Vascular Medicine at St Vincent’s Hospital provides inpatient and outpatient services for patients with a variety of vascular disorders including venous, arterial and lymphatic disease. These services are undertaken with the support of vascular surgery, interventional and diagnostic radiology and allied health services. The department in collaboration with St Vincent’s Private Hospital has been involved in the development and implementation of campus policies for the prevention of venous thromboembolism (VTE). Recognition of the importance of VTE among hospitalised patients has led to the appointment of a VTE Clinical Nurse Consultant (CNC) at St Vincent’s Hospital. The department manages VTE such as lower limb deep vein thrombosis and pulmonary embolism providing up to date therapies, including systemic thrombolysis for the management of massive pulmonary embolism and, in collaboration with vascular surgical and interventional radiology colleagues, endovenous techniques for the treatment of extensive deep venous thrombosis. The Vascular Wound Care Clinic at St Vincent’s Hospital provides a multidisciplinary approach to the management of lower limb ulceration. This is supported by the department’s vascular physicians, outpatient nursing staff and the hospital’s Wound CNC. In collaboration with local researchers and those from other institutions, research is currently underway in the areas of deep vein thrombosis and peripheral arterial disease. This has been supported by funding that has been successfully obtained to further vascular research.
Perioperative Services
Perioperative Services comprises Anaesthetics, the Recovery Unit, Sterile Processing Centre and Support Services, in order to provide optimal care to patients undergoing elective and emergency surgery. The Sterile Processing Centre also provides a variety of sterilisation services to all departments at a hospital wide level. All surgical specialties, including trauma but with the exception of obstetrics and paediatrics, are catered for within Perioperative Services. A variety of postgraduate courses are run each year to assist with professional development and upskilling of nursing staff to maintain a highly skilled nursing workforce within the service.
Renal Ambulatory Care The Renal Ambulatory Care unit provides haemodialysis and peritoneal dialysis for patients with acute and end stage renal failure, across St Vincent’s and St Vincent’s Private Hospitals. The unit also provides clinical support to other units such as the Intensive and Coronary Care Units. The unit has a 24-hour on call service for urgent dialysis needs. The education and assessment of patients with chronic renal impairment, hypertension and renal transplantation are managed in three outpatient clinics as well as in the Renal Ambulatory Care unit. An in-home training program with extensive follow-up is also in place for community-based peritoneal dialysis patients, including an around-the-clock telephone counselling service. Activity has remained steady throughout the year with more than 10,000 haemodialysis treatments performed and up to 23 patients being managed at-home on peritoneal dialysis. A generous donation from a patient in 2011 saw the purchase of new dialysis chairs, which has significantly improved the comfort of all patients. In 2011 the unit also implemented the use of a database for dialysis called Smarthealth, which has enhanced data collection and storage.
Surgery Sub-Specialities St Vincent’s Hospital has both a predictable elective surgery and emergency surgery load and the Acute Program manages all of the hospital’s surgical services. Colorectal Surgery The Colorectal Surgery team treats all aspects of colorectal surgery, with a particular focus on colorectal cancer, anal cancer and inflammatory bowel disease. There has been an increase in the number of laparoscopic procedures required in 2010/2011 and the department has also increased its expertise in colonoscopic removal of large polyps. While the department’s research interests include the value of multidisciplinary meetings, the genetics of colorectal cancer, the treatment of anal intra-epithelial cancer and solitary rectal ulcer syndrome, there is also an ongoing commitment to student teaching.
Gynaecology The Department of Gynaecology provides a range of services including emergency surgery, elective surgery, education and training. Active in laparoscopic gynaecological surgery, the department uses the laparoscopic skills laboratory for registrar training. Ophthalmology With a solid presence in ophthalmic care, the department offers virtually all ophthalmic sub-specialties including cornea, vitreo-retinal surgery, medical retina and oculoplastics. Caring for both inpatients and outpatients the department facilitates a wide range of specialist clinics including oculoplastics, glaucoma and medical retina. The department continues its focus on education and routinely teaches registrars in the area of phacoemulsification surgery. Orthopaedics More than 5,000 orthopaedic procedures are carried out each year across the St Vincent’s campus. Further growth has continued in the areas of adult joint reconstruction and arthroplasty surgery, including hip and knee replacement and revision joint surgery, as well as foot and ankle surgery and shoulder surgery. The area of musculoskeletal oncology also continues to grow. Otolaryngology, Head and Neck and Skull Base Surgery One of the country’s leading units in the discipline of skull base surgery, the department also provides expertise in otology, neuro-otology, head and neck cancer surgery and advanced endoscopic sinus surgery. Working in close collaboration with neurosurgical and plastic surgery colleagues, the department provides multidisciplinary care and undertakes a large number of procedures including surgery for acoustic neuroma, Cochlear and brainstem implants as well as major head and neck surgical oncology cases. Additional facilities have been provided to the Microsurgical Skills Laboratory, which is involved in the teaching of otologic and rhinologic surgery. There is ongoing active research in rhinology and hearing disorders in collaboration with the Garvan Institute of Medical Research. The department maintains its teaching of two advanced surgical trainees, as well as providing fellowships in otology, neuro-otology, head and neck cancer surgery and Annual Review 2010/11
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Vascular Medicine
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