N a t io n a l I n s t it u t e o f H e a lt h S c ie n IN THIS ISSUE c e s R • The Known Prevalence of e se Diabetes Mellitus by Age a rc in Irish General Practice: h B A Cross-Sectional Examination u lle t • The Effect of Head Protection in on the Hearing of Rugby Players D e • Impact of Hepatitis C c e m on Health-Related b e Quality of Life - r 2 An Irish Perspective 0 0 6 • Assessment of Biocompatibility of an Acellular Scaffold Derived from Porcine Urinary Bladder Membrane Utilizing L 929 in a Novel Bioreactor Volume 3 Issue 4 ISSN: 1649-0681 St. Camillus Hospital December 2006 Shelbourne Road Limerick, Ireland V o lu m T: 061 483975 e F: 061 326670 3 I s E: [email protected] s u e W: www.nihs.ie 4 Research Bulletin ISSN: 1649-0681 Volume 3 Issue 4 2006 National Institute of Health Sciences, St. Camillus Hospital, Shelbourne Road, Limerick, Ireland All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or any information storage and retrieval system, without permission from the contributors. © NIHS 2006 Published by Designers Ink, Limerick If you wish to contribute to future editions of this publication, please contact: The National Institute of Health Sciences St. Camillus Hospital Shelbourne Road Limerick t: 061-483975 f: 061-326670 e: [email protected] w: www.nihs.ie National Institute of Health Sciences (NIHS) ABOUT THE NIHS The NIHS represents a strategic alliance between the Health Service Executive (HSE) and the University of Limerick (UL). The primary goal of the NIHS is to advance and support high quality health-related research and to promote evidence-based healthcare delivery. This is achieved through advanced education, access to and dissemination of information and the fostering of partnerships between educational organisations, the healthcare service and the private sector where appropriate. GUIDE TO GOOD RESEARCH PRACTICE In order to provide more practical support to health researchers in the region the NIHS has produced a “Guide to Good Research Practice” which is supplied as a supplement to this issue of the Research Bulletin. This guide outlines in step-by-step fashion the key aspects of conducting health research and the pitfalls to avoid. This guide is supported by the provision of up-to-date texts in the Regional Medical Library and will shortly be available on the NIHS website along with several other useful documents providing advice on conducting health research. Cover of Guide to Good Research Practice ii HSE Libraries Online HSE LIBRARIES ONLINE • Do you need information for your clinical practice? • Are you studying for futher qualifications or engaged in a research project? • Do you need help to find the right information? In May 2006 Professor Drumm launched two major online resources for HSE staff – HSE Libraries Online and the Digital Archive of Irish healthcare information. HSE Libraries Online www.hselibrary.ie is the first national electronic library and information service to be set up in Ireland which is designed for healthcare staff working within the HSE. The two main aims of this website project are: 1. To provide a single point of access to electronic journals and databases 2. To provide access to the Digital Archive of Irish healthcare information The website was developed to provide high quality, value for money, co-ordinated library and information services for all HSE staff, thereby enhancing patient and consumer care. Key information resources available on www.hselibrary.ie include: • Fulltext electronic journals • Databases of journal articles • Irish Health Publications Archive • A Directory of HSE Libraries HSE Libraries Online provides 24/7 access from work or home and also acts as a contact point for a Digital Archive of Irish Health Information which may be accessed from any computer with Internet access. The Irish Health Publications Digital Archive is a collection of Irish Health publications including former area boards, Department of Health and Children and current HSE publications. The documents are all available in PDF format. Access to the majority of these resources is free for all e-Library users. Many of the electronic journals and some of the electronic and databases require an ATHENS password, which is available to all staff working or training with the Health Service Executive. HSE staff should register online at www.hselibrary.ie or at your local HSE library for an Athens password. It is envisaged that the range of resources available will be extended and developed over the coming months and years to provide comprehensive subject coverage to reflect the commitment of the HSE to supply high quality, evidence based information to all staff at the point of care. For more information log on to www.hselibrary.ie or contact your local HSE Library. iii Contents ABOUT THE NIHS ii HSE LIBRARIES ONLINE iii CLINICAL RESEARCH Medical (Unpublished) An Audit of the Assessment of Venothromboembolism (VTE) Prophylaxis for 1 Patients Admitted to The Mid-Western Regional Hospital, Ennis, Co. Clare Suliman, A., McNamara, P., Abass, K., Abdelrazig, A., Banaga, Y., Hennessy, T. Audit on Non-Invasive Ventilation in a District General Hospital 4 Hussain, M., Stephens, N., Power, J. An Audit of the Reporting and Treatment of Pressure Ulcers in the Mid-Western 6 Regional Hospital, Ennis, Co. Clare McNamara, P., Liddy, D. Are there Changes in Usual Acitivites in Patients following a Cardiac Event? 8 Cantwell, A. Gait Analysis in Orthostatic Hypotension Using Footswitches 10 O’Connor, M., Culhane, K., Finucane, A.M., Lyons, G., Lyons, D. CLINICAL RESEARCH Medical (Ongoing) The Yeast Yarrowia lipolytica as a Model for Obesity 11 Pembroke, J.T. CLINICAL RESEARCH Palliative Medicine (Unpublished) Evaluating the Need for a Staff Support/Counselling Service in a Palliative Care Setting 14 Houghton, F., Christensen, S. CLINICAL RESEARCH Surgical (Unpublished) The Effect of Head Protection on the Hearing of Rugby Players 16 Kieran, S.M., Dunne, J., Hughes, J., Fenton, J.E. Management of Acute Cholecystitis Patients in an Acute General Hospital 17 Abdeldaim, Y., Mahmood, S., McAvinchey, D. iv A 14 Year Audit of Vascular Trauma Management in the Irish Mid-West 19 Abdulkarim, A., Fleming, F., Kavanagh, E., Burke, P., Grace, P.A. Blood Transfusion Requirements in Otolaryngology, Head and Neck Surgery 21 Adelola, O.A., Kieran, S.M., Joyce, S., Hughes, J., Manning, K.P., Fenton, J.E. Is Preoperative Group and Hold Necessary in Laparoscopic Cholecystectomy? 24 Hussain, A., Rashid, A., Ali, A., Ahmad, N.Z., O’Ceallaigh, D., Byrnes G., Naqvi, S.A. Variations in Inguinal Hernia Repair in Ireland 25 Hussain, A., Ali, A., Lal, K., Ahmad, N.Z., O’Ceallaigh, D., Byrnes, G., Naqvi, S.A. High Incidence of Malignant Skin Lesions over the Age of 70 - A Prospective Analysis 27 Ahmad, N.Z., Ali, A., Hussain, A., Byrnes, G., O’Ceallaigh, D., Naqvi, S.A. Close Monitoring is as effective as Immediate Re-excision in Cases of 29 Incompletely Excised Malignant Skin Lesions Ahmad, N.Z., Hussain, A., Ali, A., Byrnes, G., O’Ceallaigh, D., Naqvi, S.A. Optimizing the Medical Therapy of Acute Surgical Patients 31 Ahmad, N.Z., Mirghani, D., Byrnes, G., O’Ceallaigh, D., Naqvi, S.A. Circumcision with Gomco Clamp is Safe and Straightforward 33 Ahmad, N.Z., O’Ceallaigh, D., Naqvi, S.A., Byrnes, G. CLINICAL RESEARCH Surgical (Ongoing) Wide Diversity in Operative Technique for Laparoscopic Cholecystectomy 34 Exists Among Irish Surgeons Lal, K., Abdulkarim, A., Muhammad, K.M., Hussain, A., Ali, A., Coakley, D., Byrnes, G. O’Ceallaigh, D., Naqvi, S.A. CLINICAL RESEARCH General Practice (Unpublished) The Known Prevalence of Diabetes Mellitus by Age in Irish General Practice: 36 A Cross-Sectional Examination Houghton, F., O’Connor, R., Saunders, J., Dobbs, F. Variation in the Known Prevalence of Type 2 Diabetes Mellitus in the Mid-West: 43 A Practice Population Study O’Connor, R., Houghton, F. v CLINICAL RESEARCH Nursing (Unpublished) The Motivation of Nurses to Participate in Continuing Professional Education in Ireland 46 Murphy, C., Cross, C., McGuire, D. CLINICAL RESEARCH Clinical Services –Physiotherapy (Unpublished) Influence of Instruction Method on Recruitment Ratio of Vastus Medialis 47 Obliques/Vastus Lateralis during a Mini-Squat Conroy, C.J., O’Sullivan, K. To Examine the Reliability of the Electrogoniometer to Measure Maximum Knee 51 Flexion during Gait McGroary, S., Clifford, A. Intra and Inter-rater Reliability of the PowerTrack II Hand-held Dynamometer in 53 the Measurement of Shoulder Flexion and Elbow Extension Strength Cahill, F., Clifford, A. CLINICAL RESEARCH Mental Health (Unpublished) A Qualitative Study of End-Stage Renal Disease Patients’ Experience of 55 Haemodialysis and their Mental Health Needs Cullinane, E. Bullying Experiences of One Post-Primary School in a Semi-Rural Location in Ireland 57 Mangan, E., Coleman, D., Ryan, P. An Evaluation and Comparison of the Relationship between Olfactory Function 58 and Cognitive Ability. A Pilot Project Gillan, D., Wale, S., Ryan, P. Evaluation of the Parent Plus Early Years Programme 61 Brain, K., Fitzsimons, S., Ward, M., Shaw, J. CLINICAL RESEARCH Biomedical Engineering (Unpublished) Assessment of Biocompatiblity of an Acellular Scaffold Derived from Porcine 63 Urinary Bladder Membrane Utilizing L929 in a Novel Bioreactor Shaikh, F.M., O’Brien, T.P., Callanan, A., Badalyk, S.F., Kavanagh, E.G., Burke, P.E., Grace, P.A., McGloughlin, T. vi POPULATION HEALTH Public Health (Unpublished) Health of Informal Carers: Analysis of Irish 2002 Census Data 64 Houghton, F., Cowley, H., Kelleher, K. Needs Assessment Survey of People with Acquired Brain Injury in the Mid-West Region 70 Ross, P., MacMathúna, L. POPULATION HEALTH Public Health (Ongoing) Impact of Hepatitis C on Health-Related Quality of Life – An Irish Perspective 74 McKenna, O., Blake, C. Working towards Changing Policy in the Prevention and Treatment of Head Lice 77 – The Bugbusting Method McGuirk, D., Quirke, G., Doyle, E., Ormsby, J., Horgan, B., Lavin, N., O’ Hanlon, A., Douglas, B., McMahon, N. Public Health Nurse-led Child Health Screening Programme 79 Horgan, B., Murphy, T., O’ Connor, C., Murphy, J., Lavin, N., McMahon, N., McDermott, M., Hartford, M., Doyle, E., Curtis, M., Pollard, G. POPULATION HEALTH Health Promotion (Unpublished) Physical Activity among National School Children in the Mid-West 82 Houghton, F., Cowley, H., Meehan, F., Kelleher, K. HEALTH SYSTEMS MANAGEMENT Clinical Services - Physiotherapy (Unpublished) A Focus Group Study of Student Physiotherapist’s Perceptions of Reflection 84 Roche, A., Coote, S. NEwS 86 EVENTS 88 vii EDUCATION, TRAINING AND CONTINUING PROfESSIONAL DEVELOPMENT 95 ABSTRACT SUBMISSION fORM 99 ABSTRACT SUBMISSION GUIDELINES (Unpublished) 101 ABSTRACT SUBMISSION GUIDELINES (Published) 103 viii Clinical Research d Medical e h s TITLE An Audit of the Assessment of Venothromboembolism (VTE) i l Prophylaxis for Patients Admitted to the Mid-western Regional b Hospital, Ennis, Co. Clare u AUTHORS Suliman, A., McNamara, P., Abass, K., Abdelrazig, A., Banaga, Y., Hennessy, T. p Mid-Western Regional Hospital, Ennis, Co. Clare n u INTRODUCTION Venothromboembolism (VTE), deep vein thrombosis of the lower limb (DVT) and pulmonary embolism (PE) are a common cause of morbidity and mortality. They are a preventable cause of death in hospitalized patients. Recent controlled trials suggest that antithrombotic prophylaxis in appropriate people at increased risk of thrombosis, not only reduces disability and mortality, but is also a cost-effective therapy in selected, high-risk patients. An audit was performed to determine (1) the frequency of medical inpatients receiving VTE prophylaxis, (2) whether patient’s risk of VTE was well assessed, (3) whether contraindications to VTE prophylaxis were documented. METHODOLOGY A retrospective review was performed on 100 patients admitted to medical wards in the Mid-Western Regional Hospital, Ennis, Co. Clare in 2005-‘06 with high risk for VTE (e.g. age more than 75 years, malignancy, immobility for 3 days or more, congestive cardiac failure, obesity, recent surgery, previous VTE). RESULTS Of 100 patients reviewed age ranged from 26-94 years, only 32 (32%) patients were assessed for risk of VTE, 9 patients (9%) received enoxaparin (clexane) 40mg s/c o.d, 3 patients (3%) received Tinzaparin (Innohep) 3,500 units s/c o.d, 30 patients (30%) were taking aspirin75mg o.d, 6 patients (6%) on clopidogrel 75mg o.d, and 20 patients (20%) were already on warfarin. Mechanical VTE prophylaxis (anti-embolic stockings and intermittent pneumatic compression) was not used. Only 2 patients (2%) have hypersensitivity to thromboprophylaxis, 13 patients (13%) have bleeding or potentially bleeding problems. Table 1 - Thromboprophylaxis Treatment Taken Total No.100 No. Received % Received TED stockings 0 0% Enoxaparin (Clexane) 9 9% Tinzaparin (Innohep) 3 3% Aspirin 30 30% Warfarin 20 20% Clopidogrel 6 6% No Action Taken 33 33% 1