Irish journal of medical science
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Urological service provision has changed dramatically with the advent of the SARS-CoV-2, necessitating restructuring and reorganization. The aim of this study was to review the reorganization of our unit, map the change in volume of departmental activities and discuss potential solutions. ⋯ Compared with 2019, we performed fewer operations and outpatient procedures, had fewer admissions and diagnosed fewer patients with new cancers. However, outsourcing elective operation to designated non-COVID hospitals prevented the infection of any patient with COVID-19 in the post-operative period. The use of virtual clinic and telephone clinic has had some success in replacing traditional outpatient visits. The overall significant decrease in operative volume will likely precipitate a mismatch between demand and service provision in the coming months, unless capacity is increased.
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Breastfeeding rates in Ireland are among the lowest in the world; thus, it is important to understand what knowledge and skills exist and what are the education needs of dietitians. There has been no Irish research on dietitians' perception of their role in promoting, protecting and supporting breastfeeding. ⋯ Further examination of the role of the dietitian and the establishment of expected competencies would provide a clear framework for future training and education of dietitians towards increasing breastfeeding prevalence in Ireland.
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Patellar instability is a disabling condition that limits the functional ability and physical aspirations of patients. There are multiple anatomical structures which stabilize the patella and surgical treatment is tailored to repair the underlying aetiology. ⋯ Patellar stabilization surgery is an effective method of treating patellar instability, resulting in stability of the knee in 94.4%. Despite this, patient dissatisfaction rates are quite high suggesting that this patient group, whilst mostly stable, remains significantly symptomatic from their knee. These positive results which are reflected in the recent literature represent a strong case for consideration of primary surgical stabilization in cases of patellar instability.
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The true incidence of sepsis in surgical cohorts in Ireland remains unclear. According to inpatient audits, patients in surgical diagnostic groups (DRG) who developed sepsis had a longer length of stay and higher mortality rate compared with medical DRG patients who developed sepsis. ⋯ Sepsis was under-documented, and barriers exist with use of the national sepsis screening form. Frailty, which is a sepsis risk factor, should be assessed pre-operatively to maximise prevention.
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COVID-19 required rapid innovation in health systems, in the context of an infection which placed healthcare professionals at high risk; general practice has been a key component of that innovative response. In Ireland, GPs were asked to work in a network of community assessment hubs. A focused training programme in infection control procedures/clinical use of personal protective equipment (PPE) was rapidly developed in advance. University departments of general practice were asked to develop and deliver that training. ⋯ Academic departments, GPs and the Irish health system collaborated effectively to respond to the need for community assessment of COVID-19 patients.