1,281 Works

The genomics of transplant-related outcomes and familial renal disease

Caragh Stapleton
Chronic kidney disease (CKD) is a growing global health concern with an age-standardized global prevalence of approximately 10%. Of those with CKD, approximately 2% will go on to require renal replacement therapy within any given 5-year period. Renal transplantation is accepted as the most clinically- and cost-effective treatment for end-stage kidney failure. In this thesis, we set out to examine the impact of common genetic variation on renal transplant function as well as a common...

Exploring the experiences of patients with primary and secondary, non-cancer related, lower limb lymphoedema during the intensive and maintenance phases of Complex Decongestive Therapy and its’ impact on their lives

Mary Costello
IntroductionLymphoedema is an incurable, progressive condition, which results in the swelling of a limb or limbs and impairs mobility (Lymphatic Framework, 2006). The psychosocial impact of lower limb lymphoedema is also devastating as body image and quality of life are greatly affected (Lasinski et al, 2012). Although lymphoedema is a chronic condition, it is manageable through treatment modalities which include manual lymphatic drainage, compression bandaging, compression hosiery, skin care and exercise, otherwise known as Complex...

The role of sub-epidermal moisture measurement versus traditional risk assessment and visual skin assessment in the prediction of pressure ulcer risk among adults undergoing surgery.

Ana Lucia M. De Oliveira
Aim: To compare the predictive ability of sub-epidermal moisture measurement versus traditional risk assessment and visual skin assessment as a means of detecting early pressure ulcer damage development among adults undergoing surgery. Method: A non-experimental, comparative, prospective, descriptive design was used. Participants who gave their informed consent had their skin assessed over the areas that were weight bearing during surgery, using visual skin assessment and the sub-epidermal moisture measurement. Visual pressure ulcers were graded according...

A social-ecological approach to examine body mass index during early childhood in Ireland

Samira Barbara Jabakhanji
Background: Childhood overweight and obesity (OWOB) is associated with adult obesity (10) and ill-health (11); however the prevalence among young children in Ireland is unknown. For prevention programmes to target those children most in need, risk factors of OWOB and critical time points when these factors occur need to be identified. This thesis investigated in-depth the OWOB prevalence and risk factors among young children in Ireland.
Methods: A literature review was conducted to identify a suitable...

Mechanical Insufflation Exsufflation and Lung Volume Recruitment in Amyotrophic Lateral Sclerosis: a Prospective Study of the Prescription Process, the Outcomes and the Experience

Rachel McConnell
Introduction: Mechanical Insufflation Exsufflation (M-IE) and Lung Volume Recruitment (LVR) increase cough strength in Amyotrophic Lateral Sclerosis (ALS). Changes in respiratory measures, morbidity, physical function and outcomes; participant’s characteristics prescribed a M-IE and LVR device and their experience with devices are unknown. Finally, LVR adherence is difficult to measure. Aims/Objectives: The primary aim was to measure, respiratory measures, morbidity, physical function and outcome in an Irish ALS cohort. Secondary aims were to examine the characteristics...

Musculoskeletal Clinical Vignettes: a case based text

John M. O'Byrne, Richie Downey, Iain Feeley, Martin Kelly, Lauren Tiedt, Mark E. Murphy, Ellen Stuart &
Musculoskeletal conditions are an extremely common presentation to general practitioners, emergency departments and hospitals. Although the clinical examination for each joint involves a similar approach (the ‘Look, Feel, Move’ format), be it the shoulder, hip or knee, many students can find the subtle differences between each examination difficult. They may also struggle to generate an appropriate differential diagnosis, based upon the history and examination. Commonly presenting musculoskeletal conditions in general practice and orthopaedics are presented...

Musculoskeletal Clinical Vignettes: a case based text

John M. O'Byrne, Richie Downey, Iain Feeley, Martin Kelly, Lauren Tiedt, Mark E. Murphy, Ellen Stuart &
Musculoskeletal conditions are an extremely common presentation to general practitioners, emergency departments and hospitals. Although the clinical examination for each joint involves a similar approach (the ‘Look, Feel, Move’ format), be it the shoulder, hip or knee, many students can find the subtle differences between each examination difficult. They may also struggle to generate an appropriate differential diagnosis, based upon the history and examination. Commonly presenting musculoskeletal conditions in general practice and orthopaedics are presented...

The Relationship Between Performance On Cognitive Screening Tests And Everyday Functioning In Older Adults With Mild Cognitive Impairment

Elaine Scally
Introduction: Occupational therapists (OTs) play an important role in evaluating the cognitive and functional abilities of older adults with mild cognitive impairment (MCI) in the acute hospital setting. Cognitive screening tools such as the Montreal Cognitive Assessment (MoCA) and the Addenbrooke’s Cognitive Examination (ACE-III) are regularly administered by acute hospital OTs to assist in predicting the functional capacities of individuals with MCI. However findings from clinical practice show that performance on cognitive screening tools is...

Implementation of a Visual assessment Tool to Ensure that central Venous Access Devices Care is Delivered and Documented

Diana Paul
Aim: The core aim of this project is to implement a visual assessment tool to ensure that all the CVADs on the patients are checked on every shift, adequate care is provided and proper documentation is done post care delivery. Rationale: All CVADs‟ are a potential source of infections. The microbes that colonize catheter hubs and the skin surrounding the insertion site are the source of most catheter-related bloodstream infections which could result in further...

An Evaluation of the Impact of the \"Talk downs\" Model on ~Self-perceived Confidence of Nurses for Descalating Potential Aggressive Episodes.

Francis Mc Carron
This change initiative sought to ensure the development of confident and competent nursing staff capable of effectively deescalating potentially aggressive episodes. The initiative was developed in response to feedback given by nursing staff working in an acute mental health setting regarding their concern in relation to their confidence in deescalating potentially aggressive episodes. The author identified utilising educational groups on de-escalation as a method of improving nursing staff confidence. This change initiative will focus on...

An Evaluation of the Impact of the \"Talk downs\" Model on ~Self-perceived Confidence of Nurses for Descalating Potential Aggressive Episodes.

Francis Mc Carron
This change initiative sought to ensure the development of confident and competent nursing staff capable of effectively deescalating potentially aggressive episodes. The initiative was developed in response to feedback given by nursing staff working in an acute mental health setting regarding their concern in relation to their confidence in deescalating potentially aggressive episodes. The author identified utilising educational groups on de-escalation as a method of improving nursing staff confidence. This change initiative will focus on...

Utilising Available Technology to Reduce Waste and Decrease Patient Experience Times

Keith Barter
This Organisational Development Project focused on how admissions through a hospital’s Emergency Department are organized. The primary aim was to streamline the process of organising these admissions by reducing waste and utilising available technology to improve patient flow. Following the introduction of Governmental targets in Healthcare, individual healthcare institutions are seeking ways to achieve these targets. The current process in place has many steps with duplicate paper records of ward allocation for patients who require...

Utilising Available Technology to Reduce Waste and Decrease Patient Experience Times

Keith Barter
This Organisational Development Project focused on how admissions through a hospital’s Emergency Department are organized. The primary aim was to streamline the process of organising these admissions by reducing waste and utilising available technology to improve patient flow. Following the introduction of Governmental targets in Healthcare, individual healthcare institutions are seeking ways to achieve these targets. The current process in place has many steps with duplicate paper records of ward allocation for patients who require...

Quality improvement plan to reduce patient waiting times in a private emergency department

Ciara Melia
Emergency department overcrowding is a public health problem and results in long waiting times and delays in critical treatment for patients. Moreover it has been associated with a number of negative clinical outcomes such as increased complication rates and mortality. Using the DMAIC (define, measure, analyse, improve and control) model for quality improvement (QI), this dissertation investigated the long patient waiting times experienced in a private emergency department in Dublin West. Applying a variety of...

Quality improvement plan to reduce patient waiting times in a private emergency department

Ciara Melia
Emergency department overcrowding is a public health problem and results in long waiting times and delays in critical treatment for patients. Moreover it has been associated with a number of negative clinical outcomes such as increased complication rates and mortality. Using the DMAIC (define, measure, analyse, improve and control) model for quality improvement (QI), this dissertation investigated the long patient waiting times experienced in a private emergency department in Dublin West. Applying a variety of...

An Analysis of the Challenges Encountered by Anaesthetists when Obtaining Consent for Obstetric Epidurals

Rebecca Conlon
Background Obtaining informed consent for obstetric epidurals is a complex area of anaesthesia. Practice among obstetric anaesthetists in this jurisdiction is widely varied. This paper provides an analysis of the ethical and legal challenges encountered by anaesthetists when endeavouring to obtain informed consent to administer the obstetric epidural and makes recommendations as to how these challenges might be lessened. Methods A systematic review of research papers sourced from relevant data bases and websites was conducted....

Reducing the Waiting List for New Referrals to the ENT Outpatient Department

Jana Crowley
Lengthy outpatient waiting lists are a global healthcare concern affecting most hospital specialities, including in Ireland. The result is a delay in treatment and suboptimal outcomes for newly referred patients. Simultaneously, patients requiring long-term follow-up care exist amid this overburdened system. Data collection showed that in December 2017, 3,944 patients were waiting for a first time appointment within the ENT service of a large urban teaching hospital in Dublin. Of these, 766 were waiting to...

Introducing a Fast Track for Patients Undergoing Arthroscopic Subacromial Decompression and/or Rotator Cuff Repair

Javier Rojas
The prolonged length of stay (LOS) after Arthroscopic Subacromial Decompression (ASD) and Rotator Cuff Repair (RCR) is having an adverse effect on the efficiency of the healthcare system. Improving the time patients remain in hospital after surgery will have a positive impact on the patient and on the healthcare providers. The aim of this Quality Improvement Plan (QIP) is to reduce the LOS after ASD or/and RCR designing a Fast Track to allow patients to...

Increasing Compliance with the National Sepsis Management Guideline through Sepsis Screening Form Utilisation

Orla Brett
Sepsis continues to be a major burden on the healthcare service at both a national and international level, affecting millions of people annually. Sepsis is a medical emergency and if not recognised and treated promptly, can be fatal. In an aim to tackle this burden, the National Sepsis Management Committee introduced the sepsis screening form to Irish hospitals in 2016. Using the DMAIC (define, measure, analyse, improve, control) framework for quality improvement (QI), this QI...

Reducing the Waiting Times in a Vascular Outpatient Clinic

Helen Farrell
Improvement of waiting times and a reduction in numbers on waiting lists for outpatient care is a constant battle in healthcare in Ireland. Over the course of the year in 2016 there were some 8,000 patients waiting to be seen by the vascular team in an outpatient clinic. The waiting time of these appointments ranged from 0-18 months. Some of these are new patients, referred from GP or other sources, but a large percentage of...

Developing Service User Involvement in the Mental Health Department of a Paediatric Hospital

Julie Howley
This dissertation traces the development and implementation of a Quality Improvement Plan (QIP) in the area of Service User Involvement within the mental health department of a paediatric hospital. The change management project described focused specifically on the setting up and initial meetings of two Service User panels – one for parents/carers and their representatives and one for young people and their representatives. The dissertation sets out the rationale for this change project drawing on...

Developing Service User Involvement in the Mental Health Department of a Paediatric Hospital

Julie Howley
This dissertation traces the development and implementation of a Quality Improvement Plan (QIP) in the area of Service User Involvement within the mental health department of a paediatric hospital. The change management project described focused specifically on the setting up and initial meetings of two Service User panels – one for parents/carers and their representatives and one for young people and their representatives. The dissertation sets out the rationale for this change project drawing on...

The development of a reflective portfolio of comprehensive, holistic, patient care as a means of assessing dental undergraduate competence

Philip N. Hardy
In a Dental University Hospital the assessment of clinical competence for senior students (4th and 5th year students) prior to this change initiative, was achieved by requiring the students to attain numerical targets for specific clinical procedures. These multiple clinical procedures could be carried out on any number of different patients and the focus of attention was on the procedure and not the patient. Under this system there is no incentive for a student to...

The development of a reflective portfolio of comprehensive, holistic, patient care as a means of assessing dental undergraduate competence

Philip N. Hardy
In a Dental University Hospital the assessment of clinical competence for senior students (4th and 5th year students) prior to this change initiative, was achieved by requiring the students to attain numerical targets for specific clinical procedures. These multiple clinical procedures could be carried out on any number of different patients and the focus of attention was on the procedure and not the patient. Under this system there is no incentive for a student to...

A systemic review and meta-analysis on the impact of perioperative antiplatelets and anticoagulants on the clinical course of chronic subdural hematoma

Ashraf Elmahdi
Background: Chronic subdural hematoma is one of the most common conditions related to neurosurgical practice in the elderly. Reports about recurrence of patients on antiplatelets and/or anticoagulants are highly contradictory. Little current data exists regarding the outcome of chronic subdural hematoma patients on peri-operative medication related coagulopathy. We aimed to review the literature for studies about these drugs and outcome in chronic subdural hematoma patients. Objectives: to perform a systematic review and meta-analysis of studies...

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