http://hdl.handle.net/10147/189006 Sun, 26 May 2013 08:05:57 GMT 2013-05-26T08:05:57Z http://hdl.handle.net/10147/252913 Title: South Tipperary General Hospital continuous quality improvement strategy and achievements 1996-2003 Abstract: In South Tipperary General it was agreed basically to provide a circle of people from all professional disciplines within the hospital whose remit is to improve the quality of service throughout the hospital, to provide liaison with people of recognised expertise, and to evaluate procedures through reflective practice against the evidence of current research available. Having developed as a unilateral group initially in 1996, the group evolved into a truly Multidisciplinary group 1988 and functions as a very effective team ongoingly. The group has sought to develop terms of reference as a guide to ongoing continuous quality improvements. Thu, 01 Jan 2004 00:00:00 GMT http://hdl.handle.net/10147/252913 2004-01-01T00:00:00Z http://hdl.handle.net/10147/219014 Title: Fracture liaison service in a non-regional orthopaedic clinic--a cost-effective service. Authors: Ahmed, M; Durcan, L; O'Beirne, J; Quinlan, J; Pillay, I Abstract: Fracture liaison services (FLS) aim to provide cost-effective targeting of secondary fracture prevention. It is proposed that a dedicated FLS be available in any hospital to which a patient presents with a fracture. An existing orthopaedic clinic nurse was retrained to deliver a FLS. Proformas were used so that different nurses could assume the fracture liaison nurse (FLN) role, as required. Screening consisted of fracture risk estimation, phlebotomy and DXA scanning. 124 (11%) of all patients attending the orthopaedic fracture clinic were reviewed in the FLS. Upper limb fractures accounted for the majority of fragility fractures screened n=69 (55.6%). Two-thirds of patients (n=69) had reduced bone mineral density (BMD). An evidence based approach to both non-pharmacological and pharmacotherapy was used and most patients (76.6%) receiving pharmacotherapy received an oral bisphosphonate (n=46). The FLS has proven to be an effective way of delivering secondary prevention for osteoporotic fracture in a non-regional fracture clinic, without increasing staff costs. Description: Fracture liaison services (FLS) aim to provide cost-effective targeting of secondary fracture prevention. It is proposed that a dedicated FLS be available in any hospital to which a patient presents with a fracture. An existing orthopaedic clinic nurse was retrained to deliver a FLS. Proformas were used so that different nurses could assume the fracture liaison nurse (FLN) role, as required. Screening consisted of fracture risk estimation, phlebotomy and DXA scanning. 124 (11%) of all patients attending the orthopaedic fracture clinic were reviewed in the FLS. Upper limb fractures accounted for the majority of fragility fractures screened n=69 (55.6%). Two-thirds of patients (n=69) had reduced bone mineral density (BMD). An evidence based approach to both non-pharmacological and pharmacotherapy was used and most patients (76.6%) receiving pharmacotherapy received an oral bisphosphonate (n=46). The FLS has proven to be an effective way of delivering secondary prevention for osteoporotic fracture in a non-regional fracture clinic, without increasing staff costs. Sun, 01 Jan 2012 00:00:00 GMT http://hdl.handle.net/10147/219014 2012-01-01T00:00:00Z http://hdl.handle.net/10147/189015 Title: Healthcare professionals' experiences of the implementation of integrated care pathways. Authors: Hogan, Catherine; Barry, Maria; Burke, Mary; Joyce, Pauline Abstract: The purpose of this paper is to report on a study that explores healthcare professionals' experiences of the implementation of integrated care pathways (ICPs).; This study used a phenomenological research approach with a purposive sample of ten multi-disciplinary healthcare professionals across two acute hospitals in Ireland. Data were collected via semi-structured interviews and analysed using Colazzi's framework.; The findings of the study are presented under four themes: buy-in from all disciplines, multidisciplinary communication, service-user involvement, and audit of ICPs. These themes emanated from the questions asked at interview.; The limitations of the study include the small sample size and the use of two different interviewers across the sites. The inexperience of the interviewers is acknowledged as a limitation as the probing of some questions could have been improved. In addition the themes of the findings were predetermined by the use of the interview guide.; Changes in existing institutional structures and cultures are required when introducing ICPs. It is necessary for senior management in organisations to lead by example. They also need to identify where support can be offered, such as in the provision of an ICP facilitator, education sessions in relation to ICPs and the development of strategies to improve multi-disciplinary buy-in and participation.; The findings of this study respond to a gap in the literature in Ireland on the experiences of healthcare professionals who have implemented ICPs. Key findings of the study are the perception that the doctor is pivotal in driving the implementation of ICPs, yet the doctor was not always interested in this responsibility. Sat, 01 Jan 2011 00:00:00 GMT http://hdl.handle.net/10147/189015 2011-01-01T00:00:00Z