St. Columcille's Hospital annual report 1999
Item Type Report
Authors St. Columcille's Hospital, Dublin
Rights St. Columcille's Hospital
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Link to Item http://hdl.handle.net/10147/42832
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Annual
Report,,e..4- --'b *..~,l *~,.n -.,-r I __..I. ~--..?,?-' c..::..-~ ..,, l. -.*' '-' r .-.. ,.:-ls,..'- r: /d.# Eastern Health Board Membership
ealth Board Management Team
pitals and Services for the Elderly Programme Committee 6
Hospital Committees 7
Medical Board 7
Statistical Review Out-patients 13
Other Hospital Services 16
Financial Out-Turns 17
Nursing Report 18
Departmental Reports 29-40
Appendix 1. Out-Patient Clinics 41
Appendix 2. Obstetric/Gynaecology 42
Appendix 3. X-Ray Examinations
Appendix 4. Laboratory Statistics 44-46
Annual Pa.-.-..+ BOARD MEMBERS Members appointed by Local Authorities
Dublin Corporation Kildare Countv Council
Cllr. Eric Byrne, 32 Ashdale Road, Terenure D 6W. Cllr. Jack Wall T.D., Castlemitchell, Athy, Co. Kildare
Ald.. lvor Callely, T.D., 7 St. Laurence Road, Clontarf, D3 Cllr. Sean O'Fearghaill. Fennor, Co. Kildare
Cllr. Roisin. Shortall, T.D., 12 lveagh Rd, Whitehall D9 Cllr. Jim Reilly, Ballinakill, Carbury, Co. Kild
Cllr. Dr. Dermot Fitzpatrick, 80 Navan Road, D7 Wicklow CounW Council 1 Cllr. Deirdre Heney, 12 Sion Hill Road, Whitehall, Dg k, Baltinglass, Co.Wic Cllr. Christy Burke, Liffey House, Tara Street, D2 Cllr. Andrew Doyle, Lickeen, Roundwood, Co Ald. Sen. Joe Doyle, 14 Simmonscourt Terrace, Donnybrrok, Dq. I Cllr. Patrick Vance, Beachmount, Putland,Road, 1 Bray, Co. Wicklow.
Dublin South Countv Council
Cllr. Charles O'Connor, C/O South Dublin Co. Council, P.O. Box 4122, Tallaght, Dublin 24
Cllr. Colm McGrath, 2 Moyle Park, Clondalkin D22
Cllr. Don Tipping, 7 The Dale. Kingswood Heights, Tallaght, D24
Fingal Countv Council
Cllr. Liam Creaven, 43 St. Fintan's Park, Sutton, D13
Cllr. Anne Devitt, Lispopple, Swords, Co. Dublin
Cllr. Michael O'Donovan, 70 Delwood. Castleknock, Dl5
DunlaoghairelRathdown CounW Council
Cllr. Tony Fox, 93 Mountainview Park, Rathfarnham, D14
Cllr. Jane Dillon Byrne, Silchester House, Silchester Rd, Glenageary. Co. Dublin
Cllr. Olivia Mitchell, T.D. 18 Ballawley Court, Sandyford Road, Dublin 16 MEMBERS APPOUNUED UNDER HEALTH .- BOARD (ELECUUON OF MEMBER% REGULAUUON 2972
Registered Medical Practitioners Dr. John Fennell, "Chesapeake", 2 Kendallstown Rise, Delgany, Co.Wicklow. Dr. Siobhan Bary, Chain Mhuire Service, Blackrock, Co. Dublin Dr. Charles Smyth, Central Mental Hospital, Dundrum, Dublin 14. Dr. K. Harkin, 15 Grattan Cresent, Inchicore, Dublin 8. Dr. Ray Hawkins. Bray Medical Centre, Herbert Road, Bray, Co.Wicklow. Dr. Marie Laffoy, 20 Avoca Park, Blackrock. Co.Dublin. Dr. Phillip O'Connell, 57 Craysforts Downs, Blackrock, Co. Dublin. Dr. lames Reilly, Fingal House, Lusk, Co. Dublin.
Registered Dentist Dr. D. I. Keane, 130 Merrion Village, Dublin 4.
Registered General Nurse Ms. Maria Hoban, 6 Ashgrove Cresent, Naas, Co. Kildare
Registered Psychiatric Nurse Mr. Gery McGuire, IThe Strand, New Road, Donabate, Co. Du
Registered Pharmaceutical Chemist Mrs. Bernadette Bonar, g Leopardstown Park, Blackrock, Co. Dublin
MEMBERS APPOINTED BY THE MINISTER FOR HEALTH
Cllr. Laurence Butler, 3 Whitehall Mews, Westminister Road, Foxrock, Dublin 18.
Mr. P. Aspell, 61 College Park, Newbridge Co. Kildare
Cllr. Dr. W.O'Connell, Vale Road, Arklow, Co. Wicklow
Mrs Catherine Quinn. 47 Beechwood Lawns, Rathcoole, Co.Dublin klANAGEMENT TEAM PROGRAMME COMMITTEE
Thief Executive Officer Acute Hospitals & Services for fir. Pat McLoughlin the Elderly Programme
Drogramme Manager, Mr. Gerry McGuire, Chairperson 4cute Hospitals and Services for Cllr. Deirdre Heney, Vice Chairperson !he Elderly Programme Cllr. Roisin Shorthall, T.D. Mr. Seamus O'Brien Ms. Maria Hoban Dr. Marie Laffoy Cllr. Jim Reilly Programme Manager, Community Services Cllr. Pat Vance Mr. Michael Walsh Ald. lvor Callely, T.D. Ald. Sen. Joe Doyle Programme Manager, Health Promotion Cllr. Michael O'Donovan Mental Health, Addiction & Social Development Mr. Martin Gallagher
Programme Manager Services for Persons with Disabilities Ms. Maureen Windle
Programme Manager, Children & Families Ms. Brid Clarke
Finance Officer Mr. Martin Gallagher
Personnel Officer Ms. Mary Kelly
Technical Services Officer Mr. I. Curran
Estate Management Officer Mr. Phillip Doyle
Communications Director Ms. Maureen Browne
Director of Public Health Dr. 8. O'Herlihy
Management Services Officer Ms. Mary Crowe HOSPITAL COMMITTEES
+ Hospital Management + Casemix + Drugs and Therapeutics + Infection Control + Health & Safety + Radiation Safety + CPR Committee + Bed Management Committee + Complaints Committee + Medical Ethics + Library Committee + Medical Records Committee + Hospital Community Liaison Cc + Freedom of Information + Transfusion Committee
MEDICAL BOARD
Dr. Hugh Gallagher, Chairperson
CONSULTANT. STAFF
Dr. John Fennell, Consultant Physician Dr. Morgan Crowe, Consultant Physician in Geriatric Medicine Dr. Oonal O'Shea, Consultant Endocrinoligist Dr. Diarmuid O'Shea. Consultant Physician in Geriatric Medicine (commence 4th January 2000) Dr. Shaun O'Keeffe, Consultant Physician in Geriatric Medicine Dr. Peter Quigley, Consultant Cardiologist Mr. Geoff Chadwick, Consultant Physician Mr. Declan Magee, Consultant Surgeon Mr. Stephen Sheehan, Consultant Surgeon Mr. John Hyland, Consultant Surgeon Mr. Justin Geoghegan, Consultant Surgeon Mr. Gary Brow, Consultant Surgeon (Locum) Or. Hugh Jordan, Consultant Radiologist Dr. Susan Pender, Consultant Radiologist Dr. Brian McGlone. Consultant Radiologist Dr. Kinross Burke, Consultant Anaesthetist Dr. Patrick Benson, Consultant Anaesthetist Dr. Hugh Gallagher, Consultant Anaesthetist Dr. Bernard Nally, Consultant Anaesthetist (Locum) Dr. Niamh Nolan, Consultant Histopathologist Mr. Kieran O'Rourke, Consultant Orthopaedic Surgeon Mr. Eamonn Kelly, Consultant Orthopaedic Surgeon Dr. Orla Shiel, Consultant Obstetrician/Gynaecologist Dr. Peter McParland, Consultant Obstetrician/Gynaecologist Dr. Grainne Flannelly, Consultant Obstetrician/Gynaecologist Mr. Stephen McDermott, Principal Dental Surgeon Mr. Hugh Barry, Consultant Oral Surgeon Mr. David Ryan. Consultant Maxillofacial Surgeon Prof. Noel Claffey, Consultant Periodontoiogist Dr. Caoimhe McGrane, Senior Clinical Dental Surgeon
NURSE MANAGER Ms. Mercedes Hurley
HOSPITAL MANAGER Mr. John Hempenstall HOSPITAL SERVICES . .
St. Columcilles Hospital, Loughlinstown provides services as listed hereunder to its immediate catchment area of South County Dublin and East Wicklow.
-General Medical -Acute Elderly Assessment/Rehabilitation -Day Hospital for the Elderly -General Surgery -Vascular Surgery -0rthopaedic Surgery -Gynaecology -Dental Surgery -Cardiology -Intensive Care/Coronary Care -Endocrinology -Anaesthesia -Pain Therapy -Day Procedures -Accident & Emergency (24 hour service) -Radiology -C.T. Scanning -Pathology / -Phys~otherapy -Occupational Therapy -Speech Therapy -Pharmacy -Social Worker -Dietician -Chiropody - ECG -Out-patients (including Obstetrics/Gynaecology)
Peripheral Ante-Natal Clinics are serviced from the Hospital in conjunction with the National Maternity Hospital, Holles Street, at Arklow, Wicklow. Bray and Greystones.
The Hospital also provides a comprehensive service to the General Practitioners in the catchment area including direct access to:
-Radiology -Pathology -Physiotherapy -Diabetic -Dietetic -Endoscopy -Routine & Stress ECG -Day Hospital (Elderly) The recent trends in the increasing need for hospital services over the past number of years continued in 1999. 1 must acknowledge the dedication and tremendous commitment of all our staff as it was only with their co-operation and exceptional efforts that the Hospital was able to respond appropriately to the service need of the catchment population.
The Hospital had and continues to face the ongoing problem of shortage of suitably qualified nurses in the employment market. This we feel is going to continue for some time into the future. The nursing staff are to be complemented on their commitment and efforts in maintaining services at existing levels throughout the year.
SERVICE DEVELOPMENTS IN 1999
In addition to core activities, a number of service developments place during the year which will both enhance the overall quality of provided for our patients and expand the range of services available at the Hospital. , I These included:
4 ' Development of C.T. Scanning Services I
Development of Endocrinology Services 1 I
Development of Cardiovascular Services
Development of Information Technology Systems
HOSPITAL DEVELOPMENT - ACCOMMODATION/INFRASTRUCTURE
In 1998 a detailed planning brief and schedules of accommodation was completed for the Hospital and the plan is now with the Department of Health and Children for consideration. In lggg an architect was engaged to draw up a Development Control Plan for the Hospital campus A Draft Feasibility Study has now been completed and was presented to the members of the Hospital's Review Group set up to review the future role and developmental potential of the Hospital at its meeting in August 1999.
The priority areas for development in the Hospital are the Accident and Emergency Department, Radiology Department, Day Procedures Unit, completion of the Intensive Carelcoronary Care Unit, and the upgrading of the mechanical and electrical services.
Annual ----A CONSULTANT MANPOWER
The following consultant appointments were made in 1999:
Dr. Donal O'Shea, Consultant Endocrinologist - July 1999 Dr. Susan Pender, Consultant Radiologist - August 1999 Dr. Brian McGlone, Consultant Radiologist - October 1999 Mr. Justin Geoghegan, Consultant Surgeon - November 1999 Dr. Diarmuid O'SHea, Consultant Geriatrician - January 2000
Financial clearance has also been sought from the Department of Health and Children to proceed with the following consultant appointments:
- Consultant Anaesthetist - Consultant Neurologist - E.N.T. Consultant - Consultant Urologist - Consultant Cardiologist - Consultant Ophthalmologist
Discussions are also taking place in relation to the development of paediatric services and dermatological services.
HOUSEHOLD SERVICES DEPARTMENT I
A Household Services Department was established this year at the Hospital and the Household Services Officer took up duty in September 1999.
FUND RAISING
Quite a number of fund raising activities were organised throughout the year and substantial sums have been raised For hospital projects. The hospital is fortunate to have a very committed voluntary group "The Friends of St Columcille's Hospital" to whom we are very grateful.
EQUIPMENT REPLACEMENT PROGRAMME
The Board's letter of determination of 1999 included a special allocation of £130,000 For the purchase of equipment at the hospital. Equipment purchased with the funding included:
- Radio Frequency Lesion Generator
- WasherIDisinfector - Theatre
- Volumetric Pumps - Wards
- Syringe Pumps - Wards
Theatre Monitors
Diathermy Machines - Theatre
A planned programme of equipment replacement which includes an annual review of all medical equipment is ongo- ing at the Hospital to ensure that all equipment is brought up to modern standards to facilitate quality patient care. STRUCTURAL IMPROVEMENTS . . During the course of 1999 the following improvements were completed at St. Columcille's Hospital:
Completion of extension and upgrading of the Radiology Department to accommodate the C.T. Scanning Service
Continued programme of replacement of old wooden windows throughout the Hospital
Decoration of Medical Accommodation in Staff Home
In 1999 a special allocation of f40,ooo was approved by the Department of Health and Children towards the cost of repairs and upgrading of the heating system in the Hospital. This work was completed in November 1999.
A submission has been made to the Department of Health and Children regarding the necessary funding to facilitate the total upgrading of the mechanical services at the Hospital, the completion of work on the electrical services and the resultant necessary decoration.
I would like to thank my colleagues on the Hospital Committees, Ms. M. Hurley, Matron, Dr. Hugh Gallagher, Chairman. Medical Board and his consultant colleagues for their support during the year. A special word of thanks to Mr. John Broe, Assistant Hospital Manager and Ms Patricia O'Callaghan, Head of Medical Records and all the staff of the Hospital for their support and commitment throughout the year in the provision of an excellent quality service to the patients. 1
John Hempenstall 2nd December 1999 Hospital Manager
Annual Reaort
Specialty 1999 1999 8 (Projected) (Oct)
Medical 2399
Surgical 3393
I.C.U./C.C.U. 342
Acute Assessment Elderly
Orthopaedics 19% 151 218
OUT-PATIENT ATTENDANCES
Specialty 1999 1999
Medical
Surgical
Elderly 542 452 631
Otthopaedics 5745 4788 6167
Obstetrics/Gynae 4053 3377 4522
Geriatric day Hospital 1532 1277 1644
Pain Relief 165 $29 179
Warfarin Clinic 3004 2404 2780 A&E In-patient Attendances Admissions
Out-patient Attendances --
Admissions by Geographical Source 1999 Distribution 1999
Under 14 Years 204 (3%)
Annual Dm.-.c.r+ 1999 1999 (Projected) (OCt)
Diagnostic Services
Radiology 34209 28,508 36.846
Dietetics
Day Services
Day Surgery Procedures 1,896 1,580 1,674 Geriatric Day Hospital 1.532 1.277 1,644 Endoscopy Unit 337 281 335
Pathology Department
Microbiology 34872 12,240 14.869 Blood Transfusion 2,768 2.323 2.760 Bio Chemistry 57.787 48,001 4.131 Histology/Cytology 1,847 1,512 1.752 Haematology 59.635 49.185 53.174
A&E Department
Number of new patients 22,177 18,481 23.743 (1st Attendance) Number of Return Visits 5.320 4,433 8,832 Number of Admissions 4,020 3,350 4.177 Total Attendance 27.407 22,914 32.575 R.T.A. Admissions 90 75 108
Theatre
Major Operations 623 519 747 Minor Operations 2,189 1,824 2.083 Dental Operations 173 144 158
NURSING REPORT 2999 Nurses in Ireland not only enjoy the confidence of patient and clients of the Health Service but have an international reputation for their professionalism and the excellence of their care.
Nursing is a dynamic, complex and developing profession. As health care charges, practice continues to evolve and many nurses now work in very different ways and at higher levels of practice than previously. Nurses develop their knowledge and competence in different ways. At Columcille's Hospital, most nurse's use formal education and training opportunities, but much can also be gained from activities such as clinical supervision, learning sets, mentorship and self-study.
The report on the Commission on Nursing "A Blueprint for the Future" was published in September 1998. The role of advanced and specialised clinical nurses has been developed in St. Columcille's Hospital in line with the Commission's recommendations.
In response to the National Cancer Strategy the Eastern Health Board have appointed Sister Stella Eyre as the Cancer Nurse Co-ordinator to St. Columcille's Hospital. Her remit is to improve and streamline services for patients with cancer and to provide information and support to patients and families. Sister Eyre is an integral part of the multi-disciplinary team.
Staff Nurse Roisin Cleary is responsible for providing education and support to patients and their families who have diabetes. A new education centre for this purpose has been set up and it is hoped to increase the service over the next few months.
The nurse led, leg ulcer and dressing clinic have proved to be both popular and patient focused. This clinic was set uk in October 1998 and caters for 9-10 patients per session. All outpatient nurses involved in wound care are required to attend regular updates per year. All members of the multi-disciplinary team, both within the hospital and community setting are invited to attend the Annual Wound Care Update organised by Sister Byron and her team.
The Commission also identifies education requirements for career pathways. This has shown the way forward for many members of the staff at St. Columcille's Hospital who have accessed Post registered and professional development courses.
Higher Diploma in nursing studies (Critical Care) UCD Supervisory Management Skills IMI BSc Nursing Management RCSl BSc Health Care Management TCD Complementary Medicine Degree in Nursing DCU & UCD Research and Development EHB
Student Nurses St Columcille's Hospital welcomed the first intake of student from Tallaght Hospital in March 1999. Students were assigned to both the medical and surgical areas and facilitated by the Clinical Placement Co-ordinator. All staff were excited if not initially apprehensive, but this was overcome by the enthusiasm from all members of the multidisciplinary team and the positive feedback from the students.
Cardio-Pulmonary Resuscitation Basic Life Support Classes are held regularly by Staff Nurse Sophie Charles. They consist of four hours instruction in CardiojRespiratory Arrests and the management of choking in Adults, children and infants. Standardisation of Cardiac Arrest trolleys and defibrillators has begun on all wards and pre-packed emergency drugs were introduced in Ian 1999.
Moving and Handling Moving and Handling classes are conducted by Staff Nurse Patsy Walsh and physiotherapist Mary Hyland for all members of the multidisciplinary team. A nursing representative from each area within the hospital attends on a monthly basis.
IV Study The intravenous study day, which is part of the extended role of the nurse is held on a three monthly basis by Charge Nurse Jim McNamee for all members of new staff.
Health Promotion Staff Nurse Gave Griftin was nominated to the Health and Safetv Committee and in line with EHB uolicv assisted with introducing a nb smoking policy to the hospital.
I would like to take this opportunity to thank all members of nursing staff for their continued support and commitment The quality of care has continued to be of a high standard. Congratulations to Ms Deirdre Breslin, Ms Veronica Lacey and MS Anita Delaney on their appointment to Ward Sisters positions. Finally, I would like to wish a happy retirement to Ms Phil Pope, Ms hrhra Rvan mrl M= Attrarta ivnrh for the s~~icethev orovided and who will be missed by their colleagues. Agreement has been reached within the South East Dublin Department ofsurgery to the creation of a post DEPARTMENT OF SURGERY of Consultant Urologist. This post is structured St Columcille's Hospital (7 sessions) and St Vincent's The Department of Surgery under the direction of Mr. Hospital (4 sessions). Application for financial clearance Declan Magee and Mr Stephen Sheehan, Consultant in respect of this post has been made to the Surgeons continued to be very busy during 1999. The Department of Health and Children. It is anticipated Department provides a comprehensive general surgical that this appointment will take place in 2000. service resulting from Out-Patients, General Practitioners and Casualty Department referrals. The Agreement has also been reached within the South East caseload in the Department has shown an increase in Dublin Department of Surgery to the creation of a post admissions, out-patient attendance and theatre activity of Consultant ENT. Surgeon. This post is structured St during 1999. Columcille's Hospital (7 sessions) and Royal Victoria Eye and Ear Hospital (4 sessions). Application for finan- In 1999 approval was received from Comhairle na cial clearance in respect of this post has been submit- n-Ospideal to the joint appointment of a third post of ted to the Department of Health and Children and a Consultant General Surgeon with a special interest in decision is awaited. Hepatobiliary Surgery/Transplantation. This post is structured St Columcille's Hospital 5.5 sessions and St A Cancer Nurse Co-Ordinator, Ms Stella Eyre, has been Vincent's Hospital 5.5 sessions. Interviews were held appointed as part of the Cancer Strategy and com- for this post in 1999 and the successful candidate, Mr menced duty at the Hospital. Her chief role will be to Justin Geoghegan took up duty on 1st November 1999. assess the ontological needs of the catchment popula- tion and to assess the resource needs of the Hospitd The complement of Consultant General Surgeon posts to provide optimum treatment for the catchment popu- for St Columcille's Hospital, as a result of this lation, in line with the goals and aspirations of the appointment is as follows: Cancer Strategy. She will additionally proyide a direct input into rationalising the management of gastroin- testinal and breast cancer in the Hospital.
Consultant
Mr. I. Hyland 3 Sessions 8 Sessions
The surgical unit consists of 54 beds and a full range of general surgical conditions is managed. Four Out- Patient clinics are held weekly at the Hospital and an Out-Patient clinic is held fortnightly at Arklow Health Centre at which Mr Magee attends.
The projected number of admissions for 1999 is 3.393. Attendance at the surgical Out-Patient Clinic for 1999 was 4,022. The number of operative procedures carried out in theatre for 1999 was 2,985. The percentage bed occupancy in the Department of Surgery in 1999 was 91% and the average length of stay was 6.95%.
The Hospital continues to participate in the joint Department of Surgery for South East DublinIEast Wicklow. The Hospital Manager and Director of Surgery are members of the Steering Committee which was established to oversee, in consultation with the Co- Annual ordinator, the functioning of the joint Department. -----* ACCIDENT AND EMERGENCY THEATRE DEPARTMENT
The Accident & Emergency Department at St The Theatre Department provides a 24-hour, 7-day Columcille's Hospital provides services on a 24 hour, 7 week elective and emergency service. The projected day week basis to an increasing population in its number of operations carried out in the Theatre catchment area of Dublin South EastIEast Wicklow. Department in 1999 was 2,985.
The Accident & Emergency service continued to be very It is anticipated that with the appointment of the third busy during 1999. There were 22,177 new patients Consultant General Surgeon with a special interest in attended for treatment during the year. A further 5.320 Hepatobiliary Surgeryflransplantation in November return patients attended. 1999, the number of operations will increase in the coming year. An indication of the important role that the Accident & Emergency Department plays in the overall context of Nursing activities in Theatre include the following: the Hospital is reflected in the high percentage of over- all Hospital admissions coming in via the Accident & Post graduate anaesthetic nursing link with St Emergency Department. Vincent's Hospital - Continuation of Dental Nurses Teaching Programme The projected number of admissions to the Hospital via with the Dublin Dental Hospital the Accident and Emergency Department in 1999 is 4,020 or 85% Courses attended by Nursing Personnel were as follows: One vitally important aspect of the Hospital's role is the World Symposium on Sterile Services, U.S.A. provision of a 24-hour 7-day per week Accident and Emergency service for its catchment area is that it takes Minimal lnvasive Surgery - Leeds Institute pressure off the tertiary referral Dublin Accident &Emergency hospitals and in' particular St Vincent's Annual Conference lrish Association Sterile Services Hospital thereby ensuring that patients are treated at a Managers level more appropriate to their medical needs. Principles and Practice of Surgical Endoscopy for Peri-operative Nurses In order to extract comprehensive statistical data and patient information, the Board is at present arranging Annual Theatre Conference - Wexford for the installation of a suitable computerised A&E Staff Nurse Barbara Smyth is secretary of lrish Information System at St Columcille's Hospital which Association Sterile Services Managers. will have the capacity to interface with other Departments within the Hospital. Sr Margaret Higgins and Staff Nurse Smyth were involved in organising the Annual Conference in Discussions are at an advanced stage within South East Malahide - lrish Association Sterile Services Dublin regarding the structuring of a post of Accident & Managers Emergency Consultant between St Columcille's Hospital and St Vincent's Hospital. Sr Higgins chaired the morning session for the Colo-rectal Surgery Day for nurses in St Vincent's Hospital
Purchases within the department included
- Video colonscope - Additional patient monitors - Instrument washer disinfector - Diathermy Machines x 3
The Department is constantly updating the equipment to provide a modern updated service to patients. DEPARTMENT OF ORTHOPAEDIC SURGERY
The projected number of patients seen at the Out- The Obstetric/Gynaecology service at St Columcille's patient Clinics during 1999 is 5,745 and of these 2,332 Hospital is provided by Dr Orla Shiei, Dr Peter are first attendances. The number of in-patients McParland and Dr Grainne Flannelly. Consultant admitted for treatment by the Orthopaedic Team during Obstetricians/Gynaecologists. 1999 was 191 and a total of 191 operative procedures were performed on these patients. In addition to the Consultant-based Out-Patient ante-natal clinics are held above many elective procedures on patients seen in the weekly at St Columcille's Hospital and peripheral Out-patients were performed in Cappagh Orthopaedic ante-natal clinics are held weekly at Arklow. Wicklow, Hospital. Bray and Greystones. The projected number of attendances at ante-natal out-patient clinics in 1999 is The Orthopaedic Service provided at St.Columcille's 4,053. Hospital under the direction of Mr. Kieran O'Rourke and Mr. Eamon Kelly, Consultant Orthopaedic Surgeons. A weekly Ultrasound session is held at St Columcille's includes out-patient clinics, operating sessions, in- Hospital and a mobile Ultrasound machine is available patient care and ward consultations. for use in the peripheral ante-natal clinics which saves the patients from having to travel to the Hospital for Two additional posts of Consultant Orthopaedic this service. Surgeon are being structured in South East Dublin with I additional sessions to St Columcille's Hospital. It has The Ante-Natal Education Programme for ,patie+$ been agreed to restructure one of the existing posts at continues in St Columcille's Hospital and Wickiow the Hospital to give St Columcille's Hospital a majority Health Centre. This,is organised each wbek'byI. the ibc?,l sessional commitment of a post of Consultant nursing midwived and ph&o\herabists and is fully Orthopaedic Surgeon, which will allow for more acute availed of by the patients. orthopaedic work to be carried out at St Columcille's I : !, Hospital. In 1999 an amount of f60,o Department of Health and Children for the development of gynaecology services at St Columcille's Hospital. This money will allow for the employment of one Obstetrical Registrar and two Staff Nurses to assist with the development of gynaecological services at the Hospital.
Annual R-nnrt OUT-PATIENTS DEPARTMENT
The projected activity in the Out-patient Department in iggg is 20,526.
Clinics held at the Hospital are as follows: 2 Medical (Weekly) 1 Elderly (Weekly) 2 Obst./Gynae (Weekly) 3 Diabetic (Monthly) I Warfarin (Weekly) 4 Surgical (Weekly) 2 Orthopaedic (Weekly) 1 Dietetic (Weekly) 1 Asthma (Monthly) 2 Pain Relief (Weekly) 1 Leg Ulcer (Weekly) 1 Respiratory (Weekly) 1 Cardiology (Weekly)
In addition to the above a Surgical Clinic is held fort- nightly in Arklow and Ante-Natal clinics are held weekly / in Arklow, Bray, Wicklow and Greystones. Further details of out-patient clinics are contained in Appendix I.
In lggg a Diabetic Day Centre was established at the Hospital. A Staff Nurse is assigned as full-time Diabetic Specialist Nurse. The nurse is based in the Out-Patient Department and Day Centre to provide care, advice and education to the patients. The provision of this service has given our patients with diabetes a better quality of life.
Advice and education are now available to diabetic patients by attending the Hospital or by contacting the Diabetic Nurse by telephone.
Dr Donal O'Shea commenced duty at the Hospital in July lggg as Consultant Endocrinologist. Dr O'Shea attends thi~iabeticOut-Patient Clinics and Day Centre and is actively involved in the further development of the diabetic out-patient services. IEPARTMENT OF MEDICINE Endocrinology and .Diabetes-- rhere continued to be a high demand for medical beds In July of 1999 the new consultant in Diabetes and n 1999. Projected admissions for 1999 is 2,399 and Endocrinology, Dr Donal O'Shea, took up his post. The led occupancy was averaging 90%. This results in med- main purpose of this post is to expand the diabetes cal emergencies being admitted to surgical wards service which was previously provided by Dr lohn ~hichreduce the availability of beds for emergencies Fennell. With the increasing incidence of diabetes a ~ndfor elective work in the Department of Surgery. dedicated specialist in the area was required. Over the coming years there will be a significant expansion of 'rejected out-patient attendances for 1999 was 2,995. the diabetes services. The outpatient clinic, which was The number of new patients who attended was 415. previously held on a Thursday morning, has been Day procedures are carried out twice weekly, including moved from November 1999 to a Thursday afternoon. gastroscopy, colorioscopy and bronchoscopy. In 1999 The diabetes clinic will run three out of the four weeks the total number of endoscopies carried out in the of each month. By the end of year 2000 it will run on Department of Medicine was 337. a weekly basis. The Department's other clinic day has not yet been identified. Areas that will be covered by The Department of Medicine, under the direction of Dr this clinic will include thryoid disease and obesity man- lohn Fennell, provides a comprehensive in-patient ser- agement. vice for patients with general medical problems and also specialised areas such as diabetes, asthma, hyper- The Diabetes Specialist Nurse, Ms Roisin Cleary, pro- lipidemia and acute cardiology. vides a comprehensive education programme in associ- ation with the Senior Dietician, Ms Mary O'Riain. With the expansion of the diabetes service, a dedicated dia- betes day centre has been identified which is situated above the Private Clinic at the Hospital. This allows a drop-in service to be provided for patients who canxome and chat through problems they may be hav- ing with their diabetes during office hours. The diabetes day centre has been a key part in improving the man- agement of diabetes across Europe and America and is a welcome and important development in St Columcille's Hospital.
Annual Dan-rt
Department of Medicine for the Elderly In ~gggDr Crowe presented the results of a nationwide survey on facilities f07'5cute stroke patients in general The Department of Medicine for the Elderly under the hospitals at the Irish Gerontological Society. direction of Dr Morgan Crowe and Dr Shaun O'Keeffe, Consultant Physicians in Geriatric Medicine, comprises In lggg approval was received from Cornhairle na a 30 bed in-patient facility for the acute assessment n-Ospideal to the joint appointment of a replacement and rehabilitation of elderly patients. A Day Hospital post for Consultant Geriatrician for the Dublin South facility attached to the Department allows for the East/East Wicklow catchment area to replace Dr Denis continuing treatment and rehabilitation of approximately Keating who is retiring. The successful candidate, Dr lo to 15 patients per day on an out-patient basis. The Diarmuid O'Shea will commence duty on 4th January Day Hospital offers a valuable assessment and rehabil- 2000. itation service to patients who would otherwise require admission. A fourth post of Consultant Geriatrician is proposed for the Dublin South East / East Wicklow area. The pro- Secondary rehabilitation is provided at St Colman's posed structure of the post is at present being dis- Hospital, Rathdrum and District Hospital Wicklow for cussed before application for Financial Clearance is Wicklow patients. Access is available to secondary reha- made to the Department of Health and Children. bilitation facilities in the Royal Hospital, Donnybrook for patients from South East Dublin. The Department The post of Ward Sister for St Joseph's Unit for the also has access to an intermittent respite care facility Elderly was advertised in 1999 and Ms Veronica Lacey which has been developed at Leopardstown Park has taken up duty in this post from 15th Movember Hospital where patients are admitted for three days 1999. every fortnight.
Patients are admitted to the acute assessment unit via the A&€, Day Hospital or following transfer from other wards in the Hospital. The Day Hospital provides facilities for multi-disciplinary assessment (medical, nursing, physiotherapy, speech therapy, occupational therapy and social work) of new patients reftrred by their General Practitioners and ongoing review and Celebrating the United Nations Year of the rehabilitation of day patients. The multi-disciplinary Older Person in the Day Hospital towards team is very involved in rehabilitation of in-patients in a Society for all Ages the unit and progress is reviewed at weekly case conferences. A report form Ms Mary Connolly, Nurse in Charge, Day Hospital for the Elderly. In lggg there were 628 in-patient admissions and 1,532 Day Hospital attendances to the Department at St iggg has been designated International Year of Older Columcille's Hospital. In addition the Department also Persons. The overall objective is to implement the prin- carried out over 200 consultations on patients from ciples promoting the basic rights of Older Persons other wards in the Hospital including general medicine, based on independence, participation, care. self-fulfil- general surgery and orthopaedic surgery. ment and dignity
There is a consultant-based out-patient clinic held While continuing to provide day hospital service under weekly at the Hospital and attendances for lggg were the direction of Consultant Geriatrician Dr Morgan 542. Crowe to facilitate diagnosis, treatment and rehabilita- tion of older patients using a multi-disciplinary The Department has been functioning with an average approach, the focus of activity centred around organ- percentage bed occupancy of 96% in 1999. Over 70% ising events to celebrate one of the greatest single of patients are successfully rehabilitated to a degree achievements of this century - namely the huge that enables them to be discharged home with the increase in life expectancy. The Year also recognises support of the Community Care Services. The remaining the contribution our older generation has made patients are discharged to areas of care appropriate to towards creating immense social and economic their degree of complexity. progress, particularly in the last 50 years.
Annual Report In the Day Hospital we embarked on a series of stimulating and fun-filled activities of which the social and participating element for older people was so important. We were most fortunate to have on board team members Robert Haughton (Attendant), Ann-Claire Butler (Occupational Therapist), Mary O'Sullivan (Social Worker) and Mary Connolly (Nurse in charge) and more recently Catherine Conway (Occupational Therapist) Erid Nic Mhathuna (Physiotherapist) and Ray Brady (Ambulance Driver) have joined the team bringing with them fresh vigour and enthusiasm.
Throughout the Year we made the most of all occasions. We celebrated romance on St Valentine's Day in February. Blooms Florist Dalkey and Jones' Florist Shankill kindly donated a red carnation spray for all patients. Nat King Cote and Shirley Bassey gave us renditions of classic love songs throughout the week,
La Feile Padraig saw the Day Hospital adorned with ment to mark th green, white and orange. Everyone wore their shamrock badges with'pride. We played traditional music and we , entertained with Irish dancing.
Easter week we decorated Easter bonnets and on Bloomsda; we wore our boater hats. In May we joined the Bealtaine Festival in the National Gallery celebrat- ing creativity in older age. We enjoyed a guided tour of the Gallery followed by lunch in Fitzers Restaurant, kindly sponsored by Dr. Crowe. Our thanks to Dalkey Cabs for providing transport for our patients.
Our next venture in June took us to National Sea Life, Bray and during our guided tour of the Aquarium, wit- nessed a variety of sea creatures at close range. Most
National Garden Exhibition ere we visited the magnificent nch in the Pagoda Tea Rooms.
Education
Ms JacquelineWalsh completed the first year of her Msc in Clinical Pharmacy from Queen's University Belfast. The course consists of three components : self-teaching units, in-practice training and a research project. The aim of the course is to improve the knowledge base and practice skills of hospital pharmacists so that they can contribute more fully to clinical pharmacy programmes and i he delivery of pharmaceuti- cal care to patient
Ms Paula Brads eted several educational courses run by the Pharmaceutical Society. She attended a two-day course on diabetes patient care, a lecture on pain control and evening courses on the ' rosoft Office Programmes.
Future Developments
The employment of a pharmaceutical technician is being examined. Once the technician is appointed, we will provide a ward pharmacy service to all wards.
The pharmacists plan to work with medical and nursing staff in the hospital to design and introduce a new inpatient drug kardex.
The pharmacists would like to provide in-service train- ing and lectures on drug-related issues to medical and nursing staff.
The Drug & Therapeutics Committee plans to develop and introduce drug treatment protocols and review the Hospital drugs formulary. Social Work Department .- The Social Work Department, under the direction of Ms Mary Courtney, Senior Social Worker provides a comprehensive jocial assessment service to all wards and department in the Hospital. It enables families to deal with the impact of lospitalisation and to maximise the benefit of health and social care services.
Ms Barbara Slattery and Ms Mary O'Sullivan took up permanent job-sharing posts during 1999 which has greatly enhanced the service available to patients and their families, particularly in the Day Hospital and Accident and Emergency Department.
Overall activity was up in the Department for the year 1999. A large increase has been seen in the referral rate from our Accident and Emergency Department. This could be due to continuing education in the area of child protection/abuse and in the area of domestic violence.
The Senior Medical Social Worker and staff from the Accident and Emergency Department attended an excellent train- ing day by the local community care team to help promote awareness and multi-agency approach to this very difficult problem of child abuse. Further training is anticipated in the light of the new National Guidelines on Child Abuse pub- lished in September 1999.
Following the launch of a resource pack for training A&E personnel to respond to women experiencing abuse by a male partner, it is hoped that one of the social work team will attend this course to become a trainer. / The Senior Medical Social Worker is also part of a Women's Health Promotion Group with specific reference tcr domes- tic violence which also has links to Southside Partnership. This ahareness around this complex issue.
The Social Work Department also has links with the two main This has proved very worthwhile and beneficial during the year This resulted in a survey of nursing homes been presented at
Links have also been made with local support groups for relatives bereaved by suicide. The intention is to establish the needs and improve the services which the Hospital offers in this area.
A comprehensive assessment service for the older patient is run in conjunction with other members of the multi-disci- plinary teams i.e. Occupational Therapists, Physiotherapists and Speech and Language Therapists.
On all the wards the Social Worker assigned works as part of the team, and one innovation rounds and meetings which have resulted in planned interventions while the patient Is in hospital, planned discharges and close collaboration with the Geriatricians.
In this way patients are assessed, potential problems identified and successful discharge planning carried out, linking in very closely ~iththe Community.
The number of referrals to the Social Work Department in 1999 was 1,516 which is on a par with 1998.
1 Conferences. Meeting and Courses attended: . - I Bronagh O'Leary (Microbiology) has been awarded an Eastern Health Board-sponsored place on the Certificate in Health and Safety at Work in University College Dublin. Martin Gallagher (Cellular Pathology) has enrolled in the MSc in Healthcare Information in Trinity College Dublin.
Hilary Collins (Biochemistry) attended both the ACS User Group meetings in Oxford and also the Beckman CX5 (Biochemistry Analyser) in Dublin.
V~ctor Shaw attended the Bactec User Group in Oxford and also gave a lecture entitled "Keeping an Eye on Acanthamoeba" at the annual meeting of the Microbiology Advisory Body.
Anne McDonnell (Haematology) attended both the N.E.Q.A.S. Coagulation meetings in Birmingham and Academy of Medical Laboratory Sciences Haematology Morphology Workshop in Dublin.
Niamh Nolan Liver EQA Meeting Cambridge January 1999 American Association for the study of Liver Diseases, Dallas, November lggg
Dr. Niamh Nolan Publications: "Multiple Gastric Polyps in Familial Polyneuropathy" Greaney TV, Nolan N Malone DE Abdom. Imaging 1999 May 24 : / "The Incidence of Sudden Unexp (SUDEP) in South Dublin in Wic Langan Y, Nolan N, Hutchinson M Seizure 1998 Oct 7 : 5, 355-8
"Barrett: Oesophagus and the Presence of Helicobacter Pylori" Henihan RD, Stuart RC, Nolan N, Gorey TF, Hennessy TP, O'Moriin CA AmJ Gastroenterology 1998 hpr. 93:4 542-6
"Clinical Outcomes after Hepatitis C Infection from Contaminated Anti-D lmmuno Globulin" Eliz. Kenny for Irish Hepatology Research Group. New England Journal of Medicine 1999 34026.
Presentations: "Differentiating Haematopoietic Stem Cells in Tumour-Bearing Adult Human Liver" Golden-Mason L, Curry MP, Nolan N, Traynor 0, McEntree G, Kelly 1, Hegarty I, O'Farrelly C. Hepatology Suppl. 30:4(2) 267A
"Follow-up Chronic Hepatitis C virus Genotype ~b Injection in a Unique Cohort" Curry MP, McKiernan SM, Reilly M, Nolan N, McDonald EG, Kelleher D, Hegarty I Hepatology Suppl. 30:4 (2) : 267A Cellular Pathology Medical Library
July 1999 saw the commencement of a rotating NCHD Each year shows an increase in most measures of Library Post between St Columcille's Hospital and St Luke's activity. Demand for books, documents, document supply Hospital. The SHOIRegistrar based in St Vincent's and database search activities are growing annually. Hospital spends a fortnight in each and gains specialist experience in autopsy pathology - cytopathology Books before returning to St Vincent's Hospital. This arrangement has proved of immense benefit to the 1999 has been a year of progress and expansion, par- NCHD training programme and has been a useful ticularly in our Book Lending Department. This was due addition to the St Columcille's Hospital Pathology to the allocation of monies from the Eastern Health Department. Board at the end of 1998. It enabled the Hospital to purchase books to update and expand our collection. Mortuary Our book stock now extends to 500, which includes a seminal reference section. Ms Mary Henry has completed two years experience in the mortuary and autopsy suite. She is now eligible to Journals undertake a formal course in the Royal Institute of Public Health and Hygiene and thereafter sit the certifi- Our journal collection reflects the growth of new depart- cate examinations in Anatomical Pathology Technology. ments within the hospital, our subscription lists now totals 51 journals which subsequently are bound at the end of the year.
Computer Facilities
This year saw continuing developments in the Library's computer facilities, which were extended to include:
CD Tower for our Medicine and CINAHL An Internet line which opens up worldwide search- ing and of course E-mail. Document creating applications which includes:
- Microsoft Word - Power Point - Excel - Access - CD-ROM Textbooks on our other computers
Technical Services Department By, where necessary, providing some form of grief counselling with relatives who have been bereaved. The Technical Services staff under the direction of Mr Michael Kinsella, Engineering Officer, and Mr William By offering support and concern for the staff McKenna, Maintenance Officer have continued to make throughout the Hospital a significant contribution throughout 1999 in maintaining the fabric of the building and are to be A very large part of the work of the Chaplaincy complemented on their efforts. Department is with relatives in time of death and the new mortuary facilities, which were extended and refur- Routine maintenance of facilities, plant and equipment bished in recent years has been a great support in that took place in 1999 together with the provision of a work. service to the Hospital for carrying out minor works and on-going repairs. These works were carried out by staff Relatives are escorted to the mortuary to identify their in the mechanical, plumbing, electrical, carpentry/build- loved ones and the Chaplains are available to say ing, painting and gardening sections. prayers before the departure of all funerals.
As part of the on-going programme of upgrading of The Chaplaincy Department at St Columcille's Hospital accommodation in the Hospital, the following priority has two full-time Catholic Priests, Father Simeon Breen works a larger nature were carried out: and Father john Coen and a part-time Church of Ireland Minister, Rev. Fred Appleby. There are also two Continued programme of replacement of old conferences of the St Vincent De Paul Society who visit wooden windows throughout the Hospital the patients once a week and who also supply books, audio-books and magazines. - Decoration of Doctors Residence in staff Home
In lggg a special allocation of f40,ooo was approved by the Department of Health and Children towards the cost of the upgrading and replacement of the heating system in the Hospital. This work was completed in November 1999.
Chaplaincy Department
The aim of the Chaplaincy Department is to supply full pastoral care to the patients, their families and to the staff on a 24 hour basis. This involves:
Offering all patients the spiritual support of their faiths tradition by being available to all patients for emergency sacramental ministry.
Administering the Sacraments, the daily celebration of The Chaplaincy Department enjoys a great team work the Eucharist and particularly administering the experience with all the various disciplines in the Hospital Sacrament of the Sick to those who are seriously ill or in providing a high standard of pastoral care to patients, undergoing surgery. relatives and staff,. In November the Chaplaincy Department organised the annual special remembrance Providing ongoing support to patients, both spiritu- mass for deceased patient and staff members and invit- al and emotional in their illness and especially those ed their relatives to participate. who are critically or terminally ill. In September 1999 Father John Coen took up duty as the - Providing ongoing support to families in their con- second Chaplain to St Columcille's Hospital. Father Coen cern for their relatives by being available to them is a member of the Pallotine Fathers and has previously when hospitalisation is sudden, unexpected and been assigned to duties in Reno, USA. traumatic. Also, supporting families in situations of critical diagnosis and terminally ill. OUT-PATIENTS CLINICS
Day Time Consultant Specialty
Monday 9.00 a.m. Dr. Morgan Crowe Geriatric Medicine
9.00 a.m. Dr. Orla Shiel/ Gynaecology
Dr. P. McParland
9.00 a.m. Dr. P. Boylan
1.30 p.m. Mr. IKieran O'Rourke Orthopaedic/Fracture
1.30 p.m. Dr. 0. Shiel Obstetrics (Wicklow)
2.00 p.m. Mr. John Hyland General Surgery
Every 2nd Monday 1o.00 a.m. Mr. Declan Magee General Surgery
(Arklow) / Tuesday ' 9.30 a.m. Dr. G. Chadwick General Med~cine
9.30 a.m. Dr. 0. Shiel Obstetrics
2.00 p.m. Mr. Justin Geoghegan General Surgery
2.00 p.m. Mr. Stephen Sheehan Leg Ulcer Clinic
2.00 p.m. Mr. Gary Brow General Surgery
Wednesday 9.00 a.m. Dr. John Fennell General Medicine
9.00 a.m. Dr. Mary Wingfield Obstetrics (Arklow)
2.00 p.m. Mr. Declan Magee General Surgery
2.00 p.m. Dr. Kinross Burke Pain Relief
Thursday 9.00 a.m. Mr. E. Kelly Ortho/Fracture
9.00 a.m. Dr. Grainne Flannelly Obstetrics (Bray) st, znd, 4th Thursday 2.00 a.m. Dr. Donal O'Shea Diabetic of each month
3rd Thursday of 2.00 a.m. Dr. Donal O'Shea General Medical each month
Friday 9.00 a.m. Mr. Stephen Sheehan General Surgery
Every Second Friday moo a.m. Dr. Hugh Gallagher Pain Relief
1.30 p.m. Dr. Peter Quigley Cardiology
/ LABORATORY STATISTICS ~ggg- CONTINUED. Annual Report QQ