OLD SOLDIER SPEAKS UP FOR QUALITY OF HOSPITAL CARE · Anna Moran, External Affairs Manager for Fighting Blindness, said, “AMD Awareness Week is about empowering people to take positive

December 2013 Issue 5 INSIDE

OLD SOLDIER SPEAKS UP FOR QUALITY OF HOSPITAL CARE

Old soldier speaks up for quality of care 1 Hitting our targets 2 New Logo for UL Hospitals 2 Car Parking 2 Top award for UHL team 3 75% of Blindness is Preventable 3 Liam’s sight saved: Treatment for AMD 5 Get to know our staff: UMH 5 World Prematurity Day Celebrated 7 UHL Christmas Tree Switched On 7 Promotion for Professor Stewart Walsh 8 Childhood Obesity 8 First UHL Research Symposium Launched 8 Guide Launched for Patients with CKD 10 Thank you Soroptomists 11 Participants Needed: Study of Lung 11 Use antibiotics wisely campaign 12 Return the books! 12 5 new Intermediate Care Ambulances 12 750 women with PGD treated 13 ‘Always there is a presence loving and guiding along the way’

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UHL and Brook Catering join forces 16 The late Dan Gallery 16 Outpatient Performance Improvement Programme At UHL

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Publication Achievement For UHL CNM's 18 Break the silence of domestic abuse 18 The Development of Respiratory Services in Ennis.

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Pilot Leadership and Management Development

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Ennis Hospital: Productive ward initiative 20 UMH: Annual Remembrance Service 2013 21 Annette wins Scottish fellowship 21 UMH welcomes new midwifery students 22 International Infection Prevention & Control Week

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Public Access Defibrillator Launch in Nenagh

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End-of-Life Care Awareness Week 25 UCC Art 26 Nenagh Lab Transfers 27 Fundraising 27

Ex soldier Kevin Mc Cormack took to the national airwaves recently when he went on the Joe Duffy programme to lavish praise on hospital staff in Ennis and Dooradoyle for the care and attention given to him during the course of a serious illness. Kevin, a native of Newmarket on Fergus, and a retired member of the 30th Infantry Battalion, Kilkenny, was attending a military display at the Curragh racecourse when he suffered an insect bite. “”Septicaemia, cellutis, kidney failure, the works, followed. It took three years to come right and by that stage they all knew me in Ennis and Dooradoyle”, he said. “I cannot speak highly enough of what they did for me. The clinical nurse specialist in the heart failure clinic Siobhan Murray and Kay Sheridan before her are marvellous. Where would you get a health service like ours where they ring you to see how you’re doing and tell you don’t hesitate if you need us, you don’t need a note from a doctor ‐ just come in.

Kevin McCormack and Clinical Nurse Specialist Siobhan Murray.

“Terry Hennessy and his team are totally dedicated and I must also mention Joan Dunne and all in 3 D and when I was in intensive care there was another person who was brilliant. She had “Galway Girl” as a ring tone on the phone.

“I rang Joe Duffy to speak out because I got annoyed listening to a woman cribbing and I wanted to tell people my experience. These people saved my life and I have no time for people cribbing and complaining about hospital food which I found to be excellent by the way”, he added.

Issue 5 December 2013 page 2

HITTING OUR TARGETS The national performance ranking report published on Nov 14th shows excellent results from UL Hospitals in terms of treating patients waiting for longer than eight months for an inpatient procedure. UL Hospitals are now out of the red zone and are expected to be green by December 20th. On a site basis Nenagh Hospital is the best performing in the country, Croom Hospital is in fourth place, Ennis Hospital in sixteenth, St John’s Hospital in nineteenth, and University Hospital Limerick (Dooradoyle) is 27th. In January, 2013 we had 2,202 patients waiting longer than eight months on the inpatient treatment list and on November 14th this had been reduced to 302. The objective now is to meet all national targets by December 20th, i.e no adult waiting longer

than eight months, no child waiting for longer than 20 weeks and nobody waiting for a Gastro intestinal scope for longer than 13 weeks. This is a remarkable achievement in difficult circumstances and testimony to what can be achieved by a united effort. I would like to take this opportunity to thank all staff members across the board, clinical, support, administrative and managerial for these excellent results. May I also thank all staff for their tremendous work in 2013 and wish each and every one a very Merry Christmas and an even greater 2014.

Ann Doherty Chief Executive UL Hospitals

NEW LOGO FOR UL HOSPITALS We are pleased to present a new name and logo for our hospital group. UL Hospitals is now a single organization operating across five public hospital sites (Limerick [general and maternity], Croom, Ennis, Nenagh) under one management team and one Voluntary Hospital (St John’s Hospital, Limerick). Below are representation of the new logo for our hospital group now called ‘UL Hospitals’. The logo is a representation of the letters ‘U’ ‘L’ ‘H’ in the ancient Irish Ogham script, which was used in the earliest Old Irish texts dating from the 3rd to the 6th century CE. Mostly Ogham was used for inscriptions on the corners of large stone slabs. The script is read from bottom up rather than top down. The colours we have chosen represent the GAA county colours for Limerick, Clare and Tipperary, and the Munster rugby colours. We hope you like our new logo which we see as something that will help to bring us all together as group as we progress towards trust status. The new logo, letter templates, and a style guide for using both are now being rolled out. You can access them on the intranet at:

0http://hsenet.hse.ie/Hospital_Staff_Hub/ulh/Identity/

Colour

Greyscale

CAR PARKING Due to construction work at University Hospital Limerick in Dooradoyle staff car parking is under pressure at present. Management are aware of the difficulties and are looking at a number of possible solutions and hope to have new arrangements in place at the earliest possible date. Please bear with us in the meantime.


TOP AWARD FOR UHL TEAM An antimicrobial app developed in Limerick has been awarded Antimicrobial Project of the Year 2013 at the hospital pharmacy awards ceremony held in Dublin on 21st September. The app was developed by Doctot in collaboration with Dr. Nuala O’ Connell and Dr. Lorraine Power (consultant microbiologists) and pharmacists at University Hospital Limerick. The award was made to Anne Harnett (Chief Pharmacist) and pharmacist team members Susan Stack, Siobhan Barrett and Michelle English for their involvement in the development of the app. This app supports clinical staff at the point of care in the treatment of commonly seen infections. Evidence‐based antimicrobial guidelines are a key tool in efforts to improve antimicrobial prescribing, reduce the progression of antibiotic resistance and optimise patient outcomes.

Back row,: L to R Fergal McDonnell (technical Director, Doctot), Susan Stack (pharmacist antimicrobial), Anne Harnett (Chief Pharmacist), Paula Cussen Murphy (Manager Directorate of Medicine), Professor Declan Lyons (Professor of Medical Science and Consultant Physician) Front row, L to R : Siobhan Barrett (antimicrobial pharmacist), Dr Nuala O'Connell (consultant microbiologist), Dr Lorraine Power (consultant microbiologist

75% OF BLINDNESS IS PREVENTABLE Over 50s Urged to Stay Vigilant for AMD, Leading Cause of Blindness in Ireland

Dublin GAA legends Barney Rock and David Hickey, Turlough O’Connor, former Ireland soccer player, and Tony Ward, former Garyowen and Ireland rugby international, came together to launch AMD Awareness Week at Croke Park.

Sight loss is set to rise in Ireland but 75% of blindness is preventable, according to figures from a framework report released ahead of AMD Awareness Week 2013 which ran from 23 – 29 September.

Age‐related Macular Degeneration (AMD) is the most common cause of registered blindness in Ireland(1) affecting 1 in 10 people over the age of 50 (2). Each year AMD Awareness Week aims to increase public awareness on how to spot the symptoms of AMD and to highlight the importance of early diagnosis. Supported by the NCBI, Fighting Blindness, the Irish College of Ophthalmologists (ICO) and the Association of Optometrists Ireland (AOI) in association with Novartis, AMD Awareness Week also strives to empower patients with the information and resources to maintain healthy eyesight, with free testing available nationwide and patient support information available on 1www.amd.ie. With 224,000 people affected by severe vision loss in Ireland, the framework report recently launched by the National Coalition for Vision Health in Ireland highlighted that this number is expected to rise by 21% to 272,000 by 2020 as a result of a number of changing lifestyle factors,


but particularly as a result of Ireland’s aging population. Patricia Quinlan, Eye doctor and ICO Council member, explains, “The framework report shows that the number of people in Ireland with sight loss is likely to increase substantially as the overall population ages over the coming years.

As the leading cause of blindness among people over the age of 50, it is likely that AMD will continue to affect vision loss in this older age group.

However it is reassuring to note that 75% of blindness is preventable through early diagnosis and treatment. In the case of AMD, prevention is aided by maintaining a healthy lifestyle with a balanced diet and blood pressure control, quitting smoking, and by having regular eye tests,” she concluded. Lynda McGivneyNolan, Optometric Advisor with the AOI added, “It is important that people over the age of 50 have their eyes tested regularly; in fact it is advised that you should undergo a test at least every two years.

We encourage this age bracket to stay vigilant for the early signs of the condition and avail of the free testing throughout AMD Awareness Week,” she said. The early signs and symptoms of AMD include sudden onset of distortion of vision and blurring in the centre of a person’s vision. The test to detect the signs of AMD can be carried out by local opticians/optometrists and eye doctors and can take place as part of a routine eye examination. It is a simple, quick, non‐invasive test which provides an immediate result. Anna Moran, External Affairs Manager for Fighting Blindness, said, “AMD Awareness Week is about empowering people to take positive steps towards looking after their vision health.

Fighting Blindness funds world leading research into treatments and cures for blindness caused by conditions such as AMD and furthermore, we deal directly with those affected by sight loss, offering support, information and advocacy on sight loss.

Along with our colleagues in the NCBI, who are the front line service providers for vision impaired people, we are proud to be part of AMD Awareness Week and we encourage anyone interested in these issues to get in touch."

Des Kenny, NCBI Group CEO, said, "Because eyesight can start to deteriorate gradually in old age, too many older people put up with it, seeing the deterioration as just part of the ageing process. In so many instances that is not the case.

To unnecessarily lose your sight because of failing to visit an optician, is one of the saddest mistakes a person can make and this is all the worse when eyesight can be saved through prompt diagnosis and treatment."

Loretto Callaghan, Managing Director of Novartis Ireland said, “We are delighted to continue to support AMD Awareness Week and to help patients in Ireland get access to innovative treatments.”

Free AMD testing was during the week available at a range of participating opticians nationwide. A mobile testing unit supported by Novartis visited venues in Dublin, Galway, Limerick, Cork and Waterford References

1. NCBI Report ‘The Cost of Sight Loss; the economic impact of vision impairment and blindness in the Republic of Ireland’

2. Fighting Blindness – Quoted in press release 2008

STRESS CONTROL A 6week course for staff, teaching about stress and ways to control it.

The course is taught by Dr Valleri Switzer, Senior Clinical Psychologist with the Department of Liaison Psychiatry, UHL, Dooradoyle. If you have any queries about the course or would like to register, please contact the department on 061 485092.


LIAM SAVED FROM LIFE OF TOTAL BLINDNESS: SWIFT TREATMENT FOR AMD Ballinlough man Liam O’Flynn would be totally blind now if it wasn’t for swift medical action. Colette Sheridan discovers how the condition AMD can affect sufferers.

If it wasn’t for a timely medical intervention, Liam O’Flynn would now be totally blind. As it is, the 75 year old – based in Ballinlough – has no sight in his left eye but the sight in his other eye was saved. He was lucky to be the first person in Ireland to be treated successfully for Age‐related Macular Degeneration (AMD). His wife, Veronica, recalls how initially her husband thought he had grit or an eyelash in his eye. “I kept saying there was nothing in his eye. When Liam covered his right eye, he discovered that he couldn’t see out of his other eye. It was that quick. It’s something that just creeps up on you.” Nothing could be done about Liam’s loss of sight in his left eye. “A haemorrhage at the back of the eye had brought the retina down”, says Veronica. “You can’t see it. It is totally silent. Liam had three years of the right eye being very good. Then ten years ago, while watching TV, he thought the screen was distorted. He could see lines on it. “We went straight to CUH and saw ophthalmologist Professor Cleary. He said there was bleeding in the eye and told Liam that he had four to six weeks of eyesight left.” The O’Flynns, who have three daughters and six grandchildren, were devastated. “We immediately got working on sourcing any information we could on the internet and discovered there was a treatment called

photodynamic treatment”, says Veronica. “We didn’t know if it was available in this country but we were prepared to travel anywhere.” When the couple told Professor Cleary about the treatment, he said there was a risk that if it didn’t work, Liam could go blind immediately. “But we had very little to lose at this stage”, says Veronica. “I was looking for a lifeline. I felt that if Liam had the treatment and it didn’t work, then we would at least have tried everything. If it did work, then we would be blessed.” The treatment was available at University Hospital Limerick. “We drove down the next morning and met Dr Marie Hickey Dwyer who I call our guardian angel. When she first looked into Liam’s eye, she said “Oh my dear, you’re in big trouble”. “She gave him a drug that she was using on her diabetic patients. It was given intravenously. We went back two weeks later. Liam ‘s sight was brilliant. Within months Dr Hickey Dwyer started injecting the back of the eye. It’s a simple procedure that doesn’t hurt as a drop on the eye anaesthetises it.” If Liam experiences any change in the eye, he can ring Dr Hickey Dwyer’s secretary and go to Limerick straight away. The treatment he is receiving is now available at CUH. “We could go there is we wished but we choose to stay with Dr Hickey Dwyer as she knows the back of Liam’s eye better than she knows the back of her own hand. I say a prayer for her every night”, says Veronica. (Reproduced courtesy Evening Echo, Cork.)

GET TO KNOW OUR STAFF: UNIVERSITY MATERNITY HOSPITAL Each quarter we hope to showcase a different department at University Maternity Hospital. This quarter we are introducing you to the team of staff working in the Ante Natal Clinic and giving you a brief overview of the service.

Staff: Susanne Jackman CMM 2, Patricia Lennihan CMM1, Staff midwives Maura Newe, Caitriona O Donoghue, Mary Sheeran, Nessa Power, Rachael Shier, Jenny Kenny, Yvonne Bourke, Nicole Whelan . Maddy Lynch, Rachael Corry, Jenny O

Donnell. Phlebotomist ‐ Eileen Gibbs. Clerical Support; Maria Dovey, Jean Sparling, Francis Sexton and Ann Shanahan. Ward attendant –Deirdre Schmid. Consultant teams ; Dr Burke, Dr


Slevin, Professor Cotter, Dr Skehan, Dr Fahy and Dr Umar. Dr Stack , Dr Screenen, Dr John Kelleher

Suzanne Jackman, CMM 2

Patricia Lennihan, CMM1

Current Service

The Ante natal clinic provides the following service: Booking ante natal clinics Consultant led clinics Midwife delivered clinics Ante natal diabetic clinic Miscarriage clinic Neonatal/ paediatric clinic High risk anaesthetic clinic Links with independent midwife for women

planning home birth Referrals to; Medical social worker,

bereavement counselling midwife, physiotherapist.

In 2012 there were 4,013 bookings and 18,164 follow up visits. There has been a decrease of 182 bookings in 2012 compared to 2011 but the number of return visits increased by 600 from 2011 to 2012.

Attendant: Deirdre Schmid‐Garvey

Achievements since 2012 Direct questioning regarding domestic

violence as per The National Guideline on Ante Natal Routine Enquiry Regarding Violence in the Home (IO&G2012)‐commenced May 2013.

ANC has been re‐painted, seats upholstered and toilets refurbished.

Rose Room Care pathway improved (where care is provided to ante natal women who are diagnosed with a fetal abnormality) The woman now has a named midwife assigned to her for her ante natal care with very positive feedback from the bereavement counselling midwife.

Strengthened links with PHN regarding women who are accessing homeless services.

Strengthened links with Drug and alcohol abuse centre with the overall objective to increase attendance and outcome.

Hospital complex now smoke free – smoking cessation advice given at booking and return visits.

BFHI standards implemented with breastfeeding promoted at all clinic visits.

Introduction of anaesthetic clinic for High Risk women in July 2013.

Clerical : Ann Shanahan, Frances Sexton and Jean Sparling.


Midwives : Front Nessa Power and Rachel Corry. Back : Rachael Shier and Jenny O’Donnell.

Challenges High volume case load – increase number of

women diagnosed with gestational diabetes – increase number of return visits.

To decrease the number of DNA’s at clinics – DNA chart reviewed after each clinic by a midwife

To book all women at 12 weeks or less.

Support the clinical placement and learning environment with the variety of students, Higher Diploma in Midwifery, Bsc Midwifery, Bsc Nursing and medical students.

To decrease the number of women smoking – Smoke free campus, HSE booklet ( Give your baby a breather)

Increase the number of women planning to breastfeed.

Meet the needs of women attending the ANC who require interpreter services.

WORLD PREMATURITY DAY CELEBRATED Sunday the 17th November was World Prematurity Day. The staff in the Neonatal Unit at University Maternity Hospital marked it by hanging clothes lines with nine white socks and one red sock , the red sock symbolizing that one in ten births worldwide is premature. Staff also gave each mother of a premature baby flowers to acknowledge their premature delivery. All the babies born prematurely were given purple ribbons, purple being the worldwide colour used for the day. The Clarion and Strand hotels lit their buildings in purple like many other buildings around the world that night. While celebrating World Prematurity Day we acknowledge the huge contribution that Limerick’s first neonatal midwife Marian Byrnes has made over the last 35 years and all her colleagues in the Neonatal Unit wish her a long and happy retirement.

(lR) Midwives Eimear Breen, Mary O’Neill, Marie Carroll holding baby Jack Cleary. Anne McAuliffe and Dawn Halpin. (Photo courtesy Cleary family)

Jack Cleary is the baby photographed with the staff Jack is the oldest patient in the neonatal unit

born at 25+2 he is currently 13 weeks old and nearly ready for home. Photos by kind permission of parents UHL CHRISTMAS TREE SWITCHED ON

Three young patients from the Children’s Ark did the honours at the official switch on of the Christmas Tree lights at UHL in Dooradoyle as darkness fell on Monday, December 9th.

They did the job by walkie talkie sending an instruction to technical staff behind the scenes. Children from St Nessan’s primary school in Mungret were also on hand to sing seasonal carols.


PROMOTION FOR PROFESSOR STEWART WALSH UL Hospitals Newsletter would like to offer its congratulations to Professor Stewart Walsh, consultant vascular surgeon at UL Hospitals, who has been awarded a significant promotion by the University of Limerick. At a meeting of the Governing Authority of the University of Limerick on 31 May 2013, in accordance with the Scheme for Internal Promotion to Professor (Personal Chair), it was agreed to approve the promotion of

Professor Stewart Walsh to Professor (Personal Chair). Professor Walsh’s promotion is in recognition for his work in teaching, research and organization at the Graduate Entry Medical School. He is the lead clinician on a large multi‐centered trial, funded by the Health Research Board, on the effects of remote preconditioning on outcomes in vascular surgery

CHILDHOOD OBESITY Increasing levels of childhood overweight are a cause of real concern, but if you decide to become involved, it is very likely that you will be able to meaningfully assist parents and children in a very important part of good childcare A new set of resources have been produced by the HSE and partners such as Safefood, ICGP, Irish Nutrition and Dietetic Institute, Irish Society of Chartered Physiotherapists. Such resources

should assist health professionals and parents in dealing with childhood overweight. HSE‐ICGP Weight Management Treatment

Algorithm available for download from 2www.hse.ie/weightmanagement

Eat Smart Move More –Can be ordered online from 3www.healthpromotion.ie

Your Child’s Weight… A Guide to Preventing Childhood Obesity – can be ordered on line from 4www.healthpromotion.ie

FIRST UNIVERSITY HOSPITAL LIMERICK RESEARCH SYMPOSIUM LAUNCHED Foundation Chair of Medicine calls for greater emphasis on research at UHL at Inaugural Symposium

The Inaugural Research Symposium organised by University Hospital Limerick recently took place at the Strand Hotel, Limerick. The one day conference covered topics from healthcare reform to surgical innovations. Organiser Professor Austin Stack, Foundation Chair of Medicine, University Hospital Limerick & Graduate Entry Medical School, University of Limerick said; “the response and enthusiasm for this inaugural research symposium was unprecedented with over 200 submitted abstracts, 176 posters, and 18 oral presentations and expert talks from 5 national and international speakers. Our first symposium here at UHL is a landmark event, bringing together research talent from across the hospital and University campus, supporting innovative science, and providing a forum for interaction and communication.” “It was a great opportunity to profile the breadth and depth of research activity in clinical

departments, sub‐specialties, primary care and allied health disciplines,” said Prof. Stack, “This forum should serve as a catalyst for research collaboration in the Midwest Region” The symposium attracted over 250 attendees from research, healthcare and industry sectors. The speakers included Dr Áine Carroll, National Director of Clinical Strategy and Programmes, Health Services Directorate, Professor Niall O’Higgins, Chairman, UL Hospitals, Professor Peter Blake, Professor of Medicine, University of Western Ontario and London Health Sciences Centre, Professor Alison Perry, Chair of Clinical Therapies, UL, and Dr Teresa Maguire, Head Population Health of the Health Research Board (HRB) The welcome address was given by Professor Niall O Higgins. Commenting on UHL’s symposium, he said, “The UL hospitals have been aligned successfully into a coherent entity. Now


affiliated to the University of Limerick, the hospitals are developing rapidly as academic centres. With such progress comes the obligation to participate in research. Research effort is of huge importance in improving the care of patients. The success of the Inaugural Annual Research Symposium of the University Hospital Limerick demonstrates that collaboration between the hospital and the university is strong. A high degree of research expertise is in place. It is hoped that the Annual Research Symposium will provide clear proof that standards of research and education continue to rise and will bring with them improvements in patient care. With continued co‐operation the UL Hospitals are well‐placed to become among the best academic medical centres in the country.” Key invited speaker Professor Peter Blake, Professor of Medicine at the University of Western Ontario, London Health Sciences Centre in Canada highlighted the challenges and opportunities in building research programmes, and chronicled the success of epidemiological, and health outcomes research at his institution. National Director of Clinical Strategy and Programmes, Dr Áine Carroll focused on the changing face of the HSE and current developments that are focused on quality improvement and patient‐centred care. The leadership role of the Health Research Board (HRB) in supporting health research in Ireland and emerging funding opportunities was discussed by Dr Teresa Maguire, Head of Population Health Research. Professor Pierce Grace, Chief Clinical Director, UL Hospitals said; “This is a fantastic day for UL Hospitals. We aim to be one of the top three university hospitals in Ireland by 2018 and strategically we see excellence in research as one of the ways that we will achieve that goal. This symposium has brought together the UL Hospitals community around research and it is staggering to see the number and quality of projects presented here today. With our academic partner, UL we will promote research across our directorates and this symposium will become an important annual event in our calendar".

Symposium organiser Professor Austin Stack, Foundation Chair of Medicine, University Hospital Limerick, Graduate Entry Medical School, Dr Áine Carroll, National Director of Clinical Strategy and Programmes, Health Services Directorate, and Professor Niall O’Higgins, Chairman, UL Hospitals. Picture Liam Burke/Press 22

Professor Michael Larvin, Head of UL’s Graduate Entry Medical School said: “The recent inaugural joint Research Symposium marks a closening of the relationship between UL and our HSE partners, in line with the recommendations of the government’s Higgins Report launched earlier this year. The symposium has, for the first time in Limerick, brought together academics and clinical staff, junior and senior, across the entire range of disciplines involved in healthcare research. The Medical School is proud of Professor Stack’s initiative in bringing this about, and we look forward to supporting the symposium as an annual event in future. UL is delighted to have been selected as academic partner to the new hospital group for our region. Together we are committed to achieving the highest standards of safe healthcare for patients, and high‐quality collaborative research is essential to ensure this.” Awards were presented to the best oral and poster presentations from three major categories: Technology and health, Lifestyle and health and Population health Research. In a very competitive field, awards were presented to the following winners The list of presentations covered a range of healthcare topics from lifestyle, technology to population health research and can be viewed at: 5http://www.ul.ie/UHLResearchSymposium2013‐Programme.pdf


NEW GUIDE LAUNCHED TO EMPOWER PATIENTS WITH CHRONIC KIDNEY DISEASE It is estimated that up to one in every ten people have one level of Chronic Kidney Disease (CKD). Early detection allowing intervention is vital in slowing the progression of kidney disease becoming end stage, requiring dialysis and transplantation.

A Guide is now available to aid patients in Ireland who have been diagnosed with Chronic Kidney Disease to assist them in understanding and taking control of their illness thereby protecting their remaining kidney function, overall general health and quality of life. The Guide, sponsored by AbbVie, is a collaboration between by the Irish Kidney Association and Consultant Nephrologist Professor Austin Stack, Chairman of Medicine at University Hospital Limerick and the Graduate Entry Medical School. The book was launched by Prof. Stack at the Irish Kidney Association’s Renal Support Centre, located on the grounds of Beaumont Hospital, on Friday, 13th September. Speaking about the book Prof. Stack said, “This new addition to the Irish Kidney Association kidney book series will be a fantastic reservoir of knowledge and advice for our patients in Ireland. The Guide will not only enlighten and inform patients who have been diagnosed with kidney disease in our community; it will also empower them to better manage their overall kidney health.” Mark Murphy, the Chief Executive of The Irish Kidney Association, we are pleased that a resource gap which specifically targets recently diagnosed kidney patients with CKD has now been filled with this comprehensive book. We hope that it will help patients come to terms with and take control of their silent disease, improving their health outcome to prolong their overall quality of life. This practical guide explains the medical terms around CKD as well as the benefits of early intervention. It lays out simple steps to ensure the best possible outcome with advice on nutrition, overall physical and emotional health and medication. It will also inform patients on other conditions, such as diabetes, obesity, high blood pressure and heart disease, which can be a catalyst for kidney disease and vice versa.”

The Guide is published by the Irish Kidney Association and is supported by an educational grant from global healthcare company AbbVie Ltd. The Guide now completes a series of five books on kidney disease, dialysis and transplantation which can be downloaded from the Irish Kidney Association’s website 6www.ika.ie Mr. Robert Love, Head of Communications, AbbVie Limited said, “CKD is a silent disease which affects an estimated 10% of our population. We are delighted to sponsor this important Guide which we hope will be a useful aid for the medical, pharmaceutical, nutrition and other health professionals, to recommend to CKD patients in helping them to achieve the best possible health outcomes”


THANK YOU SOROPTOMISTS

Caitriona Hayes and Marcella Clancy TLC4CF with Dr Brian Casserly and Peig Harnett, CNS Cystic Fibrosis.

A function to thank Clare Soroptomists for their fundraising efforts for CF was held in University Hospital Limerick on September 26th. The organization has worked hard over the past few years and has donated €63,500 towards an advanced piece of pulmonary function equipment which will help young adults with Cystic Fibrosis. Cardio pulmonary Exercise Testing (CPET or CPEx) is a non‐invasive simultaneous

measurement of the cardiovascular and respiratory system during exercise to assess a patient’s exercise capacity. It provides assessment of the integrative exercise responses involving the pulmonary, cardiovascular and skeletal muscle systems, which are not adequately reflected through the measurement of individual organ system function. CPET is considered the ‘gold‐standard’ test to measure the fitness of patients with mild‐to‐moderate CF. The maximum rate of oxygen that a person consumes is particularly important since it has been shown to relate to better health. The European CF Society recently promoted CPET as the exercise test of choice where possible and this helps elevate Limerick to a state‐of‐the art testing centre. This equipment was funded by the Soroptimists, the Colleran family (Clare Branch) and TLC4CF. The cost of MasterScreen PFT ‐ €77,877.88 + VAT i.e over €100,00.

PARTICIPANTS NEEDED: STUDY OF LUNG PERFORMANCE, UNIVERSITY HOSPITAL LIMERICK

We are looking for healthy children (aged 4 ‐ 16 years old) to volunteer to take part in a study on Lung Performance. As a participant in this study, your child will perform a basic lung function test which requires only regular breathing (known as tidal breathing) while being monitored. Your participation would involve attending the Paediatric Department, University Hospital

Limerick, on one occasion for approximately 30minutes. There are no known risks with this procedure. The information gathered will help us to identify lung disease in children affected with cystic fibrosis and asthma. First, we need to measure lung function in normal children, without these conditions. For more information about this study, or to volunteer for this study, please contact: Ms. Louise Keane (Phone 086‐3258325) under the supervision of Dr. Barry Linnane, Phone: (061)482220. (Cystic Fibrosis Unit, University Hospital, Limerick) This study has been reviewed by, and received ethics approval from University Hospital Limerick Ethics Committee, October 2013.


USE ANTIBIOTICS WISELY CAMPAIGN

Antimicrobial pharmacist Siobhan Barrett and consultant microbiologist Dr Lorraine Power at the European Antibiotic Awareness Day.

The HSE has launched a new public information campaign to highlight the importance of using antibiotics wisely. Remember antibiotics don't work against infections caused by viruses, such as colds and flu. Taking antibiotics when you don't need them is a waste. It can also mean that they won't work when you really need them for a serious infection and taking them when you don’t need them puts you at risk of side effects. For more information and to download materials including campaign posters and leaflets visit 7www.hse.ie/antibiotics

RETURN THE BOOKS! We are currently doing a review of our book stock here in the UHL Library and we regret to say that there are a large number missing from our collection. We are hoping that you can help us get them back. From now, until 15 December 2013, there will be a book amnesty. Any book, regardless of whether it has been out of the library for a month, a year or a decade, can be returned without fear of penalty. Please, take that book out from wherever it may be and return it. Maybe it is propping up the couch, or gathering dust in a pile on the floor, or even in an office where it has been sitting for the last year. Perhaps you see a discarded library book (or two) where you work everyday. Just drop them in the returns box outside the library. You don’t even have to walk through the door! It’s your library. Make it the best it can be!

FIVE NEW INTERMEDIATE CARE AMBULANCES INTRODUCED IN THE MID WEST The HSE’s National Ambulance Service (NAS) has introduced five new Intermediate Care Ambulances in the Mid West as part of its commitment to develop and improve response times to life threatening emergency calls in the region. The introduction of the Intermediate Care Ambulance service is a central part of the improvement of response times for the ambulance service in the Mid West region. The five new Intermediate Care Ambulances, costing approximately €200,000 each, will take over roles that were previously carried out by the Emergency Ambulances in the area. These roles include inter‐hospital transfers and transporting patients from acute hospitals such as University Hospital Limerick, Ennis Hospital and Nenagh Hospital to stet‐down facilities, particularly nursing homes.

Members of the new Intermediate Care Service in the Mid West region; lr, Brendan Higgins, Emergency Medical Technician (EMT); Richard Qiunlan, Ambulance Officer; Mike Coffey, Control Room Supervisor; Katherine Moroney, EMT; Sarah Davoren, EMT; Kieran Connell, EMT; Tony Duggan, EMT; Mark Tyrrell, Ambulance Officer


The staff that crew the new Intermediate Care Ambulances are trained as Emergency Medical Technicians and also have been trained in emergency blue light driving. They will form the backbone of the NAS in the Mid West region, freeing up Emergency Ambulances crewed by paramedics who have up until now been carrying out this work. It is also envisaged that the crew of this service may at times be required to attend a life threatening call if the Control Centre identifies the vehicle as the nearest available resource. Ambulance Control will task them as a first responder to the emergency until the arrival of an Emergency Ambulance that will be crewed by either Advanced Paramedics or Paramedics. They will also play a central role in the event of a Major Emergency in the region. Welcoming the introduction of the Intermediate Care Ambulances, Pat Mooney, Operations Performance Manager for the Mid West region said, “These new ambulances will look after patients already within the healthcare system, which means that the emergency ambulances will be able to focus on services delivered by the

Paramedics and Advanced Paramedics on Pre‐Hospital Emergency Care calls. “The Intermediate Care Service is an essential part of how the NAS is modernising, organising and delivering ambulance services by using available resources to their full potential. This is done to ensure the most effective service for patients moving through the healthcare system.” The new ambulance vehicles have been built to transfer a number of stable patients, both sitting and on stretchers. The ambulances are also designed to transfer specialised stretchers which will facilitate the movement of incubators and intensive care patients.

CONTRIBUTIONS News items, letters, and photographs for the next edition of this letter should be sent to Michael Walsh, c/o CEO’s office, [email protected], 087‐2556494. closing date for contributions Friday, January 31st, 2014.

750 WOMEN WITH PGD TREATED The Department of Physiotherapy at University Maternity Hospital treats close to 750 women with third trimester pelvic girdle dysfunction (PGD) yearly. Due to increased waiting times and in keeping with International Best Practice, the pelvic girdle dysfunction class was set up in October 2012. The class is run by Chartered Physiotherapists specialising in Women’s Health. The referral process, initially accepted from Consultants only, was expanded to include self referral from pregnant women to increase accessibility to services in a timely fashion. PGD classes include education, exercises, provision of massage balls and supports as required. There is a strong emphasis on patient empowerment and self management through practical advice. However, if patients still require individual treatments, it can be provided. We are delighted to announce that after one year the class has been so successful that waiting times have been reduced significantly and all pregnant

women receive treatment for this painful condition within 1 week.

Pictured StandingMary Flahive, Chartered Physiotherapist Class Participants Seated; Wiebke due Wel, Noreen MacBoogle, Emma Hoffler, Regina Ring, Rachel O’ Doherty.


‘ALWAYS THERE IS A PRESENCE LOVING AND GUIDING ALONG THE WAY’ Dr. Mary Mc Auliffe

In December of 2009 a specially commissioned healing artwork by Rebecca Carroll titled ‘Camino to Santiago de Compostela’ was erected in the nursing station in the newly commissioned Department of Otorhinolaryngology from donations from healing and healed patients accompanied by the above poem. All research would suggest in the emerging field of mind and body medicine that physical environments affect patient outcomes and as the patient centered expert Alison Binnee stated we are ‘professional companions at a time of crisis’. This beautiful backdrop and inspiration was highlighted in the magnificent auditorium of the Gems Centre (General Entry Medical School) in the University of Limerick which hosted the first National Tracheostomy Study Day facilitated by Prof. Michael Larvin and Prof. Calvin Coffey. The focus was on Tracheostomy safety ICU to Home to successful decannulation was the brainchild of the administrative Head of ENT Department Mr. Joseph Hughes and his nursing staff on Ward 2C, University Hospital Limerick, due to the overwhelming need for awareness, knowledge and skills around Tracheostomy. Evidence shows that in modern healthcare tracheostomised patients can be in all wards and care can be disjointed and fragmented with particular skill deficits in emergency situations particularly blocked airways, accidental decannulation and respiratory cardiac arrest. Professor Caitriona Kennedy opened the proceedings with Prof Coffey with great enthusiasm for developing education and they acknowledged their support for any further collaboration. The Medical School Building and Medical Science Building stand side by side denoting their natural links in academia surrounded by lush pastures and the ebb and flow of the River Shannon. The organising committee were delighted to welcome from Temple Street Hospital and from Crumlin Hospital Ms. Cathy Roche and Ms. Sheila Hayes ‐ Clinical Nurse Specialists, who facilitated the Paediatric workshops for over sixty attendees from all regions. This was complemented by the

excellent presentation by Mr. Nico Jonas ‐ International Guest Speaker who specialises in Paediatric Airway Reconstruction. Mr. Neville Shine, Consultant ENT Head & Neck Surgeon, Dr. Aidan O’Brien and Dr. Brian Casserly, Consultant Respiratory Physicians, Ms. Frances Shinkins, Senior Speech and Language Therapist , from Limerick University Hospital added their own distinctive knowledge and experiences to the many aspects of care that are linked with the Trachoestomy Care, but it was the Hands on workshops experience that captured the imagination and with the help of natural airways/specially prepared sheep tracheas and representing the Critical Care Service Intensivists Dr. Catherine Motherway and Dr. James O’Donovan guided participants through criothyroidotomy and percutaneous tracheostomies. What an opportunity to feel the similar type trachea and to perform the above under expert eye and there were no objections from the sheep. The nursing staff of ward 2C lead the workshops on Care of the Tracheostomy/Suctioning/ Humidification and the simple attention to details of dressings and ties and mouth care that can influence the comfort and care of a patient. This was done with great pride as they demonstrated their competence, expert skills and knowledge that illuminate practicality and advocacy in a specialist area. Ms. Marie O’Hora Resuscitation Officer facilitated a very important workshop on Cardiac Pulmonary Resuscitation, and this workshop was much sought after to continue past its time clearly denoting its impact and importance. Ms Cathy Ryan, Acting Director of Nursing in the Community related how important good discharge planning is and hospital to Home must be planned and implemented with the full understanding of patient and family needs. The study days were concluded with our inspirational patients who spoke with courage and hope and many tears were shed when relatives recounted their stories of unconditional love, the challenges of coping and caring but their over all gratefulness for support and guidance.


Let us never forget how important we are in the lives of others and how we are humbled in the presence of this greatness. In acknowledgement to Ms. Mary Francis O Reilly National Nurse Practice Development Unit, Ms. Kay Chawke, Assistant Director of Nursing, and to our sponsors and our backroom co‐ordinator Ms. Marie Allen, Secretary to Mr. Hughes we say thank you and we are ready to begin again with renewed energy from the enthusiasm and feedback and the great deference to our ward philosophy. ‘Our philosophy is rooted in the dignity and reverence for the whole person, and expressed in personalised and compassionate care. The nurse as a professional values the person in his/her dignity and uniqueness. Appreciating the complexity of modern health care, the nurse accepts the challenge of change and the need for constant updating which such a challenge demands from the nursing profession.’ What is clear is that Trachoestomy care is a complex phenomenon with life threatening complications in hospital, life changing and life altering disabilities, with highly resourced care, and long stay in hospital and complex discharges and challenges. An inexperienced nurse may add unwillingly and unwittingly to situations due to lack of awareness. Experts in Tracheostomy care are unique carers that empower patients to take care of themselves, who can change their care from dependency and malfunction to structural and functional development that can alter their life and that of their family. An experienced Tracheostomy Care Professional can illuminate the sick journey, be creative in care plans and time frames and use their unique knowledge to enable and empower the patient and the service. Ultimately care of the vulnerable is about recognising are we capable of service delivery required or are we placing patients at risk. Policy Makers need to be aware that patients’ lives are placed in our care with trust and hope and is this being sufficiently honoured in limiting circumstances?

In my observation it is false economy to sustain care on wings and prayers without proper control of service delivery that can cause lengthy protracted care and disabling or mortality without a sound knowledge base. Whilst it would be falsely interpreted that I.C.U. and H.D.U. staff are knowledgeable in Tracheostomy care all research from Study Days would show that they too struggle with its complexity. Positive Outcomes should be our mantra. The human body with its emotional and physical needs accept that there are challenges and it is up to clear and logical thinkers to have experienced staff to care for them. Let’s give Tracheostomy Care the recognition that all other Specialties have. We are in discussions at present with the Nursing Department University of Limerick looking at continuing Practice Development in the format of Accreditated Study Days , Trachoestomy Care Modules & Trachoestomy Care Programme Level 9. We would be delighted with feedback from this article. Please contact, Ms. Carmel O’Sullivan: [email protected]


UNIVERSITY HOSPITAL LIMERICK AND BROOK CATERING JOIN FORCES

James Stack of Brook Catering

A new partnership between Brook Catering and University Hospital Limerick is committed to delivering quality food and service daily to staff and patients and is constantly looking at ways in which improvements can be made in menus, cooking methods and overall efficiency. Catering consultant James Stack commented “The partnership means that patients can be assured that food produced in the hospital is fresh and, where possible, ingredients are locally sourced to create wholesome meals. Chefs at the hospital no longer use processed foods such as packet gravies

or soups in the kitchen. Dishes are made from fresh ingredients using herbs and spices to naturally enhance flavours. “ Rape seed oil will be introduced as a healthier alternative to vegetable oil and only skimmed milk, low –fat yogurts and low fat crème fraiche will be used in sauces and dressings. Cooking techniques are an important component in delivering healthy dishes. The hospital chefs have reintroduced cooking methods proven to preserve the health benefits and nutritional values of foods such as steaming, dry roasting and stir frying.

“Together, Brook Catering and the University Hospital Limerick catering team will be adding exciting new dishes to the hospitals recipe database. Our teams will be working together developing menus that will change with the seasons and feature culinary influences from all over the world. As a company we are very excited to be working with the University Hospital Limericks catering division and look forward to delivering a wonderful culinary experience to all the hospital staff and patients”

THE LATE DAN GALLERY

Dan Gallery RIP

Many tributes have been paid to the late Dan Gallery, Chairman of the Mid‐Western Hospitals Development Trust that has raised in excess of €17.5 million for a significant range of medical equipment and infrastructure in the region. Major contributions have been made by the Trust in the areas of cancer treatment, cardiology, diagnostics, endovascular surgery, colorectal surgery, urology,

ophthalmology, intensive care, neurology, orthopaedics, emergency medicine, respiratory, breast and dermatology treatment and renal medicine. Mr. Gallery, former Regional Manager of Bank of Limerick, and late of Ennistymon, Co Clare, and Castletroy, Limerick, was the driving force behind the Mid‐Western Hospitals Development Trust since his appointment as Chairman in 2011, a position he held until his death. As Chairman, he played a central role on the Board in overseeing the many Trust developments and initiatives that have taken place at University Hospital Limerick over the past three years. Mr. Gallery worked closely with UL Hospitals chief executive Ann Doherty and senior clinical and management staff. Ms. Doherty said Mr. Gallery combined experience with courtesy and tact and had a remarkable ability to achieve consensus in situations that might have started out with conflicting opinions.


The fruits of Mr. Gallery’s labours can be seen on the campus. The Trust’s latest projects was the handing over in June of this year of a Minimally Invasive Integrated i Suite to the Theatre Complex along with an Interventional System for the Radiology Department at University Hospital Limerick, costing in the region of €1.2 million. A Vivascope was presented to the Dermatology Department which is the 1st Vivascope in an Irish hospital. The Trust is funding the development of a new Mid‐Western Regional Symptomatic Breast Unit and Dermatology Day Treatment Centre at a cost of circa €4 million along with a €5.55 million Renal Dialysis Unit. These three projects are at construction stage. Patients’ lives will be enhanced and touched as a result of Mr. Gallery’s enormous contribution, perseverance and undivided attention to the needs for healthcare facilities.

Mr. Gallery had a strong sense of public duty to the community. He was involved in many voluntary organisations and made a major contribution to each. Mr. Gallery will always be held in high esteem by the Board. The work that he did over the past 4 years since he became a Board Director and Chairman will stand as a great testament to him. He would have been the last person to seek praise but he is deserving of our gratitude. Mr. Gallery passed away on September 26th and was buried in his beloved Ennistymon. He is survived by his loving wife Eileen, children, Kieran, Donal, Aidan and Niamh.

OUTPATIENT PERFORMANCE IMPROVEMENT PROGRAMME AT UHL The Outpatient Service Performance Improvement Programme is being implemented nationally between 2012 ‐2015, to remodel the provision of Outpatient services to patients in acute hospitals. The overall aim of the programme is to ensure timely, appropriate access so that the right patient is seen by the most appropriate member of the clinical team at the right time. This will improve access to Outpatient services in public hospitals. The focus for 2013 has been to ensure no person will wait longer than 52 weeks for an Outpatient appointment. The programme is addressing: Management of Referrals Management of waiting lists, booking &

scheduling Management & delivery of Outpatient clinics Management of patients who Do Not Attend

(DNA) Clinical Outcome management Discharging of patients from the Outpatient

services Governance & Accountability Extensive work has been carried out by staff across UL Hospitals in validating all Outpatient waiting lists followed by 105 additional blitz clinics across all specialities to review patients waiting for longer than a year. These clinics have

been facilitated late into the evening and on Saturdays. I would like to acknowledge & thank all staff members in all disciplines within the Outpatients & supporting services who have shown great commitment throughout the year in reconfiguration of the outpatient service which in turn has allowed us to offer additional patients access to our services. I look forward to continuing this effort in 2014 thus assisting our hospitals in offering timely local access to outpatient services.

Bernadette Nolan Clinical Nurse Manager , Outpatient Department.


PUBLICATION ACHIEVEMENT FOR UHL CNMS Congratulations to both Carmel O’Sullivan, CNMII, Ward 2C and Niamh Hurley CNMII, Ward 2B , of University Hospital Limerick’s Peri‐operative Directorate on their recent publication achievement. Both Carmel & Niamh were invited in conjunction with Dympna Tuohy and Jan McCarthy, Lecturers

in University of Limerick, to put forward a chapter entitled “Nursing Care of Conditions related to the Ear, Nose, Throat & Eye” . The submission has been accepted and is due to be published this December by Wiley‐Blackwell Publishing in the book entitled “Fundamentals of Medical‐Surgical Nursing: A Systems Approach”

BREAK THE SILENCE OF DOMESTIC ABUSE A message from the Medical Social Work Team University Hospital Limerick

Student social worker Sarah O’Rourke and Medical social worker Linda Donegan at the launch of the 2013 campaign in UHL

Violence against women can happen in all relationships. It exists irrespective of class, culture or religion and can affect each and every one of us: our family, friends and

neighbours.

November 25th 2013 was United Nations International Day for the Elimination of Violence against Women. This marks the commencement of 16 days of action and awareness opposing violence against women, an annual global campaign running up to International Human Rights Day on December 10th. The campaign focused the elimination of violence against women. In Ireland today, research shows that one in five women experience abuse and violence within their intimate relationships. Their children will also be affected in this type of home environment. Support & information services within University Hospital Limerick Medical Social Work Department: 061‐482972 / 061 482965 Services which provide Emergency Accommodation & Supports are: Adapt House, Limerick – Tel 061‐412 354 / 1800 200 504 ClareHaven Services, Ennis ‐ Tel 065‐6842646. 24hrs‐Helpline‐065 6822435


Other Support Services Include: Ascend Services Roscrea ‐ Tel 0505‐ 23379/23999 Rape Crisis Centre Limerick‐ Tel 1800 311 511 We appeal to you to help us to break the silence of domestic abuse

National Women’s Aid Helpline Number

1800 341 900

THE DEVELOPMENT OF RESPIRATORY SERVICES IN ENNIS. Ennis Hospital had anticipated the upsurge of interest in Respiratory disease and in 2007 was one of the first hospitals in the Mid‐West Group to appoint a Clinical Nurse Specialist (CNS) in Respiratory. Carmel McInerney, Clinical Nurse Specialist Respiratory initiated a smoking cessation programme, a nurse led clinic, and advocated the need for a Pulmonary Rehabilitation Programme for the Clare area. The nurse led clinic, especially, played and continues to play, a major role in the developing Respiratory services in Ennis. The clinic offers help, support and education on their illness to COPD patients. It also acts as a first response for patients with potential exacerbations as Carmel can be contacted directly should a patient be worried about their disease. This service is further enhanced now that Carmel has gained her Nurse Prescribing certification. Thus in 2009 the groundwork was already in place in Ennis when two new Respiratory Consultants were appointed in the Mid‐West. Doctors Aidan O'Brien and Brian Casserly were dedicated Respiratory Consultants with their focus firmly fixed on improving the service for Respiratory patients in the region. Once the initial programme of up‐grading the Respiratory Unit in Limerick was in motion the consultants turned their attention to the other hospitals in their area. Ennis Hospital was in the process of redefining itself and with a Respiratory CNS and her ancillary services already in place it was an ideal location in which to expand services. A Pulmonary Rehabilitation Programme was commenced. Carmel and Mary Dervan, Senior

Physiotherapist in Ennis Hospital, developed a highly successful programme in 2011 which continues to run 4 times a year . Since then Respiratory services in Ennis Hospital have developed organically and 2013 has marked a significant increase in services offered in the Hospital. In March of this year, Polysomnography (PSG), the ultimate test to diagnose Obstructive Sleep Apnoea, was commenced. This highly specialised test requires an in hospital overnight stay and presently the hospital accommodates two tests per week with plans to increase this in the near future. With the support of Paula Cussen Murphy. Directorate Manager for the medical directorate. and Margaret Gleeson, Director of Nursing, a fully functioning Pulmonary Function Lab was set up in June 2013, offering a full range of Spirometry, Diffusion Capacity and Lung Volumes tests. The Lab is currently staffed from the Unit in Limerick and testing is offered one day a week with plans to increase this to two or more days now being discussed. The development of Respiratory services in Ennis Hospital is on‐going with plans including the instigation of both Public and Private clinics, run by Dr Aidan O’Brien and facilitated by the Out Patients Department. Thus the development of Respiratory Services in Ennis has been of immense benefit to both the patients of the region and to the Hospital itself.


PILOT LEADERSHIP AND MANAGEMENT DEVELOPMENT A Leadership Programme for the Health and Social Care Professions (HSCP) Beginning a New Leadership Journey has been developed. The Programme has been developed based on HSE National Director Competencies. HSCPs are invited to apply for this new Programme. Closing date for receipt of applications is Thursday, 12th December, 2013.

An application form and further details are available on the HSCP HUB on HSELaND. http:www.hseland.ie Note: First time users of this website will need to register to access the full content.

RELEASING TIME TO CARE: THE PRODUCTIVE WARD INITIATIVE AT ENNIS HOSPITAL The Productive Ward (PW) initiative commenced in April 2012 in Ennis Hospital. Each module provides guidance to help ward staff to review and make changes to ward processes and the ward environment, making it easier and safer for staff to work and ultimately giving staff more time to spend with the patient. Communication was a key factor in commencing the programme in Ennis, to ensure the relevant information was available to all staff. Both wards began with the foundation modules of the ‘well organised ward’ and ‘knowing how we are doing’ which involved waste walks, stock taking, activity follows, patient and staff satisfaction surveys and development of new ward vision statements. Outcomes and improvements to date Surgical Day ward:

Direct patient care increased by 10% A better organised ward, with excess stock

being recycled and an agreed stock list and level set.

Improved filing system for venesection patients.

The development of a draft MDT perioperative admission document.

Patient satisfaction with care increased. Staff interruptions decreased by 75% with the

introduction of a modified patient status at a glance board (psagb) and the development of a patient admission documentation package.

Fergus Ward:

Improved MDT communication and reduction in staff interruptions with the use of a specially designed PSAG board.

Patient falls reduced by 50% with a Fall Collaborative initiative of referring all patents with a FRASE score of 9 or greater to physiotherapy for gait and balance assessment and placing a ‘falling star’ on the doors of patients at risk of falling.

Patient satisfaction with care increased by 8%. Reduction in medication round times with the

introduction of a second medication trolley on the ward and the use of tabards during medication administration.

The introduction of ‘Protected Meal Times’ for patients.

Time taken for handover reports reduced with walking rounds.

Three members of our current steering group have now applied to attend the PW Train the Trainer education sessions in December 2013 and help roll out the Productive Ward Programme to other sites within the UL Hospitals group.

Patricia Buckley, PW Facilitator and

Siobhan Tubridy, PW Lead Ennis Hospital

http:www.hseland.ie�


UNIVERSITY MATERNITY HOSPITAL: ANNUAL REMEMBRANCE SERVICE 2013 The University Maternity Hospital Annual Remembrance service took place on Sunday 10th November 2013 at the Holy Rosary Church, Ennis road Limerick. The service was lead by Fr. Liam Ryan and Fr. Willy Walsh, with beautiful music provided by Jacqui Keane and Miriam Dawson. This set the mood for a time of remembrance and expression of love for the babies who have died through miscarriage, stillbirth or neo natal death. The church was a well of emotion and tears on the day as approximately 400 people gathered together to remember their babies who have had only little lifetimes but have left a lasting impression in their families lives. Each baby’s name was called out during the service and the parents and grandparents along with the many staff of the Maternity hospital who attended were invited to light a candle in remembrance of each little soul they wished to remember. The candles were brought to the alter where all the candles were gathered together as a symbol of unity and love for the babies who have died. Each person was invited to collect a memory stone to take home as a symbol of comfort, support and acknowledgement of their love for their baby. This year a brave father was invited to tell the story of his and his wife’s journey through peri natal loss. They had lost babies through miscarriage and neo natal death. They shared the

story of their emotional journey and showed the congregation great strength and courage in their ability to grieve and to get through their experience together. They gave comfort to the many couples in the congregation who are still struggling to have a baby. They brought their little girl with them who came as a gift to the couple after all their losses. The feedback from the service was very positive. Many couples expressed how helpful it was for them as it provided a space for them to express their emotion about their loss, acknowledged their babies existence as all babies names were called out during the service and it gave them hope and comfort as they shared the experience with other bereaved parents. We are grateful for the opportunity to provide such a valuable service to our families who have been bereaved at any stage of pregnancy and the neo natal period and look forward to next years service and the healing that once again it may bring to many .

Marie Hunt A/CMM2 Bereavement Counselling Midwife,

UL Maternity Hospital, Ennis Road, Limerick

061483196 [email protected]

ANNETTE WINS SCOTTISH FELLOWSHIP Annette Ridley CNMII UL Hospital Nenagh has gained one of four Fellowships representing the Republic of Ireland on the Scottish Patient Safety Fellowship Programme cohort 6. The Healthcare Quality Strategy for NHSScotland has three Quality Ambitions, one of which aims that in Scotland ‘There will be no avoidable injury or harm to people from healthcare they receive,’ – the Scottish Patient Safety Programme (SPSP) is key to the delivery of these ambitions. The programme aims to reduce mortality in Scotland's hospitals by 20% by 2015 with 95% of patients free from harm.

The SPSP is lead and coordinated by Healthcare Improvement Scotland and brings together a number of organisations, including the Scottish Government, Health Protection Scotland, NHS Education for Scotland, NHS boards and patient representatives, to systematically improve the safety and reliability of hospital care throughout Scotland.

http://www.amd.ie/�


Annette with Paul Grey Director General Health and Social Care & Chief Executive of NHS Scotland.

The Fellowship Programme Aims The SPSP Fellowship Programme aims to develop and strengthen clinical leadership and improvement capability in NHSScotland to support the development and delivery of the SPSP as well as contribute to the development of a long‐term quality improvement and patient safety culture within NHSScotland.

Annette attending first residential at Stirling Management Centre, Edinburgh.

Objectives To develop clinical leaders capable of delivering

improved health and healthcare for the people of Scotland.

To enhance knowledge of the science and methods for improvement amongst clinicians working with the SPSP who have enthusiasm, experience and skills to: ‐ support the development of safety programmes ‐ spread improvements both within their organisation and nationally.

To establish a learning support network for transformational leadership within the SPSP with the potential to spread beyond it into other areas of healthcare improvement.

To complement wider improvement capacity building programmes within NHSScotland while supporting NHSScotland workforce development.

To strengthen cooperation and collaboration with important overseas healthcare providers in Europe and beyond.

We all wish Annette the very best in her participation in this programme which strengthen quality care and safety within the UL Hospital group.

UNIVERSITY MATERNITY HOSPITAL WELCOMES NEW MIDWIFERY STUDENTS University Maternity Hospital in partnership with the University of Limerick are pleased to welcome two new groups of midwifery students this autumn. 10 students undertaking the Higher Diploma in Midwifery programme and 18 students on the undergraduate BSc midwifery programme completed their first clinical placement in November. Since 2006 it has been possible to undertake an undergraduate four year BSc education programme to register as a midwife with The Nursing and Midwifery Board of Ireland, without first registering as a nurse.

18 students on the undergraduate BSc midwifery programme completed their first clinical placement


This is a key development for the Midwifery profession in Ireland and is in line with international standards. For nurses there remains the option to undertake the post registration 18 month programme to register as a midwife in the same way.

10 students undertaking the Higher Diploma in Midwifery programme

The team in the Midwifery Practice Development Unit , the Clinical Midwife Managers and staff midwives undertake all the ‘behind the scenes’ work, in collaboration with the University of Limerick, to support students on both programmes to achieve the programme requirements and maintain excellent standards for clinical placements. They also link with partners in the HSE South Maternity Services in Waterford Regional Hospital, South Tipperary Hospital Clonmel and St Lukes Hospital Kilkenny where BSc midwifery students also undertake clinical placements. All the staff in the University Maternity Hospital wish the students well as they embark on their new career pathway to become midwives. Mary Doyle Midwifery Practice Development

Coordinator

INTERNATIONAL INFECTION PREVENTION & CONTROL WEEK, OCTOBER 2013 We all work in a very challenging environment. Our priority as healthcare providers is to carry out safe working practices to protect our patients from acquiring a healthcare associated infection. The question we constantly ask ourselves is how we can ensure that all staff are equipped with the skills, expertise and guidance to provide high quality care to our patients. During International Infection Prevention & Control Week, the IPC Team used this occasion to meet staff, support evidence based practice & provide an opportunity for staff to review new products and services which promote best practice in this area. .Both staff and the public enthusiastically visited our stands across all sites. Over 430 staff availed of mandatory hand hygiene training during this week. There was immense interest in the interactive hand hygiene training tool Surewash (Sisk Healthcare), dummy blood culture packs &

peripheral cannula insertion packs (Iskus) , Microclave & “Scrub The Hub” best practice initiatives (Fannin), hand hygiene & skin health promotion with Ecolab and Hydrogen Peroxide Vapour decontamination (Bioquell). We are pleased to announce the following staff members who availed of hand hygiene training won spot prizes during that week: Mary Corry, Endoscopy Ennis Hospital John Spillane, OPD Nenagh Hospital Shonas Friel, Neonatal Unit, UMH Rena O Brien, St Marys, Croom Hospital Ann Doran, OPD UHL Deirdre Russell, A&E, UHL Mary O Brien Directorate Nurse Manager Blanaid Hughes, SDW, UHL April While, medical secretary, UHL Bart Ramsey, Consultant Dermatologist. Ciara Connelly, 3D, UHL Phil O Brien, Recovery Room, UHL

We would like to thank all our sponsors and staff for their support during this week.


Hand Hygiene week in University Maternity Hospital

Hand Hygiene week in University Hospital Limerick

Hand Hygiene week in Nenagh Hospital


PUBLIC ACCESS DEFIBRILLATOR LAUNCH IN NENAGH ,CO.TIPPERARY The official launch of the Nenagh Public Access Defibrillator ( PAD) Programme took place on September 30th and was hosted by the Nenagh Lyons Club. Guest speakers were Ms. Brigid Sinnott, Basic Life Support Co‐ordinator, Irish Heart Foundation, Mr. Mark Tyrell, Operations Resource Manager for the National Ambulance Service ,Mid ‐West Region, Dr. Muiris O Keefe, G.P. Nenagh ( Medical Director of the programme ) and Mr. Brian Duggan President of Nenagh Lyons Club. Gardai were represented by Sgt. Lynda Stack . It is the first public access defibrillator programme in the Mid ‐West region and is also the first programme to be linked with Ambulance Control via 999/112. In the event of a cardiac arrest occurring in the Nenagh area and a call to 999/112 being placed by a member of the public, ambulance control will inform the caller of the location of the Automated External Defibrillator ( AED ), the access code to retrieve the AED and will take the caller through the steps of CPR and the operation of the AED. The time from cardiac arrest to defibrillation is the single most important determinant of survival and with the installation of the two AEDs in Nenagh town a person’s chance of survival from a sudden cardiac arrest is greatly increased . This initiative was brought about by Mary O Brien, Resuscitation Officer HSE (who is based in Nenagh Hospital) together with the local PAD committee and Mr. Mark Tyrell (Operations Resource Manager Ambulance Service , Mid ‐West Region) .The Nenagh Lyons Club provided

funding for the purchase of 2 AEDs and cabinets . The Bank of Ireland ,Mitchel St. and Mulrooney’s Gala Filling Station , Borrisokane Rd. readily agreed to the positioning of the AEDs on the exterior of their property. Any member of the public can use the AED without training but CPR classes will be held locally .

Attending the Launch of the Nenagh Public Access Defibrillator Programme. Standing: (l to r) Shane Mulcahy, Mike Barry, Mark Griffin, John Tuohy, Shane Mulrooney, Brian Duggan (Nenagh Lions Club), Mark Tyrell. Seated: Michael Moloney, John Sherlock (Chairman Nenagh PAD Programme), Sargeant Lynda Stack, Mary O’Brien (Resuscitation Officer HSE), Dr Muiris O’Keeffe (Medical Director of the Programme), Brigid SinnottProgramme), (BLS Coordinator, IHF).

ENDOFLIFE CARE AWARENESS WEEK: STRIVING TO IMPROVE TOGETHER Monday 18th November was the start of the inaugural End‐of‐Life Care Awareness Week in UHL Dooradoyle. An initiative of the End‐of‐Life Care Standing Committee in UHL, the purpose of the Awareness Week was to promote the resources used when a patient is dying or has died in our hospital and to provide support for staff who are caring for patients and their families during the last days and hours of their life.

Four ‘Lunch & Learn’ sessions took place. Dr Val O’Reilly, Palliative Medicine SPR, provided a very informative session on ‘Symptom Control at End‐


of‐Life’. This looked at how, as healthcare professionals, we can address both the pharmaceutical and person‐centered aspects of end‐of‐life care. Ms. Julie McCabe CNM and Ms. Kate Ryan HCA from Ward 4B, UHL, presented an education session entitled ‘Care of the Dying Patient’. The importance of diagnosing patients as dying and the positive impact the end‐of‐life care resources at ward level have had was highlighted. These resources include the Spiral Symbol, the end‐of‐life care handover bag, an information leaflet for relatives (‘When a Loved One Dies: Information for Relatives) and the ‘Care of Patients after Death’ guideline. The End‐of‐Life Care Spiral Symbol is appears on many of the resources developed by the Hospice Friendly Hospitals Programme to respectfully identify items connected with end of life. It is inspired by ancient Irish history and is not associated with any one religion or denomination. The 3‐stranded white spiral represents the interconnected cycle of life – birth, life and death. The white outer circle represents continuity, infinity and completion. Purple was chosen as the background colour as it is associated with nobility, solemnity and spirituality.

Two communication sessions relating to communication with relatives and patients at end‐of‐life were facilitated by experienced professional actors. The actors also provide workshops on advanced communication skills in Staff attending the ‘Communication Workshop’ Milford Care Centre. Staff had the opportunity to participate first‐hand in interactive and extremely educational role plays. Over 100 healthcare workers from throughout the hospital attended the ‘Lunch & Learn’ sessions during the week. Feedback was excellent, averaging 9/10 for usefulness. Comments included ‘Excellent workshop‐ would have loved a

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OLD SOLDIER SPEAKS UP FOR QUALITY OF HOSPITAL CARE · Anna Moran, External Affairs Manager for Fighting Blindness, said, “AMD Awareness Week is about empowering people to take positive