• Acute medical units: review of evidence.

      Byrne, Declan; Silke, Bernard; Department of Medicine, Kerry General Hospital, Tralee, Ireland. declangbyrne@physicians.ie (2011-08)
    • Avascular necrosis of bilateral femoral heads in a patient with Fabry's disease.

      O'Neill, Francis; Rice, John; Trauma and Orthopaedic Department, Kerry General Hospital, Tralee, Kerry, Ireland. fneill@hotmail.com (2012-07-13)
      The underlying cause of avascular necrosis (AVN) of the femoral head is often not apparent. We report the case of a 26 year old builder with a four month history of bilateral hip pain, and a diagnosis of bilateral femoral head avascular necrosis. Fabry's disease was identified as the probable cause. Since 2001, enzyme replacement therapy for Fabry's disease has become available, with a potential to influence the disease process, and this is of potential importance to clinicians treating AVN.
    • Do we need community geriatrics?

      O'Hanlon, S; Liston, R; Kerry General Hospital, Tralee, Co Kerry. sohanlon@gmail.com (2012-01-30)
      Community geriatrics has evolved as a specific aspect of geriatric medicine in the UK. In Ireland there is uncertainty as to how it should be planned. This is the first national survey of consultants, specialist registrars and general practitioners to seek their opinions. Most consultants and GPs reported already having a community aspect to their current practice, e.g. nursing home visits or community hospital visits, whereas most SpRs did not. Forty three of 62 respondents (69%) agreed that there is a need for community geriatricians and that there should be integration with hospital medicine. Fifty seven of 62 respondents (92%) felt that there would be a beneficial effect on GP services, though some expressed concern about work overlap. Thirteen of the 25 SpRs (52%) in training hoped to begin practice in community geriatrics in the future.
    • Education in geriatric medicine for community hospital staff.

      O'Hanlon, Shane; Liston, Richard; Kerry General Hospital, Ireland. sohanlon@gmail.com (2010-12)
      Community hospitals provide many services for older people. They are mainly managed by nursing staff, with some specialist input. Little is known about education provided in these facilities. Most education in geriatric medicine is provided in hospitals, despite most elderly care being provided in the community. The authors surveyed senior nursing staff in Irish community hospitals to examine this area in more detail. Staff in all 18hospitals in the Health Service Executive (South) area were invited to participate. The response rate was 100%. Sixteen of the 18 respondents (89%) felt staff did not have enough education in geriatric medicine. Just over half of hospitals had regular staff education sessions in the area, with a minority of sessions led by a geriatrician, and none by GPs. Geriatrician visits were valued, but were requested only every 1-3 months. Staff identified challenging behaviour and dementia care as the areas that posed most difficulty.
    • Family planning and inflammatory bowel disease: the patient and the practitioner.

      Toomey, Desmond; Waldron, Brian; Department of Surgery, Kerry General Hospital Tralee, Co Kerry, Ireland. toomey.des@gmail.com (2013-02)
      Patients with inflammatory bowel disease (IBD) are commonly in their child-bearing years. Maintainance medication, as recommended by international guidelines, is an emotive topic and an anxiety source. This study measures the awareness of patients and primary practitioners of the issues involved.
    • Gastric cancer-related information on the Internet: incomplete, poorly accessible, and overly commercial.

      Killeen, Shane; Hennessey, Arthur; El Hassan, Yahear; Killeen, Kelvin; Clarke, Nick; Murray, Kevin; Waldron, Brian; Department of Surgery, Kerry General Hospital, Tralee, Co. Kerry, Ireland. sdfkilleen@eircom.net (2011-02)
      Internet gastric cancer information is overtly commercial, generally incomplete, and poorly accessible.
    • Refocusing acute psychiatry, performance management, standards and accountability, a new context for mental health nursing.

      Harnett, P J; Bowles, N; Coughlan, A; Kerry Community Services, Kerry General Hospital, Rathass, Tralee, Co. Kerry, Ireland. pj.harnett@hse.ie (2009-06)
      The term 'performance management' has an aversive 'managerial' aspect, is unappealing to many public sector staff and has an 'image problem'. Perhaps as a consequence, it has failed to make a significant impact on Irish public sector workers, notably mental health nurses. In this paper, performance management is introduced and examined within an Irish healthcare context and with reference to its use in other countries. Some of the challenges faced by Irish mental health nurses and the potential benefits of working within a performance managed workplace are discussed. The paper concludes that performance management is likely to increasingly affect nurses, either as active agents or as passive recipients of a change that is thrust on them. The authors anticipate that the performance management 'image problem' will give way to recognition that this is a fundamental change which has the potential to enable health services to change. This change will bring high standards of transparency, worker involvement in decision making, an explicit value base for health services and individual teams. It provides the potential for clear practice standards and high standards of transparency as well as worker welfare in all aspects, including supporting employment and career progression.
    • Severe hemorrhage from a hypodermoclysis site.

      O'Hanlon, Shane; Sheahan, Patricia; McEneaney, Robert; Kerry General Hospital, Tralee, Co Kerry, Ireland. sohanlon@gmail.com (2012-01-31)
      Hypodermoclysis, or subcutaneous infusion of fluids, is an alternative means of administration of fluid. It is sometimes used in older patients in whom there is difficulty achieving intravenous access, or who are entering the terminal stage. It is considered a relatively low-risk procedure. We report a case where a patient's death may have resulted from its use.