----
Undergraduate activities: The number of undergraduate students in Medicine from University College Dublin attached to St. Vincent's Hospital has increased over the past number of years. There is also more hospital based teaching in the preclinical years. This has increased the demands on the clinical staff. In view of this the number of Special Lecturers has increased this year from one to two. High standards are achieved by St. Vincents based students in Final Medical Examinations.
Postgraduate activities: The highlight of this year was the meeting of the European Society of Surgical Oncology hosted by the Professorial Department of Surgery September 4-6, 1996. Professor O'Higgins is currently President of the European Society of Surgical Oncology. The Meeting was held in the O'Reilly Hall and Conference Centre at the Belfield Campus. Several hundred delegates from all around the World attended. The meeting was a great success.
Professor O'Higgins is President of the Irish Society of importance of the development of the Breast Unit in future Surgical Oncology. The society is at present establishing developments at St. Vincent's Hospital. clinical guidelines for the management of common surgically treated cancers. Research activities: Research activities continue at both basic science and The surgical services in St. Vincent's Hospital are clinical levels. This can be seen in the publications and participating in the new Dublin Regional Basic Surgical presentations below. Collaborative research both within St. Training Scheme. This is a two year scheme with the Vincent's Hospital and University College Dublin takes trainees rotating between General and Specialist Surgical place. With the large cli.Jlical commitment to breast cancer Services at St. Vincent's Hospital Tllis has the advantage many clinical research projects are underway with the that we get to know the trainees well from early on. It also department of Medical Oncology. Collaborative research means that there is a major commitment to actively training with other universities including Dublin City University is these trainees. also llnderway and an initial report has been published. Service Workload: Publications - 1996 ______The Department continues to develop its interests in General and Endocrine surgery and in Surgical Oncology. There were a total of 1644 admission under the care of the O'DriscoiI, Kennedy S, McDermott E, Kelehan P, Clynes Surgical Professorial Unit for the yea r 1996. The M. Multiple drug resistance-related messenger RNA comnlitment and activity of the Breast Clinic continues to expression in archival formalin-jixed paraffin-embedded increase. (see diagram below) human breast tumour tissue. Eur J Cancer 1996; 32A: 128- 133. Future developments: Caulfield RH, Hill ADK, Shering SG, McErlaine D, The Surgical Professorial Unit has greatly welcomed the Murphy JJ, McDermott EWM, O'Higgins NJ. Benign announcement by the Minister for Health outlining the rectal stictllres - radiologic ally controlled balloon ditation. Ir comnlitment of the Department of Health to screening for J Med SCI 1996;165:27. breast cancer. The Surgical Professorial Unit look forward to taking a major role in the implementation of breast Chin D, Maguire T, O'Reilly T, O'Riain S, Naidll R, cancer screening in Ireland. The Minister also stressed the
1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996
Attendence 1670 2226 2521 3124 3682 3776 4497 4375 4165 5961 6164 New patients 724 707 827 918 966 1008 1112 1035 1294 1400 1463 New cancers 59 56 75 115 98 125 104 III 148 160 175
A1l111tfll Report J 996 St. Vincent's Hospital
McHugh M, O'Higgins NI, Duffy MI. Urokinase Mullet JR, Rahim A, Hegarty I, Sheehan K, Murphy TT, plasminogen activator in basal cell carcinomas of skin. Eur J Mesenteric Lymphangiomatous cyst. Ir J Med Sci Surg Oncol 1996; 22; 445. 1996;165:299.
Duffy MJ. Pro teases as prognostic markers 111 cancer. McDermott EW, O'Higgins NI. Management of early Clinical Cancer Research 1996;2:613-618. breast cancer. Irish Doctor 1996;8:17-21.
Duffy MJ. The biochemistry of metastasis. Adv Clin O'Driscoll L, Kennedy S, McDermott EW, Kelehan P, Chem 1996;32:135-166 Clynes M. Multiple drug resistance-felated messenger RNA expression in archival formalinfixed pamffin embedded Duffy MJ. PSA as a marker for prostate cancer. Ann Clin human breast tumour tissue. Eur J Cancer 1996;32A: 128- Biochem 1996;33;511-519. 133.
Duffy MJ, Duggan C, Magure T, Mulcahy K, Elvin P, O'Sullivan J, Reardon D, McGreal G, Hehir D, Kirwan L, McDermott EWM, Fennelly TT, O'Higgins NI. Urokinase Brady M. Deliberate ingestion of fOfeign bodies by plasminogen activator as predictor of agressive disease 111 institutionalised psychiatric hospital patients and prison breast cancer. Enzyme Protein 1996;49:85-93. inmates. Ir J Med Sci 1996;165:294-296.
Duffy MJ, Duggan C, Maguire T, Blaser I, Tschesche H, Rafferty MA, Hill ADK, Shering SG, Caul field RH, McDermott EWM, O'Higgins NI. Proteases as prognostic McDermott EW, O'Higgins I. Cervical explomtion for markers in breast cancer. Clin Exp Met 1996;14:26. primary hyperparathyroidism - 25 year experience. Br J Surg 1996; 86:45. Duggan C. Chevillard S, Magdelenat H, McDermott EW, Sharma S, Hill ADK, Shering SG, Dunne B, Kennedy S, O'Higgins N, Duffy MI. Attempts to quantitate mRNA McDermott EWM, O'Higgins NI. Twenty year experience levels for uPA in breast cancer using RT-PCR. lr J Med Sci with dtlCtal carcinoma in situ of the breast. Ir J Med Sci 1996;165:1. 1996;165 :22-23. e Duggan C, Maguire T. Chin D, McDermott EW, Shering SG, Zber A, McDermott EWM, Smyth PPA, O'Higgins NI, Fennelly TT, Crown I, Duffy MI. O'Higgins NI. Thyroid gland volume in breast cancer Relationship between urokinase plasminogen activator and its patimts. Ir J Med Sci 1996;165:29-30. :l receptor in breast cancer. Ir J Med Sci 1996;165:10. :l Shering SG, Duffy MI, Zbar A, Sherry F, Sharp M, Duggan C, Mulcahy H, McDermott EWM, Fennelly TT, McDermott EWM, Fennelly TT, Zber A, Shering S, Crown J, Duffy MJ. Evaluation of a urokinase plasminogen McDermott EWM, Sharp M, O'Higgin NI. Infiltrating activatory ELISA kit for assessing prognosis in breast cancer. lobular cancer - does prognosis differ from ductal cancer. Ir J e Ir J Med Sci 1996:165:11. Med Sci 1996;165:51. n Geraghty JG, Young HL. Satellite-delivered continuing Shering SG, Duffy MI, Zbar A, Sherry F, Sharp M, medical education in Europe. Postgraduate Med J 1996; McDermott EWM, Fennelly TT, O'Higgins NI. 72:218-220. Perioperative CEA and CA 15.3 values predict survival in breast cancer: a nelV observation. Ir J Med Sci 1996;165:49. Hill AD, McDermott EW, O'Higgins NI. Current issues in the management of breast cancer. IrMed J 1996;89:46- Shering SG, Hill ADK, McDermott EWM, Duffy MI, 1 48. O'Higgin NI. The contribution of the primary tumour to d serum CA 15.3 levels in breast cancer. Eur J Surg Oncol Kennedy SM, Duggan C, Barnes C, McNamara M, Duffy 1996;22:432. MJ. Expression of the urokinase plasminogen activator system in ocular melanoma. Ir J Med Sei 1996;165:6. Shering SG, Mac Sweeney F, Zber A, Mercer P, O'Riordain D, McDermott EWM, O'Higgins NI. Fibrin n" Kilbane MT, McDermott EW, Shering SG, O'Higgins NJ . Sealant does not reduce seroma formation follolVing .r Smyth PPA. Involvement of thyrotrophin (TSH) and thyroid mastectomy and axillary clearance: a randomised controlled perosidase (TPO) in human breast disease. lr J Med Sci trial. Ir J Med Sci 1996;165:60. 1996;165:77. Shering SG. Maguire T, McDermott EWM, Duffy MI, Luca F, Kilbane MT, Cusack A, McDermott EWM, O'Higgins NJ. E-cadherin: an adhesion molecule O'Higgins NI, Smyth PPA (1996). Do reductions in IVithprognostic significance in breast cancer. Ir J Med Sci mperoxide dismutase (SOD) activity precede morphological 1996;165:19-20. cha11ge in human breast cancef (Abstmct). Eur J Surgl OncoI1996;22:401. Shering SG, Zbar A, McDermott EWM, Smyth PPA, O'Higgins NI. Thyroid gland volume in b1'east cancer Mercer PM, McCabe MM, Murphy TT· Recurrence of patimts. Br J Surg 1996;83:1297-1298. osteoclast-like giant cell carcinoma of the pancreas after 10 years. Aust New Zea J Surg 1996:66:334-335. Smyth PPA, Smith DF, McDermott EW, Murray MI, Geraghty JG , O'Higgins NI. A direct relationship between
A1l1111al Report 1996 St. Vincent's Hospital
thyroid enlargement and breast cancer. J Clin Endocrinol Cunney RJ, Harkin R, Geraghty JG, Keane N, Lane B, Metab 1996;81:937-941. Smyth EG. Cathether related sepsis in patients on total parenteral nutrition. J Ir Coli Phys & Surg 1996;25:179- Troy A, Connell T, Duggan C, Skelly MM, Mulcahy HE, 181. Rajendiran S, DufIY MJ, O'Donoghue DP, Sheahan K. Levels of u-PA antigen reflect neoplastic potential of colorectal Audisio RA, Veronesi P, Maissoneuve P, Chiappp A, mucosa. Ir J Med Scl996;165:7. Andreoni B, Bombardieri E, Geraghty JG. Clinical relevance ofserological markers in the detection and follow-tip Walsh Sr, Hill ADK, Schering SG, Kelly PM, Sharp M, of pancreatic adenocarcinoma. Surgical Oncology O'Brien A, McDermott Ew, O'Higgins N. Arm volume 1996;5:49-63. changes following axillary clearance for breast cancer. Ir J Med Sci 1996;165:33. pJ·esentation and invited lectures at Young LS, Regan MC, Barry MK, Geraghty JG, Conferences - 1996 ______Fitzpatrick JM. Methods of renal blood flow measurement. Urol Res 1996;24:141-148. Duffy MJ, Duggan C, Maguire T, Elvin P, O'Higgins NJ- Clinical significance of urokinase plasminogen activator Zbar A, Shering S, McDermott EW, Sharp M, O'Higgins and its receptor in breast cancer. Proc of 21st Meeting of the N. Infiltrating loblllar cancer - does prognosis differ from International Association for Breast Cancer Research, Paris, ductal cancer. Ir J Med Sci 1996;165:51. July 1996. Zbar A, Shering SG, McDermott EW, Sharp M, O'Higgins Duffy MJ. Which is the best protease for assessing prognosis N. infiltrating lobular carcinoma of the breast. Ir J Med Sci in breast cancer? Bull Cancer 1996: 83:1038 (Invited 1996;165:9-10. presentation to Symposium on Prognostic Markers in Breast Cancer, Paris, December 1996. Zbar A, Shering S, McDermott EWM, Lucey M, Carton E, O'Higgins NI. The sllrgical management of primary JG Geraghty hyperparathroidism. Ir J Med Sci 1996;165:59. Workshop on cancer education. Sixth International Congress on Anti-Treatment, Paris, Zbar A, Shering S, Tucker 0 , McDermott EWM, Mullett France. February 1996. H , O'Higgins NI. A review ofparotidectom y at St. Vincent's Hospital (1971-1994). Ir J Med Sci, 1996;165:61. JG Geraghty The good nelVS about cancer. Geraghty JG. Familial adenomatous polyposis and Canadiana Conference, Milan, Italy. 10 March 1996. translational medicine. Lancet 1996;348:422. S Sharma, ADK Hill, SG Shering, B Dunne, S Kennedy, Geraghty JG, Stoltenberg RL, Sollinger HW, Hullett DA. EWM McDermott, NJ O'Higgins. VasCIIlar smooth mllScle cells and neointimal hyperplasia in 20 Year experience with ductal carcinoma in sitl{ of the chronic transplant rejection. Transplantation 1996;62:502- breast. 509. Sylvester O'Halloran Surgical Scientific Meeting, Limerick. March 1996. Hullett DA, Geraghty JG, Stoltenberg RA, Sollinger HW. The impact of aCllte rejection on the development of intimal RH Caulfield, ADK Hill, SG Shering, T Maguire, D hyperplasia associated with chronic rejection. Transplantation MacErlean, TT Murphy, EWM McDermott, NJ 1996;62:1842-1846. O'Higgins. Benign rectal strictures - radiologically co1ltrooed balloon Armand JP, Costa A, Geraghty JG, O'Higgins NJ, Brow P, dilation. Holmberg L, Sleijfer D, de Toeff I. Continlling medical Sylvester O'Halloran Surgical Scientific Meeting, Limerick. education in oncology in Ellrope. Eur J Cancer March 1996. 1996;32A: 1296-1299 EWM McDermott. Young LS, Regan MC, Barry MK, Geraghty JG, Breast Cancer: new science new challenges. Fitzpatrick JM. Methoda of renal blood flow measurement. Society Radiation Oncology Annual Meeting. Dublin Urol Res 1996;24:141-148. Institute of Technology Audisio RA, Seni-Carraro P, Segala M, Capko D, SR Walsh, ADK Hill, SG Shering, PM Kelly, M Sharp, Andreoni B. Tiberio G. FollOW-lip on colorectal cancer A O'Brien, EWM McDermott, NJ O'Higgins. patients: a cost-benefit analysis. Ann Surg Oncol 1996;3:49- Arm volllme changes following axillary clearance for breast 57. cancer. ational Scientific Medical Meeting, The Royal College of Aftab F, Stoldt HS, Tertori A, Imperatori A, Chinol M, Physicians of Ireland, Dublin, March 1996. Pagenelli G, Geraghty JG. Radioimmtl1logt{ided surgery and colorectal cancer Eur J Surg Oncol 1996;22:391-391.
AlInual Report 1996 St. Vincent's Hospital • w.. ·· • e" C~I'"
EWN McDermott J Dowdall, ADK Hill, C Williams, SG Shering, G Breast cancer screening. Irish Family Planning Association, Duffy, EWM McDermott, NJ O'Higgins. St, James Hospital, Dublin. March 1996. A prospective study comparing conventional mammography to scinti-mammography in the diagnosis of breast lesions. JG Geraghty. 21st Preyer Surgical Symposium, Galway September 1996. " Apoptosis and tumour biology. d Royal College of Surgeons in Ireland Meeting, Cork . S Sharma, ADK Hill, SG Shering, EWM McDermott, P 20 April 1996. NJ O'Higgins. y Tubular carcinoma of the breast. S Sharma, ADK Hill, SG Shering, B Dunne, S Kennedy, 21st Pryer surgical Symposium, Galway, September 1996. EWM McDermott, NJ O'Higgins. Ductal carcinoma in situ of the breast: our 20 year experience. S O'Connell, ADK Hill, SG Shering, F Ryan, D Irish Association for Cancer Research, Limerick. Barton, EWM McDermott, NJ O'Higgins, April 1996. Familial adenomatous polyposis coli - the role of screening for the adenomatous polyposis coli (ape) gene mutation. JG Geraghty. 21st Preyer Surgical Symposium, Galway, September 1996. Molecular genetics of cancer. e University of Modena, Italy. 23 April 1996. D Chin, T Maguire, T O'Reilly, S O'Riain, R Raidu, M McHugh, N O'Higgins, MJ Duffy. ;, MA Rafferty, ADK Hill, SG Shering, RH Caulfield, Urokinase plasminogen activator in basal cell carcinomas of EWM McDermott, NJ O'Higgins. skin. Cervical exploration for primary hyperparathyroidism - a 25 8th Congress of the European Society of Surgical IS d year experience. Oncology, Dublin. September 1996. & n Association of Surgeons of Great Britain Ireland, Glasgow, Scotland. F Luca, MT Kilbane, A Cusack, EWM McDermott, NJ O'Higgins, PPA Smyth. SG Shering, A Zbar, EWM McDermott, PPA Smyth, Do reductio ns in superoxide dismutase (SOD) activity precede NJ O'Higgins. morphological change in human breast cancer? Thyroid gland volume in breast cancer patients. 8th Congress of the European Society of Surgical ;, Annual Meeting of the British Association of Endocrine Oncology, Dublin. September 1996. Surgeons, Liverpool, United Kingdom. May 1996. NJ O'Higgins, EWM McDermott, A Maguire, T Healy. JG Geraghty. Total axillary clearance in breast cancer (Video Towards a common screening policy for cancer. Presentation) . Irishjltalian Society Meeting, Rome, Italy. 3 June 1996. 8th Congress of the European Society of Surgical Oncology, Dublin. September 1996. ~, NJ O'Higgins. le SU'lJical Oncology. NJ O'Higgins, EWM McDermott, A Maguire, T Healy, European School of Oncology, Vienna, Austria. Superficial parotidectomy (Video Presentation). June 1996. 8th Congress of the European Society of Surgical Oncology, Dublin. September 1996. SG Shering, EWM McDermott, NJ O'Higgins, M D Moriarty, PPA Smyth. NJ O'Higgins, EWM McDermott, A Maguire, T Healy. Thyroid disorders and breast cancer. Total thyroidectomy (Video Presentation). J European Cancer Prevention Organisation Workshop, 8th Congress of the European Society of Surgical n Elbigenalp, Austria. June 1996. Oncology, Dublin. September 1996.
Duffy MJ, Shering SG, Sherry F, McDermott EWM, SG Shering, ADK Hill, EWM McDermott, MJ Duffy, Co O'Higgins NJ. NJ O'Higgins. CA 15-3, a circtJlating markers JVith strong prognostic value The contribution of the primary tumour to serum CA 15.3 in breast cancer, new observation. Proc of the SVl levels in breast cancer. International Congress of Clinical Chemistry, London, 8th Congress of the European Society of Surgical n July 1996. Oncology, Dublin.
RH Caulfield, ADK Hill, SG Shering, EWM Professor N.O'Higgins attended tlle International Surgical McDermott, NJ O'Higgins. Group Meeting in Manchester, England. September 1996. Cellulitis - an increaseing burden on hospital resources. st 21 st Preyer Surgical Symposium, Galway, September 1996. Professor N. O'Higgins attended the Big18 Surgeons Group Meeting in London, England, October 1996. B Dunne, ADK Hill, SG Shering, P Kelly, S Sennedy, EWM McDermott, NJ O'Higgins. M Duff, ADK Hill, T O'Neill, SG Shering, B Dune, P The value of diagnostic imaging for axillary lymph nodes. Kelly, S Kennedy, EWM McDermott, 21 st Preyer Surgical Symposium, Galway, September 1996. NJ O'Higgins.
Amlltal R eport 1996 St. Vincent's Hospital
The value of diagnostic imaging for axillary lymph nodes. Surgical Section of the Royal Academy of Medicine, University of Modena Waterford. October 1996. Molewlar genetics of cancer Modena, Italy, April 1996 PPA Smyth, SG Shering, MT Kilbane, A Zbar, EWM McDermott, DF Smith, NJ O'Higgins. JG Geraghty Thyroid peroxides antibodies (TPo.Ab) as predictors of Canadian a Conference outcome in breast ca1lcer. Early detection of cancer Irish Endocrine Society, Dublin. November 1996. Milan, 10/3/ 1996
JG Geraghty. JG Geraghty Swiss Society of Surgery Irish/ Italian Society Total or hemithyroidectomy for differentiated thyroid cancer TOJvards a common screening policy for cancer Geneva, June 1996 Rome, 3/6/1996
JG Geraghty JG Geraghty Sixth International Congress on Anticancer Treatment Italian Society of Coloproctology, Workshop on cancer education Education and Training in Europe Paris, February 1996 Rome, November 1996
JG Geraghty JG Geraghty. World Summit of Deans and Experts in Health and Medical Royal CoUege of Surgeons in Ireland Meeting Education Apoptosis and tumour biology The important role of continuing medical education Cork, April 1996 Buenos Aires, September 1996 JG Geraghty JG Geraghty Italian Society of Coloproctology, European Society of Surgical Oncology Management of 10lV rectal cancer European dimensions of cancer care Rome, November 1996 Dublin, September 1996 JG Geraghty European School of Oncology Annual Convention Futllre prospects for cancer education in Europe Paris, October 1996
Ammal Report 1996 St. Vincent's Hospital , \001'" .. e.. c~ .:J'I'
General Surgical Unit - St. Teresas Ward ______
Subspecialty Interests Coloproctology (JH) Mr. John Hyland FHlminant Colitis in Inflammatory BOlVel Disease (IBD). A Hepatobiliary (OT) Mr. Oscar Traynor Detailed Pathological and Clinical Analysis. N Swan, F Carton, JS Geoghegan, DP 0 Donoghue, J Hyland, K Sheehan. Irish Journal of Medical Science 1996; 165: The Unit continued with a very busy year in 1996. The SuppI4,3. Casemix complexity continues to increase with increases in secondary and tertiary referrals in the subspeciality Restorative Proctocolectomy A Decades Experience. FJ interests These increases are reflected in Inflammatory Shannon, DC Grant, TJ Boyle, OJ Clyne, JMP Hyland. Bowel Disease and complex colorectal and hepatobiliary Irish Journal of Medical Science 1996; 165: cases. Mrs. Anne Keogh, Ward Sister, continues to direct the Unit Sllrgery for Gallstones in the Laparoscopic Era. I Norton, T activity with her accustomed professionalism. Ms.Inez Boyle, M Eogan, El Mudaffar, 0 Traynor, J Hyland. GafIney left for Wexford to our great disappointment·we Irish Journal of Medical Science 1996; 166: Suppl 2,18. wish her well . We are delighted to welcome Ms.Ann Dwyer as the new J nr. Ward Sister. Surgery for Ileo Colic Crohn 's Disease. 0 Clyne, M Eogan, We also welcome Sr.Grace McEvoy(Coloproctology urse T Boyle, D Grant, F Shannon, 0 Traynor, J Hyland. Specialist) and MS.Denise Grant(Coloproctology Research Irish Journal of Medical Science 1996; 166: Suppl 2, 17. Nurse). Their enthusiasm has allowed the Unit to continue to develop the Anorectal Physiology Laboratory and the OHtcome follolVing Restorative Proctocolectomy. FJ Stomacare service for the Hospital. Shannon, DC Grant, TJ Boyle, OJ Clyne, JMP Hyland. Mr.Justin Geoghegan (S nr.Registrar) left in July to Irish Journal of Medical Science 1996; 166: Suppl2, 9. undertake a Fellowship in Hepatobiliary surgery 111 Perianal Crohn 's Disease. DP 0 Donoghue, JMP Germany. Hyland. European Journal of Gastroenterology and The 4th Coloproctology Study Day was a great success.The Hepatology. In Press. topics covered were Infective Colitis and Pelvic Floor Disorders. ImmHnohistological and FloJll Cytometric Analysis of Lymphocyte PopHlations in the Healthy AdHlt HHman Mr. John Hyland is a member of the following comminees. Appendix. Carton J. Attwood S. Hyland JMP. O'Farrelly C. Irish Journal of Medical Science 1996; 165: Suppl 4, - RCSI Representative Specialist Advisory 20. Committee London - Irish Surgical Postgraduate Training Committee Proctectomy in Crohn 's Colitis. Geoghegan J. Hyland - General Surgery Sub Committee JMP. Int. J.of Colorectal Disease 1996 11 No 3 141 - Court of Examiners FRCSI - Chairman of Division Surgery SVH Evidence for the Polyp Cancer Seqlwlce in Gallbladder - Chairman of Medical Ethics Committee SVH Cancer Harbison J. Reynolds ]V. Sheahan K. Gibney - Coordinator of South East Dublin Department RG. Hyland JMP. Irish Medical Journal (in press) of Surgery - Member ofIrish Society of Gastroenterology Inflammatory Bowel Disease Directorate Meetings - 1996 ______
Specialist Advisory Committee Hospital Inspections, South Publications - 1996 ______East Thames, February 1996
A Comparison between SHprapHbic and Urethral Bladder International Inflammatory Bowel Disease Meeting, Catheterisation in Elective Abdominal Surgery. M Barry, M Amsterdam, March 1996 Mc Nicholas, P Gillen, 0 Traynor, J Hyland. Journal of the Irish College of Physicians and Surgeons; In Press. Inflammatory Bowel Disease, Chester, April 1996
Pathological evidence in SHpport of Total Mesorectal Excision Surgical Discussion Group, Waterford Regional Hospital, in the Management of Rectal Cancer. ]V Reynolds, WP May 1996 Joyce, J Dolan, K Sheahan, JM Hyland. British Journal of Surgery 1996; 83: 1116-1120. Tripartite Coloproctology Meeting, American Association of Colorectal Surgeons, American Association of Colorectal Septic Complications in the Management of Colovesical and Surgeons, Association of Coloproctologists Britain and Colovaginal FistHlae. G Bourke, SEA Attwood, L Ireland, July 1996 Lawlor, J Hyland. Irish Journal of Medical Science 1996; 165: Suppl 4, 58 Invited Chairman of Inflammatory Bowel Disease
Amlltai Report 1996 '" St. Vincent's Hospital ~ e.C' ... ~ 1
Directorate Irish Society of Gastroenterology, Ennis, The Challenge of Cancer in the Elderly. Recovery and August 1996 Rehabilitation from Radical Surgery. JMP Hyland. Oncology Study Day, Education & Research Centre, St. Inaugural Meeting, RCSI, October 1996 Vincent's Hospital. November 1996.
Waterford Surgical October Club Meeting, Ardkeen Management of Recto Vaginal Fistula. JMP Hyland. Hospital, Waterford, October 1996 Surgical Discussion Group Dublin. November 1996.
Outcome FolloJVing Restorative Proctocolectomy. FJ Presentations - 1996 ______Shannon, DC Grant, TJ Boyle, OH Clyne, JMP H yland. ISG. November 1996. Ano Rectal Crohn 's Disease. J. Geoghegan, JMP H yland. Irish Association of Coloproctology, Limerick. May 1996 Surgery for Ileocolic Crohn's Disease. OJ Clyne, M Eogan, T Boyle, D Grant, F Shannon, 0 Traynor, J Hyland. Septic Complications in the Management of Colovesical and ISG. November 1996. Colovaginal FistuJae .. G. Bourke, S.E.A Attwood, L. Lawlor, J. Hyland. Sylvester 0' Halloran Surgical Surgery for Gallstones in the Laparoscopic era. I Norton, T Scientific Meeting. March 1996 Boyle, M Eogan, El Mudaffar, 0 Traynor, J Hyland. ISG. November 1996. Disorders of the Pelvic Floor The Clinical Spectrum. JMP Hyland. Third Coloproctology Study Day, Education & Transanal Advancement Flap Repair of a Rectovaginal Research Centre, St. Vincent's Hospital. August 1996 Fistula. 0 Clyne, T Boyle, J Hyland. RAMI Surgical Section December 1996.
Plastic Surgery ______
A number of significant developments occurred in 1996 in The majority of elective plastic surgery cases are admitted the Department of Plastic Reconstructive and Aesthetic through the five day ward and the day ward. Surgery. For the first time there is now a plastic surgery unit with the appointment of two full-time plastic surgeons Three hundred and fifty nine patients were admitted to the . Mr. Seamus O'Riain continues as a locum plastic surgeon plastic surgery service in 1996. One hundred and six and will be with the department until the end of December patients passed through St. Mark's Day Centre Ward. 1997. Two full-time plastic surgeons were appointed in Three hundred and ten cases were dealt with under local September 1996. anaesthesia in the extra mural theatre. There are two plastic surgery outpatients and a hand clinic per week. A total of Mr. Tom O'Reilly who has been filling the role for 4 years 2,882 patients attended these clinics. Mr. Seam us O'Riain as a locum plastic surgeon has been appointed to a pu blished an article in the Irish Medical Journal, permanent position. Miss Margaret O'Donnel1 was September/ October '96, volume 89, number 5, page 170. appointed to the second position. Presently, Miss 1. O'Donnell is working in Adelaide Australia as a clinical fellow in plastic surgery. 2.
In this unit there is a strong emphasis on craniofacial surgery, head and neck surgery, cleft lip and palate surgery, microvascular surgery and hand surgery. There is a nucleus for a third consultant plastic surgeon in St. Vincent's Hospital and this will be actively pursued in 1997.
There are presently two full -time plastic surgeons employed in St. Vincent's Hospital, i.e. Mr. Seamus O'Riain and Mr. Tom O'Reilly. There is one locum registrar position and one SHO position. This latter position is shared with the professional unit. There is one intern attached to tlle department and he or she rotates on a three monthly basis. There are approximately 7 days beds.
Annual Report 1996 St. Vincent's Hospital ~···· - dJ.C"''' 1'
nd d. Department of Anaesthesia ______St.
.d. 1996 was an extremely busy year for the three major areas changes introduced following upon the recommendations of clinical activiry - Anaesthesia, Intensive Care and Pain of the Theatre Task Force and the Management Management. Consultancy Group 'Cannizaro' have improved the PJ working of the theatre complex. [p South East Dublin Department of Anaesthesia - SEDDA ______Theatre Case Load ______n, Staffing deficiencies at Consultant Anaesthetist level within Total - 11,012 d. the various hospitals in the group were largely resolved by the end of 1996. This could not have been achieved without the active support of the Department of Health Intensive Care Unit ______T and Cornhairle na nOspideal. d. Medical Director - Dr. Kieran Crowley Significant progress has been made in a number of other Senior Sister - Ms. Geraldine Carey areas. Consultant - Dr. Pat Benson at :al (A) Academic 1996 saw another busy year in ICU, with a continuation of It is hoped that in the near future a consultant post with a the trend of increasing complexiry of patients'condition. significant academic component can be structured. We are very appreciative of the support received from Comhairle na Activity ______nOspideal, Department of Health and of course the Medical Faculry of UCD and Board of Management of St. leD Activity 1996 Vincent's Hospital. Admissions 566 % (B) Trainee Rotations Surgical 406 72 :d During 1996 a number of trainee anaesthetists commenced rotational trairllng within a number of hospitals with the Medical 160 28 South East Dublin Group. 1 day stay patients 267 47 le ix (e) Equipment Procurement and Maintenance 3 days or more 208 37 Discussions took place during the year with management ]. Transfers from other hospitals 30 5 al representatives from the constituent hospitals of SEDDA towards putting in place a common approach to the Deaths 95 17 purchase and maintenance of anaesthetic equipment within the constituent hospitals. n 1996 1994 1993 I, All are agreed that such a system would be l 1. Cost effective. Admissions 566 544 559 Surgical % 72 80 77 2. Would ensure that all anaesthetic equipment in use met an acceptable operational standard. Medical % 28 20 23
Appointmenu ______1 day stay patients % 47 51 44.3 3 days or more % 37 31 35 Dr. Raymond Victory to St. Vincent's Hospital/St. Luke's Deaths % 17 14 16.8 Hospital is due to take up his appointment in early 1997.
Dr. Dermot Kelly to St. Vincent's Hospital/Royal Victoria Addendum Eye and Ear Hospital is due to take up his appointment in Spring 1997. Source of Admission Anaesthesia/Operating Theatre Activity __ A&E 72 The Department has coped well with a significant increase Ward 368 in the complexiry of surgery performed at St. Vincent's Private Hospital 96 Hospital in recent years. This is true both for elective Other Hospital surgery, emergency surgery and liver transplantation. The 30
Ammal Report 1996 St. Vincent's Hospital
Medical Surgical 1 day 57 210 2 days 23 68 3 days or more 80 128
There is a gradual trend away from short stay elective postoperative patients to more complex, emergency patients.
Pressure on availability of ICU beds necessitated postponement of elective surgery cases on many occasions, causing an upset in the working of other departments and undesirable delays in treatment of patients.
Cross-infection with resistant bacteria (particularly MRSA) continues to be a problem in the hospital, ICU being no exception.
Staffing Admissions During the year the ICU welcomed the arrival of Ms. Anne St. Catherines Ward 209 Lister to the post of Junior Sister. A part-time St. Mark's Ward 120 secretary/receptionist Ms. Antoinette Copley, was Extra Mural Theatre 220 appointed during the year, who will relieve nurses of clerical duties and who has already helped in gathering statistics for Staffing 1996. Or. James Lyons who completed his Senior Registrar Training in SVH in July 1996 has now been appointed Further Education Consultant Anaesthetist with an interest in Pain An increasing number of nursing staff are engaged in formal Management with attachment to the Royal Victoria further education, including degree courses in psychology, Infirmary and Freeman Hospital in Newcastly, UK. business studies, nursing studies, and courses III management and personnel management. Or. Simon Adanlo (Australian Exchange Resident) who spent almost 9 months working with the Pain Service Developments during the course ofl996 has been appointed as the Fellow The ICU has been a contributor towards the development in Pain Management at the North Shore Hospital, Sydney, of MICAS (Mobile Intensive Care Anlbulance Service) Australia under the directorship of Professor Michael which got under way during the year. This involves Cousins. providing a suitably qualilfied staff nurse and doctor to carry out transfer of criticallly ill patients from peripheral to It is gratifYing for tlle Department of Anaesthesia and referral hospitals, during "regular" hours, Monday to Division of Pain Management staff to see both these Friday. There is a specially equipped ambulance and residents placed and still involved in Pain Management in dedicated driver provided through the Eastern Health these excellent units. Board. This service is already being seen, particularly by the peripheral hospital, as an improvement in the safety of patients undergoing such transfers. Post Registration Anaesthetic Nursing Course (PRANC) The eight Post Registration Anaesthetic Nursing Course The ICU received upgrading of the equipment for commenced in April with 6 student participants. The continuous renal replacement therapy (CRRT), which is Department of Anaesthesia is actively involved in me working out well. lecture programme and clinical instruction. The second National Epidural Study Day for Nurses was held in March Pain Management Services ______of this year.
Pain Management Activity (1996) Congratulations to Sr. Maureen Flynn on receiving me Cecil King Memorial Award at the recent Prizegiving. Otttpatient Consults 265 (In-house) Presentations Pain Clinic: New 174 Total Attendances 1199 «CPAP impairs JVeaning from mechanical ventilation». Dr. K. Crowley. European Society oflntensive Care Medicine, Follow-Up Clinic (SARC) 800 Glasgow 1996. Pain Management Programme 80 «Closed Sttction does not reduce contaminaton of hands». Dr.
AmHtal Report 1996 St. Vincent's Hospital \I···· .. a lBC""Sl1 et
K. Crowley. European Society ofIntensive Care Medicine, Air Ambulance Conference - Berlin. 9th & lOth May - Dr. Glasgow 1996. P. H ealy.
"PEEP: the unSltspected inotrope". Dr. P. N aughton; Air Med "96 World Congress - Munich - June 11th - 14th. Intensive Care Society ofIreland, Autumn Meeting 1996. What Cost Chronic Pain? Sheehan J. McKay J, Ryan M, "Waititwfor Godot: when to operate after fat embolism". Dr. Walsh N , O 'Keeffe D. B. Golden; Intensive Care Society of Ireland Autumn Irish Medical Journal Nov/ Dec Volume 89, Number 6. Meeting 1996. Royal Academy of Medicine Lecture on Chronic Pain "Blind placement of nasoduodenal feeding tllbes". Dr. Management. M.Griffm; Intensive Care Society of Ireland Autumn Meeting 1996. Presentation on (Interventional Pain Management> at the "Maternal and fetal effects of adrenaline with bupivicaine Annual Scientific Meeting of the Irish Society of Chartered (0.25%) for epidural analgesia during labour". M. Dounas, Physiotherapists - Dr. Declan O'Keeffe. B. O'Kelly et al. European Journal of Anaesthesiology 1996; 13; 594 -598. Presentation on Chronic Pain to the Bray Clinical Society - Dr. D. O 'Keeffe.
Department of Cardiology ______
During 1996, the Department of Cardiology continued to We have been engaged in ongoing discussions with the develop a comprehensive in-patient and out-patient General Practitioners Liaison Committee on the provision diagnostic and therapeutic service. The accompanying of direct access services for Echocardiography, Exercise statistics show an increase in the total number of cases dealt Testing and Holter Monitoring. A pilot project has been with, in the number of non-invasive and out-patient agreed and funding to implement this is being sought. It is investigations performed and in the complexity of these hoped tllat work in this area can begin before the middle of investigations and of invasive investigations in the this year. In this respect I would particularly acknowledge catheterisation and angiographic laboratory. The overall the contribution of Dr. Rita Doyle and Dr. Paul Lacey. number of patients investigated in the catheterisation service remained the same but the complexity of the We already run an open access Chest Pain/ procedures carried out increased. In line with the Electrocardiograplucy Clinic for all General Practioners. directions given by the Board of Management, every effort This is not a recognised Out-Patient Clinic and is held in has been made to contain the costs incurred by the the Cardiac Department on four afternoons of each week. Department and this reflected in the numbers of invasive Patients referred by General Practioners get an ECG and if investigations carried out, which remained constant. Many any abnormality is detected by tile Senior House Officer or of the patients so treated however can now be managed by Registrar, the patient is seen and advised or treated medical interventional techniques such as Angioplasty and appropriately. This clinic was attended by 1159 patients in Stenting and this reflected in the rise in the total number of 1996 and would undoubtedly be used by more Practioners interventional procedures from 87 to 105. A considerable were it to be publicised. Unfortunately due to staffing number of patients undergoing these procedures required problems we are unable to expand this service at present multiple vessel coronary angioplasty and stenting and this is but has proved a highly cost effective way of reducing the reflected in a substantial rise in costs. It can be anticipated burden on the Accident & Emergency referral service and that this trend will continue and a larger number of patients on containing the number of acute admissions. It also who would currently be placed on tile surgical waiting list reduces the burden on tile regular Out-Patient Cardiac will be managed by medical interve ntional procedures. Clinics. Consideration should be given to the proper Assuming that the- total numbers of patients being recognition and the funding of this clinic. investigated in the Laboratory remains constant, a substantial further increase in interventional costs is likely During the year Dr. Elizabetll Dilill decided to pursue a this year. career in other aspects of medicine and resigned as Director of Rehabilitation and Research. Her departure left a gap The total number of non-invasive investigations in the which it has been difficult to fill but we are hoping to Department increased substantially. Tlus reflects further appoint a Coordinator of Rehabilitation early in 1997. In effort on the part of the staff to carry out all possible the meantime the rehabilitation service has been firmly investigations as out-patients and so to both reduce demand established and courses of six weeks duration for six to eight on in-patient beds and to give a more efficient service to patients are now rWl on a continuing basis. We would like those referred to us . to express our appreciation of the services of Dr. Dinn and of the Staff who served and trained with her and who are
Annual R eport 1996 St. Vincent's Hospital
now running the service. We welcome Dr. Aine Tubridy We are outlining our efforts to rationalize cardiological who has joined the team as a Clinical Psychologist and who services within the Dublin South/ Eastern Metropolitan will concentrate on the rehabilitation of patients with major Area. As reported last year, an agreement has been reached stress problems, following myocardial infarction or surgery. with St. Michael's Hospital on the appointment of an additional Cardiologist. Unfortunately this appointment is Research in the Department continues and during the year still awaiting sanction by the Department of Health. As this a number of papers were published. The European study appointment was given priority by the Hospital last year, on pacing in hypertrophic cardiomyopathy of which Dr. and was approved by the Board several years ago, the delay Maurer was a founder and is treasurer was completed and in proceeding this appointment is a matter of extreme confirmed the effectiveness of this treatment in certain concern. Until this problem has been solved, it will not be types of hypertrophic myopathy. The RlTA II Trial, a major possible to develop services at St. Vincent's Hospital any international cooperative study on Angioplasty compared to further and it will be extremely difficult if not impossible to surgery has also been completed in terms of recruitment maintain the current level of service. It will certainly not be but follow-up in continuing. A number of other studies possible to extend the facilities of this hospital to the other continue and some new projects are planned. hospitals in our area as we would like and as we have been Unfortunately staffing and space difficulties have made it requested to do. very difficult to undertake, the number of studies which would be appropriate to a unit of this size and importance. Finally we would like to thank all the Staff of the Coronary It is hoped that this problem can be solved within the Care U nit, the Catheterisation and Invasive Laboratory, the context of the new development. non-invasive investigative area, the Cardiac Department and our Secretarial Staff for their unswerving loyalty, We referred above to the complexity of the procedures support and dedication to the patients referred to this unit. undertaken. This is true not only in the field of cardiac Without their ready and good humoured acceptance of the catheterisation but in the therapeutic and non-invasive difficulties and short-comings of the Department, it would diagnostic areas. be impossible to provide a prompt,humane and compassionate service to our patients. We would also like More sophisticated forms of cardiac pacing are becoming to thank the Chief Executive and his Staff, who have been essential in the management of patients with compels extremely supportive and pro-active in trying to solve the conduction system disease and rhythm disturbances. problems which beset us . We hope that it will be possible Implantation of artificial defribrillatiors is now well to submit a more cheerful report at the end of 1997. established as a necessary treatment for a minority of a patients with life threatening rhythm disturbances. While this procedure has not been carried out in St. Vincent's Signed: Hospital to date, some of our patients have been so treated Dr. Brian Maurer & Dr. Peter Quigley outside the country. There is no reason why these patients should not be treated here and funding for these procedures will be actively sought from the Department of Statistics for Department of Cardiology 1996- Health. Additionally increasing sophistication in pacing devices has meant that more complex pacemakers should be Cardiac Department inserted and the percentage of such devices used in this hospital compare to the total pacing load has been relatively ECG/Chest Pain Clinic 1,159 small. This too has to change and will cause some increase in costs. Electrocardiograms 16,434 Exercise Tests 1,184 The limited accommodation available to the Department continues to be a cause of major concern. Shortage of in Echocardiograms 2,399 patient beds results in a turn over of patients which is too Holter Monitor 1,288 rapid for comfort. Any further increase in the numbers of patients demanding in-patient accommodation could have Cardiac Admissions 1,538 disastrous results. While every effort is made to treat all patients who can be managed as out-patients and on a day Cardiac Out-patients 3,933 care basis in an appropriate manner, it should be possible, in the context of the new development to expand the Day Investigative Laboratory Statistics Care and Over- ight Services. The possibility of providing hostel accommodation should be explored. Cardiac Catheterisation & Coronary Angiograrns 908 The demands on space with the Diagnostic Department are extreme and the services maintained only by the dedication Pacemaker Insertion 124 and good humour of the Technical, Secretarial and Junior Coronary Angioplasties (PICA) 66 Medical Staff who work under extremely cramped conditions. Again it is hoped that this problem will be Stent Insertion 41 resolved within the context of the new development. Intra-Aortic Baloon Pump 4
An1lual R eport 1996 St. Vincent's Hospital . ~· ··· . dJc .... " "
Medical Oncology Department ______
1996 was a period of growth and development for the In July 1996 Dr. Fennelly joined me staff of the department Medical Oncology Department in St. Vincent's Hospital. as a Consultant Medical Oncologist. Dr. Fennelly had spent the five years prior to his retun in New York's The Unit continues to have an extraordinary workload. prestigious Memorial Sloan-Kettering Cancer Centre where The Oncology Day Centre provides outpatient oncology he had become an internationally recognised leader in me services five days a week throughout business hours. An treatment of gynaecological cancer. In 1996 Dr. Fennelly ever increasing proportion of our cancer treatments are was invited to join an EBMT working group to develop an administered in the Day Centre setting, and hence, international study of high-dose chemotherapy in ovarian although we operated throughout the entire second half of cancer. 1996 with one third of our beds closed, we have still managed to insulate our patients from any service Another major development which took place during the deficiencies which might have been expected to arise in this year was the announcement of the formal administrative circumstance. In this regard, particular credit is due to the linkage between St. Vincent's Hospital and St. Luke'sjSt. nursing staff both in St. Anne's Ward and the Day Centre. Anne's. There is already a very active collaboration between the two institutions, and both of the St. Vincent's The most noticeable growth has been in the area of clinical Medical Oncology Consultants have major commitments to research. During 1996, 75 patients were accrued to clinical St. Luke's. trials. Several major international projects which were in various stages of planning were activated during the year. Highly successful fundraising events were held in Sotheby's In particular, three international trials which are chaired or in London and in Donnybrook Lawn Tennis Club. co-chaired here in St. Vincent's made steady progress. The Anglo-Celtic study of high-dose versus conventional The educational activities of the department also continue chemotherapy in women with multi-node positive breast to expand. Weekly oncology, pathology, radiology and cancer has now recruited over 200 patients throughout breast conferences are held. Drs. Crown and Fennelly Europe, including 13 patients here in St. Vincent's. The lectured in the UK, Signapore, Austrialia, Italy, France, European Breast Cancer Dose Intensiry Study, which is a Portugal, Germany, Austria and Spain. similar trial aimed at women whose cancer has already become overtly metastatic, accrued its fLrst patients during The Unit wishes to acknowledge the outstanding co 1996, and following its ongoing pilot phase, formal operation it has had in its development from our colleagues randomisation will be activated in the spring of 1997. In in the various disciplines of surgical oncology and also addition, St. Vincent's is co-chairing an international study radiation oncology. ofTaxotere-containing adjuvant chemotherapy for women with node-positive breast cancer, and again tl1e first patients Publications were recruited on the study during 1996. Major infrastructure developments in the research front were the E. O'Reilly, Crown J; Second cancers complicating setting up of the national headquarters for the Irish Clinical Hodgkin's disease; Ann Oncol. 7(4 ) 405 - 8, 1996. Oncology Research Group, and the international headquarters for the European Breast Cancer Dose Crown J. High -Dose Chemotherapy in Resistant Breast Intensiry Study on the St. Vincent's campus. Two very Cancer. The Breast 5;298-303; 1996. experienced Senior Clinical Research Coordinators have been hired to supervise these projects. Hudis C; Seidman A; Raptis G; Fennelly D; Gilewski T; Baselga J; Theodoulou M; Sklarin N; Moynahan M; In July, Professor J ames J. Fennelly retired from his position Surbone A; Currie V: Lebwohl D: Uhlenhopp M; as Consultant Medical Oncologist in the hospital and Crown J, Norton L. Seqltential adjuvant therapy; me Professor of Oncology Research in UCD. It is difficult to Memorial Sload Kettering Cancer Centre; Scmin oncol 23; adequate justice to Professor Fennelly's extraordinary (1 suppl) 58-64, 1996. contribution to the development of medical oncology in tllls country. He was the founder of the specialiry in Ireland Hudis C A; Seidman A D; Crown J P; Balmaceda C; and for may years the sole medical oncologist working Freilich R.; gilewski T A; Hakes T B; Curriee V: wimin me jurisdiction of the state. Few clinicians can have Lebwohl D E; Base1ga J: Raptis G; Gollub M; Robles had as great an impact on the standards of care for a whole M; Bruno R.; Norton L. Phase II and pharmacologic study specialiry in a country as did Professor Fennelly. In addition of docetazel as initial chemotherapy for metastatic breast to his successful efforts in building up medical oncology, cancer, J Clin Onco114: (1) 58 - 65, 1996 particularly in St. Vincent'S, The National Children's Hospital and the National Materniry Hospital, he had a Gogas H; Fennelly D, Avascular necrosis following crucial role in education and has maintained an active entensive chemotherapy and dexamethasone treatment in a research interest iliroughout his professional life. He was patient with advanced ovarian cancer. Gynaecol Oncol 63; also me founding President of the Irish Sociery of Medical (3) 379-81, 1996. Oncology.
A1l1mai Report 1996 ••• St. Vincent's Hospital I 'J .. •C~ l ' Gilewski Tj Baselaga Jj Theodoulou Mj Sklarin Nj Fennelly Dj Kelsen DP. The role of chemotherapy in the Moynahan Mj Survone Aj Curriee Vj Lebwohl Dj treatment of adenocarcinoma of the pancreas. Hepato Uhlenhopp Mj Crown Jj Norton L. Sequential adjuvant Gastroenterology, 43 (8) 356 - 62, 1996. therapy. Seminars in Oncol; 23 (1 Supp 1) 58 - 64, 1996
Seidrnan A Dj Hochhauser Dj Gollub Mj Edelman Bj Gogas Hj Shapiro Fj Aghajanian Cj Fennelly Dj Yao TJj Hudis CAj Frands Pj Fennelly Dj Gilewski T Aj Almadrones Lj Hoskins W J j Spriggs D R. The impact of Moynahan M Ej Curriee Vj Baselga Jj Tong Wj Disbetes mellitus on the toxicity of therapy for advanced Donaghue Mj Salvaggio R; Auguste Lj Spriggs Dj ovarian cancer. GynaecolOncol. 61 (1) 22-6 1996. Norton L. Ninety-six hour paclitaxelinfusion after progression during short tazane exposure. J Clin Oncol 14 Fennelly D. The role of high-dose chemotherapy in tbe (6) 1877-84, 1996 management of advanced ovarian cancerj Current Opinion in Oncology; Sept 1996. Hudis Cj Seidrnan Aj Raptis Gj Fennelly Dj Gilewski Tj Baselga Jj Theodoulou Mj Sklarin Nj Fennelly Dj
Gastroenterology / Liver Unit / National Liver Transplant Programme------
As in previous years the clinical activity of the Education & Research ______gastroenterology and liver services continue to expand mainly as a result of increased out-patient activity with over The Gastroenterology and Liver Unit hosted the annual 6,000 patients being processed through general Coloproctology and Hepatobiliary Study Days which have gastroenterology, colorectal, liver and viral hepatitis clinics. now become an established focal point for highlighting the The elective investigation of gastroenterological and liver specialist interests of the Unit. Both these meetings, disorders continued to be largely facilitated by the one and addressed by renowned international speakers, were five day units in St. Mark's and St. John's ward which saw attended by over 200 delegates representing G.I. and Liver an increase of 10% on the activity of 1995. The G.I. and Units around the country. National and international Liver Unit continues to attract an increasing number of meetings attended by various members of the Unit included complex diagnostic and management problems particularly the American Gastroenterological Association, the in the areas of chronic inflammatory bowel disease and in a American Association for the Study of Liver Disease, the broad spectrum of acute and chronic liver diseases. In European Association for Gastroenterology, the British particular the introduction of transjugular stent shunts, a Society of Gastroenterology, World Congress in non surgical method of treating complications of portal Immunology in addition to national meetings of the Irish hypertension, has seen a significant increase in the referral Societies of Gastroenterology and Immunology the Irish of patients with advanced chronic liver disease. 1996 saw Association of Pharmacology. A total of 25 abstracts were the Liver Transplant activity fall to its lowest level since the presented by members of the Unit at these meetings. programme commenced in 1993 with twelve patients undergoing liver grafting. Despite the reduced liver The research interests of the Gastroenterology Unit transplant activity in 1996 allied surgical activity and donor continue to focus on inflammatory bowel disease and organ retrieval increased significantly. colorectal cancer with its major interests in the mechanisms of secretory diarrhoea which continue successfully in collaboration with Or. Alan Baird, Department of Endoscopy Unit ______Pharmacology, U.C.D. 1996 saw the establishment of an inflammatory bowel disease working group of clinicians and Interventional endoscopy continues to play a major role in scientists at St. Vincent's Hospital and U.C.D and which the management of patients with complications with biliary include Or. Alan Baird, and Dr. Paul Moynagh (U.C.D.), tract, oesophageal and colonic disease and with the ongoing Or. Cliona O'Farrelly (Education and Research Centre, development and restructuring of the Endoscopy Unit and S.Y.H. ), Dr. Kieran Sheahan (Department of Pathology the availability of additional staff and radiological screening S.Y.H.), Mr. John Hyland (Department of Surgery S.Y.H.) sessions, it is anticipated that the level of activity in this and Or. Diarmuid O'Donoghue (Department of important area will increase. Despite the initial difficulties Gastroenterology S.Y.H. ). This group will also avail of the related the delay in the opening of the second endoscopy expertise of Dr. Steven Simpson who has a particular suite, over 4,000 procedures were performed during 1996 interest in animal models of inflammatory bowel disease with this level of diagnostic endoscopy likely to increase and who has recently joined the staff of the Educational further with the availability of Open Access Gastroscopy Research Centre from Yale University. Research which will commence on a limited and trial basis. continues into the biology of colorectJ.l cancer in collaboration with Dr. Kieran Sheehan, Mr. John Hyland
An1lual Report 1996 St. Vincent's Hospital
and Dr. Joe DuffY (Department of uclear Medicine appointed Clinical Lecturer at the Liver Unit at King's SVH.). Successful collaboration continues with Dr. Cliona College Hospital, London. O'Farrelly into immunological aspects of coeliac disease. Dr. J. E.Hegarty, and Dr. P.A.McCormick were elected The Liver Immunology Research Group has continued to fellows of the Royal College of Physicians (U.K.) expand under the supervision of Dr. Cliona O'Farrelly and r has initiated a number of collaborative studies which will Dr. Aiden McCormick and Mr. Oscar Traynor were invited I significandy broaden the scope of the group. The main lecturers at international liver update meetings in Malaysia areas of research include a) Haematopoietic and and Bangladesh respectively. Lymphopoietic potential of normal adult liver - Initial results from this novel area of research has prompted a Dr. Diarmuid O'Donoghue completed his two year collaborative study with Prof. Hergen Spits of the presidency at the Irish Society of Gastroenterology. Netherlands Cancer Institute in Amsterdam where Dr. Orla Crosbie has spent three months refining techniques which Dr. J. Hegarty was elected to the Consultative Council on will be used to support the investigation of a possible Hepatitis C infection. haematopoietic/lymphopoietic function for the human liver in adult life. b) The molecular evidence for Bibliography ______extrathymic T-Cell maturation. c) Liver T-Cells sub populations in the normal human adult liver and d) 1. Long-term outcome following curative surgery for Immunohistochemical properties of lymphoid populations malignant large bOlVel obstruction. in the normal liver, in conjunction with Dr. Niamh Nolan Mulcahy H.E., Skelly M.M., Husain A. and (Department of Pathology S.v.H). The initial studies have O'Donoghue D.P. indicated that the adult human liver maybe an extrathyrnic British Journal of Surgery (1996) 83: 46-50. site ofT cell maturation/development and contains within it, unique subpopulations of Iymphocytes the function of 2. The diagnosis of iron deficiency in patients with which may have important implications for the Rhmmatoid Arthritis and anaemia: an algorithm understanding of graft tolerance and cellular rejection using simple laboratory measures. following liver transplantation. Mulherin D., Skelly M., Saunders A., Mc. Carthy D., O'Donoghue D.P FitzGerald 0., Bresnihan B. and During 1996 a successful application was made to the Mulcahy H. Health Research Board for the establishment of a Hepatitis J. Rheumatol., (1996), 23.237-240. C Research Unit in the Education and Research Centre as part of a collaborative study with the Virus Reference 3. An image a1mlysis study of DNA content in early Laboratory (Prof. William Hall) the Department of colorectal cancer. Biological Sciences, Maynooth (Dr. Kingston Mills) and Kay. E., Mulcahy H.E., Curran B. , O'Donoghue D.P T.C.D. Medical School St. James's Hospital (Dr. Dermot and Leader M. Kelleher). This unit, established to evaluate the European J. of Cancer (1996) 4: 612 616. mechanisms of liver cell damage and progression of disease and the persistence of virus infection will receive funding of 4. Bone remodelling indices and secondary £700,000 pounds over the five year period of the grant. hyperparathyroidism in Coeliac disease. Keaven y A.P., Freaney R. , McKenna M,J., Masterson The Unit's interest in the pathophysiology of portal J. and O'Donoghue D.P. hypertension continues with the Health Research Board The American J. of Gastroenterology (1996) 91 funding of studies examining the effects of somatostatin 6 1226-1231. and octreotide on the splanchnic circulation in an animal model of portal hypertension and which are being 5. Prognostic significance of pS3 abnormalities in supervised by Dr. Aiden McCorrnick and Prof. James Colorectal carcinoma detected by PCR -SSCP and Docherty (Department of physiology RCSI). immunohistochemistry analysis. Dermot T. Leahy, Reem Salman, Hugh Mulcahy, Based on the research activities of the Unit several members Kieran Sheahan, Diarmuid P.O' Donoghue and Nollaig will receive higher degrees and include Dr. Maeve Skelly A. Parfrey. (PhD), Dr. Suzanne Norris (PhD), Dr. Orla Crosbie (MD), The Journal of Pathology (1996) 180: 364-370. and Dr. M. Curry (MD). 6. RAG1, RAG2, and pre-TcR expression in the human Prizes / Awards ______adult liver: evidence for extrathymic T cell differentiation. Dr. Maeve Skelly was awarded the William Stokes prize Collins C, Norris S, McEntee G, Traynor 0, Bruno L. from the Royal College of Physicians of Ireland and von Boehmer H, Hegarty 1, O'Farrelly C. obtained a two year Health Research Board post-doctoral Eur J Immunol ( 1996 )26: 3114-18. fellowship in Gastroenterology and Pharmacology. 7. Orthotopic liver transplantation for veno-occlusive Dr. Suzanne Norris also obtained a Health Research Board disease complicating autologous bone marroJV post-doctoral fellowship and in ovember 1996 was transplantation.
Annltlll Report 1996 St. Vincent's Hospital
Norris S, Crosbie 0, McEntee G, Traynor 0, Nolan Keogh B, Watson A. Preside N, McCann S, Hegarty J. The Irish Journal of Medical Science (1996) 165 (41: of Me, Transplantation (1996) In press. 271-273 Disord Society 8. Brain MRI changes in chronic liver disease. 11. The prevention of relapse in reflux oesophagitis· Skehan S, Norris S, Owens T, Hegarty J, MacErleanD. a placebo controlled study of Ranitidine lSOg B D Papers European J. Radiology (1996) In press. and Ranitidine 300g BD. Labora Hegarty J, Halvorsen L, Hazenberg B, Nowak A, numbe 9. Resolution of paraneoplastic duct pattcity following Smith CL, Thompson A, Vantrappen G, McKe nna C, Ameri successful treatment of Hodgkin's disease. MillTG. Socie. Crosbie 0, Nolan ,Crown J, Hegarty J. Can J Gastroenterol (1996) In Press. (Decer Hepatology (1996) (In press)
10. Acute renal failttre in orthotropic liver tra11Splantation. Actili Thomas G, Ke lly D, Crosbie 0, Norris S, Hegarty J,
Department of Respiratory Medicine ______
Sleep Labo1·atory ______Deirdre Donaghy made presentations at the 4th The workload of the Sleep Laboratory continues to grow International Conference for Health Promoting Hospitals rapidly, and despite an increase of 67% in the number of and The Irish Thoracic Society annual meeting. She also patients investigated in the Laboratory during 1996 organised a successful Respiratory Information Day in compared to 1995, the waiting list fo r new patients with November 1996 with 130 delegates. Further training suspected sleep apnoea in the out-patient clinics remains at updates are planned for 1997. She was co-author of 'A approximately one year. There is an urgent need for a One-Year Prospective Audit of an Asthma Education comprehensive plan to cater for this large and growing Programme in an Out-Patient Setting', published in the patient population. Irish Medical Journal and was guest speaker at The Irish college of General Practitioners and Asthma Associations. Asthma Centre ______Deirdre Donaghy is Chairperson of the Asthma Nooc Association Ireland (Anail).[Meetings are held every two Sr. Deirdre Donaghy, Asthma Nurse Specialist, has months]. responsibilty for the Asthma Education Centre. The 2. D Director of the Centre is Dr. W Mc Nicholas. There were 1,537 patient consultations in 1996. This Dr. McDonnell was a member of the Working Party on includes those patients seen in the Out Patient Department, Tuberculosis originally established by the Minister for Asthma Centre and as In-patients. Health in October 1992 to evaluate policy on the prevention and treatment of tuberculosis. The final repon 3. Patients with asthma are guided through an asthma of the group was published in 1996. education programme which explains the patient's condition, medicines used, possible side effects, Academic Achievements -______deteriorating signs, action to be taken, home peak flow monitoring, trigger factors and family involvement. Other Grant Awards 4. interventions with patients diagnosed with Respiratory illnesses, include checking and instruction in, the numerous Dr. John Kiely continues a Health Research Board i1' inhaler and spacer devices, ordering home nebuliser Fellowship in the Respiratory Sleep Laboratory. Cl compressor units, Oxygen concentrators, and advice on their use and maintenance. Dr. Waiter McNicholas continues a three-year Health 5. D Research Board grant which has allowed the employment of E a Science graduate to undertake studies towards a PhD d The role of the Asthma Nurse Specialist involves the degree. J provision of Inservice-education, which comprises of 8 workshops on nebuliser compressor units and inhaler device Dr. McNicholas continues his appointment as Associate technique; Delivering lectures in the school of nursing, at Editor of the European Respiratory Journal, which is the 6. M ward level, to post graduate groups, and visiting nurses; on official journal of the European Respiratory Society, and is C the role of the Asthma Nurse, Patient education, also a member of the Editorial Board of the European Q Compliance, Medicines in Asthma, and inhaler device Respiratory Review. 8 technique. Dr. McNicholas also continues his appointments as
Allll ual Report 1996 St. Vincent's Hospital ······ • w tWJC~$1'
President of the Section of Medicine in the Royal Academy 7. McNicholas WT. (4): of Medicine in Ireland, and as Chairman of the Sleep Diagnostic criteria for sleep apnoea - time for Disordered Breathing Group of the European Respiratory consenms? (Invited editm·ial). Society. EUROPEAN RESPIRATORY JOURNAL 1996; tis - 9:634-635. D Papers arising from research in the Respiratory Sleep 8. Kiely JL, Delahunty C, Matthews S, McNicholas WT. Laboratory have been presented throughout 1996 at a Comparison of a limited comp/~terizes diagnostic A, number of international scientific conferences including the system (ResCare Autoset) with polymmlOgraphy in the a C, American Thoracic Society (May), European Respiratory diagnosis of obstmctive sleep apnoea syndrome. Society (September), and British Thoracic Society EUROPEAN RESPIRATORY JOURNAL 1996; 9: (December). 2360-2364.
9. Deegan PC, McNicholas WT. Activity ------Comparison of a sustai1led -release theophylline with a long-acting inhaled beta agonist (salmeterol) in the Admissions: 781 management of nocturnal asthma. Outpatient Attendances: New 346 BRITISH JOURNAL OF CLINICAL PRACTICE Total 1576 1996.
Pulmonary Laboratory attendances: 3387 Abstracts Sleep Laboratory: 157 admissions 1. Kiely JL, McNicholas WT. TB/Chest Clinic attendances: 443 The effects of nasal continuous positive airway pressure 4th (Excludes Contact Tracing) treatment on subjective quality of life in partners of tals patients with sleep apnoea. uso IRISH JOURNAL OF MEDICAL SCIENCE 1996; m Publications: Dr. McNicholas ______165 (suppI4): 72. ing 'A Full papers: 2. Kiely JL, McCabe M, McNicholas WT. Ion Multiple pulmonary nodules from a malignant the 1. Deegan PC, McNicholas WT. chondroid syringoma; a case report of a rare tl/mOU1' 1sh Predictive value of clinical features for the obstructive and its features. Ins. sleep apnoea syndrome. IRISH JOURNAL OF MEDICAL SCIENCE 1996; rse EUROPEAN RESPIRATORY JOURNAL 1996; 165 (suppI4): 72. wo 9:117-124. 3. Kiely JL, McNicholas WT. Response of patients and bed partners to nasal 2. Donohoe P, McNicholas WT. An unusual case of orthopnoea. continuous positive airway pressure (NCPAP) for on POSTGRADUATE MEDICAL JOURNAL 1996; obstructive sleep apnoea. for IRISH JOURNAL OF MEDICAL SCIENCE 1996; 72:439-440. be 165 (suppl 2): 12-13. xt 3. Mulloy E, Donaghy D, Quigley C, McNicholas WT. A one-year prospective audit of an asthma education 4. Kiely JL, Buckley A, Shiels P, Deegan P, Maurer B, programme in an out-patient setting. McNicholas WT. IRISH MEDICAL JOURNAL 1996; 89: 226-227. Awake hemodynamic effects of nasal contillllOlts positive airway presmre (NCPAP) in patiC1lts with severe heart failure: comparison of differertt levels of 4. Mulloy E, McNicholas WT. Ventilation and gas exchange during sleep and exercise NCPAP in sinus rhythm and atrial fibrillation. rd in patients lVith severe COPD. AMERICAN JOURNAL OF RESPIRATORY AND CHEST 1996; 109: 387-394. CRITICAL CARE MEDICINE 1996; 153 (SUPPL): 468 th 5. Deegan PC, olan P, Carey M, McNicholas WT. of Effects of positive airway pressure on upper airway 5. Kiel), JL, Delahunty C, Matthews S, McNicholas WT. D dilator muscle activity and ventilatory timing. Comparison of a limited diagnostic system (Rescare JOURNAL OF APPLIED PHYSIOLOGY 1996; Autoset) with computerised polysomnography in the 81 :470-479. diagnosis of sleep apnoea syndrome. te AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE 1996; 153 (SUPPL): le 6. McNicholas WT. is Clinical assessment of sleep apnoea (invited revielV). 871. In QUARTERLY JOURNAL OF MEDICINE 1996; 6. Kiely JL, Buckley A, Shiels P, Deegan P, Maurer B, 89:637-640. McNicholas WT.
IS Comparison of different levels of nasal continuous
Ammal Report 1996 ···· St. Vincent's Hospital , '" dJC"''S1'
positive airJVay presSltre (NCPAP) in sinus rhythm and Publications: Dr. T. McDonnell _____ atrial fibrillation in patients lvith severe congestive heart failMe. 1. Davern SM, O'Connor CM, McDonneU TJ: EUROPEAN RESPIRATORY JOURNAL 1996; 9 Lipopolysaccharide does not induce neutrophil (suppl 23): 19s. adhesion to hmnan pl{lmonary endothelial cells. Irish The Journal of Medical Science 1996;165:S(2)11. Dep 7. Kiely JL, Delahunty C, Matthews S, McNicholas WT. heac Comparison of a limited diagnostic system with 2. Davern SM, O'Connor CM, McDonneU TJ: PMA bllt resu. computerised polysomnography in the diagnosis of not LPS induces neutrophil adhesion to humall suspected sleep apnoea syndrome. have pulmonary endothelial cells. American Journal of EUROPEAN RESPIRATORY JOURNAL 1996; 9 Respiratory and Critical Care Medicine (suppl 23): 198s. The 1996;153:A617. inter 8. Kiely JL, McNicholas WT. dru 3. Johnson H, Lee B, McDonneU TJ: Tuberculin testing dise; Response of patients and bed partners to nasal heaf or mantoux American Journal of Respiratory a11d patif continuous positive airway pressure (NCPAP) for Critical Care Medicine 1996;153:A485. obstructive sleep apnoea. EUROPEAN RESPIRATORY JOURNAL 1996; 9 4. Davern S, O'Connor CM, McDonnell TJ: Interleukill (suppl 23): 463s. l-b induces neutrophil adhesion to human pulmonary endothelial cells. Thorax 1996;51:S(3)53.
Department of Nephrology ______
The Departments' clinical aCUvltIes continue to increase Walsh P., Eustace J., QuinIan D., Watson A. Acute mm/ with over 1,700 dialysis treatments being provided failure dl{e to ureteric obstruction in advanced prostatic throughout the year. Four patients with end-stage renal carcmoma. Irish Journal of Medical Science, 165, p 26, disease received a kidney transplant. 1996.
Funding for two Newman Scholars in Nephrology was Thomas G., Keogh JAB. Acute renal failure in orthotopic obtained and the positions have been filled. liver tra1lSplantation. Irish Journal of Medical Science 1996. Prof. Keogh is President elect of the Royal CoUege of Physician of Ireland and is the current President of the Irish Eustace J., Buckley M., Keane FB., Mellotte G., Keogh Nephrological Society. Dr. Watson is secretary of the Irish JAB. Laparoscopic aided diagnosis of recurrent peritonitis ill Nephrological Society. a patient on CAPD. Neph Dial Trans. Vol 11 ( Nov 1996 ) pp 2338-9. Publications ______Eustace J., Mellotte G., Keogh JAB. The treatment of Whelton A., Watson AJ. Acute renal failure. The post-transplant Erythrocytosis by Angiotensin 1I Type I Co principles and Practices of Medicine, 23rd edition, p 382, meptor antagonists. I eph Dial Trans VaI 11 ( Nov 1996) 1996. pp 2373-4. Dr
Watson AJ., Gimenez LE Chronic Renal Failure. The Eustace J., Buckley M., Mellotte G., Keogh JAB. Principles and Practices of Medicine, 23rd edition, page Nodular regene,·ative hyperplasia of the liver in association 389,1996. with a case of Pauci-Immune crescentic glomerulonephritis. Neph Dial Trans. Whelton A., Watson AJ. Tublar interstitial disease. The Dr. Principles and Practices of Medicine, 23rd edition, p 407, Sheil K., Mulligan S., Keogh JAB. N/{tritional status in 1996. continous ambulatory pertioneal dialysis patients. Peritoneal Dialysis International Vo!. 16; (1996) pp 21-23. Watson AJ., Rock RC. Nitrogen metabolites and "enal function. The Fundamentals of Clinical Chemistry, 4th edition, 1996. Dr
Trerotola SO., Scheel PJ., Watson AJ. Screening for dialysis access graft malfunction: comparison of physical examination JVith ultrasound. Journal of vascular intervention and radiology, 7: pp 15.20, 1996.
A 1l1l1tal Report 1996 St. Vincent's Hospital _·· • v • dJC~',Jl'
Department of Neurology ______
The year was marked most importandy for the Neurology Neuropsychological assessmC1lt In multiple sclerosis: Department by the arrival of Dr. Sean Connolly who now methodological issues and concerns. Multiple Sclerosis 1996; heads the Department of Clinical Neurophysiology. fu a 2:57-65. but result patients for neurophysiological investigation now have an excellent service and an unrivalled expert opinion. Ducros A, Nagy T, A1amowitch S, et ai, Hutchinson M, et al. Cerebral autosomal dominant arteriopathy with me The year was also noted for the introducation of beta subcortical infarets and lettkoencephalopathy, genetic interferon for the treatment of Multiple Sclerosis. This homogeneity, and mapping of the locus with a 2 cM interval. drug has been shown to reduce the relapse rate in this Am J Hum Genet 1996; 58:171-181. 'lg disease but is expensive and requires close monitoring of :nd patients in the Outpatient Clinic. There is a continuing O'Shea B, O'Brien M, Tubridy N, Hutchinson M, trend for increased outpatient activity which is reflected in Bilateral foot-drop and electroconvulsive therapy. Irish both increased numbers seen and in somewhat longer Journal of Psychological Meclicine 1996; 13 :40-41. ~in waiting lists. With the future development of the ~ry outpatient block there will be a need for more weekly O'Riordan Jl, Javed M, McShane D, Hutchinson M, clinics. Murphy R. Superfical siderosis of the central nervous system. Ir J Med Sci 1996; 165:182-184. Difficulty in admirting elective patients for neurological investigation was helped by a waiting list initiative funded Hutchinson M. NelV treatments for multiple sclerosis. Ir by the Department of Health and dle numbers of patients Med J 1996; 89-44. on the waiting list was at a more manageable level by the end of the year. Webb S, Flanagan N, CalIaghan N, Hutchinson M. Hereditary spastic paraparesis and epilepsy. Epilepsia 1996 1ai .tie Dr. Michael Hutchinson was appointed to the advisory (in press). committee established by the Department of Health to ~6, address the problems posed by the newly described new Dr. J. Redmond variant Creutzfeldt Jakob disease. Redmond JMT, McKenna MJ, Feingold M, fuhmed BK. pie Smoking impairs sensation in health individuals. J Irish Coli The neurology Registrars continued to be productive both Ice Phys Surg 1996; 25:19-21. in research publications and presentations. In particular, Dr. Stewart Webb's work on Hereclitary Spastic Paraplegia Tubridy N, Redmond JMT. Nettrological symptoms gh has produced novel finclings on cognitive impairment in attributed to epidural analgesia in labour: an observation this clisorder. Collaborative research with Prof. Nollaig tn stlldy ofseven cases. Brit J Obstet Gynaecol1996; 103:832- Parfrey's team and with Dr. Teresa Burke in 833. ~6 Neuropsychology is casting new insights into molecular genetics of this clisorder and variable phenotypic expression. Redmond JMT. The management of partial seizures. of Irish Med J 1996; 89:54. I Conferences Attended ------) ) Hutchinson S, Redmond JMT. The ma1!agement of Dr Janice Redmond Parkinson's disease. Modern Meclicine 1996; (Supp):l - 3. American Academy of Neurology - San Francisco, B. April 1996 Tubridy N, Redmond JMT. Suddm u1!explained death on First World Congress in Neurorehabilitation and epilepsy (SUDEP). Irish Med J 1996; 89:213. 'H. - Newcasde -on-Tyne, June 1996 Redmond JMT, McKenna MJ. QJtantitive sensory testing. Dr. Michael Hutchinson Muscle and Nerve 1996; 10:403. tn European MS meeting - Copenhagen, September :a1 1996 Redmond JMT, McKenna MJ. Nellt'opathy C1ldpoints. Association of British Neurologists - London, eurology 1996; 46:1193. September 1996
Dr Stewart Webb Po~n------American Neurological Association - October 1996 Langan Y, McCarthy S, Redmond JMT. A case of mitochondrila myopathy. Irish J Med Sci 1996; 165 (Supp Papers Published 1996 2): 29. (Abstract). Langan Y, McCarthy S, Redmond JMT. Phenytoin Dr. Michael Hutchinson induced lymphadenopathy: a case study of phenytoin Hutchinson J. Burke T, Hutchinson M. h,vpersensitivity syndrome. Irish J Med Sci 1996; 165 (Supp
Aml/tal Report 1996 St. Vincent's Hospital
2): 30. (Abstract) Hutchinson J, Burke T, Hutchinson M. A follow-up stt/dy of cognitive, physical and magnetic resonance imagillg Langan Y, McCarthy S, Redmond JMT. Pudendal nerve changes in multiple sclerosis. Europ J Neurol 1996; 243 and bowel control. Irish J Med Sci 1996: 165 (Supp 2): 30. S4:61. (Abstract) . European Neurological Association, Anlsterdam, June McGeeney B, Redmond JMT. Mitochondrial cytopathy - a 1996 - case report. lrish J Med Sci 1996; 165 (Supp 1): 7 (Abstract). Hours M, Cortinovis-Tourniaire P, Moreau T, Hutchinson M, Confavreux C and the PRlMS group. The influence of Papers read and Posters presented pregancy on multiple sclerosis. A European multicentric at Conferences ------prospective study. First results. J eurol 1996; 3:52.
Irish Neurological Association, Belfast, May 1996 - Association of British Neurologists, Norwich, April 1996 -
Webb S, Patterson V, Hutchinson M. Kjellin syndrome (or Tubridy N, Murphy RP, Hutchinson M. Amnesia by the variant)? . seaside revisited. J neurol eurosurg Psychiatry 1996;61:223. Hutchinson J. Burke T, Hutchinson M. Measllri,'B disability in mt{ltiple sclerosis; the patient knoJVs best. American Neurological Association, October 1996 - Langan Y, Hutchinson M. Sudden unexplained death in Webb S, Coleman D, Hutchinson J, Hutchinson M. Pure epilepsy. autosomal dominant spastic paraplegia with late onset dementia; a family study. Ann neurol 1996; 40:530. O'Toole L, McAuliffe D, Hutchinson M. Benign recllrrent optic nmritis. 12th Congress of the European Committee for Treatment and Research in Multiple Sclerosis, Copenhagen, 28 Se pt 1996 -
Department of Clinical Neurophysiology ______
The department of Clinical Neurophysiology became The department is currently staffed by one consultant, one established when Dr Sean Connolly took up his post of senior physiological measurement technician and onc Consultant in Cli nical Neurophysiology on 1st July 1996. secretary who is shared with the Neurology service. The department is part of the South Dublin Clinical Neurophysiology Service, which also includes units at St. A weekly teaching session for the South Dublin neurology James's Hospital and the Meath & Adelaide Hospitals, trainees has been established. The neurology registrar is incorporating the National Childrens' Hospital. The given additional hands-on experience witll performing and department continues to work closely with the department interpreting some of the investigations. Group sessions for of neurology at St. Vincent's Hospital, and in particular the South Dublin neurophysiology technicians have also with neurologists Dr. M Hutchinson and Dr. J. Redmond. taken place, witll the aim of teaching, improving and agreeing metllOds and standards of performing relevant The range of investigative/ diagnostic services provided investigations, and encouraging interest and involvement in include Nerve Conduction Studies (NCS), research projects. Electromyography (EMG), Electroencephalography (EEG) and Evoked Potentials (Eps ). Some facilities and equipment to perform basic neurophysiological Publications ______investigations had been already available prior to 1st July 1996. Routine paper EEGs (reported by Mr F Donovan), Heald A, Connolly S, Hudgson P. Neurosyphilis presenting visual evoked responses (VERs) and some EMG studies had as complex partial status epilepticius. European eurology also been performed in the department of 1996; 36:111-112 Neurology/Neurophysiology between 1st January 1996 and 30th June 1996, using the existing equipment. Baxter P, COlll1olly S, Curtis A, Spencer V, Ravindranath C, Burn J, Gardner-Medwin D. Co-dominant inheritance of Requests for investigations since 1st July '96 have come hyperekplexia and spastic paraparesis. Development from many hospitals throughout the COWl try. A wide range Medicine and Child eurology 1996;38:739-743 of specialities were served, including in particular: Clinical Neurology, Neurosurgery, Psychiatry, Rheumatology and Plastic Surgery and Orthopaedics.
Annual Report 1996 St. Vincent's Hospital , w···· • dJ"C"""n' rdy Dermarology ______ng 43
In December of 1996, after many years of service dedicated Oral Presentations ______ne to dermatology at St Vincent's Hospital, Dr FOC Meenan retired. A new consultant appointment was made to St Irish Association of Dermatologists, Dublin Long tenn Vi ncent's (6 sessions), Hume Street (3 sessions), and St cyclosporin in severe recalcitrant psoriasis. B Kirby, A Watson, on Michael 's (2 sessions), thereby strengthening ties on the S Rogers of South East side of Dublin. nc British association of Dermatologists, Bournemouth Long Or Paul Collins was appointed to this post and he is term cyclosporin in severe recalcitrant psoriasis B Kirby, A ex pected to take up duty towards the end of 1997. Dr Watson, S Rogers Collins was dermatology registrar at St Vincent's and completed his training in Dundee and Leeds. At present, Royal Society of Medicine, London A Case of Dermatitis or he is completing a fellowship in lasers and dermatologic Herpetiformis and Sclerosing Cholangitis B Kirby, 0 surgery in Minnesota. O 'Donoghue, S Rogers ng Or Breege O 'Donnell is Locum Consultant Dermatologist Royal Society of Medicine, London Multiple sql~amous cell at present. carcinomas in a patient with photosensitive dermatitis / actinic retiettloid. B Kirby, S Rogers During the year a total of 1821 patients were treated in the Outpatient clinics. Publications ______'nt Patients requiring Psoriasis Day Care have been treated at Long term cyclosporin in severe recalcitrant psoriasis B Kirby, Hume Street and those who need patch testing are also A Watson, S Rogers Br J Derm 1996 ; 135 :suppl 47 48 investigated at H ume Street. Capsaicin treatment of PUVA itch B Kirby, S Rogers letter Conferences/Courses Attended ______to British Journal of Dermatology (in print)
The following conferences were attended:- Achievements ______
Dermatology Section of the Royal Society of Medicine Or Rogers is President of the Dowling Club of Irish Association of Dermatologists Dermatologists and is also Vice President of the European ne British Association of Dermatologists Academy of Dermatology and Venereology Congress to be European Academy of Dermatology and Venereology ne held in Dublin in September,1997. American Academy of Dermatology International Skin Therapy Forum Or Rogers is the Irish representative to the International Psoriasis from gene to clinic - symposium gy League of Dermatologists and is one of two Irish IS Ambassadors to the World Congress of Dermatology to be 1d held in Sydney in 1997. or so 1d nt Department of Endocrinology & Diabetes Mellitus _____ in
The Department of Endocrinology and Diabetes Mellitus continues in post as Lecturer. Dara Clarke and Ursula provides a clinical in -patient and out-patient service for Fearon, graduate students in the Department for the last 4 patients with disorders of the endocrine glands, including years both submitted theses to the Department of patients with diabetes mellitus. Other conditions include Biochemistry, University College Dublin and both were 'l.g under-activity, over-activity and tumour formation of the awarded Ph.D degrees. David Pattwell continues these gy thyroid, parathyroid, pituitary and adrenal glands, ovaries studies which extend further our understanding of the and testes. In addition, the Department runs basic science control of the different steroid hormones produced by the and clinical research programmes. These include adrenal cortex. All of the studies on the control of adrenal c, examination of the normal control and functioning of the steroidogenesis are undertaken in conjunction with Or. of endocrine glands, evaluation of disease mechanisms, their Sean Cunningham of the Biochemistry Department and in nt diagnosis and their treatment. In June Dr. Frances Hayes, collaboration with the National Kidney Transplant Team, University College Dublin, lecturer in this Department, Beaumont Hospital. Eugene Halligan who initiated said farewell and moved to pursue her career in the research into the impact of the development of diabetes on Reproductive Endocrinology Department of the collagen and who conducted his studies jointly in this Massachusetts General Hospital, Boston. Or. Tarek Fiad Department and in Bristol University also submitted a
Annual R eport 1990 St. Vincent's Hospital
thesis to the Department of Biochemistry University Diabetes urse Specialist Association and Nurse Deirdre College Dublin on his findings . He too was awarded a Gleeson is a member of dle Irish Diabetes urse Specialist Ph.D degree. Medical student Molcfe Rapalai was the Association Sub-Committees for Audit and the Newsletter. recipient of a Summer Research Student Award from the Ms. Kirsten Doherty is co-ordinator of the Diabetes Health Research Board. He investigated specifically the Interest Group of the Irish Nutrition and Dietetic effect of age and gender on the adrenal androgen, Institute. dehydroepiandrosterone sulphate and also cortisol.
The Diabetes Service embraces in-patient and out Meetings attended by Departmental PersonneC patient components. Nurses Jenny Dunbar, Deirdre Gleeson and Nora Col lis are our diabetes nurse specialists International Congress on "The Ovary: Regulation, while urse Justine McGrane combined activities as the Dysfunction and Treatment": Marco Island, Florida, research nurse attached to the Department of January 25th-27th 1996 (Professor TJ. McKenna, invited Endocrinology & Diabetes Mellitus with contributions as a lectllrer) . diabetes nurse specialist. In addition, Ms. Kirsten Doherty is the dietitian associated with the Diabetes Centre. The Symposium on disorders of Growth Hormone Secretion: service provided in the Diabetes Centre includes planned Dublin 20th February 1996 (Professor Tj. McKenna education and counselling programmes for in-patients and invited lecturer) . for out-patients. In addition, the staff provides an emergency service both over the telephone and on a drop Union of European Medical Special ties: Committee on in basis. There are three weekly formal Diabetes Clinics Endocrinology Meeting: Dublin March 23rd-24ili under the direction of Professor T.). McKenna, Dr. A. (Professor Tj. McKenna local convenor and delegate Heffernan and Dr. M. McKenna. In addition to education representing Irish Endocrinologists). and counselling for patients with diabetes in their families, the Centre also provides consultations for hospital nurses, Fifteendl Joint Meeting of the British Endocrine Societies: general practice nurses and public health nurses. This year University College Dublin, March 25dl - 28th 1996 (Six in association with the Department of Preventative papers presented JlIith Dara Clarke, U. Fearon, Dr. Frances Medicine, the Diabetes Centre was involved in a "Diabetes H ayes and Dr. Tarek Fiad as first authors). Training Day" for medical professionals which covered the essentials in background and provision of service for British Diabetic Association Meeting: University College Del ! diabetes patients. Professor T.). McKenna, Dr. A. Dublin, 28th-29th March 1996. 199 Heffernan and Nurse Jenny Dunbar participated in the UCD Diploma in Diabetes Course held in Kuwait. National External Quality Assessment Scheme Meeting: Cardiff, April1st-3rd 1996. P The Endocrine Laboratory continued to provide a busy service in the area of steroid hormone determination The Diabetes Nurses Study Day: Athlone, May 17th 1996. 1. and pituitary hormone assessment. The laboratory also received a grant to establish a national service for the Royal Society of Medicine, Continuing Education SUldy measurement of insulin like growth factor 1 (IGFl ) which Day, Endocrinology: Belfast, Wednesday 22nd May 1996 is useful in the assessment of growth hormone deficiency, (Professor Tj. McKenna invited lecturer). 2. the response to growth hormone deficiency, growth hormone excess, i.e. acromegaly and gigantism, and the International Aldosterone Conference: San Francisco, response to the treatment of dlese disorders. Dr. Tom 10d1-l1th June 1996 Smidl, Principal Biochemist, was awarded an M.SC degree (Professor TJ. McKenna invited lecturer) . 3 in Clinical Biochemistry. Robert Daly started a one year locum in September 1996 for Seam us Connolly who is on 10th International Congress of Endocrinology: San leave of absence to do an MSc in the Institute of Psychiatry Francisco, 12th-15th June 1996 in London. (ProfTj. McKenna invited symposillm lecturer and Sessional 4. Chairman: 6 papers presented JVith Ursula Fearon, Dara Clarke, Dt: Frances Hayes and Dr. Tarek Fiad as first Distinctions ______authors). 5. Joint Meeting Royal College of Surgeons of Ireland and Professor T.). McKenna completed his term of office as The Mayo Clinic, Rochester, Minnosota: Dublin, 26ili- president of the Irish Endocrine Society. In October he was 28th of June 1996 (Professor Tj. McKenna invited appointment Registrar, Royal College of Physicians of lecturer) . 6. Ireland. Professor McKenna is a member of the Health Research Board and is Chairman of the Metabolism and European Association For The Study Of Diabetes: Endocrine Committee and of the Reproductive Medicine Diabetes and utrition Study Group. 14th International 7. Committee. Ms. Marie Culliton, senior medical Symposium on Diabetes and Nutrition: Ascona, technologist in dle Endocrine Laboratory, is a council Switzerland, 30dl June-3rd July 1996. member of the Academy Of Medical Laboratory Sciences. 8. Nurse Jenny Dunbar is Honorary Secretary of the Irish
A1I1l1tal R eport 1996 St. Vincent's Hospital _..- • v - dJc:...",.,..
:dre Diabetes Education Study Group: Switzerland, 12th-17th adequacy of mineralocorticoid replacement in primary alist September 1996. adrenal insufficiency. Clin Endocrinol 45 : 529-534, :ter. 1996. :tes Irish Diabetes Nurse Specialists Association Annual etic Meeting and Study Day: Portlaoise, 18th-19th October 9. Clarke D, Fearon U, Cunningham SK, McKenna 1996 (Kirsten Doherty invited lecturer). TJ. The steroidogenic effects of b-endorphin and joining peptide: A potential role in the modulation of adrenal British Diabetic Association Meeting: Exeter, September andl'ogen production. J. Endocrinol 151: 301-307, el 18th-20th 1996. 1996.
'on, British Society for Paediatric Endocrinology Meeting: 10. Fiad TM, Cunningham SK, McKenna TJ. Role of da, Dublin, September 26th-27th 1996 progesterone deficiency in the development of luteinizing :ted (Professor Tj. McKenna invited lectttrer). hormone and androgen abnormalities in polycystic ovary syndrome. Eur J. Endocrinol135: 335-339, 1996. The 22nd International Symposium on GroWtll Hormone and Growth Factors In Endocrinology and Metabolism: 11. Power C, Doherty I<. Questions raised by theglycaemic Vienna, lOth-11th October 1996. index. Irish Nutrition focus 14: 3-4, 1996.
Association of Clinical Biochemists In Ireland Meeting: 12. McKenna, T.J., Cunningham, S.I<., Testing for on Dublin, 18th-19th October, 1996. adrenal abnormalities in polycystic ovary syndrome; In, lth The Ovary: Regulation, Dysfunction and Treatment, International Congress Series 1106, (Filicori M. & Me Irish Endocrine Society Annual Meeting: Dublin, 25th- 26th October 1996 Flanligni C. eds. ) Elsevier, Amsterdam, pp 295-301, (Three papers presented with Nurse Jenny Dunbar, Ms. 1996. es: Ursula Fearon and Dr. T Fiad as first authors). Six ces Quality Assurance In Nursing Audit In Clinical Practice: University College Dublin, 14th ovember 1996. Department of Endocrinology & Diabetes Mellitus ______ge Delphia Workshop: Worcestershire, 5th-6th December 1996. 1994 1995 1996 .g: Publications ______Activity Analysis Out-Patient Attendances
I. McKenna TJ. Editorial: 6. Targets and thresholds in Endocrine/Metabolism Clinics 2,040 2,186 2,375 insulin-dependent diabetes mellitus. Dialogue 1; 5-7: jy 1996. Diabetes Clinics 2,915 2,926 2,892 )6 2. Hayes F, Sheehan K, Heffernan A, McKenna TJ. Diabetes Centre Attendances 2,171 2,024 2,094 Aggressive Thyroid Cancer associated with toxic nodular goitre. Eur J. Endocrinol134; 366-370, 1996. Laboratory Test 18,319 17,680 13,766
3 O'Connell Y, McKenna TT, Cunningham SI<. b-lipotropin-stimulated adrenal steroid production. 11 Steroids 61; 332-336, 1996.
4. Hayes F, McKenna TJ. Current concepts on the investigation and treatment ofhirsutism. J. Ir Coll Phys Surg 25; 332-336, 1996.
5. Hayes F, McKenna TJ. The ocmrrence of lymphocytic d hypophysitis in a first but not subseqttent pregnancy. I- J. Clin Endocrinol Metab 81; 3131-3132, 1996. d 6. Doherty I<. Food choices and diabetes. Identity 3; 9-13, 1996.
u 7. Doherty I<. Fat - What's all the ftm about? Identity 4; 15-17,1996.
8. Fiad TM, Conway JD, Cunningham SK, McKenna TJ. The role of plasma renin activity in evaluating the
A,mltal Report 1996 St. Vincent's Hospital
Department of Metabolism ______Americ Meetin
Murpt Scope of the Metabolic Service Symposium on Metabolic Bone Disease, Royal College of FitzGc Pathologists, London - April 1996. patient The clinical service comprises an outpatient clinic and inpatient consultation service on metabolic problems for World Congress on Osteoporosis, Amsterdam - May 1996. Intern. medical and surgical patients. The range of disorders Confer includes metabolic bone disease such as osteoporosis (post Fifth Conference on Osteoporosis and Bone Mineral menopausal/steroid related/post transplantation), Measurement, Bath, England - June 1996. Freanc osteomalacia, and also rare bone disorders, together with Bioche disorders of mineral metabolism, acid/base disrurbance and International Congress of Clinical Chemistry Meeting, disease. hyperosmolar and hypo-osmolar states. Consultation in London - July 1996. genetic, developmental and dysplastic skeletal disorders is Natior available. Irish Endocrine Society, Dublin - October 1996.
The metabolism laboratory provides a diagnostic service for Association of Clinical Biochemistry; 19th Annual Meeting, a) patients in St. Vincent's Hospital, St. Michael's Hospital, Dublin - November 1996. St. Columcille's Hospital, The Royal Hospital and St. Joseph's Harold's Cross. International Congress of Clinical Chemistry; 6th Bergmeyer Conference, Tutzing, Germany - November A comprehensive service for investigation and management 1996. of patients with post-menopausal osteoporosis was b) introduced, and for assessment of fracture risk in patients Eurochem Ireland; Launch Meeting, Dublin - December with metabolic bone disease secondary to other clinical 1996. Eurochem is a network of European Analytical disorders. The rising costs associated with osteoporotic Laboratories concerned with quality in analytical fractures emphasise the importance of development or measurements. prevention and management strategies in this high prevalence disorder. Presentations ______
N ational/Intet 'national In 1996 presentations made included: - Appointments/Honours ______Fifth Conference on Osteoporosis and Bone Mineral Measurement - Bath, England. June 1996. Dr. Malachi McKenna: 36th Graves Lecture RCPI 1996. "Osteoporosis prevC11tion; from Vitamin D to HRT". Freaney R, McBrinn Y, Murray B, McKenna MT. Bone turnover indices in post-menopausal osteoporosis: Dr. Rosemarie Freaney: Nordisk Lecture, Irish Endocrine Influence of Vitamin D status and proposed model for Society 1996. interpretil1g biomarkers. "Metabolic Bone Disease: Modelling and Markers". International Congress of Clinical Chemistry - London. Health Research Board - Member of Endocrinology and July 1996. Metabolism Committee. Freaney R, Byrne P, McKenna MT. Associate member of International Federation of Clinical Masked primary hyperparathyroidism: An unusual Chemistry Committee on markers for bone rurnover and presentation of multiple endocrine neoplasia Type I. bone disease . Invited reviewer for Annals of Clinical Biochemistry. Irish Endocrine Society - Dublin. November 1996. Meetings Attended ______Byrne P, Freaney R, McBrinn Y, Murray B, McKenna MT· UnttSual presentation of MEN Type I: Zollinger Ellison Syndrome with marked primary hyperparathyroidism. A number of meetings were attended by the department personnel including: Association of Clinical Biochemists: 19th Annual Conference - Dublin 1996. National Scientific Medical Meeting, Dublin - April 1996. Freaney R, Eriksen E, McBrinn Y, Murray B, McKenna British Endocrine Society Meeting, Dublin - Graves MT· Biochemical and histomorphometric indices of bone Centenary Meeting, Dublin - 1996. ttJrnover in post-menopausal osteoporosis: Influence of Vitamin D status. Irish
Annual Rt'port 1996 St. Vincent's Hospital .· ·~· ·· . tB''''4,.,.
American College of Rheumatology: National Scientific Park-Tae-Hyung, Smyth MR, McShane AJ, Freaney R. Meeting - Florida. October 1996. Sol-Gel based amperometric biosensor incorporating an osmium redox polymer as mediator for detection of L.Lactate. Murphy E, Freaney R, Bresnihan B, McKenna MJ, Talanta - accepted for publication. : of FitzGerald 0. Evidence for increased bone turnover in patimts with dystrophic calcification. Redmond JMT, McKenna MJ, Feingold M, Ahmad BK. Smoking impairs sensation in healthy individuals. '6. International Federation of Clinical Chemistry: Bergmeyer J Irish Coll Phys Surg 1996; 25: 19-21. Conference - Tutzing, Germany. ovember 1996. :ral Redmond JMT, McKenna MJ. Freaney R, Crosbie 0, McKenna MJ, Hegarty J. Q]ta1ltitative sensory testing. Biochemical markers for bone turnover in chronic liver Muscle and Nerve 1996; 10: 403. disease; pre and post liver transplantation. Redmond JMT, McKenna MJ. National Scientific Medical Meeti ng - RCPI , Dublin. Neuropathy endpoints. March 1996. Neurology 1996; 46: 11 93 .
tg, a) Registrar 's Prize: Selected presentation 111 McKenna MJ. gastroenterology. Risk of venous thrombosis with hormone replaceme1lt therapy. Crosbie 0 , Freaney R, McKenna MJ, Hegarty J. Lancet 1996; 348: 1668. th Assessment of fracture risks in patients with chronic er liver disease.
b) Rabenstein K, McShane AJ, McKenna MJ, R eporu ------er Dempsey E, Freaney R. al A prototype system for continuous on-line Report to the European Commission (Contract No: MATI al measurement of biochemical analyses. CT 930009) en titled "Novel Instrumentation for Real Time Monitoring Using Miniaturized Flow Systems with c) McKenna MJ, Byrne P, Freaney R. Lips CJM. Integrated Biosenors " R Freaney (Co-ordinator), A Irish kindred with multiple endocrine neoplasia 2A - McShane, 1V Keaveny, MJ McKenna, K Rabeinstein (St. RET proto-oncogene mutation. Vincent's Hospital); FW Scheller, D Pfeiffer (Max Delbruck Centre fo Molecular Meclicine, Berlin, Germany); Urban G, d) Scrinivasan S, Byrne P, Freaney R, McKenna MJ. I Moser, G Jobst (Technical University of Vienna, Vienna, Pregnancy-induced osteoporosis: Need to consider Austria); A Manz, S Verpoorte, M Widmer (Ciba Geigy, calcium & Vitamin D intake. Basle, Switzerland), D Diamond, E Dempsey, M Smyth (Dublin City University); based on a 2-year project (Nov Health Research Board - Poster presentation. 1993 - Oct 1995 ): pp 1-94.
:: e) Lenihan B, Eustace J, Freaney R, McKenna MJ, r Watson A. The immediate effects of iv Calcitriol on serum PTH and ionized calcium levels.
Publications
Keaveny AP, Freaney R, McKenna MJ, Masterson J, O'Donoghue DP. Bone remodelling indices and secondary hyperparathyroidism in coeliac disease. Amer J Gastroenterology 1996; 91: (6) 1226-1231.
Rabenstein K, McShane AJ, McKenna MJ, Keaveny TV, Freaney R. A11 intravascular microdialysis sampling system suitable for application in continuous biochemical monitoring ofglucose and lactate. Tech nology and Health Care 1996; 4: 67-76.
Ong JSK, McKenna MJ, Lorrigan JG, Watson A, Freaney R. Renal osteodystrophy in association with spinal stmosis in an achondroplastic patient. Irish J Med Science 1996; 165: 155 -156.
Ammai Report 1996 St. Vincent's Hospital
Department of Rheumatology ______
Developments in Department Staffillg ______of Rheumatology ------There have been several new additions to the staff during 1. HRB Unit Grant 1996.
The Department was awarded a Unit Grant (£75,000 per 1. Or. Peter Youssef joined the Department as research annum for five years) by the Health Research Board. The fellow for one year !Tom flinders University, Adelaide, Early Arthritis Unit was developed by Professor B. Australia . Bresnihan and Or. 0. Fitzgerald in collaboration Professor S Whitehead, Department of Medical Genetics, Trinity 2. Two Newman scholars have been recruited and College. appointed . Or. Eithne Murphy was appointed to the Rohan Newman scholar. Or. Eveyn Murphy from 2. Introduction of arthroscopy Baylor University, Houston, Texas was appointed Pfizer Newman scholar. This technique has been developed with the assistance of 3. Dr. David Kane was appointed Lecturer In Mr. W. Quinlan, Department of Orthopaedic Surgery. Dr. Rheumatology. Oliver Fitzgerald, Dr. David Kane and Or. Eithne Murphy have become competent in this technique under the 4. Miss Michelle Hickey was appointed Academic guidance of Or. Peter Youssef. Secretary to the department. 3. Bone Densitometry 5. Nurse Ursula Lewis was appointed Rheumatology Research Nurse. The service has continued to expand and is available to all hospital departments and to local general practitioners. The service is co-ordinated by Nurse Susan Van Der Kamp. Confe1'ences / Courses attended 4. The Early Arthritis Clinic Members of the Department incl uding Professor Barey The service has continued to expand providing a fast-track Bresnihan, Dr. Oliver FitzGerald, Dr. Gaye Cunnane, Dr. service to local general practitioners. The service is now co Eithne Murphy, Nurse Anne Madigan and Mr Patrick ordinated by Or. Oavid Kane and Or. Eithne Murphy. Costello presented their work at National Meetings and at the British Society for Rheumatology (Brighton) and American College of Rheumatology (Orlando). 5. Rheumatology N,me Specialist British Society for Rhettmatology, Brighton: Nurse Anne Madigan has been appointed to this new post. Bolger T, Coyle M, Power C, Fitzgerald 0 , McCarthy Service Workload ______D, Bresnihan B. Antiphospholipid antibody screening. Br J Rhellmatol 35,23. 1996
A total of 5,283 patients was seen in the Rheumatology Cunnane G, Bresnihan B, Fitzgerald 0, outpatient clinics during 1996. Of these, 940 were new Immunohistologic analysis of Peripheral joint disease ill referrals. There were 383 acute medical admissions to ankylosing spondylitis. Br J Rheumatol 35, 154, 1996 hospital wards. A htrther 650 patients were admitted to St. Joseph's Unit, Harold's Cross. Costello P, O'Farrelly C, Bresnihan B, FitzGerald 0. Characterisation of CD8+ T cells in psoriatic arthritis. Br. Dr. Fitzgerald spent a three month period on sabbatical J. Rheumatol 35,160.1996 series: leave as Hecht visiting professor of Rheumatology in 1. Melbourne, Australia, February to April. Dr. Dan Mulherin D, FitzGerald 0 , Bresnihan B, Mechanism of McCarthy, Professor of Rheumatology, Medical College of articular destruction in the feet and hands may differ. Br. J. Wisconsin and former President of the American College of Rhellmatol 35, 192. 1996 2. Rheumatology visited the Department for three months as locum consultant during Dr. Fitzgerald's absence. Mulherin D, FitzGerald 0, Bresnihan B, Walking time 3. may be a very useful measure of clinical laboratory and radiological status in patients JVith rhettmatoid arthritis. Br 4. J Rheumatol 35, 192. 1996
Mulherin D, Fitzgerald 0, Bresnihan B, Walki1W time
A 1lIlUai R eport 1996 St. Vincent's Hospital
may be a very useful measure of clinical laboratory and Professor B Bresnihan was appointed to the Editorial board radiological status in patients with rheumatoid arthritis. Br of Arthritis and Rheumatism. JRheumatol, 35 195, 1996 Or. Gaye Cunnane spent six weeks continuing her American College of Rheumatology, Orlando: collaborative work with the Department of Rheumatology at Addenbrookes Hospital, Cambridge. Bresnihan B. Lookabaugh J. Witt K, Musikic P. uring Treatment with Recombinant Human Interleukin-l Pat Costello visited Colombia Presbyterian University, New Receptor Antagonist (rhIL-ra) in Rheumatoid Arthritis York for four months, August to December, perfecting (RA): Results of a randomised dOllbled blind, placebo molecular technology as part of his ongoing study into :arch controlled multicenter trial. Arthritis Rheum 39:9, S73, disease mechanisms in psoriatic arthritis. laide, 1996 Dr. Gaye Cunnane won first prize for best poster at the Irish Cunnane G, Madigan A, Fitzgerald 0, Bresnihan B. Society for Rheumatology meeting. and Treatment with recombinant human interleukin-l receptor ) the alltagonist (rhIL-Ira) may reduce synovial T-cell infiltration from in rheumatoid arthritis (RA). Arthritis Rheum 39, 9 Publications 'fizer :S245 , 1996 Cunnane G. Brophy DP, Gibney RG, FitzGerald 0. Murphy E, Freaney R, Bresnihan B, FitzGerald 0. Diagnosis and treatment of heel pain in chronic in Evidence for increased bone turnover in patients with inflammatory arthritis using ultrasound. Semin Arthritis dystrophic calcification. Arthritis Rheum 39, 9:S97, 1996 Rheum 25: 383-289, 1996
:mic Cunnane G, Summers Charlotte, Taylor D, Cawston T, Mulherin D, Skelly M, Saunders A, McCarthy D, Bresnihan B, FitzGerald 0. Elevated serum and synovial O'Donoghue D, FitzGerald 0, Bresnihan B, Mulcahy fillid levels of collagenase, stomelysin and tisme inhibitor of H. The diagnosis of iron deficiency in patients with logy metalproteinases (TIMP-l) in early inflammatory arthritis. rheumatoid arthritis and anaemia: an algorithm using Arthritis Rheum 39,9: S132, 1996 simple laboratory measures.
Professor Barry Bresnihan and Or. Gaye Cunnane Mulherin D, Fitzgerald 0, Bresnihan B. SYllovial tissue participated in the European Synovitis Workshop, macrophage populations and articular damage in Stockholm. rheumatoid arthritis. Arthritis Rheum 39: 115-124, 1996 arry Dr. Dr. Gaye Cunnane was invited to present aspects of her Mulherin D, Fitzgerald 0 , Bresnihan B. Clinical rick work at meetings in Padua in April, Bologna in September. improvement and radiological deterioration in rheumatoid d at arthritis: evidence that the pathogenesis of synovial and Professor B Bresnihan and Or. O. FitzGerald were invited inflammation and articular erosioll may diffel: speakers at the APLAR meeting in Melbourne, Australia. Br J Rheumatol35: 1263-1268,1996.
The department hosted an international meeting funded by Mulherin D, Veale DJ, Belch JJF, Bresnihan B, Pfizer at the Royal College of Physicians. FitzGerald 0 , Synovial membrane expression and soluble thy adhesion molecule levels in previously untreated inflammatory 3r J The Department also hosted the European Synovitis arthritis, QJ Med 89: 195-203, 1996 workshop with collaborators from Leeds, Leiden, Berlin, Stockholm: Eustace JA, Brophy D, Gibney R, Bresnihan B, 0, FitzGerald 0. Comparison of the accuracy of steroid tn placement with clinical outcome in patients with shoulder Academic Activities ______symptoms. Annals of Rheum Dis. 1997; 56:59-63
0. The following visited the department during the year as Br. part of the continuing postgraduate rheumatology seminar series: 1. Dr. Carwile LeRoy, University of Koln. ! of «rhree faces ofscleroderma, autoimmlme, vascular .J. and fibrotic". 2. Dr. Paul Peter Tak, University Hospital Leiden. "I nterletlkin -15 in rheumatoid synovial tissue }} me 3. Or. Johannes Roth, University of Munster. nd «Activation of monocyteslmacrophages» Br 4. Dr. Michael Naughton, Charing Cross Hospital «The role of locally secreted complement proteim»
me
A1l111tal Report J 996 St. Vincent's Hospital
Department of Medicine for the Elderly ______H P. Departmental Statistics: The S.H.O. staff continue the rotation to the Rehabilitation 1994 1995 1996 Ward and Day Hospital at the Royal Hospital Donnybrook. Inpatients The great majority of elderly patients requiring further rehabilitation have been treated in these facilities. Admissions 429 445 448 Discharges 460 504 509 The Royal Hospital Outpatients In-Patients New Patients 254 226 261 Admissions: 231 Total attendances 1,044 988 1,018 Discharges 217 R.I.P. 8 The departments clinical services provide an in-patient and out-patient consultation service, treatment and Day Hospital rehabilitation, primarily for elderly patients from the New Patients 111 hospitals catchment area in South East Dublin. The number of in-patients treated has remained unchanged on the previous year, though out-patient attendances have Dr. Keating and Dr. Crowe received requests for increased. This probably indicates that capacity has been consultations for over 500 patients during the year. Weekly reached by the service and this against a known increase in meetings are held and chaired jointly with the the elderly population, i.e. 4% per annum increase of a 75 Rehabilitation Physicians on Rehabilitation of Stroke of year old population. The waiting list for non-immediately which representatives of the nursing, therapy and medical urgent patients has increased. departments attend. Meetings are also held weekly between Dr. Keating and the Medical Social Work During the year hospital policy has been followed and only Department to plan discharges for all elderly and residually patients aged 70 and over have been treated in Our Lady's disabled patients. Ward, the Hospitals geriatric ward, 90% of whom have come in through the A & E Department as urgent referrals. The nursing dependency levels have increased and tribute Achievements ______must be paid to the nursing staff in particular for the G excellent standards which have been maintained. Dr. Keating has completed a year as Chairman of the Irish o Physicians in Rehabilitation Medicine. Smjfingr ______Dr. J. Harbison attained a Senior Registrar training post in s the Professorial Department of Professor Oliver James, The department has been strengthened by the restoration Royal Infirmary, Newcastle. 0' of a third S.H.O. in the rotation with The Royal Hospital. tn The Senior Ward Sister, Sr. Mary Ignatius, retired at the end of the year after 13 years in post and her guidance, Conferences Attended ------0' dedication, great knowledge and wisdom are greatly di, missed. Dr. Keating, Dr. Crowe and Dr. O'Keefffe attended the Spring Meeting of the Irish Physicians in Geriatric Medicine 0' The Department lost the services of Ms. Joanne Crevan, and the Annual General Meeting of the Irish el Senior Physiotherapist, during 1996, after eight years Gerontological Society, in October 1996. Members of service, when she left to take up another post. staff, as below contributed to tlle latter meeting.
Dr. Keating attended tlle Irish Association of Rehabilitation Dr. Shaun O'Keeffe was appointed as a third Physician in Medicine, St. Vincent's Hospital , October 1996, on 0' Geriatric Medicine and has taken up post. He is currently "Rehabilitation of the Elderly Patient", and The Annual ho~ developing the new allied service at St. Michael's Hospital. Oncology Meeting, "Cancer in The Elderly", November, 19 Close liaison is maintained with St. Columcille's Hospital, 1996. (Chaired Session) Department of Medicine for the Elderly under tlle direction 0' of Dr. Morgan Crowe. Dr. Keating and Dr. Crowe attended the European In' Conference on Alzheimer's Disease, Limerick, November, The administration of the ward has been greatly helped by 1996. 0 ' the appointment of a Ward Clerk, Ms Margaret Dunne, late S'J' in the vear. Dr. Crowe attended the European Stroke Meeting, Pr Munich, September 1996. Le
A1I1l1tai Report 1996 ••••
St. Vincent's Hospital • v • •"c"" st,
Pape~ ______O 'Keeffe ST, Lye M. DNR orders in acute stroke. Lancet Horgan F, Crowe M, Keating D, McNamara A, Leahy 1996; 347:1415 P.: IrDevelopment of a Comprehensive Stroke Programme in ltion the Acttte Hospital". The Irish Medical Journal, Nov I Dee O'Keeffe ST, Kazeem H, Gosney M, Philpott R, Playfer ook. 96. JR, Lye M. Gait disturbance in Alzheimer's disease: a ·ther clinical study. Age Ageing 1996; 25:313-316 Harbison J, Keating D.: «Lamotrigine: A Potential New Therapy for Neuropathic Pain with Hypersensitivity)). Presented at AGM of Irish Gerontological Society Meeting, O'Keeffe ST, Lavan IN. Predicting delirium in elderly October 96. patients: development and validation of a risk-stratification For publication Irish Medical Journal. model. Age Ageing 1996; 25 :317-321
Cagney M, Harbison J, Keating D, Crowe M, ((Asset O'Keeffe S. Diastolic dysfunction in elderly patients with Rich, Income Poor: The Property Boom and Nursing Home dyspnoea and normal left ventricttlar systolic function. Placement in South East D/{blin. Presented at AGM Irish Cardiology in the Elderly 1996; 4:51 -52. Gerontological Society Meeting, October 1996. O'Keeffe ST, Jack CIA, Lye M. Use of restraints and Crowe M., "Profile of Risk Factors in 100 Acute Stroke bedrails in a British hospital. Journal of the American Admissions" . Geriatrics Society 1996; 44:1086-1088. for ekly Presentations ______the : of 'Nature and persistence of delusions during delirium in lica! elderly hospital patients '. British Society of Gerontology, :kly Liverpool, August 1996 Dr. Shaun O'Keeffe 'ork ally 'Aetiology of delirium in elderly hospital patients'. British Geriatrics Society Autumn meeting, London, October 1996 Dr. Shaun O'Keeffe
'Cognitive testing in delirium '. European Association of Gerontology, Thessalonoki, November 1996 Dr. Shaun :ish O'Keeffe
: m Selected Abstracts ------les, O'Keeffe S, Jack CIA, Lye M. Inappropriate use of cotsides in a British hospital Age Ageing. 1996; 25(Suppl 1 ):48.
O'Keeffe S, Lavan J. Responsiveness of the MMSE in the diagnosis of delirium. Age Ageing 1996; 25(Suppl 1 ): 26. :he me O'Keeffe ST, Gosney MA. Assessing attentiveness in ish elderly hospital patients. Age Ageing 1996; 25(SuppI2):28. of Papers ______on on O'Keeffe ST, Lavan IN. Subctttaneous fluids in elderly la! hospital patients with cognitive impairment. Gerontology er, 1996; 42:36-39.
O'Keeffe ST. Restless legs syndrome: a review. Archives of an Internal Medicine 1996; 156:243-248. er, O'Keeffe ST, Lye M. Heart failure in the elderly: the same syndrome as the clinical trials? In: Heart Fai/t{re in Clinical g, Practice. Eds JTV McMurray, JGF Cleland. Martin Dunitz, London.1996, pp 47-71.
Awmal Report 1996 St. Vincent's Hospital
Department of Psychiatry ______
St. Camillus Unit ______In Autumn 1996 19 students graduated from the Masters Course (5 Diplomas). In 1996-97 The School of We undertook a major review of our Eating Disorder Psychotherapy accepted 12 students on the Masters in Programme and initiated a new programme, which Individual Psychotherapy course and 45 students on the included a special eating disorder group, which has been Group Psychotherapy course. A Postgraduate reading facilitated by the nursing staff on a weekly basis. Ongoing group meets each Monday. evaluation of the new programme is taking place joindy with our dietician - Margaret Doyle. Congress: International Congress on "Crucial Problems in We also welcomed our first patients from the Psychiatry of Psychoanalysis" - Research Centre - SVH. Nov. 1996. Old Age service under the care of Dr. Colm Cooney and his team and we welcomed Dr. Anthony McCarthy to his new post as Consultant in St. Vincent's, Eastern Health Board Office Administration ______and National Maternity Hospital. Ms. Rosaleen Maguire Day Hospital in St. Camilltls's: ______Ms. Amanda Hardy, Professor Walsh 's Secretary Ms. Brenda Lavin was secunded part-time in order to setup 1 student nurse was allocated to the Day Hospital for the Administration of the new Department of Old Age experiential learning. Psychiatry in Carew House.
Occupational Therapy Department ____ We thank Helen Nestor who worked part-time during the year to replace Brenda Lavin. Senior Occupational Therapists We welcome Ms. Siobhan Flynn who replaced Brenda Lavin job-sharing: Ms Adele Thompson, Dip.COT, for her maternity leave. Ms Trish Caren, Dip.COT, Locum aT: Ms Maeve Crean Dip.COT, Ms. Rosaleen McGuire continues to be an active member of the Council of the Irish Health Services Management During the year Adele Thompson acted as Local Examiner Institute. in the School of Occupational Therapy in association with Trinity College Dublin. She also implemented a regular six week Anxiety Management Programme in the Day Education / Educational Awards _____ Hospital.
Art Therapy Treena Hynes - Ward Sister - Graduated from LSB College on 8th November 1996 with a B.A. Psychoanalytic Studies Therapist: Ms. Deirdre Horgan. (Hons.) Ca One weekly Art Therapy session is held in the Day Hospital Mairead McDonnell:- Having successfully completed .. ftm and is attended on average by 8 patients over an 8 week The Management Development Programme run by the el basis. Institute of Public Administration and St. Vincent's Hospital, was presented with a certificate on 17/ 5/'96. Me Social Work: rh, Social Worker Teresa Dowd SjN Noelle Bickey was awarded a diploma in Management me, from the Faculty of Nursing, Royal College of Surgeons - PS) In 1996 there has been a development of social work input June 1996, and is now undertaking - Diploma in Nursing into the therapeutic process with both inpatients and Administration in the Faculty of Nursing, Royal College of Me outpatients. Fan1ily members have been involved in joint Surgeons. m~ doctor and social work sessions and this provides an D. opportunity to observe current family dynamics and to aid Mairead McDonnell, Ward Sister, received Certificate communication and understanding in relation to the following completion of The Mission Effectiveness Sic patients illness and ongoing recovery. Couple and family Programme run by the Sisters of Charity. P, therapeutic sessions along the same lines are also ongoing. ps; Dr. Fiona Johnson received Diploma in Management for 11 Doctors - Computer Literacy: (Excel / Word) The School of Psychotherapy ______"1 Departmental staff attended various courses throughout the Tl Director Dr. Cormac GalIagher year including the following. "l Secretary Fiona O 'Brien-Lavin Tl
Annual Report 1996 St. Vincent's Hospital ··· I ~ dJ· c~ ''" '
Or. Siobhan Rooney attended the course in The Royal "Trauma in Charlton-Report on Conference on Trauma, College of Surgeons for the "Diploma in Medical Greenwich consortium of Psychotherapists, October 1995 " Management" - which commenced September 1996. The Letter 1996: 7; 112-113. Dr. Ashling Camp bell Dr. Siobhan Rooney Isters Book Review - "The Remarkable Beatrix Potter" Alexander ,I of Dr. Siobhan Rooney attended an 8 week statistics course - Grinstein. Connecticut, International Universities Press, :s in Trinity College - October - December 1996. 1995. Irish Journal of Psychological Medicine 1996: 13 . the (3); 127. Dr. Ashling Campbell ding "The Joy of Sound" 1 day, Music Course by Thercse Tinaney - October 1996. Irish Journal of Psychological Medicine - December 1996 Maeve Crean OT Department "A comparison of voluntary and involtmtary patients admitted to hospital". Dr. Siobhan Rooney Presentations ______Irish Medical Times: 3 letters published - October - ~96 . The Influence of psychoanalytic theory on clinical November 1996 on "Irish Public Psychiatric Services". Dr. psychiatric nursing. Siobhan Rooney Back to Nursing course - 'Modern Perspectives in Psychiatric Nursing '. - The School of ursing, SVH, Elm Park. - April Abstract published. Royal college meeting - January 1996. 1996. Sr. Treena Hynes. " P~'evalence of abnormal Thyroid Function Tests in a Down's Syndrome Population ". Dr. Siobhan Rooney "Psychiatric Training in Ireland - an Overview " t up Research in Progress ______Age UEMS (Union of European Monospecialists) Conference, St. Vincent's Hospital, April 1996. Dr. Ashling Campbell "Assessment ofsuicidality and suicidal constructs following an the "Tbe Future of Psychoanalysis in Ireland" episode of deliberate self-harm ". UEMS conference, St. Vincent's Hospital, April 1996. Dr. Siobhan Rooney Dr. Ashling Camp bell "An medical students satisfied with their training?" - LVill "Ho w can Lacanian theory be represented in the Media?" completed. Universities Association for Psychoanalytic Studies Annual Dr. Siobhan Rooney rof Conference, LSB College, Dublin, May 1996. Dr. Ashling ent Camp bell "Gender differences in Final Medical examination results in Psychiatry" - completed. - Royal College of Psychiatrists - Meeting - January 1996 Dr. Siobhan Rooney "Prevalence of Thyroid Dysfunction in a Down 's Syndrome Pop ulation ". Dr. Siobhan Rooney "Exogenous Factors in Anxiety Disorden" Dr. Fiona Johnson :ge Publications ______les Social ------Casey P, Meagher D, Butler E (1996). Personality, ftmctioning and recovery from major depressive disorder. Congratulations to Amanda Hardy who got married in :he ervous Mental Disease 184:240-5. Dr. D. Meagher March 1996. We would also like to congratulate Brenda t's who gave birth to a baby boy in November. Meagher D, O'Hanlon D, O'Mahony E, Casey P (1996). The use of environmental strategies and psychotropic We would like to welcome SI N Evelyn Nolan to our :nt medications in the management of delirium. British J nursing staff. ; - Psychiatry 168:512-5. Dr. D. Meagher 19 of Meagher D, Quinn J (1996). Practical issues in the management of delirium. Geriatric Med 26:12;52-4. Dr. D. Meagher te ss Sloan D, Browne S, Meagher D, Lane A, Larkin C, Casey P, Walsh , O'Callaghan E (1996). Attitudes toward psychiatry amo~1fJ final year medical students. Eur Psychiatry
)[ 11 :407-11. Dr. D. Meagher
"Tbe Absence of Anxiety - A Case of Transvestism " le The Letter 1996: 6; 91-98. Dr. Ashling Camp bell
"How can Lacanian theory be represented in the Media ?" The Letter 1996: 7; 12 -2 0. Dr. Ashling Campbell
An1lual Report 1996 St. Vincent's Hospital
Department of Old Age Psychiatry ______Detec Ment and Confe The Department of Old Age Psychiatry has recently been per week) witl1 functional psychiatric illness. We are set up to provide a hospital-based community-orientated expecting to see the day hospital open later this year. What old age psychiatry service for community care areas one and Acade two covering Dublin South East. The catchment area has a Prize population of over 29,000 elderly patients over tl1e age of Staffing 65. The service headquarters is located at Carew House, St. Vincent's Hospital. Development of the service has The Department would like to welcome the following very Pub involved close liaison between St. Vincent's Hospital, the recent new members of tl1e multidisciplinary team: Ms. Eastern Health Board and St. John of God Hospital. Ruth Ryan, Grade IV Secretary; Ms Aideen Lewis, Senior Clinical Psychologist (part time with the service); Ms. Mary The service caters for those over 65 with new-onset Headon, Psychiatric Social Worker and Ms. Francis Weir, psychiatric illness or dementia with severe behavioural Occupational Therapist. Dr. Michacl Kirby, Senior problems who live in the catchment area. The emphasis of Registrar continues \vith the service until July 1997. We tl1e service is to provide a needs-based, comprehensive expect to appoint nurses in the community and day hospital Lawl service to both patients and tl1eir families. The Department nurses later this year. towaT, takes referrals by phone from general practitioners and diagn hospital consultants. This facilitates the collection of important background information on each patient. Conferences and Courses ______
Section for the Psychiatry of Old Age Annual Residential Developments and Activities in 1996 ___ _ Conference - March 1996. Colm Cooney (Speaker) Elder Abuse and Dementia. 1996 was a very important year in the development of the old age psychiatry service. Irish Medical Organisation AGM - April 1996 Colm Cooney (Invited Speaker) - Elder Abuse and Clinical activity began initially witl1 liaison referrals from St. Dementia - Out of sight but not out of mind. Vincent's Hospital and subsequently extending to St. Colmcille's Hospital, Loughlinstown; The Royal Hospital, O ld Age Psychiatry Section (Institute of Psychiatry) - Short Donnybrook; St. Michael's Hospital, Dun Laoghaire and Course July 1996 Baggot Street, Community Hospital, Eastern Health Colm Cooney (Invited Speaker) - Diogenes Syndrome: a Board. In addition to Liaison Psychiatry, the Department review. conducts extended care Psychiatry at Unit D and Unit E at Vergemount Clinic, Clonskeagh, acute inpatient psychiatry National Council for the Elderly: Mental Disorders in at St. CamiUus's Ward, SVH and domiciliary and nursing Older Irish People: Incidence, Prevalence and Treatment home visits in community care areas 1 and 2. October 1996. Colm Cooney
A record system was established for the Department in view Alzheimer's Disease and Related Disorders - European of our diverse activities across different sites and our Conference - November 1996. geographical separation from the main hospital. A form was designed to facili tate the collection of basic socio Prevalence of Mental Disorders and Psychotropic Drug Use demographic and medical information on each patient among the Elderly Living in the Community. Kirby, M. referred to the service. This data is entered into a statistical Royal College of Psychiatrists, Winter Meeting, Stratford package (SPSS for windows) and it is planned to use this on Avon, 1996. information to influence the development of the service and encourage research. In addition, in conjunction witl1 the Social Support Networks among the Community Dwelling Computer Department, we are investigating setting up a Elderly. Kirby, M. basic computerised clinical information network within the Royal College of Psychiatrists, Winter Meeting, Stratford unit. Piloting of tlus network is expected to commence in on Avon, 1996. the near fuulre . We have also carried out an audit of the general practitioners in commllluty care area 1 to assess Dementia, Depression and Neuroses in an Irish Elderly what they perceive to be tl1e greatest needs for older Population. Kirby, M . patients with mental healtl1 problems. UCD Medical Graduates Assocation, Scientific Conference ErtaJ and Research Award 1996. (sub" In 1996 there were important negotiations regarding the development of the day hospital for the elderly with mental Suicidal Feelings among the Community Dwelling Elderly. illness. Building work has recently begun on this project. Kirby, M. Annual Psychiatry Senior Registrar Scientific When in operation this will cater for up to 8 patients (3 days Meeting, 1996. per week) witl1 dementia (complicated by psychiatric illness or severe behaviour problems) and up to 12 patients (2 days
A 1l1lttal R eport 1996 St. Vincent's Hospital ! ··· • w dJco ..... ," ,
Detecting Mental Disorders in Older People. Kirby, M. Book Reviews ______Mental Disorders in the Irish Elderly: Incidence, Prevalence and Treatment. National Council for the Elderly Dementia. Eds.A.Burns and R..Levy. Chapman and Hall Conference, 1996. Medical, 1994. International Journal of Social Psychiatry, are Autumn 1996. Vo!. 42. Part 3, Page 240. C. Cooney. What is Dysthymia in the Elderly? Kirby, M. Royal Academy of Medicine, Psychiatry Section-Senior Registrar's Principles and Practice of Geriatric Psychiatry. Prize Meeting 1996. International Journal of Social Psychiatry, 1996. Vo!.42 . Part 2, Page 160-161. C. Cooney.
_ery Publications ------Elder Abuse. International and Cross Cultural perspectives. Ms. Eds. J.1 . Kosberg and J.L.Garcia. Age and Ageing, July :uor Harnid, W., Cooney, C., Stein, G. The O~aniser and 1996 Vol (4). C. Cooney. lary MRCPsych Exam: The College's Instructions versus Murphy's Teir, Law. Psychiatric Bulletin, 1996,20,681-682 Elder Abuse in Perspective. Eds. S. Biggs, C. Phillipson, P. lior Kingston. Open University Press. Age and Ageing, July We Maguire, C.P., Kirby, M., Coen, R., Coakley, D., 1996 Vol (4 ). C. Cooney. ,ital Lawlor, B.A., O'Neill, D. Family members' attitttdes toward telling the patient with Alzheimer's disease their diagnosis. British Medical Journal 1996, 313, 529-530.
Swanwick, G., Kirby, M., Coen, R., Maguire, C.P., O'Neill, D., Walsh, B.J., Coakley, D., Lawlor, B.A. tial Effects of co-existent cerebrovascular disease on rate of progression in Alzheimer's disease. Irish Journal of Psychological Medicine 1996, 13 (3): 91 -3.
Cooney, C., Mortimer, A., Smith, A., Newton, K. and nd Wrigley, M. Carbamazepine in treating aggressive behaviour associated with senile dementia - a placebo controlled trial. International J. Of Geriat. Psychiatry, 1996, art 11(10),901-905.
: a Mullan E., Cooney C. Mania and Cortical Lewy Body Dementia - a case report. International Journal of Geriatric Psychiatry, 1996, 11, 837-839. In t - eoen, R.F., Swanwick, G.R., Maguire C., Kirby, M., Lawlor, B.A., Walsh, J.B., Coakley, D. Memory impairment in Alzheimu"s disease: replication and extention an of the delayed JVord recall (D WRY test. Irish Journal of Psychological Medicine 1996, 13 (2), 55-58.
'se McLough1in, D., Cooney, C., Holmes, C., Levy, R. \11.. Garer Informants for Dementia Sufferers: Carer Awareness rd of Cognitive Impairment in an Elderly Community - resident sample. Age and Ageing 1996, 25: 367-371.
Cooney, C. & Wrigley, M. Abuse ofpatients JVith dementia by their carers - an Irish study, Irish Journal of Psychological rd Medicine, 1996, 13, (3),94-96.
ly Papers Submitted
:e Ertan, T., Cooney, C. Mania and dementia - a review (submitted to International Journal of Geriatric Psychiatry)
y. \C
Annual Report 1996 ···· St. Vincent's Hospital ~ dJ.C"'t '111
H, ~ Department of Nuclear Medicine ______marl
Dufl In 1996 there was an increased demand on the imaging Honours and Invitations ______Clin services of the Nuclear Medicine Department and despite its re Ass. an increase of approximately 22% in the number of scans Dr. M.J.Duffy was invited to represent Ireland on a performed the outpatient waiting list continued to rise. The European Union Working Group to discuss priority areas Duf main increase was due to the number of oncology patients for Cancer Research Funding within the E.U. Dr. MJ brea. who were referred for imaging studies. New equipment has Duffy was also invited to address a Symposium on Breast pre enabled us to perform more detailed tomographic Cancer in Paris and to write a chapter on The Biochemistry Brea examinations and, while time consuming, these add greatly of Metastasis for Advances in Clinical Chemistry. to the diagnostic accuracy of some studies i.e. myocardial perfusion studies and bone imaging. She Conferences attended ______0 '1: The total number of tests carried out in tile Nuclear Medicine Laboratory during 1996 was 54,362 (53,069 in Nuclear Oncology Symposium, Baltimore, U.S.A. 23rd - 1995), the highest since the establishment of the 25th March Laboratory. PET Symposium, Mater Hospital, Dublin 15th April This year has also heralded major staff changes in the Society of Nuclear Medicine Annual Meeting, Denver, Department. Ms. Lindsay Cunningham our acting Senior Colarado, June 1st - 5th. Radiographer returned to her home in Liverpool and Ms. GaiI Keane is now acti ng Senior. Ms. Elaine McHale, one European Association of Nuclear Medicine Annual of our nurses, left to take care of her new baby, Blaithin, and Meeting, Copenhagen, September 13th -18th has been replaced by Nurse Deirdre Kelleher. At the end of the year one of our most experienced radiographers, Ms. Amersham Symposium on SPECT imaging of the brain, Carol McLelland, returned to Scotland after 8 years Belfast September working in the Department. Radiographic staffftom the X ray Department are being temporarily secunded to Nuclear British Nuclear Medicine Association, Cardiff 9th - 14th Medicine to fill the vacancy. For the latter part of the year October. Ms. Jackie McCavana, Senior Physicist, has been on maternity leave having given birth to a baby girl, Aoife. Mr British Nuclear Cardiology Conference, Brompton Ruairi O'Donnell is helping us with medical physics services Hospital, London 11th - 12th December pending her return. Dr. Nicole Farrell joined the department as a clinical research house officer and has been ADAC Computer Users Meeting, Preston, 2nd May of great assistance both from a clinical service point of view and in the development and evaluation of new scan British Nuclear Medicine Society Meeting, London, April procedures. The close relationship with tile Nuclear Medicine service at St. Lukes/St. Annes has been enhanced CT Quality Control Meeting, London, 17th October with the appointment of Dr. Charles Williams as part-time temporary consultant to the Nuclear Medicine service at St. Lukes on the retirement of Dr. Paddy Browne. Dr. Publications ______WilIiams and Dr. G. Duffy work closely in providing a Nuclear Medicine service for both Hospitals. Duffy, MJ. Duggan C, Maguire T, Mulcahy K, Elvin P On the education front, there has been plenty of activity MeDermott, E, Fennelly JJ, O'Higgins N, Urokinase and staff continue to play an active role in the Irish Nuclear plasminogen activator as a predictor of aggressive disease in Medicine Association. Furthermore, Ms. Judith McMahon breast cancer. Enzyme protein 1996; 49: 85-93. is at present enrolled in the Postgraduate Diploma in Nuclear Medicine in U.C.D. Duffy, MJ. The biochemistry of metastasis. Adv Clin Chem Dr. Maura Rabitte PhD joined the department for a 3 1996; 32: 135-166. month period and successfully set up the C-14 Urea Breath Test for the detection of helicobactor pyelori infection of Duffy, MJ. PSA as a marker for prostate cancer. Ann Clin the stomach. Hopefully this test will be funded by the Biochem 1996; 33: 511-519. Department of Health during 1997 and so become available for all our patients. Duffy, MJ. Pro teases as prognostic markers in cancer. Clin Cancer Res. 1996; 2: 613-618. Scintimammography, a new nuclear imaging technique for primary breast cancer, is also being evaluated and if found Abrrracu ______clinically useful will be introduced as a service for patients attending the breast clinic. Duffy MJ, Duggan C, Maguire T, Blaser J, Tschesche
A1I111tal Report 1996 St. Vincent's Hospital -···~ - e.c~.., .
H, McDermott E, O 'Higgins N. Proteases as prognostic markers in breast cancer. Clin Exp Met 1996;14(suppI1 ) 26.
Duffy MJ, Duggan C, Maguire T, Elvin P, O'Higgins N. Clinical significance of Ilrokinase plasminogen activator and itsreceptor in breast cancer. Proc of 21st Meeting ofrhe Int. Ass . For breast cancer research, Paris, July 1996. a :as viJ Duffy MJ. Which is the best protease of assessing prognosis in breast cancer? Bull Cancer 1996; 83: 1038 (Invited ast :ry presentation to Symposi um on Prognostic Markers in Breast Cancer, Paris, Dec., 1996.
Shering SG, Hill A, McDermott EW, Duffy MJ, O'Higgins N. The contribution of the primary tumOllr to serum CA 15-3 levels in breast cancer. EUR J Surg Oncol 1996; 22: 432. 1- Chin D, Maguire T, O'Reilly T, O 'Riain S, Naidu R, McHugh M, O'Higgins N, Duffy MJ. Urokinase plasminogen activator in basal cell carcinoma of the skin. er, Eur J Surg Oncol1996; 22: 445. ' . . Duffy MJ, Shering SG, Sherry F, McDermott EW, lal O'Higgins N. CA 15-3, a circulating marker with strong prognostic value in breast cancer, new observation. Proc of the XVI Int congress of Clinical Chemistry, London, July in, 1996.
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Amlltal Report 1996 St. Vincent's Hospital
Department of Preventative Medicine / Cardiology ___ He Thl Ho Developments ______Ch ch sur During 1996 an Occupational Health Physician has been co appointed to St. Vincents Hospital. This post will be De closely associated with the Department of Preventive an, Medicine/Cardiology. m E It is hoped that a co-ordinator of cardiac rehabilitation will Eli be appointed in 1997. Pa M: Training Days for health professionals run by this department are set to expand into new areas including information days for pharmacists. A link with the Education Officer of the Royal Hospital Donnybrook, has been made and new courses on Aging and Bereavement will be offered in 1997. screening programme in the early 1980s. All data has been computerised and follow-up commenced early 1996. The Link with Health Promotion Unit and training for unit gratefully acknowledges the contribution of the dietitians in General Practice - A Seminar was held in Kellogg Foundation in this project. December by the Department of Preventive Medicine/Cardiology in conjunction with the Health Promotion Unit at the Department of Health for Service Workload ______"Dietitians working in General Practice" to assist service development. Follow-up seminars are planned. Cardiac Rehabilitation
Ongoing Research Projects:- Cardiac rehabilitation is an indispensable element in the longterm care of patients with coronary heart disease. The formal rehabilitation programme commenced in the 1. Smoking Prevalence among Student Nurses hospital in October 1995. Its aim is to facilitate the This study was set up in 1996 and its aim is to assess continuing rehabilitation of cardiac patients following smoking prevalence and attitudes of student nurses entering discharge from hospital. The programme has a the new diploma course in nursing studies and following up multidisciplinary team with members from the those students who continue their studies at 2nd and 3rd Departments of Cardiology, Physiotherapy and Preventive year to assess a change in their smoking status. A smoking Medicine. The programme coordinator at present is the education programme will be offered at each year as part of Health Promotion/ Research Nurse from the Department the student's health promotion module of their training. of Preventive Medicine/Cardiology.
2. 24hr ABPM - is it patient friendly? Does the The six week Exercise Rehabilitation Programme and the client understand the significance of lifestyle advice? Monthly Educational Rehabilitation Meeting are well The 24hr ambulatory blood pressure service of the utilised by past patients and their fanlily members. With the Department of Preventive Medicine is recognised as a appointment of a Cardiac Co-ordinator Sister in early 1997, valuable and practical service in 1996. A study was we will continue to strive for excellent care for the future. undertaken to assess the clients perception of tllis service and to evaluate their understanding of the pre mOllitoring lifestyle advice given. Cardiovascular Risk Factor Intervention Clinic (G.R.I. G.) 3. The Epidemiology and Outcome of Hip Fracture in the Elderly A weekly clinic is held providing a referral service for This study, supported by the Health Research Board, was general practitioners, for the cardiac department, and for conducted in association with the Department of Radiology diabetics and other hyperlipidaemic patients. Dr. John in St.vincent's and the Department of Public Health Erwin runs the clinic with staff from the Dept. of Medicine and Epidemiology in University College Dublin. Preventive Medicine/Cardiology. Lifestyle and risk factor This study was completed in June 1996. modification advice is given individually to each patient on each visit. 4. Coronary Risk Evaluation and Screening Study (CRESS) . This study involves a mortality follow-up of over 4,000 persons first seen at a worksite cardiovascular risk factor
Ail/Will Report 1996 St. Vincent's Hospital :. ···'oJ ·.. dJc-"",'S1 '
Health Promoting Hospitals 2. Lectures and demonstrations on practical aspects of The hospital is a member of the Irish Health Promoting health promotion and preventive medicine were Hospital Network of which Professor Risteard Mulcahy is provided for 1st, 2nd and 3rd year student nurses and Chairperson. The Hospital Health Committee which is staff nurses in conjunction with the School of Nursing. chaired by Dr. Malachi McKenna continues ro direct and Approximately ten sessions were provided. support health promotion initiatives in the hospital. The committee's activities are co-ordinated from this 3. Mec1ia: - Ms. Vivien Reid gave an interview re utrition Department. Healthwise SVH continues to be published and Coronary Heart Disease on the Health Progran1me and distributed to hospital staff. In September an open RTE 1. meeting on Health Promoting Hospitals was held in the Education and Research Centre. Speakers included 4. Community Activities/ Public Talks: - Talks on healthy Elizabeth Jasprizza, Manager Health Promotion and lifestyle were provided on request to groups. Patient Education Unit, Westmead, NSW, Australia and Ms. ArUl 0' Riordan, National Co-orc1inator of the Irish 5. The Department continues to act in an advisory capacity Health Promoting Network to agencies incluc1ing the Department of Health and the Irish Heart Foundation. Wormation stands on topics of interest have become a feature in the hospital. Topics have included Exercise and 6. The Department contributed to the St. Vincent's keeping fit, Healthy Eating : Eat more fruit and veg, and Hospital Annual GP Study day provic1ing information on :en Back to school. services available to GPs. 'he :he Training Daysfor Health Professionals Nationwide Conferences / Courses Attended ______
Stop Smoking, Coronary Risk Intervention Strategy A number of Conferences/ Courses were attended by Progran1me (CRISP), Diabetes and CPR training days are a departmental personnel incluc1ing: - regular activity of this department. Twelve training days International Conference on Health Promoting Hospitals, were held in 1996. Londonderry (Presentation) Business Conference on Health Promoting Hospitals, he Bavaria he Stop Smoking Services. he ational HPH Meeting on Smoking Policy in Hospitals - 1. Individual inpatient and outpatient counselling by he (Presentation) ng trained nurse counsellors. Approximately twenty a patients were seen per week. Hypertension Ongoing Education Day - London he Nurses Hypertension Association Conference, Cambridge 2. 6-Week Stop Smoking Courses. Three courses were ve (Presentation) he held in 1996, open to hospital patients and the general :nt public. A total of thirty five completed the course. Annual Nursing and Research Conference, Faculty of Nursing, RCSI -(Presentations) 3. Stop Smoking Support Session held every Tuesday from European Society of Cardiology Annual Meeting, 1.00-2.00pm. FaciJitator is Ms. Veronica 0' eill. he Berminghan1 (Presentation) ell he 4. Worksite Programmes; the department participated in British Dietetic Association Diamond Jubilee Conference, '7, four worksite programmes where a Clean Air Policy was Stratford-on-Avon being introduced. British Dietetic Association/ Community Nutrition Group. 5. Four training days were provided to Professionals "Meeting of Community Dietitians Working in Primary interested in helping people to stop smoking. In 1996 Care" sixty seven persons attended. Association for the Study of Obesity. St. Bartholemew's Hospital, London 6. 'Smoking - The Choice is Yours '. A lecture and or or information session was availed of by twenty three post primary schools ID Awards / Achievements ______of Other Services Provided Include:- or Ms. Veronica 0' NeiJl was awarded the prestigious Johnson )0 and Johnson Medical Nursing Research "Regal 1. Twenty-four Hour Ambulatory Blood Pressure Scholarship" . Monitoring Service - was provided for over 600 patients in 1996, each of whom received inc1ividual counselling. Professor Bernadette Herity has been appointed to the This service was evaluated during 1996 (see research ational Cancer Registry Board by the Minister of Health. projects).
Amlltai Report 1996 St. Vincent's Hospital
She has also been appointed Chairperson of the Medical cooperation. Proceedings of the Nutrition Society Bureau of Road Safety. 1996;55:679-688. Comerford. D. The Female Smoker. An Bord A1tranais Ms Denise Comerford has been appointed Vice News 1996;Vo18 04:9-10. Chairperson of the newly formed Nurses Cardiovascular Association. She also acts as Secretary to the Irish Subgroup Meleady R, Verhoef P, D aly L, Graham I. Does Nurses Hypertension Association. homocysteine contrib/~te to post-menopausal vasct~lar disease risk? Eur Heart J 1996;17 (Abstract Supplement):433. Ms Vivien Reid has been appointed to the Nutrition Committee of the Food Safety Advisory Board at the Daly L, Meleady R, Graham L. The extra yield of a post Department of Health. methionine load homocysteine estimation over a fasting valm Co in determining vascular risk. Eur Heart J 1996;17 Dr. Anna Clarke has been appointed to the National (Abstract Supplement):510. Steering Committee of the Irish etwork of Health Promoting Hospitals Gormally SM, Kierce BM, Daly LE, Bourke B, Carroll R, Durnin MT, D rumm B. Gastric metaplasia and dt~oderlal ulcer disease in children infected by Helicobacter Publications Pylori. Gut 1996;38:513-17.
Reid.V. Clinical assessment in primary care:professional The for Palliative Care Service ______
During 1996 the palliative care team continued its aim to ranges from two to thirty visits depending on severity of achieve quality care for patients not only with advanced symptoms and length of hospital stay. Other patients are pal cancer but also non malignant disease. As always, the policy referred for psychological support for themselves and their is to work alongside the primary team, offering advice and families. The figures below represent team activity. Iris support but without assuming management. Co It was another busy year for the team. The II1creasing New referrals 282 service workload has finally been met with an increase in nursing staff. We welcome Anna Marie Lynch who came to Patients discharged home us !Tom St. Gcorge's Hospital in London where she worked (with hospice home care teanl support) 69 as a clinical nurse specialist in palliative care. This post is un funded for two years by the Irish Hospice Foundation. The Patient discharged home with no an clinical area continues to demand most input, however, it hospice home care 25 has been possible to begin to expand the other essential Th aspects of the service i.e. education and research. Patients transferred to other hospitals 19 Bri ac Patients who died in St. Vincent's Hospital. 109 Members of the team ______Patients transferred to Hospice 50 Dr. Michael Kearney, Consultant in Palliative Medicine at Our Lady's Hospice, Harolds Cross and St. Vincent's Hospital. Audit ______Specialist Nurses: Noreen Holland and Phi I Pyne who share one full-time post and Anna Marie Lynch who has a full In the autumn we were in a position to reintroduce time post. computerized documenatation of team activity as well as The team is very grateful to Dr. Dymphna Waldron who our plarmed clinical audit. Clinical audit is carried out to provided locum consultant cover while Dr. Kearney was on evaluate the effectiveness of our interventions. A modified sabbatical. version of STAS (Support Team Assessment Schedule), a measurement tool originally developed for community palliative care teams was initially piloted in December. It Set'vice Wo t'kload ______will be implemented from January 1997.
The control of pain and other symptoms is the commonest reason for referral. Patients referred specifically for referral Education ______to community palliative care teams often also have unresolved symptoms. Our involvement with patients Education is an important part of the team role as the
Awmal Report 1996 St. Vincent's Hospital
dety priniciples of palliative care need widespread dissemination. Individual Study ______Teaching takes place both informally on the wards and in
anais the school of nursing. Ward based teaching is very much Phil Pyne successfully completed a Higher Diploma 111 reactive in nature when for example there have been Oncology Nursing at University College, Dublin. difficult situations that have been distressing for the staff Does involved . The team partipipate in student nurse education Anna Marie Lynch received a B.Sc. (Hons) - Palliative isease during the first and final year of their student nurse training. Nursing from University of Manchester at the Royal I. Marsden Hospital, London.
post 'a/ue Conferences attended ______Conclusion ______6;17 Moving points in Palliative Care, Our Lady'S Hospice, The palliative care team is now a well established service Harolds Cross, March '96 within St. Vincent's Hospital and is raising awareness of the troll principles of pallliative care widely across different and 9th International Conference on Cancer Nursing, disciplines. Areas of particular interest for the future lcter Brighton, August '96 include the expansion of the service to include a greater number of patients with advanced non malignant disease. Palliative Care Research Forum, Coventry, November '96 We also need to increae our profile in nurse education particularly regarding formal continuing education for The A.G.M. and half day seminar of the Irish Association trained staff. for Palliative Care, December '96
Oral Presentations ______
The Annual Conference of the Department of Nursing, { of University College Dublin. Advances clinical practice in are palliative care. Noreen Holland. heir Irish Association for Palliative Care, Third Annual Conference of the Nursing Advisory forum, Current issues ill palliative care nursing', the Education and Research Centre, St. Vincent's Hospital, An overvieJV on palliative care mming in the acute setting, Noreen Holland Our Lady's Hospice, Harolds Cross, Education department. Palliative care in the acttte hospital, for nurses undertaking the eight week course 'care of the dying patient and his family:. Noreen Holland
The 9th Internation Conference on Cancer Nursing in Brighton. The development of bereavement follow up in an acute hospital setting. Anna Marie Lynch.
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A1l111tai Report 1996 St. Vincent's Hospital
Pathology Department ______
During 1996, the number and range of diagnostic the Rhewnatology Department about Lupus anticoagulant investigations offered continued to increase. Departmental in S.L.E. patients at me British Society of Rheumatology. staff continue to significantly contribute to both hospital She also presented a paper about me Irish experience of based, clinical and research conferences and projects, activated protein C resistance at me annual conference of National & International Meetings and publish in the me Academy of Medical Laboratory Sciences. biomedical literature. Pathology staff were associated Witll 21 publications in peer-reviewed journals in 1996. One of the major tasks of tlle year was the drawing-up of an outline Publications ______plan for a new Pathology Deparmlent which will be part of the new developments in the hospital. Abramson G.M., Bird J.M., Newland A.C., Dominar E., Giles C., Joiner M., Ke1sy S.M., Lewis D., Haematology Department___ _ McCarthy D.M., Roques A.W., Tew C.J., Tracey M., Ban de Pette J and Sampson D. A randomised study of VAD therapy with either concurrent or maintenance This year the number of tests requested increased by 5%. A interferon in patients with newly diagnosed multiple large number of these tests were requests for myeloma. British Journal of Haematology, 94: 659-664, Thrombophilia screens which were particularly time 1996. consuming. With the introduction last year of the test for the abnormal DNA for the Factor V Leiden abnormality, Mulherin D., Skelly M., Saunders A., McCarthy D.M., there has been an increase in work especially from outside O'Donoghue D., Fitzgerald 0., Bresnihan B., hospitals and general practitioners. Mulcahy H. The diagnosis of iron deficiency in patient's lvith Rheumatoid Arthritis and anaemia: an alg01'ithm using The peripheral blood stem cell transplantation programme simple laboratory measures. Journal of Rhewnatology, 23: for oncology and clinical haematology patients has become 237-240, 1996. exceptionally busy, especially during the latter part of 1996. 45 stem cell collections were performed and cryopreserved. Clinical Biochemistry Department_ This year saw the start of the anticoagulant monitoring service for the whole hospital. Since April 1996, when the service started, 2,800 alterations in patients anticoagulant The number of tests performed in me Biochemistry doses have been made. Anticoagulant patients are Department in 1996 topped me million mark (total = phlebotomised in Outpatients and their blood and 1,028,734) for me first time, due to a further increase in anticoagulant booklets are sent to the Haematology service workload of 5.3% over that in 1995. Once again, deparmlent. There, at 2 pm each day, a member of staff me most significant increases were in liver function tests, reviews me results and me new dose of warfarin is amended reflecting the Hospital's commitment to liver transplant, in me patient's booklet. This is men posted to tlle patient, hepatitis C and oncology patients. There was also a who receives it tlle next morning. This has been a great significant increase in cholesterol testing, reflecting me success as me patients do not have to wait to be told meir increased emphasis on cholesterol as a risk factor in result and me possibility of error in prescribing and ischaemic heart disease. Due entirely to the dedication of monitoring anticoagulant has been greatly reduced. tlle Biochemistry staff, mis furmer increase in workload was once again achieved without any increase in staffing levels. Demands on tlle out-of-hours emergency service Meetings Attended ______remained very high in 1996. The first six monms of me year were extremely busy, wim record levels of out-of-hours Dr. McCarmy and Ms. Pauline Crosby attended me first requests being received for each monm from January to international symposium on autografting for autoimmWle June, making it very difficult to cope wim me demands. disease in Base!. Mr. Ivan Shirley and Ms. Pauline Crosby attended me Coulter Flow Cytometry users group meeting A Biochemistry Test Manual incorporating details of tests in Manchester. Ms. Bernie Collins attended me U.K. performed, specimen requirements, reference ranges and Quality Assurance meeting in Sheffield and Ms. Pauline factors influencing test results, was prepared and circulated Crosby attended the Flow Cytometry workshop in to all wards (word processing and layout by Marian Kelly). Newcastle and me stem cell harvesting symposium in As part of me Management Development Programme at St. Birmingham. Vincent's Hospital, Dr. S. Cunningham and others engaged in a group project to study me problem of specimens received in me laboratory which are unsuitable Presentations ______for analysis. Arising from this study, Phlebotomy Guidelines were prepared in collaboration wim Ms. Brenda Ms. Cariosa Power presented a poster in conjunction wim Flannery, Senior Phlebotomist, and circulated to all staff
Ammal Report 1996 St. Vincent's Hospital ,,· • v dJc~, \
engaged in phlebotomy. A Biochemistry Laboratory potential role in the modulation of adrenal androgen Journal Club was established to discuss developments in production. J. Endocrinol151: 301-307, 1996. new tests and analytical techniques and has proved very successful. Fiad TM, Cunningham SK, McKel111a TJ. Role of ant progesterone deficiency in the development of luteinizing 'gy. New methods for complement components C3 and C4 hormone and androgen abnormalities in polycystic ovary of based on improved IFCC standardized methods were syndrome. Eur J. Endocrinol135: 335-339, 1996. of established on the Beckman Array instrument. This work led to interesting observations regarding C4 activation in McKel111a, T.T., Cunningham S.K. Testing for adrenal vitro in specimens from some Hepatitis C patients. Aspects abnormalities in polycystic ovary syndrome; In , The Ovary: of this work were presented at ACBI '96 (the Annual Regulation , Dysfunction and Treatment, International Conference of the Association of Biochemists in Ireland ) Congress Series 1106, (Filicori M. & Flamigni C. Eds. ) and at the 16th International Congress of Clinical Elsevier, Amsterdam, pp 295-301, 1996. Chemistry (ICCC) in London by Orla Maguire, Sean lar Cunningham and Pauline O'Gorman. Other current areas )., of development involve evaluation of Troponin I as a -i., marker for myocardial damage and of new methods for of Department of Histopathology direct measurement of HDL cholesterol (development tce work mainly carried out by Michael Kelly, Paula O'Shea and Die (including Cytopathology) ___ Mairead O'Leary). i4, Dr. Cunningham, in collaboration with Prof. T. J. Mc Kenna, presented studies on the influence of age, There was a continued increase in the number and 1., testosterone, calcium and calcium antagonists on human complexity of histopathological and cytological t, adrenal androgen and cortisol synthesis at the Irish examinations performed. Although, the number of post :th Endocrine Society Annual Meeting, the 16th ICCC mortems showed only a slight increase, the complexity fig meeting in London and the 10th International Congress of involved in many cases continues to increase. 3: Endocrinology in San Francisco. Ursula Fearon, a postgraduate student in the Education and Research We welcomed John Crosbie as our new Mortuary Centre, obtained her PhD Degree in Biochemistry based in Technician. John has extensive experience in the area, part on this work. gained largely at the Ealing Hospital Trust, Middlesex. Dr. Ann Reilly has greatly assisted in the locum consultant position made vacant by Dr. McCabe 's death and is Michael Kelly gave a presentation for measurement of contributing to consolidating our links with St. Luke 's :y Angiotensin Converting Enzyme at the Annual Meeting of Hospital. Dr. Catherine Clarke continues to perform a the Irish External Quality Assurance Scheme, (also valuable 8 session locum. We welcomed Dr. Radhika 11 attended by P. O'Gorman ). Colette Hatton attended a Ramnath, Dr. Fergus McSweeney & Dr. Helen Corby as 1, Royal College of Pathologists Seminar in London on SHOs and Dr. Gerry McCarthy as registrar into our s, "Stress in the NHS " and spoke on Stress on a number of training programme. t, occasions in St. Vincent's Hospital during the year. A a Beckman protein electrophoresis workshop was attended by Both medical and laboratory- based members of staff .e P. O'Gorman and C. Hatton. Biochemistry staff also attended and presented at numerous National & n attended meetings organised by the Academy of Medical International Meetings. Rosaleen Rafferty attended the )f Laboratory Sciences and the A.C.B.I on Accreditation, Management Course run by Institute of Public d Safety, Oncology, Computing in Clinical Laboratories, Administration and the Mission Effectiveness Course. g Biochemistry of Critical Care and attended AdLab and Patricia McCarthy attended the Irish Association of Cancer e ACBI '96. Research Annual Meeting. Ann O'Callaghan attended the e Annual Meeting of the British Association of Cytology. 's ) Publications ______Dr. Susan Kennedy is presently Secretary of tile Pathology Section, Royal Academy of Medicine in Ireland. Dr. iamb O'Col111ell Y, McKel111a TT, Cunningham SK. b Nolan continues as Chairperson of the Irish Association of lipotropin-stimulated adrenal steroid production. Steroids Clinical Cytology. Dr. Kieran Sheman is the Education 61; 332-326, 1996. Sub-committee Secretary of the Faculty of Pathology, R.C.P.I, and is also the Secretary of the Inflammatory Fiad TM, Conway JD, Cunningham SK, McKel111a TJ. Bowel Disease Directorate of the Irish Society of Ibe role of plasma renin activity in evaluating the adequacy Gastroenterology. He was recently appointed for a five year of mi1Jeralocorticoid replacement in primary adrenal term to the National Cancer Registry Board. This f insufficiency. Clin Endocrinol 45: 529 -534, 1996. department liaises closely with the Board 's Tumour Registry Officer based in this hospital (Ms. Martina Ryan ) Clarke D, Fearon U, Cunningham SK, McKel111a TT. and is responsible for supplying much of the cancer data. Ibe sterodogenic effects of b-endorphin and joining peptide: A The Board 's first report (for 1994) will soon be published.
Ammal Report 1996 St. Vincent's Hospital
Publications ______preoperative autologous blood donation programme was nlrther developed but demand from surgeons is so far Mercer P.M., McCabe M., Murphy J.J. Recurrence of limited. osteoclast-like giant cell carcinoma of the pancreas after 10 years. Aust. N.Z.J. Surg 66: 334-335, 1996. A new image analysis system for blood grouping was set up which allows a permanent image of the patient's blood Mullett J.H., Rabim A., Hegarty J., Sheahan K and group to be held on record indefinitely. CMV testing was Murphy J.J. Case Report: Mesenteric LymphangiomatottS introduced to aid in a more efficient and cost effective Cyst, Irish J. Med. Science 165: 299, 1996. approach in the management of blood and blood product needs in Liver Transplantation and Haematology/ Hayes F.J., Sheahan K, Heffernan A and McKenna Oncology. T.J. Aggressive thyroid cancer associated with toxic nodular goitre. European J. OfEndocrinology 134: 366-370, 1996. Despite an increase in patient throughput in the department, blood usage fell for the first time in recent Leahy D.T., Salman R., Mulcahy H., Sheahan K, years. This may be due to a decrease in the number of liver O'Donoghue D.P. and Parfrey N .A. Prognostic transplants during the year or possibly a more cautious significance of p53 abnormalities in colorectal carcinoma approach to transfusion. detected by PCR -SSCP and immunohistochemical analysis. J. Pathology. 180: 364-370, 1996. Carol McSherry departed to take up a Senior position at the blood transfusion laboratory in the Coombe Hospital and Reynolds J.V., Joyce W.P., Dolan J., Sheahan K and Deirdre O 'Neill returned from leave of absence. Hyland J.M. Pathological in SIlpport of the importance of total mesorectal excision in the management of rectal cancer. Among the many meetings attended during the year were Br. J. Surg. 83: 1112-1115,1996. Safety in the Pathology Laboratory (A.Doherty). National Forum for Standards in Blood Transfusion Practise O'Driscoll L., Kennedy S, MacDermott E., Kelehan P (L.Hopkins, P.O 'Brien, T.Cronly) and Accreditation in the and Clynes M. Investigation of expression of multiple drug Pathology Laboratory (P.O'Brien). resistance (MDR) related genes in formalin -fixed paraffin - embedded tissues. European J. Cancer 32A; 128-133, 1996. Department of Microbiology ___ Mulhern M., Moriarty P and Kennedy S.M. Bilateral Orbital Kimura's Disease. Orbit 15; 91 -96, 1996.
Kennedy S.M., McNamara M., Hillery M., Hurley C., Collum LMT. and Giles S. Combined Granular Lattice During 1996 the department's workload showed an Dystrophy (Avellino Corneal Dystrophy). Br. J. Ophthalmol. increase of8% over 1995. The department made a decision 80; 489-490,1996. during the year to automate TB culturing by purchasing two MB/BacT instruments from Organon Teknika. This Fitzsimon J.S., Mulvihill A., Kennedy S.M., Finch A., was done to enable the department to handle the hospital's Collum LMT and Eustace P. The association of HLA type workload and in addition provide this service for St. with psuedoexfoliation of the lens capsule. Br. J. Ophthamol. Michael 's and St. Columcille's hospitals, whose work we 80; 402-404, 1996. have undertaken from October of this year. Another interesting feature of this system is that it is likely to increase Bourke B., Goggin N., Walsh D., Kennedy S.M., the yield of positive cultures and produce results a week SetcheU KDR and Drumm B. Byler-like familial cholestasis earlier than at present. in an extended kindred. Archives of Disease in Childhood 75; 223-227, 1996. Research Activities ______McNamara M., Clynes M., Dunne B., NicAmhlaoibh R., Lee WR., Barnes C and Kennedy S.M. Multidrug Current research activities are focussed on Clostridium resistance in ocular melanoma. Br. J. Ophthalmol 80; 498- Difficile, infective endocarditis, MRSA in cystic fibrosis, and 499,1996. antibiotic prescripting habits.
Staffing ______Blood Transfusion ______Professor W. Hall, a Consultant Virologist, joined the consultant staff during the year. He is also Director of the During the year a Hospital Blood Transfusion Committee Virus Reference Laboratory in UCD. was set up with the objective of promoting the highest standards of Blood Transfusion Practice in the hospital. The
Ammal Report 1996 St. Vincent's Hospital V··· I dJ" c~'Sl '
lS Conferences / Courses attended ______Mycology. Editor: Kibbler e.C., MacKenzie DWR., Odds I F.C., Wiley, 1996. A large number of courses and conferences were attended by staff including: Fene10n L.E. Unumal infections and novel therapy in the :> immtmocompromised host. Current opinions in infectious :l Parasitology Workshop (College of Surgeons) attended by diseases . 1996: 9, 246-251. Dr. fume Gilleece and Margaret Pickup.
Parasitology NEQAS Workshop (Regional Hospital, Cork) attended by Ed. McCullagh. Pathology Professorial Unit ---
BacT Alert User Group meeting (Warwick, UK) attended by Eugene Crummy and Margaret Pickup.
BacT Alert Irish Users Group Meeting (Dublin) attended Smffing ______by Eugene Crummy, Margaret Pickup and Helen Barry. Dr. John McMahon took up a post as Special Lecturer in BOC Gases Safery Seminar (Dublin) attended by H. Barry July, 1996. Dr. Maire CalIaghan moved to take up a and Donal Quinn. permanent lecturer post at the RTC, TalIaght. Dr. Priya Abrallam returned to her native country of India after European Congress of Chemotherapy (Glasgow) attended spending a year as Special Lecturer with the department. by Dr. L. Fenelon and Dr. A. Gilleece. Dr. Hilary Lane departed for a year in the USA.
Interscience Congress of Antimicrobial Agents and Chemotherapy (New Orleans). Attended by Dr. L. Post-Graduate Students ------Fenelon. 1996-1997 Antibiotic Assay Course (Bristol) attended by Dr. A. M.Med.Sci Dr. Uzuma Zafar, Gilleece. Dr. Donal Tansey Ph.D. John Stephens, Bacterial Surface Structures (SGM) meeting in Galway Dermot Leai1y, attended by D. Drudy. Collette Hand. 1996 Laboratory Accreditation meeting (Dublin) attended by Summer Students Tan See Ling, Vincent Cheai1 . Eugene Crummy, Helen Barry and B. Cassidy.
Food Microbiology meeting (Dublin) attended by J. Kavanagh. Presentations ______
Mr. Eugene Crummy and Dr. Lynda Fenelon visited A large number of presentations were made at National and Manchester General Hospital to see the Mast Radius International meetings during the year (details available in antibiotic sensitiviry testing instrument in use . Deparmlent) .
Achievements ______Papers Published ------
Dr. Ann Gilleece passed the MRC Path , Part I in Leahy D.T., Salman R., Mulcahy H., Sheahan K., November and now has the DipRCPath. Ed. McCulIagh O'Donoghue D.P. and Parfrey N.A. was conferred with the MSc degree during the year. Eugcne "Prognostic significance of p53 abnormalities in colorectal Crummy completed the Management Course run by the carcinoma detected by PCR -SSCP and immtmohistochemical Institute of Public Administration for SVH. analysis ". Journal of Pathology, 180: 364-370,1996.
Publications ------
Moorhouse E., Fenelon L.E., Hone R et al. StaphylocctlS Aureus sensitivity to various antibiotics. A national survey in Ireland 1993. Irish Journal of Medical Science 1996: 165, 40-43.
Fene10n L.E., Kennedy S.M. Fungal Disease in Ophthalmology. In: Principles and Practice of Clinical
A1I1lttal Report 1996 St. Vincent's Hospital ~ ······v - dJC""''JI
Department of Immunology ___ Detection interpretation and clinical significance of autoantibodies in systemic rheumatic disease.
The workl oad in the Immunology Laboratory has continued to increase in 1996. ew developments included the introduction of testing for Alpha Gliadin antibodies, anti Jo, Anti LKM and the monitoring of FK 506 Department of Endocrinology (Tacrolimus) levels. & Metabolic Medicine - --- The number of requests for PCR and Southern blotting studies of complicated cases of lymphoid neoplasms has The aCUvItIes of these laboratories is included under increased through 1996. In addition, to immunoglobulin Department of Endocrinology/ Diabetes Mellitus & and T-cell receptor gene rearrangement studies, Southern Metabolism. Blot analysis has recently been established for the identification of monoclonal EBV proliferations. We are currently developing PCR analysis to detect BCL-1, (t(1l;14) translocation, which is associated with Mantle cell lymphoma. Department of Phlebotomy
Staffing ______1996 continued to be a very busy year for the department. Weekend cover of the hospital continued. Saturdays had been extremely busy so a priority list of wards was drawn up Sheila Friel BSc, returned to England to work in tlle and specific quotas were set. A Sunday phlebotomy service Molecular Biology section of the Blood Transfusion Centre was established during the year, covered by one in St. Albans, Sheila has been replaced by Sharon Ayers phlebotomist, CCU, St. Raphael's and St. Teresa's Wards. MAMLS. Bernadette Daly-Burns BSc, who was on a part This service worked satisfactoril y and was closely time contract has now been appointed to a full -time monitored. position. Evelyn HarUligan FIMLS, FAMLS, has recently been promoted to Chief Technologist. In OPD, the walk-in GP service continued and led to a huge increase in the workload of the department. This operates from 9 am to 12 mid-day, Monday to Friday. Seminars and Conferences Attended A total of 36,548 patients for blood tests were seen at the The Immunology staff regularly attended the lunchtime Out-Patient Cli nic in 1996. This was an increase of 7,080 Pathology Conferences and Biomedical Research Seminars. patients on the previous year. Other specific conferences were as follows:
The Inaugural Conference of the Institute of Molecular Medicine.
Joint Scientific Meeting of the Irish Society for Immunology/Ulster Immunology Group.
"Accreditation - Towards Quality in Pathology" organised by the Management Advisory Body of tlle Academy of Medicine Laboratory Science.
"Cellular and Molecular Regulatory Mechanisms in Human Disease ", organised by St. Vincent's Hospital Education & Research Centre.
"Update in Autoimmunity" organised by the Immunology Advisory body of the Academy of Medical Laboratory Science.
Evening Safety Seminar organised by the Safety Advisory body of tlle Academy of Medical Laboratory Science.
AdLab Scientific Conference and Trade Exhibition.
Update on Transplantation in Ireland.
Amll School of Nursing ______ Development and Activities Library, Medical Records and Out-Patients, Missions, Product Evaluation, Theatre Education and Wound Care. 1996 was a challenging and busy year for the School of The school staff organised and participated in the following Nursing. in -service education programmes for registered nurses: In April the Department of Health gave approval for the Five one-day seminars on Assessing and commencement of the Registration/ Diploma Course of Interviewing Student Nurses in the Clinical Area. Nursing, and advancement in nurse education which was Five two-day courses for Critical Care Nurses. enthusiastically welcomed. Academic accreditation of the Fourteen sessions on Intravenous Policy. three year curriculum leads to Registration as a General Five one-day seminars on Teaching and Learning Nurse with An Bord Altranais and a Diploma in Nursing Methods. from the National University of Ireland. Nurse teachers Five sessions on Quality Assurance which initiated together with a committee representing administrative and the formation of a Quality Assurance Group. clinical nursing staff in collaboration with the Department of Nursing Studies, UCD developed the curriculum. Teaching commitment to other education programmes In December work commenced in the basement to create a within the hospital included: simulated ward comprising a six-bedded room, a treatment room, a nurses station and storage space. The teaching and Basic Life Support - thirty seven sessions learning of clinical nursing skills in a supervised safe CPR Trainers Course - six days environment will be enhanced by this addition to the Advanced Cardiac physical resources of the school. Life Support - two days Manual Handling - six and a half days Lack of adequate classroom space to accommodate sixty students necessitated using the lecture theatre in the Throughout the year, nurse teachers continued to maintain Hospital whenever possible and further facilities will be links with their assigned clinical areas. needed for September 1997. Six students undertaking the BNS Course in UCD and one student studying for the Further and Higher Education Service Wo·,..kload ------Diploma at the University of Ulster were facilitated on teaching practice. Sixty supernumerary students commenced the Four staff members acted as examiners for An Bord registration/diploma programme on 30th September. In Altranais' Registration Examination. addition, there were two hundred and thirty students pursuing the traditional course and eighteen students undertaking post-registration courses as of December 1996. Staffing The advent of the registration/diploma course increased Sister Anne Curry departed in July, after five and a half years and intensified the volume of work for both teaching and as Principal Tutor, to study theology. Mrs Anne Malone secretarial staff. This situation is likely to be sustained until retired to Cork in June and Miss Cecilia O'Reilly resigned 1999 when students undertaking the traditional course in July to pursue her career in psychiatric nurse education at have completed their training. There are fifty eight weeks St. John of God Hospital, StilIorgan. Miss Heather theoretical input in the new course as opposed to forty Kevelighan transferred to Nursing Service and was weeks in the old programme. Two different curriculum appointed Clinical Practice Development Co-ordinator. models are used which compound the workload. Sincere gratitude is expressed to each of them for their committed and dedicated work in the school. Staff are members of six new committees related to the development, implementation, monitoring and evaluation Miss Marian Quinn and Miss Regina Joye were welcomed of the new course. The Policies and Procedures Committee to the staff in September and December respective ly. and the Education Committee continue to meet regularly. As of December 1996 there was a shortfall of three teachers In addition nurse teachers attended meetings of the in the school. following hospital committees: Back Care, CPR, Clinical Practice Development, Drugs Usage, Ethics and Research, Infection Control, IV Policy, A1l1lttal R eport 1996 St. Vincent's Hospital Conferences and Courses Attended _____ Mrs. Mary Nicell - Irish Nurses Organisation Theatre Nurses Annual Miss Loretto Browne Conference, Dublin. An Bord A1tranais National Conference for Nurse - First Year M.Ed. Course, University of Wales, Bangor. Tutors and Clinical Teachers, Dublin. 8th AImual Conference of the Quality Assurance Miss Cecilia OJReilly Nursing Association, Dublin. - Study Day on Aspects of Psychiatric Nursing, Faculty - An Bord A1tranais National Conference on Continuing of Nursing, RCS!. Professional Education, Dublin. Mrs Jacqtteline Burke Achievements ______- Bachelor of Nursing Studies Course, UCD. Pre-Registration Course Miss Sheila Byrne - Interpersonal Skills Course For Nurse Teachers, UCD Eighty seven students were successful in the Intermediate - M.Sc(Mgmt) in Organisation Behaviour Course, Irish Certificate Examination and ninety seven in the Management Institute in association with TCD. Registration Examination. Mr. Kevin Connaire Post-Registration Courses - An Bord A1tranais Study Day on Issues in Written Registration Examinations, Dublin. A total of thirty five students successfully completed post - Commenced sttldies for M.Sc in Nursing, Royal registration courses in the following nursing disciplines: College of Nursing and University of Manchester. Accident and Emergency (six), Anaesthetics (twelve), Coronary Care (six), Intensive Care (six) and Theatre (five). Ms. Loretta Crawley - Association of Nurse Teachers Seminars and AImual Nurse Teachers General Meeting, Dublin. Commenced course leading to Masters Degree in Congratulations were extended to: Equality Studies, UCD. Mr. Thomas Kearns who was conferred with a M.Ed. from Sister Anne Cttrry University College Cork. An Bord A1tranais National Conference for Nurse Miss Marie Maume who was awarded a M.Ed. from the Tutors and Clinical Teachers, Dublin. University of Wales. Miss Mary Killeen Ms. Loretta Crawley on winning a Milupa Bursary to attend - Management Development Programme, St. Vincent's 13th Annual Nursing and Research Conference, Faculty of Hospital. Nursing, RCS!. - Interpersonal Skills and Problem Solving Course, Faculty of ursing, RCS!. - Seminar on HIV and Brain, St. James's Hospital. Conclusion ______- Annual Conference ofIrish Association of Nurses in AIDS Care, Dublin. Appreciation is extended to nursing administration, clinical - Interpersonal Skills Course for Nurse Teachers, UCD. nursing staff, lay management, heads of departments and all those who were of support and assistance during this Miss Geraldine McSweeney momentous year for nurse education in St. Vincent's. - CICIAMS European Regional Congress, 's Hertodenbosch, Holland. Geraldine McSwemey, Miss Hilary Merchant Acting Principal TlItor. - An Bord A1tranais Study Day on Issues in Registration Examinations, Dublin. - Second Year M.Ed. Course, University of Wales, Bangor. Miss Marie Maume - Interpersonal Skills Course for urse Teachers, UCD. - An Bord A1tranais Study Day on Issues in Registration Examinations, Dublin. A1I1Htal Report 1996 St. Vincent's Hospital ···· • V dJ~"" 'S1' Department of Diagnostic Imaging ______ A new spiral CT scanner was installed mid year and ably The statistics of the Diagnostic Imaging Department for commissioned by Senior Radiographer Susan McAlinden. 1996 are as follows: With the addition of this new unit we have increased the throughput of patients whilst reducing the volume of out of Inpatient Examinations 30,545 hours work. It is now possible to perform procedures of Outpatient Examinations 19,223 greater complexity which previously would have required more costly invasive investigation. Casualty Examinations 29,907 GP Examinations 11,824 1996 also saw the installation of Digital Fluoroscopy Other Hospital Examinations 3,158 equipment. This 'state of the art' replacement for the 26 year old room provides optimum image quality and Total Of Examinations in 1996 94,657 diagnostic information with minimum radiation dose. This is a very important factor in Interventional Radiology which, due to the benefits for tlle patients, is increasing. Smjfing------This workload is mainly carried out in the Angiography room which, being now 14 years old, needs to be replaced Dr. Jim Griffin completed his term as Director of the with the latest technology. Department at the end of August at which point Dr. Robin Gibney commenced in this role. During 1996, a Management Consultancy firm was engaged to advise regarding improvements in overall Dr. Dermot Malone has been appointed as Postgraduate efficiency and utilisation of the Department, particularly in Education Coordinator. relation to services for in -patients. In conjunction with the Director , Superintendent Radiographer and Clerical Dr. Neil O'Donovan joined the department as Lecturer in Supervisor, major changes were recommended and Radiology. implemented. Further reorganization of the clerical staff improved working conditions and staff morale. Ms. Deirdre Scott-Hayward was promoted to Superintendent Radiographer III. We are delighted that our radiographers, particularly in the Service Wo rkload ------specialist areas, are so highly regarded as to be sought after both as lecturers and supplications specialists. In the latter We are happy to note that although examination numbers capacity, Senior Radiographers, Joan Miller and Elizabeth are slightly increased, they have been contained at roughly D'Arcy have both been highly acclaimed for their the same level as the previous year. However, we have been knowledge and expertise, at home and abroad. able to increase access for GP patients particularly for general radiography and for ultrasound. In addition, we Joanne Hammond has returned to us having completed her have been able to accommodate the increased demand for Msc. studies. Gail Keane took up tlle post of Acting Senior mammography with a substantial reduction in the waiting Radiographer in Nuclear Medicine. time for symptomatic patients. We welcome SjN Deirdre Kelleher, a new addition to our AmlZtai Report 1996 St. Vincent's Hospital department in a job share capacity with Nuclear Medicine. Conferences and Courses Attended In the area of research, Ursula Long is to be commended Radiological society of North America, Chicago. on successful completion of her part in a major study into contrast media coordinated by Dr. Masterson. This Canada Association of Radiologists Annual Meeting, department's component of the study was performed so Vancouver. efficiently that this hospital was asked to take over the final Fleischner Chest Society, Vancouver. stages from another European hospital. European Society for Gastrointestinal and Abdominal Radiology, Brussels. Department staff are involved in the provision of both undergraduate and postgraduate radiography education, as Endovascular Radiology, Leicester. well as career guidance. In addition, staff are very much Faculty of Radiologists AImual Meeting, RCSI. concerned with their own continuing professional Royal College of Radiologists, Birmingham. development. American Roentgen Ray Society, San Diego. In March, Helen O'Reilly (Clerical Grade HI) returned CPR Certificate Course. from Australia after a one year career break. Helen Supple Manual Handling Course. and Deirdre Thornton were promoted to Grade In positions. Towards the end of the year a restrucutring Bi-annual Irish Radiology Nurses Conferences. exercise was undertaken by the Department of Health European society of Thoracic Imaging, London. which created Grade VI and Grade IV clerical positions. These positions will be filled early in 1997. Imaging Services Management Seminar. The Trauma Patient Seminar. Ultrasound Update - Vascular Imaging. Honours and Achievements ______Aspects oflntervention in Imagine Departments. In November, Prof. Donal MacErlaine completed his two Minor Trauma x-rays Requests - A Multidisciplinary year term of office as Dean of the Faculty of Radiologists, Approach. RCSI. Radionuclide Imaging Update. Quality Issues of Mammography - Institute of Radiological Dr. J ames Masterson was elected President of the Irish Sciences. Hospital Consultants Association. Mammography Physics Training Meeting - University of Ms. Deirdre Scott-Hayward completed a 3 year term in the York. Council of the Society of Radiographers (London). During Post Graduate Diploma Course in Computed Tomography. this time she was able to initiate the formation of an Irish Society - The Irish Institute of Radiography was Post Graduate Diploma Course in Ultrasound. subsequently inaugurated on November 2nd. Post-Graduate Diploma Course in Radionuclide Imaging. Concepts of Care in Professional Practice. FRCR Oct 1996 FFRRCSI Nop 1996 Dr. Richard Murray Dr. Richard Murray Intravenous Injection Course. Dr. Deirdre Coil Dr. Deirdre Coil Health Services Management Diploma Course. Dr. Stephen Skehan Or. Stephan Skehan Uoint first place in the exam) Or. Tommy Greaney 1996 Publications ______Uoint first place in the exam) "Is transrectal ultrasound lvithout biopsy justifiable» Part 1 FRCRJune 1996 European]. of Surg. Oncology. 1996;22 (4) :410 Dr. James Carr Cunningham PM, Lynch TH, Sheikh N. Gibney RG, Dr. Peter Mac Eneaney Kelly DG, Quinlan DM. UCD Higher Diplomas were awarded with credits to: CfDiagnosis and Treatment of Heel Pain In Chronic Inflammatory Arthritis Using Ultrasound » Fiona Flatley - Ultrasound Semin Arthritis Rheum, 1996 April 25: 1-7 Susan Collins - Computed Tomography Cwmane G, Brophy DP, Gibney RG, Fitzgerald O. (First place in exam) CfDorsal Agenesis of the Pancreas: A Cause of Diagnostic Error on Abdominal Sonography" Deignan RW, Nizzero A, Malone DE. Clinical Radiology; 51: 145-147, 1996 CfDiagnosis of Hirschprung1s Disease» O'Donovan AN, Habra G_ Somers S, Malone DE, Rees A, Winthrop AL. Am J Roentgenol; 167:517-20, 1996. AlIIlItai Report 1996 St. Vincent's Hospital ···· ~ dJ.C"~"." "Water as an oral contrast agent in upper abdominal Annual Radiology Registrar'S Prize Meeting, December Magnetic Resonance Imagi~~ » Blake M, Masterson J. 1996. Irish Journal of Medical Science, Volume 165,3.221., 1996. Spiral CT of Abdominal Aortic Anettrysms with 3-D Image Reconstruction: Preliminary Experience «Comparison of accuracy of steroid placement with clinical Carr J, O'Donovan N, Malone DE Presented at the outcome in patients with shoulder symptoms» Eustace J, Annual Radiology Registrar's Prize Meeting, December Brophy D, Gibney RG, Bresnihan B, Fitzgerald O. 1996. Annals of Rheumatic Disease (in press). Invasive lobular breast cancer. Mammographicl Pathologic Correlation. Annual Scientific Meeting, Faculty of Radiologists Irish. Presentations Coll D, Mac Erlaine D, O'Connell E, Zbar A, Schering S, Kennedy S. "Sedation and Analgesia in Interventional Radiology» -Malone, DE a) Faculty of Radiologists, RCSI Imaging Services Management Seminar (Annual Refresher Course Meeting) Ms. Catherine McCoy b) European Society of Gastrointestinal and Abdominal Radiologists The Trauma Patient Seminar c) Radiological Society of North America Ms. Geraldine Coleman Ms. Elizabeth D'Arcy, «Combined Radiologic - Endoscopic Treatment of Biliary Ms. Edel Shom Obstruction » Blake M, Curry M, Malone DE, O'Donoghue D, Ultrasotmd Update - Vascular Imaging Gibney RG Combined Spring Meeting, Faculty of Ms. Fiona Flatiey Radiologists RCSI, April 1996. Aspects of Intervention in Imaging Departments "Radiological Approaches to Relief of Biliary Obstruction» Ms. Catherine Dullea Gibney RG SjN Brian Dempsey "Pre·operative Imaging in Pancreatic Cancer" Malone DE The Eight Annual Hepatobiliary Study Day, Minor Trauma X-Ray Reqtl,ests St. Vincent's Hospital Liver Unit. April 1996. -A Multidisciplinary Approach Ms, Elaine Scully "The Radiology of Liver Transplantation» - Malone DE Ms , Deirdre Scon-Hayward Dublin/ Boston Postgraduate Courses in Gastroenterology, St. Vincent's Hospital Postgraduate Medical Education Department. "Quantitative Hepatic Artery Doppler Studies after Liver Transplantation: An Evaluation » MacEneaney P, Skehan S, Curry M, Miller J, Gibney RG, McCormick PA, Malone DE. Presented at the School of Diagnostic Imaging ______ Development and Activities ------the same time, A short course leading to competence in intravenous injection procedures has been developed, and The full Honours degree programme is now operational, gained the commendation of the UK based CoUege of ineteen students entered the course in September 1996, Radiographers, who have used our course as the basis for Within the four year programme there are 72 their national standard programme. undergraduates in full-time education. Owing to the transition from a three year to a four year programme, there All the above courses have been granted the full were no graduates from UCD in 1996. professional accreditation of the College of Radiographers, and during the validation event in November, the CoUege A new Higher Diploma course in Radionuclide Imaging of Radiographers representatives praised the proactive commenced in September 1996, The second cohorts operation of the School and stated that its courses were studying Ultrasound and Computed Tomography began at amongst the best they had seen, Ammal Report 1996 St. Vincent's Hospital Postgraduate research is ongoing, with students Conferences Attended ______progressing towards Masters of PhD award. Adrian Adams The Programme of in -service education for qualified CAMME Validators Workshop, London radiographers continued, with a series of 8 study days and evenings being offered during 1996. These were very well Patrick Brennan attended by 155 qualified radiographers and associated Radiobioloby Seminar, St. Luke's Hospital, Dublin. imaging department staff from around the country. Irish Association of Cancer Research, Limerick Annual Conference of Irish Radiographers, Cork. A one day course in Radiation Protection has been British Sociery of Gastroenterologists, Brighton, U.K. developed which fulfils the requirements of radiation legislation for clinicians directing x-ray exposure: this will Lis Darcy operate bi-annually subject to demand. To date it has been Computed Tomography Conference, Edinburgh attended by 28 doctors from hospitals nation-wide. Trish Hayes Following the success of last year's pilot course, and 111 Radiology 96, Birmingham conjunction with the Dublin Dental Hospital, two three month training courses in basic radiography for dental Jan Healy nurses were offered in 1996. Continuing Strategy for your Survival, The Association of Radiography Managers Meeting, London. In total, there have been 72 undergraduates, 3 postgraduates research students, 3 students resitting old Kate Matthews curriculum diploma examinations, 26 Higher Diploma Conference on Consequences of Chernobyl Accident, students, 25 certificate students and 155 occasional Dublin Consortium for the Accreditation of Ultrasound students in the School during 1996. Education, London Geraldine O}Connor Service Workload and Staffing ______Equipment Management for Europe, Institute of Engineers, Dublin Workloads have reached a critical level. The delivery of four years of the degree programme, together with development Triona O}Farrell and delivery of three postgraduate diplomas, and a very Radiology 96, Birmingham active ongoing education programme, as well as British Medical Ultrasound Sociery Annual Meeting, undertaking and supervising research, have staff stretched Edinburgh to the limit. Louise Rainford Negotiations with UCD resulted in the appointment of IRS Qualiry Assurance Course, Liverpool three part time Special Lecturers, Liz Darcy is seconded Neuro Imaging Workshop, Belfast from St. Vincent's to teach in CT, Adrian Adams from the Mater to teach in RNI, and Triona O'Farrell takes up a post Marie Stanton to teach Ultrasound. These staff are crucial to the delivery British Medical Ultrasound Sociery Annual Meeting, of the postgraduate courses. Edinburgh National Ultrasound Education Group, London Obstetric Ultrasound Course, Dublin Achievements ______ Prizes were awarded to the following undergraduates: Publications ______ Catherine Doyle Brennan PC., Hogan C. & Matthews K. A study offttme Second Year Scholarship Award 1996 levels in three processing areas in one hospital. Sinead Peters Radiography (1996) 2: 11-18 Third Year Scholarship Award 1996 Geraldine Butler Daniels SI & Brennan PC. A comparison of tomography Fourth Year Scholarship Award 1996 and zonography during intravenous ttrography. Geraldine Blltler Radiography (1996) 2: 99 109 Siemens Award for First Place in Equipment Brennean PC & Carr KE. A tech1~ique for assessing radiation-induced change within a multicellular OI';gan, Irish Journal of Medical Science. (in press) O'Connor G Reflection on Clinical Practice: A Means of Fostering Professional Development Radiography (1996) 2,53-56 A1l1l1tal Report 1996 St. Vincent's Hospital Stanton M Biological Safety of Ultrasound: In sufficient Hogan C. Chemical fume levels in X-ray processing areas. Practical Information and No Consmsus on Responsibility Annual Conference ofIrish Radiographers. Cork, May. BMUS Book of Abstracts (1996) Matthews K. Diagnostic imaging of the foot and ankle. Irish Chiropodists Conference, Athlone, November. Presentations Nallon A. The darkroom disease: fact or fiction? Annual Arango D. MIP-I alpha reduces number of arrested Conference of Irish Radiographers. Cork, May. metaphases in small intestine. Annual Conference of Irish Stanton M. Radiographers. Cork, May Biological Safety of Ultrasound: Insufficient Practical Information and No Consensus on Respo1lSibility, Brennan P. A techniqlJe for assessing radiation -induced British Medical Ultrasound Society Annual Scientific change within a multicellular organ. Irish Association of Meeting, Edinburgh, December. Cancer Research, Limerick Outpatient Department ______ Out patient acuvlty continued to increase across all Dr. F.O.c. Meenan retired after many years service and we specialities. New patient referrals have increased to wish him well in his retirement. unprecedented levels. In 1996 a total of 81,628 patients Dr. B. O'Donnell Consultant Locum Dermatologist has were seen in the Outpatient Department. taken up his clinic. The setting up of a warfarin monitoring service provided by The staff or the outpatients department are delighted to the phlebotomy service in OPD and the haematology note the priority given to the outpatient service within the department has proved to be very well received by patients. project brief. In addition the provision of a walk-in GP referral phlebotomy service has been well utilised. Smffing------ Martin Bolger, Plaster Nurse, left to take up a much deserved charge nurse position in Cappagh Hospital. Staff Nurse Terri Lafferty has replaced him. AlIlIual Report 1996 St. Vincent's Hospital Personnel Department The past year has been a busy one 111 the Personnel implemented or in the process of being implemented. Department. During the year we also appointed a part-time Occupational From the point of view of recruitment considerable activity Health Physician. Due to unavoidable difficulties it was not took place over and above the normal levels, as a result of possible to establish the service fully in 1996. However, we the activation of the Project Team and the preparation for ex pect to see a significant contribution from the new service the opening of Carew House, which is planned for early in 1997 which should assist many important facets of the 1997. operation of the hospital. There was considerable change in the clerical/administration areas during the year. A new Personnel Department ______Management Structure was put in place, involving the establishment of two new General Manager posts. The The following senior appointments were made in 1996: Department of Health also agreed to a major review of the grading levels in all administrative areas. The results of this J J Cummins - Project Manager review have now been sanctioned and we plan to have all John O 'Callaghan - Technical Services Manager elements of the new grading structure in place by April Eamonn Fitzgerald - General Manager 1997. A further national development which has Robert Martin - General Manager implications for the new grading structures mentioned Phil Shovlin - Nurse Planning Officer above, is that the old Grade II level clerical posts are to be Maeve Crean - Senior Job-Sharing Occupational amalgamated \vith the Grade Ill. Therapist Nuala Moloney - Senior Occupational Therapist On the general services side, following national (Geriatric Day Hospital) negotiations, agreement was reached that staff formerly Gerard Russell - Purchasing Officer paid on a weekly basis would in the future be paid fortnightly. This change has been implemented for most maintenance, portering, catering and related grades, and is Retirements ______a more cost effective system than the former arrangement. Joe Scully - Ward Orderly The Management Development Programme, involving (Acting Mortuary Technician) approximately forty people from a very wide range of Sean Kavanagh - Fitter/ Plumber hospital departments, which commenced in 1995, Colette Mulhare - Housekeeper continued until May/ June 1996. A number of projects were completed by the various groups involved in the programme and many of their recommendations are now Pharmacy Department ______ 1996 saw an increase in activi ty and some important Claire Keane's pre-registration project "Adverse Drug event developments in the Pharmacy Department. An reporting in a busy Dublin Hospital" was shortlisted for improve ment in staffing levels was the single most best pre-registration project of the year. She presented her important factor in facilitating these developments. project at the Irish Pharmaceutical Congress (Ennis, October 1996). Achievements ------Developments / Activities Jacinta Deane presented a poster "An Audit of Drug Administration in a Large General Hospital, at the HPA While the number of items dispensed by the Pharmacy in Annual Clinical Conference (Dublin, April 96). 1996 (180,000) was marginally decreased compared to 1995 figures, overall activity increased. Fionnuala Kenedy did a presentation on the - "SeJf Expenditure on drugs increased by approximately 14% administration of Medication Programme in a Liver mainly due to an increase in activity in ICU, and the Cystic Transplant Unit" at the HPA Annual Clinical Confernece Fibrosis and Oncology specialities. (Dublin, April 96) A1I111tal Report 1996 St. Vincent's Hospital Aseptic Services by staff members and followed by a question/answer - the aseptic cytotoxic chemotherapy service was extremely session and group discussion. busy. A total of 5087 preparations were compounded and dispensed in 1996. The monthly average of 460 showed an A series of pharmacology and therapeutics lectures for 18% increase on 1995 activity. The number of PCA pharmaceutical technicians was held in the department. infusors filled in the Pharmacy was 1084 which was slightly less the previous year. In 1996 Pharmacy staff also lectured to NCHDs and nursing staff (IV critical Care Study days ). Information Technology In March 1996 tlle department hosted a visit from final year - a decision was taken in 1995 to re-organise the drug Pharmacy wldergraduates (TCD) as part of their "Practice information service in the Pharmacy and this became a of Pharmacy" module. reality in 1996. The Pharmacy was involved in compounding, dispensing The service is now located in the Pharmacy's Secretary's and record keeping for twelve clinical trials in 1996. Office (Ext 4738) and manned by a pharmacist. The In addition a number of Pharmacy-driven research studies information resources (textbooks, journals, etc .. )have been were conducted. supplemented with drug information software (MICROMEDEX) which gives users ready access to up-to A study of refrigeration conditions for medicines on date reliable references. wards/departments throughout the hospital was conducted Drug information queries are welcomed from health care in October/ November. Data is being collated for personnel in the hospital. presentation to hospital management and nursing staff early in 1997. A"Pharmacy Review" is compiled by the drug information pharmacist and circulated to wards and staff every two A drug utilisation evaluation (DUE) of certain GI drugs months. The review contains an update on the hospital was carried out by pharmacists in May 1996. This was been drug formulary, changes in hospital drug policies relevant followed in December by a joint Pharmacy/ up-to-date safety information on drugs (Adverse drug Gastroenterology Study. Results of the latest study were reactions, interactions etc ... ) and other drug related topics. being evaluated and written up at the time of writing (February 1997). Department Policies and Protocols - during the year work has been ongoing with respect to Cli11ical Interventions written policies/protocals on all aspects of the Pharmacy - Between 3 - 4 clinical interventions were made each day servIce. by pharmacists in 1996 (Total 767). These covered a wide spectrum e.g. drug inapproptriate for condition, suggested I11tern Orientation Programme drug therapy for condition, dose inappropriate for - June 1996 condition, therapeutic duplication, non-formulary drug prescriptions etc ... The Pharmacy Department was represented by two Prescribers were contacted by pharmacists and where members of staff at the intern organisation programme. A appropriate, interventions were noted by pharmacists in 36 page booklet "Guide to Pharmacy Services" was green pen on patient notes. prepared and distributed to interns. This covered subjects such as Pharmacy services, good prescribing practice, Inpatient Prescription Sheet aseptic technique etc .. - the Drugs Usage Committee agreed in December that the Suggestions on how the programme, especially the time current inpatient prescription sheet needed to be allocated to the Pharmacy contribution could be improved amended/ replaced. A senior pharmacist and representatives were subsquently relayed to the organiser. from nursing and medical staff are currently working on the new sheet. Edttcati011 and Research - Irene Maher joined tlle Pharmacy staffin January 1996 on Patient Information Leaflets (PIIS) a two year Msc in Hospital Pharmacy course. Senior - In 1996 a senior pharmacist (HDU) put together Pharmacists in the department have been involved in the information leaflets for liver transplant patients. These process of tutoring and assessment which tlus course entails. leaflets present concise guidelines on drug therapy and information on medication taken by transplant patients in Claire Keane successfullly completed her pre-registration user friendly language. training year in November 1996. There are general statements on groups of drugs and more specific monographs on individual products. A Grainne Murphy joined the staff in ovember 1996 for her questionnaire was also devised to gain feedback from pre-regristration year. patients on format and content. A programme of inhouse educational presentations and New Edition of Hospital Formulary lectures commenced early in 1996. This is co-ordinated by - At the end of 1996 the Drugs Usage Committee agreed a senior pharmacist. Case presentations, disease therapy, that a subcommittee should review the hospital formulary. ongoing research projects, new projects etc ... are presented Representatives of Pharmacy, nursing and medical staff have Anllltal Rt'pm·t 1996 St. Vincent's Hospital started the review process. It is envisaged that where Deirdre Mulligan and Carmal Bogue were appointed as possible disease treatments protocols will be included. pharmaceutical technicians. Faustina Reidy resigned from her basic grade pharmacist Contributions to Committees/Policy Documents position in September. Elizabeth Barry was appointed to a Grade TV Clerical The Hospital TV Policy Committee reconvened in 1996. Officer post. The Pharmacy Department is represented by Jacinta Deane. Mark McCullagh joined the Wound Care Committee and is Myra Tyrrell was promoted to the new grade senior also representing the department in the Cardiac pharmaceutical technician. Rehabilitation Programme. Grainne Murphy joined the staff in November 1996 for June O'Shea and Claire Keane are Pharmacy representatives her pre-registration year. on the Drugs Usage Committee. Jacinta Deane is a member of the Steering Committee of the Mission Effectiveness Programme. Conclusion ______ June O'Shea was a hospital pharmacist representative on the Finally it would not have been possible to deliver a Pharmaceutical Society of Ireland B.Sc (PHARM) SyUabus Pharmacy service during the year without the dedication, Review Committee. good humour and commitment of our staff. The department also had an input in the "TV Critical Care Policy Book" which was published during the year. Conferences and Courses Attended _____ HPA Management Seminar/ Dublin Se pt 96 Sile Trimble HPA Annual Clinical Conference/ Dublin April 1996 J O'Shea, J. Deane, S. Trimble, F. Kennedy, C. Kingston, C. Keane. U.K./ Republic of Ireland Liver Transplant Pharmacist Group - I. Maher, Leeds/ April, London July - F. Kennedy HPA presentation of Pre-Registration Projects/ SVH Dublin Oct 1996 C Keane, C Kingston, M. McCuIlagh, J. O'Shea. SVH Management Development Programme J O'Shea Pharmaceutical Society of Ireland Annual Conference Ennis Oct 96/ C. Keane UK Drug Information Pharmacists Annual Conference/ Belfast September 1996 - Irene Maher ASHP midyear Clinical Conference / New Orleans Dec 96 J.O'Shea Smlfing ______ Irene Maher joined the staff in January 1996, the start of a two year Msc in Hospital Pharmacy course. Claire Kingston and Mark McCuIlagh were appointed as basic grade pharmacists. AlI1l1t(l/ Repo/'t 1996 St. Vincent's Hospital Physiotherapy Department ______ The Physiotherapy Respimto1'y Unit ---- The appointment of a senior physiotherapist (half-post) to the medical and cardiac service has resulted in a much improved service to in-patients in the Coronary Care Unit and has contributed to the development and delivery of out-patient programmes in cardiac rehabilitation which have proved very successful and which are being expanded in 1997. Respiratory caseload management was further complicated by the increasing number of patients requiring isolation and by the observation of the necessary infection control protocol. The Adult Cystic Fibrosis Centre continues to play a key role in the treatment and education of a broad range of patients, families and professionals. A patient Information Day in workshop form proved popular and another similar day is planned for 1997. The Physiothe1'apy Rehabilitation Unit --- While referrals to the Physiotherapy Rehabilitation service A critical review of the Physiotherapy Department's service including Stroke Rehabilitation remain in line \vith 1995 activity in the latter part of 1995 indicated continuing figures a more efficient and effective model of care is growth and demand for physiotherapy. Recognising that emerging \vith approximately 50% of all strokes on active continuing growth may challenge quality of service and rehabilitation being discharged \vithin a period of 6 - 8 precipitate quantitative overload it became evident that weeks. some changes in management practice were indicated if the high standard of care synonymous with the Physiotherapy In 1996 the Rehabilitation Unit expanded its service to Department was to be maintained. include a fitness programme for patients in the Psychiatric unit. A pilot study was undertaken in 1996 to review the A scheme, where out-patients are assessed at point of effectiveness of the existing programme and based on these referral and streamed according to a devised care plan, is a findings new programmes are currently being devised. move away from the traditional model of waiting lists to a more patient focused model. The Physiotherapy Bone and Joint Unit --- Similarly the in-patient service scheme incorporates detailed assessment and identification of critically ill patients The number of outpatient referrals to this unit increased requiring intensive treatment. Alongside this the concept from 4,123 in 1995 (includes the waiting list initiative) to of care pathways is adopted for in-patients requiring a more 4,357 in 1996. holistic model of care where treatment programmes are In spite of this, due to improved organisational and incorporated into patients' daily hospital routine. streaming measures, the waiting lists for these services have been abolished. A further indication of the success of the The third stream of in -patients requiring intensive drive toward improved efficiency has been that this rehabilitation are managed under the umbrella of the increased number of patients has been treated in fewer Stroke/Neurology/ Elderly Medicine teams which include attendances, 22,339 in 1996 as compared with 25 ,555 in the five allied health professions of Physiotherapy, 1995. Occupational Therapy, Speech Therapy, Dietetics and The services of the unit have been extended to cover all Social Work. orthopaedic clinics and also attendances at A&E clinics. The Physiotherapy Department continues to place great emphasis on continual professional development which Physiotherapy Specialist Services include: incorporates planned and regular in-service education The Back Care and Ergonomics Programme which now programmes with structured staff appraisals as well as consists of three separate programmes, the In-house one actively supporting and co-funding, with management, post day Training Programme in Lifting and Handling for graduate education. clinical services personnel, the Instructors Training Course Allllltal Repm·t 1996 St, Vincent's Hospital and the In-house Training Programme for non clinical Poster P1'esentations ______personnel. "A study of Back Care Programme in SVH" The Lymphoedema Physiotherapy Programme initiated T. Flynn 5th International Conference on Health in 1991 and now established as a prototype for similar Promoting Hospitals. Derry services in other hospitals. The Pain Management Programme and Back School Conferences ______established in 1990 and 1992 respectively are integrated components of the Physiotherapy health care service Dimension of Quality in Health Care Achievements ______Irish Society for Quality in Health Care. P. Leahy World Conference of Physiotherapy - Europe. - Ms. Denise Hanly and Ms. Martine D'Arcy Eastbourne. P. Leahy & A. O'Brien - M.Sc (Manipulative Therapy) University of Norwich. North American Cystic Fibrosis Conference Orlando. Ms. Caitriona Cunningham D. Concannon - M.Sc (Physiotherapy) University College London. British Lymphology Interest Group Meeting U.K. Ms. Anne O'Brien A.O'Brien - President of the Irish Society of Chartered Physiotherapists. Ms. Theresa Flynn - Manual Hanclling Instructors Course February '96. Ms. Norma Doyle National Certificate in Exercise and Fitness University of Limerick. Presentations ______ "Physiotherapy - A Plan for Life" D. Concannon Cystic Fibrosis Association of Ireland ational Conference Dundalk. "Secretion Management" D. Concannon Active Cycle Technique Workshop D. Concannon & M. Hill-Duffy Study day for asthma and practice nurses. "Tbe Use of the Aircast Splint in the Rehabilitation of the Hemiplegic Patient ". B. Monaghan Annual Rehabilitation Conference, Dublin. "E. U. Directives and Physiotherapy A.O'Brien "E. U. Directives in Health & Safety at the Work Place " T. F1ynn Annual Joint Meeting of Physiotherapists in Management (North and South). "Physiotherapy & Lymphoedema" A. O'Brien A.G .M. Physiotherapy Midland Branch "Psychological issues post Mastectomy" A. 0 ' Brien Breast Care Nurses Association A 1lI111ai R epo/'t 1996 St. Vincent's Hospital Medical Social Work Department Activities ------Staffing ------ In 1996 departmental activity remained at levels similar to Presently the department's establishment is made up of 10 a year ago. However, qualitatively the issues presented by posts, which are staffed by 12 people due to job sharing. patients have become more complex and demanding. This reflects the increasing levels of information and During 1996 we welcomed Teresa McDonnell, Eimear sophistication in our society - thus the professional time per Coffey and Mary Headon to the department. Susan patient continues to increase. Murphy left to take up a post in the E.H.B. We also welcomed Karen Kane as our Senior Secretary Service Workload ------while Noreen Kelly was promoted to a post elsewhere in the hospital. Secretarial regrading in the hospital in 1996 has 1994 1995 1996 given appropriate recognition to staff whose contribution is 9,965 10,478 10,556 often overlooked. The two principal services provided to patients and their Continuing Education & Development families in all of the specialities in the hospital are: Team Approach: In 1996 our training focus was Psycho-Social Councetling: This is conducted on a one concentrated around specific areas such as - to one basis, making it very staff intensive. - Domestic Violence Our bereavement work continues to grow in both size and - Critical Incidence Stress Debriefing frequency. It has benefits both for the relatives who - Mandatory Reporting of Abuse participate and the hospital - a future development will be - Education on drug issues. to research its effectiveness. The department has on-going commitments to student education, not just in the area of Social Work, but Nursing, Grottp Work: is the second principal service provided. This Medical, other Allied Health Professional Groups, Pastoral mainly encompasses areas such as Psychiatry, Pain Care and Theological Students. Management and Cardiac Rehabilitation. It enables us to reach more patients with limited resources Training Courses Attended ______as does our work with the patient education programmes. 1 Community Mental Health Services. The care of the elderly continues to be an area of high and 2 The Contribution of Mandatory Reporting. increasing demand. It ranges from advice and facilitation 3 Mental Disorder in the Irish Elderly. on placement issues to Nursing Home legislation and costs. 4 Breaking tile Silence in Ireland - Elder Abuse. It also includes support for individual elderly patients 5 Organ Donation & Transplantation in Ireland. around issues of loss and readjustment. 6 The Challenges of Cancer in the Elderly. 7 Violence Against Women. Team work and collaboration with colleagues in the 8 Critical Incidence Stress Debriefing hospital and in the community continues to ensure that our Conference & Training. patients receive good quality care. We establish a pathway 9 Health Professionals in Rheumatology. of care for patients back in to the community and to health. 10 Multiprofessional Course in Palliative Care. 11 National Conference on Cancer Self Help Groups. Developments ------Involvement of staff (in their own time) in such diverse During 1996 the departmental workload was arranged so as professional groups as Irish Association of Social Workers, to allow the Head Medical Social Worker to work in that Special Interest Group on Ageing, Men Against Cancer, post on a dedicated basis. This has enabled the Head C.A.N.T.E.E.N. (Teenage Cancer), Psycho-Analytic group Medical Social Worker to participate in the planning and work, Professionals in Rheumatology, Chronic Pain Group, development of the two Day Hospital Projects (which ensures an awareness of issues in the wider arena. should open in early 1997). Participation in the Bed Management Committee has highlighted the need for a During 1996 the department continued to deliver coherent discharge planning policy. professional and timely services to patients, tlleir families and carers. This was due to the dedication and Staff support and development is an area of critical priority. commitment of all our staff. Social Work's only resource is its staff, as in many other health care professions. In a climate of stress and tension, rearranging priorities in the light of newly emerging emergencies can lead to even more stress. All/lllal Report 1996 St. Vincent's Hospital Department of Occupational Therapy ______ 1996 saw the appointment of two new occupational therapy Achievements ______posts for Carew House (Department of Old Age Psychiatry) services, bringing our number of 8.5 posts or Ginny Hanrahan has been re-appointed as Chairperson of 11 staff. the Association of Occupational Therapists ofIreland. Year Patient Number Units of Treatment Adele Thompson acted as Local Examiner for the final year 1994 3,645 48,577 Occupational Therapy students for psychiatric clinical fieldwork practices. 1995 3,284 42,557 1996 3,480 45,768 Papers / Presentations ______Nuala Maloney joined us on the 1st December as Senior Occupational Therapist in Geriatrics, based in Carew House Drivers lvith Special Needs - workshop May 1996 Geriatric Day Hospital which is due to open in early 1997. presented by Ginny Hanrahan and Tony Regan (Irish Frances Weir will join us in February 1997 as Senior Wheelchair Association) Occupational Therapist in Psychiatry of Old Age, Carew "Anxiety Management» six week programme - May 1996 House. Other changes in our staffing included the granting presented by Ade1e Thompson of unpaid leave to Patricia Caren, Senior Occupational Joint Association of Occupational Therapy of Ireland and Therapist is St. Camillus unit from her job-sharing post for British Association of Occupational Therapist (Northern 2 years - she has now been replaced by Maeve Crean. Ireland Regional Group) conference, Dundalk, Co. Louth. CoUette Forkin was appointed as Basic Grade Occupational Therapist. (Another job-share post has been on trial during Normal Movement Workshop half day - August 1996 this year between Helen Norris and Aine O'ReiUy). presented by He1en Norris and Louise Mulholland (Adelaide Hospital) The staff of this department are aUocated to particular St. Vincent's Hospital Occupational Therapy Department teams primarily medical teams, care of the elderly and psychiatry. AU other medical and surgical teams' patients Driving for people with disabilities - day workshop are treated on a consult basis. The numbers of these November 1996 organised by Ginny Hanrahan, Tony referrals have increased dramatically over the past few years Regan and Nuala Tierney, National Rehabilitation Hospital. St. Vincent's Education and Research Centre. Year Nttmber of Referrals 1993 333 Courses Attended ______1994 353 1995 422 St. Vincent's Hospital Management Course run by l.P.A. 1996 671 Attended by Ginny Hanrahan. Major interventions are frequently required, as these people "HolV Effective is Occupational Therapy» - Looking at are often in vulnerable situations - frail aged and living outcome measures and standardised assessments April 1996 alone. We liaise with our medical social work coUeagues but (2 days) Attended by Helen Norris limited community services can lead to difficulties with the discharge of these patients in particular if the person has "Understanding and Treating Dyspraxia D achieved their maximum level of independence, but needs April 1996 - 2 days Attended by Collette Forkin help to remain at home. Joint National Conference of Association of Occupational Stroke R ehabilatation Therapists of Ireland and British Association of Approximately 180 people with strokes are treated in this Occupational Therapists (Northern Ireland Regional department each year. Problems encountered include Group )Various members of Department attended different cognitive or perceptual difficulties, decreased independence sessIOns. in self maintenance, vocational skills (where applicable ) and leisure including driving. British Association of Occupational Therapists' Annual Conference Leeds, U.K Invited and attended by Ginny Undergraduate Education Hanrahan. - St. Vincent's continues to provide placements for Occupational Therapy Students from Dublin University. In Numerous splinting and equipment courses 1996 10 students were placed with the department in "Treatment Protocols for Tendon and Nerve Repairs" Aine addition to a Norwegian student from Teeside University. O 'Reilly Annual R eport 1996 St. Vincent's Hospital ···· :0 v ... dJC,""IJ'l' Speech and Language Department ______ The caseload this year is as follows: In house lectures on: Violence against Women, Sexual Harassment in the Work Hospital Inpatient: 1235 Place Out-patient (St. Anthony's): 1965 The department has continued to act as a clinical training and examination centre for students from Trinity CoUege, Dublin. Courses Attended ______It is to be hoped that the future year will see continued expansion of the Speech and Language Therapy services Catherine Mair within the hospital, particularly in the area of dysphagic Interdisciplinary Oropharyngeal Conference March 1996 management, which has had considerable growth within Irish Association of Rehabilitation Medicine-Geriatric the past year. Rehabilitation October 1996 Identifying and Managing Individuals with Motor Neurone Disease and Parkinson's Disease. November 1996 Hilary den Hollander Workshop on Spasmodic Dysphonia November 1996 Smior Speech and umgttage Therapist Hilary den Hollander Workshop on Experiential Learning (FoUow-up) May 1996 Second Voice Symposium September 1996 Conference on Geriatric Rehabilitation October 1996 Department of Nutrition and Dietetics ______ Developments / Activities ------Interdisciplinary involvement by this department continued in 1996 with the Hospital Health Committee, Wound Care Committee and Stroke conference and the Dysphagia The department continued its pro active role in the Group who produced a policy for nurse education "on nutrition management of patients, the fostering of a specific Rules for Feeding and Swallowing". Patient information / commitment to quality and improved standards of care for education workshops were organised in conjunction with our patients. Diabetes and Cystic Fibrosis tean1S . The department participated in the new format for the The department reviewed work practices, support clinical training of final year BSc. human nutrition & mechanisms and ways of optimising professional dietetics students. This involved a problem solving, student competence - a team working system was agreed to foster directed approach with more objective assessment work. responsibility and enhance expertise in a rapidly developing Four students successfully completed their clinical training scientific environment. The expertise of department and another her undergraduate research project in members in a number of specialities has been called upon conjunction with the care of the elderly team. with increasing frequency as guest speakers at interdisciplinary meetings, professional update seminars. Our active involvement with the hospital nutrition The specialities involved include Cardiology, Diabetes committee continued. Another successful interdisciplinary Education, Liver Disease, Cystic Fibrosis, Eating Disorders, nutrition support seminar was held in April with interested ephology and Oncology. staff and students queuing for canceUation places on the day. Multiple choice questionnaires completed before and after, suggested that participants found it both useful and Service Workload informative. Inpatients (Diagram beloJV) Year Case Load New in patients Review patients Total Referral Date Av. Bed Stay 1994 8,957 3,325 15,722 19,047 35% 6.0 1995 10,287 3,366 19,244 22,610 40% 6.0 1996 10,425 3,499 16,145 19,644 38.5% 5.7 All/mal Report 1996 ... St. Vincent's Hospital a ~ .. $( ....· S 1. Out patients (Diagram belolV) Year New Out patients Review Out patients Total 1994 679 989 1668 1995 834 840 1674 1996 903 847 1749 Service Workload ______J ulie Dowsett: . Multi disciplinary conference on the Management of The changing profile of the service was notable caseload Dysphagia is St. James' Hospital, Dublin 29th -30th new patient referrals and percentage referral rat~ continu~ March 1996. to rise. The reduction in reviews is an obvious consequence - The Tenth North American Cystic Fibrosis Conference, of an increased case load and rising referral rate in Florida 22nd - 27th October 1996. conjunction with static staffing levels and the reduced average length of stay. Kirsten Doherty Our patient activity showed a shift towards a greater - The 14th International Symposium on Diabetes and number of new referrals with a natural limit being imposed Nutrition, Ascona, Switzerland 30th June - 3rd July on the number of reviews possible within the present clinic 1996. limits. Eating disorder referrals dominate the general clinics, limiting access from other specialities. The waiting Lynda Parke list is now six to eight weeks . The Seventh British Renal Symposium, Eastbourne, 6th and 7th September 1996 Staffing ______Elizabeth Barnes: The British Association for Parenteral & Enteral Nutrition, Blackpool, 3rd - 5th December 1996. The departmental staffing level of eight was augmented in March by an additional half time temporary position to June Ruigrok: facilitate J ulie Dowsett providing a fuU time dietetic service - The Management development course, St. Vincent's to respiratory medicine and the adult cystic fibrosis unit Hospital. with particular emphasis on the developing ambulatory care - The British Dietetic Association open meeting of service. Deirdre Hoslin joined the department on a Dietetic Managers, Manchester 13th June 1996 temporary basis from March to November when she left to - The European Society for Parental & Enteral take up a full time permanent position in the Meath Nutrition, Geneva. 7th - 12th September 1996 Hospital. Clare Corish was granted three years leave of - The Seminar / meeting for dietitians working in absence to pursue her PhD in clinical nutrition. Anita Hade primary care, Department of Health, Health was appointed for the three year locum and ably took on Promotion unit in Conjunction with the Department responsibility for the nutrition / dietetic service to the liver of Preventive Medicine / Cardiology, lOth December unit. 1996. Conferences / Courses Attended ______Anne Foster: - The Annual Meeting on Eating Disorders, St. John of Gods Hospital, StiUorgan, 8th November 1996. Vivien Reid: British Dietetic Association Diamond Jubilee Conference in Stratford - on - Avon 19th - 22nd April Achievements ______1996. - Irish Association of cardiac Rehabilitation AGM 18th Kirsten Doherty, Nominated as co ordinator, INDI October 1996 - chaired the session "The Challenge of Diabetes interest Group. Julie Dowsett, appointed as Rehabilitation in the Community" Nutrition Representative to the Royal Irish Academy. - British Dietetic Association / Community utrition Elizabeth Barnes and June Ruigrok were invited to act as group Meeting for Community exanuners for the BSc. Human Nutrition & Dietetics - Dietitians working in Primary Care, 23rd October Clinical exanlination in St. James's Hospital. Vivien Reid 1996. continued her involvement with the Department of Health, - Association for the study of Obesity, St. Bartholomews Nutrition Committee, Food and Nutrition Policy Working Hospital, London 13th November 1996. Group and the Health Promotion Unit. - Irish Hyperlipidaemia Association AGM Dublin 6th hlDcr~~1~6. " AllIlItlll Report 1996 St. Vincent's Hospital Publications ______Vivien Reid "Clinical assessment in primary care: professional co. operation)) in The Proceedin gs of the Kirsten Doherty Two articles written for the Irish Diabetes Nutrition Society (1996 ) 55,679 - 688. Association magazine - "Food choices and Diabetes» and "fat - lVhat)s all the fuss about?» ]ulie Dowsett, " Nutrition and Wound Healing» in the World of Nursing. Doherty K. , Power C. CIQJmtions raised by glycaemic index» in Irish Nutrition Focus Project Department ______ by the Project Team, as Priority One. These include Intensive Care, Accident & Emergency, Day Care and Out patients, Radiology and Pathology. It is anticipated that these Priority One areas will be addressed in Phase 1. Recruitment of a Design Team followed with advertisements placed in the official European Journal and the national press for the recruitment of a Professional Design Team. There was a substantial response to the advertisements, and a shortlisting and interviewing process was entered into. This was a lengthy and detailed process which was completed at the end of October 1996. The leaders of the design team who were picked for Phase I works are Scott, TaIlon and Walker, a Dublin based architectural company. Internally Mr. J. J. Cummins was appointed as Project Manager in August 1996. Recruitment of a Nurse Planning Officer ensued and Ms. Phi! Shovlin has been seconded to tile post from the Liver Unit. On joining the Project Team, tile initial task for Mr. The Joint St. Vincent's Hospital and Department of Health Cummins and Ms. Shovlin was the completion of the Project Team was appointed in 1994. The remit of this Development Brief. The Development Brief provides the team was to examine the hospital's infrastructure and information required by the Design Team to complete a services in the light of the changing needs of patients and Development Control Plan and acts as an instruction for staff. Priorities for development were identified by the the Phase I developments. Frequent meetings of the Project Team and in early 1996 a site appraisal and Project Teanl and consultation with staff ensued and the evaluation was carried out by members of the Hospital Development Brief was submitted to the Department of Planning Department from the Department of Health. Health early in December, 1996. On the 16th May, 1996, the Minister for Health, Mr. Following review of the Briefby the Department of Health, Michael Noonan, T.D., visited St. Vincent's Hospital and sanction to pass tile Brief to the Design Team is expected in announced a major development plan for St. Vincent's January, 1997. Thus, a Development Control Plan for St. Hospital. Vincent's Hospital can be commenced after sanction is received. This plan will look at the total needs of St. Mr. Noonan acknowledged that this development would Vincent's Hospital, not just Phase 1 and it is expected to be "... herald the beginning of a new era not just for St. completed around Easter, 1997. The recommendations of Vincent's but for the delivery of acute hospital services in the Design Team will then be considered by the Joint St. the South East Dublin area". Vincent's/ Department of Health Project Team and decisions regarding Phase I will be finalized. It is The development required at St. Vincent's Hospital will anticipated that tile following areas will be addressed wholly take place on a phased basis. The first phase \vill cost in the or in part, during Phase 1: - Intensive Care Unit, Accident & region of £33 million. Mr. Noonan has sanctioned the Emergency Unit, Ambulatory Day Care Unit, Pathology provision of £33 million to proceed with Phase 1. and Radiology. The Psychiatric Unit may also be addressed during Phase I. The funding source for Psychiatry will be Mr. Noonan, in his address, referred to the areas identified separate to the £33 million. All/lItal Rfp01·t 1996 St. Vincent's Hospital Secretary, Ms. Alison Galbraith, Secretary. The detailed planning leading to the construction of Phase I will then commence. Building is expected to start in early We look forward to meeting the unique challenges 1998. Once decisions on Phase I have been agreed, the associated with the Development Control Plan and the Project Development Team would be hopeful to secure a Phase I design developments in the year ahead. commitment from the Department of Health regarding Phase II of the development. Joint St. Vincent's Hospital/Department of The proposed infraStructural developments at St. Vincent's Health PI'oject Team Hospital will take cognisance of the constant state of change in the healthcare environment recognising that no Dr. Jane Buttimer, hospital can remain static and provide a quality service. The Deputy Chief Medical Officer, Department of Health. philosophy and Mission of the Religious Sisters of Charity Mr. Vincent Barton, with its focus on providing for patients in a healing and Principal Officer, Department of Health. caring environment will guide the development of the new Mr. Derus O'Sullivan, facilities at St. Vincent's Hospital. Principal Officer, Department of Health Mr. Frank J ackrnan, Staff input is essential in all aspects of facility planning. Chief Architect, Department of Health, Liaison with the staff will take place with the Project Mr. Tom Condon, Manager and urse Planning Officer. Such participation Engineering Advisor, Department of Health. will ensure that staff have a voice in design Mr. Terry Woulfe-Flanagan, recommendations. The Project Team has recognised that Principal QJtantity Sttrveying Adv., Department of Health. interim solutions in some departments may be required to Mr. N. Jermyn, alleviate problems in advance of final solutions. A major Chief Executive Officer, St. Vincent's Hospital. concern during the project will be the retention of the Mr. William Quinlan, viability of hospital services during conStruction. A project Chairman, Medical Board, St. Vincent's Hospital. of this nature cannot possibly take place on the site without Sr. Joseph Cyril, some disruption to the hospital. However, it will be of Superior, St. Vincent's Hospital. paramount importance that such disruption is minimised Miss Pauline Doyle, for patients particularly. Director of Nursing, St. Vincent's Hospital. Prof. M. X. FitzGerald, A Project Office was set up, and this is housed in a new Professor of Medicine, St. Vincent's Hospital. Porto-cabin structure which became available in early Prof. T. J. McKenna, December 1996. The Project Office is located at the rear Consultant Endocrinologist, St. Vincent's Hospital. of the Hospital adjacent to the Education & Research Mr. David Quinlan, Centre. Consultant Urologist, St. Vincent's Hospital. Mr. J. J. Cummins, An Open Day was held in the new Project Office on Project Manager, St. Vincent's Hospital. Thursday 19th December 1996 for Department Heads and Miss Phi! Shovlin, Ward Sisters to introduce both the location of the Project Nurse Planning Officer, St. Vincent's Hospital. Office and the Personnel working on the Project. These are Mr. J. ]. Curnmins, Project Manager, Ms. Phi] Shovlin, Nurse Planning Officer, Miss Theresa Ward, Administrative Technical Services Department ______ During 1996 many projects were completed along with the A summary of these projects is as follows: normal maintenance of plant, equipment and facilities in the hospital by our staff in the various sections of the A new sewing room was built on the ground floor of the Technical Services Department. These sections include the Nurses Home, a new electrical workshop established in an Electrical, Carpentry/ Building, Painting, Bio-Medical old filing room/ old sewing room in the basement area of Engineering and Mechanical. the hospital and the old electrical workshop converted into a stress room for the Nuclear Medicine Department with Some of the projects were carried out entirely by our own supporting facilities. A new plant room had to be created in -house staff, some by a combination of in -house staff and in the basement corridor to facilitate these works. A new contractors working together and others carried out meeting room was formed in St. Annes Ward. The old entirely by contractors. windows removed from the S.R.C. building and new double glazed windows fitted, similarly selected windows All1l1tlll Report J 996 St. Vincent's Hospital ·V ·· ~ dJ... c .... 'S" on the west end of the Mortuary and the entrance corridor new flooring for the same unit. to the convent were replaced with new aluminimum double glazed windows. A new suspended ceiling was fitted in the Renovation took place in Carew House to provide offices S.R.C. building complete with a new lighting system and and facilities for both Administration and the Department this building was also painted. of Old Age Psychiatry. A new office facility was established in the Mortuary. Refurbishment of the two centre lifts with All of St. Camillus Ward and Out· Patient circulation and new car door operators and variable speed drives fitted. waiting areas were painted. The refurbishment took place Also equipment to allow for better levelling of the lifts at of two offices for computer training for Nursing floor levels. Administration. The disabled toilet facility was created at one of the entrances to the Cafeteria. The installation of A new security lighting system was installed outside of the new central heating and domestic hot water pumps to Nurses Home. A new nurses station and Sister's office were service the whole of the hospital was completed. established in St. Vincent's Ward. A new combined heat and power unit (CHP) was installed in the boiler house area The installation of a new state of the art C.T. Scanner was in order to reduce energy costs. A new disabled shower and carried out. Much of the old lighting in the hospital was toilet were fitted in St. Paul's Ward. A new automatic door replaced with energy efficient lights. Draft proofing of was fitted to the front entrance of the hospital. windows in selected patient areas was carried out. The telephonists office was refurbished. A cat-walk was fitted at high level over the steanl boilers in the boiler house to allow for safer access to working parts at The installation took place of a new Generator and high level. A new waste trap system was fitted in the yard Transformer and new Switchboard to service the whole in the compactor area as well as a three part fuel interceptor hospital to replace the old Generator which was unable to in the oil tank area to comply with Dublin Corporation provide all of the power for the hospital at peak usage. pollution requirements. A new air-handling unit was fitted Preliminary work necessitating many electrical shut-downs for the Sister's Office in the Out-Patients Department. took place between January and April with a culmination of Windows were fitted in the Biochemistry Department. the final connecting of the new equipment taking place Alterations and renovations took place to facilitate during an eight hour shut-down on Good Friday, the 4th of substantial changes in the School of Nursing and a new April 1996. linen room was established on the ground floor in the Nurses Home. Three new anaesthetic offices were created on the second floor of the west link. The gents toilet and the ladies toilet Much painting work took place and the following is a brief were refurbished in the Out-Patients Department with the summary: installation of electric hand dryers. The Medical Board orth west staircase, two class rooms and practical room in Office/ Post Room areas were refurbished. The heaters School of Nursing, Generator room and transformer room were removed from these offices in order to reduce the and C.H.P. room in boiler house area, the Chaplain's flat, electrical load in the hospital. The Unit Nursing Officers St. James Ward, St. Laurences Ward, St. Annes Ward (5 Office was refurbished. A new security lighting system/car ward areas), St. Vincent's Ward, north centre staircase, park lighting system was installed on the outside of Carew compactor and shredder room and Porters room, House. The installation work took place of the new X-Ray Endoscopy corridor, treatment rooms in E.E.G., Professor Fluoroscopy Unit. A disabled shower was fitted in St. O'Higgin's suite of offices, St. Charles Ward (3 ward areas), Annes ward. The coffee bar in the basement corridor was St. Michael's Ward (4 rooms). completely refurbished. A lot of work has taken place on our grounds over the past year by Anthony Benson, Martin Reardon and David Douglas, and the fruits of these efforts will be there in all its The installation of new security lights outside St. Anthonys glory for everyoneto see and delight in when the spring and Rehabilitation Centre took place as well as wiring for the summer come around. public address system. The installation of the fuel supply pipes for the Generator to comply with pollution Mr. Sean Kavanagh, Fitter, retired in September 1996 and requirements took place along with modification to the oil we wish him a long, healthy and happy retirement. Mr. tank bund systems. The conversion of the bathroom to a John O'Callaghan took over Technical Services Manager on relatives room in St. Annes Ward. Work took place with the 8th of October 1996 whilst Mr. J.]. Cunlmins became regard to leaks in underground pipework outside the Project Manager for the new development about to take School of Nursing (this job is not finished yet ). Three place in St. Vincent's Hospital. offices were refurbished in the ground floor of the Nurses Home for the Nursing Administration. Wiring for security system in the Pharmacy area for a CCTV facility. A new phone system was installed in the Out-Patients Department. New lights were fitted in St. Annes, St. Michaels and St. Vincents and wiring was altered to suit. Refurbishment of plumbing and electrical services for the Dialysis Unit took place along with some woodwork and a A/l1l/1(11 Report 1996 ··· St. Vincent's Hospital I v :; dJ' .... SI' Purchasing Department ______ There was a significant increase in the general level of Equipment activity in the Hospital in the course of the year. The requests for capital equipment and non-stock items were In September 1996 we purchased a number ofClinirest and quite high. Staff generated an even larger number of Debut Mattresses for the ward areas. This will result in requisitions in 1996 and the number of orders were higher considerable savings of costs which the hospital would than any other year. othenvise incur in renting these items. Overall, the Department responded well to all the demands Staff ------placed upon it considering the various projects and developments taking place in 1996. A number of re-gradings were also sanctioned for various posts in the department. Mr Gerard Russell was officially appointed Purchasing Manager in November 1996. Medical Records Department Workload / Activity ______(3) The Hospital took part in a restructuring exercise with the Department of Health for the staff in Medical Records There was an increase in inpatient activity over the past year and Patient Care areas. This exercise was completed and - mainly in the area of Day Care. Activity in Outpatient approved by the Department of Health in 1996 and was Clinics and Accident and Emergency was slighdy down announced to the staff in November. from 1995 figures . Several promotional posts will be made available to existing The Admissions Office was once again actively involved staff through open competition. Additional benefits of the with Waiting List Initiative work which involved on-going restructuring are improvements in organization of the validation of the Inpatient Waiting Lists. Medical Records Department and clarification in reporting relationships. Staffing------Interviews and appointments to these posts will take place early in 1997. (1) Secretarial and clerical support services to specialities are constandy under evaluation with an aim to re-organize and improve the services provided. Changes made in 1996 include: (1) Addition of a 3rd secretary to the Endocrinology/ Diabetes Services; (2) Establishment of an office in the Oncology Unit with two secretaries and plans to add a 3rd secretary early in 1997; (3) Provision of a secretary to assist in the services provided for Breast Clinic patients. This secretary works closely \vith the Clinical urse Specialist in Breast Care. (2) HIPE: An additional coding position was approved for this section. There has also been increased interaction between Deirdre Lynch, HIPE Case-Mix.Assistant, and the Finance Department in order to improve the overall quality of data being submitted to the Department of Health. Ail/ilia! Repol't 1996 St. Vincent's Hospital Catering Department ______ The development of the Catering Department continued throughout 1996. At the beginning of the year the coffee lounge was refurbished and designated as the staff smoking area, allowing the cafeteria to become a smoke-free area with the introduction of an improved night service. In addition, during the year various improvements took place in the service offered to patients and staff. The patients service was improved by the introduction of a supplementary menu to cater for those whose requirements are not met by the standard daily menus. Efforts have been made to alleviate waiting times in the main cafeteria. Hygiene continued to be a high priority and throughout the year training and retraining of staff took place in this area. The cafeteria staff have been most helpful in introducing changes and improvements throughout the past year. Portering Service Department ______ The department provides portering service to 21 areas in The new training course for all portering staff was the Hospital. Demands on the service in 1996 were heavy introduced. The course includes manual handling, major with additional service agreed for Pharmacy, Diagnostic disaster procedures, health & safety, general employee Imaging and Stores. information and interaction with patients/ publici employees. At the invitation of Fr. CahiIl, we were pleased to outline the role of the portering service to each new group of clinical pastoral education students during the year. In May 1996 we commissioned a new paper shredder for confidential waste paper and a baler to compact the high volume of cardboard received by the Hospital. Sadly, we are unable to introduce a comprehensive paper recycling policy for the Hospital as there is currently no market for paper. Storage and Disposal of Bio-hazardous waste presented some difficulties during the year but these were overcome. Central Sterile Supplies Department (CSSD) 1996 saw a continuing increase in the workload in the secretary of the Irish Association of Sterile Services Managers. CSSD Department both in administration and sterilization in the continuing effort to combat hospital infection. Conferences Attended ______ A new Sterile Services Department is planned adjoining the Mary Deane attended the Annual conference of the new operating theatres in Phase 2 of the hospital European Society in Edinburgh in June and the Annual development plan. It is very important that this conference of the British Institute in November. department meets the stringent new European Directives Mary Deane, Susan Heran, Kathleen Lynch and Gerry on sterilization. Ryan attended the annual conference of the Irish Association of Sterile Services Managers in Dublin in Mary Deane continues to be the Irish representative on the November. board of European Society for Hospital Sterile Supply and is Annual Report 1996 ! ··· St. Vincent's Hospital , ~ . dJc.,.'S,. Health & Safety Report ______ During 1996 we continued our efforts in making staff more hospital is now in the process of finalising the establishment aware of Health and Safety as follows: - of a fully active Occupational Health Department. 1. Fire Safety 5. Security We continued holding regular fire drills, and evacuation During the year we increased our Night Time Security procedures in wards and departments. cover. It is intended to carry out a detailed review of the hospital's total security requirements early in 1997. We carried out a full evacuation drill at 6.00 A.M. in both the urses Home and St. Rita's Residence. During 1996 Ms. Helen Barry (Microbiology technologist) who has acted as staff safety representative since 1990, We also installed fire doors in the underground tunnel to resigned. I would like to thank her for all the assistance, the Nurses Home. expertise and support she gave to me and all the staff during the past six years. 2. Sharps In October, as part of an ongoing educational programme David Ormonde (Theatre Porter) was elected in March to reduce sharp injuries amongst staff, a seminar was held 1996 as the new Safety Representative and I wish him every for staff with speakers from all our Main Contractors, success in this onerous position. Cleaning, Laundry, and Waste Disposal and over 250 staff attended this seminar. We also attached small sharp boxes to ward trolleys in an effort to make it easier and quicker for staff to dispose of needles. Aidan Moriarty Health & Safety Co-ordi~/ator As part of The Full Day Orientation for the New Interns in July 1996 one of the workshops was entirely devoted to the Safe Disposal of Sharps. 3. Back Injuries Under the direction of our Manual Handling Co-ordinator Physiotherapist, Ms. T. Flynn, training in patient and non patient lifting was carried out on a weekly basis. An additional 10 staff received their national qualifications , as training instructors bringing the total of qualified instructors in the hospital to 18. 4. Occupational Health During the year Dr. Mary McMahon was appointed as the new Occupational Health Physician. Dr. Sheila O'Brien has acted as a locum Occupational Health Physician. The A 1II111al Report 1996 St. Vincent's Hospital ~'" e.C.... 'S l. Report from the Chairperson of the Management Committee ______ Two new members joined the Management Committee of Hospital, Mr. icholas Jermyn for his generous assistance at the Education and Research Centre in 1996. Dr. Kieran all times and the members of the Committee of Sheahan and Professor T.}. McKenna were nominated to Management of the Centre for their valuable work during the Committee by the Executive of the Medical Board of the year. St. Vincent's Hospital. I wish to acknowledge the enthusiastic commitment of the Details of the successful academic and research activity of Medical Director of the Centre, Prof. Barry Bresnihan, to the Education and Research Centre in 1996 are given the continuing development of the Education and Research elsewhere in the Report. Centre and the hard work and dedication of Dr. Cliona O'Farrelly and all the staff of the Centre during 1996. The debt on the Centre has been reduced to £228,238.00 thanks to the efforts of the Development Office, headed by Finally, I would like to thank the Sisters of Charity for their Sr. Joseph Cyril. The considerable sum of £348, 128.00 extremely generous financial support of the Education and was brought in by the office in 1996 and warmest Research Centre in the years since its foundation and for congratulations are due to Sr. J oseph Cyril, assisted by their patience in waiting for the debt to be cleared off. Ethna O'Keeffe, Bernadette McCarthy and Marie Lambe Thankfully, the end of this particular burden is now almost for this great achievement. in sight. I would like to express my thanks to Chairman and Board ]oyce Andrews of Management of St. Vincent's Hospital for their Chairperson continuing interest in and support for the Education and Research Centre; the Chief Executive Officer of the Report from the Medical Director ______ The educational and research activities continued to expand Grants which provide funding for five year projects. The in the ERC during 1996. In fact, the facilities are now successful recipients were the Liver Group and the Early coming under increasing pressure as the demand for access Arthritis Unit directed jointly by Professor Barry Bresnihan increases each year. The number of medical and science and Dr. Oliver Fitzgerald in collaboration with Professor graduates engaged in full time research projects continues Steven Whitehead, Department of Genetics, Trinity to rise. Several individual groups are gaining increased College. international recognition as a result of high quality research presentations and publications. It has been particularly The third Annual Biomedical Research Symposium, at St. gratifYing to recruit to the Research Laboratories a number Vincent's Hospital addressed the theme "Cellular and of postdoctoral scientists. This has been facilitated by the Molecular Regulatory Mechanisms in Human UCD Newman Scholarship scheme. At the end of 1996, Disease"cosponsored by Pfizer Limited and Elan four Newman Scholars were engaged in original research at Corporation, was another success attracting approximately the ERC. The academic ambience and intellectual one hundred delegates from most of Ireland's leading achievement was greatly enhanced by a number of biomedical research institutions. The invited speakers from committed individuals and, particularly, by the dynamic overseas included Professor Alan Hall, London, Sheila enthuasirn of Dr. Cliona O'Farrelly and the continuing Farrow, University London, Jeremy Tavare from the support of Mr. Nicholas Jermyn, Chief Executive Officer. Department of Biochemistry, Bristol. The Irish One highly significant development this year was the contributors included Dermot Walls, DCU, Finian Martin, opening of a purpose-built, state of the art molecular UCD, Paul Moynagh, UCD, Tom Cotter, UCC, Luke biology laboratory. Techniques requiring RNA extraction, O'Neill, TCD and Aideen Long, TCD. The Chairpersons polymerase chain reaction and, insitu hybridisation have included Hugh Brady, Nollaig Parfrey, Keith Tipton and been developed. Niall O'Higgins. Posters were also presented and prizes for best posters were judged by Richard Gallagher (European As with all research institutions, one measure of success is Editor of Science) and Prof. Muiris FitzGerald. the number of newly acquired research grants. Happily, research funding has been acquired by all of the groups working in the Centre but the highlight this year was the Professor Barry Bresnihan award of two very competitive Health Research Board Unit A1I1wa/ Report 1996 St. Vincent's Hospital Report from the Director of Research Laboratories ____ 1996 has been another year of growth in the Research Newman Scholar. Dr. Murphy brings with her an extensive Laboratories with new people, equipment, facilities and expertise in molecular biology. technologies all jostling for place. Four Post-Doctoral Dr. Laura Madrigal was awarded the Baxter Newman Fellows took up positions during the year as part of the Scholarship in Nephrology and is part of the collaboration Newman Scholarship scheme, four graduate students - between the Dept. Pharmacology UCD, the Depts. three with First Class Honours degrees joined the labs and Nephrology and Pathology and the ERC at St. Vincent's three MD students also started bench work. Five Hospital. undergraduate students and two HRB Summer students carried out project work under the guidance of ERC Dr. Eithne Murphy has joined the Rheumatology Group as researchers. The new molecular biology facilities are in the Rohan Newman Scholar in Bone and Cartilage constant use by several researchers in the Research Research. David Kane has joined the Rheumatology Group Laboratories and also by the Depts. Haematology and as Research Lecturer. Michael Curry, GI Registrar joined Immunology while they develop and optimise new the Liver Immunology Group to pursue research towards diagnostic techniques. an MD thesis. Kevin McCarthy, a first class honours graduate ofUCC has joined the Tumour Biology Group to A key feature of the academic activities at the ERC has been work on breast cancer. Lorraine Flynn, a First Class the development of collaborative research projects which Honours student from DCU started a collaborative project reflect interests in the routine laboratories and offer with Professor Col m O'Herlihy of the Obstetrics and opportunities for the medical laboratory scientists to pursue Gynaecology Department of UCD. Lucy Golden Mason, higher degrees. At the moment, Dr. Lynda Fenelon and First Class Honours graduate from DIT, Kevin Street, from Denise Drudy from the Microbiology Department are the Dept. Biological Sciences, DIT Kevin Street, joined the examining C.difficile adherence to epithelial cells while Dr. Liver Immunology Group. Alastair Thin, a graduate of Niamh Nolan and Fiona Smith from the Histopathology Glasgow University joined the Respiratory Physiology Department are looking at T lymphocyte populations in Group (Paul McLoughlin and Prof. M.X. FitzGerald) to normal liver. pursue post-graduate studies on the beneficial role of exercise in cystic fibrosis patients. Productivity in research is primarily measured using three criteria: degrees and grants awarded and papers published in Gmnts ______peer reviewed international papers. By each of these criteria, 1996 was a productive year. Four higher degrees Dr. Derek Doherty of the Liver Transplant Immunology were awarded for work carried out in the Research Group was awarded a New Investigator Award (£16,000) Laboratories (see below) and many papers were accepted by Fobairt. for publication (details given elsewhere). Two Unit Grants The Tumour Biology Group were awarded a project grant worth (together) in excess of £1 million were awarded by (£30,000) by the HRB. the HRB to the Rheumatology and Liver Groups and their The GI Immunology Group in collaboration \vith Dr. collaborators. Several other grants were awarded by the Diarmuid O'Donoghue was awarded a Basic Research HRB and by Fobairt (see below). Award (£46,000) by Fobairt. This will be used to fund Dr. Stephen Simpson, currently a post doe at Harvard Medical Prizes ______School who has asked to join the group to pursue his interests in mucosal immunology and its relevance to the Suzanne Norris of the Liver Transplant Immunology pathogenesis of Inflammatory Bowel Disease. Group won first prize for her poster at the National Medical Scientific Meeting. Suzanne Norris was awarded a HRB Fellowship to "Characterise CD3 K Cells from the Human Liver". Janet Carton of the Gastrointestinal Immunology Group Suzanne was also awarded a project grant (£12,000) by the won first prize at the poster session of the Irish Society of HRB to provide reagents for this work. Immunology. Exchanges New Faces ------Teasie Maguire, post-doe with the Tumour Biology Group Dr. Derek Doherty joined the Liver Transplant spent some weeks at the Pasteur Institute in Lille looking Immunology group as the Liver Trust Newman Scholar. for transcription factor expression in breast tissue by Derek brings extensive experience in Immunology and Northern blotting. Patrick Costelloe from the Molecular Biology from his years at Queen's University in Rheumatology Group spent three months at Professor Bob Belfast, Kings College Hospital in London and the Virginia Winchester's laboratories in Columbia University, New Mason Institute in Seattle, USA. York learning about T cell molecular biology. Gaye Cunnane, also from the Rheumatology Group, spent a Dr. Evelyn Murphy from the Baylor University, Houston, month at Professor Tim Cawston's Laboratory in Texas has joined the Rheumatology Group as Pfizer Cambridge, UK performing ELISA assays for All/lllal R eport 1996 St. Vincent's Hospital metalloprotease inhibitors. Orla Crosbie from the Liver Immunology Group successfully defended their Ph.D Immunology Group visited Professor Hergen Spits theses. David Chin was awarded an M.Ch. for his work on laboratory in Amsterdam. PS3 expression in breast tumours with Dr. Joe DuffY, Professor Niall O'Higgins and Professor Nollaig Parfrey. Peter Youssef from Adelaide, Australia, has joined the Rheumatology Group as Visiting Research Fellow for 12 Academic Programme ______months. Johan Karlsson from Pharmacia in Uppsala spent time with the GI Immunology Group learning methods of A full programme of Research Seminars was held on Friday epithelial cell preparation. lunchtimes during each academic term of 1996. A major academic event of the year was the talk given by Nobel Visitors ------Laureate, David Baltimore in July. A regular journal club was held every Friday morning at 9.00am covering topics of Professor Bengt Lindholm from the Karolinska Institute in interest to anyone in Biomedical Research. A course on Sweden, who heads Baxter's European Biomedical Fundamental Immunology was offered by the Research Programme visited the ERC at the time of Dr. Gastrointestinal Immunology Group and attended by >30 Laura Madrigal's appointment as Baxter Newman Scholar. from the hospital, UCD, TCD, Elan Corporation and The Minister for Health, Michael oonan, visited the Teagaisc. Research Laboratories. None of these developments or successes could have been Nobel Laureate Professor David Baltimore of MIT, Boston achieved without the committed effort of everyone spent an afrernoon at the ERC, visiting the laboratories, involved, researchers, principle investigators, administrative talking with the Management Committee and giving a staff, the hospital medical board, Bernard Mullen, the Research Seminar which was attended by over 120. Thanks Development Office and in particular Mr. Nicholas Jermyn, to Elan, BRr and St. Vincent's Hospital for support. Chief Executive Officer of St. Vincent's Hospital. Miroslav Holub, Immunologist and poet entertained and Dr. Cliona O'Farrelly educated during a brief visit. Degrees/Awards ______ Dara Clarke and Ursula Fearon from the Department of Endocrinology and Laura Madrigal from the GI Report from the Director of Fundraising 1996 was a very successful year for the Development Office. We would not be in as good a situation today were it not In total an amount of £3S2.7k was raised on behalf of the for the continued behind the scenes financial and moral fundraising campaign while outlay was kept well below support of the Religious Sisters of Charity and St. Vincent's £S.Sk. Hospital as well as the consultants and our Corporate friends who continue to support the Trust with convenants. The First event of 1996 was the Easter Raffle and then Thanks are due to Ethna O'Keeffe, Administrator in the there was the Trust Golf Outing in June. Dunnes Stores ERC, as without her organisational abilities and generous continued with their sponsership of this event and ensured co-operation the above events would have not been so that the day was very successful once again. Dunnes have successfully achieved. A word of thanks to Bernadette also agreed to sponsor the event in 1997. I would like to McCarthy-Kerins (since moved department)who also was a give a special mention to Michael Donohoe from Dunnes great supporter, and not forgetting Bernard Mullen and our Stores whose great energy and enthusiasm ensured that the new receptionist/secretary, Marie Lambe. golf was a great success. Michael sadly passed away in October. I would like to take this opportunity to record my deep appreciation to all those who supported us during 1996 and Later in June St. Vincent's continued its involvement in the I look forward to your continued support in 1997. If you World Mercy Ball, albeit on a smaller scale. would like further information on the role of the Developement Office please contact either Ethna O'Keeffe At the beginning of September the Art Exhibition took or myself at ext. 4914. place. This event is run by Maeve Taylor on behalf of the Trust and from a fundraising point of view 1996 was by far the most successful Exhibition to date. In September we also started selling tickets for our Christmas Draw. This Sr. Joseph Cyril year we were delighted that Gowan Motors agreed to donate a car for this event. Not surprisingly, the draw was a great success. Amlllal Report 1996 St. Vincent's Hospital The Postgraduate Department ______ The St. Vincent's Hospital Postgraduate Department had GP Meeting another very successful year. Meetings organised at The monthly G.P. meetings are organised through this postgraduate level for the hospital staff continued to attract office, with Dr. Edmond O'Flaherty as Co-ordinator. A large audiences and are a vital contact for all N.C.H.D.'s Consultant gives a talk on a topical subject that is relevant here in the hospital. to the G.P. These meetings are an important source of contact between the hospital and the community. They are Annual Hospital Study Day advertised in the Irish Medical TimesjNews monthly. The Hospital's Annual Study day remains the most important date in the calender bringing together both the hospital staff and the general practitioners in the Clinical Science community. The 1996 programme was again innovative in The Clinical Science meetings continue to be organised by that a poster display and a workshop completely replaced the Postgraduate Department in conjunction \vith the the old lecture format. This was regarded as a major success Royal College of Physicians. These meetings are aimed at and attracted the biggest attendance to date. Candidates preparing to sit Part 11 of the MRCPI Examination. The Course is run from this office twice a International and National Meetings year, ending before the June and November examinations. In addition to the large number of in-house meetings, the Postgraduate Department helped organise two major Pharmaceutical Representations international meetings during the year. The first of these The link for the Pharmaceutical companies here in St. was the third Coloproctology Meeting. This year's topic Vincent's Hospital is the Postgraduate Department. The was 'Infection of the Lower Gastrointestinal Tract and companies sponsor the Medical and Surgical Lunchtime 'Pelvic Floor Disorders'. The Principal oversees speaker was Meeings and in turn the Medical Representative meets the Dr. Ciaran KeUy from Boston who gave the audience a NCHD's and Consultants to discuss their products. This is magnificent update on the problem of Clostridium an important link for both the doctors and Medical Difficile. Representatives. The second meeting-the Oncology study Day - was Eamon and Elizabeth Travers Scholarship dedicated to 'The Challenge of Cancer in the Elderly\vith 1996 saw the inaguaral winner of this travelling scholarship the Guest speaker Professor Montfardini from Italy. The - Ms. Catherine Dubban. This scholarship commerates the meeting concluded with an address from the EU memory of Eamon and Elizabeth Travers. The funding for Commissioner Padraig Flynn. this is organised by Cathal Coleman from E.S.B. Medical and Surgical Meetings The Medical Lunchtime meetings include Gastroenterology, Respiratory, Neurology, Cardiology, Nephrology and the Tuesday Lunchtime Report. These meetings ensure that each team presents clinical cases and Dr. Diarmuid O'Donoghue engages in discussions. The Surgical Audit takes place once Postgraduate Co-ordi1Iator, Consultant Gastroenterologist. a month and continues to be organised under the guidance of Professor Niall O'Higgins. Lunchtime Report The Tuesday Lunchtime Report is organised by the NCHD's. This year the Registrars are teaching the Interns on a current topic every week. The feedback from the NCHD's is that it is an extremely constructive format. The Student Summer Research Project The Student Summer Research Project has become a very important part of the hospital's academic year. The aim of the Project for the Student is to develop an interest in Research so that he/ she will continue to develop this interest at Postgraduate level. The participating student submits a one page abstract on their Research Project and a Panel of Physicians and Surgeons select the winner. AnnulII Rt'plwt 1996 St, Vincent's Hospital St Vincents Hospital Library ______ The Medical Library of St. Vincent's Hospital caters for all The UCD library catalogue is readily available on the students in the various schools - medicine, nursing, network, and most major library catalogues may be accessed radiography, physiotherapy, occupational therapy, dietetics - by Telnet. all the elective courses attached to these, and all hospital tutors and staff. Apart from normal expenditure, the Library accessed extra funding for special projects from several sources. The 1996 saw continuing developments in the Library's Faculty of Medicine, UCD, provided considerable funding computer facilities, which were extended to include: for textbooks and CDs, as did the Postgraduate Medical and Dental Board. A special grant for developing Nursing educational facilities was provided by the Dept. of Health. Computer Facilities ______Mr. Jermyn, Hospital Chief Executive, authorised maintenance of our Medline licence, which is the most essential medical research tool. The Faculty of Medicine, CD Tower UCD, is also providing the funding for the current 5 AppleMacs extension of CD-Tower facilities . 5 IBN-compatible PCs Scanner The Faculty of Medicine also funded the post of Computer Laser printer Support Officer for the ERC, and during 1996 both Stephen Ryan and, subsequently, Dr. Amel Rouche were of The system is networked throughout the Education & tremendous assistance with the developments in the library. Research Centre, running the file-server SVHERC. There Their expert support is very much appreciated. is also an online connection to the UCD file -server. The SVHERC network can also now be accessed from Available on the SVHERC network are: selected points in the main hospital - courtesy of Hospital Medline -complete, unabridged 1966-present. Computer Dept. - and also by home dial-in. Runs of Mac & PC. Current Contents PsychLIt Journals ______Cl AHL Netscape (Internet) Pegasus Mail (e-mail ) The library subscribed to 70 journals, with 70 journals taken on donation from consultants / departments. also document creating applications: Microsoft Word (word processing) Books Powerpoint (slide-making ete.) Excel (spreadsheets) Book stock now amounts to approx. 3,600 copies. Cricket Graphics (graphics) Investment in 1996 was primarily in medical undergraduate SPSS (statistics) texts & CDs, and major reference works. and CD-ROM textbooks Inter-Lib1'a1'Y Loans ______ During 1996 there were 700 requests processed via Earlsfort Terrace, UCD. There were also 600 requests exchanged within the Hospital Libraries group. COU1lcil of International Hospitals ----- The Librarian continued to coordinate requests for CIH reports on best demonstrated practices in the health care industry. Reports are issued free of charge. Throughout 1996 approx. 130 reports were processed through the library. Ammal Report 1996 St. Vincent's Hospital Other Facilities ______Future Developments ______ Photocopying, current awareness, microfiche searches, The planned extension to the CD nedwork facilities is audio-visual resources. almost complete (as I write), so we should soon have up to 30 major textbooks available on the network, with scope to extend this resource in time. Staff ______The Librarian would particularly like to thank the Faculty of Sean Love - Librarian Medicine, UCD, for its financial backing for this project, During 1996, part time library assistants Sorcha and Dr. Amel Roche for implementing it. Schlindwein and Colleen O'Kane. He would also like to acknowledge Mr. Jermyn's continued Mildred Cahalane was also available part-time on work active support for library developments. experience programme. Locum librarian - Aine Burke. Library Sub-committee ______Sean Love Librarian This committee met once a month, chaired by Dr. D.P. O'Donoghue. Its members included Mr. Steve Shering, Dr. Catherine Odium, Dr. John Boylan, Mr. Kevin Connaire, Dr. Cliona O'Farrelly, & Dr. Dearbhaile O'Donnell, and Dr. Amel Roche. The Librarian would like to acknowledge the tremendous support received from Dr. O'Donoghue and all the members of this committee. Mission Committee The Mission Committee was established in September, appreciative of the celebration and enjoyed meeting 1995 and is a sub-committee of the Board of Management. afterwards for a cup of tea. Promotion and continuation of mission is part of the remit of the Mission Committee and this links with Mission In such a large facility as St. Vincent's it takes time to reach Effectiveness. all members of staff. The Mission Committee are, at present, endeavouring to devise the best means, together, The main goal of Mission Effectiveness is to ensure that the of promoting mission. mission, started in 1815 by Mary Aikenhead to serve the sick poor, continues to be effective. To date 100 staff members have attended Unit 1 of the Mission Effectiveness Programme which will continue to be held regularly. Unit 2 will commence in 1997 for those who have completed Unit 1. The Mission Committee, representative of a cross section of staff, met regularly. The formation of the Mission Statement was the focus of the work. The statement was circulated to Department heads for the attention of all staff late in 1996. A Celebration of Rembera1zce was organised in November, 1996 in remberance of deceased staff. Relatives were truly A mlllal Rt'jJo1't J 996 St. Vincent's Hospital ··· v - dJ" C-""Sl1 St. Vincent)s Private Hospital ______ 1996 opened with the move of the following services to the avoided the daily journey to St. Lukes and the nurse escort newly completed purpose built extension: time. This is particularly beneficial to palliative care patients who may have pain. Non Oncology Day Ward - 20 Bedded unit Endoscopy Unit Because the admissions and practice policy of SVPH is to Minor Op Theatre offer privileges to those Consultants attached to SVH, Dressings Room for Outpatients patients benefit from the expertise of Teaching Hospital E.C.G. Room Consultants whilst enjoying the Privacy and Access to care Dietetics Room by the Consultant of their choice that Private Health Physiotherapy Department Insurance offers. Commencement on refurbishing the freed up space began, SVPH receives no state funding and is entirely dependant giving priority to a relatives room ( for interviews with on patients settling their accounts usually through Health doctors, chaplains etc. ) Insurance membership. In 1996 93% of patients were insured with VHI and the remainder with occupational The original day care area was converted into a Pulmonary schemes such as ESB, Garda and Prisoner Officer schemes. Function Laboratory attached to the already established Sleep Apnoea service. Almost 50% of admissions are day care and the remainder inpatient. Having commenced Radiotherapy treatments in 1995, the In 1996 12,000 patients were admitted. service grew in 1996 to include Simulation, Treatment The inpatient average length of stay was 6.2 days . Planning, External Beam Radiation using Photons and Electrons and High dose Rate Brachytherapy using Iridium. In Medical Oncology there was a swing from day care to inpatient care with an average length of stay in this speciality Because of constraints in activity resulting from a one year of 5 days. Medical Oncology had been growing both in agreement with VHI the hospital sought the co-operation numbers and complexity and the Medical Oncologists of the Consultants in striving to keep \vith the agreement choose to divert day cases elsewhere in an effort to meet the i.e. to treat a similar number of patients as in 1995. curtailments imposed. This is an example of how the VHI This proved unachievable and approximately 250 more activity constraint has actually led to an increased acuity of patients were admitted with a diminishing average length of care in this hospital, which in turn places additional stress stay. on the carers. The agreement was not reached until April 1996 but was Co-operation between the two hospitals is ongoing and St. operational from 1st January 1996. This meant that beds Vincent's Campus is ideally positioned to offer all that is were kept unavailable to VHI patients on a phased basis best in patient care, whilst promoting medical, nursing and throughout the remainder of the year in an effort to meet ongoing education for all health care professionals. the terms of the agreement. For the first time since the hospital opened in 1974, wards were closed during the summer months as the hospital was not being adequately funded to sustain full occupancy through the year. Staff were offered leave of absence \vithout pay and less summer locum work was available than in previous years. Co-operation between St. Vincents Teaching Hospital and St. Vincents Private Hospital continued throughout the year with SVPH purchasing in excess of £1 million of services from SVH mainly in the areas of Pathology, ITU, CCU and specialised theatre i.e. Vascular and Thoracic Surgery. SVH likewise purchased MRI services for SVPH. SVPH thereby deleting the need to travel to the RVEEH and saving on nurse escort time. Likewise, a small number of inpatients in SVH had Radiotherapy treatment in SVPH and in this instance A1l1l1tlll Report 1996 ! ··· St. Vincent's Hospital = ~ dJ, .... ,s,. General Practitioners Liasion Committee ______ The relationship between the G.P. community and the local St. Vincent's Hospital is recognised nationally as a Hospital, so positive and cordial at a personal level, has "Flagship Hospital" in relation to the provision of C.M.E. always had its inherent strains in the broader context. G.P.'s for G.P.'s. I am confident that the Hospital can also set a complain of poor communication, difficulties with access national standard in how G.P.'s and Hospital staff can, in a and an impersonal approach to patients concerns. Hospitals two - way parmership, improve their ability to provide highlight their practical problems in dealing with such a better services for our patient population. This disparate group of professionals, and also document areas of improvement must be equitable, rational, cost - effective poor communication at the G.P. / Hospital interface. and appropriate. We, the local G.P. community, are very committed to playing our part in this process, and accept Traditionally, an impasse has existed, resulting in little fully tl1at we too must critically evaluate our methods and progress on these key issues, disillusionment witl1 "the organisation, and implement necessary changes in our other side", and sadly, a missed opportunity to achieve what practices. we both fundan1entally strive for, a better level of care for our patients. Now all has changed. Tremendous new ground has been Dr. Tiernan Murray broken by the G.P. Liaison committee which meets Gmeral Practitioner quarterly in the Hospital. All our successes are based on two sin1ple developments. Firstly the G.P.'s understanding that we must enter right into the Hospital decision - making structures, if we are to influence how we are dealt with, and what access to services we are likely to achieve. Secondly, the Hospitals willingness to take this bold step, knowing that it cannot control its services and structure them in an ideal way, without the help of the "troops on the ground". Already our co-operative approach has brought many worth while changes; non-appointment pathology and radiology access for patients, "semi-urgent" radiology access for G.P.'s moves towards open - access endoscopy and cardiology services, standard pathology forms, standard G.P. referral letters, better phone access to personnel and services, improved communication with A&E, new access to disposal of medical waste, new structures to ensure that G.P.'s are notified of patients in - hospital deaths. We are now moving on to tackle other areas; more rapid discharge of patients back from OPD to their G.P.'s; the possible deployment of a G.P. Liaison Nurse in A&E; protocol development to allow the transfer of Chronic Disease Management back to a community setting. Ammal Report 1996 St. Vincent's Hospital ··· ~ dJ.' ... , Prize Winners - Tuesday, 20th February 1996 _____ Nuning ______ Mother Mary Aiken Head Medal Sr. Manus Daly Mother Mary Bernard Medal Ms. Mary Devnish Magennis Medal Nurse Fiona Wymer Nuala Deeney - Brennan Memorial Prize Miss Jean McCarthy The Cecil King Memorial Prize Mi ss Philomena Shovlin RCS! Bursary The Nursing Staff of St. Raphael 's Ward Prize for Outstanding Patient Care 3rd Year Nurse Eli zabeth Fitzpatrick 2nd Year Nurse Mary Doheny 1st Year Nurse David O'Sullivan First Place In Examination for 3rd Year Nurses; Group A urse Caitriona O'Donovan ex aequo Nurse Fiona Wymer Group B Nurse Eli zabeth Fitzpatrick First Place in Examination for 2nd Year Nurses: Group A Nurse Siobhan Ryan Group B Nurse Eilish O'Connel First Place in Examination for 1st Year Nurses: Group A Nurse Marguerite Quirke Group B Nurse Grainne O'Brien jfedicine------ Department of Anaesthesia Gold Medal Dr. James Lyons Bellingharn Medal in Medicine Or. Jean Doyle Magennis Medal in Clinical Medicine Dr. Jean Doyle ex aequo Dr. Susan Connolly O'Ferrall Medal in Surgery Dr. Jean Doyle McArdle Prize in Surgery Dr. Susan Connolly ex aequo Or. Onoagh Clyne Dargan Prize in Medicine Mr. iall Sheehy Tobin Prize in Surgery Mr. Niall Sheehy St. Vincent's Hospital Consultant Scholarship Mr. Niall Sheehy Dr. Francis MsLaughlin Prize in Psychiatry Miss Sinead Byrne Mc Grath Prize in Pathology Mr. Nial l Sheehy Student Prize in Anaesthesia Mr. Niall Sheehy Student Research Project Prize Mr. Eamonn Molloy UCD School of Diagnostic Imaging Bachelor of Radiography Examination: Philips Award for overall Academic Excellence Miss Mary Brosnan Siemens Award for First Place in Equipment Miss Elaine Fitzpatrick Best Practical Student Miss Michelle Foley Second Year University Examination; First Prize Miss Geraldine Butler First Year University Education: First Pri ze Miss Sinead Peters A1I111/al Report 1996 ··· St. Vincent's Hospital i v - dJ(" ....'11. Hospital Committees ______ Board of Management ---___ Finance Committee Chairman: Professor Noel Whelan. Chairman: Mr. Cathal McAllister Hon. Sec: Mr. Cathal McAllister. Members: Mr. N.C. Jermyn. Mr. Sean Fagan. Members: Mr. Denis J. Bergin. Mr. Patrick Meade. Sr. Joseph Cyri!. Mr. Cormac Maloney Mr. Gerald Scanlan. Mr. Wi!liam Quinlan Mrs. Joyce Andrews. Mr. Ean10nn FitzGerald Professor M.X. FitzGerald. Mr. Robert Martin. Mr. William Quinlan. Mr. Patrick Meade. Mr. Stewart Harrington. Sr. Joseph Eugene. Sr. Joan O'Connor. Ethics & Medical Research Committee _ Mr. Daniel G. Kelly. Chairman: Mr. John Hyland. Sr. Marie Peter. Hon. Sec: Or. Oliver FitzGerald. Or. Caroline Hussey. Members: Sr. Agnes Reynolds. Mrs. Patricia Maguire. Mr. Denis Bergin. Sr. Agnes Reynolds. Miss L. Browne. Sr. Helen Deane. Or. B. Ferris. Executive Council ______Dr. S. Kennedy Chairman: Mr. Nicholas C. Jermyn. Mr. G. Scanlan. Members: Mr. Sean Fagan. Dr. D. Rutledge. (G.P. ) Sr. Joseph Cyri!. Miss Pauline Doyle. Mr. William R. Quinlan. Bed Management Committee _ _ _ Or. Waiter McNicholas. Chairman: Mr. David Quinlan. Dr. Kieran Sheahan. Members: Mr. WiIlian1 Quinlan. Miss Pauline Doyle. Mr. Robert Martin. Mr. Eamonn FitzGerald Executive of the Medical Board ___ Miss Margaret Conway Chairman: Mr. William Quinlan. Mr. John Hyland. Hon. Sec; Or. Waiter McNicholas. Ms. P. Turner Members: Mr. John H yland. Dr. Diarmuid O'Donoghue Or. Robin Gibney. Mr. Dan Kelly. Dr. Brian Maurer. Mr. Robert McQuillan Dr. Kieran Sheahan. Dr. Brian Maurer Dr. Neil McDonald. Miss Kay Hennigan Or. Diarmuid O'Donoghue. Ms. T. McDonough Mr. Kieran O'Rourke. Or. Oliver FitzGerald. Mr. David Quinlan. Dr. M. Hutchinson. Or. Oliver FitzGerald. Dr. L. Fenelon. Miss P. Martin. Fundraising Committee ______Chairman: Mr. Denis Bergin. Members: Mr. N. Jermyn. Sr. J oseph Cyri!. Mr. S. Fagan. Mr. D. Kelly Mrs. J. Andrews. other medical and management representatives are in the process of being nominated to the Fund Raising Committee. A1l1mal Report 1996 Designed by EM Design Consultancy Produced by C&A Print Services