1,333 Works

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...

The Implementation of an Audit Programme across Drug Treatment Centre (DTC) Pharmacies

Implementing clinical audits is an internationally recognised way of getting evidence into practice. There is an increased emphasis towards conducting audits within the Health Service Executive. Drug Treatment Centre pharmacies, due to the nature of the specialised services that they provide, are situated at different sites, and variations in practices were expected and accepted. The aim of the project was to develop and implement an audit programme across eight pharmacies within an eight month period....

Enduring Power of Attorney (EPA) - implementing and sustaining discussions

This change project focused on increasing the awareness and understanding of the Enduring Power of Attorney among members of a regional Mental Health Team, patients and carers. In 2011, 1405 Wardship orders, a provision under the outdated Lunacy Regulations Ireland Act, 1871, were signed in Ireland as opposed to 440 appointed Enduring Powers of Attorney, under Irish Power of Attorney Act 1996. This suggests a probable lack of awareness or understanding and uptake of the...

Implementation of a Pressure Ulcer Prevention Protocol in a Coronary Care Unit

Samir Eshdooh
Healthcare clinicians perceive care standardization as a requirement. Hospital Acquired Pressure Ulcers (HAPU) is a leading cause of preventable harm. It is associated with a significant increase in treatment cost, length of stay, and poor patients’ satisfaction. This project applies the principle of care processes standardization via developing and implementing evidence based Pressure Ulcer Prevention Protocol (PUPP). A comprehensive process starts on admission and continues throughout the course of hospitalization in the Coronary Care Unit...

Unscheduled patients: the introduction of a structured booking form to enhance workflow patterns from point of booking until transition to the operating theatre.

Bernadette Kilmartin
Background: The management of unscheduled patients presenting to an operating theatre poses a major obstacle for service planning and provision. The ability to schedule these cases during rostered working hours, where possible, is safer for the patient1 and a more efficient use of theatre, staff and hospital resources2. Aim: The aim of this project was to introduce a structured booking form to enhance workflow patterns from point of booking until transition to the operating theatre...

Unscheduled patients: the introduction of a structured booking form to enhance workflow patterns from point of booking until transition to the operating theatre.

Bernadette Kilmartin
Background: The management of unscheduled patients presenting to an operating theatre poses a major obstacle for service planning and provision. The ability to schedule these cases during rostered working hours, where possible, is safer for the patient1 and a more efficient use of theatre, staff and hospital resources2. Aim: The aim of this project was to introduce a structured booking form to enhance workflow patterns from point of booking until transition to the operating theatre...

Redesigning a speech and language therapy service in a school for emotional, behavioural disorders: perspectives of service users

Marie Fahy
This project takes a whole systems view of the challenges and opportunities for individuals working towards integration for children with speech, language and communication needs. The context involves collaboration across mental health and special education, to improve vocabulary outcomes for children attending a school for emotional, behavioural disorders. The facilitator of this project (student) viewed collaboration from a multilayered perspective, incorporating children, parents, school staff, operational and strategic levels of collaboration. Policy and the literature...

Reducing Clinical Waste in a Haemodialysis Clinic, Small Change Big Impact.

Myriam Reidy
The „Small Change, Big Impact‟ project was implemented in a busy 14 bed haemodialysis unit. The organisation as a whole was looking at ways to reduce waste production throughout the hospital. It was found, by looking at a departmental level that the amount of clinical waste generated by a single haemodialysis treatment was substantial. While this waste production cannot be eliminated, there are measures that can be taken to substantially reduce the majority of this...

Reducing Clinical Waste in a Haemodialysis Clinic, Small Change Big Impact.

Myriam Reidy
The „Small Change, Big Impact‟ project was implemented in a busy 14 bed haemodialysis unit. The organisation as a whole was looking at ways to reduce waste production throughout the hospital. It was found, by looking at a departmental level that the amount of clinical waste generated by a single haemodialysis treatment was substantial. While this waste production cannot be eliminated, there are measures that can be taken to substantially reduce the majority of this...

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