Integrated Care Approach to Frailty in the Older Person · (TILDA) ’ Dr Aisling M. O ......

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Integrated Care Approach to Frailty in the Older Person Conference Booklet Office of the Nursing & Midwifery Services Director The Nursing and Midwifery Planning Development Unit HSE West/Midwest The Directors of Nursing Older Persons Services CHO 2 & 3 March 8th 2017

Transcript of Integrated Care Approach to Frailty in the Older Person · (TILDA) ’ Dr Aisling M. O ......

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Integrated Care Approach to Frailty in the Older Person Conference Booklet

Office of the Nursing & MidwiferyServices Director

Office of the Nursing & MidwiferyServices Director

The Nursing and Midwifery Planning Development Unit HSE West/Midwest

The Directors of Nursing Older Persons ServicesCHO 2 & 3

March 8th 2017

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I N T R O D U C T I O N

The Nursing & Midwifery Planning Development Unit HSE West/Midwest together with the Directors of Nursing for Older Peoples Services CHO 2 & 3 would like to take this opportunity to welcome you to our conference. The conference aims to support nurses and all members of the mul�disciplinary team to adopt an integrated care approach to care for the frail older person. With an ageing demographic, the challenge to provide care and support to assist older people to live a fulfilling and independent life in their own home remains a priority. Today’s conference aims to raise the profile of older peoples’ care delivery across services so as to enhance the roles necessary to deliver integrated care within the mul�disciplinary team through linking services across the acute, community and home se�ngs.

We would like to thank all our presenters, clinicians and session chairs for taking �me from their busy schedules to share with us today their knowledge and exper�se in the applica�on of integrated care approaches to care for frail older persons. Many thanks to all who submi�ed a poster or oral abstract, your e�orts’ are much appreciated. We would encourage all delegates to take �me to visit the poster display throughout the day. To the organising commi�ee and administra�ve sta� who have worked hard to bring the conference to frui�on, many thanks for the long hours and a�en�on to detail to make this day a success.

Finally to our delegates who have come from far and wide, we hope you enjoy today and take the opportunity to network with other delegates to inspire and foster personal learning.

_______________________

Mary Frances O’Reilly

Director

Nursing & Midwifery Planning Development Unit

HSE West/ MidWest

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#hellomynameis was started by the late Dr Kate Granger in the UK a�er she became frustrated with the

number of sta� who failed to introduce themselves to her when she was an inpa�ent with post-opera�ve

sepsis.

The concept is simple-reminding sta� to go back to basics and introduce themselves to pa�ents properly.

Dr. Kate spoke about this as the ‘first rung on the ladder to providing compassionate care’ and seen it as

making a vital human connec�on ,beginning a therapeu�c rela�onship and building trust between pa�ents

and healthcare sta�.

Sta� can greatly enhance or nega�vely a�ect pa�ent experiences of healthcare services. Simple things like

introducing yourself can put pa�ents at ease and posi�vely influence their experiences of the Irish healthcare

system. Pa�ent engagement and compassion need to be at the centre of the Irish healthcare services and

built into everything we do.

Dr. Granger’s legacy lives on through #hellomynameis which con�nues to go from strength to strength

improving pa�ent’s experience of healthcare.

All HSE sta� – par�cularly frontline sta� - are being asked to tell their pa�ents their name, as part of the

#hellomynameis campaign for more compassionate care.

The #hellomynameis campaign is being supported by the HSE as part of the Quality Improvement Division’s

pa�ent engagement strategy

h�p://www.hse.ie/eng/about/Who/qualityandpa�entsafety/About_QPS/

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C O N T E N T SPROGRAMME ..............................................................................................................................................4

BIOGRAPHIES ..............................................................................................................................................6

POSTER No1 Addressing the Acute Needs of the Oldest Old in a Rural Hospital:

The Frail Elderly Assessment Team (FEAT) Pilot Project ......................................................12

POSTER No2 A Community Virtual Ward – An Integrated Care Approach to Case Management

for our Frail Elderly in the Community” ..............................................................................13

POSTER No3 Bridging the Gap .................................................................................................................14

POSTER No4 Frail Elderly Pilot Programme Connolly Hospital Blanchardstown 2016 .............................15

POSTER No5 Applica�on of the Frailty Index: A Community Hospital Ini�a�ve .....................................16

POSTER No6 Frail Interven�on Therapy (FIT) Team: Early Assessment in the Emergency ......................17

POSTER No7 'Reducing the number of fall’s related injuries in frail older people in

the residen�al care se�ng. .................................................................................................18

POSTER No8 Examining the process and impact of risk stra�fica�on using a

community virtual ward model to manage older persons complex care needs’ ................19

POSTER No9 Hardwicke; transi�on from a surgical ward to an exemplar

Specialist Geriatric Ward through dedica�on, hard work and belief

from a fantas�c mul�disciplinary team. ..............................................................................20

POSTER No10 A Plan for Every Pa�ent: Achieving excellence in communica�on and

interdisciplinary working on a Specialist Geriatric Ward (SGW) ........................................21

POSTER No11 Nursing and Midwifery Quality Care-Metrics: A Na�onal Quality Ini�a�ve ........................22

POSTER No12 Provision of an Out-reach Pacemaker Follow-Up Service in a Community Nursing Unit ....23

POSTER No13 Pilo�ng a Cogni�ve S�mula�on Group in East Galway – Was It Plane Sailing? ...................24

POSTER No14 Public health nurses’ understandings and experiences of elder abuse and

how they respond. .............................................................................................................25

POSTER No15 Improving the quality of Care for older persons SUH/ CHO1 ..............................................26

Calendar of Learning Events

CNME Galway ....................................................................................................................28

CNME Castlebar ..................................................................................................................31

CNME Limerick ...................................................................................................................33

NOTES ............................................................................................................................................37

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Integrated Care Approach for Frailty in the Older PersonCONFERENCE PROGRAMME

08.30- 09.00Registra�on & Refreshments

Time Title Speaker09.00-09.05 Welcome Ms Mary Frances O’Reilly, Director NMPD09.05-09.15 Opening Address Mr Tony Canavan, Chief O�cer, CHO Area 2

Session 1 CHAIR – Ms Elaine Prendergast, Head of Services, Social Care, CHO 2

9.15 – 09.45 ‘Frailty as an emerging public health crisis - Knowing frailty at popula�on level’

Dr Rónán O Cáoimh, Consultant Geriatrician, UHG, & Ireland’s [HSE] representa�ve on the European Commission 3rd Health Programme-funded Joint Ac�on on Frailty Preven�on

09.45 – 10.15 Economics of Frailty in Older AgeProfessor Eamon O’Shea, Irish Centre for Social Gerontology, Na�onal University of Ireland Galway.

10.15 – 10.35‘Early Supported Discharge for Stroke; Bringing Stroke Care Home’.

Really looking forward to and presen�ng

Mairead Chawke, Senior Physiotherapist, Early Supported Discharge for Stroke Co-Ordinator,University Hospital Galway.

10.40 – 11.00 Co£ee

Session 2 CHAIR - Ms Margaret Casey, Director CNME, Castlebar

11.00 – 11.45 ‘Integrated Care- an Irish Perspec�ve’Dr Siobhán Kennelly, Consultant Geriatrician, Clinical Lead Integrated Care Programme for Older People HSE.

11.45 – 12.20‘Recognising Frailty: Insights from The Irish Longitudinal Study on Ageing (TILDA)’

Dr Aisling M. O’Halloran, PhD, CARDI Leadership in Ageing Research Fellow, TCD.

12.20 – 12.40 ‘Na�onal Frailty Educa�on Programme’

Ms Deirdre Lang, Director of Nursing, Na�onal Clinical Programme for Older People (NCPOP)and Leadership Development Nursing Profession Older People

12.40 - 13.00 Panel Discussion Speakers from Sessions 1 &2

13.00 – 14.00 LUNCH & Networking

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Session 3 CHAIR – Ms Teresa Loughnane, Director of Nursing, D’Alton CNU, Claremorris, Co. Mayo.

14.00 – 14.20‘O�ce of Nursing and Midwifery Services Priori�es 2017’

Mr Patrick Glackin, Area Director, NMPDU

14.20 – 14.40 ‘Implemen�ng a novel service model iden�fying and tailoring care for frailty in the acute care se§ng - our real �me experience’

Dr Stephanie Robinson’ Consultant Geriatrician’ & Ms Edel Mannion’ Clinical Nurse Specialist in Care of the Frail Older Adult, University Hospital Galway Frailty Team.

14.40 - 14.50

‘A Nurse led fracture liaison service has the poten�al to maximise diagnosis and treatment of osteoporosis: Results of the HOOF Project’

Catherine Armstrong, Clinical Nurse Specialist Orthopaedics, University Hospital Galway.

Session 4 CHAIR – Mr Paschal Moynihan, Head of Services, Social Care, CHO Area 3

14.50 – 15.10‘Providing an alterna�ve to acute care for the frail elderly pa�ent’

Elaine Dunne, Clinical Case Manager for Older Persons CHO Area 9 North Dublin

15.10 – 15.30‘A Virtual Ward Team Approach’Living well in the community

Mayo University Hospital Frailty Team’ & PCCC Mayo - Victoria McGuiness (Medical Social Worker), Mairead O’Boyle (RGN), Marie Alexander (Director of Nursing, Ballina District Hospital)

15.30- 15.50‘Age should never be a barrier in living life to its fullest’

Dr Michael Lo«us, General Prac��oner, Crossmolina, Co. Mayo.

15.50 - 16.00 Closing RemarksDr Anne Marie Ryan, Deputy Chief Nursing O�cer, Department of Health

Poster Presenta�on Dr Anne Marie Ryan and Mary Frances O’Reilly Director NMPD

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B I O G R A P H I E S

Dr Rónán O’Cáoimh is a Senior Lecturer/ Consultant Geriatrician in the Na�onal University of Ireland, Galway’s School of Medicine/University Hospital Galway. Dr O’ Cáoimh has completed a PhD on cogni�ve screening, (University College Cork), a MSc in Geriatric Medicine (Keele University) and a Diploma in Cerebrovascular and Stroke Medicine (RCPI). He is a commi�ee member of Irelands’ Na�onal Clinical Care Programme for Older People and chairs the frailty subgroup. He also sits on the execu�ve of the Irish Gerontological Society and the regional ethics commi�ee of the Galway University Hospitals. He led the cogni�ve screening task of the FP-7 funded PERSSILAA pre-frailty ICT trial and is currently leading Irelands’ role as work package leader in the 3rd HP-funded ADVANTAGE study on frailty in

Europe. Locally he is a site PI for the MSD funded Phase 3 of MK-8931 in amnes�c MCI/prodromal Alzheimer’s demen�a (APECS), and vTv sponsored Phase 3 trial of Azeliragon in early Alzheimer’s demen�a (STEADFAST). As part of higher specialist training he completed a two-year research fellowship in community public health centres and a memory clinic developing an Alzheimer Café, Memory Gym and Memory Interven�on Support Service. He is an associate editor for the Journal of Alzheimer’s Disease. He co-developed and is joint copyright holder for several cogni�ve and frailty screening and assessment instruments including the Quick Mild Cogni�ve Impairment Screen (Qmci), the Quick Memory Check (QMC), Community Assessment of Risk Instrument (CARI) and the Risk Instrument for Screening in the Community (RISC). He has co-developed the Community Assessment of Risk and Treatment (CARTS) frailty training and assessment programme. He is author/co-author on over 100 publica�ons (abstract/peer reviewed journal/book chapters).

Professor Eamon O’Shea is a Personal Professor of Economics in the School of Business and Economics at the Na�onal University of Ireland Galway. He is founder Director of the Irish Centre for Social Gerontology (ICSG) and is now the Director of the Centre for Economic and Social Research on Demen�a (CESRD) at NUI Galway. His research interests are focused on the economics of ageing, rural gerontology and demen�a. His work has been influen�al in se�ng the agenda for the reform of services and policies for older people in Ireland. Professor O’Shea is a Health Research Board (HRB) Na�onal Leader in Demen�a.

Ms Mairéad Chawke qualified in 2003 with a BSc in Physiotherapy from Trinity College Dublin. Since then Mairéad has worked across mul�ple clinical areas within the field of Gerontology. Presently she is Senior Physiotherapist and Joint Co-Ordinator of the Galway Early Supported Discharge Team for Stroke. She is currently undertaking post-graduate studies in the University of Limerick in Neurological Rehabilita�on.

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Dr Siobhán Kennelly is a Consultant Geriatrician in Connolly Hospital, Dublin and Honorary Clinical Senior Lecturer in the Royal College of Surgeons, Ireland. Her areas of clinical and academic interest are integrated care of the older person, management of frail older persons in community and domiciliary se�ngs and end of life care. She has collaborated with other healthcare professionals on a number of na�onal educa�onal ini�a�ves (www.inecma.org) to promote Interprofessional collabora�on on care of the older person in nursing homes. She is the clinical lead for the Genio integrated care pathway for demen�a in Connolly hospital. She is currently Na�onal Clinical Advisor Group Lead for the Social Care Division and Clinical Lead for the Integrated Care Programme for Older People.

Dr Aisling M. O’Halloran BA, PhD, is a Research Fellow with The Irish Longitudinal study on Ageing (TILDA) within the academic unit of Medical Gerontology at Trinity College Dublin and Mercer’s Ins�tute for Successful Ageing (MISA) at St. James’s Hospital, Dublin. She has been the research lead on both the Frailty and Biomarker Working Groups within TILDA and also manages the TILDA Bio bank, the largest of its kind in the Rep. of Ireland. Dr O’Halloran holds a PhD in the gene�c epidemiology of cardiovascular disease from the Royal College of Surgeons in Ireland and a BA (Mod) in Natural Science, specializing in gene�cs, from Trinity College Dublin. For over nine years, Dr O’Halloran has conducted research on studies of ageing, health epidemiology, immunology and gene�cs.

Her research interests are in the area of frailty and ageing biology in older adults, including related risk factors (biomarkers) and pa�erns of service use. She has secured a combined peer-reviewed grant porµolio of >€500K, including a CARDI Leadership in Ageing Research fellowship. She has published >20 peer-reviewed ar�cles in interna�onal journals. Dr O’Halloran is also a member of the Execu�ve Commi�ee of the Irish Gerontological Society (IGS).

Ms Deirdre Lang is the Director of Nursing Na�onal Clinical Programme for Older People (NCPOP) and Leadership Development nursing profession Older Persons. Deirdre trained in St Vincent’s hospital as a Registered General Nurse. During the early part of her career she spent a number of years working in acute services both in Australia and in Ireland. She has had a variety of experiences in healthcare having worked in mental health nursing and also in prac�ce development in the roles of Clinical Placement Co-ordinator and Facilitator for Newly appointed Sta� Nurses in AMNCH. In her role as Project O¸cer with the Nursing Midwifery Planning Development Unit (NMPDU) she managed a Government to Government recruitment ini�a�ve across a number of Irish service providers and Spain, which

she feels has provided her with a strategic overview of the health services. Her experience in Older Persons Services includes the role of CNM 2, Assistant Director of Nursing and Director of Nursing both in the HSE and private sector. Her passion for older person services and nurses working in this specialist area saw her set up a subgroup within the Irish Associa�on of Directors of Nursing & Midwifery (IADNAM). The aim of this group is to provide a forum and network for Directors of Nursing in this sector to support each other in

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managing unprecedented challenges and change. As a qualified coach she has provided support through her coaching to colleagues both formally and informally. Her role as Director of Nursing of the NCPOP and its joint role of leadership development of older persons nursing bring together all aspects of her experience to date together with her passion for the older pa�ent and those who provide their care. Her approach to life is Henry Fords “Whether you think you can or you think you can’t ………you are right” She is presently undertaking her Masters in Leadership (RCSI).

Mr Patrick Glackin is the Area Director for Nursing and Midwifery Planning and Development, HSE West and works for the Na�onal O¸ce of Director of Nursing and Midwifery Services, HSE. Patrick is trained as a General Nurse and a Psychiatric Nurse and holds a Masters in Business Administra�on. Patrick is currently undertaking a Doctorate in Business Administra�on. He has gained a broad range of clinical, managerial and leadership experience working in health services in England, Channel Islands and Ireland. Patrick is the nominated ONMSD senior nurse link for a number of di�erent na�onal ini�a�ves including older person services, sexual assault trauma unit training, electronic rostering, healthcare assistant training, immunisa�ons and demen�a.

Ms Edel Mannion holds a BNSc, Masters in Health Science Nursing, Post Grad in Nursing Science Gerontology, and just completed a cer�ficate in Nurse Prescribing from Na�onal University of Ireland Galway. Edel currently works as a Clinical Nurse Specialist in the Frailty Service Galway University Hospital.

Previous to that, Edel worked for 8 years in Nursing Prac�ce Development and has 5 years’ experience in an acute medical ward and in the Geriatric Rehabilita�on Unit.

Dr Stephanie Robinson MRCPI, MSc Clinical Research. Dr Stephanie Robinson is a consultant physician specialising in Geriatric Medicine. Dr Robinson is currently working in development of frailty services for the older person requiring acute medical care at Galway University Hospital. She holds a Master’s degree in Clinical Research from the Na�onal University of Ireland Galway and is widely published in peer review journals on the topics of frail older adults in acute care, demen�a care in the acute care environment, ageism and ageist views in medical educa�on in addi�onal to other key medical topics pertaining to older adults. She will speak today on her experience of developing a frailty service.

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Ms Catherine Armstrong completed her general nurse training in 1994 in Por�uncula Hospital. She gained valuable medical and surgical experience in the intervening years in Por�uncula Hospital, St Vincent’s University Hospital, Sligo General Hospital and in Australia. Upon her return to Ireland in 2001, she worked in the acute trauma ward in Merlin Park University Hospital before becoming a CNM1 in an elec�ve ward there. With the transfer of trauma services to Galway University Hospital 10 years ago, she pursued a new role there as a Clinical Nurse Specialist in Orthopaedics.Catherine has introduced various successful programs into orthopaedics, amongst them, an enhanced recovery program in the elec�ve se�ng, the development of

Integrated Care Pathways, and a fracture liaison service for inpa�ent orthopaedic fragility fractures. She also coordinates and manages care of new Spinal Cord Injuries in GUH.

Ms Elaine Dunne is a Clinical Case Manager (CCM) for Older Persons working in CHO 9 since 2003. She trained as a nurse in the United Kingdom. Elaine has worked in many di�erent areas in nursing in the UK and Ireland including coronary care, invasive cardiology, vascular surgery, colorectal and hepato-biliary surgery, general medicine and occupa�onal health. She completed her Bachelor’s Degree in Nursing in Dublin City University in 2005 and has done several standalone modules in DCU & UCD including demen�a champion and advanced health assessment. Elaine is currently in year 1 of her Master’s Degree in Gerontological Nursing in Trinity College Dublin.

In her current role Elaine works closely with the Consultant Geriatricians in Connolly Hospital in Blachardstown. Her current role as CCM aims to case manage older persons with complex needs working across both hospital and community. It means she works across service boundaries co-ordina�ng care based on a person’s and family’s’ clinical need. The aim of the role is to support both pa�ent and family to remain at home with appropriate services for as long as possible and to re-evaluate service provision through an ac�ve case management programme of care. In addi�on, the role works closely with secondary care services including specialist Gerontology Services in providing �mely interven�ons for older persons with complex needs and co-ordinate planned admissions if necessary. The CCM role acts as a single point of reference for co-ordina�on of care for pa�ents referred for the clinical case management programme.

Ms Mairead O’Boyle is currently a CNM2 on the Frail Elderly Assessment Team in Mayo University Hospital. She trained as a General Nurse at the University of Herµordshire, UK and returned to Mayo in 2005 where she has worked with the surgical and medical division as a registered nurse. She spent four years working as a Nursing Discharge Manager in Mayo University Hospital and joined the Frail Elderly Assessment Team in January 2016. Mairead has completed her Masters in Health Science in Nursing at the Na�onal University of Galway in 2011 and has recently completed a course on Pa�ent Safety in the Healthcare Se�ng at St Angela’s College, Sligo.

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Ms Victoria Mc Guinness is the Medical Social Worker for the Frail Elderly Assessment Team in Mayo University Hospital. Victoria completed a BA in Applied Social Studies (Social Care) in Ins�tute of Technology, Sligo. A�er gradua�ng in 2007, Victoria worked for a number of years in the Social Care sector with a variety of marginalised client groups including young people in care, early childhood care and educa�on, older persons and adults with an intellectual disability, with some �me also spent working as an Individual Support Specialist for people with an intellectual disability in Anchorage, Alaska, USA. Victoria returned to educa�on in 2013 where she undertook the Masters in Social Work in NUI Galway, gradua�ng in 2015. Victoria took up the posi�on of Medical Social Worker in Mayo University

Hospital in December 2015 and was subsequently shortlisted for a na�onal social work award in the newly qualified social workers category for her role in establishing the Frail Elderly Service in Mayo University Hospital.

Ms Marie Alexander, Director of Nursing, Ballina District Hospital successfully trained as a General Nurse in 1991, in Whipp’s Cross University Hospital, London. During her �me there, she worked predominately in the speciality of Orthopaedics, from sta� nurse to ward sister, to the planning, development and management of nurse led pre-assessment clinic. She was instrumental to the development of the bone bank and the PPG’s and quality assurance required in safe guarding the recipient. Marie has undertaken further educa�on in the areas of teaching and assessing course, orthopaedic course, management course, and counselling course to name just a few. In 1999, Marie returned to the Irish health services to Sligo Regional Hospital and transferred to Ballina District Hospital in 2008 as a

Clinical Nurse Manager 2. In 2011, Marie was appointed as Director of Nursing for Ballina District Hospital.

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Dr Michael Lo«us was born in Kiltoom, Co. Roscommon in 1929, aged eight he moved to Crossmolina, Co. Mayo following the death of his mother. He received his educa�on at the local Na�onal School in Crossmolina and St Muredach’s College in Ballina. He then a�ended University College Galway qualifying as a medical doctor in 1954.

He was Coroner for North Mayo for 30 years and it was during this period that he developed concerns regarding alcohol abuse, par�cularly its e�ects on young people in rela�on to road tra¸c accidents, and on the lives of others surrounding the vic�ms of accidents and alcohol misuse.

Michael Lo�us excelled as a football player in his chosen sport of Gaelic football at club, county, university and provincial levels. He won three All-Ireland University Football Championships with University College Galway in the 1950s. He played in minor, junior and senior All-Ireland Football Finals and was part of the famous Mayo team who won the All-Ireland Senior Football Championship in 1951.

Following his success as a player he served as a referee, o¸cia�ng at all levels including club, county, and na�onal level. He was in charge of the senior deciders in 1965 and 1968.

O� the field he is a noted administrator within the Gaelic Athle�c Associa�on. He served as Chairman of the Mayo County Board, and subsequently Provincial Chairman of the Connaught Council, and ul�mately became the third medical doctor to become President of the Gaelic Athle�c Associa�on in 1985-87.

Dr Lo�us con�nues to work �relessly on behalf the community in his area. Na�onally, he had par�cular involvement in campaigns which dealt with issues of alcohol misuse and abuse. Michael is an advocate for ac�ve aging, compe�ng twice in the World Senior Games and was a recipient in the first All-Ireland Inspira�onal Life Award for his work as chairman of Na�onal Council of Aging and Older People. In 2015, Dr Michael was awarded an Honorary Doctorate by NUI Galway acknowledging his contribu�on to public life in Ireland, his work as an advocate of healthy living, campaigner against alcohol abuse and leadership in the world of sport. Dr Lo�us con�nues to prac�ce and serve his community as a General Prac��oner in his na�ve Crossmolina where he has been working since 1957.

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P O S T E R N o . 1

Addressing the Acute Needs of the Oldest Old in a Rural Hospital:

The Frail Elderly Assessment Team (FEAT) Pilot Project

Co-Presenters: Simon Rowan, Mairead O Boyle, Victoria McGuinness, Amanda Brady, Clare Greene

Presenter: Sarah Ronayne

Current posi�on: Occupa�onal Therapist

Organisa�on: Mayo University Hospital, Saolta Hospital Group

Background/ContextOlder people have more frequent hospital admissions and occupy more bed days than any other pa�ent group. Pa�ents over 80 years are most at risk of adverse outcomes e.g. death and ins�tu�onalisa�on (Na�onal Clinical Programme for Older People, 2012); therefore, it is impera�ve acute services are streamlined for this pa�ent group.

Aim / Objec�veThe objec�ve of the mul�-disciplinary team (MDT) was early iden�fica�on of frail older pa�ents on presenta�on to Mayo University Hospital; to include assessment of frailty syndromes (falls, immobility, cogni�ve impairment, incon�nence and poly-pharmacy) to improve pa�ent flow through the hospital and facilitate a more integrated approach to discharge.

Outline of ContentAn MDT was established in the Emergency Department and Acute Medical Assessment Unit comprising of Clinical Nurse Manager, Medical Social Worker, Occupa�onal Therapist, Physiotherapist and Pharmacist. They assessed adults over 80 years using “PRISMA 7”, “4 Metre Gait Speed Test”, and “Mini-Cog”. The e¸cacy of the team was measured by analysing pa�ent outcomes in the domains of “�me to frailty screening” (i.e. pa�ents assessed within 4 hours of presenta�on to hospital) and discharge outcome (i.e. des�na�on on discharge and re-admission rates).

Evalua�on / Results Ninety six percent of pa�ents screened had one or more frailty syndromes. Pa�ents seen by FEAT were more likely to return to their own homes. Re-admission rates of pa�ents seen by FEAT were found to be lower than the hospital average for comparable pa�ents. This demonstrates that co-ordinated, mul�-faceted approach to assessment, interven�on and discharge planning for older people at point of entry to acute hospital leads to improved pa�ent outcomes.

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P O S T E R N o . 2

“A Community Virtual Ward – An Integrated Care Approach to Case Management

for our Frail Elderly in the Community”

Co- Presenters: Helen Browne, Paula Mc Greal and Mairead O’Boyle

Presenter: Marie Alexander, DON Ballina District Hospital

Organisa�on: Ballina District Hospital, CHO Area 2

Background

The propor�on of people aged 65 years is increasing in Ireland. Co. Mayo has a popula�on of 130,638 residents of which 19,539 are aged over 65 years. This combined with an increase in the propor�on of people with one or more chronic condi�ons, requires that care is co-ordinated and our health and social services are integrated to ensure that quality is improved and pa�ent outcomes and experiences are at the centre of everything we do.

A Community Virtual Ward was established in 2013 following funding from NMPDU to deliver an innova�ve co-ordinated care to the Frail elderly pa�ents living in the community. The community virtual ward model a�empts to integrate health and social care by o�ering mul�disciplinary case management to the frail elderly pa�ent living in Mayo who is a predicted risk of unplanned hospitaliza�on.

Aims and Objec�vesOne of the core objec�ves of the community virtual ward was to streamline and co-ordinate care for elderly pa�ents who are at risk of hospital re-admission and employ a mul�-disciplinary approach to address their individual needs across health and social care.

Process Predic�ve modelling is used to support pro-ac�ve case management of pa�ents by risk-stra�fying the popula�on and iden�fy pa�ents who are suitable for admission to the community virtual ward. Pa�ents remain at home in the community while in the community virtual ward and receive integrated mul�disciplinary case management to maintain or improve their health status and reduce the risk of unplanned hospital admission. The virtual ward team seeks to improve con�nuity and quality of care across providers and ensures that resources in the community are used e¸ciently by targe�ng addi�onal services of those most at risk. The virtual ward model consists of two fundamental components: (1) pa�ents at high risk of unplanned admission are iden�fied using a predic�ve model and (2) o�ering those iden�fied an intense period of mul�disciplinary case management using some of the systems of a hospital ward (Lewis et al, 2013).

Evalua�on and outcomesThe ward currently has 37 pa�ents receiving case load management. It represents a novel approach to integrated care for our frail elderly pa�ent living in Mayo. Sta� report sa�sfac�on in working on a virtual ward and the opportunity to share problems and find solu�ons with colleagues to ensure integrated safe care is delivered to our frail elderly.

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Bridging the Gap

Co- Presenters: Marion Du�y, PHN, Bernie Brennan, RGN

Presenter: Mary Cunni�e, PHN

Current posi�on: Public Health Nurse, Ballaghaderreen Health Centre, Co. Roscommon.

Organisa�on: Roscommon Community Care, HSE CHO Area 2

Background Frailty is a common clinical syndrome in older adults that carries an increased risk for poor health outcomes including falls, incident disability, hospitaliza�on, and mortality (Enrud et al 2009). The frail elderly o�en present late and in crisis to health services so their care may be episodic and unplanned (Lyndon, H., 2015).Frailty should be addressed as a long term condi�on that can be managed proac�vely in community se�ngs by supported self-management and person centred care.

According to Seegart (2015) most frail elderly wish to remain at home. However Seegart(2015) states that we have an array of disjointed services that do not take pa�ents values about what ma�ers to them into account.

Aims and Objec�ves Promo�ng an integrated primary care team (PCT) approach involving health, social care, voluntary and community groups working in partnership will help facilitate a wraparound care and seamless client service and enable the frail elderly to live at home.

Content and Processes usedPrimary care is o�en delivered in a fragmented way. Implemen�ng an integrated PCT approach will facilitate care to be delivered in a client centred holis�c way embracing the principles of access, equity, choice, value and quality. By promo�ng a mul�disciplinary team approach, opportunity is a�orded to conduct integrated assessments, joint care planning and joint home visits and case discussion. Embracing this process of service delivery will result in greater sa�sfac�on for service users and providers.

OutcomeThe development of a client held passport will greatly improve communica�on between the client and all professionals. This will help build a connec�ng bridge for all professionals thus ensuring smooth transi�on between primary, secondary and ter�ary services resul�ng in be�er outcomes for clients regardless of where they are seen within the care system.

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Frail Elderly Pilot Programme Connolly Hospital Blachardstown 2016

Co- Presenters: George Je�eries (Clinical Nurse Specialist), Niamh Muldoon (Occupa�on Therapist), Sarah Gleeson (Physiotherapist), Caroline Stapleton (Die�cian), Jennifer Kane (Speech & Language Therapist), Basil Sullivan (Medical Social Worker), Derry O’ Loan (Pharmacist) and Jackie Convery (Pa�ent Flow Coordinator).

Presenter: George Je�eries (Clinical Nurse Specialist)

Organisa�on: Connolly Hospital, Blachardstown

Background The Specialist Geriatric Services Model of Care aims to improve quality and e¸ciency of care for older people with complex health care needs. The Frail Elderly Pilot Programme commenced in Connolly Hospital Blanchardstown (CHB) in January 2016 to achieve these aims. It involves the early iden�fica�on of the ‘frail older person’ with confusion, falls, poor mobility, poly-pharmacy, malnutri�on, dysphagia, communica�on and social factors which may warrant a comprehensive mul�disciplinary assessment.

MethodsThe Frail Elderly Team (FET) was established within the Emergency Department (ED) and the Acute Medical Assessment Unit (AMAU) in CHB. Pa�ents over 75 years were screened for frailty indicators during core hours. Pa�ents presen�ng with frailty received a comprehensive mul�disciplinary assessment. Rehabilita�on and discharge pathways were promptly iden�fied. To facilitate ED discharge, a rapid access pathway to the Day Hospital was established.

ResultsA total of 738 pa�ents received input from the FET from January to September 2016. Referral reasons included func�onal, cogni�ve, social, dysphagia and nutri�onal assessment, falls and poly-pharmacy. Pa�ents were categorised as mildly to moderately frail on average (5.5 Rockwood Clinical Frailty Scale). Results will be presented from the data gathered from January - December 2016.

ConclusionsThe FET aims to improve the quality and e¸ciency of care and outcomes for the frail older person presen�ng to CHB. The team will con�nue to provide educa�on and leadership in rela�on to the iden�fica�on of the frail older person, comprehensive mul�disciplinary assessment and early discharge planning where possible of iden�fied frail older people.

References - By request from authors

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Applica�on of the Frailty Index: A Community Hospital Ini�a�ve

Presenters: Dr Claire Welford General Manager, & Mr Conor Barry Physiotherapist

Organisa�on: Community Hospital & Hospice, Ennis

Background & ContextAs a method of training geriatricians in the assessment of older individuals Cape (1978) developed the “Geriatric Giants”. These ‘giants’ remain the cornerstone of geriatric medicine teaching today. These giants are: Falls, Incon�nence, Confusion, Iatrogenic illnesses and impaired homeostasis. More recently, the frailty syndrome has been added and can be aptly called the ul�mate geriatric syndrome due to the complexity of its causes and the wide range of adverse outcomes it may lead to in older persons (Shun, 2015).

Aims & Objec�vesThis presenta�on will describe how the “Frailty index” was introduced into a residen�al community hospital. Correla�ons between frailty, falls and demen�a were subsequently surveyed. People aged 65 and older have the highest risk of falling, with 30% of people older than 65 and 50% of people older than 80 falling at least once a year. In Ireland, every year 10% of all older people need treatment following an injury. Falls account for 75% of these injuries. Hip fractures are one of the most serious injuries (approximately 2,800 hospital admissions each year).The inpa�ent cost of trea�ng a hip fracture is €12,600. The inpa�ent cost of fall-related injury hospitalisa�ons among older persons is currently es�mated at €59 million and inpa�ent hip fractures cost is es�mated at €35 million.

Frailty has been described as “a dynamic state a�ec�ng an individual who experiences losses in one or more domains of human func�oning (physical, psychological, social), which is caused by the influence of a range of variables and which increases the risk of adverse outcomes” (Gobbens et al, 2010:342). Frail individuals in the general popula�on are more likely to fall, have fractures and get admi�ed to a hospital (Gobbens et al., 2010b, Hogan et al., 2012, Macklai et al., 2013, Tang et al., 2013 and Weiss, 2011).

Evalua�ons and outcomes /results: To be reported at the conference.

References: By request from authors

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Frail Interven�on Therapy (FIT) Team: Early Assessment in the Emergency Department

Co Presenters: Ivan Clancy, Paul Maloney

Presenter: Ivan Clancy A/Clinical Specialist Physiotherapist,

Organisa�on: Beaumont Hospital, Dublin.

Background and contextOlder people present to the Emergency Department (ED) with medical condi�ons o�en further complicated by func�onal decline, cogni�ve deteriora�on and complex social care needs. Services for older pa�ents should provide access to comprehensive mul�-disciplinary team (MDT) assessments and appropriate treatment in the most appropriate se�ng, without unnecessary delay or admission.

Aim and objec�vesThe FIT Team comprises of PT, OT, MSW SLT, Diete�cs and Pharmacy and work closely with the medical and nursing sta� in the ED. The vision for the FIT Team is to foster a culture of ‘every hour counts’ for frail elderly pa�ents and aims to: Provide rapid access and comprehensive MDT assessment to all pa�ents over 75 years iden�fied as frail who present to the ED.

Outline of Main ContentThe “Think FRAILTY” assessment tool is used to iden�fy pa�ents. When a pa�ent is iden�fied as frail, his/her specific care needs are established with early iden�fica�on of the appropriate care pathway i.e. admission or supported discharge with immediate referral to other MDT services as indicated. For pa�ents deemed to require admission, rehabilita�on commences immediately. Where pa�ents are recommended for discharge, a rapid access, and intensive rehabilita�on service is provided.

Processes usedA Quality Improvement methodology was used with repeat PDSA cycles. Interac�ve HSCP planning workshops guided the process and helped to:A) Foster frontline ownershipB) Cri�que prac�ceC) Develop e�ec�ve care pathways and suppor�ng processes

Evalua�ons and outcomes /resultsSince September, 2015, over 7,500 pa�ents have been screened for frailty. Of those screened for frailty, 83% required HSCP interven�on and the average age of this pa�ent group was 84 years.

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Reducing the number of fall’s related injuries in frail older people in the residen�al care se§ng.

Co- Presenters: Angela Lyons, Helen Whelan

Presenter: Mary Doyle

Organisa�on: CNS for the care of the older person, Peamount Healthcare, Dublin

Background and context Between 50% and 75% of nursing home residents fall annually, twice the rate of their age-matched community dwelling older people, with a 3-11 �mes greater rate of hip fracture. Many of the falls that occur in residen�al care se�ngs are falls from bed. Tradi�onally used interven�ons to prevent falls from bed such as bedrails, may put residents with cogni�ve impairment at risk of entrapment, entanglement, or falling from a greater height possibility sustaining injury or death.

Aim and objec�ves The aim of this ini�a�ve was to reduce the number of fall related injuries in the residen�al care se�ng by introducing interven�ons to promote the safety of the residents while maintaining a restraint free environment.

Processes usedWhen a resident was iden�fied during the pre- admission assessment as high risk of a fall from bed and bedrail use was assessed as unsafe or restric�ve, alterna�ves e.g. floor beds, bed alarms, bed wedges and/or crash mats were prescribed for use.

Evalua�ons and outcomes /resultsA retrospec�ve audit from Jan–Dec 2014 prior to the introduc�on of interven�ons: Total falls from bed = 48: Injuries sustained = 12 (Fracture =1 Bruising= 8 Lacera�ons= 3) while the audit from Jan–Dec 2016: showed that 37% (n18) of the residents (Age range 71- 98yrs) were prescribed floor beds, bed alarms, bed wedges and/or crash mats. Total falls from bed = 38: Injuries sustained = 0.

Although the number of falls from bed remained high, fall related injuries in this se�ng may have been reduced by the introduc�on of appropriate interven�ons.

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‘Examining the process and impact of risk stra�fica�on using acommunity virtual ward model to manage older persons complex care needs’

Co- Presenters: Lewis, C 1, PhD student Nursing and Midwifery, Royal College of Surgeons Ireland Pa�on, D2, Nugent L.E3. Nursing & Midwifery Royal College of Surgeons Ireland

Organisa�on: Royal College of Surgeons Ireland.

BackgroundThe aging popula�on within the Republic of Ireland is increasing exponen�ally to approximately 20,000 per year. As a result there is an increase in frail older persons living within the community with increased risks of emergency department presenta�ons and hospital admissions. Healthcare professionals are challenged with determining risk of a hospital admission in a frail older popula�on due to complex health and social care needs. Within North Dublin a Community Virtual Ward (CVW) model was introduced to assist the healthcare prac��oner with appropriate risk stra�fica�on of the pa�ents’ care needs to reduce emergency department presenta�ons and unplanned hospital admissions. However, there is a gap in research in examining if risk of an event or hospital admission has reduced within the care of older persons expanding beyond chronic disease through a CVW model of care.

AimsTo examine the characteris�cs of risk in a frail cohort of older persons with complex care needs and how they respond to service interven�ons over�me.

MethodsA non-experimental longitudinal study in older persons (N= 80) admi�ed to the CVW. Descrip�ve as well mul�variate logis�c regression and mul�nomial logis�c regression will be used to analyse risk.

ResultsThe study outputs will examine risk scores and the rela�onships between these and the types of events, service interven�ons and responses over�me.

ConclusionThe CVW o�ers a new approach to complex care for older persons however, as the popula�on is aging with an increase in care needs it is envisaged that this research will iden�fy that risk scoring alone is inadequate in determining a reduced risk of a hospital admission or further event. Therefore it is predicted that the events, interven�ons and response to these will guide clinicians through this model of care.

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Hardwicke; transi�on from a surgical ward to an exemplar Specialist Geriatric Wardthrough dedica�on, hard work and belief from a fantas�c mul�disciplinary team.

Co Presenters: Grace Corcoran, Louise Lawlor, Sr. Carol Lyons, Sr. Elaine Moloney, Dr Alan Moore, Dr Linda Brewer, Una Donnelly, Anne Healy, Paul Maloney, Gemma Crinion.

Presenter: Margaret O’ Donoghue, Senior Die��an, Beaumont Hospital

Organisa�on: Beaumont Hospital

BackgroundBeaumont hospital catchment area has a 20% higher propor�on of over 65’s and over 85’s than the na�onal average. In 2015 an external review of Beaumont Hospitals Care of the older person services was completed and the Beaumont improved performance plan was developed.

Aims & Objec�vesTo deliver the objec�ves of the Na�onal Clinical Programme for Older People (NCPOP, 2012) by crea�ng a SGW in Beaumont Hospital.

MethodologyA mul�disciplinary clinical subgroup was formed with the aim of suppor�ng the transforma�on to a SGW. A QI methodology approach was adopted and evidence based Clinical Performance Improvements (CPI’s) were generated. This provided structure to our developments, accountability for sta� and a formal way to iden�fy gaps and streamline the service. A number of service developments were introduced and are now embedded into daily prac�ce to ensure comprehensive geriatric assessment, rapid access to MDT treatment, clear communica�on with interdisciplinary goal se�ng and early decision making to reduce poten�al delay.

Communica�on CPI’s:• A daily Plan for Every Pa�ent (PfEP) board mee�ng with full MDT (including a member of pa�ent

flow) a�endance with an emphasis on collabora�ve discussion regarding outstanding needs, goalsand predicted dates of discharge. Standardised documenta�on for iden�fica�on of frailty

• Improved MDT referral response �mes to 24hrs• Enhanced pharmacy role and par�cipa�on in consultant led ward rounds• Weekly ward educa�on sessions.

Rehab Ethos CPI’s• Environmental changes - pa�ent orienta�on charts and demen�a friendly signage• Day room redesign including kitchen installa�on and art-work• Establishment of a Daily Breakfast Club and Cogni�ve S�mula�on Therapy group• Nutri�on and Hydra�on developments: Implementa�on of the Malnutri�on Universal Screening

Tool, the Red Mat system and a Plate Pals volunteer programmeOutcome and FutureAs an exemplar ward Hardwicke has successfully reduced length of stay, improved sta� sa�sfac�on, created a rehab ethos and a demen�a friendly environment. Our focus is now on sustaining, embedding and further streamlining our CPI’s, emphasising con�nued alignment with the NCPOP and Beaumont Improved Performance Plan. In addi�on we are now sharing our experiences and learning with other MDT’s ini�ally focusing on spreading to a second SGW.

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A Plan for Every Pa�ent: Achieving excellence in communica�on and interdisciplinary working on a Specialist Geriatric Ward (SGW)

Co-Presenters: Dr Linda Brewer, Dr Alan Moore, Sr. Carol Lyons, Sr. Elaine Moloney, Margaret O’ Donoghue, Louise Lawlor, Una Donnelly, Anne Healy.

Presenter: Grace Corcoran

Current posi�on: Senior Physiotherapist, Care of the Elderly,

Organisa�on: Beaumont Hospital

Background and ContextBeaumont hospital catchment area has a 20% higher propor�on of over 65’s and over 85’s than the na�onal average. In 2015 a Beaumont Hospital improved performance plan was developed to deliver the objec�ves of the Na�onal Clinical Programme for Older People by establishing a SGW. A mul�disciplinary clinical subgroup was formed with the aim of suppor�ng this transforma�on.

Aim and Objec�vesTo enhance interdisciplinary communica�on with an emphasis on early decision-making to reduce poten�al delays and predict dates of discharge via prompt comprehensive geriatric assessment, rapid access to MDT and clear interdisciplinary goal se�ng.

Main ContentThe clinical needs of older pa�ents are complex as they frequently present with mul�ple co-morbidi�es accompanied by func�onal decline, cogni�ve deteriora�on and complex social care needs. In order to deliver CGA and minimise length of stay on Hardwicke ward, a daily Plan for Every Pa�ent (PfEP) board mee�ng was established. Led by the CNM at 8.30 am and las�ng approximately 15minutes, the daily mee�ng is a�ended by the full MDT including Consultants and Senior Registrars, as well as a representa�ve from the hospital pa�ent flow department. This mee�ng also allows for prompt iden�fica�on of new pa�ents and poten�al discharges, referral to the MDT and monitoring of a pa�ent’s condi�on.

Processes used Quality improvement methodology was adopted via an MDT clinical subgroup, incorpora�ng a driver diagram, specific aims and mul�ple plan-do-study-act cycles.

Evalua�ons and Outcomes/Results:Daily PFeP board mee�ngs have been embedded into prac�ce. An ethos of daily decision making, communica�on and planning for discharge from admission has been established on the ward. MDT a�endance at the mee�ng has improved from a baseline of 66% at its incep�on to 100% a�endance currently. MDT referral response �mes have improved with ini�al assessment within 24hrs of referral. Moreover, outside of the morning mee�ngs, the PfEP board is fully u�lised to act as an up-to-date visual representa�on of the pa�ent’s journey.

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Nursing and Midwifery Quality Care-Metrics: A Na�onal Quality Ini�a�ve

Co- Presenters: Anne Gallen (Na�onal Lead), Paula Kavanagh, Gillian Conway, Johanna Downey,Leonie Finnegan, Lore�o Grogan, Mar�na Giltenane, Margaret Nadin.

Presenter: Mary Nolan,

Current posi�on: Quality Care-Metrics Project O¸cer Midland Region HSE,

Organisa�on: NMPDU Midlands

BackgroundQuality Care-Metrics are agreed measurements for nursing care where can be monitored against agreed standards. The central driver for ini�a�ng the development and implementa�on of metrics is to generate real �me data to monitor care and promote a culture of quality and pa�ent / resident safety

Aims:• Introduce and implement a standardised set of nursing/midwifery quality care-metrics across all health

services.• Introduce a na�onal web tool to collate and report on results in a standardised format.• Provide real �me reports for nurses, midwives and their managers on the delivery of safe, quality care.

Main Content/Processes usedMetric indicators enable Older Persons nurses to understand how procedures are progressing and how they can be improved. The collec�on of nursing metrics provides valuable informa�on to all nurses in understanding how well their individual wards and Older Person se�ngs are managing the delivery of safe, quality care to residents. Metrics may iden�fy good prac�ces which must be shared and celebrated; it may also highlight areas of poor performance. The so�ware used is a web based system designed to collect data and create reports in a ‘real-�me’ mode to assist with care improvements.

Metrics measure processes such assessing pa�ents for risks rela�ng to medica�on management, falls, observa�ons, pressure ulcers and documenta�on. The introduc�on of metrics allows for consistency in data collec�on across all par�cipa�ng Older Persons se�ngs.

Results:Quality care-metrics are currently in use in 500 services/ ins�tu�ons na�onally and provide reports individualised to each ward/service indica�ng targets achieved using a tra¸c light and percentage system. Ac�ons plans are implemented monthly to support and improve nursing standards of care.

Conclusion Nursing/midwifery metrics o�er an opportunity to maintain high nursing standards, providing tangible measures of nursing contribu�on to care of the frail older person.

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Provision of an Out-reach Pacemaker Follow-Up Service in a Community Nursing Unit

Co- Presenters: Paul Nolan, Laura Moylan, Michelle Fahy, Bernie Aus�n

Organisa�on: Galway University Hospital, Saolta University Healthcare Group, Ireland; St Brendan’s Community Nursing Unit, Loughrea, Galway;

Introduc�onPa�ents with implanted pacemakers require at least annual checks on their device, which are typically carried out in large hospital se�ngs. Some pa�ents are elderly, frail and may require ambulance transfer. In 2016, St Brendan’s Community Nursing Unit (CNU) iden�fied 11 pa�ents who required ambulance transfer to University Hospital Galway (UHG) for this service. Descrip�on of Prac�ce Change UHG and the CNU collaborated to provide an Out-reach Pacemaker Follow-up Service for these pa�ents in their nursing unit.

Aim and Theory of ChangeThe aim was to deliver a safe follow-up service in the CNU, minimising pa�ent upset and reducing sta¸ng (pa�ent escort) and transport (ambulance) costs compared to the tradi�onal model.

Targeted Popula�on and StakeholdersThere were 11 pa�ents, mean age 84.8yrs (64-96) with complex care needs. Stakeholders included Cardiac Physiologists, Lead Cardiologist and Manager in UHG and Nursing sta� and Nursing management of the CNU.

TimelineThe pa�ents were iden�fied in August 2016. Following collabora�on between UHG and CNU sta�, specifically around internet access to the UHG web-based Pa�ent Pacing Record, environment appropriateness, safety and funding, the first Out-reach Clinic took place on December 19th 2016.

HighlightsThis service required 8.6 hours of a Senior Cardiac Physiologist’s �me. Travel costs for this clinic amounted to €56.60.If each pa�ent was to have been followed up in the tradi�onal model it would have involved 11 separate transfers to hospital. Pa�ent escort �me, based on a minimum of 1.8hrs per visit, would have totalled 19.8hrs. Ambulance transfer costs for these visits would have, based on minimum cost of €330 per transfer, and totalled €3630.The new service showed a reduc�on in sta¸ng hours of 56.5% and a reduc�on in transport costs of 98.4%. Comprehensive checks were carried out in a safe, appropriate environment.

SustainabilityThis service is highly sustainable, as all pa�ents currently only require an annual check. Even if all pa�ents required three monthly checks, the substan�al savings in transport costs support this level of service. Internet access to allow clinical details of the follow-up checks to be entered on our web-based Pa�ent Pacing Record, allowed all documenta�on to be completed at the �me of the check.

TransferabilityThis service could be equally replicated in any centre, where there a suitable number of pa�ents to make it cost e�ec�ve.

ConclusionsAn Out-reach Pacemaker Follow-Up Service in a Community Nursing Unit showed significant reduc�on in sta� hours and transport costs of 98.4%. It also resulted in care being delivered in a more pa�ent centric manner.

DiscussionThe ini�al query regarding the possibility of this service was ini�ated by sta� in the CNU. Support of management in both UHG and the CNU, par�cularly around, releasing a Cardiac Physiologist, the funding of travel costs and working space in the CNU allowed the service to start in just over three months. Lessons learned: Significant savings can be made by providing out-reach services to Community Nursing Units appropriately, as opposed to hospital based service. Collabora�on between the hospital and community based service was vital.

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Pilo�ng a Cogni�ve S�mula�on Group in East Galway – Was It Plane Sailing?

Co- Presenters: S Hanley, D O’ Mahony, A Murray, S Fahy

Presenter: Dr Sarah Hanley,

Current Posi�on: Psychiatry Registrar, NUIG Deanery

Organisa�on: University Hospital Galway

BackgroundCogni�ve s�mula�on therapy (CST) is an evidence-based therapy for individuals with mild-to-moderate demen�a. CST has been demonstrated to improve both cogni�ve func�on and quality of life for people with demen�a. World Alzheimer 2016 Report recommends o�ering CST within the first year of a demen�a diagnosis.

Aims(1) Evaluate whether CST improves cogni�ve func�on and quality of life within cohort.(2) Survey pa�ent experience of service.

MethodsAll pa�ents a�ending Galway East pilot CST group were invited to partake. Mini Mental State Examina�on (MMSE), Alzheimer’s Disease Assessment Scale (ADAS-Cog) and Quality of Life in Alzheimer ’s disease (QoL-AD) measured pre-CST & within 3 weeks of group comple�on. A 9-item anonymised survey of pa�ent’s experience of CST was devised and distributed before & a�er group comple�on. The CST programme was delivered once/week for 7 weeks, 90 minutes/session.

ResultsDrop-out rate was 22%, sample size therefore 5. 80% female, 20% male, average pre MMSE = 25.8. Following CST comple�on, mean MMSE improvement was 1 point (SD 0.70, max 2, Min 0). Mean ADAS-COG improvement was 3 points (SD 3, Max 6.5, Min -0.5). Mean QOL-AD-Family change = -0.2 (max 4, min -6), mean QOL-AD-Pa�ent change = +0.6 (max 5, min -3).Post-CST survey received 63% response rate (n=5). 100% respondents stated they would recommend group to others. Theme of ‘improved concentra�on & memory’ supported 2/5, ‘increased hope for future/worrying less’ present in 3/5. Theme ‘finding group enjoyable’ present in 4/5. Recommenda�ons for future improvement included running group geographically closer to par�cipants, encouraging more to partake.

ConclusionThe preliminary findings of this pilot interven�on suggest that CST posi�vely impacted cogni�ve func�oning, fostered hope, and was enjoyable for those who partook. Quality of life findings were equivocal. We recommend replica�ng this study on larger scale, using control group & randomisa�on. Going forward, this project may benefit from community based rather than centralised group sessions.

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Public health nurses’ understandings and experiences of elder abuse and how they respond

Presenter: Andrea Devine

Current Posi�on: Public Health Nurse,

Organisa�on: Loughrea Primary Care Centre

Aims and Objec�vesThe objec�ves of the study are; to inves�gate from the perspec�ve of PHNs, their experience of and encounter with abuse of older people, to explore the ways PHNs respond to elder abuse and to make recommenda�ons for policy and future prac�ce.

Background and ContextThe study explores the literature surrounding the di�erent range of defini�ons, the risk factors associated with elder abuse and prevalence studies from di�erent countries. This is followed by examining the many factors which interact in the phenomenon of elder abuse and the professionals dealing with elder abuse and finally it discusses how public health nurses are involved with older people in the community and healthcare professionals’ knowledge and management of abuse.

Processes UsedQualita�ve research methods in the form of semi-structured interviews and a focus group were used in this study. The interviews were carried out with fourteen public health nurses, two occupa�onal therapists, two physiotherapists, one assistant director of public health nursing and one academic that specialises in researching elder abuse.

FindingsThe findings of this study indicate that public health nurses and other members of the mul�disciplinary team are aware of the importance of detec�ng elder abuse at an early stage. However, many professionals strife to detect and manage cases due to insu¸cient knowledge on how to deal with elder abuse which is further compounded by par�cipants not having recent training on elder abuse. The research highlights the importance of using a team approach when dealing with elder abuse. The research also highlights the significance of providing social support to the older person and to the carer who may be under stress because of not ge�ng enough support.

Recommenda�onsRecommenda�ons were sought from par�cipants included provision of a screening tool that would consequently improve service delivery. The literature from both an Irish and interna�onal context supports the important role public health nurses play as been central in the iden�fica�on, response and management of elder abuse.

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P O S T E R N o . 1 5

Improving the quality of Care for older persons SUH/ CHO1

Presenter: Maura He�ernan

Current Posi�on: Assistant Director of Nursing,

Organisa�on: Sligo University Hospital

BackgroundA significant propor�on of older people presen�ng to the acute hospital se�ng are frail and less likely to adapt to stressors such as acute illness. This increased vulnerability contributes to mul�ple adverse outcomes such as falls and increased hospital stays. Sligo University Hospital and CHO 1 is severely challenged by inadequate bed capacity and a 26% increase in the number of pa�ents on trolleys. There was also a lack of co-ordinated integrated approach to caring for frail older pa�ents. This project set out to improve the experience of care for frail older pa�ents by the development of an integrated frailty pathway involving both acute and community sectors.

The overall aim was to: • Increase frail older pa�ent sa�sfac�on ra�ng from 67% to 95%• Decreased length of stay by 1 bed day for >70 year olds with no increase in readmission rate• Reduce pa�ent experience �mes >9 hours in ED to 0%• Experience no increase in adverse events such as falls

These aims were addressed by establishing a frailty pathway with a par�cular focus on integra�on between community and acute services. This was achieved through a cohesive MDT approach to care and the establishment of a specialist gerontology ward.

A pa�ent centred ques�onnaire showed an increase in pa�ent sa�sfac�on levels from 67% to 79.6% a�er 3 months. The median length of stay for this cohort of pa�ents reduced from 12.6days to 9.73days, a reduc�on of 22% with no increase in readmission rates or adverse events.

The net saving calculated on bed days saved less addi�onal resources is es�mated at €3,128,456 per year. Undoubtedly, this project has delivered many benefits to date. Placing the pa�ent at the centre of the project has been key to its success. Phase 2 will focus on admission avoidance and reduc�on in pa�ent experience �mes in the Emergency Department/ Acute Assessment Unit.

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Making his debut appearance;

the conference would like to welcome

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Centre of Nursing & Midwifery Educa�onGalway

Calendar of Learning Events & Contact DetailsJanuary – July 2017

January Programme Title Venue 10.01.2017 Anaphylaxis Training for Healthcare Providers CNME Galway

10.01.2017 Breasµeeding Refresher Course – UHG CNME Galway

10.01.2017 Fundamentals of Fetal Monitoring Workshop CNME Galway

12.01.2017 Intravenous Drug Administra�on Study Day CNME Galway

13.01.2017 Anaphylaxis Training for Healthcare Providers CNME Por�uncula

16.01.2017 Management of Adult Neurogenic Bowel CNME Por�uncula

17.01.2017 Haemovigilance Programme CNME Por�uncula

17.01.2017 Stroke Swallow Screening Training CNME Por�uncula

17.01.2017 Core Infec�on Preven�on & Control Knowledge and Skills CNME Por�uncula

23.01.2017 Plaster Cas�ng – 2 Day Programme (Day 1) CNME Galway

24.01.2017 Plaster Cas�ng – 2 Day Programme (Day 2) CNME Galway

24.01.2017 Heart Failure Programme CNME Por�uncula

25.01.2017 Venepuncture & Cannula�on CNME Galway

25.01.2017 What Ma�ers to Me – End of Life Care CNME Galway

26.01.2017 Breasµeeding Refresher Course – UHG CNME Galway

26.01.2017 Neonatal Resuscita�on Provider Course CNME Galway

27.01.2017 Paediatric Immediate Life Support Course CNME Por�uncula

31.01.2017 Stroke Swallow Screening Training CNME Por�uncula

February Programme Title Venue 01.02.2017 A.N.T.T. Master class on Asep�c Non Touch Technique CNME Galway

02.02.2017 Central Venous Catheter Management CNME Por�uncula

02.02.2017 Intravenous Drug Administra�on Study Day CNME Galway

03.02.2017 PEG Tube Management in Primary Care Se�ng CNME Galway

06.02.2017 Venepuncture & Cannula�on CNME Por�uncula

07.02.2017 Anaphylaxis Training for Healthcare Providers CNME Galway

07.02.2017 Core Infec�on Preven�on & Control Knowledge and Skills CNME Por�uncula

07.02.2017 Haemovigilance Programme CNME Por�uncula

07.02.2017 Stress Management CNME Galway

07.02.2017 Stroke Swallow Screening Training CNME Por�uncula

08.02.2017 Demen�a Care – 2 Day Programme – PUH (Day 1) CNME Por�uncula

09.02.2017 Demen�a Care – Acute Care Programme CNME Por�uncula

09.02.2017 Non-Invasive Ven�la�on Study Day CNME Galway

10.02.2017 Con�nence Promo�on Study Day CNME Galway

10.02.2017 Electrocardiograph/ Rhythm Recogni�on Study Day CNME Por�uncula

14.02.2017 Anaphylaxis Training for Healthcare Providers CNME Por�uncula

14.02.2017 Prac�cal Obstetric Mul� Professional Training (PROMPT) CNME Galway

14.02.2017 Stroke Swallow Screening Training CNME Por�uncula

14.02.2017 Tracheostomy Care Study Day CNME Galway

15.02.2017 Venepuncture & Cannula�on CNME Galway

20.02.2017 Pa�ents Journey of Sepsis, From Admission to Discharge CNME Galway/PUH

22.02.2017 Demen�a Care – 2 Day Programme – UHG (Day 1) CNME Galway

22.02.2017 Stress Management CNME Por�uncula

23.02.2017 Breasµeeding Refresher Course – UHG CNME Galway

23.02.2017 Introduc�on to Clinical Audit CNME Por�uncula

23.02.2017 Neonatal Resuscita�on Provider Course CNME Galway

24.02.2017 Paediatric Immediate Life Support Course CNME Por�uncula

28.02.2017 Code of Professional Conduct & Ethics CNME Galway

28.02.2017 Demen�a Care – 2 Day Programme- PUH (Day 2) CNME Por�uncula

28.02.2017 Scope of Nursing Prac�ce for Nurses & Midwives CNME Galway

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March Programme Title Venue 01.03.2017 Haemovigilance Programme CNME Por�uncula

01.03.2017 Core Infec�on Preven�on & Control Knowledge and Skills CNME Por�uncula

01.03.2017 Venepuncture & Cannula�on CNME Galway

02.03.2017 Anaphylaxis Training for Healthcare Providers CNME Galway

02.03.2017 Intravenous Drug Administra�on Study Day CNME Galway

02.03.2017 Midwifery Overview for Registered Midwives working in the Community

CNME Galway

02.03.2017 What Ma�ers to Me – End of Life Care CNME Por�uncula

09.03.2017 Breasµeeding Refresher Course – PUH CNME Por�uncula

09.03.2017 Demen�a Care – 2 Day Programme – UHG (Day 2) CNME Galway

09.03.2017 Male Urethral / Supra – Pubic Catheterisa�on Study Day CNME Galway

13.03.2017 Code of Professional Conduct & Ethics CNME Por�uncula

13.03.2017 Scope of Nursing Prac�ce for Nurses & Midwives CNME Por�uncula

14.03.2017 Anaphylaxis Training for Healthcare Providers CNME Por�uncula

14.03.2017 Breasµeeding Refresher Course – UHG CNME Galway

14.03.2017 Fundamentals of Fetal Monitoring Workshop CNME Galway

15.03.2017 Safeguarding Vulnerable Adults CNME Galway

16.03.2017 Venepuncture & Cannula�on CNME Por�uncula

21.03.2017 Teaching and Assessing (Preceptorship) Refresher Course CNME Galway

22.03.2017 Final Journeys Programme CNME Galway

23.03.2017 Paediatric Study Day – Basic Care of the Child in the Emergency Department

CNME Por�uncula

24.03.2017 Oral An�coagula�on Therapies: An Update CNME Galway

30.03.2017 Breasµeeding Refresher Course – UHG CNME Galway

30.03.2017 Neonatal Resuscita�on Provider Course CNME Galway

30.03.2017 Type 2 Diabetes: Educa�onal Overview & Workshop CNME Galway

31.03.2017 Paediatric Immediate Life Support Course CNME Por�uncula

April Programme Title Venue 04.04.2017 Haemovigilance Programme CNME Por�uncula

04.04.2017 Core Infec�on Preven�on & Control Knowledge and Skills CNME Por�uncula

05.04.2017 Pa�ents Journey of Sepsis, From Admission to Discharge CNME Galway/PUH

05.04.2017 Stroke Care Founda�on Educa�on Programme CHME Galway

06.04.2017 Best Prac�ce in Recording & Report Wri�ng for Midwives CNME Por�uncula

06.04.2017 Gynaecology Women’s Health Study Day CNME Galway

06.04.2017 Intravenous Drug Administra�on Study Day CNME Galway

06.04.2017 Safeguarding Vulnerable Adults CNME Por�uncula 10.04.2017 Electrocardiograph/ Rhythm Recogni�on Study Day CNME Por�uncula 11.04.2017 Prac�cal Obstetric Mul� Professional Training (PROMPT) CNME Galway 11.04.2017 Teaching & Assessing (Preceptorship) Course CNME Galway 12.04.2017 Introduc�on to Clinical Audit CNME Galway 13.04.2017 Venepuncture & Cannula�on CNME Por�uncula 25.04.2017 Anaphylaxis Training for Healthcare Providers CNME Por�uncula 25.04.2017 Paediatric Study Day – Basic Care of the Child in the Emergency

Department CNME Galway

26.04.2017 Anaphylaxis Training for Healthcare Providers CNME Galway 26.04.2017 Mental Health & Intellectual Disability Training CNME Galway 26.04.2017 Venepuncture & Cannula�on CNME Galway 26.04.2017 What Ma�ers to Me – End of Life Care CNME Galway 27.04.2017 Breasµeeding Refresher Course – UHG CNME Galway 27.04.2017 Breasµeeding Refresher Course – PUH CNME Por�uncula 27.04.2017 Mental Health & Intellectual Disability Training CNME Ballinasloe 27.04.2017 Neonatal Resuscita�on Provider Course CNME Galway 28.04.2017 Back to Basic’s Infec�on Preven�on and Control CNME Galway/PUH 28.04.2017 Paediatric Immediate Life Support Course CNME Por�uncula

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May Programme Title Venue 02.05.2017 Demen�a Care – 2 Day Programme – UHG (Day 1) CNME Galway 02.05.2017 Anaphylaxis Training for Healthcare Providers CNME Por�uncula 04.05.2017 Intravenous Drug Administra�on Study Day CNME Galway 04.05.2017 What Ma�ers to Me – End of Life Care CNME Por�uncula 05.05.2017 Final Journeys Programme CNME Galway 09.05.2017 Anaphylaxis Training for Healthcare Providers CNME Galway 09.05.2017 Breasµeeding Refresher Course – UHG CNME Galway 09.05.2017 Fundamentals of Fetal Monitoring Workshop CNME Galway 09.05.2017 Haemovigilance Programme CNME Por�uncula 09.05.2017 Core Infec�on Preven�on & Control Knowledge and Skills CNME Por�uncula 11.05.2017 Community Respiratory Workshop CNME Por�uncula 11.05.2017 Non-Invasive Ven�la�on Study Day CNME Galway 12.05.2017 Maternity & Gynaecology Study Day CNME Galway

15.05.2017 Leadership Development and Emo�onal Intelligence for DON’s & ADON’s CNME Galway

16.05.2017 Demen�a Care – 2 Day Programme – UHG (Day 2) CNME Galway 18.05.2017 Breasµeeding Refresher Course – PUH CNME Por�uncula 23.05.2017 Tracheostomy Care Study Day CNME Galway 24.05.2017 Venepuncture & Cannula�on CNME Galway 25.05.2017 Breasµeeding Refresher Course – UHG CNME Galway 25.05.2017 Neonatal Resuscita�on Provider Course CNME Galway 26.05.2017 Paediatric Immediate Life Support Course CNME Por�uncula 29.05.2017 Occupa�onal First Aid Programme (Day 1) CNME Por�uncula 30.05.2017 Heart Failure Programme CNME Por�uncula 31.05.2017 Teaching and Assessing (Preceptorship) Refresher Course CNME Galway June Programme Title Venue 01.06.2017 Final Journeys Programme CNME Por�uncula 02.06.2017 Pa�ents Journey of Sepsis, From Admission to Discharge CNME Galway/PUH 06.06.2017 Haemovigilance Programme CNME Por�uncula 06.06.2017 Core Infec�on Preven�on & Control Knowledge and Skills CNME Por�uncula 07.06.2017 Demen�a Care – 2 Day Programme – PUH (Day 1) CNME Por�uncula 08.06.2017 Intravenous Drug Administra�on Study Day CNME Galway 08.06.2017 Safeguarding Vulnerable Adults CNME Por�uncula 12.06.2017 Electrocardiograph/ Rhythm Recogni�on Study Day CNME Por�uncula 12.06.2017 Occupa�onal First Aid Programme (Day 2) CNME Por�uncula 13.06.2017 Prac�cal Obstetric Mul� Professional Training (PROMPT) CNME Galway 19.06.2017 Occupa�onal First Aid Programme (Day 3) CNME Por�uncula 21.06.2017 Demen�a Care – 2 Day Programme – PUH (Day 2) CNME Por�uncula 21.06.2017 Venepuncture & Cannula�on CNME Galway 27.06.2017 Anaphylaxis Training for Healthcare Providers CNME Por�uncula 28.06.2017 Anaphylaxis Training for Healthcare Providers CNME Galway 29.06.2017 Breasµeeding Refresher Course – UHG CNME Galway 29.06.2017 Neonatal Resuscita�on Provider Course CNME Galway 30.06.2017 Paediatric Immediate Life Support Course CNME Por�uncula July Programme Title Venue 04.07.2017 Haemovigilance Programme CNME Por�uncula 04.07.2017 Core Infec�on Preven�on & Control Knowledge and Skills CNME Por�uncula 04.07.2017 Venepuncture & Cannula�on CNME Galway 11.07.2017 Breasµeeding Refresher Course – UHG CNME Galway 11.07.2017 Fundamentals of Fetal Monitoring Workshop CNME Galway 27.07.2017 Breasµeeding Refresher Course – UHG CNME Galway 27.07.2017 Neonatal Resuscita�on Provider Course CNME Galway

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Centre of Nursing & Midwifery Educa�onCastlebar

Calendar of Learning Events & Contact DetailsJanuary – July 2017

January Programme Title Venue 11.01.2017 Anaphylaxis Management in Primary Care SHH Roscommon 16/20 2017 Health Service Skills Cer�ficate (HSSC) QQI Level 5 CNME Castlebar24.01.2017 Risk Register Process Review CNME Castlebar27.01.2017 Basic Life Support – Health saver programme for HCA’s CNME Castlebar30.01.2017 Basic Life Support for Healthcare Providers CNME Castlebar30.01.2017 Assisted Decision Making Master class CNME Castlebar

31.01.2017 Safeguarding Vulnerable Persons – Designated O¸cer/Service Manager Training CNME Castlebar

February Programme Title Venue 01.02.2017 Diabetes – Type 2 Workshop CNME Castlebar06.02.2017 Suppor�ng Bereaved Families with their Baby’s/Child’s death 0-21 years CNME Castlebar9.02.2017 Peripheral Intravenous Drug Administra�on Study Day CNME Castlebar 13th – 17th 2017 Health Service Skills Cer�ficate (HSSC) QQI Level 5 CNME Castlebar15.02.2017 Male Urethral and Supra-pubic Catheterisa�on Programme SHH Roscommon 16.02.2017 Intravenous Drug Administra�on test re-sit CNME Castlebar 20.02.2017 Sepsis: Care and Management of the Pa�ent CNME Castlebar 21.02.2017 Preparing for HIQA Inspec�ons within Public Health/Community Se�ngs CNME Castlebar 22.02.2017 Final Journeys Programme CNME Castlebar 22.02.2017 Breasµeeding Refresher Programme CNME Castlebar24.02.2017 Oral An�coagula�on Therapies: An Update CNME Castlebar27.02.2017 Behaviours that Challenge in Older Persons Service CNME Castlebar28.02.2017 Management of Implanted Ports CNME Castlebar28.02.2017 Safeguarding Vulnerable Persons – Awareness Programme SHH RoscommonMarch Programme Title Venue 01.03.2017 Safeguarding Vulnerable Persons – Awareness Programme CNME Castlebar02.03.2017 Emergency First Aid Training Day CNME Castlebar02.03.2017 Midwifery Overview CNME Castlebar02.03.2017 Hemochromatosis: Treatment & Management of Adults Update CNME Castlebar07.03.2017 Healthy Bladder Update CNME Castlebar08.03.2017 Integrated Care Approach to Frailty in the Older Persons Conference Clayton Hotel, Galway09.03.2017 Breasµeeding Refresher Programme (video link) CNME Castlebar14.03.2017 Breaking/Delivering Bad news CNME Castlebar14.03.2017 Injec�on Technique Training Programme SHH Roscommon20.03.2017 Injec�on Technique Training Programme CNME Castlebar21.03.2017 Behaviours that Challenge in Older Persons Services SHH Roscommon23.03.2017 Health Service Skills Cer�ficate (HSSC) QQI Level 5 CNME Castlebar24.03.2017 Basic Life Support – Health saver Programme for HCA’s CNME Castlebar27.03.2017 Sta� Engagement: Building Morale & Produc�vity within the team CNME Castlebar27.03.2017 Basic Life Support for Healthcare Providers CNME Castlebar29.03.2017 Wound Assessment & Selec�on of Wound Dressings CNME Castlebar30.03.2017 Non-Invasive Ven�la�on (NIV) CNME Castlebar30.03.2017 Stress Management Through Mindfulness CNME Castlebar

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April Programme Title Venue 03.04.2017 Safeguarding Vulnerable Persons – Awareness Programme CNME Castlebar04.04.2017 Healthy Bowel Update CNME Castlebar05.04.2017 Safeguarding Vulnerable Persons – Awareness Programme SHH Roscommon05.04.2017 Sepsis: Care and Management of the Pa�ent CNME Castlebar06.04.2017 Gynaecology Study Day (video link) CNME Castlebar07.04.2017 Venepuncture Skills Workshop CNME Castlebar11.04.2017 Heart Failure – Acute & Con�nuing Care Management CNME Castlebar

11.04.2017 Venepuncture Skills Workshop Roscommon University Hospital

13.04.2017 Stress Management Through Mindfulness Primary Care Castlerea25.04.2017 Epilepsy Awareness & the administra�on of Buccal Midazolam CNME Castlebar25.04.2017 Falls Preven�on, Management & Post Falls Review CNME Castlebar26.04.2017 Final Journey’s Programme SHH Roscommon27.04.2017 Breasµeeding Refresher Programme (video link) CNME Castlebar

28.04.2017 Back to Basics: Infec�on Preven�on & Control in Clinical Prac�ce CNME Castlebar

May Programme Title Venue 04.05.2017 Medica�on Safety: Systems Analysis Approach Master class CNME Castlebar08.05.2017 Enabling and Enhancing Wellbeing for the person with Demen�a CNME Castlebar

10.05.2017 Caring for a Person with Intellectual Disabili�es in a Mental Health Se�ng CNME Castlebar

11.05.2017 Falls Preven�on and Management CNME Castlebar12.05.2017 Maternity, Gynaecology & Women’s Health Study Day CNME Castlebar15.05.2017 Delega�on & Supervision of Healthcare Assistants in Clinical Prac�ce SHH, Roscommon17.05.2017 Con�nence & Enuresis Management in the Child CNME Castlebar17.05.2017 Safeguarding Vulnerable Persons – Awareness Programme CNME Castlebar18.05.2017 Breasµeeding Refresher Programme (video link) CNME Castlebar19.05.2017 Basic Life Support – Health saver Programme for HCA’s CNME Castlebar22.05.2017 Basic Life Support for Healthcare Providers CNME Castlebar23.05.2017 Legal Issues: Capacity Assessment & Consent CNME Castlebar24.05.2017 Legal Issues: Capacity Assessment & Consent CNME Castlebar25.05.2017 Audit – A Prac�cal Approach CNME Castlebar29.05.2017 Enabling and Enhancing Wellbeing for the person with Demen�a CNME Castlebar31.05.2017 Hand Hygiene, Train the Trainer Programme CNME Castlebar31.05.2017 Safeguarding Vulnerable Persons – Awareness Programme SHH, RoscommonJune Programme Title Venue 01.06.2017 E�ec�ve Presenta�on Skills CNME Castlebar02.06.2017 Sepsis: Care and Management of the Pa�ent CNME Castlebar08.06.2017 Restraint in Clinical Prac�ce – Minimising its use CNME Castlebar12.06.2017 Best Prac�ce in Medica�on Management CNME Castlebar14.06.2017 Anaphylaxis Management in Primary Care CNME Castlebar

15.06.2017 Safeguarding Vulnerable Persons – Designated O¸cer/Service Manager Training CNME Castlebar

20.06.2017 Delega�on & Supervision of Healthcare Assistants in Clinical Prac�ce CNME Castlebar21.06.2017 Restraint in Clinical Prac�ce – Minimising its use SHH, Roscommon22.06.2017 Emergency First Aid Training Day CNME Castlebar29.01.2017 Stress Management Through Mindfulness CNME Castlebar

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Centre of Nursing & Midwifery Educa�onLimerick

Calendar of Learning Events & Contact DetailsJanuary – July 2017

January Programme Title Venue 11.01.2017 Hand Train the Trainer CNME Limerick 12.01.2017 Respiratory Educa�on Programme CNME Limerick

17.01.2017 Demen�a-Enabling and Enhancing Quality of Care with the person with demen�a-Acute Care Programme CNME Limerick

19.01.2017 Emergency Department Founda�on Programme –Day 1 CNME Limerick 24.01.2017 Final Journeys End of Life Care CNME Limerick 24.01.2017 Preceptorship Teaching and Assessing in Clinical Prac�ce CNME Limerick 26.01.2017 Epidural Analgesia Management CNME Limerick

26.01.2017 Diabetes in Pregnancy Study Day – Na�onal Programme University Maternity Hospital Limerick (UMHL)

27.01.2017 Mentorship Educa�on Programme – Part A CNME Limerick February Programme Title Venue 04.02.2017 Endovascular Study Day CNME Limerick 08.02.2017 Mentorship Educa�on Programme – Part A CNME Limerick 09.02.2017 Con�nence Promo�on CNME Limerick 09.02.2017 Breasµeeding & Lacta�on Update UMHL 09.02.2017 Emergency Department Founda�on Programme –Day 2 CNME Limerick 15.02.2017 Pain Management-Acute and Chronic Educa�on Programme CNME Limerick 20.02.2017 Asthma Management-Na�onal Guidelines Educa�on for Nurses CNME Limerick 21.02.2017 Epidural Analgesia Management CNME Limerick 22.02.2017 Compassionate Care in Perinatal Bereavement UMHL 22.02.2017 Final Journeys End of Life Care CNME Limerick23.02.2017 Diabetes Mellitus for Nurses in the Non Acute Care Se�ng CNME Limerick28.02.2017 Sepsis: Care and Management of the adult with sepsis CNME LimerickMarch Programme Title Venue 08.03.2017 Mentorship Educa�on Programme – Part B CNME Limerick09.03.2017 Respiratory Educa�on Programme CNME Limerick09.03.2017 Diabe�c Foot care – Na�onal Programme CNME Limerick

14.03.2017 Demen�a-Enabling and Enhancing Quality of Care with the person with demen�a-Acute Care Programme CNME Limerick

21.03.2017 Preceptorship Teaching and Assessing in Clinical Prac�ce CNME Limerick28.03.2017 Emergency Department Founda�on Programme –Day 3 CNME Limerick 29.03.2017 Founda�ons in Paediatric High Dependency Nursing – Day 1 CNME Limerick29.03.2017 Hand Hygiene Train the Trainer CNME Limerick30.03.2017 Founda�ons in Paediatric High Dependency Nursing – Day 2 CNME Limerick30.03.2017 Final Journeys End of Life Care CNME Limerick31.03.2017 Anaphylaxis for Health Professionals CNME Limerick

April Programme Title Venue 03.04.2017 Diabetes Mellitus for Nurses – Acute Care Services CNME Limerick 05.04.2017 Founda�ons in Paediatric High Dependency Nursing – Day 3 CNME Limerick 05.04.2017 Compassionate Care in Perinatal Bereavement UMHL06.04.2017 Breasµeeding Course – 20 hours – Day 1 UMHL06.04.2017 Founda�ons in Paediatric High Dependency Nursing – Day 4 CNME Limerick 06.04.2017 Wound Management Study Day CNME Limerick 08.04.2017 Laser Surgery CNME Limerick

10.04.2017 Demen�a – Enhancing & Enabling Well-Being for the Person with Demen�a-2 Day Programme Day 1 CNME Limerick

12.04.2017 Colorectal Educa�on Programme CNME Limerick 13.04.2017 Epidural Analgesia Management CNME Limerick

14.04.2017 Scope of Nursing and Midwifery Prac�ce Framework (NMBI 2015) Workshop CNME Limerick

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24.04.2017 Medica�on Management for Nurses & Midwives CNME Limerick 25.04.2017 Anaphylaxis for Health Professionals CNME Limerick 26.04.2017 Infec�on Preven�on & Control CNME Limerick 26.04.2017 Pain Management-Acute and Chronic Educa�on Programme CNME Limerick 27.04.2017 Diabetes in Pregnancy Study Day – Na�onal Programme UMHL27.04.2017 Final Journeys End of Life Care CNME Limerick 27.04.2017 Emergency Department Founda�on Programme –Day 4 CNME Limerick

May Programme Title Venue 02.05.2017 Care planning for Nurses working in Learning Disability Services Lakeview training room,

Bawnmore 04.05.2017 Breasµeeding Course – 20 hours – Day 2 UMHL09.05.2017 Preceptorship Teaching and Assessing in Clinical Prac�ce CNME Limerick 09.05.2017 Early Pregnancy Loss & Ectopic Pregnancy UMHL10.05.2017 Peri-opera�ve study day for nurses CNME Limerick 10.05.2017 Founda�ons in Paediatric High Dependency Nursing – Day 1 CNME Limerick 11.05.2017 Founda�ons in Paediatric High Dependency Nursing – Day 2 CNME Limerick 11.05.2017 Neurogenic Bowel Management CNME Limerick 11.05.2017 Asthma Management-Na�onal Guidelines Educa�on for Nurses CNME Limerick 12.05.2017 Recording Clinical Prac�ce Guidance for Nurses & Midwives CNME Limerick 17.05.2017 Founda�ons in Paediatric High Dependency Nursing – Day 3 CNME Limerick 18.05.2017 Founda�ons in Paediatric High Dependency Nursing – Day 4 CNME Limerick 18.05.2017 Breasµeeding Course – 20 hours – Day 3 UMHL

22.05.2017 Demen�a – Enhancing & Enabling Well-Being for the Person with Demen�a-2 Day Programme Day 2 CNME Limerick

23.05.2017 Sepsis in Pregnancy & Childbirth UMHL

23.05.2017 Demen�a-Enabling and Enhancing Quality of Care with the person with demen�a-Acute Care Programme CNME Limerick

24.05.2017 Final Journeys End of Life Care CNME Limerick 25.05.2017 Emergency Department Founda�on Programme –Day 5 CNME Limerick 26.05.2017 Professional Issues Applicable to Nursing & Midwifery CNME Limerick 26.05.2017 Anaphylaxis for Health Professionals CNME Limerick 30.05.2017 Principles of Injec�on Technique Workshop CNME Limerick June Programme Title Venue 02.06.2017 Code of Professional conduct & Ethics CNME Limerick 08.06.2017 Emergency Department Founda�on Programme –Day 6 CNME Limerick 14.06.2017 Anaphylaxis for Health Professionals CNME Limerick 15.06.2017 Respiratory Educa�on Programme CNME Limerick 26.06.2017 Compassionate Care in Perinatal Bereavement UMHL27.06.2017 Final Journeys End of Life Care CNME Limerick 30.06.2017 Medica�on Management for Nurses & Midwives CNME Limerick July Programme Title Venue 12.07.2017 Care planning for Nurses CNME Limerick

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Centre of Nursing Midwifery Educa�onHSE West – Mid West

Contact List

CNME GALWAY CNME CASTLEBAR CNME LIMERICK

Ms Marissa Butler Director 091 544351 Galway O¸ce 0909648311 Por�uncula O¸ce 087 1332778 [email protected]

Ms Margaret Casey [email protected]

Ms Margaret Crowley-Murphy Director 061-483162/[email protected]

Ms Maura Lo�us Specialist Co-ordinator: 091 893346 Galway O¸ce 0909648311 Por�uncula O¸ce 087 6318568 maura.lo�[email protected]

Mr Philip BeirnePrincipal Nurse [email protected]

Ms Nuala Flannery Specialist Co-ordinator: 061-482675.086 [email protected]

Ms Angie Barry Nurse Tutor091 544969 086 0138953 [email protected]

Ms Gráinne GlackenSpecialist [email protected]

Ms Fiona Hurley Specialist Co-ordinator: [email protected]

Ms Mary Connor Nurse TutorTelephone: 091 544308 Mobile: 086 7833892 [email protected]

Ms Rachael ComerSpecialist [email protected]

Ms Emer O’Donoghue Specialist Co-ordinator: 086 3884332 [email protected]

Ms Marie Delaney Nurse Tutor091 544521 087 2999142 [email protected]

Ms Mairead Lo�usNurse Tutor094-9042184087-7645883Mairead.lo�[email protected]

Ms Marie O’Dowd Clerical O¸[email protected]

Ms Carmel BranniganClerical O¸cer 091 544362 [email protected]

Ms Paula ScullyClerical O¸[email protected] number094-9042075

Ms Caroline RockeSta� O¸cer (Por�uncula Hospital)[email protected]

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Nursing & Midwifery Planning & Development UnitHSE West – Mid West

Contact List

Name Title Address Number Email

Ms Mary Frances O Reilly Director

NMPDU, HSE West –Mid West, Clinical & Administra�on Building, Block A, Merlin Park University Hospital, Galway

091-775840/1087-9087552 [email protected]

Ms Gillian Conway Project O¸cerNMPDU O¸ce, Nurses Home, University Hospital, Ennis, Co. Clare

065-6863225087-2023377 [email protected]

Ms Anne�e Connolly Project O¸cer NMPDU, 31/33 Catherine Street,

Limerick061-483283086-0470863 Anne�[email protected]

Ms Fiona McMahon Project O¸cer NMPDU, 31/33 Catherine Street,

Limerick061-483552087-2363913 [email protected]

Ms Valerie Ryan Sta� O¸cer NMPDU, 31/33 Catherine Street, Limerick 061-483552 [email protected]

Ms Carmel Hoey Project O¸cer St. Brigid’s Hospital, Creagh Road, Ballinasloe, Co. Galway

091-775843087-7903569 [email protected]

Ms Mary B Rice Project O¸cer CNME, St. Mary’s Campus, Castlebar, Co. Mayo

094-9042038087-9087482

[email protected]

Ms Anne McCarthy Research O¸cer

NMPDU, HSE West –Mid West, Clinical & Administra�on Building, Block A, Merlin Park University Hospital, Galway

091-778542 [email protected]

Ms Mary GannonClinical Link Facilitator Gerontology

NMPDU, HSE West –Mid West, Clinical & Administra�on Building, Block A, Merlin Park University Hospital, Galway

091-775844087-1224237 [email protected]

Ms Sarah Deeney A/Sta� O¸cer

NMPDU, HSE West –Mid West, Clinical & Administra�on Building, Block A, Merlin Park University Hospital, Galway

091-775839 [email protected]

Ms Jackie Lillis Assistant Sta� O¸cer

NMPDU, HSE West –Mid West, Clinical & Administra�on Building, Block A, Merlin Park University Hospital, Galway

091-775842 [email protected]

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N O T E S

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N O T E S

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N O T E S

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M y C o n t a c t s f r o m t o d a y

CONTACT NAME WORK PLACE EMAIL Phone Number

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Integrated Care Approach to Frailty in the Older Person Conference Booklet

Office of the Nursing & MidwiferyServices Director