Health Matters Spring 2021

MAT T ERS

Health S TA F F M AG A Z I N E O F T H E I R I S H H E A LT H S E R V I C E

SPRING 2021

Hold Firm WE CAN DO THIS

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05/03/2021 09:31

A M ESSAG E F RO M O UR ED I TO R Welcome to the latest edition of the new-look Health Matters.

We enter spring of 2021 with a renewed sense of hope and optimism. It’s hard not to feel there’s light at the end of the tunnel when you are faced with happy and smiling faces behind the masks, in stark contrast with the images we are more used to seeing of a battling staff on the frontline.

And, of course, the source of this renewed optimism is the small vials of COVID-19 vaccines being rapidly distributed around the country.

In the first two months of the year, we have seen our tireless healthcare workers receive their COVID-19 vaccination, providing a sense of relief in the midst of the deadly third wave of the pandemic.

Staff have shared with us their own feelings of happiness, determination, and relief as they get the vaccine and the opportunity to give the protective jab to our most vulnerable across our long-term residential care facilities and hospitals.

And who couldn’t be moved by best friends Florence O’Reilly, aged 87, and Nancy Keogh, aged 92, who all but danced out of the room in Navan Road Community Nursing Home after getting their COVID-19 vaccine?

But there’s still plenty of work to be done before we can put the worst of COVID-19 behind us. We chat to one of the busy contact tracing teams about their work at the height of the third wave. We also take a look at the many initiatives being introduced in healthcare settings up and down the country to safely deliver care to patients.

On a lighter note, we see how HSE staff members Hazel Hartigan and Sharon Gaffney got on in the Operation Transformation spotlight as two of this year’s leaders.

A sincere thanks to all those who have sent in contributions to this edition and I hope you find plenty of interesting reading in it.

Joanne Weston Editor

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CONTENTS 1

Healthcare Heroes

51 Breast cancer referral guidelines

2

A Year in COVID

52 Restarting elective surgery

8

Vaccination update

54 Antibody tests

9

Joy as vaccines arrive

54 Community Assessment Hubs

14 News round-up

55 NAS play vital COVID role

18 Contact tracing team

55 Defence Forces

20 Instagram takeover

56 Psychosocial response to

21 A Haven for staff

COVID-19

22 Operation Transformation

57 UHL cardiology

23 Coombe Care

58 Schwartz Rounds mentoring

24 Midwife retires

59 Dementia during COVID

25 World Prematurity Day

60 Corporate Plan

26 QUIT

62 Adult Safeguarding course

28 Fostering

63 Oxygen metering system

30 GAA lend a hand

64 Screening services

30 Health Service Excellence

66 Conserving Energy

Awards 31 Arthur’s Promise

68 Quality improvement during COVID

32 Return to nursing programme

69 Make Every Contact Count

33 Breastfeeding policy

70 HBS new information system

34 HSE social media

71 NiSRP goes live

36 Lourdes ICU initiative

72 Health Innovation course

37 Home First celebrates first

73 Infection control

birthday 38 Make a change to public health nursing

74 Healthy eating 75 Screens and greens 76 Sports and social committee

40 Special days at Ark

77 Art in CHI

42 Screening videos go multilingual

77 Virtual nature walks

43 Vascular clinic

78 Poetry work

44 Know Check Ask in Birr

78 Art therapy

45 Video-enabled care

79 Filmmaking group at work

48 Digital advances

80 Music therapy in action

50 Staff survey

80 HSE staff choir goes virtual

05/03/2021 09:33

PUBLIC SHOW DEPTH OF GRATITUDE When I first shared some of the cards and letters that I received from the public last year, I did so with immense pride as they truly illustrated the depth of gratitude for your incredible commitment and resilience. I want to share again some more of the correspondence I have continued to receive.

The notes, letters, cards and emails reflect not just how much the public value the vital role you play, but they also acknowledge how you are all continuing to work while living through the everyday reality of this pandemic.

The public see that and they know and appreciate the pressures experienced by everyone and in particular our frontline staff. When I spoke recently at our staff webinar I expressed my own appreciation for how our staff have been dealing with the higher emotional aspect of this - caring for patients and their families, at what has to be the worst time for them.

Paul Reid, HSE CEO

M EET T H E TEA M

H SE Head of Internal Communications Emma Finn Internal Communications Team Yvonne Costello Ann McLoone Jennifer Carrie Amy O'Neill

A s hvi l l e Med i a Gro up Editor Joanne Weston Art Director Áine Duffy Creative Director Jane Matthews Published by Ashville Media, Unit 55 Park West Road, Park West Industrial Estate, Dublin 12, D12 X9F9.

Tel: (01) 432 2200 ISSN: 0332-4400 All rights reserved. Every care has been taken to ensure that the information contained in this magazine is accurate. The publishers cannot, however, accept responsibility for errors or omissions. Reproduction by any means in whole or in part without the permission of the publisher is prohibited. © Ashville Media Group 2021.

MESSAGES OF THANKS TO HEALTHCARE HEROES “I am in first year in school. I just wanted to write to thank you for all of the hard work you have been doing for our country. I want you to know that we are really grateful for everything you do. It must be hard. Hopefully, we get out of this pandemic soon, I think there are positives as well, like we get to spend time with our families and we can appreciate the little things in life. Thank you so much and keep smiling!” - Emme

performance during this pandemic. I wish good health and energy to you and your families.”

- Ruth

“A very sincere thank you to you all for your endurance of patience, tolerance during this most awful of times. Best of luck.” - Gemma

“Just this short note to offer you a BIG THANK YOU and your HSE TEAM, for the powerful and highly effective work you do every single day. Millions of us ordinary citizens have good reasons to be grateful to you and the team you lead, especially during these very troubled times. Sincere thanks once again.”

- James & Mary Jo

"Just a note to say thank you and to acknowledge your hard work leading the HSE over the past year of this COVID-19 crisis. The regular press briefings and Staff Webinar and email updates you provide have given reassuring confidence that you and your team and all at NPHET are doing your utmost to keep people as safe as possible during this time.

While I am not a frontline worker I feel proud to work for the HSE.” - Caroline “My name is Millie, I am 8 years old. I would like to say you should add the negative cases because of the worries people to show that there is nothing to worry about because there is probably more negative than positive.”

- Millie Mc “When a storm is coming, all other birds seek shelter. The eagle alone avoids the storm by flying above it. So, in the storms of life may your heart be like an eagle's and soar above.”

- Rita “Keep up all the good work. Delight in every success and do not be disappointed with a failure. It is the final destination that we are all working toward – the bumps along the road will, in time, be forgotten. Take Care. Blessings.”

– Maria “This note is to thank you and congratulate you in equal measure for your exceptional

“You are providing public service at its best.

Your calm measured approach to many challenges are very welcome in these uncertain times. Keep up the good work and hopefully the vaccine roll out will bring brighter and better days ahead. Beir bua.” - Mary

“My mother Mary passed away last week after suffering ill health for some time and I thought it was important to share with you our experiences as a family. My mum received fantastic care from her doctor, her careers, district nurse and the amazing community nurses. We received all the appropriate equipment when needed, everything was done for her and ultimately this was of great comfort to us as a family. I know the main focus for the HSE has to be reducing the numbers of Covid patients however it’s important to highlight that the regular services are running well due to fantastic people who work for the organisation.” - Bertie "My wife and I were referred for Covid testing by our local GP yesterday. Within 15 minutes we had received confirmations, separately, on our phones. We were met with courtesy and care.

I cannot express our thanks enough, especially to the lady who administered the tests and we were blown away by reception of the results only 13 hours later - negatives. You and your team have been doing a superb job I wish you well in the remaining year of hard work and hope you have as few obstacles in your way as possible.” - Mick

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05/03/2021 09:35

COVID

A YEAR IN

COVID

HSE staff reflect on how the pandemic has changed who we are and how we work

I

t has been 12 months since COVID-19 landed on our shores and changed all our lives.

For the workers in the Irish health service, the changes were extraordinary and the volume of work needed from them was huge.

Three waves of the pandemic later, still in lockdown but with the vaccines bringing some light to the end of this long tunnel, a wide range of staff from around the HSE reflect here on the last 12 months.

HSE staff and service delivery has been put under huge pressure and have had to fundamentally change how they provide care to the public. That included hospital staff who gave everything they had to give as they cared for an increasing number of COVID positive patients; those redeployed to completely new roles to help deal with the spread of the virus; the many who brought their interactions with their service users onto virtual platforms to ensure continuity of care; those working from home while trying to home-school their children; as well as the many HSE staff working behind the scenes to make sure everything functioned as it should in the public health emergency.

On a more positive note, they share with us their proudest moments from this unprecedented year and the changes from the last 12 months that they will bring with them into the future.

PAUL REID CEO

WHAT WAS YOUR PROUDEST MOMENT? There have been many proud moments throughout the pandemic. However one that particularly stands out for me was April when we were reaching the peak of the first wave. I was moving between meetings in the office when I got a call asking could I take a call from President,

Michael D Higgins. He immediately said he wanted to express his huge gratitude on behalf of the people of Ireland to all of the staff working in the HSE and in particular to our brave frontline workers who had shown such courage when much of the country was quite scared of what we had seen on our screens from other countries due to the pandemic. I was so proud to receive this call on behalf of everyone in the HSE. It was a very proud moment and one that I actually felt quite emotional about after the call as it felt such a privilege to be able to relay this message from the President to our staff.

WHAT WAS THE HARDEST MOMENT FOR YOU PERSONALLY? I have consistently found the hardest moments are when I make contact with family members who have lost a loved one through COVID that worked in the HSE. On all occasions when I do this, the family member or next of kin consistently set out how their loved ones were so

committed to working in healthcare and loved their jobs and particularly working with patients WHAT THINGS (LITTLE OR BIG) HELPED GET YOUR THROUGH THE TOUGHEST TIMES? We have one granddaughter, Aisling, who was born in October 2019 in Austin, Texas and lives there with our son and his wife. We got to see her in December 2019 when we travelled there for Christmas. It’s been really hard not being able to visit her since then and indeed for them to visit us. We miss them all so much.

However what gives me great joy is our regular Facetime calls. She has really got to know us in a new and virtual way. Our son tells us that she pulls a chair beside their TV screen regularly (it is connected to a portal) and asks them to call Nanny and Granda. Of course with a six-hour time difference, this can mean that it could be all hours of the night when we jump up to take the calls!

COVID HAS BROUGHT MANY ENFORCED CHANGES TO OUR LIVES. WHAT CHANGE WILL YOU BRING FORWARD WITH YOU? We always had a place in Co Leitrim that we went to at the weekends, for the past 17 years. We had always planned to eventually move there as we love it so much. In January of 2020, my wife decided that she would stay there from January to March and I would travel up to Dublin for work. Then came the lockdown and continuous restrictions.

So we made the decision that we would move there full time.

WHAT HAS COVID TAUGHT YOU ABOUT YOURSELF? I guess it has put things in perspective for all of us. For me, I really feel so sorry for people who have lost loved ones, or suffered financially through losing their job or business. The pandemic has put a lot of mental strain on everyone and that is no different for myself. I have realised that we all have to watch ourselves in periods of relentless pressure and stress.

Listening to family and friends is key as they are also the ones most likely to spot when you are not yourself.

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COVID WHAT WAS THE HARDEST MOMENT FOR YOU PERSONALLY? Personally, not being able to see friends and family in the same way has been hard, which is probably the same for many people. The uncertainty and relentlessness of many aspects of normal life and work has been challenging at times and even now the lack of social events or holidays to look forward to adds to a feeling of general weariness

ANNE O’CONNOR HSE Chief Operations Officer WHAT WAS YOUR PROUDEST MOMENT? I am very proud of how our teams around the country have worked throughout the pandemic and put in place new ways of working across all services and even brand new services like community assessment hubs and community swabbing centres which have really made a difference to our response to the pandemic. While it is a source of great pride, it is of no surprise to me and I am glad that it can be seen more publicly.

WHAT THINGS (LITTLE OR BIG) HELPED GET YOUR THROUGH THE TOUGHEST TIMES? Family life has been a very important anchor for me over the past year.

Their support and the support of friends and colleagues has helped to carry me through the most difficult times. Having three teenagers ensures there is little or no time for self-pity! I have also tried to keep an eye on daily routines relating to sleep, exercise and diet as I know that neglecting any of those makes things that bit harder. We got a German Shepherd puppy a couple of months ago and she has added a new dimension to life – not least by dragging me out for walks. And then there’s chocolate..!

WHAT WAS YOUR PROUDEST MOMENT? Realising the breadth of my ability and that of my team at HSELive to cope with extraordinary events in these unprecedented times.

Connecting at such a personal level with the public, listening to their sometimes very sensitive and emotive issues and being able to reassure them with delivering the best customer experience and advice governed by our clinical colleagues.

GERALDINE CHARMAN Team Manager, HSELive

WHAT WAS THE HARDEST MOMENT FOR YOU PERSONALLY? The volume of staff working within HSELive on any one day and responsibility over those staff ensuring that all agents were adhering to the script and also following public health advice.

Minding those staff, some staff found listening to callers particularly challenging.

COVID HAS BROUGHT MANY ENFORCED CHANGES TO OUR LIVES. WHAT CHANGE WILL YOU BRING FORWARD WITH YOU? Life after the pandemic is hard to imagine at the moment, and like most people, it’s easier to think of the things I would not take forward.

But from a work perspective, I’ll seek to continue with a balance of virtual and face to face meetings, as well as ensuring we continue with the collaborative, integrated ways of working we’ve established this year.

WHAT HAS COVID TAUGHT YOU ABOUT YOURSELF? I have learned that while I am generally a very resilient person, I have a tendency to keep going and I need to take time out for myself every so often – sometimes just to do nothing! Having an Occupational Therapy / mental health background has been really good training for many aspects of trying to deal with both the work challenges and life challenges that have arisen during the pandemic however the drawnout nature of COVID has really highlighted that self-care is critical to ensuring that we get through these extraordinary times.

WHAT THINGS (LITTLE OR BIG) HELPED GET YOU THROUGH THE TOUGHEST TIMES? Support I got from my Team, my peers and particularly my supervisors + endless cups of coffee.

WHAT CHANGE WILL YOU BRING FORWARD WITH YOU? Gratitude for what you have every day and realising that when things are not going your way stop and think. There is always someone else worse off than yourself.

WHAT HAS COVID TAUGHT YOU ABOUT YOURSELF? I learned that I have resilience way beyond what I ever thought I would have in dealing with very challenging situations plus a lot of patience which was very much needed over the last year.

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COVID

AIDAN O’CONNOR WHAT THINGS (LITTLE OR BIG) HELPED GET YOU THROUGH THE TOUGHEST TIMES? It was definitely the support of my colleagues. A lot of my work previously involved working alone, so I really enjoyed working again as part of a team.

CAROLINE KEHOE Public Health Nurse for Travellers in Waterford, redeployed as Clinical Lead COVID-19 Test Centre Waterford WHAT WAS YOUR PROUDEST MOMENT? It’s hard to pick one specific moment. I am very proud of my profession, I think nurses have really stood up to the mark in this pandemic.

WHAT WAS THE HARDEST MOMENT FOR YOU PERSONALLY? Like so many other people not being able to see my family was the hardest thing for me. My parents live in a different county, it’s hard not being able to visit them. Also my oldest daughter returned to university. Again it was difficult not seeing her as she couldn’t travel home at the weekends.

DR COLM HENRY HSE Chief Clinical Officer

WHAT CHANGES WILL YOU BRING FORWARD WITH YOU? I think I will prioritise things more and take things a bit slower. I hope to continue to make more time for just doing the simple things like family walks and meals together.

WHAT HAS COVID TAUGHT YOU ABOUT YOURSELF? COVID has taught me I am more resilient than I thought I was and I can adapt very quickly to change. I am grateful to now have the opportunity to work as Clinical Lead in the COVID-19 Test Centre, I work with a great team. We all appreciate the importance of this service to the people of Waterford and sometimes beyond, not only the important role of taking the swab but especially as we may at times be the only face-to-face contact for people who are selfisolating or living alone.

Estates Manager and Lead on field hospitals and mass vaccination centres WHAT WAS YOUR PROUDEST MOMENT? Seeing people working together to deliver projects that made a difference. That included the development of the infrastructure for the Field Hospitals (that we hoped not to have to use but we had to have them in place). Instead they were used to make a huge difference to waiting lists. For example, reducing a waiting list of four years for Child Allergy testing and it being delivered by services in seven weeks. The feedback from parents has been incredible.

WHAT WAS THE HARDEST MOMENT FOR YOU PERSONALLY? The scale of the issue that was facing us at the beginning and what was coming down the line and making sure that we could deliver infrastructure on time to make a difference.

WHAT THINGS (LITTLE OR BIG) HELPED GET YOU THROUGH THE TOUGHEST TIMES? People coming together from all the different agencies working together for the common good – everyone got on with the job and worked at any time.

COVID HAS BROUGHT MANY ENFORCED CHANGES TO OUR LIVES. WHAT CHANGE WILL YOU BRING FORWARD WITH YOU? Never assume or take anything for granted and we can do great things when we have a clear understanding and common purpose delivered by key people.

WHAT HAS COVID TAUGHT YOU ABOUT YOURSELF? Being part of group who works together and having the right people around you can achieve anything.

WHAT WAS YOUR PROUDEST MOMENT? When the first vaccine was administered to a patient and a healthcare worker on 29th December 2021. The sense of relief and hope in the room was palpable.

WHAT WAS THE HARDEST MOMENT FOR YOU PERSONALLY? Without doubt the deaths. Whoever it was, a nursing home resident or someone in hospital, no words could bring solace.

WHAT THINGS (LITTLE OR BIG) HELPED GET YOU THROUGH THE TOUGHEST TIMES? The resilience and imagination of our teams of healthcare workers across hospitals and the community.

The meitheal of the Irish people. We really came together at the right time The team work of colleagues across the public sector.

COVID HAS BROUGHT MANY ENFORCED CHANGES TO OUR LIVES. WHAT CHANGE WILL YOU BRING FORWARD WITH YOU? Appreciating what is important in getting things done: relationships and teamwork.

WHAT HAS COVID TAUGHT YOU ABOUT YOURSELF? We are all stronger as one team. The best way to mind yourself is to mind others.

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DR RAMAKRISHAI SOONDRON

COVID

Renal Registrar, Tallaght University Hospital

WHAT WAS YOUR PROUDEST MOMENT? One of my proudest moments during COVID has not been personal but collective. Being part of the frontline as a team took a new whole definition, but in my case being on

the other side of the line, when I was a patient and being looked after by my colleagues. They made me feel even prouder for doing what we do.

shifts and my bosses and team gave me time to recover. I felt protected and wanted to come back stronger to continue the fight.

WHAT WAS THE HARDEST MOMENT FOR YOU PERSONALLY? Living on my own, at the worst part of my COVID symptoms, I would often go to bed wondering if I would ever stop breathing during my sleep. I still have not told my parents abroad that I had COVID and was admitted for it.

COVID HAS BROUGHT MANY ENFORCED CHANGES TO OUR LIVES. WHAT CHANGE WILL YOU BRING FORWARD WITH YOU? Health hygiene would be the big one – more sports, less junk food, reducing all those risk factors that make some of us more susceptible to this nasty virus.

WHAT THINGS (LITTLE OR BIG) HELPED GET YOU THROUGH THE TOUGHEST TIMES? My friends and colleagues. During my isolation period they came to check on me and dropped food, they covered my

WHAT HAS COVID TAUGHT YOU ABOUT YOURSELF? I used to be young and strong, now I have to mind myself and still none wiser. But I count myself as one of the lucky ones.

PAULA CONRAN

PROF MARTIN CORMICAN

Senior Medical Scientist/Quality Officer, Microbiology Laboratory, Beaumont Hospital

HSE's Clincal Lead for Antimicrobial Resistance and Infection Control

WHAT WAS YOUR PROUDEST MOMENT? During first lockdown, the lab was working 12 hour days. I took to running during my lunchbreak to help get through them. In November 2020, I completed my first half marathon supported my some of my laboratory work colleagues and raised nearly €2,500 for my nephew’s special needs school.

WHAT WAS THE HARDEST MOMENT FOR YOU PERSONALLY? Working in a healthcare setting, I have been particularly conscious about meeting other people, petrified I might somehow pass on COVID. The last year, when I’m not working, has been spent with my husband and three children. I have seen my parents and family, who all live in Limerick, just three times.

WHAT THINGS HELPED GET YOU THROUGH THE TOUGH TIMES? As you can imagine, work has been stressful and exhausting since March 2020. Even on the darkest day, my colleagues in the microbiology lab in Beaumont (or work family as we call each other), kept me going and we always found something to smile about.

WHAT CHANGES WILL YOU BRING FORWARD? I am going to appreciate the time I get to spend with my family and friends so much more. If we have learned anything from this pandemic it’s that nobody knows what is around the corner.

WHAT HAS COVID TAUGHT ME? Hopefully, that no matter what life throws us we are determined to come out shining on the other side.

WHAT WAS YOUR PROUDEST MOMENT? A card from a woman who said she heard me on the radio and it helped her and she was praying for me.

WHAT WAS THE HARDEST MOMENT FOR YOU PERSONALLY? Thursday, January 21st this year when we looked at the number of people who caught COVID in hospital in the previous week.

WHAT THINGS (LITTLE OR BIG) HELPED GET YOU THROUGH THE TOUGHEST TIMES? Family (including dogs), colleagues, running, tea and giant chocolate buttons, not necessarily in that order of priority.

COVID HAS BROUGHT MANY ENFORCED CHANGES TO OUR LIVES. WHAT CHANGE WILL YOU BRING FORWARD WITH YOU? Less travel to Dublin for meetings that work just as well on video conference from Galway.

WHAT HAS COVID TAUGHT YOU ABOUT YOURSELF? That I am not quite as anti-social as I thought I was – seeing people now and again is nice.

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COVID

JACKIE KELLY Principal Environmental Health Officer based in Blanchardstown and covering Dublin north-west city which includes Phibsboro, Finglas, Ballymun and Glasnevin WHAT WAS YOUR PROUDEST MOMENT? It’s hard to pick one moment but I’m very proud of my team and how all the staff in the Environmental Health Service responded. The last 12 months have been consistently challenging and brought many changes. We had to adapt and be flexible. As well as our core work EHS staff also worked in Dublin Airport where they informed the public about the latest public health information. Staff were also working

KEELA BROGAN Team Lead, Contact Tracing Centre Galway WHAT WAS YOUR PROUDEST MOMENT? My proudest moment was working in the Contact Tracing Centre on Christmas Day. There was a huge build up to the day. We were concerned about calling people on Christmas morning with news nobody wants to hear. However, everyone we called was so grateful for the job we were doing.

WHAT WAS THE HARDEST MOMENT FOR YOU PERSONALLY? The hardest moment was the first week of January when we were faced with more positive cases of COVID-19 than we could have imagined. It felt like we were facing an endless amount of calls. The people on the calls seemed sicker and more anxious than during the previous surges.

WHAT THINGS HELPED GET YOU THROUGH THE TOUGHEST TIMES? My colleagues’ kindness in the Contact Tracing Centre got me through the toughest days. We are all going through a tough time

on helplines and on contact tracing. I’m very proud of the way our people pulled on the green jersey and did what was required in such a professional way.

WHAT WAS THE HARDEST MOMENT FOR YOU PERSONALLY? There was a lot of change during the year and sometimes that was challenging to manage.

People are comfortable when they know what to expect and the constant change felt non-stop for the whole year. Like everyone else in the country people in general were more anxious, especially if they felt there was a risk of them getting COVID. Our staff were great but it wasn’t always easy especially in this third wave as case numbers went up.

A lot of the time you’re dealing with these issues through teleconferences not face-toface so it’s harder than usual.

WHAT THINGS (LITTLE OR BIG) HELPED GET YOU THROUGH THE TOUGHEST TIMES? It’s a combination of things for me. Walking the dog is great to clear the head and trying out new recipes. I also found the chat on the WhatsApp groups great. I’m in a group with

and many challenges in our personal lives too such as not seeing family and friends, home-schooling etc… and on top of that the calls were difficult also.

COVID HAS BROUGHT MANY ENFORCED CHANGES TO OUR LIVES. WHAT CHANGE WILL YOU BRING FORWARD WITH YOU? One change I hope to take with me is the slower pace of life and the appreciation of the little things that we once took for granted, such as meeting a friend for coffee.

I really enjoyed the 20-second timeout that handwashing has given us all, it’s like several dedicated moments of mindfulness throughout the day.

WHAT HAS COVID TAUGHT YOU ABOUT YOURSELF? This year has taught me how resilient and adaptable we all are. My daily life looks entirely different to how it did a year ago. I have been able to keep positive and adapt accordingly by wearing a face covering, regularly washing my hands and keeping a two-metre distance.

a Leaving Cert class from 40 years ago. In Sept 2019 our old school was celebrating an anniversary and we stayed in touch after it and I find the chats and sharing jokes or a bit of craic great. Work itself can also be a good distraction.

COVID HAS BROUGHT MANY ENFORCED CHANGES TO OUR LIVES. WHAT CHANGE WILL YOU BRING FORWARD WITH YOU? I think this has shown that remote working or working from home is really possible and can be done and people are accountable and work hard when they’re not visible in an office. Staff are adaptable.

WHAT HAS COVID TAUGHT YOU ABOUT YOURSELF? Life can be short and some things we just can’t control so it’s important to look after what you can and try not to worry too much about what’s outside our control. I think it’s shown some younger people that material things are not that important. Life really is about people and looking after the people we care about.

LOUISE DEVOY Community swabber, Punchestown

WHAT WAS YOUR PROUDEST MOMENT? Becoming a volunteer in the COVID-19 Testing Centre in Punchestown. It was a chance to help and be useful and to give something back to the community and I felt I was using the huge amount of down time from work I suddenly had for a good purpose.

WHAT WAS THE HARDEST MOMENT FOR YOU PERSONALLY? For me it was watching a career I love hover on the brink of disaster, the downturn in the aviation sector meant I was only working five days a month. It led to me deciding to take a career break

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SINEAD GROGAN Clinical Case Manager/CNM2 Integrated Care Programme for Older Person DNCC WHAT WAS THE HARDEST MOMENT FOR YOU PERSONALLY? When I got the call last March to redeploy to St Mary's Hospital, I decided to give my help where it was needed the most. Walking onto that ward that first day I was nervous and unsure of what to expect. The team stood in front of me waiting for instructions, and reality hit that this would be the most difficult challenge I’d experience in my nursing career.

WHAT THINGS (LITTLE OR BIG) HELPED YOU THROUGH THE TOUGHEST TIMES? I remember the weather during these months was incredible and I often took my lunch breaks on this beautiful little rooftop garden between the wards whilst watching the deer of the Phoenix Park laze around and chew on the grass. There was such a stark contrast between the wards, where we wore full PPE

from Aer Lingus and apply for the role of community swabber.

WHAT THINGS (LITTLE OR BIG) HELPED GET YOU THROUGH THE TOUGHEST TIMES? Certainly the support of my husband, family, and friends. For me, it was sending cards and parcels to family and friends to spread a little joy and lift the monotony, and, of course, the video chats and the Zoom quizzes! Getting out and walking, giving yourself some time to yourself.

COVID HAS BROUGHT MANY ENFORCED CHANGES TO OUR LIVES. WHAT CHANGE WILL YOU BRING FORWARD WITH YOU? It has certainly shown me that family, friends and the health of the people you love is the priority in life. Visiting those people more often will be something I will aim to do when it’s safe again.

WHAT HAS COVID TAUGHT YOU ABOUT YOURSELF? I am more resilient than I thought I could ever be. I like to be busy, occupied in a meaningful way. I have lots of experience and it’s nice to use it!

and tried to minimise the impact of COVID-19 and the sunshine on the rooftop.

I was so grateful for those moments of peace and beauty, which helped me through some of the toughest days of my career as a nurse.

WHAT CHANGE WILL YOU BRING FORWARD WITH YOU? As someone who is used to living a life at 100 miles per hour I began to enjoy this slightly slower pace of life. There were still no big nights out and celebrations through the Christmas period which I realise now I don’t miss all that much. But the nights in and cold winter walks with the people in my life I hold closest have become the moments I cherish the most. The simplest of pleasures in life with the people I love the most. I’m hoping when things do open back up I can remember to slow down more often and continue create more space in my life for these simple pleasures.

WHAT WAS YOUR PROUDEST MOMENT?I was called for redeployment a few more times since then, the COVID-19 testing centre in Swords and Lusk Community Nursing Unit.

MARY SMITHWICK Communications Manager, Cork Kerry Community Healthcare WHAT WAS YOUR PROUDEST MOMENT? Seeing and showcasing the amazing dedication of staff across Cork and Kerry. I’ve watched them create swabbing centres in days; develop vaccination strategies and locations in the blink of an eye by working collaboratively, and go to heroic lengths so that they could continue vital services in the most difficult of circumstances. Meeting staff in our community hospitals has been particularly humbling, their compassion and care for our residents is unending.

WHAT WAS THE HARDEST MOMENT FOR YOU PERSONALLY? Missing loved ones, every single day.

There are so many family members and friends I haven’t been able to see properly for a year now, and I miss them. I really miss my brother, sister-

I’ve never been more proud to be a nurse and to be able to help in whatever way I could throughout this pandemic.

COVID

WHAT HAS COVID TAUGHT YOU ABOUT YOURSELF? I never realised until now just how resilient I am and managed to get through this past year making adjustments to my life and lifestyle as and when needed. I always thought I feared change and in the past I worked hard to keep the day to day stuff always the same, and yet here, in a year where my life has become unrecognisable from what it was and everything has changed I have adapted and in some ways embraced it.

I’m learning to be patient for the life I wish to have and enjoy in the future but more so to hold fast to the present or risk missing out on moments like those beautiful and peaceful lunches on the rooftop garden in Mary’s in the park.

in-law and niece who live in Dublin, we haven’t seen them since last September.

Watching the impact of restrictions on my five-year-old has been difficult, especially during Level 5 restrictions when he can’t see his grandparents.

WHAT THINGS (LITTLE OR BIG) HELPED GET YOU THROUGH THE TOUGHEST TIMES? Hugs from my five-year-old, cups of tea from my husband and video calls with the people I miss. There’s also a great network of communications staff across the country who are a massive support.

WHAT CHANGE WILL YOU BRING FORWARD WITH YOU? We can do more than we thought, faster than we believed. COVID brought an agility to some of our ways of working that I really want to keep.

WHAT HAS COVID TAUGHT YOU ABOUT YOURSELF? That I’m resilient and that no matter how hard things are, I’ll plough on and get the job done. And that I made a great career choice when I joined the HSE.

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Vaccines

VACCINE DELIVERS HOPE

Celebrations as vaccines are administered

DID YOU KNOW

80%

OF ADULTS SHOULD HAVE RECEIVED THEIR FIRST VACCINE DOSE BY THE END OF JUNE 2021

Lorraine Guthrie, CNM2, gets her vaccine at Letterkenny University Hospital from Virginia Murray, CNS.

On December 29th 2020, 79-year-old Annie Lynch became the first person to get a COVID-19 vaccine in Ireland. Since Annie walked away feeling ‘privileged to have received the vaccine’, the national vaccination programme has continued to gain pace.

Ronan Glynn, Deputy Chief Medical Officer, said the country is on course to have given 80% of adults their first dose of the vaccine by the end of June.

“Vaccines are already having a very positive impact here with cases falling dramatically among healthcare workers and in our nursing homes. Evidence is mounting quickly that these vaccines, as well as stopping people from getting sick, also help to stop people passing the virus onto others,” he said.

An extensive vaccination plan for all people aged 70 and over is currently under way nationwide. We expect this group will have completed their two doses by mid-May. In February, the locations of 37 HSE vaccination centres were confirmed, with at least one for every county. These centres will support vaccination of the general population in a safe and efficient manner, as more vaccines are available.

While currently vaccines are being

administered in healthcare settings and

by GPs in communities, many people will be offered their vaccination in these centres, having self-registered online, as the supply of vaccines increases.

The vaccination programme involves national partnership with GPs, pharmacists, and other healthcare professionals across Ireland, as well as the specialist vaccination hubs.

The COVID-19 vaccine registration portal is now available for frontline healthcare workers to register for their vaccine. How early you register will have no impact on how quickly you will get the vaccine. Appointments will be scheduled based on the priority groups in the guidelines.

For healthcare workers who are not in direct contact with patients, you will be contacted when it's time to register for your vaccine. You can register here: www.hse.ie/hcwvaccine For vaccine queries, please visit: www. hse.ie/covid19vaccine or contact HSELive www.hse.ie/eng/hselive/ Recommendations about the vaccine are changing as more information becomes available so please check our website for the most up to date information. www.immunisation.ie

72.5k 850k

PEOPLE AGED OVER 85 IN IRELAND

MEDICALLY VULNERABLE PEOPLE AGED 18-64 MOVED UP THE VACCINE LIST

85% OF PEOPLE POLLED SAID THEY WOULD BE HAPPY TO TAKE A COVID-19 VACCINE

14m DOSES OF AT LEAST FIVE DIFFERENT VACCINES IN LINE FOR DELIVERY TO IRELAND DURING 2021

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Vaccines ABHISHEK FEELING 'PRIVILEGED'

Abhishek Suroy gets his COVID-19 vaccine.

How early you register will have no impact on how quickly you will get the vaccine. Appointments will be scheduled based on the priority groups in the guidelines. You can register here www.hse.ie/hcwvaccine

Sinéad Creedon, Infection Prevention and Control Clinical Nurse Specialist, Cork University Maternity Hospital.

35-year-old Abhishek Suroy, from Dublin, works as a children’s staff nurse and became the first person at Children’s Health Ireland at Crumlin to receive the COVID-19 vaccine.

He received his vaccine from peer vaccinator Caroline Kelly, Assistant Director of Nursing. Abhishek is a COVID-19 patient swabber at the hospital and has done over 3,000 Covid swabs for patients so they can be tested for COVID-19 as they undergo treatment in the hospital.

He has been living in Ireland since 2018 after leaving his home in Punjab in Northern India when he started work in the hospital as a theatre staff nurse.

“I feel very privileged to be the first person in CHI at Crumlin to receive the vaccine. Just during Christmas and New Year’s, Ireland has seen a dramatic increase in the number of cases. If we keep on social distancing, wearing our masks and washing our hands we can help keep everyone safe especially the most vulnerable.”

Denise Reynolds, Staff Nurse and Peer Vaccinator was one of the first staff in CHI at Connolly Urgent Care Centre to receive their vaccine. “In order to keep our staff safe and protected, and in order to serve our patients and continue to provide world class care, it’s so important that we get the vaccine. I feel honoured to help lead the way,” said Denise.

Jilu Jacob from Clonee, Dublin is an education facilitator in St Patrick’s Ward, CHI at Temple Street. “I feel hugely privileged to be the first person in CHI at Temple Street to receive the vaccine. I hope that everyone in Ireland will soon have access to the vaccine and also feel protected.”

When asked about her hopes for 2021, Jilu replied, “I sincerely believe that hope needs to be our foundation and we should remain firm in our conviction that we will be beat this virus.”

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Vaccines

ALL-IRELAND WINNER TO VACCINATOR Above right: Former Dublin player and public health nurse Karen Kennedy readies a vaccine for delivery. Above left: Michael Farrelly, resident in St Mary’s Hospital, Phoenix Park receives his COVID-19 vaccination, administered by Karen.

100TH BIRTHDAY GIFT FOR EILEEN There was a special day for one of Dungarvan Community Hospital’s lady residents in February, as she celebrated her 100th birthday on the day she received her follow-up second dose of the COVID-19 vaccine.

Staff at the residential care centre, where Eileen O’ Brien is cared for in the St Francis Unit, facilitated a small, socially distant compliant gathering in the hospital church to mark the occasion.

A number of others in the O’ Brien family bubble were also able to gather outside and wish happy birthday at a distance.

Eileen’s son Kieran O'Brien and her daughters Mary Lynch and Claire Cummins were present to celebrate the milestone, with a special cake designed

by Eileen’s daughter-in-law Breda O’Brien.

Eileen’s late husband John and late son

Michael were remembered on the day.

Eileen is a grandmother of 16, has 31 great grandchildren and was thrilled to see some of them greet her from the hospital garden.

Dungarvan Community Hospital and the O’ Brien family were also delighted that a letter, containing birthday wishes and the 'centenarian bounty' cheque enclosed, arrived from President Michael D Higgins.

Director of Nursing at Dungarvan Community Hospital, Paula French, said, "Everyone here completed their vaccinations this week and seeing one of our residents reach 100, as we did so, was extra special. Despite the challenging times for residents, our excellent staff and their supportive families in each case, we wanted to mark the day – albeit in a limited way. I’m delighted to report that it was indeed a happy birthday for Eileen."

Eileen O’ Brien celebrates her 100th birthday with (left to right): Paula French, Director of Nursing, Dungarvan Community Hospital; daughters Mary Lynch; Claire Cummins; Femina Rajendran, Dungarvan Community Hospital; and son Kieran with his wife Breda.

Karen Kennedy was part of an historic panel of Dubliners that won a first TG4 All-Ireland Senior Championship for the county back in 2010, and more than 10 years on, she is at the heart of an even more important team.

The former Naomh Mearnóg and Dublin player is a public health nurse by trade, but since the outbreak of COVID-19 she has seen her role expand, most recently into the administering of coronavirus vaccines.

Kennedy is part of a HSE vaccination team operating in north Dublin city and county and much of their initial efforts have centred around care homes in the region. She was asked to lead a vaccination team on their recent appearance on The Late Late Show, where she was ‘honoured’ to give the vaccine to some frontline healthcare workers.

“With my history in sport, teamwork has been ingrained in me from an early age. Teamwork plays a huge part in managing our job, day to day.

But in a global pandemic, teamwork is our lifeline,” said Kennedy.

“It’s hard to put into words sometimes; it is just so rewarding to be part of it, and to be involved of this vaccination team. COVID-19 has affected all of our lives in different ways. It is personal to all of us for our own reasons.

“We have seen at first hand the relief and the joy that this vaccine has given people. It’s a symbol of hope for many and I’m in a very privileged position to give people this vaccine.

They are genuinely so happy to receive it.”

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Vaccines

Above left: Prof John Higgins from CUMH gets his first dose. Above right: Mary Meade, staff midwife, Maternity Ward, at Sligo University Hospital, with Catherine Greeney, staff nurse.

HOPE FOR TALLAGHT UNIVERSITY HOSPITAL Professor Brendan Kelly of Tallaght University Hospital has spoken of the hope the rollout of the vaccine has brought to the hard-working staff at the hospital.

“For almost a year now, I have seen my colleagues in the hospital work at the coalface of this pandemic. I have witnessed the dedication of staff in our intensive care unit and medical wards as they treat the sickest patients with COVID and other illnesses. I have seen the fearlessness of our emergency department staff as they navigate the everchanging face of the pandemic. I have admired the work of hospital management as they adapt hospital systems to an unprecedented challenge and, now, create a vast vaccination programme,” said Prof Kelly.

He said although a simple jab, the vaccine represents so much to so many.

“After so many months of build-up, the jab itself is something of an anti-climax. I barely feel it. It is less of a jab than the annual flu jab. I am observed for 15 minutes to see if I have an anaphylactic reaction. I do not. Five minutes later, I’m back at work. Over the following days, I watch for side-effects. I have none. It is as if nothing happened,” said Prof Kelly.

“But something amazing did happen. I was vaccinated against COVID-19, because of the current pandemic. It is always a privilege to work in healthcare, but now I am doubly privileged to be vaccinated too. I’ll have a second

dose in a few weeks’ time. Vaccination is what makes this lockdown different to the last one. It adds that extra dollop of hope that makes all the difference.

“After my vaccination, the hospital photographer takes a picture of me and the nurse who vaccinated me. In the photo, our faces are partially covered with masks, but it is still clear that, despite the suffering of this pandemic, despite the losses, and despite the hard weeks behind us and tough days to come, we are smiling. These are tentative smiles, but smiles nonetheless, filled with hope.”

Nurse Shauna Delaney, Clinical Facilitator in ICU, after administering the COVID-19 vaccination to Professor Brendan Kelly at TUH earlier this month

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Vaccines Nurse Siobhan Horgan vaccinates her sister Maria Donnelly in University Hospital Limerick. Maria works as an occupational therapist in Community Services.

CAMERA ROLL

Patrick Curran gets his vaccine at Sacred Heart Hospital, Carlow, with Niamh Bambrick and Zoe Doheny.

Dr Mary Kennedy, UHL MAU, gets her first dose from Caroline Mulligan.

CELEBRATIONS ALL AROUND Best pals - and our magazine cover stars Florence O’Reilly, aged 87 from Cabra, and Nancy Keogh, aged 92 from Stoneybatter, almost danced out of the room in Navan Road Community Nursing Home after getting their COVID-19 vaccine.

Florence and Nancy, who are in a social pod together, were thrilled to get their first dose and begin to put the pandemic behind them. Nancy said, “injections never bothered me, it’s good for you to get the vaccine, and I think anything that minds your health is good to get”, Florence is added, “I think it’s good to get it.”

Eamonn Hughes, a 75-year-old man who is originally from Cavan and lived in Meath for 40 years, became the first resident in St Mary’s Hospital, HSE Community Healthcare Organisation Dublin North City and County (HSE CHO DNCC) to be vaccinated against COVID-19.

“The vaccine is so important. I look forward to my wife Rose and daughters Sharon and Paula and grand-daughters Alexandria and Saoirse visiting again, and

when the weather is nice I like to go outside to see nature, and to get inspiration for my art, I’m looking forward to doing that again.”

Michael Farrelly, aged 89, from the South Circular Road, also had his vaccine and said, “I welcome the vaccine, hopefully it will help me see my son and two grandchildren again.”

Ligimol Varghese, Assistant Director of Nursing working in St Mary’s Hospital and first member of staff vaccinated, said “It’s important we get vaccinated and protect the people we care for. It is very important people under our care feel safe and protected, which is why I am getting vaccinated.”

David Lenihan, an 80-year-old from Nephin Road, got the vaccine at Navan Road Community Nursing Home, alongside healthcare workers who were also vaccinated. David said, “At 80 years of age, if I can extend my life I’ll take it, my children and grandchildren will hopefully be back in to see me. In the meantime I’ll do my crosswords.”

Marie Rochford, Tinnypark Nursing Home, Kilkenny, with vaccinators Theresa Kelly and Bernie Kavanagh, and DON Ann Walpole.

Catherine O'Regan, Healthcare Assistant, UMHL, with peer vaccinator Sarah Scanlan.

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Vaccines “THE ATMOSPHERE THIS MORNING… IT WAS LIKE PEOPLE HAD WON THE LOTTERY, EVERYONE WAS SO HAPPY TO BE RECEIVING THE VACCINE”.

Those were the words of Sheila Robertson, the 87-year-old from Kilkee, who was the first person in Regina House Community Nursing Unit, Kilrush, Co Clare to be vaccinated against COVID-19.

Sheila received the vaccine alongside healthcare workers from the Unit on January 7th. Healthcare Assistant, Patrick Kelly was the first HCA to receive the vaccine.

That same day 90 year-old Frances Hearne, from Mullinahone, became the first person at Community Hospital of the Assumption, Thurles, Co. Tipperary to receive the COVID-19 vaccine. “Today was a very special day and I couldn’t sleep a wink thinking about it all night,” said Frances.

The first staff member at CHOA to be vaccinated was CNM, Nessa Merrigan, who said, “I feel very honoured to get the vaccine today”.

On January 14th it was the turn of residents and staff at St Ita’s CNU, Newcastle West, Co Limerick, where 101 year-old Bridget (Biddy) Connolly became the first resident to receive the vaccine.

Biddy was delighted to receive the vaccine as she chatted about her love of hurling and how she can’t wait to see Limerick back

COVID19 VACCINATION PROGRAMME FOR STAFF IS COMPLETED AT THE NATIONAL MATERNITY HOSPITAL Midwife Emily Flynn from Cashel, Tipperary was the first of 1,108 staff to be vaccinated against COVID-19 at The National Maternity Hospital. The COVID-19 Vaccination Programme began at noon on Thursday, January 7th 2021 and, within 48 hours,all staff who had come forward to receive the vaccine had been vaccinated.

Speaking about being the first person to receive the vaccine, Emily Flynn, CMM2 at The NMH Emergency Room said as she received the vaccine from vaccinator and programme coordinator, Lucille Sheehy, “I feel so privileged to be the first person to receive the vaccine here. This is the moment we have all been waiting for since the pandemic started last Spring. I am so grateful to everyone around the world who

on the pitch to win another All Ireland Hurling title in 2021. She is also an avid horse racing fan and a great follower of Limerick racehorse owner J.P. McManus.

Bridget Connelly

Midwife, Emily Flynn was th first NMH staff member to receive the vaccine.

has contributed to the making and distribution of this life-saving vaccine.”

There was early good signs of the impact of the vaccine soon after as it was confirmed that one hospital reported no new cases of COVID-19 among its almost fully vaccinated staff. Early in February, there were no positive cases among staff and just nine were self-isolating due to close contact with people with the virus - the lowest figure since the beginning of the pandemic.

NHM clinical director Dr Roger McMorrow happily reported, “When we got our first vaccine, there was such joy and excitement and relief from the staff. Back in January we were facing into the very high peak of that wave. To get the vaccine offered a ray of hope for us all. The mood shifted quite noticeably among staff.

“We know that 12 days after your first dose a level of immunity develops. At three weeks you have 90% effectiveness from the vaccine.

You reach 95% about nine days after your second one. We are now at that stage.

“To have the whole hospital fully vaccinated gives us more confidence working with each other. It is an extra layer of protection from catching the virus.”

“WE KNOW THAT 12 DAYS AFTER YOUR FIRST DOSE A LEVEL OF IMMUNITY DEVELOPS. AT THREE WEEKS YOU HAVE 90% EFFECTIVENESS FROM THE VACCINE. YOU REACH 95% ABOUT NINE DAYS AFTER YOUR SECOND ONE. WE ARE NOW AT THAT STAGE."

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News EIGHT-YEAR-OLD DYLAN CYCLES A WHOLE MARATHON TO RAISE MONEY FOR STAFF AT UNIVERSITY HOSPITAL GALWAY Last April, Dylan Moran who was aged 8, cycled a full marathon around Tuam to raise money for University Hospital Galway and raised just under €25,000 which was presented to the hospital in December. The funds were divided among the Nursing Social and Recreation funds for the ICU, Emergency Department, Oncology Ward, Coronary Care Ward, Paediatric and Maternity Departments - each receiving a donation of just over €2,000. The funds were also used to purchase 25 iPads, protector covers and earphones along with 20 transistor radios which were distributed to various wards for patient use.

Pictured are Dylan Moran with his sister Faye, dad Declan and mum Deirdre presenting iPads and transistor radios for patients at University Hospital Galway. Also in the photo (second row) are Marie Burns, Director of Nursing and Chris Kane, Hospital Manager.

UPDATED CHILDREN’S COVID-19 TESTING GUIDE AND VIDEO Children, including those with special needs or who may be frightened or sensitive to sound, can now be shown an animation on a parent’s phone to ease their fears or worries, when having to attend a testing centre.

Working collaboratively, the National Communications Team, National Testing, and Community Healthcare Organisation Dublin North City and County, who had developed the original comic, developed a short animated video. A member of the COVID-19 Testing Team working in Swords National Show Centre said, “Parents are very grateful to have this to prepare in advance of going for a test with their child.”

A big thank you to the speech and language colleagues working in Croke Park COVID-19 testing who developed the original comic following their experience with children and families in the early days of testing, around St Patrick’s Day 2020.

This resource which has eased the journey for countless children, their parents and carers. Una Woods illustrated the comic which was recently updated with guidance from our Covid-19 Testing Accessibility Support Team. The updates were based on their experiences in Swords Testing Centre to reflect the changed swabbing approach for under 13s and increase relevancy for children with special needs and also included some minor changes from National Testing.

For more information on Testing for Children and to watch the video please go to: www2.hse.ie/conditions/coronavirus/children-and-covid-19/ testing-for-children.html

NEW CARDIOLOGY SERVICES ROLL OUT TO PRIMARY CARE CENTRES AS PART OF SLÁINTECARE

New cardiology services have been introduced to three Primary Care Centres in Galway (Ballinasloe, Mountbellew, Portumna) and to Monksland in Roscommon as part of the expansion of the Heart Failure Service developed by Portiuncula University Hospital (PUH) and Galway Primary Care.

The Heart Failure Service received €330k from the Sláintecare Integration Fund at the end of 2019 to recruit new staff and purchase equipment to enable the cardiac investigations department to assess and diagnose patients in the community and reduce the need for hospital appointments for these tests. Virtual clinics have commenced with general practitioners discussing

NEW RESPIRATORY UNIT OPENS A new purpose-built Respiratory Assessment Unit (RAU) has opened in the old St Martin’s Ward, Beaumont Hospital. Comprising nine single bedded rooms, initially the RAU will treat patients with COVID-19 presenting with acute respiratory failure and provide advanced respiratory supports, such as non-invasive ventilation. Early specialist respiratory input for patients presenting to ED will support inpatient and ambulatory pathways for COVID-19 care.

Opening the Unit in January, Professor Ross Morgan, Consultant Respiratory Physician (left of photo) said, “The Respiratory Assessment Unit will enhance current care pathways for those unwell with COVID-19 presenting to Beaumont Hospital and provide early acute specialist respiratory input.”

He was joined by colleagues Yvonne Whelan, ADON Respiratory; Dr Emmet O'Brien, Consultant Respiratory Physician; Dr Femi Walkins, Medical Reg; and Dr Killian Marsh, Respiratory Reg, before welcoming the first patient into the unit.

As the pandemic subsides and the need for specialist COVID-19 respiratory interventions decreases, over time the unit will provide much needed treatment for lung specific conditions such as COPD, provide specialist oxygen systems, and manage a wide range of respiratory disorders under a multi-disciplinary team of doctors, specialist respiratory nurses, physiotherapists and other healthcare professionals.

complex cases with Dr Aidan Flynn and the Heart Failure team. An Advanced Nurse Practitioner has been recruited to support the needs of patients in the community and avoid hospital admission where appropriate.

There are two types of cardiac investigations carried out by the Heart Failure Service in the Primary Care Centres: an echocardiogram which is an ultrasound test to assess the structure and function of the heart muscles and valves; and holter monitoring which is 24-hour continuous recording of the heart’s electrical rhythm to record any irregular heartbeat. Both tests are essential in helping to diagnose heart failure and to monitor patients’ progress with treatment.

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HSE PROVIDES PATIENTS WITH ACCESS TO AN EXTRA 95,000 CTS, MRI, DEXA AND X-RAYS The HSE has recently increased GP access to radiology diagnostics for patients.

Using an outsourced service model, the diagnostic services are provided by a number of private companies and hospitals around the country.

Building on work to increase GP access to ultrasounds and x-rays, this new development sees an additional 95,000 CTs, MRI, DEXA and X-rays available to patients in 2021.

By increasing GP direct access to scans, diagnostics capacity in the community is increased and hospital avoidance can be facilitated.

The move was welcomed by GPs. Dr

Tadhg Crowley, Kilkenny, said, “I am delighted with the rollout of GP access to diagnostics. In my career it is the single biggest initiative for medical card patients in this country. I no longer need to refer patients to hospital for a scan and it helps hugely in my management of my patients.

Well done to all involved. ”Geraldine Crowley, AND, Primary Care Strategy and Planning, said, “The pandemic has brought into sharper focus the need to re-examine the way our community services including diagnostic services are delivered. Not only will this improvement make diagnostic services more accessible and convenient for patients but they will help improve

News

outcomes for patients with chronic conditions and other serious conditions.”

It also supports the long-term objective to expand Primary Care services aligned to the 2017 Sláintecare Report, the 2019 GP Agreement and Winter 2020/2021 plan. These reports highlight the crucial role GPs play in the shift in the provision of care from acute to community settings.

Access to these diagnostic services is for people who hold a medical /GP visit card.

Future plans include increasing access to diagnostic services for the diagnosis and management of chronic disease such as spirometry, echocardiogram and the NTproBNP blood test in 2021.

Left: Minister for Health Stephen Donnelly and Shona Guinan, Healthcare Assistant, OLH&CS. Right: Minister for Health Stephen Donnelly and Audrey Houlihan, CEO, OLH&CS.

FAIR DEAL RESOURCES DEVELOPED FOR STAFF The Nursing Home Support Scheme National Office have developed resources to help staff discuss the Fair Deal scheme with patients and clients.

Access videos and fact sheets in the Discovery Zone in the Hubs section of HSeLanD, search for “Fair Deal”.

The Public Health Nursing Service in Co Galway would like to acknowledge and thank two transitional year students, namely Patrick O’Meara and Eva Larkin from Banagher College, Co Offaly, who prepared 280 PPE packs during their TY placement in November 2020 under the guidance of a local public health nurse. This supply of PPE packs has proven to be invaluable in protecting the community nurses in recent weeks with the increase in COVID-19 cases.

WICKLOW HOSPICE IN-PATIENT UNIT OPENS Wicklow Hospice in Magheramore has opened its in-patient unit becoming the first specialist palliative care facility in Co Wicklow, providing in-patient care to those with life-limiting conditions.

Operated by Our Lady’s Hospice & Care Services (OLH&CS), it joins the 200bed facility in Harold’s Cross and the 12-bed facility at Blackrock in Dublin, as part of the largest provider of specialist palliative care in Ireland.

Wicklow Hospice provides 15 in-patient public beds and a new base for the Specialist Community Palliative Care team. When the service is fully up and running in the coming months, there will be just over 40 staff in a wide range of clinical and non-clinical roles. The HSE will meet the operational costs of the facility and fundraising for capital costs and enhancements for patients and families will be driven by OLH&CS. Chief Executive Officer of OLH&CS, Audrey Houlihan said: “We are confident that Wicklow Hospice will transform quality of life for patients and families and meet the changing care needs of current and future generations. In the medium term, our vision is to expand the current community service, which runs five days a week. During 2021, we hope to be able to visit patients in their homes seven days a week.

“We are grateful to the HSE who will meet the operating costs of Wicklow Hospice. However, we also rely on the support of the public and COVID-19 has impacted on our fundraised by over 20% compared to the previous year. This comes at a time when we urgently need support to cover the bank loan of €2.75 million that was required to finish the building work.”

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News

HIGH-VOLUME COVID TESTING LAB ESTABLISHED

NEW REFURBISHED WARDS AT MAYO UNIVERSITY HOSPITAL Mayo University Hospital has opened two newly refurbished medical wards in which were upgraded to address long standing infection control issues. The renovation works also involved replacing windows on these two wards and the paediatric ward. The refurbishment was carried out in two phases to ensure minimal impact on the hospital, phase one involved the refurbishment of the wards which include 66 inpatient beds.

The aim of the works was to reduce the risk of outbreaks due to cross infection and introduce easy-clean surfaces for walls and floors along with new patient toilets and showers all with wheelchair access and sensor lights for patients’ safety. In addition the toilets were designed to enhance the safe care of patients suffering from dementia. Two single rooms were also upgraded for use by high dependency patients. The wards were repainted and other general improvements were carried out.

HSE, in partnership with the National Virus Reference Laboratory and the Department of Food and Agriculture, supported by the Office of Public Works, has established a specialist high-volume COVID testing laboratory at Backweston Laboratories in Co Kildare. This facility is operational since January 2021.

This facily was set up under the COVID Testing & Tracing Programme Winter Plan to provide both testing resilience and additional laboratory testing capacity.

This government interdepartmental development was instigated following an options appraisal asessment to consider accelerated options for providing the necessary building accommodation to suit high volume laboratory analysers.

Exploratory dialogue with the Department of Food and Agriculature commenced in late September 2020. A major collaborative effort with the Backweston Labs and OPW project team enabled a fastrack design coordinated by Demesne architects into the contruction phase which was delivered

by Dunwoody and Dobson. Additional Lab Specimen Reception accommodation was provided in partnership with Actavo who constucted a modular building off site in six weeks which was built on site, completed and commissioned in two weeks preChristmas 2020.

HSE Procurement managed the procurement of the new-to-market analyster equipment which was delivered to site and built in-situ over the course of November / December. UCD / NVRL staff completed training in early January and the facility is now receiving and processing live COVID test samples. It has a capacity to test up to 13,000 samples per day with scope to increase this further if required.

Top: Mayo University Hospital staff in the refurbished B Ward, from left: Shane Snee, Eileen McHugh, Rosalind George, PJ Loftus, Swapna Sebastian, Olwen Kenny and Bernie Eakins.

Above: Staff in the refurbished Coronary Care Unit at Mayo University Hospital, from left: Fiona Moran, Aileen Kirrane and Angela Gavin.

NATIONAL STANDARDISED CHILD HEALTH RECORD ROLLED OUT The Nurture Programme: Infant Health and Wellbeing is a quality improvement programme that aims to strengthen and standardise the care and support provided to young children and their parents in Ireland. As part of the Nurture Programme, the national standardised child health record is being rolled out nationally. Once implemented, the use of the chart will ensure that all children receiving core developmental assessments will be assessed using standardised tools and

records and an up-to-date evidence-based model of care, National Healthy Childhood Programme Framework.

In 2019, led by CHO Dublin North City and County (CHO DNCC) Child Health Governance Group, the project team for the implementation of the record set to work.

Despite many challenges including the COVID-19 crisis, the new child health record was implemented in September 2020. It is expected by March 2021 all community

healthcare organisations will be using the new health record.

The new child health record has been well received by both Public Health Nurses (PHN’s) and parents alike. Barbara McCann, PHN Tonlegee Health Centre, said, “The charts are comprehensive and facilitate an effective pathway for assessment.”

A big thank you to all the team, clinical, healthcare professionals and administration and other supporting staff.

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NEW FACILITY WILL REDUCE DAY SURGERY RATES WAIT TIMES TO SIX MONTHS WITHIN 12 MONTHS Tallaght University Hospital (TUH) has opened a 3,460m2 facility with four theatres and 25 recovery beds. The new Reeves Day Surgery Centre (RDSC) located across the road from the main hospital will eliminate long wait times for routine day surgery and increase day surgery rates.

The goal of the new centre is to reduce day surgery waiting times to a maximum of six months within 12 months of being fully operational.

The opening of the RDSC is part of an ambitious five-year strategy for the hospital which recognises the changing direction of health care provision across the country in respect of new infrastructure requirements, more community-based services and increased reliance on innovation, technology and research-led

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care. The opening is an important step in the realisation of this strategy. The centre will eliminate long wait times for routine day surgery and improve access for patients and support the hospital with the increasing demands of serving a growing and aging population.

The establishment of the centre was a joint project between TUH and IRES, building work began in October 2019. Within four months of opening, 80% of all day surgery activity across all surgical specialties in TUH will be performed in the new centre.

The centre will open Monday to Friday from 7am to 8pm running two surgical sessions per day in each theatre, with each session lasting four hours in length and with a 30 minute turnaround time between each session.

DR MIKE RYAN OF WHO HEADLINES SLIGO RESEARCH CONFERENCE

From left: Dr Katherine Finan, Respiratory Consultant; Professor Nash Patil, Consultant Surgeon and Board member of the REF; and Grainne McCann, General Manager.

The Research and Education Foundation (REF) at Sligo University Hospital (SUH) held its 21st annual Multidisciplinary Research Conference in November with local, national and international speakers including Dr Mike Ryan, Executive Director at the WHO. The conference was aimed at clinical and allied health professionals, third level institution staff and the healthcare industry and was streamed live to almost 1500 participants.

Commenting, Professor Nash Patil, Consultant Surgeon at Sligo University Hospital and Board member of the REF said, “The focus of this year’s conference was the COVID-19 pandemic – the experiences, responses and learning from the clinical / scientific / industry / community perspectives. The conference was an all-day event run from IT Sligo and streamed to venues in Sligo University Hospital with a mix of remote and proximate presentations.

“We were delighted to have an excellent line-up of speakers who shared their experiences and perspective with us. In particular, we were delighted that Dr Mike Ryan of the WHO joined us to talk of his role in the international response to the management of COVID-19. It was a real privilege for us here in Sligo to have an opportunity to learn from him.”

Other speakers included Professor Luke O’Neill, Trinity College Dublin; Dr Francois Roman, Senior Developer – Clinical Vaccines at GSK Biologicals, Belgium; Dr Anthony Breslin, HSE Director of Public Health in the North West and Prof Molly Byrne, Director, Health Behaviour Change Research Group, School of Psychology, NUI Galway.

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Meet the team

Contact Tracing Teams up and down the country worked between 70 and 80 hours a week during the worst of the latest wave of the COVID-19 pandemic.

We chat to some of the dedicated crews.

“People either don’t understand or don’t want to understand how dangerous and infectious this thing is. It’s like glitter,” explained contact tracer Emily Creighton.

“You don’t realise you have it till it’s stuck to you … then it’s bloody everywhere.”

Emily has been at the coalface of the surge of COVID-19 over the festive period, working between 70 and 80 hours a week during the peak, a major part of the public health efforts to suppress the virus that was running rampant. She is based in the new contact tracing centre at Heuston South Quarter. Alexis Kapoulis is team manager.

From the service industry, Emily was well accustomed to talking and listening to people.

“Sometimes it’s like getting gossip from the whole nation. You hear the TV news at home, but you get a great idea of what’s really going on in people’s lives around the country on these calls. And of course, the more you listen to them, the more likely they are to listen your stay safe advice.”

Emily said she’s used to long hours in the hospitality business when it’s busy.

“But it’s also really nice to be involved.

It’s great to be connected, and not just lost in the pandemic.” Emily said she is proud of “official Ireland” and thinks the government, the HSE and others have “done a great job”.

Noah Levitin from Indiana, USA is a graduate student of International Development at UCD, with an undergraduate qualification in Public Health. “It’s a huge honour for me to be allowed to work in the Irish public health system, as a non-Irish citizen. I’m overwhelmed by the public service ethos, compared to the private healthcare focus we have at home.” After graduating in the USA, Noah had wanted to travel to study and also immerse himself in a European experience. “Obviously, I didn’t expect anything like this, but it’s actually really satisfying to be so deeply involved with what’s going on.” He was particularly

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DID YOU KNOW In November last year, two floors of number 1, Heuston South Quarter (HSQ)were acquired for the HSE through the efforts and experience of Brian Murphy, Galway contact tracing team (CTC) mobiliser, ably assisted by Kevin McDermott, PWC project manager. The intention was to bring together the CTCs from Parkgate Street, Merrion Place and to accommodate some of the several hundred new recruits being hired to become contact tracers. Under the guidance of mobiliser, Dearbhla DeLasa, who took over the team in December, the equipment, furniture and resources essential for safe and sanitised working were installed in just a few weeks. The first of the 220 people now working in the Heuston South Quarter CTC took up their stations in December. They didn’t have much time to settle in, and the paint was still wet on this CTC when the most violent surge of this pandemic hit.

thankful for the supportive atmosphere at the HSQ, whatever the pressures. “The management style here is so unexpected for me, everyone is so approachable. It actually makes it a joy to come in to work every day.”

Another recent graduate from UCD, this time in Physiotherapy, is Limerick lady Kate Spillane. The impact of the Christmas surge was major, said Kate, with the biggest change being the explosion in the number of close contacts people had. “It was crazy. Especially on the Saturday and Sunday after Christmas. Many calls had 15 to 20 close contacts, some with 40,” she said. “And some of the calls could be very long as people go through their lists of contacts, sometimes struggling to understand fully what’s going on.”

She admitted to feeling a little overwhelmed at times, having worked three 12-hour shifts back-to-back over Christmas. “It doesn’t always help getting home and watching the media reports on how bad things were getting. Sometimes it was easier to be at work, with the calm and supportive atmosphere among the teams here!” Kate hopes to go on to study medicine in UCD and though life hasn’t

Pictured: Emily, Alexis and Dearbhla, Noah, Kate, Laura, Fahad

been easy, the exceptional experience of working in a CTC will be what she’ll remember most about COVID. From the United Arab Emirates and speaking seven languages, but living in Ireland for the last 14 years, Fahad Baloch is another international member of the team. Fahad had just come off a long and difficult call with the mother of a child that was already in hospital when he called her to inform her of the boy’s positive test.

“She was understandably upset, saying she had tried so hard to keep her son safe, but he picked up the virus while out of her care. We spoke for quite a while and she calmed down eventually, accepting that it wasn’t my fault,” he said, clearly drained by the call.

But Fahad had less time or sympathy for the people who hear of a positive test, but because they are feeling no symptoms, decide for themselves not to self-isolate. “I called one man with news of a positive test and he said, can I call him back after two days, as he had a lot to do over Christmas!” He added, even more exasperated, “I had one case of a child who had symptoms and tested positive, but his parents drove him all over the country visiting relatives over Christmas and guess what … he’s led to 32 close contacts, lots of them probably positive.”

Dealing with parents of children who have tested positive is the most difficult call to make, agreed Laura Patel from Bettystown.

“Particularly when you are speaking to them and you can tell they live in a small, crowded home, or worse, when they’re a single parent.

You just know the isolation is going to be really tough.” But like all her colleagues, Laura is relentlessly positive. “The shifts are long, but someone has to do it,” she said. “It’s been great working here. It’s a humbling experience and the people are really great here from top to bottom … and sure two metres separation isn’t so far that you can’t develop a friendship” And even though she spoke in early January, Laura could clearly see things were improving.

“The number of close contacts seems to be going down and for the first time in weeks, it seems, the call queue gets down to zero … not for long, but it shows we’re making progress,” she concluded.

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Instagram LIVE Take-over of HSE Instagram by one of our Contact Tracing Teams is a big hit with followers

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YOU CAN CHECK OUT THE CONTACT TRACING INSTA TAKEOVER ON INSTAGRAM.COM/ IRISHHEALTHSERVICE

o stand out in a sea of content – there are 300 million Instagram stories created daily - means going above and beyond for your followers. A recent take-over of the Irish Health Service Instagram account gave our ffollowers ollowers a unique insight into the world of contact tracing.

An Instagram takeover is the process of ‘handing over’ your account to someone else to run. This would be the first time the HSE Instagram account was ever ‘handed over’ to anyone outside our social media team.

For this take-over, Ali, Colm and Jess from the Cork Contact Tracing Centre were showcasing their work as contact tracers.

The day before the ‘takeover’ we posted a photo to our grid of Ali, Colm and Jess sharing the news about the upcoming event. The post was shared by journalists Zara King and Richard Chambers encouraging people to watch the takeover. This post was seen by nearly 70,000 people on Instagram.

On the day of the takeover, Ali, Colm and Jess started the day with a ‘live’ video tour of the Cork Contact Tracing Centre. This was the first of many videos giving the HSE's 86,000 followers an understanding of how contact tracing works. Ali, Colm and Jess also shared information and busted some misconceptions about COVID-19. The takeover also showed how knowledgeable and understanding our contact tracing staff are as we continue to protect the public from COVID-19.

The HSE social media team planned the ‘takeover’ timeline over the course of the "The day before the ‘takeover’ we day. They included captions in the videos posted a photo to our grid of Ali, to make them accessible to people with hearing difficulties. They also incorporated Colm and Jess sharing the news graphics and swipe-up links to the relevant about the upcoming event. The post pages on hse.ie. was shared by journalists Zara King The takeover proved to be very successful, with the Instagram live stories viewed over and Richard Chambers encouraging 663,000 times. We also gained over a people to watch the takeover. This thousand extra followers. Many people sent post was seen by nearly 70,000 people in compliments about the contact tracing on Instagram." staff and their contribution in the fight against COVID-19.

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THE HAVEN Connolly Hospital in Blanchardstown, with the generosity of small businesses, transformed an old unused room into a beautiful tranquil space for all staff.

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he room, aptly renamed ‘The Haven’ is where staff can retreat from the toil of fighting COVID-19 to a warm, comfortable, peaceful sanctuary.

Since it opened, two short mindfulness sessions have been put on for staff each week in the room. The sessions were facilitated by ANP Claire McCarrick and physiotherapist Mark Kiernan. Claire reported that the feedback they received was ‘overwhelmingly positive’.

“People greatly benefitted from our mindfulness sessions. We hope to roll out more sessions and will have a team of five facilitators from varying professional backgrounds. With improved stress management and mental health, staff can perform their jobs better. Investment in staff wellbeing can only have a positive impact on patient outcomes,” said Claire.

“I think this room is a fantastic service for all the staff of today and the staff of the future and I think that it’s an investment in the mental health and wellbeing of current and future staff.”

The decision to renovate a rarely used office in the hospital into a relaxing room for staff came from Director of Operations Marie Murray. She contacted her friend Jean Maguire, proprietor of jewellers Desert Diamonds.

“She was talking about the stress that all the frontline workers were under and that she’d found this room in the hospital and she’d love to do something with it. She asked me if I knew anyone who might give advice on colours. That night I contacted Adeline [Molloy, from Adeline Molloy Design). Adeline came on board straightaway,” explained Jean.

Adeline said she was delighted to get on

board and started making calls to all the people she deals with the next day and ‘it just escalated from there’.

“Everyone I turned to agreed to come on board and then we all just got together and started to work on a plan and a design. It just developed from there and it turned out to be something we’re really proud of and we were delighted to give something back to frontline workers,” she said.

Denise Hartigan, CNM2, said the room has been vital in helping staff to switch off and unwind.

“Having spent the last few weeks working on a COVID positive ward, unless you’re actually involved in it you cannot understand the stress that that involves. Speaking to colleagues, speaking to friends, who were going home at night, we didn’t know how to sleep, we couldn’t switch off so a space like this is so important,” she said.

A huge thanks to all those who gave their time and services: Craig Britton, Matt Britton Carpets; Juergen Riedl, Ventura Design; Keith Walker, Roundwood Design; Johnny White, V2 Living; Adeline Molloy Design; Jean Maguire, Desert Diamonds; James Doherty, Floors; Anne Dennehy, A&L Curtains; Lola Donoghue, Wilde Interiors; Orla Walsh, artist; Brooks Sandyford, materials; Nirvana Lighting; Tom Byrne, Fleetwood Paints.

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Operation Inspiration The nation has taken two inspirational women to their hearts over the last number of weeks.

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peration Transformation leaders Hazel Hartigan and Sharon Gaffney emerged from under personal clouds over the course of the eight-week programme, to the delight of their colleagues in the HSE. Nurse Hazel spent the last year on the COVID-19 frontline in St John’s Hospital Limerick, and then found the extra energy and dedication to lose an amazing two stone on the RTÉ show.

Sharon, who works as a Director of Finance and Organisation Services in the Royal Victoria Eye and Ear Hospital in Dublin, lost 1st 7.5lbs.

But it wasn’t just the weight loss that inspired their followers. The pair transformed their lifestyles, coming out with a smile on their faces and a pep in their steps.

Hazel and Sharon completed the famed OT 5k Walk last week. HSE Health and Wellbeing encouraged HSE staff to walk or run the Operation Transformation virtual 5k and support their HSE colleagues and leaders on the programme. Over 26,000 people registered for the virtual 5k this year.

As well as being an inspiration to her family and the viewers, Hazel’s journey was the encouragement behind her colleagues taking on the Jerusalema social media challenge. Some of the 60 or so staff of the hospital put their best feet forward for the dance challenge.

Speaking following the launch of the video on social media, Emer Martin CEO of St John's Hospital said Hazel has inspired everyone in the hospital and has helped them get through the worst of the current wave. “Hazel has been an inspiration to all of us. She made such a brave decision, stepped out of her comfort zone and everyone here has got a great bounce from it. It came at a time when we really needed it as the past six weeks and more has been a huge test for us in terms of trying to manage the worst COVID wave,” she said.

“We were flattened as a hospital last April and thought we’d never be able to face that level of intensity again. What we just experienced was as bad for us if not worse but the staff got through and

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Hazel’s Operation Transformation journey was such a brilliant distraction and inspiration for them," she added.

Like all of us, Hazel and Sharon have struggled with home schooling, working from home and night duty over the past few months. They have done it all in the eye of the public. Their families have played a big part in keeping them on track as well as having support from their colleagues in the HSE. Healthy Ireland sponsored Operation Transformation this year. Over the course of the show it provides the public with tools that is needed to get moving, lose weight and feel good, with the aim of having a significant impact on the behaviours we need to change to live a healthier life.

Lockdown has changed all of our lives, making it more difficult for many of us to stick to our healthy eating and exercise routines but Sarah and Hazel, our health service colleagues, have been giving us some much-needed motivation.

They have proven that healthy eating and physical activity can be a challenge, but starting with a few small changes can make a big difference.

The COVID-19 pandemic has stopped many of our usual activities in their tracks but it has helped many of us to start a healthy walking habit. Operation Transformation picked up how important that outdoor spaces have now proved for

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staff during COVID. They featured Hazel in the garden at St John’s Hospital, and Sharon in the Eye and Ear Hospital each having a virtual chat about their garden facilities and the support from HSE through the H&WB initiative funding to provide these facilities.

DID YOU KNOW OPERATION TRANSFORMATION, IN COLLABORATION WITH DCU SCHOOL OF HEALTH AND HUMAN PERFORMANCE, HAVE DEVELOPED THE MINIMUM FITNESS TESTS TO DEMONSTRATE THE MINIMUM FITNESS STANDARD FOR YOUR AGE GROUP. TRY IT OUT AT WWW.OT.RTE.IE/FITNESS-TEST/

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Service ABOVE LEFT: Three members of Coombe Care with the care packages. BELOW: An example of the items provided.

SHOWING WE CARE Coombe Care is a voluntary group that is constantly fundraising to provide underprivileged expectant mums with basic necessities such as night dresses, toothbrushes, soap, underwear and baby clothes

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n 1986, a Coombe Hospital patient, Geraldine Davy, created Coombe Care in response to a visible need in the hospital to support very disadvantaged families through the Medical Social Work Department. Since then, a completely volunteer Coombe Care group, made up of former patients and former and current staff, has set itself a goal every year to raise around €10,000 through small fundraising events, such as coffee mornings or raffles.

COVID-19 has changed the face of fundraising overnight but the needs of the disadvantaged patient have not changed and the group now moves to ensure that they can meet those needs. “We work with retail outlets to get the best possible price for products we need to buy to help our mothers and babies, and to solicit donations

of new, unused products,” said Tanya Franciosa, the Coombe’s principal medical social worker.

“We receive a very small Samaritan’s fund and rely on Coombe Care to provide funding to help patients in exceptional circumstances. With COVID-19, fundraising has been decimated. Without Coombe Care, there is a risk that some mothers will have to give birth without the basic necessities” Many women attending experience extreme socioeconomic difficulties often associated with complex social circumstances. These women often present in need of support and assistance.

“Many arrive at the hospital without basic essential items. Using the money raised, Coombe Care provides night dresses, tooth

paste and brushes, combs, soap, towels, underwear and toiletries, baby clothes, cots sheets etc. Coombe Care also helps vulnerable families at Christmas time with food vouchers. Vouchers are essential to help families over the Christmas period when many other support services are closed.”

Coombe Care also provides financial assistance to vulnerable women and their family who, due to their circumstances, may need support to access their basic human rights such as heating, electricity or indeed essential items for their baby such as moses baskets or sterilisers.

“The Coombe Hospital has around 10,000 maternity patients annually. On average, approximately 400-500 women living in our catchment area need the help of Coombe Care every year. Some women are migrants; some have left an abusive relationship; some are experiencing personal difficulties; some have no family to turn to; some are homeless and living in emergency accommodation such as B&Bs or hotels. All need help in one form or another in a way that preserves their dignity so that when they and their baby are on the postnatal ward, they are not disadvantaged, in any way, by a lack of basic essentials.”

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CORK NICU MIDWIFE MARGARET SET TO RETIRE AFTER 40 YEARS OF 'EXCEPTIONAL' SERVICE

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ork midwife Margaret O’Driscoll is set to retire from Cork University Maternity Hospital, after four decades caring for babies.

She spent 27 years in the neo-natal unit in the Erinville and 13 years in CUMH. In both hospitals she earned a special place in the hearts of the thousands of parents whose babies she cared so lovingly for.

She began her career in what is now Waterford University Hospital back in 1975, before training as a midwife in a hospital near Scotland and returning to her native Cork to embark on her career proper.

“Initially I didn’t want to work with babies at all — I felt that at least adults could tell you what’s wrong. But you learn very quickly that babies can too, in their subtle or not so subtle ways!”

After an initial year or two, Margaret found her stride and quickly realised that she never wanted to leave neo-natal. “I can honestly say that there was never a day I didn’t want to come to work,” she said.

A mother of five children, ranging in ages from 36 to 27, Margaret, lives in Kilbrittain in West Cork, and is married to Willie, a farmer.

The immense job satisfaction, despite the exhaustion, motivated her to always go that extra mile for the babies in her care. That sees her routinely give her phone number to parents when their babies are being discharged, and even offering to babysit for them on days off.

Among those forever indebted to Margaret are Elizabeth Nagle and her partner Denis Buckley. There were complications during the birth of their daughter Eve last September, and

they said Margaret was ‘amazing, brilliant, absolutely phenomenal’.

“She continually reassured us that we’d be fine. And then last Christmas, when Denis was best man at a wedding, she came and minded Eve for us for a weekend so we could go, when she was only three months,” said Elizabeth.

Another couple were so grateful to her for minding their boy while they too attended a wedding that they nominated Margaret for a Little Big Things award with Skibbereen and Bandon Credit Union and, not surprisingly, she was successful.

Margaret naturally admits that some days are harder than others in the unit that can cater for 55 babies at its busiest, but more usually treats around 37. Not every story has a happy ending there.

“But the positives far outweigh the negatives.

You see traumatic situations bringing out the best in people and the tiny babies are so brilliant. They struggle to survive and they mainly do survive. Parents are naturally so distracted when they meet us here, it’s generally the last place they expect to be, and it’s a place they usually never even knew existed, so we have to look after them as well as the babies.”

That’s been the case even more since COVID when just one parent at a time can be with a baby.

“We are literally going non-stop. We might have 10 babies going home one day, and we’d welcome in another seven or eight. But that’s

TOP LEFT: Margaret O'Driscoll. TOP RIGHT: Margaret with Sarah O’Keeffe and son Aaron, and Dr Brendan Murphy, consultant neonatologist. ABOVE: Margaret early in her career. Photos: Gerard McCarthy

our job,” says Margaret.

Working 12 hour shifts, and 36 -hours a week, it’s certainly a demanding role for anyone. Taking into account her travel time, it’s more like a 15-hour day for Margaret.

She says she’ll miss her work and her colleagues terribly.

“They’re a really great bunch. There’s not a single nurse who doesn’t want to work here, and we’ve a great group of consultants. There’s a great sense of camaraderie here.”

As she reflects on her career, she says with confidence that if she had her time back, she wouldn’t change a thing.

“Nursing is very different now compared to when I started. It’s very hard work, you’d really want to love what you do. But I’m lucky as I can honestly say there was never a day I didn’t want to come to work,” added Margaret.

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SUSAN GIVES VOICE TO THE NEWBORNS Susan Vaughan has been a nurse in the Cork University Maternity Hospital neo-natal unit for more than 10 years. She has seen her fair share of happy and sad outcomes, but throughout it all her focus is to give individualised care to every baby in their care.

Susan, from Fermoy, puts a huge focus on premature babies’ developmental care and was one of the first nurses in the country specially trained to give a voice to the newborn.

“Lots will need nasty IVs to survive, and it’s important that their only touch isn’t one of pain, but something more positive. It’s about training the pathways of their brain to develop,” she said.

She encourages lots of skin to skin contact between baby and mum and dad, and says premature babies don’t like stroking (which feels like being tickled) but prefer the gentle laying of hands on their skin.

She sees her role not as mum to the babies, but as someone who helps parents to get to know their newborn and gets them involved with nappies, baths and feeds.

The family-centred unit is staffed by 13 neo-natal nurses, and a multi-disciplinary team comprising an occupational therapist, speech and language therapist (to help with feeding), and dietician, among others.

An annual coffee morning to mark World Prematurity Day organised by Susan for over 10 years has also been a victim of the pandemic. The morning saw parents, both past and present, come together and remember the challenging journeys that babies and families undertake due to prematurity. It was also a great opportunity for staff to meet the babies again and to see how they are doing, as well as it being a great opportunity for new parents to meet others in the same situation.

Susan explained how the event usually takes place in Brú Columbanus, where many parents of babies in the unit would have stayed, and it’s a chance to say goodbye and thanks to staff there too.

Killester physiotherapist setting the pace A wonderful example of talent within Community Healthcare Organisation Dublin North City and County, is physiotherapist Mary Leech who works on the Killester Primary Care Team. While working in CHO DNCC, Mary has set three Irish Masters Records in 2020, in the 45-49 age category for 800m, 1500m and 1 mile. Her colleague Vanda Cummins, physiotherapist, paid tribute to Mary.

“While it was always known that Mary was an elite athlete, we are particularly impressed by achievements over the past year, while continuing to provide essential

Top: Susan Vaughan with other members of the Neo Natal Unit at CUMH Prematurity Day Above: Susan Vaughan of CUMH Neo natal unit.

Instead of the coffee morning, the unit made a video for their social channel to capture their message of hope and love.

As intense as it is, Susan loves her job and says all their miracles make it so rewarding.

“But working here teaches you not to sweat the small stuff. It really puts things into perspective.”

services during a pandemic and looking after her three children. It’s a great team working here, and watching Mary’s achievements gives us all a real boost, we’re delighted for her.”

Speaking about what running means to her, Mary, a member of Drogheda and District AC, said, “I love running, it’s a huge release for me. Like so many people with a busy home life, juggling work and three kids can be stressful but everything seems better after a few miles.”

Mary shares her own best advice on racing, “I love racing and getting the chance to be competitive. You have to leave the Olympics to the young ones, they are the true elites. Running is a basic and honest sport. If you're consistent with your training, fitness comes. Getting out the door is the challenge, once you begin the endorphins take over.”

Some of Mary’s previous achievements also include a silver medal in the 2018 European Athletics Championships in the 1500m indoor track event in the W40 category. In 2019 she went on to win two silver medals in the World Athletics Championships in Poland in both the 1500m and 3000m. Last year, Mary set three Irish records in the woman’s 45 age category but unfortunately the European Championships were cancelled, where she would undoubtedly have won more.

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Quitting Smoking Take the 28-day #TheLastStop no smoking challenge in March

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f you can quit smoking for 28 days, you are five times more likely to quit for good. Starting from March 2nd 2021, people who smoke all over Ireland will be taking the 28-day challenge.

According to recent research, the COVID-19 pandemic was a trigger for some to start smoking again. This is not surprising given that many use smoking as a way of managing stress. Smoking does not actually reduce stress but actually speeds up the heart rate and increases blood pressure. The research also showed that four in five people (79%) who smoke intend to kick the habit, and those who succeed in quitting for 28 days are five times more likely to quit for good.

Martina Blake, national lead, HSE Tobacco Free Ireland Programme, said, “Most people who smoke want to quit but, for many, the idea of quitting can seem like a big hill to climb. We want to let people know that the Quit service can help you plan for quitting and ways you can cope with difficult periods in your life without smoking. If you have quit before, you know that you can do it again and this time for good. There are the physical cravings for nicotine, the psychological dependence and the emotional dependence, which all need to be worked on when quitting.

“The HSE Quit Service has professionally trained staff who can assess your nicotine dependence, your smoking pattern and triggers and can help by providing the tools and supports to make it possible. This practical support and resources give you the best chance of making it to Day 28 and once you reach that, you are well on the way to long-term success and the benefits of a smoke-free life.”

If you are a HSE staff member, you can avail of free stop smoking medication to help you stop smoking throughout March and at any other time of the year. You can use a combination of stop smoking medication

(nicotine replacement therapies and/or a prescription drug called Champix) and receive support from a HSE Stop Smoking Advisor.

To find out more about availing of free stop smoking medication in your area, please visit https://www.hse.ie/eng/about/who/ tobaccocontrol/news/ Dr Paul Kavanagh, public health medicine specialist, HSE, said that smoking is ‘incredibly harmful’.

“One in two smokers will die from tobacco-related disease and a smoker can expect to lose on average about 10 years of life due to smoking. Stopping smoking is the single most important thing you can do for your health, for your future and for your loved ones,” he said.

The good news is that quitting smoking helps build up your natural resistance to all types of infections including COVID-19.

When you stop, the natural hairs in your airways (cilia) begin to work again. Within one to two days, the oxygen levels in your body will improve. Your blood pressure and pulse reduce, which in turn decreases the overall stress on your body.

Make March the month you quit for good and take advantage of the free support available from HSE QUIT services.

AREA CONTACT CHO 1: Donegal, Cavan, Leitrim, Monaghan................................................................................... Maresa McGettigan, 086-0492465, maresa.mcgettigan@hse.ie CHO 2: Galway, Mayo, Roscommon.............................................................. Leona Halton/Caroline Folan, 087-3837895/091-737262, Quitsmoking.west@hse.ie CHO 3: Clare, Limerick, North Tipperary........................................................................................................Mary McMahon, 065-6865841, maryb.mcmahon@hse.ie CHO 4: Cork, Kerry...................................................................................................................................................................Anna Burns, 087-3626535, anna.burns@hse.ie CHO 5: Carlow, Kilkenny, South Tipperary, Waterford, Wexford...........................................Catherine O’Loughlin, 087-9371973, Catherine.Oloughlin@hse.ie CHO 6: Dun Laoghaire, Dublin South East, Wicklow.............................................................................................Colleen Fahey, 087-3592513, colleen.fahey@hse.ie CHO 7: Dublin West, Dublin South City, Dublin South West, Kildare/West Wicklow.......................... Elaine Cunniffe, 087-6461143, Elaine.Cunniffe@hse.ie CHO 8: Laois, Offaly, Longford, Westmeath.....................................................................................................................Gail McNeil, 086-8157708, gail.mcneill@hse.ie CHO 8: Louth and Meath........................................................................................................................... Madeleine Kennedy, 087-2363040, madeline.kennedy@hse.ie CHO 9: Dublin North, Dublin North Central, Dublin North West...................................................................... Rachel Burke, 087-2022680 rachel.burke8@hse.ie

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Personal MARIA QUITS FOR HER DAUGHTER

MARIA MORAN AND HER NINE-YEAR-OLD DAUGHTER CAOIMHE

Just do it – Maria Moran’s advice may take a few of us back to the Nike ads from moons ago but most of us would have to acknowledge it’s the best advice any of us could ever get or give.

Do it. And she has done it. She has quit smoking. And Caoimhe is delighted. Caoimhe is her nine-year-old daughter who was the inspiration for her mum’s decision to quit late last year.

Having been a smoker since her teens, Maria had considered quitting in the past but never actively tried. Caoimhe’s announcement last year to her mum that she didn’t want her to die, was an emotional bolt she had not anticipated.

“You could see it with her – she would see the packets of cigarettes with the horrible pictures on them and every time she would see me with a cigarette she would just seem so sad.”

It was Caoimhe’s birthday in November so Maria made a pact with herself that that quitting would be her gift. “Although I had toyed with it in my head before, I had never really tried to give up, so I just thought, why not. Caoimhe’s birthday is November 22nd. And I quit on the 18th. It’s very hard to go back to a child afterwards if you haven’t succeeded.”

Having made the decision, the prompt of a work e-mail (Maria is a HSE Business Manager with Older Persons Services in Cork) providing details of the HSE Quit programme was the perfect opportunity. Her interaction with Miriam O’Shea, Smoking Cessation Officer, sealed it.

It led to Maria embarking on the three month programme that would initially involve weekly

calls with Miriam for four weeks, then a three-month follow-up call and finally projecting to a year on when the two would formally speak again on Maria’s first anniversary.

Now three months in, Maria reflects on the importance of Miriam’s advice, support and wisdom. “One of the first things she did was ask me my reasons for quitting and my reasons for staying. And honestly, there were no reasons for staying. That first session copper-fastened my commitment and we set the quit date.”

Although the first week seemed very manageable, Maria realised by the second and third that maybe a mix of naivety and adrenaline were sustaining her. But as the days turned into weeks, Maria began to adapt. Setting herself goals, she also ensured rewards.

“After things began opening up again, I went and got my nails done and brought my daughter shopping. Quitting really is like any new routine, it very quickly becomes part of who you are. Over the weeks I adapted and I got to the stage of not wanting the nicotine or the spray anymore.”

While Caoimhe’s approval and pride are a fulfilling reward, the mounting savings help too. “I tracked from the beginning how much money I have saved and after this all ends, whenever that is, we are going on a fabulous holiday!”

And her advice now that she is three months in? “There is always a reason not to quit. For me this time there were a million reasons - new job, COVID, lockdown. Ultimately you have to just do it.” Reflecting on her success to date, Maria finally notes that she now looks in the mirror, she recognises the person peering back as a non-smoker and that feels good.

ELECTRONIC CIGARETTE USE AMONG YOUTH IN IRELAND The use of electronic cigarettes (e-cigarettes) among young people in Ireland is increasing. E-cigarettes themselves have been shown to have adverse effects on the health of young people, particularly in relation to cognition and neurodevelopment. A recent review by the Health Research Board concluded that adolescents who had ever used e-cigarettes were between three and five times more likely to start smoking tobacco compared with those who had never used e-cigarettes.

Prior to 2018, data on e-cigarette use among adolescents in Ireland was limited.

In 2014, a survey of sample of 16-17 year olds showed that the prevalence of ever use, defined as having tried an e-cigarette once or twice, was 24% and the prevalence

of current use, defined as use at least once a month, was 3.2%. Four years later, published findings based on data collected as part of the Planet Youth West 2018 survey, show a significant increase in the prevalence of e-cigarette use. Among more than 4,400 15-16 year olds in the West of Ireland, 40% had ever used e-cigarettes and 14.4% were current e-cigarette users, a 4.5 fold increase since 2014. The European Schools Project for Alcohol and Other Drugs (ESPAD) Survey 2019, conducted among more than 1,900 15-16 year olds across Ireland, reported for the first time, at a national level, that the prevalence of both ever and current e-cigarette use among 15-16 year olds was higher than that of conventional smoking. Over the past

decade, there has been substantial progress made in reducing tobacco consumption among youth. With regard to e-cigarettes, important gaps exist in current legislation, particularly in relation to advertising, use of flavourings, and packaging. This has enabled e-cigarette companies to deploy marketing tactics which appeal to younger audiences. Smoking behaviours among young people in Ireland are changing.

E-cigarette use among adolescents is now more prevalent than conventional cigarette use. As a first step, we must curb advertising which is targeting younger audiences, restrict the use of flavourings intended to appeal to youth, and ensure an end to the sale of nicotine containing products to those under 18 years of age.

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Personal

“There are so many rewards.”

People who work in the health and caring professions have so much to offer a foster child. Not only that but being a foster carer can bring wonderful experiences and rewards for you and your family.

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mma, a social worker who has been fostering older children for eight years, explained how she got involved in fostering and what it entails.

What was involved in becoming a foster carer?

Fostering was always on my agenda, the first step was to pick up the phone and make an enquiry. A social worker came to my house and we talked about if it was the right thing for me. She was lovely. We got on well and I felt I could be open and honest with her.

The whole process was pretty straight forward. I had an assessment where they (the social worker) met with me a number of times. We talked about the good, the bad and the ugly! But we’ve all had challenges in our lives and they help us to understand what’s happening for the children.

Then there were the checks - Garda vetting, references and background checks. Then my report went to a foster care committee and I was approved to be a foster carer.

What kind of fostering have you experienced?

I do a type of foster care called supported lodgings. It’s for children aged 15 and over who are assessed to be a bit more independent and have the capacity to start learning life skills. They come to live with me and I help with this, I teach them cooking (although some are better than me!), budgeting, how to do their laundry and things like that. I always foster two children at a time as I feel it helps them to have another young person here.

Sometimes I have fostered siblings, but sometimes they are not related.

I have also cared for a young mother who came to live with me with her baby.

That was a fantastic experience. I’ve

fostered children in all kinds of circumstances from Ireland and also from different countries.

The shortest placement was three and a half months and the longest was three and a half years. I’ve even done some respite for a night or two.

How would you describe the impact of fostering on your life?

Fostering has had a really positive effect on my life. I wish I had done it earlier! Because I foster older children and they are in school or college I am able to continue to work.

With the support of their social workers the young people get involved in the local community and so they have their interests and hobbies. I can also still keep my interests and hobbies. They have their own lives and friends and I am able to keep that side of my life too.

What kind of support is available for foster carers?

You have your social worker and the child has theirs. The fostering social worker support is so important. They can give you advice and support. The child’s social worker helps to organise supports around them. The two social workers speak to each other and that’s really important that they can plan together.

I know there are other supports too, like Child Care leaders. I haven’t experienced them with the older children so much. I know TUSLA has a 24 hour phone line for carers now too. That’s a great support.

There’s trainings offered too and I have really enjoyed them.

WHAT IS ESSENTIAL TO BE A FOSTER CARER? •

•

•

What has been the biggest challenge?

The biggest challenge was to start the process, going into the unknown. I wasn’t a parent before I fostered. I was nervous but excited.

Making the initial connections when the children come to your home, it’s different with every child. There’s no such thing as one size fits all.

•

You and your family enjoy the company of children and young people You do not have a conviction for violence or sexual offences against a child or adult You are available to meet with and work with all the people involved in the child/young person’s life You are willing to participate in a fostering assessment which can take place over a number of months.

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Personal Have you considered becoming a foster Carer with TUSLA? Did you know that you can apply to foster regardless if: • You do not own your own home. The most important thing is that your home can accommodate a foster child/ children.

• You and/or your partner work. Fostering is about meeting the needs of the child/ children and therefore your personal circumstances are considered before placing a child with a foster carer. If you and/or your partner work, it is still worth having a conversation with the fostering team as not every child requires a parent to be at home in order to meet their needs.

• Regardless of your marital status, religious beliefs or sexual orientation.

• If you have or do not have children of your own.

• Regardless of your age and once you are relatively fit and healthy to care for a child.

• If you have faced challenges or adversity in your own childhood or adulthood, once you have effectively dealt with them and have the ability to provide care for a child/children.

For more information on TUSLA Fostering: Freephone: 1800 226 771 E: tusla.fostering@tusla.ie W: fostering.ie

What has been the biggest reward?

There are so many. I think, especially with the age group I foster. I am still in contact with almost all of the children who have stayed with me. I was with one young girl in the delivery suite when she had her son.

He’s a huge part of my life now.

Another young boy came to live here and he was so withdrawn. When he moved on a few months later he was a different child; he knew his worth and had confidence heading off to college six months later.

I can honestly think of rewards in every placement. That’s not to say there aren’t challenges. I’ve come home to water all over the floor from washing machines too heavily loaded but that doesn’t outweigh all the positives I’ve experienced.

Would you do it again if you knew what was ahead of you?

Emma

Oh yes. I wish I had done it earlier. I didn’t know I could apply as I was a lone applicant and didn’t have children.

I wish I had known sooner. I would have done it earlier.

The children I foster are fantastic kids. Teenagers can get bad press, but teenagers in foster care are just like other children. They do have the extra challenge of being in foster care and they need a safe and caring place to live to help with that.

I would recommend fostering to anyone. I have friends and family ask me about it and what it was like. I would always say I wish I had started fostering earlier. There are so many rewards.

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05/03/2021 10:59

Personal

OUR COMMUNITIES CARE Local GAA club volunteers in Co Monaghan assisted the HSE to open a new unit two months ahead of schedule in the midst of the COVID-19 pandemic, helping prevent the spread of the potentially lethal virus.

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he opening of the new unit at St Davnet’s Campus in Monaghan, relocating the last of the residents from the historical Blackwater House, was accelerated following a COVID-19 outbreak with eight positive cases of COVID-19 among the elderly service users. Individual ensuite rooms were vital for infection control as opposed to the Victorian dormitories and shared bathroom facilities.

The HSE staff locally enlisted help from Monaghan Harps GAA club and 10 volunteers turned up and worked a very long day to furnish the building and get it ready for occupancy the following day.

“This accelerated move to the new building ahead of schedule, is clear evidence of the true commitment of the Cavan Monaghan Mental Health Service staff and the wider community spirit of Monaghan town in bringing to fruition this project which will ultimately enhance the lives of the residents of the Blackwater House,” said Úna Forde, Clinical Coordinator/Assistant Director of Nursing, Monaghan Community Mental Health Team, St Davnet’s Complex, and also the Healthy Club Officer at the Harps. Úna was redeployed from her community mental health team position to co-ordinate the opening of this new facility two months ahead of schedule in the midst of the first COVID-19 lockdown.

“We worked tirelessly, over four days to get this new unit opened. I asked our local GAA club volunteers to help with the move and had a great response,” she said.

She said the residents are all delighted with their new accommodation.

“The spacious single rooms, each with ensuite facilities and a smart TV, are now individualised and personalised by the residents occupying them, made theirs by the personal items gathered over lifetimes.

Something special happened on that day with the move to the new relocated approved centre - whilst the surroundings are new the residents are still surrounded by people known to them, and are comfortable and safe,” she said.

The new build is designed as two eight-

bedroom bungalows, each with a sluice room, living room/kitchenette, quiet/ spiritual room, connected by a shared services corridor, including clinic room, consultation room, nursing station and offices, Snoezelen multi-sensory room and visitors room. The residents’ bedrooms overlook, and the living areas open out onto, three spacious gardens. St Davnet’s historical church and chapel are close by and can be viewed from the new build.

HEALTH SERVICE EXCELLENCE AWARDS There has been a great response to this year’s Health Service Excellence Awards. Entries have now closed for the awards, which will take place in April.

The awards are an opportunity to showcase and celebrate the good work that happens every day across our health service. 2020 has been one of the most challenging periods for the health service in decades, but alongside the challenges, there has been great innovation and resilience and we want to celebrate and learn from the positive initiatives that have been borne out of the COVID-19 pandemic.

Two new categories have been added to reflect the extraordinary efforts being made by health service staff up and down the country during COVID-19.

Judges are now looking at projects that have enabled staff to respond to demands created by the pandemic, as well as ones that have introduced an innovative approach in service development and design during the COVID response to support staff and patients.

The eight award categories are: 1. Supporting a Healthy Community 2. Improving the Patient Experience 3. Innovation in Services Delivery 4. Exceeding Expectations - Outstanding Employee Award 5. Excellence in Quality Care 6. Innovation in Integrated Digital Excellence 7. Operational Services Integration in a COVID Environment 8. Service Development and Innovation in Responding to COVID Following the initial round of submissions, a number of projects will be shortlisted. Each shortlisted project will be notified in March and they will then be asked to present their project to a judging panel.

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Personal

Arthur's promise

‘Kathleen’s Arthur’ keeps his promise to UHL nurse for making a birthday wish come true

Above: Limerick city man Arthur O’Sullivan, with Clinical Nurse Manager Kathleen Kennedy, pictured at UHL just before Christmas 2020.

Below: The cake delivered to Kathleen and her colleagues at UHL.

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very Christmas for the past four years, Limerick city man Arthur O’Sullivan has been keeping his promise to an emergency department nurse at UHL to bring her a slice of birthday cake if she helped him to recover from his illness to celebrate his 70th birthday.

With the attention to detail that’s evident from his stylish, dapper appearance, Arthur goes the extra mile to make good on the promise he made to nurse Kathleen Delaney on Christmas Eve 2016 in the Emergency Department at UHL. Every year since, he has delivered a special cake for Kathleen, now a Clinical Nurse Manager in the Acute Medical Assessment Unit at UHL, and her colleagues.

The impressive cake that Arthur brings to UHL every festive season is prepared by his cake-maker friend, who lives in Mountrath, Co Laois. Arthur collects the cake and delivers it in person to the hospital.

These efforts will be no surprise to anyone at UHL who is familiar with the special bond between Arthur and Kathleen. To all staff in the hospital, the Thomondgate native requires no surname for identification—he is fondly known as ‘Kathleen’s Arthur’.

The unique connection between the two was formed when Arthur, who has the rare arthritic condition ankylosing spondylitis, was brought to the Emergency Department on Christmas Eve of 2016 after he collapsed at his 70th birthday party.

“It was Christmas Eve, and I was on a trolley in A&E, and Kathleen was talking to me. I told her that it was my birthday, and she held my

hand in hers, and quietly sang ‘Happy Birthday’ into my ear.

All of my immediate family are dead, so there was nobody there for me, but Kathleen was there, and I still can’t describe how that simple gesture lifted me up.

She’s a wonderful person,” Arthur recalled.

Kathleen has been nursing at University Hospital Limerick for the past 21 years, and says that while all patients are grateful for the care they receive, it’s rare for someone to go to the lengths Arthur has gone to in order to express their gratitude.

“Some time passed, and I was working on nights, and arrived in to work to find this big massive cake for me in reception that Arthur had left for me! He’s been doing it every year since, and we just appreciate his thoughtfulness so much. Arthur is a loveable rogue, an absolute gentleman, and a very genuine person, and I can hardly describe how much his thoughtfulness is appreciated. It really lifts you up when you see people going out of their way like that; it’s so kind,” she said.

Arthur and his festive gift for Kathleen and her colleagues has become one of the most heart-warming Christmastime traditions for staff at UHL. For Arthur, it’s a simple matter of saying thank you.

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05/03/2021 11:02

Education

Return to Nurse Practice Programme Despite the COVID-19 pandemic, nurse tutors Elizabeth Reilly and Áine Lavin, and administrator Shamine Bhika, at the Regional Centre of Nursing & Midwifery Education (RCNME), HSE Dublin North, planned and delivered the Return to Nurse Education Programme 2020 to participants who were five years or more out of nursing

A

s a result of the abrupt interruption of previously planned teaching activities, the staff at the RCNME were determined not to let the pandemic win, by demonstrating resilience, adaptability, determination, creativity, innovation in not only delivering an originally designed classroom type programme online but also empowering, and kindling the flame of out of practice nurses with the knowledge and skills essential to enable them to return as part of the nursing workforce.

This was the first time the programme was successfully delivered though a blended learning approach. The participants engaged with the process with great enthusiasm and were excellent at adapting to change and using the resources provided to them. All 12 participants completed the programme and have all since found employment.

The six-week programme was designed and delivered by the programme coordinators through a blended learning approach using a variety of online and workshop sessions. The delivery of the two weeks theoretical content was by-located at two sites between Connolly Hospital and Tayleur House, St Ita’s Hospital. All programme participants were remotely logged in from many parts of Ireland.

When structuring the online timetable, the nurse tutors ensured there was daily, inbuilt protected time for participants to ask questions before they moved on to the theoretical content for the next day. This meant that each theoretical day began with one hour of protected time whereby the programme participants and nurse tutors had the opportunity to discuss the previous days learning and address any outstanding issues that may have arisen.

In addition to the online theoretical content, the theoretical weeks also included

a number of workshops sessions which focused on the practical / nursing skills elements of the programme. These workshops were specifically arranged in such a manner that ensured all COVID-19 Infection Prevention and Control Measures were adhered too at all times.

For the remaining four weeks of the programme the participants were on clinical placement in their various discipline specific sites including intellectual disability and general nursing sites. To ensure ongoing support, advice and learning continued including assistance with academic work and assignments, a number of small group face to face meetings were held each week with the

participants. This provided an opportunity for participants to ask questions, including share information and their experiences of clinical practice to date.

The successful delivery of the Return to Nurse Practice programme using a blended learning approach has demonstrated the far reaching roles and benefits of using this approach, not least the achievement of the programme learning outcomes but also the flexibility and wide accessibility it offers. In using this approach, nurses from all over Ireland were able to access and complete the programme, thus enabling more nurses to re-enter the nursing workforce equipped with the necessary knowledge and skill sets in an ever changing healthcare system.

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Personal

Breastfeeding policy a boost for working mums In line with Government and HSE Policy on Infant Feeding and supporting more mothers to breastfeed and to breastfeed for longer, the Breastfeeding Policy for Public Health Service Staff came into operation from January 2021.

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he policy applies to all employees in the HSE and Section 38 hospitals and agencies who are breastfeeding and providing breast milk up to the child’s second birthday. The new maximum age limit goes beyond the current statutory entitlement of six months and is a significant measure in supporting employees to breastfeed following their return to work from maternity leave.

The provisions of the policy are designed to promote a workplace culture that facilitates employees who are breastfeeding whilst recognising service demands and resource constraints.

Staff who are breastfeeding are entitled to breastfeeding breaks at work for up to one hour per normal working day.

The breaks may be taken until the child’s second birthday if needed. Staff who are working reduced hours, or work longer days, can take the breaks on a pro-rata basis. Breastfeeding breaks may be taken in the form of: one break of 60 minutes, two breaks of 30 minutes each and three breaks of 20 minutes each or in a manner as agreed by you and your manager.

If no breastfeeding facilities exist in the workplace, you may reduce your working day by one hour without loss of pay. This arrangement will need to be agreed with your line manager, in so far as is possible, to fit within the demands of the service.

Despite gradual increases over time, Ireland’s breastfeeding rates remain low by international comparisons. Reducing barriers to continue breastfeeding by providing facilities and breastfeeding breaks can enable mothers to continue to breastfeed for a long as they wish.

Julia Hayes, who works part-time as a senior women's health physiotherapist in the Coombe Women and Infant’s Hospital in Dublin, shared her experience of returning to work while breastfeeding.

"I am a mum to three very busy little bodies - Matthew (6 years), Alexanne (4

ABOVE: Julia Hayes and her children.

LEFT: Coombe staff breastfeeding room.

years) and Isobel (19 months).

Breastfeeding is something that I have felt very passionate about since having my children and I definitely see it as being very central in my parenting approach. It has given all of my children a great start in life," she said.

"Working in a maternity hospital has left me in a very fortunate position with regards to extended breastfeeding. The breastfeeding facilities are excellent – a warm, private space to express and access to separate fridge facilities. Since my return in May last year from Isobel’s maternity leave, work has been really hectic and I have enjoyed the quiet moments in the middle of the day expressing breast milk and doing something so beneficial for the health and development of my baby.

"I am delighted about the new breastfeeding policy at work as it will certainly make things a little easier for me and other mums. In my work, I regularly treat ladies up to and around their return

DID YOU KNOW

13% OF IRISH BABIES ARE BREASTFED AFTER SIX MONTHS.

to the workplace and there is definitely a belief that they must give up the breastfeeding at this point. As a healthcare professional who has had such positive experiences in extended breastfeeding, I always try to encourage those interested in continuing breastfeeding after they return to work by sharing my experiences.

Hopefully with this new policy, a greater number of health service staff will be encouraged to continue breastfeeding and this will mean good things overall for national breastfeeding rates."

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Digital

THE IMPORTANCE OF BEING SOCIAL

Bronagh McDermott, social media executive, and Muiriosa Ryan, social media manager, explain how the HSE is using social media during the COVID-19 pandemic

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n March 12th 2020, the Government announced that many public places and businesses would close and official St Patrick's Day celebrations were being cancelled. There was an immediate increase in activity across all our social media channels, particularly on Twitter. Understandably, there was a lot of concern and uncertainty. People had a wide range of questions about the virus and they came to our social media channels looking for answers.

As the weeks went on, our followers continued to grow across every social media channel. There was a huge appetite for information about the virus and people trusted the HSE as a reliable source of information. This increase in followers meant an increase in the number of conversations we had to monitor online. Doing this helps to ensure that our content is effective.

We also had to focus on dedicated community management to respond to people promptly. Due to the sudden and steep rise in activity across our social media channels, we set up an out-ofhours rota. This provided coverage for evenings and weekends. We also paused our scheduled social media posts so we could fully focus on COVID-19.

As with any content project, we work closely with subject matter experts. For COVID-19, our subject matter experts are mainly specialists in public health medicine. We work with them, our content design team and HSELIve call

centre staff in a coordinated way. This ensures that all our communications are consistent across all channels.

For social media content, the subject matter experts help us with responses to some of the clinical questions we get through social media. They also provide expertise when we create certain content for social media.

The COVID-19 pandemic has connected us with a new and much larger audience. Our social media channels have become a crucial part of a strategic objective – to be the trusted source of health-related information in Ireland. Using a personal and empathetic tone when responding to our audience has been important across all social media channels. As a result, we have received a lot of positive feedback from the public. On some occasions, it was our availability and caring tone that helped to relieve some anxiety and to avoid what could have become a bigger concern or even a complaint.

TWITTER AS A HELPLINE The volume of questions we receive through Twitter has grown rapidly as the pandemic has developed. HSELive’s COVID-19 helpline has had a large and sudden increase in demand, answering over 700,000 calls in 2020.

In March 2020, we replied to 12,164 direct messages and tweets compared to 105 for the same month in 2019. Many people prefer to engage online and our social media channels allow us to answer people’s questions through their preferred channel.

TWITTER LIVE-STREAMING

USING SOCIAL MEDIA TO IMPROVE OUR SERVICE

During the pandemic, we started streaming all of our weekly press briefings on our Twitter channel. This has been very popular with thousands of people tuning in to each briefing. The stream is also useful for other teams.

Due to social distancing, only a small number of journalists can attend the press briefings. The HSE Press Office encourages people to watch the briefing online and they regularly refer queries back to the stream.

Each day, the social media team notes any themes from the questions we receive through HSE social media channels. Sharing this information with the wider digital team helps to highlight gaps in our knowledge and online information and to identify any emerging issues. This has been useful in proactively preparing responses and developing online content.

TIKTOK In May 2020, we established a presence on TikTok for the first time.

Around this time, TikTok donated prominent in-feed ad space to trusted organisations and health authorities.

They did this to help the TikTok community stay safe. As part of this initiative, we launched our first campaign on TikTok using the #HoldFirm campaign

SUPPORT FROM SOCIAL MEDIA PLATFORMS At the start of the pandemic, social media platforms reached out to us to see how they could help us. Twitter had worked with us in the past on our vaccine content. During COVID-19 they created a search button for us. This meant that anyone who searched on Twitter for coronavirus or COVID-19 got an alert. This signposted them to factual COVID-19 information on the HSE website.

Facebook put a prominent COVID-19 button on everyone’s newsfeed. This drove 200k hits to our website for 4 weeks. This later changed to a ‘COVID-19 information centre’ that had content from the HSE Facebook pages and other reputable accounts. It also signposts people to HSE.ie. They also gave us an ad coupon for our COVID-19 advertising. Support from other social networks include: Google – advertising support for a paid search campaign. TikTok – advertising donation and help setting up on the platform.

LinkedIn – job slots for 6 months for a recruitment campaign.

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Digital creative materials and messaging. We have since followed up with more campaigns on TikTok. These include the ‘Stay home’ campaign, information about the COVID tracker app and the ‘Dear2020’ campaign.

INSTAGRAM Our Instagram audience grew from 5k to 81k from February 2020 to December 2020. We also had an increase in Instagram private messages.

By using Instagram stories, we have reached a younger audience and connected with influencers, as many of them only use Instagram. Influencers such as Laura Whitmore, Robbie Keane and Dr Doireann O’Leary regularly share our content.

FACEBOOK People want to know more about the virus and they want up-to-date information about public health guidelines and restrictions. We use Facebook as one of the platforms to provide this type of information. As a result, our Facebook audience grew by over 55k between March 2020 and December 2020. During this time we also had a huge increase in our engagement on Facebook, with over 70k comments.

MORE DIGITAL TOOLS Using other digital tools Communication is vital in a time of crisis. While we work remotely, digital tools help us to keep clear channels of communication open internally. They also help us to monitor and analyse external communications activity related to the HSE and COVID-19. Daily team calls - During the pandemic, information changes rapidly and new advice is announced regularly. It is important to keep the team up to speed so we are confident in responding to queries. To do this, we have daily social media team calls. Social listening - The ability to track online sentiment and conversations about the HSE helps us to measure any rise and fall in public approval. It walso alerts us to any problems in our messaging and information online.

To do this, we use a social media analytics and monitoring tool. Essentially, it gives us an insight into how people are talking about us online. At the start of the pandemic, we identified keywords to track online and extended these as the pandemic developed. We are now in a good position to use this tool rapidly for future events.

Social media management - Our social media management software tracks all comments across our social media channels. It enables us to quickly review and respond to comments and direct messages in one place. During COVID-19 it became a key tool as the focus shifted from day-to-day work to answering the questions about COVID-19 on social media. It allows us to keep track of queries and gives us insights into reporting data. It also has time-saving tools such as saved replies.

Looking ahead - As we begin a new year, the rollout of the vaccine has started in Ireland. While we are still publishing COVID-19 messages, we have now begun posting vaccine-related content. In 2021, our posts have shown the vaccine arriving and the first person to get the vaccine in Ireland. It is not surprising that these have been the most popular posts so far this year. It shows the appetite for the first glimmer of hope we have all been waiting for.

TikTok ‘HoldFirm’ campaign

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05/03/2021 11:06

Services

REFLECT & RECOVER Enhancing the psychological care of people who have survived their journey through intensive care is the aim of a new initiative from the ICU team in Our Lady of Lourdes Hospital in Drogheda

Two ICU nurses, a physio, occupational therapist and clinical psychologist attended the first virtual call with one of their COVID survivors. “Our Reflect and Recover service has been impacted by the recent surge, so overall we have only had a video follow-up session with two people prior to Christmas.

Both of these were COVID survivors from the first wave. On one of the calls, the lady’s family joined in. It was really interesting listening to their narrative and the impact ICU had on them,” explained Sinead Costello, Clinical Facilitator ICU/HDU. “The virtual service was multidisciplinary and lasted approximately one hour. It gave both participants the platform to talk about their experiences of being ill, their time in ICU and after discharge on the ward.

Ongoing physical difficulties were discussed with the physiotherapist on the call. She was also able to follow them up with exercises.”

For one of the participants, the team were able to bring forward his appointment with

LEFT: At the first meeting of the group were (l-r) Caroline Keating, occupational therapy; Dr Ciaran Wynne, senior clinical psychologist; Sinéad Costello, Clinical Facilitator ICU; Agnes Corrigan, senior respiratory physiotherapist.

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eflect and Recover is a multidisciplinary post ICU follow-up service and it is being delivered via a virtual platform during the COVID-19 pandemic.

It is committed to recovery and supporting the physical and mental wellbeing of former patients and their families. “We are here to provide support for people who have recovered from their critical illness and they are not alone. We are offering survivors a platform of support and a voice,” said Sinead Costello, Clinical Facilitator ICU/ HDU. Survivors may suffer from Post Intensive Care Syndrome (PICS) which can manifest itself as impairment or changes in the physical, cognitive, emotional and mental health of the person who has survived a critical illness. Increases in PTSD, anxiety, depression, forgetfulness and sleep disturbances have all been reported.

“The long-term physical, emotional, cognitive and mental impact of critical illness is often overlooked and can be a very lonely and frightening road to recovery,” she said. The service was set up in early 2020, but did not get off the ground until October 2020 due to the pandemic. They had to adapt and move to a virtual platform

ABOVE: The multi-disciplinary team speak online to one of their post-COVID patients. (l-r) Agnes Corrigan, senior respiratory physiotherapist; Sinéad Costello, Clinical Facilitator ICU; holding the tablet with patient waving Caroline O’Donnell, CNM2 ICU; Caroline Keating, occupational therapist; Dr Ciaran Dunne, senior clinical psychologist.

for communication, explained Sinead.

The follow-up service evolved from the patient diary initiative which has been in place since November 2018. The diary is a written account of the person’s days in ICU which they are unlikely to remember. The narrative comes from the nurses, members of the multidisciplinary team and family.

The purpose of which is to ‘fill in the gaps’ and add clarity to an often extremely distorted reality.

the respiratory consultant as he was having some difficulties. They were also able to clarify some other concerns he had.

“Both patients that we consulted with were keen to know how other COVID survivors were getting on, if they were experiencing the same symptoms. We were able to put them in touch with the ICU Steps service, a support group open to former patients and their families. It used to take place in Dublin but is now on Zoom.”

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05/03/2021 11:07

Services The Home First team of Aine and Jane.

Home First is one year old!

Home First is a physiotherapy and occupational therapy-led facilitated discharge service based at University Hospital Waterford (UHW). Launched in November 2019 as part of the HSE’s winter initiative, this very effective service is now a year in existence and seeing some great results. Physiotherapist Aine and occupational therapist Jane have spearheaded the project from the start.

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he aim of Home First is to prevent admission or re-admission to hospital, reduce length of hospital stay, maximise function at home and help with the transition from hospital to home, when patients are in their most vulnerable state.

The Home First team receive referrals from physiotherapists and occupational therapists treating patients on the wards of University Hospital Waterford. The team typically visit the patient within a few days of discharge from the hospital. However, for vulnerable patients, Home First has met them at the door or visited on the day of discharge.

In the comfort of their own home, the team assess how a patient gets around and manages in their environment and how they manage their activities of daily living, providing them with advice and education

to make the transition from hospital to home that bit easier and safer.

The global COVID-19 pandemic has put a lot of pressure on hospitals worldwide, including Ireland, to discharge patients to their homes in order to allow for a possible surge in COVID-19 cases. Home First, through implementing precautions, has continued this important service, facilitating earlier and safer discharges.

Since its establishment one year ago, Home First has helped over 500 patients to get home safely. The highest proportion of referrals has been from the Emergency Department. 88% of patients seen by Home First have not been readmitted to hospital within a month of being discharged. The service is estimated to have saved 1000 days of hospital beds through supporting people immediately on discharge, and as a result, contributed to a significant saving.

Feedback from patients who have benefitted from the service has been overwhelmingly positive, with much emphasis on its “excellent care for the elderly” and its contribution to restoring confidence to people during these tough times. One patient reported, “Absolutely fantastic service, I was very low in confidence after my fall and the therapist made feel so much better. I’m forever grateful.” Another patient said, “I thought the girls were very professional and helpful and gave me aids that were very useful.

Thanks for everything.”

One of the main priorities of Home First is ensuring safety at home, and this is emphasised in one particular family member’s feedback, when they described the service as “Excellent and supportive, and gave the family advice on how to keep safe in her own home.”

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05/03/2021 11:08

Education

Going Public Are you interested in becoming a public health nurse (PHN)? You may be eligible to apply for the Student Public Health Nurse Sponsorship and Recruitment Programme

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his is an exciting time to consider a career in community nursing as Sláintecare, a major programme of reform for the health service, is being implemented to transform and further develop care in the community. The purpose of the student PHN sponsorship and recruitment programme is to meet future service requirements for public health nurses nationally, targeting the areas of greatest service need. All RPHNs are qualified nurses who have undertaken additional study which is fully funded by the HSE. The programme is one year at post graduate higher diploma level 9 delivered in UCD, NUIG and UCC. On successful completion nurses are entered as a RPHN on the register of PHN in the Nursing and Midwifery Board of Ireland. They provide a broad based integrated service across a range of services in the community. RPHNs have scope within their practice to be innovative in meeting the identified needs of patients, families and communities across the life cycle and within the wider multidisciplinary team.

Candidates express an interest in three geographical areas. The majority of vacancies will be in the Greater Dublin region. You may include up to three Higher Education Institution (HEI) choices in your application and must rank your choices in order of preference 1- 3.

Information about the content of the course, entry requirements, duration, terms of the agreement, etc. can be located on the HSE website. Enter Jobs in the HSE in the Search Box, select Job Search, click on Nursing and Midwifery Jobs and go to PHN Sponsorship.

For more information, contact your Local Public Health Nursing Department or the HSE website. Candidates can apply on line via pac.ie

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CRITERIA HAVE YOU GOT WHAT IT TAKES? You can apply if you meet the following HSE criteria: • You must be registered in the General Nursing Division of the Register of Nurses (maintained by the Nursing & Midwifery Board of Ireland) or entitled to be registered in the Division and have a minimum of three years post registration general nursing experience.

OR • You must be registered or entitled to be so registered in the General Nursing Division and another Division of the Register. These Divisions include: - Registered Midwife (RM) - Registered Children’s Nurse (RCN) - Registered Nurse Intellectual Disability (RNID) - Registered Psychiatric Nurse (RPN) • You must also have a minimum of 18 months post registration general nursing experience as an RGN, and 18 months post registration experience as an RM or RCN or RNID or RPN. The academic criteria is set by the relevant Higher Education Institute (HEI). Applicants must hold an Irish NFQ Level 8 qualification (honours degree or higher diploma level 8), or if not must complete an Accreditation of Prior Experiential Learning (APEL) document. Applicants whose first language or primary language of expression is not English must provide evidence that their English language ability meets the required standard for admission.

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05/03/2021 11:30

Education MY Y T S OR

Why I am a Public Health Nurse “I became a nurse because I care and getting to know the clients and their families in their homes is personal and heart-warming.”

COURTNEY CHASE

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ive years in her public health nurse role, Canadian native Courtney Chase is now firmly part of the rural community of Kilmovee. She said the sense of community makes her proud and makes her contribution ‘feel important’.

“I really feel that I have become a part of the community and all the clients and their families can contact me. I feel respected and that my work and support matters to mothers needing support in the community and the older generation living at home safely and independently,” said Courtney.

“People know me and as being a ‘blow in’ and being from Canada I do love that. I love that each day is never the same and the ‘cradle to grave’ approach has not changed. My office door is open and the community feels they can ring or drop in. I get a great satisfaction from the words ‘thank you’ and that our nursing care has made a difference. I really feel that I get a sense of really getting to know families and for some we may be the only person they see in a day.”

She said there is no typical day for her in her role and she firmly dispelled ‘the myth that we go around drinking tea’.

“We book visits with clients and their families depending on nursing care needs. We are contacted regularly through liaison who is contacted on hospital discharges. Our remit and priority is new births/postnatal mothers, palliative care and clinical visits. We also are responsible for running Child Development Clinics at certain stages of child development and complete wound assessments and care,” explained Courtney.

“We are an open referral service so we receive calls from clients, families and hospitals for our service and at times that makes it difficult with priorities and fitting all the visits in on a working

day. Documentation has become more timeconsuming and comprehensive. At any point, I have even had recently having emergencies like ringing for an ambulance and sending a client to hospital. To be honest, there is no ‘typical’ week for a community nurse but that is what I like about it.”

Courtney had worked in the hospital system in Canada and Australia and, after her move to Ireland, worked in a hospital on a Same Day Surgery Unit. She then decided to make a ‘fresh start’ in the community. “I did love the variety in this setting but still felt that it was very hierarchal and what I do enjoy is the autonomy of being a public health nurse,” she said.

For anyone considering the change to public health nursing, she said you must have the experience and confidence to fill this autonomous role.

“I think it is important to be able to work independently but be able to have the interpersonal skills to work as a team. One thing I have to add is that it is important that you have the necessary assertiveness because I work on my own and I advocate for my patients in this system. You need to be able to step back also and respect client’s decisions. It is not always what you want for them but it is what the client chooses for themselves and when clients are living at home we must respect their home and their decisions.

Organisation and planning is essential and having these skills would be crucial to success,” she said.

During COVID-19, PHN staff were redeployed across a number of healthcare settings, such as community testing sites, contact tracing, residential care facilities, immunisations and community assessment hubs and played a vital role in sustaining frontline PHN services.

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05/03/2021 11:31

Services Lauren McGrath (15) from Askeaton, Co Limerick, urges Dr John Twomey, consultant paediatrician, to try out the slide in the refurbished Ark Park inclusive play area at the Children’s Ark paediatric unit in UHL. Below: Lauren with her mum June (right) cuts the ribbon.

Also pictured at the socially distanced opening ceremony were (from left) Orlaith McMahon, Play Specialist, Children’s Ark, UHL; Dr Siobhan Gallagher, Clinical Director, Maternal and Child Health Directorate, UL Hospitals Group; Niall Joyce, Building Services Manager, UL Hospitals Group; and Kris Buckley, Senior Play Specialist, Children’s Ark, UHL.

ARK PARK Refurbished playground opens at Children’s Ark in University Hospital Limerick

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t a special socially-distanced ceremony, the beautiful slides, climbing apparatus and play areas gleamed in the mid-day sun as teenager Lauren McGrath cut the ribbon on the newly refurbished playground and outdoor Park at the Children’s Ark unit in University Hospital Limerick (UHL).

The original playground was developed as part of the Children’s Ark, a bright, childfriendly paediatric unit that was originally built 20 years ago, with the support of fundraising and donations from many individuals and companies in the Mid-West. In more recent years, the park has required an upgrade.

The refurbished Ark Park, is 1,250 square

metres of colour and tranquillity, with a partially covered play area set amid landscaped green areas and flower beds, in the centre of the buildings that house the wards and offices of the Children’s Ark unit.

Visitors are greeted by a beautifully sculpted Garden Fairy perched atop a wooden toadstool in the flowerbed near the entrance, and the entire area is intended to deliver a heartening, refreshing boost to the spirits for children and parents, as well as staff, who need some time out from the hospital environment to relax and recharge.

The main climbing frame and slide area, sheltered from the elements by two huge white canopies, forms the shape of a ship, a visual tribute to the Ark that is its permanent harbour.

All photos by Brian Arthur Photography

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Services There are seats amid the carefully manicured green areas and flowerbeds with hydrangeas and other flowering plants that will pop with colour and scent during the summer June McGrath, who has been bringing her daughter Lauren to UHL for the past 11 years, was delighted to watch Lauren perform the official opening honours.

“It’s lovely to be here today for Lauren to open the new park. We’ve been coming here since Lauren was 3, and it’s just so lovely to have a new park where children, especially those who are in for long periods of time, and their parents, can get out in the fresh air. It’s so important for the mental health to get outside, breathe the fresh air, and have a bit of fun. If you don’t have that opportunity, the walls can

really close in on you,” June said.

“The old park was past its best, and this one is completely wheelchair accessible, so Lauren will be able to scoot out here on her wheelchair, especially if she has to wait for an appointment. She’ll actually look forward to coming in now. It’s not all about dressings and needles,” June added.

Kris Buckley, Senior Play Specialist at the Children’s Ark, describes the Ark Park as “an oasis”.

“This kind of atmosphere, an oasis in the middle of the hospital, is so important for the overall wellbeing of children and their parents, and also the staff. It gives them a unique opportunity to walk outside in the fresh air and get away from the noise and bustle of the hospital environment,” Kris explained.

Outgoing Children’s Ark School principal applauds team spirit throughout the hospital community The outgoing Principal of the Children’s Ark School in UHL has paid tribute to the “incredible team spirit and kindness” in the paediatric unit that helps ensure the delivery of a high standard education service for children attending UHL for treatment.

Margaret McCarthy, who retired after serving for almost 14 years as Principal of the Children’s Ark School, said: “Our ethos is that no child will be disadvantaged educationally if they have to attend hospital.

What I will look back upon most fondly is the overall sense of support, kindness and care from all staff, particularly from the nurses on the Sunshine Ward, which has helped us to focus on the children’s education.”

Her successor in the role is Kathleen Horgan, who joins secondary teacher Olive Dillon and recently appointed primary teacher Sandra Keehan, formerly of Our Lady’s Hospital Crumlin, who replaced Mary Carr on her retirement from the Ark School after 12 years.

The Children’s Ark School is a Department of Education and Skills school for day-patient or in-patient children in UHL aged from 4-19 years. It is a multi-denominational provider of primary and secondary education, and is composed of a large classroom for primary students, a second classroom for secondary students, and has its own toilets, office space and an outdoor learning area. The Department of Education and Skills has installed 100MB fibre broadband which facilitates access to the latest technology and supports innovative educational supports for the students.

Top: Margaret McCarthy, who retired after serving for almost 14 years as principal of the Children’s Ark School.

Below: Kathleen Horgan, the newly appointed principal of the hospital school.

CHAMPIONS VISIT

Limerick hurler Sean Finn dials in for a video call with a delighted Lee Ensor, 12, from Charleville.

All-Ireland champions Limerick make virtual trip to UHL Members of the all-conquering Limerick senior hurling team raised spirits at University Hospital Limerick in mid-December with a virtual Christmas visit to paediatric and adult patients.

Team captain Declan Hannon, Sean Finn, Gearoid Hegarty and Cian Lynch all dialled in for a special video call to the Children’s Ark School and Ward 2C, and were happy to take questions from patients young and old from the many passionate Limerick supporters on the staff in UHL. The call with the Limerick players was a fantastic curtain raiser to a day of excitement for the children, who immediately afterwards received another video call, this time from Santa Claus at the North Pole.

Staff thanked Declan Hannon for his words of encouragement for frontline workers and to all in Limerick GAA for their support on following the public health guidelines.

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05/03/2021 11:33

Services

MULTILINGUAL VIDEOS GET SCREENING MESSAGE OUT Understanding cervical screening in Ireland has now been made simpler, through a series of new multilingual videos aimed at those who struggle with the English language

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he National Screening Service (NSS) has teamed up with the GP-led enterprise Translate Ireland to produce new multilingual videos for its cervical screening programme, CervicalCheck. The videos explain what happens at the cervical screening test, and why it is important to come for screening. The video messages, available in a dozen languages, are presented by doctors, nurses and other healthcare professionals in Ireland who come from another country originally. They were launched by CervicalCheck in January to mark European Cervical Cancer Prevention Week.

CervicalCheck Clinical Director, Dr Nóirín Russell, said, “This is an important time for cervical cancer screening in Ireland. We have changed to primary HPV screening which means that there will be more women whose cervical cancer is prevented. Unfortunately, there is no screening test which prevents all cancers. There will always be women who develop cervical cancer after a negative screening test.”

Importantly, Dr Russell said, the videos explain both the benefits and limitations of screening.

“These multilingual CervicalCheck information videos will be an important aid for participants of screening to understand the change to HPV cervical screening. The videos will also help Graham Clifford, healthcare professionals to explain screening and CEO of Translate cervical screening tests, as they can more easily link Ireland, and Dr in patients who are eligible for screening.”

Catherine Clifford, Dr Russell said it was important to remember that Medical Lead of screening is for well women, and that anyone with Translate Ireland. symptoms should not wait for screening but should contact their GP straight away. “I would encourage all those with symptoms of cervical cancer – such as bleeding between periods, abnormal discharge and pain after intercourse - to call their GP immediately and they will arrange appropriate care for you.”

The video messages are culturally appropriate and clearly explain information which may be difficult for migrant people to understand in English.

They have been shared on the HSE social media channels and are also available on www.hse.ie/ cervicalcheck and translateireland.ie The messages are available in Polish, Portuguese, Arabic, English, Romanian, Russian, French, Urdu, Spanish, Lithuanian, Latvian and Slovak.

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05/03/2021 11:34

Services

LEFT: Elizabeth

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new leg ulcer clinic is now up and running in Tallaght, an integrated care initiative aiming to reduce outpatient lists and attendances by better management of leg ulcer patients in the community. This will result in more appointments available and reduce wait times for remaining patients.

It is a collaborative service involving Tallaght University Hospital and Community Health Organisation Dublin South, Kildare and West Wicklow, which enables integrated care between the community and the hospital.

“The main focus is on integrated care providing the right care, in the right place, at the right time, where the patient is paramount with strong emphasis placed on prevention and public health. We are aiming to reduce referrals to the hospital, to avoid ED attendances and reduce the need for admission to hospital. During this COVID-19 pandemic, this endeavour was more important than ever,” explained Clinical Nurse Specialist (CNS) Elizabeth O’Neill.

In November 2019 funding for this initiative was secured through Sláintecare.

The clinic was established and Elizabeth commenced in the role as Clinical Nurse Specialist in Vascular in February 2020.

“I established the clinic with the involvement of key stakeholders. Patients are referred internally from the out-patient department, wards and consults from other medical/surgical teams, and externally from GPs and public health nurses,” she explained.

The clinic should see a marked decrease in the need for out-patient appointments.

“Data collected from OPD activity at the start of 2020 revealed that leg ulcer patients made up a very large amount of the appointments – 22%. This CNS-run clinic can reduce this number greatly. Patients can be seen in the community, be assessed, access diagnostics and be followed up. This will reduce the activity in the out-patient service. I work autonomously which means patients may not need to see the vascular team. Diagnostic tests are carried out directly in this off-site clinic, negating the need for our patients to attend the main hospital campus,” said the CNS, who works in partnership with the vascular team.

“I am responsible and accountable for my practice. When a patient requires a different service level and care, they can be scheduled an appointment in a timely fashion with whatever service is required. During the

O'Neill, CNS in Veins and Vascular at TUH. BELOW: Consultant vascular surgeon Sean Tierney.

CLINIC WILL CUT WAITS AND FREE UP APPOINTMENTS The new Sláintecare-funded initiative enables integrated care between Tallaght Hospital and the community COVID-19 pandemic, without this innovation, patients requiring assessment and/or treatment relating to leg ulcers would have been required to attend via the ED.” She said that this new approach highlights the benefits of a nurse-led service delivery.

“I believe nurses can achieve great things while always keeping the patient their priority. The success of the clinic shows that bringing care closer to home in the community can improve service delivery, meet the patient’s needs and reduce the demand on acute hospital services,” she said.

F I N D O U T MO RE If you want to find out more about the clinic and other services at Tallaght Hospital, see www.tuh.ie

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05/03/2021 11:36

Services CHILDREN’S COMMUNITY OPHTHALMOLOGY WAITING LIST INITIATIVE

KNOW, CHECK, ASK Patients are taking an active role in ensuring safer medication practices thanks to a new campaign

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he initiative has taken off at Birr Community Nursing Unit in Co Offaly, led

by Michelle Hogan, Senior Clinical Pharmacist, with residents having a better understanding of their medication and the reason why they were taking them.

The ‘Know, Check, Ask’ global campaign was developed by the World Health Organization (WHO) to increase public awareness of the safety issues related to medication use. It encourages patients to take an active role in ensuring safer medication practices. The HSE launched the campaign in July 2019 Michelle explained that that initiative empowers and informs patients about their medication. “I started my role as the Senior Clinical Pharmacist for the Offaly Residential Care units in August 2019. I wanted to communicate with the residents in Birr CNU about their medications and ensure they understood what their medications were for and why they were taking them.

I also wanted give the residents an opportunity to ask questions and raise any concerns they had. “For each resident I reviewed their medication and notes. I completed the ‘my medicines list’ available on www.safermeds.ie. This list contains the name of the medication, strength and frequency and the reason why the medication is taken. I used plain language to explain what the medications were for. “I sat with the resident and we talked about each of their medications, why they were taking them, and any side effects that they should be aware of. I answered any questions and checked technique for certain medications eg inhalers. At the end of the session I provided them with the completed ‘My Medicines List’ which they kept with their personal belongings.” She said that after the session the residents had a better understanding for their medication and the reason why they were taking them. This improves medication safety. “It allowed the resident opportunities to ask questions in a confidential manner. It has improved the relationship between the pharmacist and the resident. The residents now know who I am, what I do and I am available to speak to them,” said Michelle.

The Grangegorman Children’s Ophthalmology waiting list initiative shows integration working well between community, hospital and new digital services. This initiative was set up by Dr Duncan Rogers, Ophthalmologist, Grangegorman, CHO DNCC in conjunction with the General Manager in Primary Care to help reduce waiting times for Children with an eye problem and who needed treatment.

Explaining how the initiative worked, Dr Rogers said, “We were able to use existing expertise from the community nursing team, combined with our team’s ophthalmological expertise to review 2,749 children and remove a waiting list that had been present for 10 years with an average waiting time of 18 months. This was possible thanks to the use of Swiftqueue, which is a cloud-based appointment system currently being used for COVID-19 screening. We currently have a waiting list of 42 and are able to see urgent patients within six-week and routine patients within three months.” He commended his colleagues, stating, “This would not have been possible without support from the HSE, particularly Michelle Forde, General Manager, Primary Care and Annette Murphy, Area Administrator, Primary Care, CHO DNCC.” The waiting list backlog has now been cleared and the initiative was a great success. Some of the positive feedback received from patients was that the initiative was “very well organised” and a “brilliant initiative to get through waiting lists, everything was communicated to me very well and docs/ nurses were lovely, well done”.

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05/03/2021 11:37

Digital

CARE ANYWHERE HSE using video-enabled care for more and more patient appointments

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ncreasing numbers of health service staff are using video calls for consultations and follow up appointments with patients. Some 123,000 video-consultations took place between patients and community health service staff between March 2020 and the end of January 2021. Fewer than 1,000 patients availed of a videoenabled care call with community health service staff in March 2020.

In contrast, in January 2021 alone, some 24,000 of these consultations took place. Doctors, nurses, occupational therapists, physiotherapists, psychologists, social workers and speech and language therapists are among community health service staff now using video conferencing tools and digital platforms to carry out health appointments with patients. For video-enabled care, appointments are arranged in the usual way with patients receiving a website link to their online consultation via email or text. On clicking a link the patient enters a private, secure online waiting room, where they are met by their clinician for an on-screen appointment. The clinician and patient can see and speak to each other as well as share and discuss documents like test results, letters and case notes. For healthcare professionals, the ability to continue to provide care despite the pandemic was an important advantage of the increase in video enabled care. A survey of 719 healthcare professionals reported fewer cancellations or failures to attend. Over 600 patients took part in a survey with many reporting that video consultations were more convenient and less stressful. Some patients said they were more comfortable doing the appointment in the comfort of their own home. Others said it was less stressful and they were able to attend appointments virtually despite feeling unwell.

HOW IT WORKS Dr Atiqa Rafiq, Consultant Old Age Psychiatrist, Mental Health Services for Older People, Louth, shares her experience of delivering care to patients using video. Our team is seeing 60-70 patients every month using video consults. The biggest advantage has been the continuity of clinical activity throughout the COVID period so unlike some other medical specialties, waiting times have not increased. We did not cancel any psychiatry clinic throughout the pandemic. Furthermore, the video platform almost provides the formality of a clinic appointment which a telephone consult did not seem to do. This improves the quality of clinical consultation and patient participation in their care plan is a lot better than on the telephone. Once the nurses who were triaging referrals came on board, almost all new patients started being seen by video consults. Some have attended using their phones and tablets and others with desktops and webcams. We offer a practice session if the patient needs it a few days ahead of the appointment time, so they can have a practice run. It’s often a spouse, a son or daughter or a grandchild setting it up, but I have learned that the majority of people under our care can actually use this platform, albeit with some help. For our memory clinic service, with the MPower project, we have transformed one of our clinical rooms into a virtual hub, which allows a detailed neuropsychological assessment to proceed on a video platform without any problem. The one-to-one contact remains under five minutes for a ‘meet and Dr Atiqa Rafiq, Consultant Old Age greet’ by an administration staff member to explain the process of assessment.

Psychiatrist, Mental Health Services for So that clinic is fully operational since October.

Older People in Louth

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05/03/2021 11:39

Digital OPPORTUNITY IN CRISIS:

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ATTEND ANYWHERE SEES HUGE GROWTH

he COVID-19 pandemic challenged health services around the world to adapt how their services were provided. The HSE’s Integrated National Operations Hub (INOH) considered what was required to support frontline staff in maintaining patient contact. In this challenge there was also opportunity, and this resulted in the rapid rollout of video-enabled care (VEC) making the Attend Anywhere platform available to staff in community and hospital settings.

In March 2020, the Telehealth Steering Group oversaw the National Virtual Health Team led by Julie Bellew to develop a systematic rollout of VEC nationally. A network of telehealth leads quickly emerged, also taking on this additional role in each CHO and Hospital Groups and, together with the NMPDU digital response team, began meeting the urgent and emerging needs of frontline staff to assist them to continue to provide care to patients and service users. The Attend Anywhere (AA) platform works well in clinical settings as it utilises a Waiting Area that patients are invited by appointment to attend. For patients video calling is convenient and easy to use, and their computer, laptop or smartphone can be used. Video calls are secure and the patients/service user privacy is protected.

During the week of February 1st AA reached a significant milestone with over 100,000 patient consultations. In the last six months alone the total number of consultations has grown from just over 10,000 (June) up to over 100,000 in February 2021. This shows the commitment of frontline staff in their efforts to connect with patients.

In the past year, the National Virtual Health Team developed a range of supports for staff to facilitate their use of AA. These are available on ehealthireland and the HSE’s virtual health webpages. Supports include a starter pack, service specific webinars, live and pre-recorded training sessions. Developments in reporting from the platform will support the national telehealth leads and the further rollout of VEC. The platform continues to be updated with new features and connectivity challenges in some areas are also being prioritised.

For Attend Anywhere licences and support, contact virtualhealth@hse.ie

This edition, we are featuring the use of the Attend Anywhere platform in our Mental Health Services and is the first in a series of articles highlighting the benefits of videoenabled care in frontline services

The National Virtual Health Team, from the top row, left to right, is: Lisa Foley, Elaine Aughey, Monica Ramsey, Fiona O’Riordan Maureen Bruen, Linda Reck, Lorraine Gilmartin, Alex Mason, Wendy Rutherford, Julie Bellew Shirley Harper, Tracey McCluskey, Fintan Murtagh, Ciara Clarke These include current and former members of the team.

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Digital ATTEND ANYWHERE SUPPORTING MENTAL HEALTH SERVICES During the pandemic, AA supported clinicians working in mental health services to continue to provide services to their patients and service users. Particularly important for those with moderate to severe mental illness where specialist multidisciplinary team input provided in a timely manner is crucial. Use of the platform continues to grow with 7,259 consultations in January bringing the total number of calls to 23,747. Some examples of its use include supporting the HSE’s National Clinical Programmes (NCP) and Specialist Perinatal Mental Health service, where a timely response by skilled professionals is so important to good patient outcomes.

ADHD in Adults For Dr Jessica Dudley, the Attend Anywhere platform has been a useful tool in the delivery of the Adult ADHD Service in Limerick. While it was initially used because of COVID-19 restrictions, it has become an important tool in the provision of the service into the future. It has proved effective in carrying out assessments and delivering Clinical Psychology and Occupational Therapy interventions.

A significant portion of our patients are accustomed to interacting with other people via technology. This platform allows the service to increase accessibility to people, providing choice in terms of how they receive a service, and increasing likelihood of engagement.

Early Intervention Psychosis Since the COVID-19 pandemic there has been a 15% increase in referrals to Early Intervention in Psychosis (EIP) services.

AA has allowed the service to continue delivering EIP evidence-based interventions to patients and their families within the comforts of their own home. The EIP service is based on a hub and spoke model, which means clinicians offer various different clinical interventions across four different large geographical areas.

Due to the successful implementation of Attend Anywhere, post-COVID, EIP teams plan to continue to integrate and offer this additional choice of engagement for patients and families, because of the benefits it can provide such as, reducing time spent travelling to clinics for both patients and clinicians.

Eating Disorders The COVID-19 pandemic has particularly affected people with eating disorders with higher rates of referrals and severity over the last 10 months. Telehealth through Attend Anywhere has provided specialist eating disorder teams with a platform to provide ongoing care throughout with over 500 therapy sessions delivered to date. Telehealth works well with first line structured treatment such as family based treatment and CBT-E. It has enabled therapy to continue when patients are admitted to acute hospitals. Blended outpatient options are also being delivered where patients are physically unwell from their eating disorders and also supported by MARSIPAN review clinics, or attend in person every 2-3 sessions.

SPECIALIST PERINATAL MENTAL HEALTH SERVICE (SPMHS)

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AA SUPPORTING PERINATAL MENTAL HEALTH IN THE MATERNITY SERVICES

t's safe to say we were a bit ambivalent about using it", admitted one of the National Maternity Hospital team about when they first got access to Attend Anywhere. "Meeting patients in person was, and remains, a big part of our assessment and treatment. Transitioning to video calls felt strange. It was good to have, of course, but we opted only to use it for return appointments, out of a concern of what might be lost in translation to the digital interface. A mental health assessment is a sensitive instrument, and long delays or glitches could have a very detrimental effect on patient and clinician experience alike," she said, "When the pandemic hit its second wave, and then a third, we recognised the need to prevent people travelling into hospitals as much as possible. Quite apart from the consultations, which could be carried out in quite a safe way with distancing, masks and ventilation, bringing patients in for appointments also frequently means them using public transport, or meeting other patients on corridors. With high community case rates, this no longer seemed safe. We changed to offering Attend Anywhere appointments as standard, with exceptions only for those who particularly needed or wished to come to the hospital in person.

It’s been good to be able to keep safely offering our service during this time of great uncertainty.

"Finally, and possibly most significantly, using the online video platform has allowed us to start up a clinic in our Spoke site of Wexford General Hospital. Perinatal mental health midwife, Jennifer Woodbyrne, and Specialist Registrar, Dr Roisin Plunkett, have collaborated on establishing a bi-weekly remote clinic to offer psychiatric input to women referred to the Perinatal Mental Health Service in Wexford."

The SPMHS at University Maternity Hospital Limerick over the past year has had to adapt like others to the changes in service provision. Attend Anywhere is used to organise our appointments.

AA has supported Psychology to continue with assessment and intervention for women during the perinatal period. AA provides pre-arranged appointments and timely sessions; standards which would be synonymous with Psychology provision.

For new mums, it allows therapy to be provided in their own environment, without the constraints of travel or having to bring a newborn to an appointment. The no show rate has reduced due to removing the barriers of transport, organising a family member to mind baby and concerns about attending a health care setting during the current restrictions.

It is envisioned that AA will provide a blended approach to working in the future, allowing accessibility for those who have limited transport links or cannot drive following a C-section.

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Digital

(l-r) Prof Martin Curley, HSE Digital Transformation Director; Richard Costello, Consultant Physician and Professor of Medicine at RCSI; Myles Murray, CEO PMD Solutions; Lorraine Smyth Communications & Innovations Lead, HSE Digital Transformation.

PARENTS WEBINAR

GALWAY SPEECH AND LANGUAGE THERAPISTS ROLL OUT PARENT TRAINING WEBINAR It is widely recognised that a child’s speech, language and communication skills develop through natural interaction with people in their lives. Prior to the COVID-19 pandemic, an in-person parent training group was offered as the first speech and language appointment for children under three years of age awaiting assessment in Galway Primary Care area.

The focus of the parent training group was to empower parents by introducing and explaining strategies that they could use at home to develop their children’s speech, language and communication skills. In response to the COVID-19 crisis, SLTs had to rethink how services were being delivered and embrace and up skill in the area of telehealth, using the Attend Anywhere and Cisco WebEx platforms.

This allowed clients to access SLT services from the comfort and safety of their home.

In October 2020, after much planning and organisation, two live ‘Early Speech and Language Skills’ parent training webinars were piloted by SLTs Emma Dunn and Patricia O’Connor. These webinars were delivered to 23 parents and seven SLTs in training. Emma Dunn, SLT, said, “The use of polling during the webinar and post-survey questionnaires provided valuable feedback and allowed for parents comments to be received and listened to.” There was also a question and answer session at the end of the webinar which gave parents a chance to ask questions and get more information.

HSE DIGITAL TRANSFORMATION TEAM ROLL OUT RESPIRATORY SOLUTIONS TO HELP FIGHT COVID-19

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s COVID-19 spread in the community, the focus shifted to enabling the vast majority of those with mild illness to self-care in their home setting, be that their family home or residential environment.

HSE Digital Transformation Team had been working with a startup in the Digital Hub Dublin, PatientMpower. They had developed an app which connected to a Bluetooth pulseoximeter. This was used to read the pulse and oxygen saturation levels in IPF patients. The CEO of the company contacted the HSE Digital Transformation Team and said he thought this could be adapted for use for COVID monitoring of patients.

“We got the approval needed to approve the first 1000 applications of the COVID Monitoring System. The normal process for an app to be built and up and running in the HSE is over a year. We needed to expedite this project and work in an agile manner to implement. We successfully rolled this out to over 20 hospitals nationally and in over 300 GP practices,” said Martin Curley, HSE Digital Transformation Director.

“The PatientMpower Monitoring system was so successful we decided to focus on digital tespiratory tools to assist frontline staff and patients in the COVID battle.”

Another respiratory solution, Respirasense, rolled out across 17 hospitals.

Respirasense is a Class 1 CE Medical Device designed to measure Respiration Rate (RR) of alert patients through a piezo electric sensor and a bluetooth wireless transmitter. Respirasense measures respiratory rate by uniquely measuring the mechanics of respiration. Respirasense provides real-time RR data which is shown on a ‘central station’ type dashboard at the nurses’ station where it alarms when the RR is outside the specified range for a patient. This can monitor patients on a COVID ward from the nurses’ station saving on patient contacts and staff having to repeatedly change into PPE gear, while safely and accurately monitoring patients.

Another clinical tool for respiratory care of COVID -19 patients rolled out by the HSE Digital Transformation Team is Enodatis. This enables hospitals to optimise and scale acute respiratory care delivery. This was designed by clinicians for clinicians. It is web accessible via mobile. Enodatis defines a novel measure of patient status called the COVID Critical Care Index (CCCI). CCCI has been designed collaboratively by a team led by Prof Richard Costello including respiratory specialist clinicians and researchers from Beaumont, St Vincent’s, St James’s, the Mater, and clinicians from S3 Connected Health.

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Digital CROSSING THE DIGITAL DIVIDE

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OVID-19 has seen a digital transformation across the region. It was immediately recognised by Tomás Murphy, Area Director of Nursing, Sligo Leitrim Mental Health Services, and the senior management team, that there remains a digital divide, especially in mental health where inequalities exist in access and use of digital technologies can bridge the gap. The team felt that they could use this rapid adoption to review how they can sustain and develop digital technologies within their services going forward. Aislinn Gannon, clinical nurse specialist, was tasked two days a week to help support making their vision a reality.

Aisling’s appointment as a Digital Transformation Nurse is the first post of its kind in Ireland. With an ambitious vision, since April 2020 the team has developed a digital implementation plan, in line with digital eHealth strategy and the nursing digital roadmap, which both put the service user at the centre, advocate for co-design and co-production. Their four key streams are: enabling a digital workforce; working towards an electronic health systems; policy and data management; and improving the service user experience through digital technologies. These are just a few of their projects since April 2020:

TOP: In the new Inpatient Unit, from left to right: Prof Geraldine McCarthy, Aislinn Gannon, Rosemary Hannigan, and from the Digital Transformation team Prof Martin Curley and Des O’Toole. LEFT: Interactive Kiosk – Louise Larkin, Staff Nurse ABOVE RIGHT: Tomás Murphy, Area Director of Nursing, at the CoWin Wall

• Completed a digital needs assessment across the whole service • Rolled out 109 video conferencing licenses, with over 140 hours consultation a month • Within the acute unit, migrated the service to a patient administrative system (PAS) • The implementation of a CoWin media wall the first in Ireland - a self-management and deescalation interactive tool for use in seclusion • The development of an Interactive Kiosk for service users, which was co-designed and co-produced

• The development and funding secured to develop a community digital hub and technology library so people can access the technologies they need to keep connected with not just mental health services but other services such as support groups, social groups and much more, in partnership with POA, Sligo Council and ALONE • They have commenced humancentred design workshops that aim to co-design solutions. The key principles and mindset are based on a few easy-tounderstand principles: Hear, Create and Deliver

COVID BRINGS DIGITAL TRANSFORMATION TO RURAL CARE The remote monitoring of people in their own homes through the use of video conferencing tools has transformed care of older people in rural areas during COVID-19. Since the beginning of the lockdown in Ireland in March 2020, the Psychiatry of Older Persons (POA) service in the rural north west have commenced various projects to ensure that routine care continues for their patients in such extraordinary times.

The POA team within Sligo/Leitrim Mental Health Services for Older Persons were especially concerned as older people are the most severely affected by COVID-19 with the highest risk of serious symptoms and increased mortality.

Alongside this, many of their service users

have significant mental health difficulties along with dementia and the usual physical health issues that affect those who are older.

“We have promoted ordinary care in extraordinary times, enabling older persons their families members carers and community to remain connected in times of prolonged compulsory physical and social distancing,” said Marguerite Cryan, team manager.

“Those residing in the rural area that we cover are also at higher risk of loneliness due to isolation which has been worsened by the pandemic.”

Marguerite and Prof Geraldine McCarthy, consultant psychiatrist, recognised the team had to quickly adapt

to ensure that they kept connected with their service users in this difficult time.

“We worked with staff to implement digital tools as a solution to our patients in the community as well as in nursing homes and other long-stay settings. In the nursing homes, we have installed mobile tablets and Wi-Fi to those that did not already have these available. These allow us to communicate with our patients and support their staff in the management of their mental health difficulties,” said Marguerite.

Sonn Patel, SR in Psychiatry, added, “We have had many challenges such as issues of technology literacy for service users, poor networks, and lack of equipment. However, as a service we have truly embraced digital transformation.”

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Corporate ff Sta tion es g ug

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A simple 'thank you' goes a long way ...

Staff Survey

... but we like awards too

First stage

SURVEY

This stage involved an online Pulse Survey which focused on staff experience during the period from March to June and aimed to assess the practises and processes that the HSE should retain as a result of COVID-19, and how services and ways of working should evolve over the months ahead.

THE MAIN FINDINGS ARE AS FOLLOWS: SATISFACTION WITH COMMUNICATION AND INFORMATION SHARING BUT ROOM FOR IMPROVEMENT. Overall, staff were positive about the amount of information they received during COVID-19 with the majority of staff reporting they received sufficient information. However, there were some staff groups that indicated they received too little or too much information. Staff feel there is a need for more and better guidance and direction especially in relation to redeployment and where staff are taking on additional roles and responsibilities.

CULTURE SHIFTS DURING COVID-19 Staff had mixed experiences of changes in workplace culture during COVID-19. Overall staff pointed to the fact that they experienced more teamwork and comraderie at work, with strong evidence of staff supporting each other and patients through the crisis. Staff also reported that they were satisfied with the remote working arrangements and the opportunities for better work-life balance with some suggesting they felt more connected to their colleagues while working remotely.

POSITIVE VIEWS OF HSE’S MANAGEMENT OF COVID-19 AND CHANGE IN OPINION In general, staff were satisfied with the HSE’s handling of COVID-19 to date and are confident in the Health Service’s ability to manage the pandemic into the future. Over half of staff reported that they felt supported, safe and in control in the workplace. However, staff who had face to face interactions with patients/members of the public and those who were redeployed had lower levels of feeling supported, feeling safe and in control versus those who had no face-toface contact and those working from home.

STAFF ‘STEPPED-UP’ TO HELP FIGHT AGAINST COVID-19 Across all sectors and categories, staff stepped up in their role and took on additional responsibilities. Some suggested they did not have the opportunity to contribute as much as they wanted to. Going forward staff have indicated a clear need for more feedback, greater recognition of their contributions and more involvement in planning and decision-making utilising staff experience and knowledge.

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A total of 7,057 responses were received to the HSE COVID-19 Pulse Staff Survey and Focus Groups

These findings offer an important opportunity for us to learn from staff feedback and inform recovery and action planning into the future.

In order to learn from staff experiences of COVID-19, the HSE, in partnership with Core Research, began a two-stage research project in July 2020. ff Sta tion es g ug

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We would like to take this opportunity to thank all staff who took the time out of their busy schedules to participate in both the Pulse Survey and Focus Groups in order to share their experiences.

Always take your breaks Second

stage FOCUS GROUP S

The sec ond sta ge of th form o e resea f nine v rch too irtual F catego k place ocus G ries ac in Septe roups re ross ge purpos mber in presen ograph e of th tative o the ical an e Focu informa f the six d healthc s Grou tion alr staff p a s re e w a s dy cap as to d what m ettings tured in ight hav elve de . The the Puls e chang eper in e Surve ed from to the y and to the peri od of Ju explore ne to Se ptembe r.

Results of the Pulse Survey are now available and can be accessed on www.hse.ie/staffengagement

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Service

National Breast Cancer GP Referral Guideline updated The National Cancer Control Programme (NCCP) is pleased to announce that the Breast Cancer GP Referral Guideline and accompanying e-referral form are being updated.

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he aim of the guideline is to ensure that patients with symptoms most suspicious of breast cancer can continue to be seen and treated in a Symptomatic Breast Disease (SBD) Clinic as a matter of priority.

There are eight SBD clinics (with one satellite clinic in Letterkenny) across Ireland, where approximately 40,000 new patients are referred by their General Practitioner (GP) each year. A referral guideline was originally developed in 2010.

It is now timely for a new guideline to be developed to reflect the most up-to-date evidence. A tremendous amount of work has been carried out by a multidisciplinary stakeholder group in both the development of the new guideline and in preparation for its national implementation. It is anticipated that the Breast Cancer GP Referral Guideline and e-referral form will be rolled out in early 2021.

AN OVERVIEW OF THE PROCESS

Development of the guideline

The new National Breast Cancer GP Referral Guideline was developed by a multidisciplinary stakeholder group, which included patient representation. This group made a series of recommendations based on the best available international evidence, combined with clinical expertise and patient values. These recommendations

PATIENT SAFETY PROGRAMME UPDATE

were then incorporated into a number of clearly defined, evidence-based algorithms which form the basis of the guideline.

These will facilitate GPs in determining which patients with breast symptoms require referral to secondary care.

Development of the e-referral form

The current e-referral form is being updated to reflect the new referral guideline. The new form will enable the GP to provide more details of the patients’ signs and symptoms so that the SBD clinic can effectively triage the referred patients.

The introduction of the new National Breast Cancer GP Referral Guideline and accompanying e-referral form will provide many benefits to all stakeholders. Risteárd Ó Laoide, National Director NCCP, said, “We are happy that work is progressing on the Breast Cancer GP Referral Guideline and are anticipating a launch in early 2021. It is a priority for the NCCP that all national cancer guidelines are developed using an evidence-based approach, which aims to improve the outcome for patients diagnosed with cancer. It is always our main goal to ensure patients are treated at the right time, in the right place and by the right people.”

As part of the project roll-out, information updates will be disseminated to all stakeholders.

The COVID-19 pandemic has led to changes in how healthcare is delivered in the HSE with everyone working towards a common goal and implementing many rapid changes in practice in order to enhance the HSE response to COVID-19.

Given the fundamental changes seen across the health service in the last year we are revisiting our approach to implementation, based on what we have learned during the pandemic. We are re-establishing the engagement process throughout the health system regarding the implementation and monitoring process for the Patient Safety Strategy and look forward to working with everyone across the system. We are also delighted to announce that Dr Orla Healy has been appointed as the National Clinical Lead for Patient Safety. Dr Healy is currently the COO with the SSW Hospital group. Further good news is the funding of 48 posts for patient safety across the local health system in 2021.

Patient Safety Awareness Week (March 14th-17th) is a reminder to encourage everyone to learn more about health care safety and serves as a platform for growing awareness about patient safety and recognising the work already being done. The theme is Together, we are Better, Stronger, and Safer, which reflects the commitment of the Patient Safety Strategy to partnership.

Tweet your safety initiatives at #PatientSafety

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Digital Corporate

COVID RESPONSE

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COVID Response

elective surgeries. The Mater’s Theatre Management Committee, chaired by the Clinical Director for Theatres/Critical Care Directorate, Dr Brian Marsh worked collaboratively with surgical teams exploring matters surrounding health care operations and resumption of elective surgeries. These involved the opportunity for a new way of doing things and rethinking priorities.

A number of recommendations from national and international societies were published to help guide the process of restarting elective surgeries.

Scheduled Care Ward, Surgical Day Ward, and Day Surgery Unit were reconfigured to ensure adherence to social distancing for staff, patients, and visitors.

Additional manpower was provided, to ensure that patients are booked and risk assessed appropriately.

Innovative ways of doing things were introduced, like virtual clinics and telehealth.

The Surgical and CCAEST Directorates have been working closely together to ensure that planned surgical activity restarted as appropriate and expands at a rate that is compatible with the safe provision of care, bearing in mind that there will be potential need to deescalate surgical activity if critical care demand rises again.

MATER MISERICORDIAE UNIVERSITY HOSPITAL DESPITE BEING AT THE EPICENTRE OF A PANDEMIC, COLLABORATION, ADAPTABILITY AND WILLINGNESS HELPED GET ELECTIVE SURGERY RESTARTED IN THE MATER MISERICORDIAE UNIVERSITY HOSPITAL.

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he COVID-19 public health crisis required clinicians and health care systems to postpone scheduled surgeries to ensure availability of resources and patient safety to those affected

by COVID-19. This crisis placed unprecedented demands on resources leading to repurposing of surgical wards, critical care beds, and redeployment of anaesthetists, nurses, and surgeons to support their colleagues with the workload of COVID-19 cases, resulting in complete stoppage of elective surgery in some hospitals. As a result, many surgeons were concerned about pending workload and resuming

Considerations for resuming elective surgery: • Continuous monitoring of COVID-19 status in the hospital and community, to plan for the second wave and trigger putting elective surgeries on hold again • Supplies capacity, including adequate levels of surgical supplies and equipment. Ensure inventory of available PPE and appropriate usage • Capacity planning for preoperative, intraoperative, postoperative and post-acute care • Workforce planning, including assessment of staff wellbeing and support • Clear patient communication • Prioritisation of surgery, ensuring safe and optimal care is provided in all phases of surgical care • Development of cohesive leadership and process of frequent communication • Infection control and prevention processes aimed at minimising the impact of COVID-19 will be in place for some time COVID-19 will be around for the foreseeable future and infection rates may fluctuate as public health measures relax. We must work collaboratively to ensure that planned surgical activity restarts as appropriate and expands at a rate that is compatible with the safe provision of care, bearing in mind that there will be potential need to deescalate surgical activity if critical care demand rises again Engagement with all health care workers in even the most challenging situations to restart elective surgery and get the hospital back to the ‘new normal’ has created a cohesive and better health system.

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COVID Response UNIVERSITY HOSPITAL GALWAY Antibody Test for COVID-19 at University Hospital Galway

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he HSE launched the Study to investigate COVID-19 Infection in People Living in Ireland (SCOPI) in June 2020, which estimated the seroprevalence of antibodies to COVID-19 in the community in Dublin and Sligo. Following this, a national study called PRECISE was launched to look at the prevalence of COVID-19 antibodies in healthcare workers in two hospitals - University Hospital Galway (UHG) and St James’s Hospital Dublin.

In October, staff working in UHG and St James’s were invited to have a blood test to determine the presence of COVID-19 antibodies. In total, almost 6000 staff members from the two hospitals participated; in UHG 65% of staff participated in the study and uptake was good across all staff groups. The main findings of the study to date: The community seroprevalence is the main predictor of serop-revalence in healthcare workers (HCWs), but not all HCWs are affected equally.

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Members of the PRECISE Study Team and staff from the Infectious Diseases Department at University Hospital Galway (UHG) who are carrying out the study into the rates of previous COVID-19 infections in healthcare workers in UHG. L-R: Darren Gee, Medical Student; Dr Catherine Fleming, Consultant in Infectious Diseases and PRECISE Site Lead; Claire Heavin, PRECISE Project Manager; Peadar Rooney, PRECISE Data Manager, Nicola Boyle, Clinical Nurse Specialist; Dr Mary Okon, SHO in Infectious Diseases.

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A much higher rate of past infection was found in the HCWs than was found in the background population.

• approximately six times higher seroprevalence in HCWs than community • 15% of SJH staff had antibodies to SARS-CoV-2 (community 3.1%) • 4% of UHG staff had antibodies to SARS-CoV-2 (Sligo community 0.6%, with Galway assumed to be similar)

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The risk was across all HCWs performing all working roles including administrative and general staff but was higher in certain groups.

The risk was higher for the following characteristics:

• healthcare assistants • nurses and doctors • daily contact with patients (especially patients with confirmed/suspected COVID-19 infection) • age 18-29 • living with others • living with other HCWs • Asian ethnicity • male sex

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Over 1/3 of infections were undiagnosed (and at least 16% were asymptomatic).

The study will be repeated in April to assess changes in overall seroprevalence as the pandemic progresses; changes in individual serostatus over time; and the antibody response to vaccination.

COMMUNITY ASSESSMENT HUBS 16 COMMUNITY ASSESSMENT HUBS ARE NOW OPEN AROUND THE COUNTRY OFFERING ANOTHER IMPORTANT LAYER IN OUR PANDEMIC RESPONSE. Community Assessment Hubs are for patients over the age of 16 who are COVID-19 positive or likely to have COVID-19 and who require a face to face assessment with a clinician. They aim to provide a timely community based clinical assessment so that patients can be supported to manage their condition through the provision of clinical input, advice and supports. Patients may only be referred to the Community Assessment Hub by a GP or the GP Out Of Hours Services. Those for assessment must have an appointment, which will be confirmed in advance of attendance. Through the provision of this community service, the HSE’s aim is to maximise the number of patients with the COVID-19 virus, who can self-care at home, and minimise any inappropriate referrals to acute hospital services. Appropriate community assessment and management of patients with COVID-19 also help in minimising the risk of community transmission of COVID-19.

The majority of patients assessed in the CAH will be able to return home following assessment and continue their care and recovery. Some patients seen at the Community Assessment Hub may have an onward referral made for them to a self-isolation unit, if they cannot self-isolate in their own home. For other patients, assessment at the CAH may indicate the need for transfer to an acute hospital for treatment.

TJ Dunford, Assistant National Director and Head of Primary Care Operations, said, “I would like to thank all the teams involved in helping to develop and deliver this service. Community Assessment Hubs are supporting local people with symptoms of COVID-19 who may require additional clinical advice, and helping to ease some of the pressures our acute hospitals have been experiencing lately as a result of COVID-19.”

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COVID Response NATIONAL AMBULANCE SERVICE

AMBULANCE STAFF PLAYING MAJOR ROLE IN VACCINE ROLLOUT The HSE National Ambulance Service (NAS) has to been to the forefront of the response to the pandemic over the past year and continues to play a vital role, both as vaccinators and in the establishment of temporary vaccine clinics.

Richard Quinlan, Chief Ambulance Officer, North Leinster Area, explained, “It’s been a huge learning curve for us, but now we have a large number of vaccinators trained. We’ve a large number of administration staff and we can now independently go into residential care facilities and even the public areas for mass vaccination, if needed.

“We’ve had a huge response from every level, from the senior executives, all the way down to our paramedics, EMTs, advanced paramedics and our admin staff have all stepped up to new roles, have adapted to completely different work practices. It’s been fantastic to see all these people engage, work together, work with the Defence Forces, the Navy, work with the Air Corps, and work with all the individual groups. It’s been a fantastic response as far as we’re concerned.”

Caitriona Edgar, advanced paramedic and National Ambulance Incident Response Team member, said that the NAS have often led the way during the COVID pandemic response.

“We’ve done a lot of different things in the last 12 months.

We were kind of first to do a lot of stuff, firstly, with COVID patients on the ambulance and we were using PPE from the outset. We also did swabbing in nursing homes, prisons, meat factories, that kind of thing. And then we did the pop-up sites.

So if there was a cluster, we do a pop-up site for the cluster,” she said.

BELOW: GP Ray Walley and Richard Quinlan of the NAS at the Mass Vaccination Centre in the Phoenix Park.

NATIONAL DEFENCE FORCES EMERGENCY EXPERIENCE PROVES VITAL

Defence Forces deliver the first consignment of COVID-19 vaccines to islands off the west coast of Ireland.

When they were needed to step up during the national public health emergency, the Defence Forces jumped into action and their experience proved vital.

As soon as the pandemic begin, a joint task force (JTF) was established, with its main effort in direct support to the HSE. The JTF brought together a wealth of operational and planning experience from across the Defence Forces with subject matter experts in logistical planning, emergency planning, engineering, medical and a myriad of other specialisations under one roof and with one clear objective, explained Brigadier General McGuinness.

“The support started with the provision of cadets as contact tracers, then to the transportation of PPE being flown in from China, the supply and erection of tents to provide additional capacity to hospitals, the deployment of medical officers to The National Emergency Operations Centre and Connolly Hospital, Dublin, the deployment of ambulances and medical staff to support the National Ambulance Service and the use of Naval Service ships in Dublin and Galway as support platforms for COVID testing,” he said.

“This was the starting point of DF COVID operations and our involvement would only increase from there, to the point today where in excess of 62,000 man-days have been utilised. At every point the JTF staff have played a central role in planning, executing and overseeing all of these operations and they have worked tirelessly to ensure that the DF have played its role in the national fight against the virus.”

Brigadier General McGuinness said he is always proud of the men and women of the Defence Forces, particularly the role they have played in the national effort in the past 12 months.

He highlighted the decisiveness they have shown, and ability to generate internal forces, move to support the HSE, train our personnel, keep them safe and operate in COVID-risk environments. “I’m proud of the ability of the Defence Forces to plan and ‘see ahead’ in terms of moving from the initial tasks focusing on PPE distribution to contact tracing, onto swab testing and finally in recent weeks provide non-clinical support to nursing homes,” he said.

“Presently the Defence Forces are engaged in planning with the HSE to support the National Vaccination rollout and engaging with a range of stakeholders on providing support to a National Quarantine Plan."

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COVID Response

A PSYCHOSOCIAL RESPONSE TO COVID-19

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he HSE has published a new detailed framework that outlines what actions are necessary to respond to the long-term impact of COVID-19. The framework has been developed to address the psychological and social effects of the coronavirus pandemic, particularly on healthcare workers and vulnerable groups.

Since the onset on the pandemic, the HSE has worked to maintain continuity and access to its mental health services.

But the wider wellbeing, resilience and mental health of the whole population are crucially important. This new framework aims to ensure all services, delivered by the HSE or through our partner and funded agencies, are all part of a cohesive and integrated approach. This framework is part of an overall strategy, developed by a dedicated Psychosocial Response Group, to consolidate integrate and enhance existing structures and responses for both the public and all healthcare workers.

Speaking about the overall psychosocial response to COVID-19, HSE Chief Operations Officer, Anne O’Connor, said, “As we face the continued challenges posed by the COVID-19 and its consequent impact on the people’s wellbeing, it is important for us to recognise that healthcare workers across all sectors and many individuals, families and communities across the country, are facing unprecedented stressors in their daily and working lives which are having significant psychological, emotional and social impacts. Therefore, it remains critical that we continue to provide sustained psychosocial responses and to effectively manage any significant psychological and social difficulties that may arise.

“Both the HSE and our partner agencies have been working hard, since the start of the pandemic, to provide mental and social wellbeing supports and services for all healthcare workers and to the many different communities in our society.

Building on all of this great work, the

HSE’s Psychosocial Framework will provide a layered care approach to addressing the psychosocial consequences of Covid-19 and sustainably support the levels of need of the population across the life span.”

Speaking about the services and supports essential to this framework Dr Philip Dodd, Consultant Psychiatrist/ Clinical Advisor of National Office for Suicide Prevention, added, “We and many of our funded agencies in the community sector, have successfully fast-tracked new service and support options this year which reflects our inter-agency efforts to improve accessibility to mental health supports at this time. Digital health options, including innovative online, text and phone supports - that many people have turned to for the first time - are now mainstreamed.”

Highlighting the importance of targeted solutions for health and social care staff, Dr Lynda Sisson, National Director of the HSE Workplace Health & Wellbeing Unit, said, “Health and social care staff across the HSE have experienced significant distress

dealing with the challenges presented by Covid-19. Their mental health and psychological wellbeing is extremely important. We have a wide range of services and support options for HSE healthcare workers available on our HSE staff supports page including: a dedicated phone line providing information and advice for all HSE staff and managers; free counselling; online stress control supports; and a range of local supports such as psychological first aid.”

Minding our own mental health is more important now than ever before. The HSE would remind people that there are many supports available during this time.

Thanks to technology, connecting with mental health supports online, by text or on the telephone, is becoming much easier for everyone. We encourage anyone who is concerned about their own mental health or the mental health of someone they care about to visit our website YourMentalHealth.ie or call the YourMentalHealth Information Line on Freephone 1800 111 888 any time day or night, to learn more.

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Services

Dr Stephen Tuohy, Consultant Cardiologist, UHL, with Joseph O’Neill from Moyasta, Co Clare.

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oseph O’Neill (74) from Moyasta, Co Clare, was treated in October

by Dr Stephen Tuohy and team in the cath lab in UHL. Himself a native of Co Clare, Dr Tuohy has recently taken up a post as consultant cardiologist at UL Hospitals Group. “This implant is still a relatively new technology and has particular advantages over transvenous devices in certain patients” explained Dr Tuohy.

“Essentially an ICD is a small implantable battery-powered device that can deliver a shock to the heart to somebody who has a life-threatening heart rhythm such as ventricular fibrillation or ventricular tachycardia. In this way, we can restore a normal heart rhythm as and when required and the device continuously monitors the patient to look out for those potentially dangerous heart rhythms.”

“Most commonly, ICDs have been transvenous but now with advent of this new technology we have the option of placing an ICD without any device actually touching the heart. This procedure is entirely subcutaneous, which means under the skin. While this option is not suitable for all patients who need an ICD, it is a preferable option in certain situations.”

74-year-old Joseph O’Neill first got a heart attack in 2010. “It wasn’t a serious one if you can say that about a heart attack but serious enough for Shannondoc to send me by ambulance first to Ennis and then into Limerick. It was Dr Terry Hennessy who was looking after me then and it was he who recommended I get my first ICD device,

NEW CARDIOLOGY PROCEDURE GIVES CLARE MAN JOSEPH A NEW LEASE OF LIFE THE Cardiology Department at University Hospital Limerick continues to improve patient services with the successful implantation of a subcutaneous ICD (implantable cardioverter-defibrillator) the kind where the wires travel along the veins and up to the heart,” he reacelled.

With the transvenous ICD safely implanted, it was a new lease of life for Mr O’Neill. However his health began to suffer after a subsequent car accident. “After the accident, I developed medical problems and I knew I had serious problems at that stage.

I was able to do a bit of research myself and I spoke to my own doctor about it and I was referred in to UHL.” Joseph recalled that he began to feel better after being put on an antibiotic but specialists in the cardiology department, including Dr Tuohy, also shared his concern about the existing device and that he should

consider a subcutaneous ICD. “That meant having to go back to the Mater Hospital in Dublin for surgery to have the older device taken out and to come back down to UHL again to have a new subcutaneous device put in. I was listening to people on the radio or in the papers talking about how they were anxious about going into hospital because of the COVID-19. The more I thought about it, the more I said to myself that people should not be afraid to get help.

I want to say to the men and women out there who are thinking that way that they absolutely need to go in for their operations.

Without the help I got from UHL and the Mater, I would not be alive today.”

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Services FROM LEFT: Irene Maguire, Catherine Anne Field and Amanda Vaughan, Schwartz Rounds mentors.

MENTORING TO MAKE A DIFFERENCE Schwartz Rounds (SR) are a framework to support and develop the emotional wellbeing and resilience of staff. They provide reflective spaces for staff to share with the goal of improving compassion and person-centred care. Here two of the HSE Schwartz Rounds mentors share reflections on their role.

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rene Maguire, Senior Physiotherapist at Galway University having worked in the field of adult learning and development for Hospital, explained, “The positive impact attending Schwartz most of her career, she has experienced many frameworks designed Rounds has on our staff, along with the emerging beneficial to bring about personal, professional and organisational change. ripple effects on the culture of our wider hospital community, “The one initiative that has had a greater impact on me than any influenced my choice to become a SR mentor. I want to help other is Schwartz Rounds. The mix of personal storytelling, reflection other services establish this very real, tangible staff support initiative.” and conversation within a boundaried space, creates a sense of She described it as a privilege to support and connection and community. This builds trust and guide SR teams in getting set up. This involves resilience and creates small ripples of change in sharing the journey from anticipation and organisational culture. Small consistent actions apprehension of preparation for the first Round, can also lead to big changes.”

She reflected that the role as a mentor for new to growing confidence as the first and later Rounds are successfully delivered. “Being a mentor gives sites “provides me with immense personal and me an opportunity to connect with colleagues professional satisfaction. I have watched teams passionate about creating a safe space for staff to take their initial, cautious steps from planning their F I N D O U T MO RE reflect on the lived experience of working in first Round to completing their implementation healthcare. Observing other facilitation styles and journey. “I enjoy the varied role, helping teams to Contact Caroline Lennon hearing stories and reflections from colleagues build wider networks within the Schwartz Nally, Schwartz Round across the HSE is a unique and continuous learning community, acting as a sounding board, sometimes Co-ordinator, National experience. The mentor role reconnects me with counsellor, while providing emotional and QI Team at caroline. the reasons I chose to work in healthcare. Being practical support.” lennonnally@hse.ie She concluded that “it is a privilege to be able a SR mentor brings with it both personal and to support the teams, yet I receive so much from professional satisfaction and an opportunity to www.hse.ie/eng/about/ the experience too, listening to the professional help make a difference in other healthcare who/qid/staff-engagement/ stories and personal narratives that have helped services,” said Irene. schwartzrounds/our-journeyAmanda Vaughan, Learning and Development shape the wise individuals and the wonderful in-ireland Specialist, LauraLynn Children’s Hospice, said, teams in healthcare service”.

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Services

Dementia supports Dementia: Understand Together aims to create communities where people with dementia are respected, supported and connected despite COVID-19 restrictions

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020 was particularly difficult for people living with dementia and their carers, family and friends.

Many have been staying at home and some services had to be changed to help protect people with dementia from COVID-19. Important social connections, activities and therapeutic interventions so crucial for wellbeing have been missed.

Research conducted by the Alzheimer Society of Ireland in June 2020 showed that people with dementia and their families struggle with loneliness, isolation, carer fatigue and a deterioration of the disease.

This group of people continues to need support from the community to stay well and stay connected and we can all look at the things we can do to be supportive at this time. Often it is the little gestures that have the biggest impact, such as picking up the phone, sending a card, a thoughtful gift or asking whether you can help with chores such as shopping.

Dementia: Understand Together’s aim is to create communities in which people with dementia are respected, supported and connected, and despite the challenges of COVID-19, many campaign partner organisations and local community champions continued to support this goal.

In a survey of community champions, 64% stated that since the beginning of COVID-19 they have undertaken actions to support the inclusion of people with dementia.

Innovations range from online dementia cafes, support groups, arts and craft classes to sing alongs by dementia inclusive choirs.

In collaboration with the Alzheimer Society of Ireland, the National Dementia Office, Dementia Information Services

ABOVE: At the launch of Boots dementia training were Fiona Foley, National Coordinator, Dementia: Understand Together in Communities; Joe Scallan, Head of Stores, Boots Ireland; and Martha Ryan, Head of HR, Boots Ireland.

and Development Centre and the Memory Technology Resource Rooms a COVID-19 resource hub, an At Home Activities Booklet and Weekly Planner for people living with dementia were developed to help add structure and meaningful activities to their day.

On a county level dementia programmes

DEMENTIA INITIATIVES: To nurture greater understanding and awareness of the experiences of those living with dementia Boots Ireland provided training to over 2000 staff members in its 89 retail and pharmacy outlets. The Men’s Sheds produced the ‘Your Shed and Dementia’ manual for all its members, to raise awareness of dementia and offer advice for Shedders, their families, carers and shed committees on facilitating a member with dementia in the shed. To keep visitors safe from COVID-19, museums such as IMMA and the National Gallery moved online with tours specifically developed for people with dementia, such as Azure. Age Friendly Ireland who provided communication training to the local authority staff manning the COVID-19 community response telephone lines included dementia in the content.

also continued. Tipperary County Council is focusing on a community response to support people with dementia during COVID-19 and into the future. Funded through a successful application to the Healthy Ireland grant round and partnering with the Dementia: Understand Together campaign, the project aims to increase understanding of dementia and inspire people in communities to take practical steps to support those affected by the condition.

In December 2020, 34 representatives of community groups, businesses and other organisations signed up for the online dementia awareness session provided by the Alzheimer Society of Ireland. Participants, such as local librarians who are working in a very changed environment due to COVID-19, described how changes to the layout within the building can be helpful for a person with cognitive, sensory or physical impairments and how the COVID-19 book-drop and delivery service can benefit a person with dementia and their family.

To support community champions in their actions, as a second phase of the project, local councillors undertook dementia training in January 2021.

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Corporate

CORPORATE PLAN Corporate Plan 2021-2024 sets out the future direction of our health service

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s our population grows and ages our health service is facing increasing demands and pressures. We know that we need to make changes. We must deliver services in a new way to meet the health needs of the people of Ireland.

We are currently planning the future of our health service for the next three years and these plans and goals are set out in the Corporate Plan 2021-2024.

The plan, developed by the Board of the HSE and endorsed by the Minister of Health, is based on extensive research and consultation with staff, stakeholders and the public.

The Corporate Plan shows our shared purpose and direction for the next three years.

It is a clear roadmap for our stakeholders, including staff and patients, aligned to Sláintecare. By setting out clear objectives with measurable goals, we can work together to create our shared vision for the future of the health service.

People, both our staff and the people that we serve, are at the centre of our work. Over the past year, we have worked together to manage the COVID-19 pandemic and have developed new ways of working and a new sense of purpose.

The plan sets out in detail what our key focus areas will be over the next three years.

We are legally required to have a Corporate Plan, and it is an important document because it: • sets out a shared vision for our health service over the next three years.

• gives clear targets and objectives that we must meet to achieve this vision, and • allows our stakeholders to measure and track our progress toward these goals over the three years.

Why are we doing this?

We want to provide the highest quality care and timely access to services and treatments for you and everybody living in Ireland. We want to support and encourage people across all walks of life to stay healthy and well, to live independently and

to live longer lives.

We want to have a health service that provides you, your family and loved ones with a good experience no matter where you live or where you receive your service.

We want a health service that our staff can be proud of.

We want the HSE to be a great place to work where people are resourced and supported to do their job and can gain satisfaction from the work that we do.

2020 demonstrated the HSE’s core values and purpose. We worked together to care for people, to change lives, to transform how we delivered our services and protect the public’s health.

There have been many positive developments and successes in the health service over the past decade but we know that more needs to be done. COVID-19 has demonstrated how vital our health service is and that it requires investment to continue to deliver.

Our aim is an Irish health service where: • You are supported to live well and you feel connected with your community • You can access the right care, at the right time and in the right place and you feel empowered, listened to and safe • We will work as one team, supported to do the best we can for patients, service users, their families and the public • You can have trust and confidence that the organisation is run well How will we know that we are improving our health service?

We will develop annual plans to support the objectives in the plan. We will measure our progress and report on improvements as we work to strengthen the health service. We are committed to our core values of trust, care, compassion and learning.

We will be developing measures to monitor progress in the following areas: • A healthier start for children and reduced health inequities • Reduced risk factors for chronic disease

•

•

•

•

•

focusing on harmful alcohol use and rising obesity rates Increased community services and support to live independently in your own home or in the community Improved access to tests and specialist appointments, closer to home Reduced waiting times for diagnostic tests, outpatient appointments, in-patient and day case procedures Mental health support that aims to keep you well and responds quickly when you need it More person-centred support for people with disabilities to live full, independent lives

We are determined to turn this Plan into real action – to make demonstrable improvements to our health service and to progress the Sláintecare vision. We recognise the budget pressures and we will work hard to secure the additional resources to deliver this Plan.

You will see that we have built on our collective experiences of living with and working in a COVID-19 environment; learning from new ways of working with a relentless ‘one team’ focus on patients, service users, families and the public. We will support our people to develop skills and to innovate and we will bring about a supportive environment that enables a healthy work life balance and a culture where everyone is free to raise concerns.

Paul Reid, HSE CEO

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Corporate

OBJECTIVES

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Manage the COVID-19 pandemic while delivering health services safely to the public

Enhance primary and community services and reduce the need for people to attend hospital

Improve scheduled care to enable more timely access and reduce the number of people waiting for services

4 Prioritise early interventions and improve access to person-centred mental health services

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6

We will work to reimagine disability services, to be the most responsive, person-centred model achievable with greater flexibility and choice for the service user

Prevention and early intervention in children’s health, harmful alcohol use and obesity

We know that there are long-standing challenges in our services, some of which have been further impacted due to COVID-19.

We recognise that tackling these challenges will not be easy, especially as we anticipate operating within a COVID-19 environment for the foreseeable future. We have seen our teams’ incredible commitment during COVID-19 and we are also keen to build upon learnings from the pandemic response.

We will need to continue to work together, be open to new ideas, and quickly identify weaknesses and improvements to successfully deliver the ambitious transformation required.

Our role as the Board is to set the vision and strategy, maintain focus and energy and hold the HSE executive team to account for delivery.

Ciarán Devane Chair HSE Board HEALTH MATTERS SPRING 2021 | 61

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Education

NEW COVID-19 WEBPAGE FOR STAFF WORKING IN RESIDENTIAL CARE FACILITIES FOR OLDER PEOPLE

eLearning programme developed for Adult Safeguarding Module aims to support learner to recognise, respond to, and report safeguarding concerns about adults at risk of abuse

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he National Safeguarding Office on behalf of the Steering Implementation Group for the revised Adult Safeguarding Policy have been working with HSELanD on the development of an online training module on Safeguarding Adults. The eLearning programme is now live on HSELanD. The aim of this module is to support the learner to recognise, respond to, and report safeguarding concerns regarding adults at risk of abuse. The eLearner module uses four illustrative scenarios. These scenarios, will target and emulate real life situations such as different service users who are at risk of abuse, how a staff member learns of the abuse, concerns they have around responding and reporting the abuse, etc. We depict various types of abuse across the scenarios. The learner faces challenging dilemmas and must select the competent path in order to progress through each scenario. The learner must complete all scenarios and visit 80% of the screens within the module. The module includes a two-minute explainer video designed for both staff and adults who may be at risk of abuse. The video which is Irish Sign Language interpreted (which can also be used as a separate media asset outside of the e Learning module) will highlight our learner’s role of recognising, responding and reporting safeguarding concerns. The animated video depicts abuse types and shows how an adult at risk of abuse can be helped through concern of abuse arising and subsequent development of a safeguarding plan. It reinforces the message that staff have a responsibility to recognise, respond and report concerns of abuse.The eLearning module also contains an ‘extend my learning’ section which includes resources and tools for staff and managers to extend learning beyond the programme itself and to help further learning and safeguarding awareness in the workplace. Learners will complete a separate assessment module on HSELanD in order to get a certificate of completion. This module is Nursing & Midwifery Board of Ireland (NMBI) Category 1 approved for 1 Continuing Education Unit (CEU) and the programme activity can attract 1 CPD credit for doctors.

The National Clinical Programme Older Persons and ONMSD have developed a webpage for healthcare workers and managers delivering care in residential settings for older people.

Residents of nursing homes have been identified as a particularly vulnerable group as they have a significantly higher risk of contracting COVID-19. Particular attention is needed when caring for Older People to support the prevention of COVID-19, identification of symptoms and clinical management of residents in these settings. The webpage is a central point of contact for residential care facilities to access up-to-date clinical guidance, information and links to inform care and supports in these settings.

It signposts to info on: • HPSC Clinical guidance for residential care facilities • HIQA assurance framework for registered providers • HSE Library Clinical Resources for Residential Services • HSeLanD resources • Consent for COVID 19 vaccination • Staff Illness Benefit for COVID-19 • COVID-19 and Bereavement • IPC Webinars

For more see www.hse.ie/ covidnursinghomeresources

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Corporate

COVID-19 DRIVES DEVELOPMENT OF AN INNOVATIVE OXYGEN METERING SYSTEM Most of us will be familiar with the important role oxygen plays in our hospitals.

However, many of us are unaware of the complex engineering systems that enable the delivery of oxygen to the bedhead terminal.

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edical oxygen systems form part of what are known as ‘Medical Gas Pipeline Systems’ (MGPS). These are specialist engineering systems that must conform to a specific set of standards. These systems are carefully maintained and looked after by our hospital engineers in our technical services departments.

Before COVID-19, medical oxygen had been regarded as a resource that was plentiful and always available. Oxygen storage and distribution systems were designed to ensure ample supply in normal use and there was little need to monitor oxygen usage in real-time.

As the COVID-19 pandemic began to spread across the globe, so too did the stories of oxygen shortages and hospitals ‘running out’ of oxygen.

Indeed, close to home, headlines about oxygen systems failing, in places such as Northern Italy and the UK, gave cause for concern here in Ireland.

Increased demands for oxygen in our hospitals shone a spotlight on our oxygen systems and brought about an urgent need for real-time information on oxygen usage and reserves. To address this need, engineers from the HSE and industry teamed up to develop a bespoke monitoring and telemetry system that provides real-time information via a cloud based portal that can be viewed on a smartphone or website.

The telemetry system started out at University Hospital Waterford (UHW) where engineers came up with the initial concept.

State-of-the-art digital cameras were directed at the contents gauge on the main oxygen storage tank and using Optical Character Recognition (OCR) technology, software engineers were able to convert the image into a volumetric flow-rate. Using a high sample rate together with artificial intelligence and tuning; the developers were able to

capture real-time flow information with a reasonable degree of accuracy. A graphical user interface was developed in tandem to enable this information to be displayed on a web portal and on smartphones.

This achievement gave hospital engineers and clinicians remote access to the performance metrics of the oxygen system. Clinicians would have access to the remaining oxygen capacity and therefore the number of patients that could be safely supported by the oxygen system. Hospital Engineers would receive early warning if the system was reaching its limitations and react accordingly and in a timely manner.

The oxygen telemetry system has since undergone further design and development. The digital camera and OCR technology have been replaced with high tech instrumentation which is capable of measuring oxygen flow and storage content with a high degree of accuracy and reliability. The oxygen monitoring and telemetry system is currently being rolled out across our hospital network in Ireland.

The oxygen monitoring and telemetry system is part of wider investment programme in our medical gases systems that will see increased capacity and resilience going forward.

Estates would like to thank all those who collaborated to bring about this initiative; including our hospital Technical Services Departments, the Office of the Chief Information Officer (OCIO) and our partners from industry.

Particular thanks is due to our engineering colleagues in University Hospital Waterford and Connolly Hospital, Blanchardstown who facilitated the development and testing of early versions of the telemetry system. We are also grateful to Douglas Carroll Engineering, Arup, Evercam, Thermal Imaging, BOC Healthcare (Linde Group) and Jones Engineering who have been instrumental in the successful delivery of this project.

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Services

Screening

BowelScreen launches new endoscopy service University Hospital Waterford (UHW) has begun to provide colonoscopy services for BowelScreen participants who have been found to have a ‘not normal’ result from their home FIT test

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owelScreen is one of the National Screening Service’s three cancer-screening programmes. It aims to detect colorectal (bowel) cancer as early as possible; and to identify and remove adenomas or polyps (abnormal tissue growths).

This greatly reduces the risk of future bowel cancer development. Screening is a two-step process: a stool sample is collected by the person at home, and is sent to a laboratory where it is tested for a level of blood. This is called the FIT test (fecal immunochemical test) which, if not normal, results in a referral for a further bowel examination via a colonoscopy. For people in Ireland’s south-east, this BowelScreen colonoscopy will now take place at UHW. Welcoming the BowelScreen service, the General Manager of UHW Grace Rothwell said it was great news for the south-east.

“University Hospital Waterford is one of eight national cancer centres in Ireland. We already provide histopathology and surgery services for BowelScreen. Partnership with BowelScreen and additional capacity will help us further deliver vital services closer to where people live in the south-east,” she said. BowelScreen Programme Manager Hilary Coffey Farrell said, “BowelScreen has the potential to reduce deaths from colorectal cancer by 36% after 10 years of screening, but only if there is growth in participation of men and women.” Clinical Director of Bowelscreen Professor Pádraic MacMathuna explained that bowel cancer (colorectal cancer) is one of the most common types of cancer diagnosed in Ireland affecting almost 3,000 people every year. BowelScreen, which offers a home bowel screening tests for approximately 250,000 people each year in Ireland, has detected 930 cancers and detected and removed 25,350 pre-cancerous growths since it began in 2012. These pre-cancerous growths are known as polyps or adenomas, and if left untreated they can develop into bowel cancer.

The programme reminds people aged 60-69 years to check that they are on the register by visiting www.bowelscreen.ie. Or, for queries, patients can call the BowelScreen freephone information line on 1800 45 45 55 or email info@bowelscreen.ie

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Services Two-yearly screening for Diabetic RetinaScreen Diabetic RetinaScreen (DRS), the National Diabetic Retinal Screening Programme, is introducing at two-yearly screening pathway for screening participants who are deemed eligible. The new pathway has received Department of Health approval and will operate from February 16th 2021. Until now, DRS has invited programme participants for diabetic retinal screening once a year. This will now change to a two-yearly appointment for people who fulfil certain criteria. If a person has received a result of ‘no retinopathy’ from their previous two screenings, their next DRS screening invitation will be two years from the time of their last screen. The new pathway will reduce the number of screening appointments and reduce unnecessary Got clinic visits and examinations. Prof David Keegan, Clinical Director of questions?

Diabetic RetinaScreen, explained, “International evidence shows that if a person has two consecutive results of ‘no retinopathy’, it is safe for them to attend their screening appointment every two years.”

If a person is suitable to avail of a two-yearly screening, DRS will People who have questions let them know. They will then be invited for screening every two about diabetic retinopathy years. Then, if their next screening results detect retinopathy, are invited to contact the they will be returned to annual screening or referred for treatment.

Freephone line on 1800 “It is important that people who have diabetes continue to attend 45 45 55 or email info@ for their screening test when they are invited. And if a person has diabeticretinascreen.ie. sight loss, they should not wait to receive an invitation from DRS. They should contact your GP, eye doctor or optician immediately for advice. When the condition is caught early, treatment is effective at reducing or preventing damage to sight,” he said.

Prof David Keegan, Clinical Director of Diabetic RetinaScreen

HSE NATIONAL SERVICE PLAN 2021 Implementing year 1 of Corporate Plan 2021 – 2024 The HSE’s 2021 National Service Plan (NSP) was published on February 24th 2021. It sets out the type and volume of health and social care services that will be provided in 2021, having regard to the funding made available and the level of staff to be deployed.

The financial allocation for 2021 is €20.623bn, an increased investment of €3.5bn (21%) in our health service, reflecting a strong level of confidence in the response of the health service to the pandemic to date. Budget 2021 also provided for an expansion in our workforce of 16,000 WTE over our employment levels as at December 2019.

THE NSP SETS OUT TO: • Protect the public, our patients and those who use our services as we continue to deliver services in the context of COVID-19 • Embed the significant service reforms put in place during the pandemic and to sustain and align these with the ambitious Sláintecare plans The Plan outlines reform measures and their expected impacts in 2021 which include:

• Enhancing primary preventive services and partnerships • Reforming our services to better support our growing and ageing population • Delivering care as close to the patient as possible through enhancing primary and community care • Increasing capacity and reforming scheduled/ planned care • Mainstreaming appropriate Sláintecare Integration Fund projects • Improving access to mental health services • Supporting the reform of disability services The Plan also contains sections on improving the patient experience of the health service; improving population health and wellbeing.

If you would like further information on the National Service Plan, please contact the team in the Planning Unit, Office of the National Director, Strategic Planning and Transformation at planning.ddg@hse.ie or telephone 021-4923531. The National Service Plan 2021 is available at: www.hse.ie/eng/services/publications/serviceplans/national-service-plan-2021.pdf

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Corporate

BEYOND 2020:

ESTATES ENERGY BUREAU As one of the largest public sector energy users, the health service is expected to be an exemplar in energy and emissions reduction, and also in mitigating the adverse effects of climate change on our environment and health.

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etween 2009 and 2019 the HSE improved its energy efficiency by 26% and this saving will contribute to Irelands 2020 public sector target of 33% energy efficiency improvement. Recently, the Government’s Climate Action Plan set a number of new targets for the public sector including the requirements to improve energy efficiency by 50% by 2030, and reduce CO2 equivalent emissions by 30% by 2030.

In order to help achieve these targets HSE Estates have set up three regional Energy Bureaus in the East, South and West. The bureaus are jointly funded by HSE Estates and the Sustainable Energy Authority of Ireland (SEAI) and are resourced with dedicated Energy Officers. These Energy Officers work with sites to embed energy management best practices into the culture and day-to-day activities of staff, and support local Energy Teams in implementing energy reduction projects.

The bureaus also assist facilities with water conservation, through the HSE’s Green Healthcare Programme, and co-ordinate the activities of partner organisations such as the OPW’s Optimising Power at Work and SEAI’s Engaging People programmes. While COVID-19 has affected the Energy Officers ways of working, they are continuing to support Energy Teams virtually and with social distancing measures in place.

In 2019 the Bureaus achieved an energy reduction of 13,788Mwh and avoided 4.64 million tonnes of CO2. This is the equivalent of the energy used in around half a million homes in one year. It was achieved through a mixture of behavioural change, awareness programmes and energy reduction projects such as lighting and insulation upgrades to existing facilities. These energy specific minor capital projects are funded through the HSE/SEAI partnership.

ABOVE: Winners of the Big Switch Off 2019 University Hospital Galway

THE WORKS INCLUDED NEW WALL AND ATTIC INSULATION, REPLACEMENT OF WINDOWS AND DOORS, AND UPGRADES TO HEATING SYSTEMS

The benefits of such projects can be seen in the recent energy retrofit of three existing HSE residential facilities for adults with disabilities in Meath. The works included new wall and attic insulation, replacement of windows and doors with triple glazing, upgrades to heating and hot water systems, and ventilation upgrades to improve air quality. Each of the residential facilities improved their BER Rating, which measures a building’s energy performance, from a D to an A3 rating. This improvement not only has a positive impact on the health service's

WATCH THE ENERGY BUREAU INFORMATION VIDEO www.hse.ie/eng/about/who/healthbusinessservices/nationalhealth-sustainability-office/designing-the-built-environment/ estates-energy-bureau/

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Corporate LEFT: Window and door upgrades at Clantara House. BELOW: Upgrades at Coill Darach.

BELOW LEFT: Heating system upgrades in Na Driseoga.

HBS ESTATES ENERGY BUREAU TIPS FOR SAVING ENERGY AT WORK

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Switch off computers and non-essential equipment each evening, at weekends, and before holidays - this will save up to 20% of your appliances’ energy use compared to leaving them on standby.

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carbon emissions, it also improved comfort levels for residents, staff and visitors.

Residents commented that “the house is so much warmer than it used to be” and the new triple glazing means residents no longer “hear the wind or rain at night”.

In addition to upgrading facilities, the East, South and West Bureaus are also progressing renewable energy projects.

These projects replace old fossil fuel systems with renewable energy sources, for example, Solar PV which generates electricity from sunlight and Heat Pumps which convert energy from the air outside of your home into useful heat inside. One such example is a recent Solar PV project in a 100 Bed Community Nursing Unit.

When completed the Solar PV panels will provide 16.5% of the CNU’s electrical power consumption, saving the hospital money and reducing carbon emissions.

Each of the Bureaus have developed a register of opportunities for energy upgrade and renewable energy projects which will be progressed over the next few years. It is also important that our new facilities are

designed to be as energy efficient as possible and therefore all new capital projects and major refurbishments delivered by HBS Estates use an energy efficient design (EED) approach. This ensures that the design will minimise carbon emissions, maximise energy efficiency and ensure compliance with energy standards.

The way people use buildings can also have a significant impact on energy use and the Energy Bureaus are supporting facilities to run behavioural change, awareness and switch off campaigns. One of these campaigns is the ‘BIG Switch Off’ competition, which is run by the Office of Public Works (OPW) in collaboration with HBS Estates. At an awards ceremony earlier this year University Hospital Galway was named winner of the 2019 competition. The hospital, with support from the West Energy Bureau, reduced their energy consumption by 10% during the three-day competition period in October last year. In total the eight hospitals who participated in the competition saved enough electricity to power an average operating theatre for 184 days by making an effort to switch off and be more aware of energy use.

As the darker evenings approach and the weather gets cooler we can all do our part to avoid wasting energy at work by following the Energy Bureaus Tips for Saving Energy at Work. By changing our behaviour and taking simple steps such as switching off our computers and printers as we leave, switching off lights when not in use and being more energy aware every individual can reduce their environmental impact and help us achieve our climate and energy targets.

Turn off lights when not needed and save to do so.

3

Activate the power saving functions on computers, printers, photocopiers and fax machines.

4

Report any dripping taps, leaking pipes or broken toilets – saving water also saves energy.

5

Keep it on the screen – only print when necessary which saves paper and energy.

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Ensure windows and outside doors are kept closed when the heating or air conditioning is on.

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Use the stairs instead of the lift and if you can, consider walking, cycling or public transport when travelling to work – this saves energy and is also good for your health.

Staff can find more resources on climate action and energy awareness, such as posters and check-lists, at www.hse.ie/sustainability.

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Digital

The Big Idea

Management of the pandemic using Quality Improvement Thinking

The sudden arrival and rapid spread of COVID-19 in early 2020 called for an immediate, decisive and multi-faceted response from the Irish health services.

But crisis management, if unstructured or haphazard can be costly and ineffective.

So how did the HSE manage a rapidly changing and unprecedented challenge of this magnitude? It did so by engaging the principles of Quality Improvement.

This means placing patient wellbeing at the heart of all actions, deploying informal but effective communications and Rapid Learning Cycles.

During the earliest days of the pandemic, Chief Clinical Officer, Dr Colm Henry asked National Director of Quality Improvement,

Dr Philip Crowley to urgently assemble a number of public health work streams to tackle the issue of Contact Tracing, using Quality Improvement thinking. The QI team assembled by Dr Crowley, working with public health colleagues, National Women and Infants Health Programme, staff from across the HSE, universities, defence forces, and government departments, set about designing and testing a process that led to the development of the Contact Management Programme (CMP).

The CMP’s systems and tools were built, tested and deployed in less than a week, drawing on WHO’s Dr Mike Ryan’s maxim that ‘speed trumps perfection’.

But because they also used Quality

Improvement methodology such as Rapid Learning Cycles (RLCs) of Plan, Do, Study, Act (see Figure ) they were anything but haphazard.

Working with this flexible model, the tools and systems the CMP developed played a significant role in bringing the spread of the virus under control, throughout the first, second and the most recent and most aggressive third wave of the infection.

The Covid Care Tracker (CCT) is a graphic example of a tool speedily deployed but refined by continual improvement. The CCT is an ICT system that now manages the flow of 1.8 million people along the COVID-19 care pathway.

But the earliest version of the CCT was developed over six days in March 2020, was paper-based and tested by army cadets, working in the basement of Dr Steevens Hospital.

After ten months however, it is entirely web based, has been upgraded with over 30 new releases and has facilitated contact with over half a million COVID-19 positive cases and their close contacts, through calls backed up with SMS messages. Nearly 3,500 people have been trained as contact tracers and while most of that training is how to communicate important Public Health information it is also about listening to feedback and channelling recommendations back to the developers at OCIO for the next upgrade or “release”.

Dr John Fitzsimons (2020) of the National QI team, channelled his inner Beckett to sum up the benefits of a Quality Improvement approach. “QI helps us learn faster and still be efficient and evidence based in decision making. It also facilitates us to fail better, learning safely and at a smaller scale and lower cost, about the ideas that do not work.” And those that do, especially in a crisis.

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Education SOCIAL PRESCRIBING ADAPTS AND RESPONDS Like many other services, social prescribing has had to adapt so that it could quickly respond to the pandemic and provide an invaluable link to people most vulnerable to loneliness and social isolation or who have poor social supports. Although a relatively new service in many communities, social prescribing link workers have demonstrated important flexibility to respond differently to existing and new referrals.

Social prescribing recognises that health is heavily determined by social factors such as poverty, isolation and loneliness. Social prescribing offers GPs and other health professionals a means of referring people to a range of non-clinical community supports which can have significant benefits for their overall health and wellbeing. The fact that many of the activities on offer from social prescribing are not available because of coronavirus has been an added challenge.

Social prescribing generally involves three key components: A referral from a healthcare professional; Consultation with a link worker; An agreed referral to a local community activity.

Examples include art, cookery, meditation, GAA, men’s sheds, music, drama, walking groups and many more.

In spite of the fact that most community-based activities are on hold currently, social prescribing link workers across the country have been adapting their support in innovative and safe ways to make sure it is practical and relevant to responding to the challenges presented by COVID-19.

Social prescribing services are now available in over 30 locations around the country, supported by Slaintecare, Healthy Ireland and the HSE as well as Community based organisations such as Local Development Companies and Family Resource Centres.

PRACTICAL BENEFITS OF VIRTUAL WORKSHOPS

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he Making Every Contact Count (MECC) ‘Enhancing your Brief Intervention Skills’ workshop is designed to follow on from the successful completion of the Making Every Contact Count eLearning modules. To date, participants who completed the eLearning modules were previously invited to a face to face workshop as part of the programme. This Enhancing your Skills Workshop provides an opportunity to practice the skills, build confidence and learn from others. Due to the current restrictions in place, no face-to-face training is currently taking place. To provide an alternative for the workshop, the National MECC Programme are introducing a new virtual two-hour workshop, where participants can join the workshops remotely. The first of the virtual workshops will commence in February and will run throughout 2021. Dates of upcoming workshops will be posted on the MECC Learning portal. Please email makingevery.contactcount@hse.ie for more information or contact your local MECC support person in Health Promotion & Improvement for workshop information Learners

• You do not need to have an online platform account to access the workshop • You will be given information on how to access the training.

• You can access the workshop from any computer or mobile device connected to the Internet. In some cases the trainers will provide a test call for participants in advance to make sure they can connect to the training.

The original face-to-face workshops were redesigned into an online experience by MECC trainers from Health Promotion & Improvement and Health and Wellbeing staff.

Agatha Lawless, Project Manager with the Making Every Contact Count Programme, said, “We recognise that it may not be possible for some staff to engage with our programme at the moment, but for those who are interested in enhancing their behavioural change conversation techniques a virtual flexible solution will be available.

“We have staff who have completed the on-line training who have asked for this feature of the programme to be made available again.” A number of staff who helped test the virtual experience said they that found the experience engaging and interactive. Features such as the chat box, videos and breakout rooms are used and learners spend more time ‘doing’ activities than in a traditional classroom setting. The virtual workshops are suitable for nine participants. Vicky Doyle, Senior Health Promotion/Improvement officer in Dublin North City and County and member of the working group, said, “This online two-hour workshop will create flexibility in accessing the training, allowing healthcare professionals to join different workshops that suit their schedule. This means they will not be required to leave a busy workplace or home to travel for the workshop.

It is convenient for teams to access and in turn create more buy in and implementation across the health care sites.”

For more information, see www.hse.ie/eng/about/who/healthwellbeing/makingevery-contact-count/training-programme/ The virtual workshops will be held by videoconferencing using Cisco WebEx or Microsoft Teams. The HSE provides training on both of these platforms on healthservice.hse.ie/staff/coronavirus/workingfrom-home/virtual-health/virtual-health.html Some 30 MECC Trainers nationally have been trained up to deliver this virtual workshop and will start to deliver them this year when the COVID situation improves.

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Corporate

INVESTING IN OUR PEOPLE THROUGH TECHNOLOGY National Estates Information System - Better Data, better decisions, better outcomes: Supporting the Sláintecare vision

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SE Estates are delighted to announce HSE Board approval of the National Estates Information System (NEIS) at the end of 2020. A contract was signed with IBM to deliver the system alongside a new dedicated NEIS Estates team of Product Owners, System Testers, Data Analysts and Change Managers. NEIS will deliver an Integrated Workplace Management System (IWMS) and Common Data Environment (CDE) which will transform how Estates does business both internally with our colleagues and externally with third parties. The NEIS will provide a digital solution to support Estates staff and the external professionals (architects, engineers, etc.) and contractors (building, mechanical, electrical etc.) who work with Estates. The NEIS project will be delivered in three phases, rolled out over a three year period, as set out below. Phase 1 will have close integration with the Integrated Financial Management System (IFMS) being implemented by our Finance colleagues.

• • • •

Phase 1A (August 2021) – Capital Projects & Construction Management Phase 1B (March 2022) - Maintenance Management Phase 2 (Q4 2022) - Real Estate & Space Management Phase 3 (Q4 2023) – Energy Management

Reaching the milestone project start date of February 1st 2021 has only been possible due to the significant work behind the scenes since 2018. This includes the Estates working group involved in scoping out requirements and the assessment of tenders with colleagues in OoCIO. The contribution by the Estates Implementation Groups to date is particularly acknowledged.

A special thanks to all those that have supported and taken the steps towards a new digital way of working within Estates.

NEIS OBJECTIVES

1 To make the delivery of modern, safe and appropriate healthcare facilities more efficient.

2 To enhance the experience for patients and service users in our healthcare facilities.

3 To improve information management and standardise workflow management and processes.

4 To facilitate timely, effective and accurate decision making and the production of key statistical information.

5 To support compliance with statutory and legal requirements.

NEIS BENEFITS • Improved productivity with business process automation.

• Improved data flow and collaboration across Estates offices.

• Reduced transaction costs and duplication.

• Real time project information and reporting.

• Digitalised information management to improve resource utilisation.

The NEIS team will be continuing to engage and communicate with all local Estates offices and staff and relevant external stakeholders to deliver NEIS, “a system for everyone”. We look forward to working with everyone on our new digital journey.

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Corporate

HR AND PAYROLL SYSTEM GOING LIVE

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National Integrated Staff Records & Pay Programme (NiSRP) goes live in HSE South East

AP HR and Payroll is a fully integrated system with HR information driving pay, providing a comprehensive view of staff information and stabilising payroll for HSE staff for years to come.

My HSE Self Service – NiSRP (previously known as NiSRP Self Service) is an online tool that allows employees view payslips, update their information and perform tasks such as submitting travel claims. The implementation of these systems is an important opportunity to deliver world-class business services across our health system. The NiSRP Programme Team continually reviews and analyses queries received by the NiSRP Helpdesk.

This process assists in the creation of new developments and new enhancing features on the system, which will ultimately lead to improved efficiencies for employees and managers. For example, the most recent enhancement to the system was the introduction of online help functionality delivering real time information and assistance on how to use different aspects of the system. NiSRP Programme Director, Miriam Keegan, said, “I would like to acknowledge the excellent work done by my team, in particularly difficult circumstances. I would also like to thank our Health Business Service colleagues, HSE managers, south east frontline staff and staff representative groups. Together we have completed a successful NiSRP implementation, in spite of

GOT QUESTIONS?

0818 300 296

significant constraints in a COVID-19 working environment. I am confident that the system will bring many benefits to staff and the HSE as a whole and am looking forward to our next implementation in HSE South.” As the pandemic hit, NiSRP had to rapidly adapt to a new and uncertain landscape in terms of the scheduled June 2020 go-live in HSE

South East. Paul Reid, CEO HSE noted, “The implementation of NiSRP in HSE South East is an extraordinary achievement in very difficult times. I think there’s a case study in this. In years to come anyone implementing change could read this to see how to keep the show on the road and get the project over the line.”

N iS RP S u p p o r t ava ila b le • Support for My HSE Self Service is available on www.hse.ie/nisrpselfservice, you will find a wealth of information here including videos, tutorials and step-by-step guides. Our colleagues SAP CoE also have a library of training materials if you require support with SAP HR and Payroll at http://hpsa. healthirl.net/moodle/ • All employees can access online interactive training on how to use My HSE Self Service on HSeLanD. • This eLearning course contains three modules for: 1) Employees 2) Managers and Approvers 3) Staff who travel for work purposes.

• The NiSRP Self Service Helpdesk continues to provide support for all staff in HSE East and South East. Call 0818 300 296 to speak to one of our helpdesk staff, or you can email hbs.nisrp@hse.ie.

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Education

LEADERSHIP & INNOVATION Students in the postgradute diploma programme are supported to identify and implement an innovative solution suitable for their workplace

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ealthcare is in accelerated disruption with the Internet of Things (IoT) at its core and driven by consumers. To survive this transition, leaders must apply innovative thinking and creative execution. Through the one-year course, Health Innovation Hub Ireland (HIHI) and TCD Postgraduate Diploma programme students are supported to develop a personal innovation framework for leadership.

Uniquely the course is clinician designed and led by Professor Seamas Donnelly (pictured above). Students are usually a mix of health industry, health sector and health policy, forming an action-focused learning community focused on accelerating change within their organisations.

Over the 12-month programme, students complete eight modules, have access to workshops, resources and events to share challenges and experience, learn from expert guest lecturers. Focusing on new health

solutions, students gain a practical understanding of applying new technologies in healthcare. Examining the role of health economics, quality improvement and the principles of governance in leading effective, innovative health services is a key learning.

The postgraduate course culminates with modules seven and eight focusing on a practical project comprising two phases.

Students are supported to identify and implement an innovative solution suitable for their workplace that will have a positive impact in Irish healthcare. A HSE and Enterprise Ireland partnership, HIHI holds a number of places for HSE scholarships, offering reduced fees. The aim is to reach right across levels, grades and disciplines in the health service, offering the academic opportunity to all. There are seven HSE scholarships available at reduced fees.

Course Director Prof Donnelly said, “Speaking as a clinician on the frontline, I know we need to adjust and reset some approaches in healthcare in Ireland and this postgraduate course is part of that effort.

Our students are confident and inspirational leaders, learning to create their personal innovation framework to apply in healthcare organisations. All of our students share a common vision of creating an innovative healthcare system to change the system and improve outcomes for patients. They come from both industry and the healthcare community and that is a unique aspect to this programme of study. Drawing leaders from across healthcare landscape to drive the healthcare innovation agenda.”

For more information contact: Nina Holmes – holmesni@tcd.ie or www.tcd.ie/medicine/clinical-medicine/postgraduate/healthcareinnovation. Delivered through the School of Medicine Trinity College Dublin, the Postgraduate Diploma in Healthcare Innovation is a one year NFQ level 9 (60 ECTS credits) course. Scholarship applications close: June 16th, 2021. All applications: June 30th.

THOSE IN THE KNOW

CAITRIONA HEFFERNAN, Cork University Hospital, 2020 graduate “Throughout my career, I have always been drawn to problem-solving and finding creative ways in which to improve patient experiences and patient outcomes.

Despite this internal drive, I found myself lacking in confidence around testing the viability of my ideas and structuring proposals to secure ‘buy in’ from essential stakeholders. The Post Gradate Diploma in Healthcare Innovation has taught me how to objectively analyse the potential of an idea using structured frameworks, how to accurately define the problem to be solved and the importance of end user involvement right from the concept stage.

It has given me the opportunity to develop and practice my skills in pitching an idea to key decisions makers in a professional and informed manner. It has also afforded me the opportunity to develop a ‘real life’ idea from initial concept to full implementation over the course of the program.”

JOHN KELLY, Deputy CEO, Tallaght University Hospital, Current student 2021 “I am completing the Postgraduate Diploma in Innovation Healthcare to provide me with the opportunity to enhance my knowledge and skills to assist me to embed a culture of innovation in a large teaching hospital. To make innovation core business for our hospital we need to create an organisational readiness for innovation. This means developing leaders, building improvement skills across the organisation, support for new thinking and creating opportunities of time and space for all staff. Having completed four modules to date it has further developed my own innovation ‘tool kit’, broadening my learning in design thinking and process innovation.”

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Education

Infection prevention and control and antimicrobial stewardship New e-learning programme launched

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he HSE’s national Antimicrobial Resistance and Infection Control team (AMRIC) has developed a new infection prevention and control/ antimicrobial stewardship (IPC/ AMS) e-learning foundation programme for all health and social care workers. This will help staff and services throughout the HSE to easily sign up for this new (IPC/ AMS) learning course. The new course is a major boost to staff development as it is an easy to use, accessible course that is open to all healthcare staff. The programme consists of 8 courses and is hosted on HSeLanD; it is highly interactive throughout and developed using best practice in learning design. The course was developed to support staff throughout the services across multiple settings. This initial suite of resources developed will meet the immediate IPC learning needs of staff. The free online course is very practical and it aims to enable staff to apply the learning to their own work. The eight courses are aligned to the HSE’s Interim Infection Prevention and Control Guidance and its framework 2020. Each course includes assessments and extend my learning pieces for those who wish to do further learning on the courses. The courses have been accredited by the Nursing & Midwifery Board of Ireland for nursing professional development and the Royal College of Physicians of Ireland has also accredited the programme with continuous professional development points (NMBI gives 7 points and RCPI awards 14 points). Staff will receive credit for each course when it is completed and do not have to complete all eightcourses.

COURSES The 8 courses are live on HSeLanD and include: 1 Infection prevention and control and antimicrobial stewardship explainer (no credits) 2 Basics of infection prevention and control and antimicrobial stewardship 3 Hand hygiene 4 Standard and transmission based precautions 5 Anti-microbial stewardship 6 Personal protective equipment 7 Respiratory hygiene and cough etiquette 8 Aseptic technique

The individual courses enable the learner to learn the principles of IPC/AMS as set out below:

Introduction to IPC/AMS (explainer) • The drive towards IPC in the health services.

• The need to involve the patient in their own care Basics of IPC/AMS • Identify and analyse risks of infection in the healthcare setting.

• Recognise how a risk-management approach can help prevent infection.

• Make on-the-spot IPC risk assessments in your day-to-day work.

Hand hygiene • Why hand hygiene is important.

• When to practice hand hygiene.

• How to perform hand hygiene in line with the WHO 5 Moments.

• How to take care of your hands.

Personal protective equipment (PPE) • Identify why you need to wear PPE and where they need to wear it.

• Recognise the appropriate PPE to wear to protect the body, face and eyes, and hands in different situations.

• Put on and remove all PPE in acute and non-acute settings.

• Dispose of used PPE safely.

• Reflect on your own actions and behaviours in relation to PPE and infection prevention and control.

Respiratory hygiene and cough etiquette • Describe the importance of respiratory hygiene and cough etiquette in preventing the transmission of respiratory illness.

• Use the correct procedures to prevent the spread of a respiratory infection within a healthcare setting.

• Educate patients on how they can protect themselves and others from a respiratory infection, assisting them if they can’t do this for themselves.

Standard and transmission-based precautions • Continually assess the risk of infection spread within your workplace.

• Identify and apply appropriate standard precautions.

• Identify and apply appropriate transmission-based precautions.

• Reflect on your own actions and behaviours in relation to infection prevention and control.

• Encourage colleagues and service users to recognise that infection prevention and control is central to their duty of care.

Antimicrobial stewardship • Explain the principles of antimicrobial stewardship to a person in your care.

• Recognise the signs and symptoms of a clinically significant bacterial infection.

• Prescribe the appropriate antimicrobial to optimise a clinical cure and reduce the chance of harm.

• Administer the appropriate antimicrobials for a person using the most appropriate method.

• Use identified tools and resources in your setting to support best practice antimicrobial stewardship.

If you would like further information on this new course or want more information on infection prevention and control please contact the AMRIC team hcai.amrteam@hse.ie Stay up-to-date with IPC guidance by checking out www.hpsc.ie or watch our most recent information webinars.

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Lifestyle

Healthy Habits

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START campaign encourages parents to add a healthy habit to family time

he pandemic has brought a lot of restrictions to our life but it has had some upsides. Spending more time together as a family has been one of the benefits of COVID-19 lockdowns. Research by Behaviour and Attitudes found that 86% of people value their family life more now than before the pandemic began. The START campaign from safefood, the HSE and Healthy Ireland encourages parents to consider this increased family time as an opportunity to add a healthy habit.

Research for the START campaign found that approximately 50% of parents found it difficult to manage screen usage, treat consumption and physical activity since COVID-19 began. Options to using family time to begin a healthy habit could include getting children more involved with meal time preparation or making healthy snacks with their parents. Putting screens away in favour of

NMH HOLLESTIC APP

indoor play or getting out safely and actively together as a family could also help.

Sarah O’Brien, National Lead, Healthy Eating and Active Living Programme said, “Since March we have been regularly checking in with people in relation to COVID-19, how they feel about it and how it affects their lives. The most recent reports tell us that around half of parents surveyed find it challenging to manage children’s diet, physical activity and screen-time.

“Taking small steps to build changes into how we spend time together either by cooking family meals or putting on the rain coats and getting out to play with the children, regardless of the weather, can pave the way for spending less time on the couch in front of a TV or other screens. It’s difficult but it will be beneficial to every family’s health. As part of the START campaign, we have really good help and useful resources for parents at www.makeastart.ie.”

It’s hard to stay focused on healthy eating during pregnancy – especially if you are craving a sugary doughnut. But help is at hand with the National Maternity Hospital’s new app Hollestic, designed to support women to achieve optimum nutrition through the access of up to 100 healthy, easy-touse recipes for meals and snacks, which are all scientifically backed.

This is the first app of its kind in Ireland, which is available to download for free on the App store and Google Playstore.

Researchers at the UCD Perinatal Research

DID YOU KNOW OF PEOPLE VALUE THEIR FAMILY LIFE MORE NOW THAN BEFORE THE PANDEMIC BEGAN

For further information on the START Campaign visit: makeastart.ie

Centre combined forces with dietitians at NMH to translate the scientific evidence for good nutrition in pregnancy into an easy-to-use, free and accessible App. Prof Fionnuala McAuliffe, Director of the UCD Perinatal Research Centre and consultant obstetrician at NMH said, “The Hollestic app is a lovely, real example of how clinical research has translated into a valuable resource for all our pregnant women. Certainly in the current climate, apps like this have an even more important role to play as access to dietitians and antenatal classes

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Lifestyle

Screens and Greens The online gardening group boosting mental health What better way to boost your mental health and wellbeing than going out into nature and getting your hands dirty?

‘Screens and Greens’ is an online gardening group devised by the occupational therapy service in Millmount Community Mental Health Team, Dublin North City Mental Health Service, that is giving its enthusiastic participants a chance for some stress relief and calm.

The group is facilitated by Niall Kirrane, an occupational therapist with Millmount Community Mental Health Team, and Occupational Therapy student David Kehoe, Trinity College Dublin. It ran for six weeks throughout November and December 2020, with continued attendance from its enthusiastic participants.

Niall outlined how it came about.

“We designed the group in response to COVID-19 restrictions, which meant that an existing gardening group in a local community garden had to be postponed. Instead, they decided to take the group online, meaning that they could still meet weekly and engage in enjoyable gardening tasks, despite COVID-19 restrictions, or the winter weather.”

The aims of the group were to offer service-users opportunities to: • Engage in meaningful and enjoyable occupation during lockdown • Reconnect with nature despite the time of year and ongoing restrictions • Maintain social interactions in a safe and COVID-19 compliant way One of the group remarked that engaging online was “equal to doing it in a classroom, if not better!”

The group was run using the online platform WebEx, meaning people could log on from

the comfort of their own homes. Each week they focused on a new gardening task that could be easily completed at home, using affordable materials, often up-cycling household waste such as plastic bottles.

“Over the six weeks we planted lettuce, grew a variety of herbs, learned how to propagate plants from seeds, and even made bird feeders to attract more wildlife into our outdoor spaces. These tasks were carefully selected to ensure that everyone could participate in them, regardless of whether they had a garden, balcony, or window sill. The valued working relationship with Muck and Magic Community Garden in Ballymun was also maintained, thanks to very informative guest lectures provided by Horticulturalist, Stephen Hayden,” explained Niall.

The team in Millmount remain hopeful of returning to the community garden at some point this year, but in the meantime online alternatives will continue to be explored and utilised.

Welcoming the innovative approach adopted, Mellany McLoone, Chief Officer CHODNCC, added, “It is positive to see

continue to be restricted by COVID-19”.

The app was originally trialled in an internationally recognised, randomised control study of over 500 pregnant women at NMH with the aim of improving nutrition and pregnancy outcomes. Following this study, the app was upgraded with beautiful imagery, top tips for pregnancy and a baby size tracker.

Dr Eileen O’Brien, senior dietitian, NMH, said, “With the ever-increasing amount of pregnancy and nutritional advice available and the added challenges posed by COVID-19, choosing three healthy meals and two to three snacks can be overwhelming, especially

The group worked on making DIY bird feeders and self-watering herbs, among many other garden projects.

technology being used to support service users staying in touch during COVID-19. While we are all living closer to our homes, it is great to utilise our space, whether it’s a balcony or garden, and from what I hear the participants in this initiative found the advice provided by professionals alongside the peer support extremely useful. I’m very proud of all the participants and the facilitators for making this happen.”

for new mums. The app is a direct result of collaborative work designed to equip women with easy and nourishing recipes, which are enjoyable to cook and have been approved by mums, dietitians, obstetricians, and midwives. Hollestic aims to act as a guide, support and motivator for women and their families, helping to ensure dietary needs are met during pregnancy and giving baby the best nutritional start in life.”

The Hollestic App can be downloaded on the App Store or Google Play Store. More information is available at nmh.ie/hollestic

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Lifestyle

Lifting Staff Spirits The need to lift the spirits of staff who were working so hard during the COVID-19 pandemic was recognised by the Sports and Social Club committee at University Hospital Kerry, who came up with the novel idea of UHKOVISION Song Contest 2020.

Committee member Sean O’Dowd thought that it would be a great way to boost morale in the 50th anniversary year of Irish singer Dana’s win with ‘All Kinds of Everything’.

Staff were invited to dress up and post a video via WhatsApp of a song from Eurovision or otherwise, individually or in a group while maintain social distancing.

The entries were uploaded to the sports and social club Facebook page and all performances were streamed live over a two-hour period for staff to view and enjoy. It was a huge success and staff totally enjoyed it as did all who posted video performances on the day.

There was four categories best individual, male, female and group. It brought much needed enjoyment, laughs and a sense of normality in very difficult times.

The Sports and Social Club has always and continues to be a unique avenue for staff to get to know each other through the activities or events organised. It helps to break down barriers of communication between the various disciplines of healthcare professionals and support staff, allowing for friendships and relationships to develop.

In 2017, a newly formed Sports & Social Club committee was deployed, having reviewed the direction the club was going and realising how multi-cultural the various levels of staff that formed the multi-disciplinary team employed by the hospital had become, a different approach was required to attract new members, while maintain the interest of current members.

They have since held a series of hugely successful fundraising events – starting with the inaugural University Hospital Kerry Sickly Come Dancing event in 2018. The event was a huge success and over €70,000 was raised. University Hospital Kerry’s Got Talent in 2019 raised a further €30,000.

The COVID-19 pandemic led to the cancellation of the 2020 Sickly Come Dancing – the Relapse.

Even though the events doubled as fundraising events, the main purpose the committee organised such events was as always with the purpose of bringing staff together in a social environment, increasing morale while offering an entertaining night out.

The success of the sports and social club within the hospital is due to the relationship that exists between all levels of the multidisciplinary team that come together to socialise within or outside the hospital, to help staff to get to know each other, lift morale and enjoy themselves. As long as that relationship exists so too will the Sports and Social Club Committee.

Pictured: UHK Sports and Social Club Committee: (l-r) Cora Walsh, Paul McCarthy, Mairead Enright, Sean O’Dowd, Therese O’Carroll and David Hobbert.

Virtual Cycling There was nothing virtual about the effort put into their exercise by service users of KARE Adult Services’ online cycling club.

Set up in response to the COVID-19 restrictions, the virtual group has helped to support new learning, social connections and positive wellbeing.

Positive outcomes for participants included participant satisfaction with how the group was presented and delivered each week, increased social connections, increased participation in a physical activity (cycling), increased understanding of the rules of the road and bike maintenance, increased time outdoors and a sense of structure/ routine to their day.

One participant completed a 5k cycle for charity. She noted that group motivated her to exercise and enabled her to have a greater road awareness during this 5k, for example being aware of the difference between pedestrian crossing and traffic lights.

Due to the COVID-19 restrictions, the Adult Clinical Support Team in KARE started to facilitate virtual therapy groups for service users to support their engagement in meaningful occupations, promote structure in their routines, have fun and to enable them to build social connections with other service users in these isolating times.

The cycling group was facilitated by the Occupational Therapist and Speech and Language Therapist, with this multi-disciplinary collaboration supporting graded occupational engagement accessible through appropriate communication strategies and socialisation for group members.

The cycling group took place in an online capacity using Microsoft Teams.

The group focused on set topics weekly over an eight-week period.

Topics included benefits of cycling, bike maintenance and rules of the road.

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Lifestyle

Our Stories Pictured here are Lori (Genetics) and Orla (Occupational Therapy Department) looking at their conversation turned into art.

A few simple conversations has been turned into a wall of magnificent for the patients, staff and visitors of three children’s hospitals to enjoy Our Stories is a series of artworks by John Conway which were inspired by the artist’s conversations with staff of Children’s Health Ireland (CHI) at Crumlin, Tallaght and Temple Street in 2019 during which they reflected on their workplaces and the role art plays in normalising the space for children.

In 2019, the CHI Arts in Health programme began working with the CHI Organisational Development Team to consider how to create a space for staff to celebrate the existing hospitals and their unique cultures before the big move. John was invited to meet with the staff in an informal way and these conversations inspired ‘Our Stories’ a series of nine risographic printed artworks. A full set of these works now hang in each CHI hospital and in Connolly Outpatient and Urgent Care Centre.

This series of artworks is a celebration of the stories and perspectives of CHI staff in relation to their workplace, and the role art can play within it. It is hoped that they will inspire new conversations and memories, as we move forward together to the new children’s hospital.

“When we first embarked on this project, we had no idea what the outcome would be but we were delighted when John proposed the creation of such child-friendly artworks based on those things staff said to him. Of the many interesting comments staff made about their working environments, we selected those things that prompted specific imagery and we are delighted with the results, said Mary Grehan, CHI Arts in Health Curator.

In the words of the artist John Conway, “Artists often have the unique privilege of being able to visit interesting and complicated spaces; observing and taking the pulse. I was very much welcomed by all the CHI staff I met through this project. They gave me an insight into working cultures across the different CHI sites. I got an understanding of what art does at the coal face in an acute health setting. The way art works for staff and children can be very different to how artists might expect.”

The project was funded by Children’s Health Ireland and Dublin City Council Culture Company's Engage The City programme.

Nature at work The Healthy Ireland committee at St Columcille’s Hospital found a unique way to support staff emotionally and spiritually.

Committee member Liz Murray said that the COVID-19 pandemic meant that she could no longer offer her eco/ mindful lunchtime walk series. Instead, a wonderful project emerged to fill the gap left during these difficult times.

“We thought it would be a nice idea to bring staff and patients a little bit of peace and hope during the difficult weeks. Over the weeks we brought staff some images, little video clips and reflections from the woodlands and other areas on the hospital grounds. It gave us the chance to see how Mother Nature is busy outside while we are all working away indoors,” said Liz. “We marked the passing of time in nature on the grounds of the hospital with intentional acts of kindness - as opposed to random. Once every week we create a laminated card with an image on one side and text on the reverse. These were displayed in the staff canteen and circulated in the weekly hospital newsletter,” said Liz. She worked with speech and language therapist Rachel Moore on the project.

“Each image was taken by myself or Rachel, and we collaborated on text and image selection.”

They did this for a full 20 weeks in 2020.

“I was very glad to be working with Liz on behalf of the SCH Healthy Ireland committee to bring the staff and patients of St Columcille’s some messages of hope from the natural sanctuaries that lie within the hospital grounds,” added Rachel.

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As They Blossomed: New poetry collection published by Magic Box Writing Group and Waterford Healing Arts Trust A group of 13 writers accessing mental health services have put pen to paper to create a wonderful new book of poems.

‘As They Blossomed’, a new poetry collection

by Magic Box Writing Group, edited by Lani O’Hanlon, has just been published by Waterford Healing Arts Trust. The first publication by Magic Box Writing Group, As They Blossomed features 37 poems reflecting each writer’s observations on life and experience and is available from Waterford Healing Arts Trust, cost €10.

The Magic Box Writing Group consists of writers accessing the mental health rehabilitation and recovery services in Waterford. Writer and movement artist Lani has been working with this group over the last six years through the Iontas arts and mental health programme, which aims to support wellbeing and recovery through person-centred arts experiences, such as visual art, music, drama, dance and writing.

Iontas is run by Waterford Healing Arts Trust in partnership with the Waterford Wexford Mental Health Services and takes place in eight mental health settings in Waterford.

“Many of these poems were crafted over time, one line at a time. The reader might want to take some time to read more slowly in order to appreciate the day by day, sensual details of a life… Each of these writers experiences the world in a unique and rare way. I hope that you can slow down, breathe, and enjoy their poems,” said Lani in her foreword to

Pictured: Back row: Anna Maria Dowling, Social Worker; Lisa Grant, Assistant Director of Nursing; Dr Darina Sloan, Consultant Psychiatrist; Dr Leona Moore.

Front row: Lesley Power, Clinical Nurse Manager; Lani O’Hanlon, Writer; Eilish Hartney, Occupational Therapist; and Paul Hartney, Clinical Psychologist.

‘As They Blossomed’.

Dr Darina Sloan, Consultant Psychiatrist with the HSE/South East Community Healthcare’s Waterford Mental Health Recovery and Rehabilitation services, added, “We are immensely proud of the Magic Box Writing Group in creating this work over the past six years with the support of writer Lani O’Hanlon. The publication of As They Blossomed marks a significant achievement for each contributing writer and adds to the legacy of the Iontas Arts and Mental Health programme.”

The Iontas Arts and Mental Health programme is funded by Waterford Wexford Mental Health Services and the Arts Council, and is one of many arts experiences which Waterford Healing Arts Trust (WHAT) brings to UHW and the wider community to alleviate stress and anxiety and to support creativity.

For more info, see waterfordhealingarts.com

Creative arts therapy There has been increasing interest in the development of creative arts therapies in Ireland and within the HSE. Permanent posts have been created in the areas of disabilities, rehabilitation, mental health and older persons’ care.

There has been an increase in qualified creative arts therapists and the Irish Association of Creative Arts Therapists (IACAT) has more than 250 members.

There are creative arts therapists working in a variety of health settings including the National Rehabilitation Hospital; the Adelaide and Meath Hospital Dublin, incorporating the National Children’s Hospital (AMNCH); St Patrick’s University Hospital; Crumlin Children’s Hospital; Our Lady’s Hospice; Milford Care Centre; Cheeverstown House; Enable Ireland; Cope Foundation; Bluebox; ChildVision; HSE mental health services and older persons’ services; as well as many other health, educational and social care settings.

Creative arts therapists are working across the HSE in numerous services, but they do not have a designated grade or pay structure.

Bill Ahessy trained as a music therapist in Australia and Spain. He works with children with emotional and behavioural disorders, visual impairment and multiple disabilities and with older adults with dementia and mental illness, at the Meath Community Unit, The Mater School, and ChildVision: National Education Centre for Blind Children. Bill is a council member of the Irish Association of Creative Arts Therapists.

“Creative arts therapies are evidencebased health professions practiced throughout Ireland and in more than 40 countries around the world. The term includes four professions: art therapy, dramatherapy, dance movement therapy and music therapy,” he explained.

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Rain into Sunshine A film-making project has given a group of young adults the chance to channel their inner Steven Spielberg.

‘Rain into Sunshine’, a filmmaking group in Dublin North City, was set up by Charlotte O’Connor, a senior occupational therapist on the Finglas Community Mental Health Team, as part of the Dublin North City Mental Health Service.

Before becoming an occupational therapist, Charlotte worked in film and television and has always been passionate about the potential of using filmmaking in a therapeutic setting.

“It was fortuitous that in my current role, through support of the occupational therapy managers, multi-disciplinary team members and funding opportunities through the Service Reform Fund, I was able to bring the idea to fruition. Through my previous experience I was able to identify an appropriate filmmaking tutor - Colm Mullen- to co-facilitate the group,” explained Charlotte.

The group members were younger adults who were linked with the mental health service. Some participants had limited engagement with meaningful activities and roles at the time of starting the group. In order to keep the group as person-centred as possible, participants were consulted at each stage of the project regarding the approaches used.

There were nine weekly sessions. The focus was on developing practical skills and having the opportunity to develop self-confidence and social skills. The participants decided to use the process of stop motion animation to create three short animations based on the elements of personal mental health recovery, including connectedness, hope and optimism, identity, meaning and empowerment.

“Participants were given the opportunity for self-expression and exploration of their mental health experiences in a safe environment. A screening of the work carried out by the participants took place in early 2020; there was also an exhibition of photography pieces created by the group.

Some of the images from the filmmaking group's short animation projects.

This was a really appealing and poignant way to acknowledge the varied work carried out by the group,” said Charlotte.

“Some participants had experienced disruption to age appropriate roles (student/ worker) due to mental ill health and it was evident that the group provided the opportunity for building confidence to re-engage with such roles.”

One participant is now enrolled on a Film Production degree programme; they directly attribute their participation in the group to being successful in applying to third level education. Other participants are completing CE scheme programmes and other further education opportunities.

When asked how the group influenced applying for third level education one participant commented, “Oh yeah, 100% [it helped] with confidence… I can do something if I focus.”

Charlotte is currently in the process of carrying out research on the project, which

will help with developing future projects.

Several participants identified they would be really interested in taking part in similar projects in the future. It is hoped that this will be possible when the current COVID-19 situation is resolved.

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Play on...

We are learning more and more about the benefits of music for elderly people and those living with dementia.

Bill Ahessy, senior music therapist, and his fellow music therapist Susan Hurley, held a number of concerts during May and June 2020 for residents at the Meath Community Unit. Lots of residents were able to attend and others got a bird’s eye view from the upper floors.

One of the residents, Nancy, was the subject of one of the songs performed at the concert.

Student music therapist Ella Millet co-composed the song with Nancy during musical therapy sessions.

In the midst of the COVID-19 restrictions, the concert was a wonderful way to boost the moods of the residents and there was lots of positive feedback from the residents.

Bill, who works at the unit providing musical therapy, has carried out a study that has highlighted that reminiscence-focused music therapy can promote positive mood and engagement and shared interaction for people living with dementia.

His study was sparked by the observing increased levels of mood, engagement and alertness that residents experienced when they attended a therapeutic choir in contrast to standard care.

Five themed sessions were planned for the programme. The themes included: Christmas, Spirituality, Autumn, Going to Dances, and Childhood.

Reminiscence occurred in all five sessions and was most observed (32%) in the Childhood-themed session. This was followed by Going to Dances (29%), Christmas (22%) and Autumn (20%) and ‘Spirituality’ (14%). Across the five sessions, much of the reminiscence shared was from childhood, adolescents and younger years with happy memories of playing games on the street or dancing with a boyfriend, early working days, as well as more difficult memories of being disciplined in school or a mother’s death.

This study demonstrated that the focused combination of both music therapy and reminiscence is an effective way of promoting positive mood and engagement levels, shared interaction and reminiscence for people with dementia.

Music therapists Susan Hurley and Bill Ahessy perform during the concert.

Staff Choir The HSE Staff Choir Concert brought an abundance of festive spirit to workplaces across the country this week, filling the gap left by a lack of the usual Christmas gatherings.

The memorable event was delivered via Zoom, with 400 logging on to watch it live and over 700 have already viewed the recording on YouTube. Such was the interest that #Sing4healthyireland was trending on Twitter.

There were amazing performances from staff choirs from Ennis, Naas, Cork, Carlow, The Coombe and St James’s Hospital along with National Ambulance Service Band, Dublin Gospel Choir and Michael Moloney, who sang on the Late Late Toy Show. A host of staff members from across the

health service also came together virtually to sing an incredible rendition of ‘Bridge Over Troubled Water’.

This third annual Staff Choir Concert hosted by HSE Health and Wellbeing was obviously much different and more challenging than the previous two as it was a virtual event. Choirs, who had been meeting and practicing virtually, recorded the performances in their own homes As well as stunning vocal talent, staff were able to showcase the breadth of musical talent across a huge range of instruments.

There are currently 16 HSE choirs up and running across the organisation.

Watch the performance now at https:// youtu.be/N9WBwkH6-VQ

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Stay safe during breaktime.

Coronavirus COVID-19 Public Health Advice

Sit alone or maintain a distance of 1 metre from others, both inside and outside.

15 MIN

Remove your mask for eating ONLY and limit this to 15 minutes. (set a reminder on your phone)

After break, dispose of used mask appropriately & perform hand hygiene; apply a clean mask.

Ensure that your break area is well ventilated.

Remember to wipe down the surface after your break.

Stay safe. Protect each other.

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EAPandME Employee Assistance Programme

Any of us can feel burdened by a life or work problem.

The HSE Employee Assistance Programme provides a free and confidential counselling service you can contact at any time.

Call

0818 327 327 to speak to someone who can help.

Go to https://www.inspiresupporthub.org/HSE-EAPandME to access our online hub of helpful resources

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