Research conducted by staff affiliated to Midland Regional Hospital, Tullamore

Recent Submissions

  • Obesity: An Independent Risk Factor for Complications in Anterior Lumbar Interbody Fusion? A Systematic Review.

    feeley, aoife; McDonnell, Jake; Feeley, Iain; Butler, Joseph (2022-02-22)
    Objectives: Raised patient BMI is recognised as a relative contraindication to posterior lumbar interbody fusion (PLIF) due to the anaesthetic challenges, difficult positioning and increased intraoperative and postoperative complications, with the relative risk rising in patients with a BMI >25 kg/m2. The impact of obesity defined as a BMI > 30 kg/m2 on Anterior Lumbar Interbody Fusion (ALIF) outcomes is not yet established. The aim of this review was to evaluate if the presence of a raised BMI in patients undergoing ALIF procedures was an independent risk factor for intra- and postoperative complications. Methods: A systematic review of search databases PubMed; Google Scholar and OVID Medline was made to identify studies related to complications in patients with increased body mass index during anterior lumbar interbody fusion. PRISMA guidelines were utilised for this review. Complication rates in raised BMI patient cohort was compared to normal BMI complication rates with meta-analysis where available. Results: 315 articles returned with search criteria applied. Six articles were included for review, with 2190 patients included for analysis. Vascular complications in obese vs. non-obese patients undergoing the anterior approach demonstrate no significant difference in complication rates (P = .62; CI = -.03-.02). Obesity is found to result in an increased rate of overall complications (P = .002; CI = .04-.16). Conclusions: Obesity was demonstrated to have an impact on overall complication rates in Anterior Lumbar Interbody Fusion procedures, with postoperative complications including wound infections and lower fusion rates more common in patients in increased BMIs. Increased focus on patient positioning and reporting of outcomes in this patient cohort is warranted to further evaluate perioperative complications.
  • Prospective Risk Assessment of Medicine Shortages in Europe and Israel: Findings and Implications.

    Miljković, Nenad; Godman, Brian; Kovačević, Milena; Polidori, Piera; Tzimis, Leonidas; Hoppe-Tichy, Torsten; Saar, Marika; Antofie, Ioan; Horvath, Laszlo; De Rijdt, Thomas; et al. (2020-03-26)
    A semi-structured questionnaire focusing on medicine shortages was distributed electronically to members of the European Cooperation in Science and Technology (COST) Action 15105 (28 member countries) and to hospital pharmacists of the European Association of Hospital Pharmacists (EAHP) (including associated healthcare professionals). Their answers were subjected to both qualitative and quantitative analysis (Microsoft Office Excel 2010 and IBM SPSS Statistics®) with descriptive statistics based on the distribution of responses. Their proportional difference was tested by the chi-square test and Fisher's exact test for independence. Differences in the observed ordinal variables were tested by the Mann-Whitney or Kruskal-Wallis test. The qualitative data were tabulated and recombined with the quantitative data to observe, uncover and interpret meanings and patterns.
  • An Unusual Case of a Facial Guard Causing Penetrating Soft Tissue Injury in the Game of Hurling

    Farrell, T; McDonald, C.; Sheehan, E. (Irish Medical Journal, 2019-02)
    Hurling is a fast-paced impact sport that is known to be associated with trauma to the head, face and hands1. Helmets with facial guards have been introduced by the Gaelic athletic association (GAA) in 2010 as a means of preventing head and maxillofacial injuries. Although the national safety authority of Ireland (NSAI) identify certain standards for hurling helmets, modifications are known to be quite common2. A recent study by O’Connor (2018) showed that 31% of players surveyed from a total of 304 had modified their helmet in some fashion either by changing the faceguard completely or removal of single bars. The main reasons given for modification were; restricted vision, comfort and perceived poor quality of the helmet/faceguard. Anecdotally, players may modify one’s helmet to help improve peripheral vision and thus situational awareness. In the literature, there exists only one case of penetrating injury from a facial guard of a hurling helmet3. The trend of modifying helmets seems to be increasing the incidence of these serious injuries. We believe that there is a general lack of awareness among players and officials as to the dangers of modifying protective equipment. We present the case of a penetrating hand injury as a direct result of a modified facial guard where a single bar was removed.
  • Survivorship care for postmenopausal breast cancer patients in Ireland: What do women want?

    Meade, Elizabeth; McIlfatrick, Sonja; Groarke, Ann Marie; Butler, Eimear (European Journal of Oncology Nursing, 2017-06)
    The aim of this study was to identify the concerns of postmenopausal breast cancer patients in Ireland and inform the development of a survivorship care plan.
  • Midland Regional Hospital, Tullamore, annual report, 2003.

    Midland Regional Hospital Tullamore.; Midland Health Board (MHB) (Midland Regional Hospital, Tullamore, 2004)
    The year 2003 saw the Midland Health Boord continue to provide services of the highest quality and standard to the people of Laois, Longford, Offaly ond Westmeath. The Board continued to benefit from the Notional Development Plan by: the completion of the Paediatric Unit, and Acute In·Patient Psychiatric Unit at the Midland Regional Hospital at Portlaoise; The tremendous progress in the building of the new Midland Regional Hospital of Tullamore, which is due for completion in 2005, and t the completion of the Development Control Plan Phase 2B for the Midland Regional Hospital at Mullingar, which proposes a €57 million capital development, and will see the bed complement at the hospital increase from 203 to 311. Twenty-four nurses from the Midland Regional School of Nursing were conferred with their diplomas at a graduation ceremony held in Tullamore on Thursday 13 February. This is the second group to graduate from the Midland Regional School of Nursing since it wos established in 1998. Nurse training, which is now a Degree programme, is conducted as a partnership between the Midland Health Board and the Institute of Technology, Athlone.
  • Through the looking glass; bioactive glass S53P4 (BonAlive®) in the treatment of chronic osteomyelitis.

    McAndrew, J; Efrimescu, C; Sheehan, E; Niall, D; Department of Orthopaedic Surgery, Midland Regional Hospital, Tullamore, County Offaly, Ireland. (2013-09)
    In terms of eradication, osteomyelitis represents one of the most challenging infective conditions in medicine and surgery. In recent years, the use of bioactive glass in conjunction with antimicrobial therapy has emerged as a viable new treatment.
  • Multidisciplinary approach to consent in arthroplasty surgery

    Mohamed, KMS; Foy, D; Cogley, D; DM Niall, DM; E Sheehan, E; Midland Regional Hospital, Tullamore, Co Offaly (Irish Medical Journal, 2014-06)
    The process of consenting has been in the heart of the surgical practice as the binding contract between the informed patient and the entrusted treating surgeon. This is to protect the patient' s autonomy and respect their right to determine their treatment. Consent validity relies on the provision of procedure information and the capacity of competent patient to understand it 1 . The Irish law states no medical or surgical treatment to be carried out without informed consent of the patient, however the law is not exactly clear in how much information to be provided prior to obtaining consent for administration of medical treatment or procedure 2 . The Irish medical council guidelines published in 2008 defines the significant information as any risk over 1-2% or any risk of grave consequences. It also implies the patient understanding is crucial part of the process 3 .
  • A rare case of calcaneal tumour in a young adult.

    Efrimescu, Catalin Iulian; Bandorf, Nadine; Maxwell, Norman; Niall, Dorothy; Department of Ortho and Trauma Surgery, MRH Tullamore, Tullamore, Ireland. (BMJ, 2012-05)
  • Use of Gamma locking nail(®) in tri-planar osteotomy in bilateral severe slipped upper femoral epiphysis: a case study and literature review.

    Sharafeldin, K N; Butt, A J; Burke, T; Orthopaedic Department, Midland Regional Hospital at Tullamore, Tullamore, Offaly, Republic of Ireland. (Springer, 2012-09)
    Slipped upper femoral epiphysis (SUFE) is a common condition affecting adolescent boys and girls. It is classified as acute, chronic or acute on chronic. The slip can be mild, moderate or severe.
  • Cost savings from batch production of IV anti-neoplastic treatments

    Nykänen, Jenni; Rautio, Eveliina; Garvey, E; Midland Regional Hospital, Tullamore (Midland Regional Hospital, Tullamore, 2012)
  • Safe compounding; it’s in your hands

    Burke, Catriona; Murphy, Dermot; Flynn, Elaine; Garvey, E; Midland Regional Hospital, Tullamore (Midland Regional Hospital, Tullamore, 2012-09-21)
  • So you thought they were clean enough?...

    Kaur, Harpreet; Midland Regional Hospital, Tullamore (Midland Regional Hospital, Tullamore, 2012)
    The extensive use of cytotoxic drugs in the treatment of cancer patients represents a health risk for all staff involved in the preparation and handling of such drugs. This qualifies as an occupational health hazard and the two groups with the highest levels of exposure are pharmacists who dispense these drugs and nursing staff who administer them [1]. Equally other staff involved in their compounding, as well as logistical and training personnel are likely to be exposed.
  • Pre-printed prescriptions as a means of reducing medication incidents in Haematology Patients at Midland Regional Hospital, Tullamore

    Garvey, E; Carr, J; Midland Regional Hospital, Tullamore (Midland Regional Hospital, Tullamore, 2012)
    A number of incidents have occurred in the midlands area due to patients receiving inappropriately prolonged courses of cytotoxic chemotherapy. For example; Incident 1: On discharge, one patient was prescribed Melphalan and Prednisolone as a 6- day course, to be repeated every 28 days. The G.P. wrote a G.M.S. prescription for a 6-day course every week. The patient had received 16 days of treatment before the error was detected. Incident 2: Patient prescribed Chlorambucil in hospital. The hospital pharmacy dispensed the full course. The patient was discharged after 5 days. Patient was due to receive 7 days of chlorambucil. Patient brought home 2 days supply from hospital. Chlorambucil was also prescribed on the discharge prescription. Patient received another 7 days supply in the community. Patient received 14 days instead of 7 days of treatment.
  • Falls prevention advice for patients, relatives and carers

    Medical Illustration Unit, Midland Regional Hospital, Tullamore; Midland Regional Hospital, Tullamore (2012)
    Falls within the hospital environment are an uncomfortable Fact for both patients and staff. Inpatient falls are generally the highest single reported incident to risk management. The aim of the fall prevention strategy is to to prevent factors within MRHM and the wider community associated with patient falls
  • A little less conversation, more action please!

    Scully, Patricia; Midland Regional Hospital, Tullamore (Midland Regional Hospital, Tullamore, 2012-09-20)
    Interruptions and distractions are significant factors in medication errors in the pharmacy environment. “Although only a small percentage of these errors cause harm, medication errors need to be minimised in an effort to improve patient safety1.” Due to the volume of telephone calls within the Regional Oncology Haematology Pharmacy (ROHP), we decided to analyse all phone calls over a secound three week period , the phonecalls were analysed in the same way using the same time frame and parameters. The recommendations from the previous study were applied . The staff in ROHDU were told which extensions were to be used when directing queries into ROHP. All go ahead confirmations were to be emailed to ROHP as apposed to ring through on the phone.
  • Medication reconciliation in oncology & haematology inpatients

    Lydon, S; Garvey, E; Midland Regional Hospital, Arden Road, Tullamore, Co. Offaly (Midland Regional Hospital, Tullamore, 2008)
    The aim was to assess whether the established advantages of pharmacist conducted medication reconciliation, applies to oncology and haematology inpatients
  • Acute shoulder injury with a normal x-ray: a simple algorithm of patient assessment to guide the need for further imaging

    O’Rourke, S; Kelly, P; Midland Regional Hospital, Tullamore (Royal College of Surgeons in Ireland (RCSI), 2012-09-20)
    Purpose: Patients presenting to their General Practitioner or to the Emergency Department following an acute shoulder injury but a normal x-ray may have a significant underlying injury to the Rotator Cuff. Imaging (whether by ultrasound or MRI) is often indicated but available clinical evidence has yet to establish what group of patients benefit most from early imaging. Method: In March 2012 a multidisciplinary approach has been introduced to assess adult patients attending the Emergency Department with acute shoulder injuries, severe pain and/or restricted shoulder movement, but a normal x-ray. This involved a senior medical assessment within 7 days following presentation. All patients with pseudo-paralysis (defined as the inability to abduct the shoulder beyond 45°) and patients with abduction in the range of 45-90° with positive clinical tests suggesting significant rotator cuff involvement are referral for urgent ultrasound. Image confirmed acute, full thickness rotator cuff tears were seen within ten days by an orthopaedic surgeon with a special interest in shoulder surgery. Results: To date 25 patients have been assessed. 11 patients (aged between 42 and 80 years) have met the criteria for early imaging for acute rotator cuff tears. Five confirmed acute tears of the rotator cuff have been referred for early surgical intervention. One patient had a fracture of the greater tuberosity not seen on x-ray. Conclusion: Early post-trauma assessment of patients with acute shoulder injuries with normal x-rays using simple assessment criteria will identify patients at significant risk of acute rotator cuff tears requiring early surgical intervention.
  • Aseptic compounding practice in Ireland – how are we doing it?

    Scully, Patricia; Garvey, E; Regional Oncology Haematology Pharmacy, Midland Regional Hospital, Arden Road, Tullamore, Co. Offaly (2012-06)
    To assess whether compounding practice in the ROHP is the same as other hospitals in Ireland. To assess whether other hospitals are using closed system or needle free compounding devices.
  • Why does it take so long? ‘Lean processing’ in the aseptic compounding unit at the Midland Regional Hospital Tullamore

    Greene, C; Crimmins, É; Garvey, E; Midland Regional Hospital Tullamore (2011-06)
    Increasing numbers of oncology/haematology patients attending Midland Regional Hospital Tullamore (MRHT) has increased the workload of the Regional Oncology Haematology Pharmacy (ROHP) compounding unit. Staff restrictions require optimisation of current workflow practices. This audit (November 2010 and June 2011) focused on workflow in the aseptic compounding unit. In MRHT, ‘go-aheads’ are given by nurses and doctors. Drugs are compounded on an individual patient basis, except for batch production of bevacizumab and cetuximab. Focusing on the workflow process and comparing individual versus batch production in this audit may identify trends to improve efficiency.
  • Think safety first an analysis of aseptic compounding practice

    Garvey, E; Crimmins, E; Ganly, M; Scully, T; Thomas, A; Burke, C; Midland Regional Hospital, Tullamore (2012)

View more