Title of Poster

							Second National Conference Building on the Health Strategy: Challenges for Nurses and Midwives
Poster Presentations
Many thanks to everyone who responded to our call for posters for the conference. Almost 100 presentations were received from all around the country and from the different divisions of the register, and featured innovations in practice, service delivery, role development, and education for practitioners and patient/clients all featured. Guest speakers Leda McKenry and Barbara Vaughan judged the posters using the criteria of appropriateness of content, visual presentation, and clarity of text. Prizes for the best poster on each day were awarded to Lynda Hayes and Emily Adamson, Wellmount Park Health Centre, Dublin, and to Margaret Carton and Mary Mullins, Midland Regional Hospital, Tullamore, for the presentations entitled “Bug Busters” and “The Saturday Club – A Child/Parent-Friendly Initiative” respectively. The winners won book tokens for the sum of €300. The standard of the entries was at least as high as in 2001, so ten runner-up prizes were awarded to the presenters of “Replacement of Gastrostomy Tubes – An Expansion of Nursing Practice”, Peamount Hospital, Newcastle; “I Have Disabilities and Behavioural Issues”, Damien House, Clonmel; “Essential Components of a Twenty-Four Hour Nurse-Led Hostel”, Bredagh House, West Galway Mental Health Services; “Assessment of Anxiety and Depression in Cardiac Rehabilitation Patients Over One Year,” AMNCH, Dublin; “Sexuality and Disability – A New Service”, National Rehabilitation Hospital, Dun Laoghaire; “Nurse-Led Peripherally Inserted Central Catheter”, St James‟s Hospital, Dublin; “The Whisper that Became a Shout”, Daughters of Charity, St Vincent‟s Centre, Dublin; “Empowerment Competency”, AMNCH, Dublin; “The Expectations and Experiences of Philippino Nurses Working in an Intellectual Disability Service in Ireland”, Dublin City University; and “Developing a Nurse-Led Epilepsy Phone Line”, Beaumont Hospital, Dublin. Congratulations to everyone who participated, and we hope that many more of you are already preparing next year‟s entries!

Abstracts for all posters, which were presented at the Conference, are listed below.

1st prize winner – Wednesday 20th November
Title of Poster Presenter (s) Bug Busters Ms Linda Hayes Ms Emily Adamson ERHA, Northern Area Health Board, Wellmount Park Health Centre, Finglas, Dublin.

Organisation (s)

Abstract

'Bug Busters' Promoting early detection and prevention of spread of head lice, in the school setting and into the community at large. The Bug Busters programme explains the nitty gritty of what head lice are, their life cycle, and the spread of lice infestation. Head lice are an ongoing Public Health issue but the problem can be treated by the 'Bug Busting Method' which is simple, reuseable, and affordable. The 'Bug Busting' programme relies heavily on involving children themselves. They get really enthusiastic about the programme. All the children are invited to take part in an art competition, telling the story of the Bug Busting Programme, and their work is displayed later in the local Health Centre. Our Poster will portray the 'Bug Buster' message and the role of health professionals in supporting effective health promotion in the school setting. Our poster will be enhanced by some of the childrens own art work - telling the story.

1st prize winner – Thursday 21st November
Title of Poster “The Saturday Club”- A child parent friendly initiative at the Midland Regional Hospital at Tullamore Ms Margaret Carton Ms Mary Mullins Children's Ward, Midland Regional Hospital, Tullamore Presenter(s)

Organisation(s)

Abstract

The Midland Regional Hospital at Tullamore participated in the National Patient Perception of the Quality of Care Survey conducted by the Irish Society for Quality in Health Care. Results indicated a need for more information as respondents indicated that only 7.3% received printed information about hospital routine and 55% were told nothing thereafter. One in eight felt their family/friends did not receive enough information about their condition/treatment. In response to this the Children‟s Ward have put this initiative in place Aim: To provide an information session explaining procedures to children/parents who will be for admission to the Midland Regional Hospital at Tullamore. Objectives: ¨To identify a suitable programme to be delivered using best practice in this area.¨To induct all staff to the new programme in order to give consistent information.¨To develop a communication strategy for the new programme for internal and external stakeholders. Methodology: Agreement and commitment sought by Senior management and staff. The programme was developed and piloted by nursing staff covering areas which had been identified as usual causes of concern for parents and children. An information poster was developed in consultation with Dental, ENT clinics and general administration to develop and communicate the new programme to relevant personnel. Results: A training package is now in place in order that staff give consistent information. The programme is in place on Saturdays –school not interrupted. A play area has been developed as children learn through play. A certificate of attendance is given to each participating child. Conclusions - Numbers attending at the beginning were small but those who attended reported that the experience was very worthwhile allaying fears and concerns. The programme was not marketed well enough at the beginning this is being addressed through a poster, letter, and media campaign currently. This programme will be fully evaluated in 2003.

Runner up – prize winner – Wednesday 20th November
Title of Poster Presenter (s) Organisation (s) Sexuality and Disability-A New Service Ms Pauline Sheils National Rehabilitation Hospital, Dun Laoghiare, Co Dublin

Abstract

The report of the Commission on the Status of People with Disability (1996) recommended to the DoHC that disabled people had the right "to information on family planning, contraceptive services, sex therapy services, and sexual equipment." The health strategy of the DoHC (2001) has stated as part of it's action plan that measures will be taken to promote Sexual Health and Safer Sex Practices. This poster will show how the National Rehabilitation Hospital has combined both these initiatives by providing a Sexual Health Service to our patients. Poster content will include the history of the service, services provided and the PLISSIS model. We are dedicated to serving patients with physical and / or cognitive disabilities and their families. Our aim is to help them achieve optimal independence and enhance the qulaity of their lives. This now includes a service dedicated to the issues of sexuality and disability.

Runner up – prize winner – Wednesday 20th November
Title of Poster Replacement of Gastrostomy Tubes - An Expansion of Nursing Practice Ms Fionnuala McMullan Mr Joe Curran Ms Nuala Joyce Mr Donal Douglas Ms Racheal Adderley Ms Anne Corcoran Peamount Hospital, Dublin

Presenter (s)

Organisation (s)

Abstract

Replacement of gastrostomy tubes by nurses at ward level. Building on The Health Strategy and the challenges for nurses to provide responsive and appropriate care, guidelines for Enteral Tube Feeding were developed in Peamount hospital by the above group of nurses. These guidelines include an expansion of nursing practice, which enables nurses to replace gastrostomy tubes at ward level. The guidelines were developed using The Scope of Nursing and Midwifery Practice Framework (2000). Peamount hospital provides health care to highly dependant long stay patients many of whom have gastrostomy tubes on admission. The follow up care of these patients includes recurring admissions to the acute hospital for gastrostomy tube replacement. The nurses in Peamount Hospital are prepared to meet the challenge this expansion of practice will require, in the best interest of their patients. The expansion of practice is based on the best available evidence, giving consideration to national policy and legislation. For nurses to practice effectively knowledge and competence must be required which the guidelines and training provided.

Runner up – prize winner – Wednesday 20th November
Title of Poster Presenter (s) Organisation (s) Essential components of a 24hr nurse led hostel Ms Grace King Ms Marie Conroy West Galway Mental Health Service, Bredagh House, Ballybane Rd, Galway

Abstract

Our poster is about "Bredagh House". It is a 24 hr nurse led hostel in the community, the first in Galway city caring for people with mental illness who have an ongoing need for nursing care and supervision. We have looked at the philosophy and good practice developments that are available to us.

Runner up – prize winner – Wednesday 20th November
Title of Poster Assessment of anxiety and depression in cardiac rehabilitation patients over one year Ms Noeleen Fallon AMNCH, Dublin Ms Shirley Ingram

Presenter (s) Organisation (s)

Abstract

The psychological implications of Coronary Artery Disease impacts on the outcome of this disease (Clarke, 2000). Research has shown that Anxiety and Depression (A&D) are prevalent in both cardiac patients and their families (Mayou et al, 1978) and are associated with increased morbidity and mortality (Reich et al, 1981). Anxiety and/or depression occurs in an estimated 20-35% of patients post myocardial infarction (MI) and may impact on their recovery (Hemingway & Marmot 1999). Symptoms may persist if action is not taken at an early stage to alleviate psychological upset in post MI patients. Objectives Cardiac rehabilitation aims to address psychological problems. At the Adelaide and Meath Hospital, Dublin our cardiac rehabilitation (CR) program includes psychological and educational interventions. Methodology In May 2001 CR at Adelaide and Meath hospital commenced a study of 25 patients. The objective was to view the levels of anxiety and depression in cardiac rehabilitation patients over one year. The CR nurse specialist met the patient in CCU during phase 1 of cardiac rehabilitation. Patients were asked to complete a Hospital Anxiety & Depression Scale (HADS). Zigmond &Snaith (1983) devised the HADS specifically for detecting anxiety and depression in the physically ill.The scale was completed at three time points 1) as an inpatient, 2) 4 months post discharge coinciding with participation in Phase 3 cardiac rehabilitation and 3) one year post discharge. Results Of the 25 patients enrolled in the study, 92% (n=23) responded at all time scales. The sample comprised of 78% men and 21% women with an age range of 31-72 years. No levels of „severe‟ anxiety were recorded. Moderate anxiety was experienced in 30% of in-patients, which fell to 4% at one year. Mild levels of depression were experienced in 13% of inpatients, falling to 9% at 4 months which however increased to 17% at one year. Conclusion As expected, levels of anxiety were elevated during the inpatient period. The subsequent fall post cardiac rehabilitation was maintained at one year. As depression levels rose again at one year, follow up for this group of patients is recommended. As a result of this study, CR at AMNCH administer the HADS pre and post phase 3 routinely, following up those at higher risk at one year.

Runner up – prize winner – Wednesday 20th November
Title of Poster Presenter (s) I have Disabilities and Behavioural Issues. Ms Antoinette Mullins Ms Siobhan Power Ms Fiona Last Ms Bridget Doyle Mr Seamus McHale SEHB, Damien House, Glenconnor Road, Clonmel, Co Tipperary.

Organisation (s)

Abstract

Damien House/Day Service- Learning Disabilities and Challenging Behaviour. The content of the poster will be as follows;  Photo of the house,  Philosophy of care and Ethos.  Leaflet as designed by staff and award wining postcard by a client with disabilities and challenging behaviour.  Day service information.  Pictures that clients have drawn and painted.  Nursing models as used on the unit and the types of care plans. We will also be using photos and pictures and lots of colour We will also show the new day service evaluation system that as a team we developed.

Runner up – prize winner –Thursday 21stNovember
Title of Poster Presenter(s) Developing a Nurse Led Epilepsy Phone Line Ms Cora Flynn Ms Maire White Beaumont Hospital, Dublin

Organisation(s)

Abstract

Developing a Nurse Led Epilepsy Phone Line.Epilepsy nurses developing practice in the care of epilepsy patients. Anti-epileptic drugs (AED'S) often require titration which patients find difficult to follow. General Practitioners may not be familiar with titrations of these drugs, hence are reluctant to alter the doses. Patients occasionally alter or stop their medication without medical advice, which may put them at risk of a prolonged seisure or even status - epilepticus. Providing a phone service to epilepsy patients gives direct access to specialised advice which can promptly review their problem. Patients tolerate the drugs with fewer side effects when supported, and medications are not abruptly or prematurely discontinued. This practice is in line with the health strategy in responding to people needs.A central role of the service is also educating people about their epilepsy and promoting a positive image of epilepsy

Runner up – prize winner – Thursday 21st November
Title of Poster Nurse-Led Peripheral Inserted Central Catheter (PICC) Program: An audit of St James's Experience Ms Paula O'Reilly Ms Deirdre O'Mahony Ms Jennifer Kerlin Ms Catherine O'Brien HOPE Directorate, St. James‟s Hospital, James‟s St. Dublin 8

Presenter (s)

Organisation (s)

Abstract
The Nurse- led PICC line insertion program for Haematology / Oncology patients in St James‟s Hospital was established in January 2002. As with all new developments, close monitoring and appraisal of its merits are a necessity, therefore we reviewed all procedures carried out in the initial 6 months. In addition, we compared this with the established X-ray department directed PICC line insertion program. 141 procedures were assessed during the study period – 46 nurse inserted and 95 X-ray inserted catheters. There was an overall complication rate of 34.7% found in the nurse inserted PICC lines, comparable to a rate of the 51.5% in the X-ray department infection and line blockage were the commonest complications.Trained nurses, reserving image guidance for more difficult cases, can successfully place the majority of PICC catheters. Patient responses indicate a favorable acceptance of a nurse directed PICC placement programme due to a reduced waiting times, continuity of care, increased surveillance and support post procedure.

Runner up – prize winner – Thursday 21st November
Title of Poster Presenter(s) The Whisper that became a shout Ms Kathleen Byrne

Organisation(s)

Daughters of Charity, St. Vincent's Centre, Navan Rd, Dublin

Abstract

People with an intellectual disability and challenging behaviour can be the most difficult, confusing and often fear evoking patients that Health Professionals, outside of the field of disability, encounter in their work. The purpose of the poster and information leflet is to give brief information in the communication function of challenging behaviour and focuses on developing a team approach between professionals that will offer a comprehensive service to the individual. Greater communication and liaison between individual clinicians within services and across services, quality and fairness - objective 1.

Runner up – prize winner –Thursday 21stNovember
Title of Poster Presenter(s) Empowerment Competency Ms Sibeal Carolan Ms Sharon Morrow

Organisation(s)

AMNCH, Dublin

Abstract

This poster presentation will outline the current projects within the AMNCH which refer directly to the two key strands within the framework for human resources as defined within the Health Strategy 2001.Namely ensuring a qualified competent work force to meet the changing demands of the people and becoming an employer of choice. Currently the AMNCH has a leadership programme for nursing staff, clinical facilitators to facilitate existing staff and newly appointed nursing staff. The organisation is also involved in an accreditation process. The outcomes of these iniatitives are outlined in this poster presentation. The fundamental principle supporting these programmes is one of continuous quality improvement.

Runner up – prize winner –Thursday 21stNovember
Title of Poster The Expectations and Experiences of Philippino Nurses working in an Intellectual Disability Service in Ireland Ms Catherine McGonagle

Presenter(s)

Organisation(s)

Dublin City University

Abstract

Since the late 1990s health services in the Republic of Ireland experienced a well-documented shortage of registered nursing staff. This article describes a study conducted in a large Dublin based Organisation providing services for people with Intellectual Disability, following the recruitment into the organisation of a large number of Philippino Nurses. The aim of this study was to explore the expectations and experiences of a sample (n=10) of those Philippino nurses who were working in this Country for at least three months. A qualitative methodology incorporating Phenomenology was chosen as the approach to investigate this topic. Data was collected using a focus group discussion followed by seven individual interviews. The emergent themes highlighted a significant amount of interesting data on these Nurses experiences and expectations since coming to Ireland. A significant finding was their need for more accurate and relevant information during their recruitment in the Philippines.

Title of Poster Presenter (s) Organisation (s)

Tracheostomy Care Guidelines Ms Margaret Codd Ms Deirdre Hyland St James's Hospital, D 8

Abstract

Best practice in Tracheostomy Care for health professionals; Information and support for patients and families. This poster combines two innovations developed by nurses caring for tracheostomy patients. A booklet titled 'Tracheostomies: information for patients and families' was written by Margaret Codd in response to an obvious need among her clients. The easy to read format aims to answer the most commonly asked questions, and encourages patients and families to seek further information at their own pace. The text is complimented by simple illustrations. The aim of the booklet is to prepare patients and families for tracheostomy and to educate them to be independant in the care of the tracheostomy on discharge home. A more detailed book - 'Tracheostomy Care Guidelines' - provides an evidence-based guide to tracheostomy care for healthcare professionals in the clinical setting. It was compiled by the tracheostomy care working group in St James's. This group was comprised of clinical and educational nursing staff in St James's, with a nurse representative from the Royal victoria Eye and Ear Hospital. Following an extensive literature review, and audit of current practice, the group produced these guidelines, which were further reviewed by senior nursing, medical and multidisciplinary colleagues before being finalised. The tracheostomy care Guidelines have been adopted by HANNA, the Head and Neck Nurses Association and are available on their webpage, hosted by the National Council for the Professional Development of Nursing and Midwifery. They are also available on the St. James's Hospital website. The poster is prepared and presented by Margaret Codd and Deirdre Hyland, fully acknowledging the contribution of the Tracheostomy Care Working Group.

Title of Poster

Provision of Specialist Training of Nurses in the Administration of Coagulation Concentrates Eadaoin O'Shea Ms Joanne Taylor Ms Colette Healy National Centre for Hereditory Coagulation Disorders,St James Hospital

Presenter (s)

Organisation (s)

Abstract

Provision of specialist training for nurses in administration of coagulation concentrates. The recommendations of a recent national commission of nursing promoted broadening the nurse‟s scope of practice with a view to improving patient care. With this in mind, a programme was put into practice to increase the knowledge and skills of ward nurses in providing haemophilia in-patient care. Traditionally, nurses working at clinical ward level have depended on haemophilia nurse specialists to administer coagulation concentrates and evaluate the care of haemophilia patients. This initiative has improved the specialist nursing care of patients with haemophilia when hospitalised.

Title of Poster Presenter (s)

Clinical Supervision of Nurses/Midwives needing support Ms Millie Power Ms Mary Dunford Clinical Supervision Development Group,Waterford Regional Hospital SEHB / Waterford Regional Hospital

Organisation (s)

Abstract

Introduction: The Commission in Nursing (1998) has led to extensive developments in the nursing profession. These significant developments have had considerable implications for clinical practice. Professional development is welcomed and acknowledged by all nursing/midwifery practitioners, however it has also been identified that a dilution in nursing/midwifery expertise has created a void in clinical expertise at ward level. In an attempt to address this issue, the introduction of a formalised programme for clinical supervision for less experienced nurses/midwives is necessary to address the shortfall of appropriate skill mix in the clinical area. The introduction of clinical supervision will enable less experienced nurses/midwives to gain the necessary knowledge, skills, support and competence to participate in clinical practice. Clinical supervision is defined as a „formal process of professional support and learning which enables individual practitioners to develop knowledge and competence, assume responsibility for their own practice and enhance consumer protection and safety of care in complex clinical situations‟ Department of Health, UK, 1993). Rationale: The introduction of this formalised structure of clinical supervision is expected to develop and consolidate nursing knowledge and clinical skills.Innovation: While acknowledging that all nursing/midwifery staff would benefit from clinical supervision, the proposed target group for this initiative are newly qualified nurses/midwives and recently employed nurses/midwives. It is envisaged that this initiative will be linked in with an induction/orientation programme for nursing/midwifery staff. Proctor (1986) found that the introduction of a formative structure of clinical supervision is acknowledged as an educative process of developing understanding and skill which is now considered an integral part of CNMI role which includes clinical leadership and staff development (Commission on Nursing, 1998). It is proposed in this initiative to utilise the skills and expertise of CNM1‟s, Staff Nurses, and Clinical Placement Co-ordinators who are most appropriately placed to influence, inform, and implement further developments in this regard. Outcome:The principle value of clinical supervision is to provide knowledgeable practitioners to maintain and improve the standard of care necessary to realise public expectations. Webb (1997) claimed that the benefits of clinical supervision has led to improved patient outcomes. Qualitative evidence also concurs with Webb‟s suggestion that nurses/midwives personally value clinical supervision and recognise its contribution to the enhancement of patient care ( Johns, 1997; Webb, 1997).

Title of Poster Presenter (s)

Australasian Triage Scale in Accident / Emergency Department Ms Anne Kelly Ms Rosemary Kearns Ms Sheila Kiernan Midland Health Board

Organisation (s)

Abstract

Triage is a formal process of immediate assessment of all patients who present in Accident / Emergency seeking emergency care. The term “triage” originates from the French word “trier” which means to sort, pick out, classify or choose. The triage principle or prioritising care to large groups of people has been adapted from its military origin for use in the civilian context of initial emergency department care. It is an essential function in the Accident / Emergency Department as many patients may present simultaneously. The Australasian Triage Scale is a five-category triage scale with a maximum waiting time for each of the categories. Each of the five categories reflects both the severity of the patient‟s illness or injury and the expected staff response time. The poster content will show The Australasian Triage Scale categories, how triage decisions are made, and response times.

Title of Poster Presenter (s)

Developing a Model of Family Centred Care Ms Collette Murray Ms Margaret Prendergast Mayo General Hospital

Organisation (s)

Abstract

The concept of family centred care is central to the rehabilitation and recovery of patients with a diagnosis of stroke. Following a retrospective audit of patients with a stroke diagnosis in 2000, we identified that many gaps existed in our present service, and that patient mortality and morbidity could be improved by developing a specific service, which is family focused. The aim of our service is echoed in the recent Health Strategy (2001), and aims to provide a quality, efficient service that is clinically effective, through dedicated multidisciplinary working, with the patient as the central focus and the family as a critical component in the patient's recovery. We aim to develop our own family centred care model, relying on existing evidence in this area, in conjunction with families themselves, voluntary groups, and service providers.

Title of Poster Presenter (s)

Clinical Learning Environment Ms Claire Gilsenan Ms Desma Christie Ms Marie Hennigan Ms Deirdre Clarke Ms Rena Nugent Beaumont Hospital Ms Sheila Enright Ms Amanda Tierney

Organisation (s)

Abstract

Following the introduction of the diploma in nursing programme in 1995, the role of the cpc was introduced. In 1997, CPCs in Beaumont hospital devised a standard for first year students to facilitate and support them to achieve maximum outcome from each clinical placement. This standard was based on feedback from student nurses experience in the clinical area in 1996, An Bord Altranais guidelines as set in "The Future of Nurse Education and Training in Ireland (1994)document and updated literature review. An Audit tool was devised to facilate the achievement of this standard which was also used as the CPC's form of documentation in relation to the student placement. In 2002, following a number of consecutive audits and a comprehensive literature review, this standard and Audit tool was reviewed. For this presentation, we would like to display our current standard and subsequently our form of documentation.

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Drug administration: the single nurse approach Ms Philippa Ryan Withero Ms Sibeal Carolan AMNCH

Organisation (s)

Abstract

In January 2001 the AMNCH undertook a pilot project, exploring and evaluating a change in nursing practice. This practice development surrounded the administration of oral medications by registered nurses. A number of registered nurses within the organisation highlighted the ambiguity between local hospital policy and the guidance by An Bord Altranais. Local hospital policy demanded that two registered nurses were required to administer oral drugs. In contrast however the nursing board stated that one registered nurse was required. In addressing this issue the nurse practice development department (NPDD) in conjunction with registered nurses in an identified clinical area, undertook a pilot project to explore the implementation of a single nurse drug administration procedure. Both quantitative and qualitative methods were utilised to explore this practice development. An evaluation of the pilot project demonstrated an overwhelming willingness of registered nurses to undertake the single nurse drug administration procedure. Subsequently, the hospital's policy on drug administration was ammended to facilitate widespread implementation of the single nurse drug administration procedure throughout the organisation.

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Emphasising and improving existing communication skills through the medium of touch Mr Declan Miskelly Ms Jackie O'Toole Ms Mary Flaherty CoisCeim / East Coast Area Health Board

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Organisation (s)

Abstract

Combining the principles of Dementia Care Mapping, and the Roger Logan Tierney Model of Nursing. Residents quality of life were assessed, with particular emphasis placed on existing communication skills. With lessening cognitive and verbal skills, touch was deemed to be an avenue to explore and develop in conjunction with verbal interaction. To develop and emphasise this art it was decided to focus on Aromatherapy, Hand Massage and Sonas Sessions. "Touch contributes towards a multi-sensory approach to help those with sensory impairment. It is supportive and comforting: it can help develop trust and relationships so adding to the quality of life." ( Nind et al 1998).

Title of Poster Presenter (s) Organisation (s)

Epilepsy and Pregnancy Ms Brenda Liggan Beaumont Hospital

Abstract

Epilepsy is a common chronic neurological condition affecting up to 10,000 Irish women of childbearing age. These women require specific consideration due to the effects of epilepsy and anti-epileptic drugs on contraception, menses and pregnancy. The Irish Epilepsy and Pregnancy Register is a nurse led project, which was developed by health professionals as a method to determine the safest strategies for the treatment of women with epilepsy who are pregnant or planning pregnancy. A Central role of this register is to educate people about epilepsy and pregnancy by giving pre-conceptual advice, advice during pregnancy and labour, in additon to baby care and breast-feeding education. Women with epilepsy and healthcare professionals necessitate a partnership when planning for a pregnancy in the future. Nurses play a fundamental role in the ongoing health promotion and education of this group and also in the development of a nurse led Epilepsy and Pregnancy Clinic proposed for the near future.

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"My teeth should all be my own, but I need help I cannot do it alone." Ms Merna Birchall Ms Evonne Grey Cheeverstown House, Templeogue, Dental Section

Presenter (s) Organisation (s)

Abstract

The poster describes an Oral Health Promotion initiative that is being put in place by Cheeverstown House Health Promotion Steering Group in collaboration with the Dental Section, Community Area 4. It contains wording outlining an Oral Health Strategy consisting of an Oral Healthcare Assessment as a first step approach. The aim is to progress oral healthcare for all service users. A visual representation of dental practice will be in the centre of the poster. The slogan "My teeth should all be my own, but I need help I cannot do it alone!" will be at the head of the poster in order to draw attention to the content as described.

Title of Poster Presenter (s) Organisation (s)

Embracing Cultural Diversity in Community Care Mr P.J. Boyle Ms Mary Martin Community Care Area 6, Northern Area Health Board, Dublin

Abstract

The poster presentation is designed to specifically highlight an initiative developed and aimed at community care staff in Community Care Area 6 and will address the topic "Cultural Awareness and Cultural Competence in Healthcare". The poster will advertise an education module developed for healthcare staff in the area which will address specific components of caring for people in a culturally diverse populated community care area. The poster will display the following: the aim of the course content, title of the course, the venue, and the duration of the course. The poster presentation will contain specific information relating to the subject matter including information on the following: recent and current demographic changes contributing to multiculturalism: Recent developments and changes occuring within Community Nursing and healthcare as a consequence of these changes: Public health data and statistics relating to the subject matter: Migration trends: Refugee healthcare: Intercultural Communication: Working with interpreters.

Title of Poster

Philosophy / mission statement for Renal Dialysis combining the Health Strategy Ms Roisin McLoughlin Ms Bernie Brady Ms Anne McHugh Letterkenny General Hospital / North Western Health Board

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Organisation (s)

Abstract

The Renal Dialysis Unit at Letterkenny General Hospital are revisiting their philosophy / mission statement. We propose in the poster competition to use the analogy of a garden and its contents to represent the elements of our philosophy / mission statement, incorporating the four principle points of the Health Strategy namely equity, people centredness, quality and accountability. Eg: Ivy in the garden - representing the intertwining of the health strategy: An open gate: welcoming people to the Renal Dialysis Unit: A tree representing a patient as part of a family / the multi-disciplinary approach, etc: Bees representing cross pollination of ideas an best practice: Borders and boundaries - representing patient individuality, respect and dignity. The poster content will contain a picture of the garden with identified areas within the garden explained in bullet points to the side of the picture.

Title of Poster

"Shaping our Future" - Clinical Midwife / Nurse Specialists National Maternity Hospital, Holles St. Ms Nicola Clarke Ms Mary Jacob Ms Mary Coffey Ms Kay Hand Ms Mary Moran

Presenter (s)

Organisation (s)

National Maternity Hospital, Holles St.

Abstract

The vision of the Commision on Nursing, developing the roles of Clinical Midwife / Nurse Specialists are supporting 5 clinical areas in midwifery practice, - Diabetes, Lactation (breastfeeding), Oncology, Ultrasonography and Urodynamics. The development of these services are in direct response to service needs, both for clients and staff, as identified by increasing case load and clinical audit / research. We have identified, clarified and developed our job descriptions, with the emphasis on providing an equitable, holistic service to the mothers, babies and families in our care. By improving the support structures for staff and enhancing current best midwifery practices, we are 'shaping our future' in Irish Midwifery Services.

Title of Poster

The Effect of CPR Training on psychological variables of Cardiac Rehabilitation Patients and Their Families. Ms Shirley Ingram AMNCH

Presenter (s) Organisation (s)

Abstract

It is widely recommended that cardiac rehabilitation programmes should include advice on what to do in an emergency including cardiopulmonary resuscitation (CPR) training . A vision of the recent Health Strategy states that “A health system that supports and empowers you, your family and community to achieve your full health potential” is desired. Previous research in which family members only undertook CPR training has shown no adverse effects on anxiety & depression in the family members post CPR, however patients whose family member had learned CPR were significantly more anxious than the control patients. Objectives: To determine the impact on anxiety, depression and perception of control of CPR training for cardiac patients and a family member, participating in an 8week phase III Cardiac Rehabilitation programme. Methodology: 49 CHD patients and 43 significant others (SO‟s) attending an 8-week CR programme were offered optional CPR training during the final week of the programme. CPR training took the form of the 2 hour AHA Family & Friends CPR course. All subjects were evaluated at the start of the rehab programme, the penultimate week and 2 and 10 weeks post programme, using the Hospital Anxiety & Depression Scale and The Control Attitudes Scale. Results: 75% (n=37) of patients and 51% (n=22) of SO‟s availed of the optional CPR training. Conclusion: Psychological aspects of anxiety, depression were not adversely affected by the CPR training & perception of control was increased.

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RESUCITATION - "Would you know what to do? The first two steps are up to you" Ms Mary Lyons Ms Helen Harney Resucitation Training Dept., Portiuncula Hospital

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Abstract

Our poster will include a brief history of Resucitation Training in Portiuncula Hospital and developments to date. As a result of the Cardiovascular Health Strategy, the need for Resucitation training was identified to reduce the avoidabel deaths from cardiovascular disease. In our poster we will outline the aims and objectives of our department. We do this through the various courses available to participants appropriate to their level of functions and practice. We aim to have our poster eye-catching, colourful, informative, with the minimum of text.

Title of Poster Presenter (s)

Post Natal Care Communication Standard Ms Ann Ellis Ms Martina Comrie Ms Paula Curtin Ms Linda O‟Callaghan Post Natal, Maternity Unit, Waterford Regional Hospital ( SEHB)

Organisation (s)

Abstract

Post Natal Care Communication Standard. - Definition of Communication: Communication utilises two main channels - verbal and non-verbal. Verbal: Communication consisting of spoken or written word. Non-verbal: Communication includes paralanguage and kinetics, both can occur simultaneously. Roper, Logan, Tierney 1996. Standard statement. The Standard should be relevant, understandable, measurable, behavioural, and achievable. (Wilson 1987) Mothers and partners on postnatal ward will feel satisfied with the level of communication they received during their stay. Target Group: Mothers, babies and fathers on postnatal ward. Process: Why we decided to look at standard of care on postnatal ward: (1) To audit our practice - evaluate our existing standard of care. (2) Midwifery Development Officer appointed to enhance Midwifery Practice. Audit Procedure and Protocol: Audit protocol consists of: Audit criteria, Audit tools to meet criteria outlined, Audit record, Audit summary, Audit action plan. Aims of the audit: To ensure continuing compliance with Communication Standard. To identify disparity in practice. Summary: Audit criteria was formulated. The source of data for audit criteria was mothers, babies, fathers, midwives, case notes, evaluation questionnaire and evaluation of environment. Principle findings: Positive - Mothers pleased with information given at education sessions. Support and information on breastfeeding was "great". - Mothers satisfied with information given on admission. Negative: Could include fathers more. Bed making referred to as unneccessary. Conclusion: It was agreed by all as a worthwhile initiative. An action plan was developed to address issues that were identified and agreed changes that would take place. The general feeling by the staff was that the process was a valuable learning experience regardless of the outcome.

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Cardiac Screening, a new initiative in Waterford Regional Hospital. Ms Ann Ryan Waterford Regional Hospital

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Abstract

Aims     The aim of the screening programme is to determine the risk factor profile of first-degree relatives of patients diagnosed with Myocardial Infarction and Angina. To ascertain whether the risk factor profile are amenable to change Early detection / Prevention of CHD and Type 11 Diabetes in high risk individuals. Raise awareness of risk factors of CHD

Audit & Evaluation.    Cost effectiveness of early detection/ prevention of high risk populations To determine if relatives and patients of acute coronary syndrome will attend a special screening clinic. Risk factor profile description. i.e. number identified as hyperlipidaemic, hypertensive, NIDDM, smokers, inactive individuals.

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A Bio-Psycho-Social Model in Practice Ms Una Forde Mr Brian Clerkin Cavan Monaghan Mental Health Service

Abstract

The Cavan Monaghan advanced community model offers an innovative approach to psychiatric nursing in the community through evidence-based practice. This allows specialisation by the nurses involved and gives the client an individualised package of care tailored to their needs and those of their families / carers thus providing a real alternative to hospitalisation and reduction in admissions. The nursing personnel involved work as integral parts of a fully functional multidisciplinary team. The management structure of this team is horizontal with the nurse clinical coordinator providing the link between all disciplines. Nurses in this team have developed into independent practitioners in their own right providing assessment (including risk assessment) and delivering integrated packages of care.

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An Experimental Study of Nursing Interventions in the Management of Mouth Care for Patients undergoing Radiotherapy Treatment for Head and Neck Cancers. Ms Wendy Fair Ms Ann Murphy Ms Christine Flusk Ms Jane McCarton Ms Carmel O‟Shea St. Lukes Hospital, Rathgar
Mouth Care – Oncology. An Experimental Study into the Nursing Interventions and Management of Mouth care for Subjects undergoing Radiotherapy Treatment for Head and Neck Cancers. This study sought to compare the use of soda bicarbonate mouthwash against the use of soda bicarbonate mouthwash plus irrigation from the beginning of treatment and the onset of symptoms. The subjects were randomised to one of the three conditions. A quantitative research methodology was carried out with a qualitative appendium. The results were significant for candida and qualitative data suggested that the instigation of the use of an irrigation spray from the onset of symptoms in this group of Subjects would be of benefit.

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Role of the Haemovigilance Officer in the care of patients with Haemophilia and other Coagulation Factor Deficiencies Ms Joanne Taylor Nat.Centre for Hereditary Coagulation Disorders, St James's Hospital

Presenter (s) Organisation (s)

Abstract
A haemovigilance officer was appointed to our hospital in 1997 to carry out surveillance of blood and blood components. The requirement for a specific haemovigilance officer to monitor coagulation factor concentrates was identified as a result of a laborious recall with a specific coagulation factor concentrate in 1999. The aims of this position in relation to coagulation factor concentrates encompasses the education of staff and surveillance of the administration and documentation of treatments. The development, implementation of policies and procedures, review and investigation of near misses and untoward incidents and audit of all aspects of administration are also carried out. The position includes;  Tracing of treatment episodes to include batch numbers.  Working closely with blood transfusion laboratory staff, the haemophilia medical and nursing staff and the data manager  Prediction of requirements of factor usage particularly in the context of possible shortages.  Financial reports of inpatient use. Conclusion: We believe that the contribution of the haemovigilance officer is essential to deliver a comprehensive programme of care to patients with haemophilia and related disorders.

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The Role of the Joint Replacement Nurse at Midland Regional Hospital Tullamore - A quality health promoting initiative Ms Sheena Fitzmaurice Midland Regional Orthopaedic Unit, Midland Regional Hospital, Tullamore

Presenter (s) Organisation (s)

Abstract

Rationale The Midland Regional Orthopaedic Unit at Tullamore is committed to providing a quality service through an integrated approach to care planning for individual needs. This has been demonstrated by the appointment of a key worker the “Joint Replacement Nurse”. This appointment assures a people centred approach responding to those most in need in a planned and coordinated way. Aim To identify those most in need of surgery for hip and knee replacement and streamline the waiting list. Objectives – To identify the current situation in relation to the waiting lists.To identify patients medically fit for knee /hip replacement through a multidisciplinary assessment. To validate and update the waiting lists and assess each patient under fairness and equity. To arrange a system for admissions and planned discharges. To provide a patient education and health promotion service in relation to joint care. To provide follow-up post operatively and create a database of patients which can be traced. To provide a one stop shop for patients, families and service providers. Methodology The patients are assessed using the following tools -Harris Hip and American Knee Score, Hodkins Cognitive Report and the SF 36 Form. Physiotherapists, Occupational Therapists and the Community Rehabilitation Team meet to put a system in place for discharge planning.Patients are admitted within a 4 – 6 week period after being deemed fit for operation. Results The average length of stay has been reduced. Communication between staff and patients has been greatly enhanced providing a more responsive and appropriate service. This has enabled the Midland Regional Hospital at Tullamore to meet their objectives in relation to waiting times for 2002 as set out in the National Health Strategy. This project is a continuous quality improvement initiative.

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"Home when fit" Examining the nurses role in discharge planning and implementing the recommendations Ms Ann Guinan Midland Regional Hospital, Tullamore

Presenter (s) Organisation (s)

Abstract

Background Health care systems are coming under increasing pressure to provide high quality services in an efficient cost-effective manner. Timely discharge planning and early assessment using multidisciplinary involvement with family and patient identifies problems and through effective communication a satisfactory transfer of care between hospital and community can take place. This can prevent premature or avoidable hospital readmission. Aim To examine the role of nurses in discharge planning and implement the recommendations on a pilot ward. Objectives To identify current practice and a suitable method of collection of data To explore how safe effective and timely discharge planning can be achieved using current best practices. To develop an awareness of the importance of early discharge planning among nursing staff. To improve documentation incorporating discharge planning into the initial assessment. To improve communication between all stakeholders imparticular the service users. To implement any other recommendations from the study. Methodology A quantitative research study was conducted over a two-month period commencing February 2001 on a medical ward. A twelve-item questionnaire was developed and distributed to 25 randomly selected staff members with a 76% response rate. When the study was complete an education programme was developed on the rationale for early discharge planning involvement picking up on the information collected. Results Discharge planning has been placed higher on the nurse‟s agenda on the medical ward. A discharge plan/assessment tool has been put in place. This quality initiative is currently being extended to all locations within the hospital through an education programme with Divisional Nurse Managers

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Induction Programme for Health Care Assistants in Caring and Coping Skills Ms Mary Maxwell Midland Regional Hospital, Tullamore

Presenter (s) Organisation (s)

Abstract

Objectives To co-ordinate a comprehensive induction programme for recently appointed Health Care Assistants, which is relevant to their working environment and learning needs. To provide them with information on coping skills and services available to them. Methodology The course participants were interviewed informally so that an appropriate programme suitable to their needs would be provided and to ensure their successful integration to the nursing team. The co-ordinator arranged for a group of speakers from a multi-disciplinary group to cover all aspects of general patient care and provide the participants with information on coping skills and services available to them. Results A two-week comprehensive programme was organised which helped the care assistant examine their role and the importance of quality patient care. There were many topics covered and demonstrations being provided in the clinical laboratory in relation to patient care. Other specialist speakers covered topics such as stress relief and management, violence in the workplace, occupational health issues, infection control and a practical demonstration on hazard identification and incident report.

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A Strategy for Excellence in Haemodialysis Care Ms Aileen Roussell Ms Karen Newsham Ms Bernie Ferrins Ms Carmel McDermott Ms Mary T Gibbon Mayo General Hospital

Organisation (s)

Abstract

When renal failure necessitates regular haemodialysis to live healthily, quality care requires multi-factorial issues to be addressed. We have focused on planning and activating an evolving care process. Our patients experience safe and effective dialysis within current funding conditions. Utilising an adaptation of Orem‟s model, primary nurses and patients develop a partnership, which flourishes as needs are met. Open communication saturates all care decisions. Patient care and educational deficits are acknowledged utilising evidence-based practice and renal nursing expertise. This allows therapy to be managed holistically, in conjunction with analysis of dialysis adequacy and anaemia audit tools. Patient and family are central to all care decisions, the health system engages in appropriate and affordable quality care.

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Early Pregnancy Unit – Women Centred Care Ms Anne Marie Staunton Mayo General Hospital

Abstract

A midwife managed service for women with pregnancy complications of less than 20 weeks gestation, following a referral from their GP or A/E department. In the gynaecology department, the woman undergoes an integrated care process. Midwife and medical assessment, scan, counselling for the woman and partner and an appropriate, agreed treatment plan is activated. Hospital admissions follows, or discharge with follow up care, as appropriate. Statistical data currently monitors the service usage and quality markers are being compared to outcomes. Centralising this service is ensuring women‟s care is individualised, creating a surrounding environment, which is supportive during a highly stressful time.

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The Tidal Model waves of change in Mental Health Nursing Ms Sharon Walsh Ms Frankie Moynihan Ms Marion O‟Sullivan South Lee Mental Health Services

Organisation (s)

Abstract

The use of the Tidal Model as an assessment tool in a community based Mental Health Service. The Model has been researched for 5 yrs in the UK and is now being introduced to pilot sites in Ireland. Tosnu Mental Health Resource Centre is a new Community development in the South Lee Mental Health Services in Cork. We are currently the first acute, Community pilot site for the Tidal Model in Ireland. The Tidal Model is an approach to Mental Health Nursing which places its emphasis on collaborating with the individual and empowering the person by putting their experience of illness and health at the heart of the care plan, thus providing client-centred interventions. The underlying principles of the Tidal Model as an assessment tool envelopes the vision of the National Health Strategy as it empowers the individual, taking their views and opinions into account. It is also in keeping with the National Goal as it facilitates Mental Health Nurses to listen to and accommodate, as appropriate, individual clients wishes.

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Developing a cardiac disease management service in Waterford Regional Hospital using the principles of the Health Strategy. Ms Anne Hennessy Waterford Regional Hospital

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Abstract

Development of Cardiac Disease Management in relation to Heart failure. Since the cardiovascular strategy was launched in July 1999 many new developments have taken place to improve quality of care and outcomes for patients with heart disease. The Cardiac disease management nurse in Waterford Regional Hospital is a new development brought about by this strategy. Aim of service: To provide a holistic evidence based service, which empowers patients and their families to be actively involved in monitoring and managing their own care. To monitor, audit and evaluate this service to ensure continuous quality improvement. There are many facets to this position but the focus of this poster presentation are heart failure patients and the development of a service to meet their needs in Waterford Regional Hospital. According to the Irish Heart Foundation, heart failure is an evolving crisis in Ireland - currently affecting up to 80,000 people. A structured approach can do much to improve quality of life and decrease admissions in those patients. This service is being developed with the principles of the health strategy to the fore.

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Advance Nursing Practice in the Emergency Dept Ms Olivia Smith Ms Nina McCawley Ms Valerie Small Ms Gabrielle Dunne Ms Margaret Keenan Mr Derek Browne St James's Hospital, D 8

Organisation (s)

Abstract

Advanced Nursing Practice in Emergency Care: Advanced nursing practice in Ireland continues to develop the Recommendations of the National Council for the Professional Development of Nursing and Midwifery. One such development has evolved in the Emergency Directorate of St James's Hospital, Dublin. Currently a team of six nurse practioners operate within an agreed framework of protocols and guidelines providing care and treatment for patients with specific complaints and injuries. The practice was founded on the basis of need to improve the quality of service for patients with non-life threatening injuries attending the emergency department. This principle of quality in health echoed in the current health strategy has remained the focus of service provision for our patients. The nurse practioners operate within four keys concepts of advanced practice in nursing {i.e. autonomy, leadership, experts and researchers}. They are fully committed to the development and expansion of autonomous, independent expert nursing practice which coupled with a vision for development and expansion into the future can only serve to contribute greatly to the professional body of nursing and continue to meet the needs of clients/patients. The poster presentation will outline the four key concepts of advanced nursing practice. It is hoped to demonstrate how these concepts are integrated practically in the clinical area of emergency care. Some data regarding audit results, service expansion, numbers of patients etc will be included.

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Day Case Liver Biopsy; Local experience and National Trends Ms Pauline Carroll Ms Noreen Maher Ms Angela Buggy Dr G Courtney Dr G Doherty South Eastern Health Board, St Lukes Hospital, Kilkenny

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Day Case Liver Biopsy; Local Experience And National Trends. Liver biopsy has traditionally required overnight admission to hospital. Day case liver biopsy is increasingly recognised as a safe alternative. We report local experiences at a regional hepatology unit where waiting times were dramatically reduced by moving to a day case model of care (from a waiting time of 4 months in 2000 when 7 biopsies were performed in 2 weeks in 2001 when 42 biopsies were performed). National HIPE date for the 5 years show a low uptake of day case practice (<5% of total biopsies performed nationally p.a.). A telephone survey of units performing liver biopsy in Ireland confirms that very few units operate a routine day case model of care. Given the difficulty in ensuring bed availability it seems unusual that day case liver biopsy has failed to become established in the Irish hospital system.

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The Rising Tide of Hepatitis B in Rural Ireland. A review of Hepatitis B notifications at a Regional Hepatology Unit Ms Pauline Carroll Ms Noreen Maher Ms Angela Buggy Dr G Courtney Dr G Doherty South Eastern Health Board, St Lukes Hospital, Kilkenny

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The Rising Tide of Hepatitis B in Rural Ireland; A Review of Hepatitis B notifications at a Regional Hepatology Unit. Hepatitis B (HBV) has had a low prevalence in Ireland but with increasing numbers of asylum seekers and migrant workers from areas with a high prevalence of HBV, a rise in case load must be expected. South Eastern Health Board figures showed no notifications of HBV in 1996; however 88 cases were notified in 2001, illustrating the trend towards an increase even in a predominantly rural area. We reviewed 54 cases of HBV notified in 2001. The average age of patients notified was 34 with the majority of patients from outside Ireland, 46% from Africa, 22% from Eastern Europe with a significant number from Asia. Language, behavioural and cultural problems emerged. Due to the massive increase in HBV we are developing a nurse-led clinic to address these issues.

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Promoting Safe Practice and Client Centred Care in Manual Handling and Client moving Ms Mary Mahon Ms Aileen Kelly Sr Ann Devine Ms Heather Hogan Sisters of Charity of Jesus & Mary, Moore Abbey, Co Kildare

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Promoting Safe Practice and Client Centred Care in Manual Handling & Client Moving. The Poster outlines the 3 main areas's focused on for the promotion of a safe quality service to staff and clients in the area of manual handling and client moving in the Intellectual Disabilities field. The first theme promotes a minimal handling approach drawing attention to the law, health and safety statements, use of equipment and care and maintenance of quipment. The second theme promotes client safety, dignity, independence and ability which we aim to achieve through each individual having Manual Handling Care Plans and Risk Management Programmes. The third theme is about on going client and staff education and training, multi-disciplinary support and on-site facilitators for staff on the front line.

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Excessive Pre Operative Fasting - Still Custom and Practice in 2002 Ms Noreen O'Sullivan Ms Helen O'Flynn Ms Therese Collins Ms Gobnait Magner Mercy Hospital, Cork

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Abstract

Excessive Pre Operative Fasting-Still Custom and Practice in 2002. Under the guiding principles of the Health Strategy, this poster addresses the themes of people centredness and quality of care delivered. Vision statement "It is to be hoped that the basic human right of having a drink of water, when it is needed, will be possible for all pre operative patients and that the traditional practice of excessive pre operative fasting will soon have disappeared forever" (Hung, 1992) Back Ground: The evidence exists in abundance, however it still remains common practice to keep patients fasting for excessive lengths of time. The Mercy Hospital study: A small scale, practice based study was carried out in the hospital in Spring 2002. The average length of time patients were kept fasting prior to surgery was 13.44 hours. Literature review: A literature review revealed that numerous studies demonstrated that it is safe practice for patients to receive food for up to 6-8 hours prior to surgery and clear fluids 2-4 hours prior to anaesthetic. (Maltby et al, 1993, Phillips et al, 1993, Splinter et al, 1990, Chapman, 1996, Hung, 1992) Actions taken: A multidisciplinary group devised a set of guidelines which come in to practice on October 1st 2002. The guidelines allow patients to take oral fluids up to 2 hours prior to their allocated theatre time and patients are allowed to consume solid food up to 4 hours prior to their allocated theatre time, maintaining good professional judgement at all times. Results: Repeat audit of average length of fasting time will be available early November 2002. Quality of care: Allowing patients to drink pre operatively resulted in a significant decrease in post operative thirst and patients felt better than after previous anaesthetics Gilbert et al, 1995) Prolonged fasting is one of the most common factors contributing to patient discomfort (Cobley et al,1991 & Gilbert et al, 1995) This study prompted a major change in nursing practice which has resulted in a tremendous improvement in the quality of patient care full references available.

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Lead me in the right direction -"Towards Workforce Planning" Ms Anne Gallen Ms Mary Cooke NMPDU NWHB

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Abstract

Workforce planning and its influence on practice development. Workforce Planning is a relatively new concept in healthcare. The need to plan for workforce requirements has arisen as a result of the dramatic shift in the supply of nurses and midwives within the labour market, and has also been complicated by recent economic growth and changes in attitude to the balance between work and life. It was initially highlighted by “ The Commission on Nursing Report-A Blueprint for the Future (1998)”, which identified the need to strengthen the workforce planning function of the Department of Health and Children . In response, the Department of Health and Children commissioned a study in December 1998, to investigate the process of establishing a measurement of the nursing and midwifery resource in Ireland. “The Study of the Nursing Resource “Towards Workforce Planning” (2002)” identified 118 recommendations for workforce planning within nursing and midwifery. “ The Health Strategy (2001) Quality and Fairness – A Health System for You” also re-enforced the need for workforce planning to be introduced to the healthcare system PURPOSE: The purpose of workforce planning is to develop strategies to ensure that sufficient numbers of appropriately qualified nurses and midwives are available for the provision of services and to meet future practice development requirements. The benefits of workforce planning will be that it will contribute to the successful accomplishment of the organisations strategic goals and business objectives. As every strategic goal and business objective within an organisation‟s service plan has a human element, this human element needs to be identified and incorporated into the service plan. Workforce planning will address this and add value to the management of nursing and the development of nursing practice within the North Western Health Board This poster presentation will depict a series of signposts “Towards Workforce Planning”

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The YPC - Promoting Sexual Health among Youth in Ireland - A Nursing Response to Gaps Services Ms Sandra Delamere Ms Ruth Buckley Ms Linda Harrington St James's Hospital, D 8
Background: A gap in service provision was first identified by the Sexual Health Nurse Practitioner in January 2001 and along with two nursing colleagues formed a multidisciplinary team with a medical practitioner and a social worker. The Young Persons Clinic (YPC) was then established in March 2001 at the GUIDE Clinic, St James‟s Hospital. The aim of this service was to provide sexual health care to people aged 18 years and under. Methods To measure the sexual health needs of this cohort of patients and to determine service need, a quantitative study is currently underway with people attending the service. This structured questionnaire explores their sexual, social and drug taking behaviours as well as their experiences of utilizing the service. Results Results from 40 young people, involved in this ongoing study will be presented using descriptive statistics.

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Conclusion This proactive venture offers many challenges and opportunities in sexual healthcare. The dedicated multidisciplinary team approach allows quality time with a potentially vulnerable group of people. The resulting service has already proved itself to be both valuable and successful in detecting sexually transmitted infections and reducing future „at risk‟ behaviour.

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A Nursing Practice Development Unit – Led Needs Analysis for the Implementation of Preceptorship Ms Jennifer Adams Ms Angela Chadwick Ms Marguerite Kearney Ms Amanda Monks Ms Vivienne Vize

Presenter (s)

Ms Maura McGowan

Organisation (s)

Nursing Practice Development, Mater University Hospital Ltd.

Abstract
A needs analysis action research study was undertaken to find out what the staff nurses on the wards (the potential preceptors) required from the Nursing Practice Development Unit. Initially focus groups were held to explore the feelings, perceptions and fears of the staff nurses. This prepared the Nursing Practice Development Unit for the pilot study in relation to supporting and guiding the preceptors. From this a pilot study was undertaken in two different ward areas. Post pilot study a problem-based programme was designed to educate the staff nurses prior to the commencement of the degree programme.

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Aims of Pre-School Service. Ms Deirdre Burns COPE Foundation

Abstract

Challenging Nurses to Co-Ordinate Mental Handling. Aims of Pre-School Service:  To provide an encouraging and stimulating play environment to promote all areas of the child's development  To provide the facility of a pool of professionals that are equipped to meet the needs of the child and family  To provide a supportive and caring environment where parents queries and concerns may be discussed  To provide an environment whereby parents can meet and support one another  To help the parents to understand queries and concerns may be discussed  To provide an environment whereby parents can meet and support one another  To help the parents to understand and optimise their child's development pattern by providing them with concrete and appropriate developmental activities. ROLE OF THE CLINCIAL NURSE SPECIALIST IN PROVIDING A 'PEOPLE-CENTRED' SERVICE.  The Specialist Nurse is a core resource in the development of services and the promotion of health gains'Leonard (1989) :  Through a collaborative approach with other disciplines to plan and coordinate a holistic approach to the individual care of the child from service to home:  Continuous assessments, intervention,evaluations, to contribute to the optimum health of the individual child.: Evidence based practices being central to the care that is provided in an effort to strive for excellence:  Working as clinician, advisor, counsellor, therapist, advocate, advisor, manager, leader, teacher, educator  Through continuous improvement, devising tools that assist in collection of information, and introducing latest research ideas

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Health Promotion in Practice Staff Health Day. Ms Carmel Redfern Sr Helen Maher Ms Mary B. Ryan Ms Anne Quinn

Organisation (s)

St Patrick's Hospital, Cashel

Abstract

Staff Health Day: AIM: The aim of staff Health Day was to promote an awareness in all health care staff in South Tipperary about the importance of looking after their own health and well being and to promote a healthier lifestyle. RATIONAL: The hospital as a health care provider should also incorporate into its culture and daily work the idea of health promotion for its staff and clients. The staff health day was an opportunity to reach as many people as possible. OBJECTIVES: The project aims to provide information to all staff through talks, information stands and health screening. To provide opportunity for individuals to meet professionals or set up an appointment afterwards. To emphasise the importance of health screening. To offer support to staff. To facilitate integration of all different health workers. METHODS: A day was dedicated to health screening. Information was obtained through Information stands and talks. All health personnel informed of the day. Time was made available to enable people to attend. Help was enlisted from different disciplines. Sponsorship was obtained. Health food was provided. Fitness assessments were organised. Questionnaires were filled by participants. RESULTS: Involvement of all staff. Created collaboration between different staff. Abnormal observations detected and referred to GP or relevant body. Increased awareness of benefits of health screening. Promote relaxation and stress management. Dissemination of information. Improve morale of staff.

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Quality Initiatives in Primary Care Ms Mary Cooke Ms Lorraine Porter Ms Donna Gallagher Ms Eileen Gallagher NWHB, Primary Care Development Unit, Sligo General Hospital
As part of the Cardiovascular Strategy GP‟s were encouraged to consider an aspect of their service that could be developed and improved.Three projects aimed at improving services for the practice diabetic population were identified and involved practice nurses setting up diabetic clinics and contributing to the development of a practice protocol based on best practice. The three practices identified their own diabetic population, set up a register, agreed a protocol and then established criteria to carry out an audit. Results were then analysed and interventions agreed. Results demonstate that more structured care is offered as a result of the clinics and the protocol. There is also an improvement in the management and recording of diabetic care. The Health Strategy proposes the introduction of an inter-disciplinary approach to primary care provision and states that community nurses should offer a more responsive and people–centred service.The priniciples of quality assurance and accountability underpin the strategy and that is what was achieved through the above inititives.

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Nurse Led Patient Centred Care Ms Mary Cooke Ms Patricia Maguire Ms Clodagh Keville The Staff of the Medical Unit NWHB, Our Lady's Hospital, Manorhamilton

Organisation (s)

Abstract

Prior to January 2002 Patient Care was delivered through the organisation of tasks by the Ward Sister.Nursing Staff had very little responsibility or autonomy. Through the introduction of Primary Nursing, nurses are now leading care delivery. Patients are more involved in their own care within hospital and in their discharge plan. The Nurses have developed new documentation to support Primary Nursing and the whole approach has rejunvenated patient care plans.

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CSII Therapy: An innovative option for treatment of Diabetes Ms Catherine Flynn Ms Geraldine Neary Ms Blaithin O'Doherty Ms Mary Ryan Diabetes Day Centre, St James's Hospital

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Abstract

Diabetes education and management using Insulin Pump Therapy CSII - Is the delivery of insulin using an electromechanical pump. It delivers a constant basal rate of rapid acting insulin supplemented by insulin boluses. Its advantages include improved glycaemic control, decreased hypoglycaemic episodes, improvements in the Dawn phenemonen and empowerment of patients to improve greater patient autonomy. It is not suitable for patients who do not monitor frequently or those with psychological problems. Over a 2 year period we have initiated CSII 19 patients with Diabetes and we have shown significant improvement in glycaemic control and reduction in insulin requirements. Patients have reported an improvement in quality of life and a reduction in hospital attendance. This translates into cost savings in terms of reducing long term complications and hospitalisations.

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Are Clinical Guidelines Available to assist Evidence-based DecisionMaking? - A multi disciplinary insight into current practice in an acute Irish hospital setting Ms Karen Reynolds Sligo General Hospital / NWHB
Purpose of study To obtain baseline data on clinical guideline activity in an Irish hospital setting. Background - There is a widely acknowledged gap between the evidence base and the delivery of healthcare. Clinical guidelines represent one of the principal means of disseminating best practice and form an integral component in international quality enhancing initiatives. They have the potential to improve patient outcomes by supporting nurses and midwives in the implementation of evidence based care. Method - A triangular methodology was applied, which involved literature review, informal interviews, design and distribution of questionnaires to 100 senior health professionals at Sligo General Hospital. Criteria adapted from the Agency of Healthcare Policy and Research, U.K. Data collection took place during August-September 2001. The quantitative data from the questionnaires returned were collated and analysed using SPSS (Statistical Packages for Social Sciences). The qualitative responses were grouped under broad themes and analysed separately. Results - Responses were received from staff in all acute specialities and clinical areas, with a response rate of 42%. Limited guideline availability was reported. Of guidelines available for local use, over half were locally produced with an unknown source of evidence. Similarly, a structured review process of clinical guidelines was lacking. Almost all respondents believe that guidelines can promote change in professional practice to comply with best practice and would like to see the development of a readily accessible clinical guideline database in Ireland. The findings suggest there are many barriers at local and national level to the effective use of guidelines such as no written advise on how to develop, write or review guidelines. Other reported barriers included poor communication, lack of time and resources. Conclusions - The findings of this study suggest that at present any guideline activity seems to be happening in the absence of a locally agreed strategic framework. Therefore the issues of development, responsibility, dissemination, implementation and evaluation are not being systematically considered. Outside a formal structure, we cannot say as an organisation we are practising evidence based decision making. This ultimately creates a very real problem in the current climate with the drive towards best practice, better accountability, risk management and accreditation. The use of guidelines in a more coordinated approach combined with other clinical effectiveness techniques needs to be explored urgently.

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Appropriate Documentation in Emergency Department empowers the Multi-Disciplinary Team to deliver best quality care Mr James Carroll Ms Ann Morris Louth Meath Hospitals / Louth County Hospital

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The Health Strategy (2001) National Goal No.4 High Performance. This goal refers to quality systems supporting best patient care and safety and ensuring that these systems are maintained and improved upon. Documentation within the Emergency Department which is continuous and includes assessment/triage and patient participation. This will ensure best quality and safety of care of the patient within the department, transfer of the patient and discharge of the patient.

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Empowerment through Partnership in the Care of the Older person Ms Millie Power Nursing Staff, Care of the Older Person, Waterford Regional Hospital SEHB

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Introduction “The concept of empowerment, as it relates to health care, implies that patient independence my be optimised through the provision of care that assists patients to assert control over their lives” (cited in Faulkner, 2001). For some patients, the desire to control their lives has to be respected. For others, the use of empowering strategies may cause undue stress or anxiety at a time in their lives when they are most vulnerable. Many older people in hospital, especially those suffering from confusion or dementia do not have the freedom nor the capability to make rational decisions for themselves. It is crucial, therefore, for others such as family members, with the guidance of the nursing staff, to enable their loved ones to retain their sense of person, through shared care, in „partnership and practice‟. Partnership is the key issue in relationship building and the avenue within which the nurse seeks to understand the needs and aspirations of the older person. Rationale: To enhance quality of care for the older person and their families, by empowering them to make informed decisions and allowing them to become involved and to tailor care to their individual needs, by developing a partnership approach with the nursing staff. Innovation: Lindgren & Murphy (2002), this study found that families are willing to help and are sometimes undervalued as a resource for the care of their relative. However, there is no known precedent for empowering the older person within a partnership innovation in healthcare. This project involves the formalization of informal care contracts between the older person, families and carers, through agreed protocols. It is the nurse who acts as a facilitator in this process by engaging in partnership practice, to achieve common goals and outcomes, thereby strengthening relationships through positive open dialogue and skill sharing. Outcome: Empowerment benefits the older person, carers and nurses. Carers can generate their own ideas, to enhance empowerment and produce a more open, professional approach, therefore enhancing job satisfaction, communication and improve patient care. The emerging theme throughout this poster presentation identifies empowerment for the older person and their carers.

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A Novel Approach to Weight Management Ms Anne Raleigh

Organisation(s)

Midland Regional Hospital, Tullamore

Abstract

Background - Cardiac Rehabilitation is usually considered in four phases. This project is centered on phase 4, which is the long-term maintenance period. It particularly focuses on weight management. The ethos of the project encourages empowerment of the individual. Objectives: To encourage post cardiac rehabilitation clients to maintain health enhancing behaviors. To increase maintenance of healthy weight by a holistic approach of reviewing participants lifestyle and formulating an individual plan tailored to the participant‟s needs and capabilities. To achieve and maintain a healthy weight. To increase maintenance by establishing a program, which is, local, accessible volunteer led by the Midland Cardiac Support Group. To empower Midland Cardiac Support group to address cardiac risk factors. Methodology: A partnership was formed with relevant stakeholders /health professionals. The program was advertised and a invitation to participate was issued to post cardiac clients. Some participants were selected to act as Peers and training was provided in Food & Nutrition and Walk/Exercise Leadership. Individual assessments and programs were drawn up for each participant. Lectures/seminars on healthy living, nutrition, smoking cessation and shopping tours were organised. Results:Individual assessments were recorded which will be repeated after 3 months. Conclusions: Assessments and analysis of findings will be available in September

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Introduction of a „Rest Period‟ in the Intensive Care Unit Ms Mary Dunne Ms Catherine O'Keefe

Organisation(s)

Midland Regional Hospital, Tullamore

Abstract

Staff in the ICU are committed to providing a service which is based on „equity people centredness‟, quality and accountability as set out in the recent National Health Strategy. Promoting rest and sleep is an important area of nursing practice, with physical and emotional health dependant on the ability to fulfil these basic needs. Due to the intensive individualised care and monitoring that patients receive in the intensive care unit, the amount and continuity of sleep are affected, and patients often suffer from sleep deprivation. It is universally agreed to many commentators‟ that sleep is related to healing. Impaired protein synthesis, cell division, and cellular immunity all affect the healing process and can thus contribute to increased morbidity and mortality. Aims: To introduce suitable rest period for patients, at a time convenient to all those delivering services to the ICU. That patient in ICU would receive maximum rest with minimal disturbance. No patient would miss out on any diagnostic or therapeutic intervention because of the rest period. Methodology: Management commitment was sought. Letters were then sent to all relevant stakeholders informing them of the rationale for the initiative and seeking there co-operation and compliance. In consultation with the Catering Department it was agreed that lunch for those patients eating would be delivered at 12.30pm, half an hour earlier than usual. Laminated signs indicating rest period times were displayed appropriately. At the appointed time blinds are drawn, lights are turned off, and environmental noise and distractions reduced to a minimum. Where applicable analgesics are administered 30minutes before the rest period begins. Results: Since its introduction, compliance for the rest period is very good. Patients, relatives, staff and multidisciplinary team members are responding very positively to it. Patients look forward to the rest period, relatives‟ express having time for themselves and do not feel compelled to have to visit in the afternoons, and staff use the time and opportunity to write up reports. Conclusions:This quality patient centred initiative has no cost. Cooperation of all stakeholders is crucial. The effectiveness of this initiative will be evaluated in the near future with the clinical audit team.

Title of Poster

Standardised Nursing Assessments for Older People ( in long-stay care) Ms Mary Dunne

Presenter(s)

Organisation(s)

St. Vincent's Hospital, Mountmellick, Co Laois

Abstract

A comprehensive process, of systematic assessment for older people, is essential if we are to adequately meet their individual and distinct, nursing care needs. The aim of the initiative was to introduce a series of assessment tools, to ensure that on admission, patients will have their nursing care needs assessed, using a standard format. This serves to guarantee, that needs assessment and subsequent planning of care, is equitable for all patients. The process involved: establishing key areas where assessment is required; identifying current practice in other hospitals, regionally; consulting with nursing staff in regard to selection of assessment tools; and implementing and evaluating, the new system. Nine areas of assessment were prioritised. Seven established assessment tools were introduced and two other tools were developed locally. The system was phased in, over a four-month period, commencing April 2002. Preliminary evaluation of the project is currently underway.

Title of Poster Presenter(s)

Clinical Audit of Australian Triage System. Ms Emer Mc Evoy

Organisation(s)

Midland Regional Hospital, Tullamore / MHB

Abstract

The Australian Triage System has been in operation for six months at the Accident and Emergency (A/E) Department of the Midland Regional Hospital at Tullamore (Midland Health Board). This Department has an average of 20,000 patients attending per annum. This is the first A/E Department in the Republic of Ireland to adopt this System. The departments‟ staff wished to review the operation of this system with a view to improving its‟ quality and effectiveness. The results of the audit will be used to inform and educate nursing staff of the benefits of the Australian Triage System and will act as a baseline from which to continuously improve. The waiting times per triage category will also provide important information for Management in the Health Board and will fulfil the requirements for the National Performance Indicators in Emergency Medicine.

Title of Poster Presenter(s)

Scale of pain - Act on what we know! Ms Ruth Lernihan

Organisation(s)

South Infirmary - Victoria Hospital Ltd.

Abstract

Pain management: Pain is subjective (McCaferkey, 1990). Preconceived notions of what the patients pain should be like still perpetuates. The development of a combined numerical pain scale and pain diary has gone some way towards addressing patients pain relief needs. This nurse led initiative has resulted in the improvement of the quality of pain management in our health care setting. Pain relief is administered on a PRN or set time basis which is generally associated with the drug round times. This practice encourages the behaviour of questioning patients regarding their pain status at these times but does not encourage evaluation of the effectiveness of the pain relief intervention. Therefore, re-evaluation of patients pain status may only occur during the next drug round at which point it may be discovered the patient did not have relief from pain during the intervening period. If patients report pain at each drug round the adequacy of analgesic prescription must be questioned. Graphically plotting patients self reports of pain and the evaluation after pain relief intervention gives, at a glance, an indication of patients pain patterns thus promoting individualised pain management. Analgesia can be prescribed to meet patients individual requirements. The use of the pain diary can indicate aggravating and relieving factors. Medication may not be the only relieving factor for patients, a change of position or massage may be adequate. Patients with chronic pain are assessed using a personalised Initial Pain Assessment chart on admission, which indicates our acknowledgement of their pain and our aim to work with them to meet their needs. Positive feedback has been received from this nurse led pain management initiative. Patients have reported the acknowledgement of their pain as being a significant factor in dealing with pain. They feel empowered and involved in their pain management. This practice development enhances individualised patient focused care while improving the quality of care provided to the patient.

Title of Poster

Implementing a system which measures Acuity / Dependancy at Unit level which empowers managers to efficiently and appropriately manage Manpower and Resources Ms Sharon Nodznaia Ms Ann Morris

Presenter(s)

Organisation(s)

Louth Meath Hospitals / Louth County Hospital

Abstract

The Health Strategy ( 2001) National Goal: No.1. Responsive and Appropriate Care deliverance. No.2 High Performance - The National Strategy outlines that we who deliver the service must provide accountable systems which are appropriate, responsive and ensure high performance. Managers must use evidence based tools which assist in appropriate and effective decision making. These decisions ultimately ensure that the service is patient / client focused and operates in partnership with staff and organizational needs.

Title of Poster Presenter(s) Organisation(s) Abstract

Utilisation of a Clinical Nurse Specialist role in a Clozaril clinic Mr Pearse Finegan Ms Marie Tuohy

WHB / Mayo Mental Health Services / St Mary's Hospital., Castlebar This year we will be presenting a poster presentation on utilisation of a Clinical Nurse Specialist role in a Clozaril clinic. This will take the form of an audiovisual presentation with poster background and the Clinical Nurse Specialist who is involved in the Clozaril clinic will also attend. Clozaril is an anti psychotic medication used in the treatment of drug resistant schizophrenia. This illness is both crippling and enduring for the person involved and their family. Because of the severity of the illness and the control and monitoring that is associated with the administration of this medication, a decision was taken to set up a specialist clinic to help improve the quality of life of the patients receiving this medication and their families. The role of the Specialist Nurse in the clinic is to 1. assess suitable clients for Clozaril 2. provide education information on the treatment for the users and their family 3. provide continuity of care in an environment away from the hospital 4. provide personalised nursing care plans 5. enable, empower and encourage the user on a one to one capacity and in the users Support Group 6. provide an ongoing education and support of family in our Carers Support Group. This presentation will be made by Marie Tuohy, CNS, Occupational Health Dept., Mayo Mental Health Services, Castlebar.

Title of Poster Presenter(s)

Home First - Care of the Elderly Ms Angela Kennedy Ms Margaret Barrie Ms Deirdre Smyth

Organisation(s)

Public Health Nursing, Northern Area Health Board, Coolock Health Centre, Cromcastle Rd, Coolock, Dublin 15

Abstract

Home First is an Action Plan, supported by E.R.H.A. since the year 2000 to deliver services to older prople in their homes and in their communities. The Home First project seeks to develop comprehensive home packages of care that will provide the increased level of home support to enable older people to continue living at home. KEY OBJECTIVES:  To enable older people after discharge to return home.  To improve levels of home based services to older people to remain at home where this is their choice.  To develop a seamless and integrated partnership between the primary care team, other agencies and the acute hospital to ensure the delivery of quality care for older people.  To develop quality assurance systems in all care settings.  To develop a consultation process and evaluation of services by all people concerned, ensuring that older people contribute to decision making in a more equal and meaningful way. The poster content will include:  Background and origins to the Home First Programme.  Objectives of Home First.  Roles of Care Teams.  The assessment Process.  The assessment Flow Chart.

Title of Poster Presenter(s)

Steps to a Quality Audit Ms Joan Brosnan Ms Mildred Keyes

Organisation(s)

ANMCH

Abstract

The increasing demand for greater efficiency and effectiveness in the health service has positioned quality improvement at the top of the agenda for health service providers. The nursing management and nursing staff at the Adelaide and Meath Hospitals incorporating the National Children‟s Hospital gave full commitment and support towards conducting an extensive audit of nursing practice. In line with the National Goal No 4 : High performance; a large scale audit was conducted to identify existing standards and to ensure that quality and continuous improvement are embedded in daily practice. The audit was not a punitive check on nursing practice but an opportunity for growth where all nursing staff will have the chance to participate in developing and improving nursing within the hospital. It was decided to use monitor 2000 as our Audit tool; it covers a wide variety of nursing issues. Audit information is obtained from three main sources, the patient, the nurse and the documentation. To lessen the risks of problems occurring during the audit it is imperative that the steps necessary prior to the audit were comprehensively completed. The audit inpatients were audited. The necessary steps are outlined in our poster presentation.

Title of Poster Presenter(s)

Health Promotion Information Boards Intitiative Ms Denise Comerford Ms Kirsten Doherty Ms Hilda Gallagher

Organisation(s)

Dept of Preventative Medicine & Health Promotion, St. Vincent's University Hospital

Abstract

St Vincent's University Hospital is a full member of the Irish Health Promoting Hospital Network. The hospital employed a Health Promotion Co-ordinator in 1997. Health promotion boards were placed at several locations in the hospital and a series of twelve topics was developed. Theses highlight SVUH as a health promoting hospital, and give clear correct health information to staff, patients, and the community. These topics have been developed with the help of specialists from various departments within the hospital and with the support from the Health Promotion Department, East Coast Area Health Board to allow change on a monthly basis. They have been well received and the original designs are being developed into poster format with the assistance of a graphic design team. Various sizes are available. This has been a successful HPH initiative, with good feedback from staff and visitors. Back up material is available and taken from dispenser. Posters have been made available to local GPs for display in their surgeries.

Title of Poster Presenter(s)

Empowering Nurses-Improving Care Ms Rosaleen Murnane Ms Darin Hines Ms Maria Meehan Ms Fridolin Kerr Ms Anne Mc Donagh Ms Eileen Molony Ms Yvonne Mulligan

Organisation(s)

Mater Misericordiae University Hospital Ltd.

Abstract

Keeping in mind the National Health Strategy launched in November 2001, the nursing project team in the Management Services Department of the Mater Misericordiae University hospital are in the process of introducing and implementing an integrated nursing information system (INIS) in accordance with the objectives of the hospital's Information Technology (IT) programme. INIS is an automated system, which will provide for the integration of the information needs and support the workflow and decision-making processes, which enable nurses to deliver optimum patient care. The foundation system components of INIS include an automated nursing documentation system (not yet developed) integrated and linked with an automated patient dependancy and nurse rostering / scheduling systems. Two of the systems: patient dependancy and nurse rostering / scheduling which are integrated, are both currently operational within the hospital. This poster will outline and demonstrate graphically the concept of INIS currently being introduced by the nursing project team in the hospital.

Title of Poster Presenter(s)

Clinical Audit of the Management of Stroke at Sligo General Hospital Ms Una Moffatt Ms M. Saba Ms Karen Reynolds Ms P Hickey

Organisation(s)

Sligo General Hospital

Abstract

Stroke remains the 3rd leading cause of death in most developed countries. It is a worldwide problem and approximately 4.5 million people die from stroke each year. Although stroke can occur at any age, it is predominantly a problem in old age with most events occuring in people over 70 years.The stroke service at Sligo General Hospital was initiated in January 2001 with the appointment of a Consultant Geriatrician. Following the appointment of a CNS in stroke care in January 2002, an interdisciplinary stroke team was established to develop protocols for the management of stroke patients.

Title of Poster

THE INTRODUCTION OF A SMOKING AWARENESS PROGRAMME FOR ALL WARD STAFF IN A LARGE TEACHING HOSPITAL Ms Hilda Gallagher Ms Denise Comerford

Presenter(s)

Organisation(s)

Dept of Preventative Medicine & Health Promotion, St Vincents University Hospital

Abstract

St. Vincent‟s University Hospital launched a smoke free policy in February 2002. To support this policy a 30 minute PowerPoint presentation on Smoking Awareness was developed and presented at ward level.
Aims and Objectives of the presentation were  To increase staff‟s knowledge of the health effects of smoking and the smoking cessation services available for patients, staff and the public.  To increase the number of smokers referred to the service.

Title of Poster Presenter(s)

Smoking Cessation – A visual Approach Ms Carol Pye Ms Denise Comerford

Organisation(s)

Dept of Preventative Medicine & Health Promotion, St Vincents University Hospital The Department of Preventive Medicine at St Vincent‟s University Hospital runs various Education and Training days for health professionals. As part of this service a display table was developed to demonstrate in a visual form: (1) the facts of what is contained in a cigarette and (2) the illusion created by the cigarette companies around cigarette smoking. The Illusion section displays cigarettes against a background of glamour, image and success. The Facts section displays various wellknown toxic household and industrial agents a component of which is known to be contained in tobacco and smoke. Tobacco is displayed in various forms, eg. plugged flaked, rolled and snuff. Cigars also feature in this display. This presentation has been used in various settings. Because of its visual impact and interactive technique it has created curiosity, invited interest and raised awareness in a friendly, non-confrontational way. It is a simple and cost effective way to connect with all age groups and with all socioeconomic groups. It minimizes language difficulties and has the potential to be adapted and developed further. A PowerPoint and slide presentation has also been developed.

Abstract

Title of Poster

Robert Mayne Day Hospital ( St. James's Hospital) - User satisfaction survey; a review of current service delivery and identification of unmet needs. Ms Catherine Kirby Ms Clare Daly D Coakley C Cunningham N Kennedy C Murphy C Walsh & JB Walsh

Presenter(s)

Organisation(s)

Medicine for the Elderly, (Medel),St James Hospital & Dept of Statistics, Trinity College, Dublin

Abstract

The objective of the study was to identify the unmet needs of users and as a result, to improve the current service provided at Robert Mayne Day Hospital, ensuring high quality standards are maintained and enhanced while developing stronger links with the community. Wide consultation within and outside medicine for the elderly was used. The project was sponsored by the Health Services Partnership Forum, and espouses the ethos of partnership through it's commitment to the delivery of a patientfocused quality service. Wide consultation was used across all employee groups, which is likely to result in a commitment to new forms of work organisations / service delivery. The survey is co-authored by C.Kirby (Project Leader), C. Daly (Database Co-ordinator), 3 Consultant Physicians in Medicine for the Elderly, one senior Nurse Manager and Statistician.

Title of Poster Presenter(s)

The role of direct interviewing in blood donor selection Ms Tina Selby Ms Roisin Brady

Organisation(s)

Irish Blood Transfusion Service

Abstract

The IBTS has undergone significant change and development in recent times. It's main objective is to collect, test and supply blood and to ensure it is as safe as possible. Ensuring a safe blood supply is determined by three stages (1) Selection of potential donors (2) Testing, and (3) Leukodepletion. This paper looks at the area of selection of potential donors. In 2000, the IBTS, in line with the Council of Europe Guidelines and best international practice introduced an interview process for new and lapsed blood donors (ie. Donors that had not donated within the last 2 yrs) The purpose of the interview is to maximise donor recipient safety. RGNs were introduced to the blood collection clinic to implement the interview process, following completion of a training programme.

Title of Poster Presenter(s)

Irish Network of Multiple Sclerosis Nurses Ms Jacqueline Scott Ms Mary O‟Grady Ms Anna McCarthy Ms Breeda Dreelin Mr Noddy Dempsey Ms Debbie McCardle Ms Mary Blake Ms Eithne Mitten Ms Joan McCormack

Organisation(s)

Irish Network of Multiple Sclerosis Nurses

Abstract

The poster explains that the Irish Network was set up in 2002 following the sanctioning of Clinical Nurse Specialists posts in Ireland. We, as a group, have been working together in the field of MS long before and have been attending both conference and study days in relation to same which has brought about dissemination and exchange for both information and ideas in the overall care of people with MS. The purpose of the poster is to inform health care professionals of our existence and highlighting the association both locally and nationally. The poster itself will include our Mission Statement and Terms of Reference contact information for our members and associate members and statistical information on MS in Ireland. Finally, we were proud to include that four members of our group have succeeded in gaining International Certification in Multiple Sclerosis this year, we are the first Nurses outside the USA to acheive this.

Title of Poster Presenter(s)

Self-medication: Implications for practice Ms Catherine Deegan Ms Fiona Connaughton St James's Hospital, D 8 Ms Anne Lowney Ms Grainne Nestor Ms Anna Watson Ms Charlotte Conlon

Organisation(s)

Abstract

Nurses working with the elderly population here in St James's Hospital frequently observed that a neglected area of patient rehabilitation and dischage planning was whether a patient could manage prescribed medication, resulting in patients being discharged home with inadequate knowledge of their medications, or with packaging they could not open. This often resulted in poor adherence to drug regimens and early readmission to hospital. One way to address this shortfall in service need and to ensure a more holistic overview of the rehabilitation process was to introduce self-medication, which was initiated and led by Nursing Practice Development but has primarily involved the participation of nurses at clinical level, who have been actively involved in the formulation of a protocol and education material to support the programme. To date the following advantages of self-medication have been realised 1) The ability of nurses to establish whether patients can manage their drug regimen before discharge. 2) The provision of a systematic format for patient education . 3) Encouragement of patients to take responsibility for their health. 4) The promotion of patient independence and autonomy. Increased patient participation in their own care. 5) A greater adherence to medication regimes on discharge. 6) Decreased redmissions related to poor adherence to prescribed medication. Self-medication is about empowering the patient to be in charge of his / her medication. By promoting patient independence, confidence and selfesteem are raised. In addition, by encouraging a greater degree of flexibility in the timing of medications, ritualistic practices are discouraged and patient centred care is promoted.

Title of Poster

Women's Bodies / Women's Minds - A sexual health promotion Project with women who have experienced mental health problems. Ms Mary Whelan Ms Denise Proudfoot St Vincent's Psychiatric Hospital, Area 7 Mental Health Services & School of Nursing, DCU

Presenter(s)

Organisation(s)

Abstract

This poster presentation will present a nurse-led sexual health course designed for women who are accessing psychiatric services. The course was devised by a group of mental health practitioners to meet the need to address sexual health issues in a safe forum for female service users. The aims of this course are to increase;      Self awareness. Knowledge of body functioning, sexual health, support networks and women‟s health services available. Sense of responsibility and value around themselves as women. Repertoire of appropriate self-care and help-seeking behaviours. Confidence in discussing health issues relating to women.

Included in the poster will be;        Rationale for the course Course delivery, content and style Referral process Pre and post course assessment methods and course resources Course Evaluation Feedback from participants Future developments

Title of Poster Presenter(s) Organisation(s) Abstract

IIntegrated Care Pathways /The Galway Experience/North South experience. Ms Tina Howard University College Hospital, Galway To develop integration of care Pathways as a quality improvement initiative and improve communication between the multidisciplinary teams/link with our northern partners. This poster outlines efforts made to:




Develop Multidisciplinary Integrated Care Pathways of patient care and forge links between the multidisciplinary teams.
Develop links with our northern partners in the Royal Hospital Belfast.

Definition: Integrated Cares Pathways: A multidisciplinary case management tool and a clinical audit tool. Integrated Care Pathways enable a multidisciplinary team (doctors, nurses, social workers, phlebotomist, x-ray, Technicians, etc) to coordinate the delivery of care by setting out all the activities of the various disciplines involved in the care of a patient, within an expected time frame. In this way all the activities occur in a synchronized and integrated manner, leading the patient towards the desired clinical outcome. The aim of this project is to develop Multidisciplinary Integrated Care records within University College Hospital Galway./Forge links with the Royal Hospital Belfast. This process of care has been ongoing in the United Kingdom and Northern Ireland over the past ten years. Modeled on similar systems in the UK and US it has proven to be a successful tool in the management of patient care and proven as an effective tool in gathering information for research. Integrated Care Pathways have been proven to be effective in:  Gathering information for research and audit  Accountability and reporting mechanisms.  Continuously improving the quality of services.  Safeguarding high standards of care.  Demonstrating clinical / cost effectiveness and best practice. Reducing the following  Delays  Fragmentation in the service  Duplication  The degree of centralization. Integration means crossing boundaries between  Different clinical professionals  Primary, secondary & tertiary care.  Organizations and professions  Managers and clinicians  Health and associated agencies.  Stages of the care process  Generalist, specialist and continuing care. This project was identified because  Excess variations in care patterns and outcomes.  Poor record keeping and communications.  Time wasted on unplanned activities  No consistent basis for audit  Professional barriers.  Poor staff moral due lack of imput into the planning process.  No consistent framework for dialogue.  Inefficient use of resources. The aim of this poster presentation - To outline areas where care pathways have been developed within the hospital. To outline aims of the pathway and where benefits have been gained.

Title of Poster

Responding to service user needs -Developing a Patient Information Booklet for ICU relatives/clients across three Acute Settings. Ms Regina Cleary

Presenter(s)

Organisation(s)

Midland Regional Hospital, Tullamore

Abstract

Background: The Midland Health Board participated in the National Patient Perception of the Quality of Care Survey in 2000. The results indicated that only 7.3% respondents received printed information about hospital routine and 55% were told nothing thereafter. One in eight felt their family/friends did not receive enough information about their condition/treatment. As a result the three Acute Hospital sites developed a patient information booklet, which contains information in relation to hospital routines and discharge procedures. Intensive Care Staff decided to develop an information booklet, which will provide explanation and reassurance to family/friends. The booklet will be given to relatives/friends at the earliest opportunity allowing staff to deal with the patient. Aim: To develop a patient information booklet for ICU relatives/clients for 3 Acute Settings. Methodology: A draft booklet was developed and circulated to the multidisciplinary team of ICU specialists across the three sites A copy was piloted with relatives and changes made accordingly. The booklet was designed to appropriate reading level with an additional CECA insert. The booklet provides information, which is easy to read, and includes the most commonly asked questions by relatives and friends. Results: The booklet is currently in the printing process. This initial pilot indicated that the booklet was very much welcomed by service users. The initiative is people centred supporting and empowering individuals to be fully informed.

Title of Poster

The evolving role of the Healthcare Assistant-Healthcare Assistants Experiences in the Midland Health Board Ms Mary Doolan Ms Gene Gallagher Ms Vera Kelly Ms Margaret Parkinson

Presenter(s)

Organisation(s)

Midland Regional Hospital, Tullamore

Abstract

Longford/Westmeath General Hospital was chosen as a pilot site for the Health Care Support Course for health care assistants in November 2001. This course was a National Council for Vocational Awards (NCVA) level 2 certificate. The course was supported and funded by the Department of Health and Children. The course consisted of approximately 225 hours theoretical instruction and 450 hours clinical practice in the acute hospitals. Eighteen healthcare assistants completed this course. Methodology: The Health Care Support Course (NCVA- level 2)The course consisted of eight modules and each module was equivalent to one credit. Eight credits were required to achieve the level 2 certificate. The eight modules included three mandatory modules, two general studies modules, two elective modules and one work experience module. The modules were as follows: Care skills; Care support; Safety and Health at Work; Palliative Care;Communications; Nutrition; Introduction to nursing; Work experience.Each module consisted of assessment criteria. The theoretical components of the assessment included projects, examinations and oral presentations. In addition participants‟ clinical skills were assessed in the clinical area. The philosophy, underpinning the course related to the principles of adult learning capitalizing on participants‟ previous experience. The course challenged participants to move to increasingly advanced stages of personal development through experiential and problem solving learning approaches. Hence participants enhanced their existing knowledge recognizing their limitations in relation to patient care and always worked under the supervision and guidance of a registered nurse/midwife. Conclusions: The course finished at the beginning of May 2002.A national evaluation of the course was conducted by the University of Ulster and was published in September 2002, and conclusions will be presented when available. Participants are eager to establish their contribution to patient care and will speak on their individual experiences to date. Ms. Gallagher will speak about her evolving role in a surgical ward, Ms Kelly will speak about her role in a medical ward and Ms. Parkinson will speak on her evolving role in a maternity ward. It is anticipated that future courses will be established

Title of Poster

Intellectual Disability and Challenging Behaviour - A Development in Practice to enable Service Users achieve Quality in Living Mr David Quinlan Ms Majella Smith Ms Mary Fitzgerald

Presenter(s)

Organisation(s)

COPE Foundation

Abstract

Challenging behaviour among people with intellectual disability is an area of increasing interest to service providers, families and health care workers. Such behaviours can lead to placement breakdown, limited access to ordinary community services, disruption to family life, and injuries to the person with challenging behaviours as well as others. [Emerson 1993]. The importance of training staff to manage challenging behaviour has been acknowledged by [Kiernan & Qureshi 1993, Emerson et al 1993]. Despite this, training in this area has been limited. Following surveys of challenging behaviour among the client population in our service, an educational programme entitled “Understanding and Responding to Challenging Behaviour” has been developed and delivered to staff. This programme has been and continues to be availed of by staff within COPE Foundation and other intellectual disability service providers in the Southern Health Board region. The programme aims to develop good practice skills in staff, which will enable them to prevent and manage incidents of challenging behaviour. It will also provide the person engaging in socially inappropriate behaviours with the best possible care, welfare, safety, and security during any challenging behaviour episode. The competencies gained from this programme will enable staff to support people with challenging behaviour, to achieve their full potential and maximum independence, including living within the community as independently as possible. This embraces the philosophy of the Health Strategy as outlined in the Department of Health and Children‟s 2001 document - “Quality and Fairness a Health System for you” by: promoting the person‟s health and well being, increasing equitable access to normal community facilities, appropriate care is delivered in appropriate settings, interventions are person centred, and the person‟s care and safety is supported. This poster presentation will give an overview of all the aforementioned.

Title of Poster Presenter(s)

MAU Responding to Needs - All in a Day Ms Mary Feeney Ms Jean Walsh Ms Mary T Gibbons Ms Fiona Gilraine Ms Martina Goldrick Ms Caroline Kavanagh Ms Monica Quinn, Ms Caroline Noone, Ms Karen Newsham

Organisation(s)

Mayo General Hospital

Abstract

In Mayo, people newly diagnosed with diabetes can travel sixty miles to attend the hospital. Nurses have developed an integrated multidisciplinary service to respond promptly to manage the health needs of these patients. „All in a Day‟ takes place in the medical assessment unit. Each person is holistically assessed care is planned, activated and evaluated before discharge home. The patient with a family member has consultations with multidisciplinary specialist diabetic personnel, investigations completed, educational support is initiated, and liaison relationships activated. Priorities include early assessment of risk factors such as diet issues, foot and eye care. Minimisation of hospital stay and visits is being analysed, patient satisfaction monitored. Quality markers are being utilised to continually appraise effectiveness.

Title of Poster Presenter(s)

Womens Support Group Project Ms Mary Kerrigan Ms Lisa Preece Community Mental Health Centre, Green Rd, Mullingar

Organisation(s)

Abstract

Delivery of Therapeutic skills in a group setting / community day centre for service users – Rationale: Literature has shown that the relationship between peers is important, rejecting or accepting one another, knowing how psychiatric disability is experienced, the effects of stigma and mental health treatment ( Wilson et al 1999). With this in mind, it was decided to trial a women's support group at the Mental Health Centre, which would be initiated by staff following an approach used by Wilson, Flanagan & Rynders (1991). The members themselves would then facilitate it. – Aims: To develop a women's support Group using Wilson, Flanagan & Rynders (1991) model. Objectives: To increase independence and encourage an individual sense of responsibility. - To establish supportive relationships - To widen local social networks - To stimulate active participation - To promote integration within the community. Results: The Women's Support Group was facilitated by the Nurse and Occupational Therapist for the first 8 sessions - and members were empowered to run the group themselves. References: Wilson, MF, Flanagan, S & C Rynders C.(1999) The friends program: a peer support group model, for individuals with a psychiatric disability. Psychiatric Rehabilitation Journal. 22(3)p.239-247.

Title of Poster Presenter(s)

"Suantrai" Ms Louise McDermott Sr Marion Harte Ms Jacinta Mulhare Ms Mary Reynolds Ms Theresa O'Loughlin Ms Breda Noonan

Organisation(s)

"Suantrai" Early Services, St Vincent's Centre, Navan Rd

Abstract

RNMH led Early Intervention for children with intellectual disabilities. - In keeping with the vision portrayed in the recent Health strategy, our poster aims to inform how a small RMHN led Early Intervention Service for children with intellectual disabilities moved forward. From a wholly centre-based service with little family involvement, we have moved to a more integrated, child-focused service, which acknowledges the central role of the family around the child. Working in partnership with families and the Multi-disciplinary team, we aim to offer a wider choice of services. Since September 2000, we have expanded our service by introducing community RMHN support. We are also developing 'Portage' home intervention as an option for families and have introduced Parent / child group sessions, while retaining the best of what was achieved by our predecessors. We believe our practice to be developing in line with the Health Strategy and wish to submit our poster outlining same.

Title of Poster Presenter(s)

Clinical Nurse Specialists in the area of Intellectual Disability Ms Susan Kenny Ms Catherine Doyle Ms Ann Marie Slattery Ms Phil O‟Brien Ms Triona O‟Connor Ambrose Ms Phil O‟Regan Ms Dorothy Kavanagh Ms Ann Lees Ms Norma McCormick Ms Fidelma Martin Ms Breda Jones Ms Paula Ryan

Organisation(s)

St Vincent's Centre, Lisnagry, Limerick

Abstract

Clinical Nurse Specialism - As Clinical Nurse Specialists in the area of intellectual disability, we aim to provide a service of quality and expertise, utilizing our specialized skills and experiences, to our service users, their families and our colleagues. In the area of intellectual disability we use various nursing models to assess, plan, implement and evaluate. This forms the baseline from where intervention begins, future recommendations are drawn and which goals and objectives are set for individual service users. We are commited to furthering our education. We provide specialised support and resource for families, colleagues and other members of the multidisciplinary team, through in depth knowledge and expertise. Audit and research is carried out through clinical practice, documentation, and review of current literature. We are currently involved in the development and revision of standards and current practices. The person with intellectual disability is the focus or our care and we, as clinical nurse specialists are at the nucleus of this delivery.

Title of Poster

Promoting Strategic Patient Care at St Mary's Orthopaedic Hospital, Cork Ms Margaret Ryder Ms Geraldine Lane Ms Mary O'Sullivan

Presenter(s)

Organisation(s)

St Marys Orthopaedic Hospital Cork

Abstract

Promoting strategic patient care at St Mary's Orthopaedic Hospital,Cork. To outline the introduction of standardised patient nursing care plans at St Marys's Orthopaedic Hospitl, Cork. The principles of people centredness, quality and accountability are reflected in this initiative. The care plan represents responsive and appropriate nursing care and places the patient centrefold to the care planning process. A standardised patient care plan which has been developed using evidence based principles ensures quality and safety. Nursing accountability is transparent. The initiative is also the first step in the development of integrated care pathways at the hospital.

Title of Poster Presenter(s)

Raising Bowel Cancer Awareness through Innovation Ms Susan Moore Ms Marian Doran Ms Mary Cooke Health Promotion Co-ordinator Project Team ( Hospital Staff, Community Staff) Sligo Stoma Support Group NWHB, Sligo General Hospital

Organisation(s)

Abstract

Raising awareness of Bowel Cancer.Health promotion, health education and stoma care. Earlier this year a campaign was launched to promote health and well being in people who have experienced bowel disease resulting in a stoma and to raise public awareness with respect to bowel cancer. The objectives were to:       Help break the taboo/silence surrounding bowel disease Enhance well being for people with a stoma. Raise awareness of bowel cancer amoungst the general public. Encourage people to seek early consultation with health professionals. Launch a check list of indicators of bowel cancer. Initate a media campaign on bowel cncer & living with a stoma.

In order to achieve the above, a partnership group was formed, including hospital,community health professionals and members of the stomasupport group. This poster will focus on the main event which consisted of an evening event open to the public with innovative approaches including the presentation of a play "Living with bowel disease", fashion and beauty consultant. Ms Celia Larkin discussed body image, personal reflections of bowel cancer and other multimedia information giving. Approx 270 people attended.

Title of Poster Presenter(s)

Making a Difference for People Diagonised with a Brain Tumor Ms Shona Beattie Ms Anne Lynch-Pope

Organisation(s)

Beaumont Hospital (Neuroscience Nursing Dept)

Abstract

Making a Difference for Patients diagonised with a Brain Tumor. Being diagonised with a brain tumor can be a very traumatic experience for patients and their families. They face fear and uncertainty. Our role as Cancer Nurse Co-Ordinator established 3 years ago has helped to alleviate some of these fears by providing information and support to over 500 patients in Beaumont Hospital. We are available to patients and their families within the hospital setting in consultation with the relevant professionals as part of the multidisciplinary team. In addition, we provide a phone link following discharge enabling patients and families direct access to specialist care when required. The quality of care for patients has now improved due to better communication, closer co-ordination and integration between primary and hospital services.

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Assisting patients with the transition from the Hospital to the Home environment. Ms Betty Hillary

Presenter(s)

Organisation(s)

National Rehabilitation Hospital, Rochestown Ave, Dun Laoghaire

Abstract

Spinal Cord Injury (SCI) is one of the most catastrophic personal events that a person can experience. The injured person changes from an independent autonomous individual, to a dependant person relying on a multitude of trained medical personnel. The physical consequences of a SCI depends on the level of the injury suffered, but may include paralysis, and lack of bladder, bowel or sexual function. Perhaps a more upsetting result, is a person‟s inability to control these changes, or to camouflage the internal or external destruction produced by the injury. The Liaison Nurse must facilitate grief, denial and a struggle for reintegration. The Liaison Service The Liaison Service for SCI at the National Rehabilitation Hospital (NRH) was set up as a separate function in 1995, to bridge the gap between the acute rehabilitation phase and reintegration into the community, although it had been performed on an informal basis for many years prior to this date. At present, there is only one Liaison Nurse for patients with SCI in Ireland. The fundamental principle guiding the Liaison Service is Patient Advocacy.

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Community Resuscitation Training programme for Sligo/Leitrim/West Cavan Ms Margaret Moran Ms Mary Cooke NWHB,Primary Care Unit, Sligo General Hospital

Presenter(s)

Organisation(s)

Abstract

The Mission of the project is to improve the success rate and quality of attempted resuscitations in the region mentioned above. The Objectives are to: Increase awareness of the need for and the benefits of learning CPRv To Promote the Chain of Survival especially the first three community based links. Address and improve the quality and retention of CPR skills Co-ordinate and standardize resuscitation training according to Irish Heart /American Heart Association guidelines. The numbers of staff requiring this training were: 550 nursing & medical staff, 1550 non-nursing staff in 10 community hospitals, 1550 Health Board Administrative Staff, Healthcare workers in community dentists, PHN‟s G.P‟s pharmacists, staff in non health board hospitals and private nursing homes. General Public; a target of 10% of the population was set. Between March 2001 & June 2002 1181 people have attended CPR training. Community Hospitals:Staff were recruited and trained as CPR instructors in the 4 largest community hospitals. Delivering 1-2 classes per month. To date, each facility has trained over half of their staff. Health care workers from the local area, non-Health Board hospitals and local private nursing homes have been facilitated on these courses. In house resuscitation committees were established to review and manage resuscitation issues locally.General Public: CPR classes have been provided for various groups eg: diving club, carers, women‟s groups and football clubs.Health Board Administration Staff:CPR training has been provided in three centres.Evaluation: 7-point likert scale with rating from excellent to poor is used to evaluate the programme. 5 categories consistently scored highest positive values for content and delivery.

Title of Poster Presenter(s)

Introduction of Antenatal HIV Testing in Ireland. Ms Chris Sheehan Dr Mary Horgan Dr A H Dillion

Organisation(s)

South Infirmary - Victoria Hospital, Cork

Abstract

Uptake of HIV Testing in the antenatal Clinics in Southern Health Board.The Department of Health and Children in Ireland introduced a policy of antenatal HIV testing on a voluntary basis in April 1999. Unlinked antenatal HIV testing showed yearly increases in new infections and treatment of HIV in pregnancy substantially reduced the risk of maternal-foetal transmission (MFT). The policy was introduced and monitored in Southern Health Board area since its inception. METHODS: The Policy of routine testing commenced in Hospital A and Hospital B in 1999 and Hospital C in 2000. It's introduction was proceeded by intensive education of staff in each Hospital. Dedicated midwives were appointed to ensure that patients were adequately informed of the test and its implications. Over a 2 - year period we prospectively collected Data on the total number of tests performed in each hospital. Since May 2001 reason for refusing the test was also collected. RESULTS: Hospital A Hospital B Hospital C 1999 64% 91% N/a 2000 91% 78% 99% 2001 94% 72% 99% 2002 to June 96% 91% 99%

The increase in uptake in Hospital A resulted from involvement of a midwife in the National Group looking at implementation of the programme and increasing experience of midwifes caring for women with HIV. The decline in uptake in Hospital B coincided with 2 events: a significant change in staff in the Out-Patients Department and the redeployment of the designated midwife to other duties. In Hospital C the designated midwife is constant and provides information to all attendees. Reasons for not accepting the HIV test: considered themselves not at risk, previously done and did not want to know. This poster presentation acknowledges the huge work and co-operation of the Directors of Midwifery and the midwives in the 2 Cork Hospitals and Tralee General Hospital.

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"Cardiac Surgery Pre Admission Clinic" Ms Mary Kingston Ms Siobhan McFadden Ms Mary Walsh

Organisation(s)

St James's Hospital, D 8

Abstract

Cardiac Surgery Pre Admission Clinic The health strategy document “Quality and Fairness – A Health System for you” (2001) outlines a vision for the future Irish health system. The four guiding principles of the health strategy are equity and fairness, peoplecenteredness, quality of care, and clear accountability. Based on these principles the delivery of patient focused, appropriate high quality care, by the appropriate people in the appropriate setting, in a timely fashion is one of the national goals. The pre admission clinic for cardiac surgery patients at St James‟s Hospital is in keeping with this goal. This multidisciplinary clinic co- ordinated by the cardiothoracic nurse practitioners provides quality patient focused care for patients awaiting cardiac surgery. Studies have shown that thorough pre operative evaluation and treatment of any cardiac and non cardiac problems minimises intra operative and post operative complications and morbidity. Approximately two to three weeks prior to their operation, patients awaiting cardiac surgery attend a pre admission clinic at St James‟s Hospital. The clinic is managed by the nurse practitioner and she is responsible for ensuring that all patient problems are addressed prior to surgery. Together with another nurse, the nurse practitioner ensures that all the appropriate testing is performed and that patients are educated regarding their upcoming surgery. Following completion of the appropriate testing patients are reviewed by a pharmacist regarding their medications. Each patient is then assessed by either a nurse practitioner or cardiac registrar, and by a cardiac anaesthetist. The nurse practitioner assumes total responsibility for obtaining all test results and making appropriate referrals. The thorough assessment at the clinic has minimised unexpected cancellations of surgery on clinical grounds and has ensured maximum usage of hospital beds and theatre time. Furthermore, patients have expressed satisfaction with the education received. Findings in a pilot study on patient satisfaction with information received pre-operatively revealed that 100% of patients were either satisfied or very satisfied (Cardiac Surgery Audit Report, 2000). This patient focused multidisciplinary clinic is in keeping with the vision outlined by the Health Strategy.

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Giving people time Mr Brendan Crowley Ms Adrienne Adams Mr Michael Bambrick

Organisation(s)

West Cork Mental Health Services, SHB

Abstract

In April 2000, a pilot project was set up by the West Cork Mental Health Services, which aimed to provide support to GPs by allocating a mental health nurse to them for half a day a week. The aim of the mental health nurse was to bring psychiatric and psychological skills into the GP surgery and to improve communication between primary and secondary care. The remit of the nurse would be screening, triage, provision of advice, support, and short term counselling. The nurse would also provide information for relatives, patients, and other medical and nursing staff. The hope was that this would also help to reduce any stigma associated with mental illness. Three GP surgeries agreed to take part in the project in the West Cork area. To date, the post has now become a full time post.
The poster will show the following:  The development of the post to date.  The location of GP practices in West Cork Area, (Map).  The first stage of the evaluation. This will show the type of referrals the Liaison Mental Health Nurse received and what she dealt with herself and what was referred to other agencies.

Presenter(s)

Mr Rory Wilkinson Mr Brendan McCormack Ward Leaders in St James;s Hospital, Dublin and Belfast City Hospital St James's Hospital, D 8 & University of Ulster / Royal Hospitals Trust An „all Ireland Collaborative Leadership & practice Development Programme for Ward Leaders in Oncology and haematology Services. The development of effective leaders is a key objective of health care strategists in Ireland and the United Kingdom (U.K.). In particular effective leaders at a local or practice level will be able to transform the context and culture of practice and the relationship between practitioners and among practitioners and patients. Such leaders would demonstrate a hunger to learn, a capability to facilitate change, and be able to motivate staff to ensure improvements in the quality of the service being provided. This intention is appropriate to the development of cancer services in Ireland and the U.K. The “All Ireland Cancer Initiative” has been explicitly established to develop efficient, effective, timely and consistent services for service users. However whilst this strategic intent can help to shape the nature of overall service delivery, the operationalisation of service quality will to a large extent be dependent on the quality of leadership at the local (i.e. clinical) interface with service users. The reality of nursing leadership has been that throughout the 1990‟s nursing leadership was eroded in a dominant ideology of managerialism. Whilst the „layers‟ of nursing hierarchy were stripped away, simultaneously, the role of ward sister shifted from that of „clinical expert‟ to that of „resource manager‟ (Mc Cormack et.al, 1999). The current ideology of person-centred services has raised again the need for this central role of ward sisters to be recognised, acknowledged and developed (Savage, 1995; Bradshaw 1995; Kitson, 1996; Cunningham & Kitson, 2000). Currently there is an abundance of literature indicating the knowledge, skills and expertise needed by ward leaders throughout the nursing literature. However, less evidence exists about the most appropriate way for this knowledge, skill and expertise to be gained and sustained. There is also an implicit agreement in much of the contemporary leadership literature of the importance of transformational leadership (Lindholm et.al 2000; Manley 2000). Such an approach to leadership enables leaders to integrate their roles of clinical expert; practice developer; resource manager and leader (Manley, 2000). These aspirations of leaders as espoused in the leadership literature match the leadership aspirations of cancer service managers in St. James‟s Hospital, Dublin and Belfast City Hospital, Belfast who have indicated a desire to  Create a service whose nursing leaders are prepared for change  Enable a culture of practice where ward leaders feel more empowered.  Develop ways of working that is committed to „getting ideas into practice‟ whilst at the same time critically challenging practices.  Move away from a culture of „medical dependency‟ among nurses to one where nurses feel able to initiate, develop and sustain creativity in practice  Explore the potential impact of new roles in practice and the need for new roles in the context of current service provision. With the above is mind a joint “all Ireland Collaborative Leadership & Practice Development Programme for Ward leaders in Oncology and Haematology Services” research project was developed. The approach adopted is that of „Emancipatory practice development (Manley & Mc Cormack, 2000)‟. This is set within the context of action research set within a philosophy of critical social science. The poster will exhibit the local context for the initiative, it‟s aims and the development and research framework.

Organisation(s)

Abstract

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Establishing a Nursing Development Unit (NDU) Ms Mary Cooke Ms Catherine Timoney

Organisation(s)

Sisters of La Sagesse, Cregg House, Sligo

Abstract

This project was initiated 18 months ago. The immediate aim of the project was to explore the possibilities of creating a Nursing Development Unit within the Challenging Behaviour units within Cregg House. A Nursing Development Unit (NDU) is defined as any area where nurses are striving to develop the service they offer to clients with the added responsibility of researching and evaluating practice, then disseminating their findings. (Kings Fund Centre 1992) The nurses in the challenging behaviour units primary concern are to seek excellence in clinical practice. This poster presentation highlights to date the various activities of the nurse manager and staff nurses as they develop clinical practice.

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Empowering Nurses to Facilitate Audit and Accountability in Clinical Practice Ms Maura Ward

Presenter(s)

Organisation(s)

Louth Meath Hospitals, Our Lady's Hospital The Health Strategy (2001) National Goal No 4 – High PerformanceThis national goal refers to the quality of care being delivered, how this care is planned and the efficiency and effectiveness of the system. Also required is a commitment to continuous quality improvement and accountability. The National Council for Nursing and Midwifery have support this training programme which will target nurses engaged in clinical practice and provide them with the theoretical and practical skill to lead clinical audit teams.

Abstract

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Responsive and Appropriate Critical Care Delivery Ms Ann Lister

Organisation(s)

Louth Meath Hospitals, Our Lady's Hospital The Health Strategy (2001) National Goal No 3 – Responsive and Appropriate Care Delivery Health system must be geared to respond appropriately and adequately to the needs of individuals and their families. The critical care environment must be supportive to patients and families who are at their most vulnerable. A competency based learning programme has been developed and will be delivered regionally within the NEHB facilitated by a CNM 3. The programme aims to equip nurses with essential skills to provide critical care in a changing multicultural context.

Abstract

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Education Programme for the client with Diabetes Ms Pauline O'Hanlon Ms Ann Morris

Organisation(s)

Louth Meath Hospitals / Louth County Hospital

Abstract

The Health Strategy (2001) National Goal:No.1 Better Health for everyone. This National goal focuses on improving the health and quality of life of the population. With the increase in the number of people with diabetes expected to more than double in the coming years, the impact on the National Health system will be huge. It is held that the health service will implement structures to cater for this impending increase. Education of people with diabetes is essential to ensure effective patient management and prevent complications. The Diabetes Nurse Specialist imparts specialist knowledge and understanding to patients to help them accept appropriately and acquire skills to manage their diabetes. A patient centered programme of care is pivotal to ensuring positive patient outcomes and hence contributing to the overall national gain.

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Improving communication in Care of the elderly through the introduction of shared decision Ms Linda Smith The staff of St Annes Ward, St Patricks Hospital

Presenter(s)

Organisation(s)

St Patricks Hospital, Wellington Rd, Cork

Abstract

Introduction The staff of St Annes Ward, St Patricks Hospital, Cork City, aim to adopt the proposals of people centred care and shared decision making from the health strategy “Quality and Fairness”, (2001). The vision of the strategy, which embraces the individual patient, their family and the environment, is similar to the mission of St Patrick‟s Hospital. As health carers in St Patrick‟s Hospital, in a care of the elderly unit, the nurses of St Annes Ward share the philosophy and mission of the Religious Sisters of Charity, who strive to provide healthcare that fosters the core values of dignity, compassion, justice, quality and advocacy. By adopting the proposals advocated by the current health strategy of people centred care and shared decision making, the ward aims to improve holistic care and enhance quality of life while embracing the ethos of the organisation. Topic Choice The topic of people centred care and shared decision making was chosen after reading the health strategy, “Quality and fairness: a health system for you” (2001). The strategy vision of a health system that supports and empowers the patient, family and community to achieve full health potential and one that encourages the patient to have a say, listens to you, and takes views into account encouraged the ward to look at its current practice. It was decided to examine the possibility that communication could be improved between health care professionals, patients and families through the introduction of a code of shared decision-making (Government of Ireland, 2001).