Journal articles on the topic 'Medical policy – Ireland'
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McKernan, David, and Olivia McDermott. "The Evolution of Ireland’s Medical Device Cluster and Its Future Direction." Sustainability 14, no. 16 (August 16, 2022): 10166. http://dx.doi.org/10.3390/su141610166.
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Ireland has developed a highly successful medical device cluster. Most of the industry started from USA multinationals that moved to Ireland in the 1990s. An ecosystem has now developed with strong linkages between universities, start-ups, multinationals, venture capital, suppliers, and supporting industries. This paper explores the Medical Device cluster in Ireland. It characterizes the industry through the companies, innovation, products, markets, and regulatory framework. It concludes that the Irish MedTech industry is successful but has been highly dependent on USA multinationals that established themselves here in the 1990s. Based on this, we summarize the opportunities and threats the industry now faces. This is one of the first studies that categorized the MedTech industry in Ireland. This study will provide valuable insights to aid government policy to sustain the medical device cluster in Ireland as well as provide insights into other countries.
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Davidson, Hope. "The Vexed Question of the Voluntary Patient." European Journal of Health Law 26, no. 3 (June 19, 2019): 205–20. http://dx.doi.org/10.1163/15718093-12261426.
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Abstract The current statutory framework in Ireland provides certain key safeguards for people who are admitted involuntarily for mental health treatment and care; the same legislation makes scant reference to the person who seeks treatment and care on a voluntary basis. This has led to concerns in relation to deprivation of liberty and to non-consensual medical treatment for these patients. This article seeks to examine the development of the law in relation to voluntary patients in Ireland and to assess in light of recent developments where Ireland now stands in terms of protecting the right of the voluntary patient to liberty.
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Whelan, Darius. "Application of the Paternalism Principle to Constitutional Rights: Mental Health Case-Law in Ireland." European Journal of Health Law 28, no. 3 (June 11, 2021): 223–43. http://dx.doi.org/10.1163/15718093-bja10047.
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Abstract In adjudicating on matters relating to fundamental constitutional or human rights, courts make important statements about the principles which apply. The principles articulated will have a profound impact on the outcomes of such cases, and on the development of case-law in the relevant field. In the fields of medical law and mental health law, various courts have moved away from deference to medical decision-making and paternalism to a person-centred rights-based approach. However, courts in Ireland have continued to interpret mental health law in a paternalistic fashion, praising paternalism as if it is particularly suitable for mental health law. This raises profound questions about judicial attitudes to people with mental health conditions and judicial reluctance to confer full personhood on people with disabilities. This article outlines case-law in Ireland regarding paternalism in mental health law and discusses the consequences for constitutional rights in Ireland.
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Sheikh, Asim. "Ireland and Medical Research with Minors: Some Medico-Legal Aspects." European Journal of Health Law 15, no. 2 (2008): 169–81. http://dx.doi.org/10.1163/157180908x322978.
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AbstractThe practice of medical research with minors in Ireland consist of practices pertaining to therapeutic and non-therapeutic medical research. Clinical trials (a category of therapeutic research), is governed by legislation. However, any other therapeutic research (non-clinical trials research) and non-therapeutic research, e.g. observational medical research such as a longitudinal study of children or non-therapeutic research such as blood sample collection for analysis of cause of disease, are unregulated by legislation. This, article will outline and describe some of the medico-legal issues involved in both types of research and will comment on matters such as what national law exists, how the directive on good clinical practice has been implemented, what guidelines, if any, exist.
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Mishtal, Joanna, Karli Reeves, Dyuti Chakravarty, Lorraine Grimes, Bianca Stifani, Wendy Chavkin, Deirdre Duffy, et al. "Abortion policy implementation in Ireland: Lessons from the community model of care." PLOS ONE 17, no. 5 (May 9, 2022): e0264494. http://dx.doi.org/10.1371/journal.pone.0264494.
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Background In 2018, the right to lawful abortion in the Republic of Ireland significantly expanded, and service provision commenced on 1 January, 2019. Community provision of early medical abortion to 9 weeks plus 6 days gestation delivered by General Practitioners constitutes the backbone of the Irish abortion policy implementation. We conducted a study in 2020–2021 to examine the barriers and facilitators of the Irish abortion policy implementation. Methods We collected data using qualitative in-depth interviews (IDIs) which were conducted in-person or remotely. We coded and analysed interview transcripts following the grounded theory approach. Results We collected 108 IDIs in Ireland from May 2020 to March 2021. This article draws on 79 IDIs with three participant samples directly relevant to the community model of care: (a) 27 key informants involved in the abortion policy development and implementation representing government healthcare administration, medical professionals, and advocacy organisations, (b) 22 healthcare providers involved in abortion provision in community settings, and (c) 30 service users who sought abortion services in 2020. Facilitators of community-based abortion provision have been: a collaborative approach between the Irish government and the medical community to develop the model of care, and strong support systems for providers. The MyOptions helpline for service users is a successful national referral model. The main barriers to provision are the mandatory 3-day wait, unclear or slow referral pathways from primary to hospital care, barriers for migrants, and a shortage and incomplete geographic distribution of providers, especially in rural areas. Conclusions We conclude that access to abortion care in Ireland has been greatly expanded since the policy implementation in 2019. The community delivery of care and the national helpline constitute key features of the Irish abortion policy implementation that could be duplicated in other contexts and countries. Several challenges to full abortion policy implementation remain.
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Balyk, Olexandr, James Glynn, Vahid Aryanpur, Ankita Gaur, Jason McGuire, Andrew Smith, Xiufeng Yue, and Hannah Daly. "TIM: modelling pathways to meet Ireland's long-term energy system challenges with the TIMES-Ireland Model (v1.0)." Geoscientific Model Development 15, no. 12 (June 29, 2022): 4991–5019. http://dx.doi.org/10.5194/gmd-15-4991-2022.
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Abstract. Ireland has significantly increased its climate mitigation ambition, with a recent government commitment to reduce greenhouse gases by an average of 7 % yr−1 in the period to 2030 and a net-zero target for 2050, underpinned by a series of 5-year carbon budgets. Energy systems optimisation modelling (ESOM) is a widely used tool to inform pathways to address long-term energy challenges. This article describes a new ESOM developed to inform Ireland's energy system decarbonisation challenge. The TIMES-Ireland Model (TIM) is an optimisation model of the Irish energy system, which calculates the cost-optimal fuel and technology mix to meet future energy service demands in the transport, buildings, industry, and agriculture sectors, while respecting constraints in greenhouse gas emissions, primary energy resources, and feasible deployment rates. TIM is developed to take into account Ireland's unique energy system context, including a very high potential for offshore wind energy and the challenge of integrating this on a relatively isolated grid, a very ambitious decarbonisation target in the period to 2030, the policy need to inform 5-year carbon budgets to meet policy targets, and the challenge of decarbonising heat in the context of low building stock thermal efficiency and high reliance on fossil fuels. To that end, model features of note include future-proofing with flexible temporal and spatial definitions, with a possible hourly time resolution, unit commitment and capacity expansion features in the power sector, residential and passenger transport underpinned by detailed bottom-up sectoral models, cross-model harmonisation, and soft-linking with demand and macro models. The paper also outlines a priority list of future model developments to better meet the challenge of deeply decarbonising energy supply and demand, taking into account the equity, cost-effectiveness, and technical feasibility. To support transparency and openness in decision-making, TIM is available to download under a Creative Commons licence.
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Ahern, Frank, and Nessa O'Doherty. "HEALTH TECHNOLOGY ASSESSMENT IN IRELAND." International Journal of Technology Assessment in Health Care 16, no. 2 (April 2000): 449–58. http://dx.doi.org/10.1017/s0266462300101096.
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Ireland's health system is primarily funded from general taxation and is publicly provided, although private health care retains a considerable role. It is a unique structure, a mixture of universal health service free at the point of consumption and a fee-based private system where individuals subscribe to private health insurance that covers some of their medical expenses. The recent history of the Irish health services saw consolidation of existing services and an expansion into new areas to adapt to changing practices and needs. There has also been a drive to extract maximum efficiency so as to maintain the volume and quality of patient services at a time of very tight financial constraints. Introduction of new health technologies continued to accelerate. New technologies tended to spread rapidly before systematic appraisal of their costs and benefits. When the state is involved in funding the public hospital system, acceptance of new technology is a matter for discussion between agencies and the Department of Health and Children. Decisions about spending annual “development funding” have generally not been based on careful assessment of proposals for new technology. In 1995, a healthcare reform put new Public Health Departments in Health Boards in a prime position in Ireland's health services organization. These departments now emphasize evidence-based medicine. While Ireland does not have a national health technology assessment (HTA) program, there are plans to form an advisory group on HTA in 1998. HTA is seen as a significant element of future health policy in Ireland.
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Dooley, Dolores. "Medical Ethics in Ireland: A Decade of Change." Hastings Center Report 21, no. 1 (January 1991): 18. http://dx.doi.org/10.2307/3563341.
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Brown, J., A. Hogg, C. Scullin, G. Fleming, and M. Scott. "7-Steps medication reviews: analysis of medicine changes in acute medical wards." International Journal of Pharmacy Practice 30, Supplement_2 (November 30, 2022): ii7—ii8. http://dx.doi.org/10.1093/ijpp/riac089.007.
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Abstract Introduction In Northern Ireland, medication errors cause 20 patient deaths, lead to around 800 non-elective hospital admissions and cost £1.9 million annually.1 The iSIMPATHY (implementing Stimulating Innovation in the Management of Polypharmacy and Adherence Through the Years) project is an EU-funded partnership between Scotland, Ireland and Northern Ireland delivering medication reviews using the 7-Steps medication review tool and asking ‘what matters to you?’ 2 The iSIMPATHY 7-Steps review is a new research study in Northern Ireland. Aim To identify medicine changes made by an independent prescribing pharmacist during 7-Steps medication reviews. Method Medication reviews were delivered on acute medical wards in the Northern Health and Social Care Trust. No patients were excluded from reviews, however reviews were targeted at patients aged 50 years and older and resident in a care home, approaching the end of their lives, prescribed 10 or more medicines or on high-risk medication. Data on medication changes made during 192 medication reviews was collected and analysed to identify the numbers and types of medicines stopped, started and doses altered. Ethical approval was not required, an approved Data Protection Impact Assessment was in place. Results Mean number of medicines per patient pre- and post-review were 12.2 and 12.3 respectively. Medicines were stopped in 49% of patients, dose decreased in 36%, changed to a more appropriate medicine in 15%, dose increased in 15% and new medicines started in 55%. Medicines stopped included opioids and gabapentenoids (18%), nutritional and electrolyte supplements (15%), items for comfort (9%), antidepressants (including amitriptyline for pain) (10%), antihypertensives and diuretics (8%), bladder anticholinergics and mirabegron (5%), laxatives (4%), betahistine (3%), quinine (2%). Dose decreases were made for analgesics including opioids (28%), PPI/H2RA (23%), anticoagulants (13%), statins and fibrates (6%), antihypertensives (6%), benzodiazepines and z-drugs (5%), antidiabetics (3%). Dose increases were made for anticoagulants and items for comfort (both 26%), laxatives (24%), pancreatin (15%), nutritional and electrolyte supplements (9%). Medicines started included nutritional and electrolyte supplements (45%), medicines for comfort (19%), laxatives (15%), nicotine replacement (7%), PPI/H2RA (2%), bisphosphonates (2%). Discussion/Conclusion The 7-STEPS medicine reviews led to important medicine changes while the number of medicines following review remained the same. The person-centred, holistic approach facilitated identification and actioning of the medicine changes that mattered to individual patients. Stopped and decreased dose medicines included high risk medicines, those likely to cause adverse effects or high anticholinergic burden and medicines no longer needed or effective for the individual. Medicine doses were increased for high risk medicines, to ensure sufficient nutritional, electrolyte and enzyme replacement and items for comfort for example constipation. Importantly, unmet therapeutic needs were identified and new medicines were prescribed to address these needs, for example, acid suppressants, bisphosphonates, anticoagulants, statins, antidiabetics, nicotine replacement therapy and for patient’s comfort including pain relief. Limitations include results may not be reflective of all hospital patients as set in an acute setting and through the iSIMPATHY project. References 1. Transforming medication safety in Northern Ireland, Department of Health 2022. Available from: https://www.health-ni.gov.uk/sites/default/files/publications/health/Transforming-medication-safety-in-Northern-Ireland_1.pdf 2. iSimpathy. Making Medication Personal. 2022. Available from: https://www.isimpathy.eu/
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Tumelty, Mary-Elizabeth. "Medical Negligence Litigation and Apologies: An Empirical Examination." European Journal of Health Law 27, no. 4 (July 1, 2020): 386–403. http://dx.doi.org/10.1163/15718093-bja10021.
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Abstract Research has evidenced the various aims of patient-plaintiffs and/or their families in medical negligence litigation, with emphasis frequently placed on the importance of an apology. Drawing on the findings of an empirical study conducted in Ireland, this article contributes to the discourse on apologies in medical negligence disputes. In particular, with reference to the findings of the research and the literature, it discusses components of apologies deemed to be important by patient-plaintiffs and/or their families. The article concludes by arguing that legislative protection for apologies in isolation will not necessarily increase the use or effectiveness of apologies in medical negligence disputes, and a combination of measures is required.
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Sheikh, Asim. "The Data Protection (Amendment) Act, 2003: The Data Protection Directive and its Implications for Medical Research in Ireland." European Journal of Health Law 12, no. 4 (2005): 357–72. http://dx.doi.org/10.1163/157180905775088568.
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AbstractDirective 95/46/EC on the Protection of Individuals with regard to the Processing of Personal Data and on the Free Movement of Such Data has been transposed into national law and is now the Data Protection (Amendment) Act, 2003.The Directive and the transposing Act provide for new obligations to those processing data. The new obligation of primary concern is the necessity to obtain consent prior to the processing of data (Article 7, Directive 95/46/EC). This has caused much concern especially in relation to 'secondary data' or 'archived data'.There exist, what seem to be in the minds of the medical research community, two competing interests: (i) that of the need to obtain consent prior to processing data and (ii) the need to protect and foster medical research. At the same time as the introduction of the Act, other prior legislation, i.e. the Freedom of Information Act, 1997-2003, has encouraged candour within the doctor-patient relationship and the High Court in Ireland, in the case of Geoghegan v. Harris, has promulgated the 'reasonable-patient test' as being the correct law in relation to the disclosure of risks to patients. The court stated that doctors have a duty to disclose all material risks to patients. The case demonstrates an example of a move toward a more open medical relationship. An example of this rationale was also recently seen in the United Kingdom in the House of Lords decision in Chester v. Afshar. Within the medical research community in Ireland, the need to respect the autonomy of patients and research participants by providing information to such parties has also been observed (Sheikh A. A., 2000 and Irish Council for Bioethics, 2005).Disquiet has been expressed in Ireland and other jurisdictions by the medical research communities in relation to the exact working and meaning of the Directive and therefore the transposing Acts (Strobl et al). This may be due to the fact that, as observed by Beyleveld "The Directive makes no specific mention of medical research and, consequently, it contains no provisions for medical research as an explicitly delineated category." (Beyleveld D., 2004) This paper examines the Irish Act and discusses whether the concerns expressed are well-founded and if the Act is open to interpretation such that it would not hamper medical research and public health work.
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O'Gorman, Aileen. "Illicit Drug Use in Ireland: An Overview of the Problem and Policy Responses." Journal of Drug Issues 28, no. 1 (January 1998): 155–66. http://dx.doi.org/10.1177/002204269802800109.
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Problematic drug use, mainly regarding the use of opiates, has been identified as a major social problem in Ireland. Such problematic drug use has been found to be concentrated in Dublin's inner city areas and outer estates where poverty, multi-generational unemployment, high population density (particularly of young adults), and poor facilities are the norm. Policy responses, although acknowledging the environmental context of the drug problem, have tended to focus on the medical treatment of the individual, rather than tackling the wider social and economic issues.
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Romero-Ortuno, Roman, Deirdre O’Riordan, and Bernard Silke. "Profiling the medical admissions of the homeless." Acute Medicine Journal 11, no. 4 (October 1, 2012): 197–204. http://dx.doi.org/10.52964/amja.0575.
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Aim: to describe the characteristics and outcomes of homeless people admitted to our Internal Medicine service in St. James’s Hospital, Dublin (Ireland), between 2002 and 2011. Methods: we interrogated an anonymized in-patient database. Results: there were 1,460 homeless admissions (623 unique patients; 39% admitted more than once). Most patients were young, male, and had low comorbidity levels. Thirty-seven percent of the admissions were alcohol-related and 27% substance abuse-related. Thirteen percent had an active psychiatric illness. Their in-patient mortality rate was 5%. Seventy two percent were discharged without the residential arrangement being explicitly documented, 15% self-discharged or absconded, and 8% were discharged to a residential facility. Conclusion: results are novel in our context and will be relevant for local policy and practice.
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Mauger, Alice. "A great race of drinkers? Irish interpretations of alcoholism and drinking stereotypes, 1945–1975." Medical History 65, no. 1 (December 15, 2020): 70–89. http://dx.doi.org/10.1017/mdh.2020.51.
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AbstractFrom the 1930s, psychiatrists and sociologists documented the prevalence of Irish alcohol-related psychiatric admissions in the United States. These studies seemed to suggest that the Irish, as a race, had a remarkable relationship with drink, therefore reinforcing the enduring ‘drunken Irish’ stereotype. By the 1960s, the alleged Irish susceptibility to alcoholism gained increasing attention from researchers and officials in Ireland itself. Significantly, this renewed awareness coincided with a shift in Ireland’s place on the international landscape and was intertwined with the broader social, cultural and political environment. While anxieties about the apparently rising incidence of alcoholism and alcohol-related harm were not unique to Ireland, the specific cultural meanings attached to excessive drinking in a nation internationally renowned for this problem mapped onto shifting international frameworks, informing medical perceptions and shaping policy developments. This article explores expert and official interpretations of alcoholism and the ‘drunken Irish’ stereotype from 1945 to 1975. This period saw a number of important developments, including the introduction of the Irish Mental Treatment Act of 1945, the establishment of the Irish National Council on Alcoholism in 1966 and the creation of specialist alcohol treatment facilities in several psychiatric hospitals. In the same era, the contexts for understanding problem drinking began to shift from the disease concept of alcoholism towards the public health perspective on alcohol. As will be argued, in Ireland, these frameworks were coloured by concerns that social and cultural factors were contributing to rising levels of alcohol consumption and psychiatric admissions for alcoholism.
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Tilson, Lesley, and Michael Barry. "Recent developments in pharmacoeconomic evaluation in Ireland." Expert Review of Pharmacoeconomics & Outcomes Research 10, no. 3 (June 2010): 221–24. http://dx.doi.org/10.1586/erp.10.33.
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Waltz, Charlotte. "A reproductive justice approach to abortion access and provision in Ireland after the Eighth Amendment." Boolean 2022 VI, no. 1 (December 6, 2022): 184–90. http://dx.doi.org/10.33178/boolean.2022.1.30.
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In this paper, I draw on ongoing ethnographic research on abortion care in Ireland. My research follows a reproductive justice framework to inquire whether pregnant people have the means and the accessibility to abortion care, and whether providers have the means to provide abortion care. I argue that my approach provides an innovative way of examining reproductive justice in Ireland through a feminist and intersectional lens. Moving away from the moral framing of abortion which has dominated the public construction of the issue in Ireland to date, the reframing of abortion as a reproductive justice opens up opportunities for a more balanced consideration of abortion provision as policy, practice and lived experience for both service users and service providers.
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Aiken, Abigail R. A., Dana M. Johnson, Kathleen Broussard, and Elisa Padron. "Experiences of women in Ireland who accessed abortion by travelling abroad or by using abortion medication at home: a qualitative study." BMJ Sexual & Reproductive Health 44, no. 3 (May 15, 2018): 181–86. http://dx.doi.org/10.1136/bmjsrh-2018-200113.
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BackgroundThe Republic of Ireland has one of the world’s most restrictive abortion laws, allowing abortion only to preserve a pregnant woman’s life. We examined the impact of the law on women’s options for accessing abortion, their decision-making regarding whichpathway to follow, and their experiences with their chosen approach.MethodsWe conducted semi-structured in-depth interviews with 38 women who had either travelled abroad to access abortion in a clinic or had self-managed a medical abortion at home using online telemedicine, between 2010 and 2017. We coded interview transcripts according to an iteratively developed coding guide and performed a thematic analysis to identify key themes.ResultsWe identified four key themes: (1) self-managing a medical abortion at home using online telemedicine can be a preference over travelling abroad to access abortion services; (2) regardless of the pathway chosen, women experience a lack of pre- and post-abortion support in the Irish healthcare system; (3) feelings of desperation while searching for safe abortion care can lead to considering or attempting dangerous methods; and (4) Irish abortion law and attitudes have impacts beyond physical health considerations, engendering shame and stigma.ConclusionsDespite the country’s restrictive abortion law, women in Ireland do obtain abortions, using methods that are legal and safe elsewhere. However, the law negatively impacts women’s ability to discuss their options with their healthcare professionals and to seek follow-up care, and can have serious implications for their physical and emotional health. This study’s findings provide evidence to inform public and policy discourse on Ireland’s abortion laws.
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Barry, Michael, Cara Usher, and Lesley Tilson. "Public drug expenditure in the Republic of Ireland." Expert Review of Pharmacoeconomics & Outcomes Research 10, no. 3 (June 2010): 239–45. http://dx.doi.org/10.1586/erp.10.23.
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Vélez, Juan R. "Newman’s Compelling Reasons for a Medical School with Catholic Professors." Linacre Quarterly 87, no. 3 (April 23, 2020): 292–301. http://dx.doi.org/10.1177/0024363920917495.
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Only one year after starting the Catholic University of Ireland (1854), John Henry Newman arranged for the purchase of a medical school, the Cecilia-Street Medical School, which gained immediate success and has continued to this day as a part of University College Dublin. This article is a historical piece that examines the importance Newman gave to Catholic doctrine for the formation of medical students. He understood that according to a hierarchy of sciences, theology and religion are above medicine and its practice and that there are some important religious truths that future Catholic physicians need to learn. In this article, we present a brief history of the origins of the medical school, and discuss his choice of only Catholic professors, and his concern for the doctrinal and moral formation of future doctors. Summary: When John Henry Newman established a medical school in Dublin he chose from only Catholic professors to ensure that the students, almost all Catholic, would receive teaching consistent with their faith, and also that they would have as role models Catholic physicians. He understood the harmony between science and faith, and thus sought professors with very good medical knowledge, who at the same time professed the Catholic faith.
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Lambe, Gerard, Niall Linnane, Ian Callanan, and Marcus W. Butler. "Cleaning up the paper trail – our clinical notes in open view." International Journal of Health Care Quality Assurance 31, no. 3 (April 16, 2018): 228–36. http://dx.doi.org/10.1108/ijhcqa-09-2016-0126.
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Purpose Ireland’s physicians have a legal and an ethical duty to protect confidential patient information. Most healthcare records in Ireland remain paper based, so the purpose of this paper is to: assess the protection afforded to paper records; log highest risk records; note the variations that occurred during the working week; and observe the varying protection that occurred when staff, students and public members were present. Design/methodology/approach A customised audit tool was created using Sphinx software. Data were collected for three months. All wards included in the study were visited once during four discrete time periods across the working week. The medical records trolley’s location was noted and total unattended medical records, total unattended nursing records, total unattended patient lists and when nursing personnel, medical students, public and a ward secretary were visibly present were recorded. Findings During 84 occasions when the authors visited wards, unattended medical records were identified on 33 per cent of occasions, 49 per cent were found during weekend visiting hours and just 4 per cent were found during morning rounds. The unattended medical records belonged to patients admitted to a medical specialty in 73 per cent of cases and a surgical specialty in 27 per cent. Medical records were found unattended in the nurses’ station with much greater frequency when the ward secretary was off duty. Unattended nursing records were identified on 67 per cent of occasions the authors visited the ward and were most commonly found unattended in groups of six or more. Practical implications This study is a timely reminder that confidential patient information is at risk from inappropriate disclosure in the hospital. There are few context-specific standards for data protection to guide healthcare professionals, particularly paper records. Nursing records are left unattended with twice the frequency of medical records and are found unattended in greater numbers than medical records. Protection is strongest when ward secretaries are on duty. Over-reliance on vigilant ward secretaries could represent a threat to confidential patient information. Originality/value While other studies identified data protection as an issue, this study assesses how data security varies inside and outside conventional working hours. It provides a rationale and an impetus for specific changes across the whole working week. By identifying the on-duty ward secretary’s favourable effect on medical record security, it highlights the need for alternative arrangements when the ward secretary is off duty. Data were collected prospectively in real time, giving a more accurate healthcare record security snapshot in each data collection point.
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Lezhnina, Elena. "The Republic of Ireland in the Context of the Pandemic: Seeking a Way out of the National Crisis." Contemporary Europe 106, no. 6 (December 1, 2021): 86–96. http://dx.doi.org/10.15211/soveurope620218696.
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The article outlines the Government of the Republic of Ireland response to the COVID-19 pandemic and explores implemented measures to overcome the negative changes caused by the coronacrises in economic, political, and social life. The study examines the period from March 2020 to June 2021, when the country experienced three waves of pandemic. It required the adoption of unique rapid measures. The problems caused by the increase in the incidences of coronavirus are considered in the context of the global crisis along with the realities of the EU and the specifics of the development of Ireland. There is no doubt that the strategy chosen by the Government of the Irish State has reduced the damage from the first wave of the pandemic as much as possible, stopped the rapid growth of the disease during the second round and continues to contain the infection and carry out recovery measures at the present stage. Transparency, a commitment to an open data policy, the use of media to inform the population have led to a high level of compliance among the general public with the various medical and non-medical measures introduced by the Irish Government.
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Haroon, Muhammad, Faiza Yasin, Rachael Eckel, and Frank Walker. "Perceptions and attitudes of hospital staff toward paging system and the use of mobile phones." International Journal of Technology Assessment in Health Care 26, no. 4 (October 2010): 377–81. http://dx.doi.org/10.1017/s0266462310001054.
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Objectives:Our objective was to document the pattern of mobile phone usage by medical staff in a hospital setting, and to explore any perceived benefits (such as improved communications) associated with mobile phones.Methods:This cross-sectional survey was conducted in Waterford Regional Hospital, Ireland, where bleep is the official system of communication. All non-consultant hospital doctors, of medical disciplines only, were asked to participate. The questionnaire was designed to explore the pattern and different aspects of mobile phone usage.Results:At the time of study, there were sixty medical junior doctors, and the response rate was 100 percent. All participants used mobile phones while at work, and also for hospital-related work. For 98.3 percent the mobile phone was their main mode of communication while in the hospital. Sixty-two percent (n= 37) made 6–10 calls daily purely for work-related business, and this comprised of ≥80 percent of their daily usage of mobile phones. For 98 percent of participants, most phone calls were work-related. Regarding reasons for using mobile phones, all reported that using mobile phone is quicker for communication.Conclusions:Mobile phone usage is very common among the medical personnel, and this is regarded as a more efficient means of communication for mobile staff than the hospital paging system.
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Hennelly, David, Conor Deasy, Siobhan Masterson, Cathal O'Donnell, and Paul Jennings. "The Implementation and Evolution of Helicopter Emergency Medical Services in the Republic of Ireland." Prehospital and Disaster Medicine 38, S1 (May 2023): s45—s46. http://dx.doi.org/10.1017/s1049023x23001553.
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Introduction:Helicopter Emergency Medical Services (HEMS) have formed an integral component of the Irish healthcare system for the past decade, yet the factors leading its commencement, its evolutions over this time, the current model of service delivery have not been widely published.Aeromedical service provision may vary significantly from country to country and may also vary regionally within countries. Health systems necessities, capacity and maturity, the level of state, corporate, private or community investment and capacity of the contracted service provider are all factors that influence the service provision.Method:This research provides a descriptive analysis of the historic factors leading to the implementation of HEMS during an era of healthcare reform, its key evolutions and current model of service delivery.Results:Health system reform in a time of global financial recession led to a unique collaboration between the Irish Defense Forces and civilian Emergency Medical Systems (EMS) to provide a sustainable foundation of primary scene landing Helicopter Emergency Medical Services for the Irish state. This sharing of professional knowledge, logistics and operational experience lead to many further system reforms and will inform future aeromedical service provision.Conclusion:Over the past decade the Irish health system has undergone significant reconfiguration and centralization of services, leading to increased demands on emergency medical ground and aeromedical services. Future advancements in aeromedical service provision require an innate understanding of the current model.This research will add to the knowledge base and inform policy makers and support decision making surrounding Helicopter Emergency Medical Services reform and enhanced service provision in the Irish state.
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Kelleher, Cecily C., Juzer Lotya, Mary-Clare O'Hara, and Celine Murrin. "Session 1: Public health nutrition Nutrition and social disadvantage in Ireland." Proceedings of the Nutrition Society 67, no. 4 (October 10, 2008): 363–70. http://dx.doi.org/10.1017/s0029665108008677.
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There is now considerable evidence from several data sources, including the National Surveys of Lifestyles, Attitudes and Nutrition, that dietary patterns vary according to social position in the Republic of Ireland and those individuals in situations of social disadvantage experience barriers to consuming a healthy diet according to recommended guidelines. Obesity is a major impending public health problem related in part to social position that requires concerted inter-sectoral policy action. The Life-ways Cross-generation Cohort Study of >1000 Irish families has been followed prospectively since antenatal recruitment in 2001. Published findings to date indicate considerable social variability in food consumption and BMI patterns during pregnancy in the case of the maternal cohort. The present paper reports nutrient intake across the four family cohorts related to a key variable of interest, means-tested General Medical Services eligibility.
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Li, Junjie, Wenbo Ma, Xin Dai, Meng Qi, and Bangfan Liu. "China’s Policy Environment’s Development and Path from the Perspective of Policy Sustainability: A Visual Analysis Based on CNKI and WOS." Sustainability 14, no. 24 (December 8, 2022): 16435. http://dx.doi.org/10.3390/su142416435.
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In this paper, we examine China’s policy environment from the perspective of policy sustainability. Through our use of the CiteSpace and NVivo software, the literature on the policy environment is visualized using a knowledge graph analysis and a content analysis of highly cited papers. The analysis shows that: the number of published papers on “policy environment” is on the rise, and the research prospect is broad. There is a lack of communication and cooperation between domestic authors and a close relationship between international authors. The main research countries included the USA, Switzerland, Finland, Ireland, and Austria, etc. Domestic research focuses on vehicles for high-quality economic and social development, while international research focuses on theoretical model discussion. The domestic optimization path focuses on the transformation from “Sending blood” (“ShuXieShi”) to “Making blood” (“ZaoXieShi”), while the international research focuses on the main line of “public health and environmental protection”. Domestic research focuses on fostering a sound business environment, while international research focuses on the public, political and professional aspects of health and medical policy environment. On the whole, in the future, we should improve the adaptability of the policy environment, optimize the policy implementation environment, and establish the interaction mechanism of policy environment optimization to achieve policy optimization.
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Nolan, Anne. "The impact of income on private patients’ access to GP services in Ireland." Journal of Health Services Research & Policy 13, no. 4 (October 2008): 222–26. http://dx.doi.org/10.1258/jhsrp.2008.008048.
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Objectives: To examine the extent to which proximity to the income threshold for free GP care results in significant differences in GP visiting. Approximately 30% of the Irish population receives free GP care (medical card patients), while the remaining 70% pays in full (private patients). Medical card eligibility exerts a significant influence on GP visiting, but how do GP visiting rates differ among private patients on differing incomes, and has the differential in visiting among private patients changed over time? Methods: Using micro-data from three nationally representative surveys of the Irish population undertaken in 1987, 1995 and 2001, multivariate models of GP utilization are estimated. Results: There is little evidence that proximity to the income threshold results in significant differences in GP visiting. The most significant difference is between medical card and private patients, rather than between private patients on differing incomes. There is also little evidence that the differential in GP visiting between private patients on different incomes changed over time. Conclusions: While recent commentary has focused on the plight of individuals just above the income threshold for free GP care, these results suggest that the key difference in GP visiting is between those with, and without, eligibility for free care. If private patients are prevented from accessing GP care due to cost, this is as much an issue for those at the top of the income distribution as for those at the bottom.
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Kahvedžić, Amila, Regina McFadden, Gerry Cummins, David Carr, and Desmond O’Neill. "General practitioner attitudes and practices in medical fitness to drive in Ireland." Journal of Transport & Health 2, no. 2 (June 2015): 284–88. http://dx.doi.org/10.1016/j.jth.2015.02.005.
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O'Reilly, Orlaith, Fiona Cianci, Avelene Casey, Eilish Croke, Celine Conroy, Anne-Marie Keown, Gemma Leane, Barbara Kearns, Shane O'Neill, and Garry Courtney. "National acute medicine programme-Improving the care of all medical patients in Ireland." Journal of Hospital Medicine 10, no. 12 (August 14, 2015): 794–98. http://dx.doi.org/10.1002/jhm.2443.
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O Riordan, Vera. "On track or not? Why modelling low carbon policy pathways for passenger transport in Ireland matters." Boolean 2022 VI, no. 1 (December 6, 2022): 118–26. http://dx.doi.org/10.33178/boolean.2022.1.20.
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Passenger transport emissions are currently responsible for 10% of all greenhouse gas emissions in Ireland. Not only is the share of emissions from passenger transport significant at 10%, but also the quantity of carbon dioxide emissions from passenger transport has been growing. The majority of passenger transport emissions come from private car transport, it being responsible for 90% of all passenger transport emissions in Ireland. Past policies to reduce the net emissions from passenger transport, such as manufacturer-based European-wide emissions and efficiency standards for private cars have had limited success, with increases in activity from passenger transport and people travelling further and more often by car counterbalancing improvements in car fuel performance. In recent years, the focus has shifted from improving and electrifying cars as a means to decarbonization of passenger transport to a broader range of measures to reduce emissions from passenger transport, including reducing the need for travel in the first place and encouraging a shift to walking, cycling or modes of mass/public transportation. We discuss the global climate imperative for passenger transport decarbonization, the policy frameworks established to facilitate this, and the energy systems models we develop here in UCC to monitor current and plan future passenger transport decarbonization.
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Keegan, Dylan, Eithne Heffernan, Jenny McSharry, Tomás Barry, and Siobhán Masterson. "Identifying priorities for the collection and use of data related to community first response and out-of-hospital cardiac arrest: protocol for a nominal group technique study." HRB Open Research 4 (November 29, 2021): 81. http://dx.doi.org/10.12688/hrbopenres.13347.2.
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Introduction: Out-of-hospital cardiac arrest (OHCA) is a devastating health event that affects over 2000 people each year in Ireland. Survival rate is low, but immediate intervention and initiation of cardiopulmonary resuscitation (CPR) and administration of an automated external defibrillator (AED) can increase chances of survival. It is not always possible for the emergency medical services (EMS) to reach OHCA cases quickly. As such, volunteers, including lay and professional responders (e.g. off-duty paramedics and fire-fighters), trained in CPR and AED use, are mobilised by the EMS to respond locally to prehospital medical emergencies (e.g. OHCA and stroke). This is known as community first response (CFR). Data on the impact of CFR interventions are limited. This research aims to identify the most important CFR data to collect and analyse, the most important uses of CFR data, as well as barriers and facilitators to data collection and use. This can inform policies to optimise the practice of CFR in Ireland. Methods: The nominal group technique (NGT) is a structured consensus process where key stakeholders (e.g. CFR volunteers, clinicians, EMS personnel, and patients/relatives) develop a set of prioritised recommendations. This study will employ the NGT, incorporating an online survey and online consensus meeting, to develop a priority list for the collection and use of CFR data in Ireland. Stakeholder responses will also identify barriers and facilitators to data collection and use, as well as indicators that improvements to these processes have been achieved. The maximum sample size for the NGT will be 20 participants to ensure sufficient representation from stakeholder groups. Discussion: This study, employing the NGT, will consult key stakeholders to establish CFR data collection, analysis, and use priorities. Results from this study will inform CFR research, practice, and policy, to improve the national CFR service model and inform international response programs.
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Keegan, Dylan, Eithne Heffernan, Jenny McSharry, Tomás Barry, and Siobhán Masterson. "Identifying priorities for the collection and use of data related to community first response and out-of-hospital cardiac arrest: protocol for a nominal group technique study." HRB Open Research 4 (July 26, 2021): 81. http://dx.doi.org/10.12688/hrbopenres.13347.1.
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Introduction: Out-of-hospital cardiac arrest (OHCA) is a devastating health event that affects over 2000 people each year in Ireland. Survival rate is low, but immediate intervention and initiation of cardiopulmonary resuscitation (CPR) and administration of an automated external defibrillator (AED) can increase chances of survival. It is not always possible for the emergency medical services (EMS) to reach OHCA cases quickly. As such, volunteers, including lay and professional responders (e.g. off-duty paramedics and fire-fighters), trained in CPR and AED use, are mobilised by the EMS to respond locally to prehospital medical emergencies (e.g. OHCA and stroke). This is known as community first response (CFR). Data on the impact of CFR interventions are limited. This research aims to identify the most important CFR data to collect and analyse, the most important uses of CFR data, as well as barriers and facilitators to data collection and use. This can inform policies to optimise the practice of CFR in Ireland. Methods: The nominal group technique (NGT) is a structured consensus process where key stakeholders (e.g. CFR volunteers, clinicians, EMS personnel, and patients/relatives) develop a set of prioritised recommendations. This study will employ the NGT, incorporating an online survey and online consensus meeting, to develop a priority list for the collection and use of CFR data in Ireland. Stakeholder responses will also identify barriers and facilitators to data collection and use, as well as indicators that improvements to these processes have been achieved. The maximum sample size for the NGT will be 20 participants to ensure sufficient representation from stakeholder groups. Discussion: This study, employing the NGT, will consult key stakeholders to establish CFR data collection, analysis, and use priorities. Results from this study will inform CFR research, practice, and policy, to improve the national CFR service model and inform international response programs.
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Crompton, Amy, Tom Macmillan, Jen Ferris, and Isobel Munro. "PD25 Use Of Real-World Evidence In The Reimbursement Assessment Of Medical Devices." International Journal of Technology Assessment in Health Care 38, S1 (December 2022): S99. http://dx.doi.org/10.1017/s0266462322002860.
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IntroductionRandomized controlled trials (RCTs) are typically considered the gold standard source of clinical evidence for reimbursement submissions, but they can often be resource-intensive, expensive, and may not always be appropriate. For example, it may be unethical to assign patients to an untreated or undiagnosed control group, or blinding may not be feasible when assessing medical devices. Evidence for medical devices is therefore often limited to nonrandomized studies. We explored the use and value of real-world evidence (RWE) in the reimbursement of medical devices across several health technology assessment (HTA) agencies.MethodsA narrative review was completed to compare the acceptability of RWE for the HTA evaluation of medical devices across a convenience sample of countries. English-language published guidance documents were reviewed, and study design preferences extracted.ResultsIn Australia, France, Germany, Ireland, Norway, and Scotland, HTA agencies prefer RCT evidence but accept RWE as supporting data. In England, there is no preferred study design, with directly observed clinical outcomes, evidence syntheses, nonclinical, and modelling studies accepted. Notably, methods and processes for HTA programs are being reviewed and are expected to place a greater emphasis on RWE. In Australia, pseudo-randomized trials, comparative cohort studies, case series, and other study designs are permitted. In France, nonrandomized or nonblinded trials, patient preference cohorts, prospective comparative observational studies, and propensity score matched cohorts are permitted, accompanied by justification. In Scotland, lived experiences, RWE, and systematic reviews are accepted. In Germany, nonrandomized studies are deemed to provide “minimum”, “very low” or “low” certainty of results. In Norway, RWE may be accepted if no RCT data are available, or to support RCTs.ConclusionsIn the assessment of medical devices, where RCTs are unsuitable, RWE can form a feasible alternative. Real-world evidence is increasingly being recognized as a valuable source of evidence for medical interventions and is accepted by a number of HTA agencies. No funding was received for this study.
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Reid, Beth A., Lee Ridoutt, Paul O’Connor, and Deirdre Murphy. "Best practice in the management of clinical coding services: Insights from a project in the Republic of Ireland, Part 1." Health Information Management Journal 46, no. 2 (January 12, 2017): 69–77. http://dx.doi.org/10.1177/1833358316687576.
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Introduction: This article presents some of the results of a year-long project in the Republic of Ireland to review the quality of the hospital inpatient enquiry data for its use in activity-based funding (ABF). This is the first of two papers regarding best practice in the management of clinical coding services. Methods: Four methods were used to address this aspect of the project, namely a literature review, a workshop, an assessment of the coding services in 12 Irish hospitals by structured interviews of the clinical coding managers, and a medical record audit of the clinical codes in 10 hospitals. Results: The results included here are those relating to the quality of the medical records, coding work allocation and supervision processes, data quality control measures, communication with clinicians, and the visibility of clinical coders, their managers, and the coding service. Conclusion: The project found instances of best practice in the study hospitals but also found several areas needing improvement. These included improving the structure and content of the medical record, clinician engagement with the clinical coding teams and the ABF process, and the use of data quality control measures.
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Scannell, M., E. Burton, and P. M. Kearney. "502 The effects of removing the requirement for prior reimbursement approval on anticoagulant use in Ireland: A cross sectional study." International Journal of Pharmacy Practice 31, Supplement_1 (April 1, 2023): i39—i40. http://dx.doi.org/10.1093/ijpp/riad021.046.
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Abstract Introduction Prior approval for reimbursement is a cost containment policy, aimed at reducing demand (1). It has been used temporarily in the Irish Healthcare system to deal with the initial financial challenges posed by the shift in use towards the Direct Oral Anticoagulants (DOACs) (apixaban, rivaroxaban, edoxaban and dabigatran) from warfarin. Improved safety of DOACs use was a secondary aim of this policy. The use of prior approval policies is increasing in Ireland but studies assessing their effectiveness are limited. Aim To examine the effect of removing the cost containment policy of prior approval for reimbursement of apixaban and rivaroxaban using a national pharmacy claims database. Methods The Health Service Executive-Primary Care Reimbursement Service database in Ireland was used in this cross-sectional study. The prescribing frequencies and associated costs of the oral anticoagulants; ((OACs) apixaban, rivaroxaban, and warfarin) listed in the top 100 most frequently prescribed drugs on the Community Drug Schemes (CDS), between 2018 and 2021 were examined. Levothyroxine was used as a negative control to detect any external deviances in the prescribing data records. Interrupted time series Poisson regression was used to assess the impact of removing the approval requirement of apixaban in September 2019 followed by the other DOACs in November 2020. Results The prescribing frequency of OACs increased by almost 20% during the study period. Figure1 shows the prescribing frequencies of apixaban , rivaroxaban , warfarin and levothyroxine on each of the three community drug schemes – General medical scheme (GMS), Drug payments scheme (DPS) and Long term illness scheme (LTI) during the study period.Timelines at September 2019 and November 2020 show the removal of prior approval for apixaban and all DOACs respectively. This study showed there were significant differences in the proportion of OACs prescribed among the CDS. A statistically significant decreased use of apixaban (<1%, p<0.05) occurred when prior approval was removed for all DOACs. Conclusion The removal of prior approval for reimbursement of DOACs in Ireland had a minimal impact on the prescribing frequency trends of the OACs. Future use of these potentially useful policies by healthcare systems requires careful consideration of drug type, approval criteria and length of time the policy remains in place. References 1. Moreno-Serra R. The impact of cost-containment policies on health expenditure 2014 Available from: https://www.oecd-ilibrary.org/content/paper/budget-13-5jxx2wl6lp9p
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Fitzgerald, James M., Katherine E. Krause, Darya Yermak, Suzanne Dunne, Ailish Hannigan, Walter Cullen, David Meagher, et al. "The first survey of attitudes of medical students in Ireland towards termination of pregnancy." Journal of Medical Ethics 40, no. 10 (August 20, 2013): 710–13. http://dx.doi.org/10.1136/medethics-2013-101608.
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Ferrando, Cristina, Martin C. Henman, and Owen I. Corrigan. "Impact of a Nationwide Limited Prescribing List: Preliminary Findings." Drug Intelligence & Clinical Pharmacy 21, no. 7-8 (July 1987): 653–58. http://dx.doi.org/10.1177/1060028087021007-819.
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In the Republic of Ireland, the state pays the cost of medical care for around 40 percent of the population through the General Medical Services (GMS). Doctors treating GMS patients are entitled to prescribe from an approved list of drugs. In October 1982, many antacids, cough and cold preparations, antihistamines, and mild analgesics were removed from the GMS prescribing list. The visiting rate and the amount of prescribing fell in the GMS during 1982–83. Drug utilization within the GMS was measured using prescription numbers and in the total population using data obtained from pharmaceutical wholesalers expressed as defined daily doses. These results showed substantial changes in GMS prescribing in the utilization of mefenamic acid, carbocysteine, and H2-receptor antagonists associated with the introduction of the limited list, suggesting a switch to these agents from delisted preparations. The therapeutic and economic implications of this policy are discussed.
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Rasi, Virginia, Helen Peters, Rebecca Sconza, Kate Francis, Laurette Bukasa, Claire Thorne, and Mario Cortina‐Borja. "Trends in antiretroviral use in pregnancy in the UK and Ireland, 2008–2018." HIV Medicine 23, no. 4 (February 18, 2022): 397–405. http://dx.doi.org/10.1111/hiv.13243.
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Clarke, S., E. Keenan, C. Bergin, F. Lyons, S. Hopkins, and F. Mulcahy. "The changing epidemiology of HIV infection in injecting drug users in Dublin, Ireland." HIV Medicine 2, no. 4 (October 2001): 236–40. http://dx.doi.org/10.1046/j.1464-2662.2001.00085.x.
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Won, Tae Joon. "British ‘Guilt’ Concerning Anglo-New Zealand Relations and the Migration of Former IRA Detainees, 1970-1977." Institute of British and American Studies 58 (June 30, 2023): 173–206. http://dx.doi.org/10.25093/ibas.2023.58.173.
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This article examines how Britain’s deteriorating relations with New Zealand in the early 1970s rendered the London government to accommodate the Wellington administration’s foreign policy decisions at the risk of exposing Britain’s contentious internal policy arrangements to the wider world. Britain’s decision in the late 1960s and early 1970s to withdraw her troops from Southeast Asia and to join the European Economic Community had a negative impact on her diplomatic relations with various Commonwealth partners, including her traditionally strong bond with New Zealand. This was evident in the increasing anti-British sentiment amongst the people of New Zealand and in the introduction of anti-British policies by the Wellington government in the early 1970s. Consequently, Britain actively sought to placate New Zealand’s feelings and to improve Anglo-New Zealand relations by agreeing to accommodate New Zealand Prime Minister Robert Muldoon’s policy of allowing former IRA detainees in Northern Ireland to emigrate to New Zealand, even though this meant that Britain’s controversial detention policy in Northern Ireland could be laid bare to global scrutiny. London’s high-risk decision to give unofficial advice to Wellington on the suitability of candidates for emigration had to be concealed in order to give the impression that the British government was not in any way involved in New Zealand’s decisions. Therefore, when questions were raised in the British Parliament over the question of London’s involvement in Muldoon’s scheme, the British government went so far as to mislead the Commons on the issue.
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Aldeyab, Mamoon A., Salah M. Elshibly, James C. McElnay, Elizabeth Davies, Michael G. Scott, Fidelma A. Magee, Paul Leyden, and Mary P. Kearney. "An Evaluation of Compliance with an Antibiotic Policy in Surgical Wards at a General Teaching Hospital in Northern Ireland." Infection Control & Hospital Epidemiology 30, no. 9 (September 2009): 921–22. http://dx.doi.org/10.1086/599308.
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Creese, Jennifer, John-Paul Byrne, Anne Matthews, Aoife M. McDermott, Edel Conway, and Niamh Humphries. "“I feel I have no voice”: hospital doctors' workplace silence in Ireland." Journal of Health Organization and Management 35, no. 9 (May 7, 2021): 178–94. http://dx.doi.org/10.1108/jhom-08-2020-0353.
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PurposeWorkplace silence impedes productivity, job satisfaction and retention, key issues for the hospital workforce worldwide. It can have a negative effect on patient outcomes and safety and human resources in healthcare organisations. This study aims to examine factors that influence workplace silence among hospital doctors in Ireland.Design/methodology/approachA national, cross-sectional, online survey of hospital doctors in Ireland was conducted in October–November 2019; 1,070 hospital doctors responded. This paper focuses on responses to the question “If you had concerns about your working conditions, would you raise them?”. In total, 227 hospital doctor respondents (25%) stated that they would not raise concerns about their working conditions. Qualitative thematic analysis was carried out on free-text responses to explore why these doctors choose to opt for silence regarding their working conditions.FindingsReputational risk, lack of energy and time, a perceived inability to effect change and cultural norms all discourage doctors from raising concerns about working conditions. Apathy arose as change to working conditions was perceived as highly unlikely. In turn, this had scope to lead to neglect and exit. Voice was seen as risky for some respondents, who feared that complaining could damage their career prospects and workplace relationships.Originality/valueThis study highlights the systemic, cultural and practical issues that pressure hospital doctors in Ireland to opt for silence around working conditions. It adds to the literature on workplace silence and voice within the medical profession and provides a framework for comparative analysis of doctors' silence and voice in other settings.
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Fitzmaurice, Kay, and Angela Flynn. "313 Caring for Older Persons with Dementia in an Acute Medical Care Setting: An Exploration of Nurses’ Experiences and Perceptions." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.202.
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Abstract Background Presently in Ireland there are 55,000 people with dementia, with figures projected to rise to 130,000 by 2041. In acute hospitals, ensuring the provision of high standard, person-centred care for people with dementia is an essential part of policy and practice development. While nurses are key in implementing safe, effective and evidenced based care it is unclear at this moment what their experiences are, when caring for patients with dementia. It is twelve years since the last study was conducted in Ireland in a purpose-built unit for older patients so will not be reflective of an acute care setting. Therefore, it is timely to gather a current description of nurses’ experiences and perceptions in caring for patients with dementia in an acute care setting. Methods A purposeful sample of nine nurses working in an acute medical ward caring for patients with dementia participated in the study. Data was collected using semi-structured interviews, transcribed verbatim and analysed using content analysis. Results The findings are current and highlight that nurse’s display immense respect and empathy to patients with dementia and see beyond the dementia to the individuality of the person. This demonstrates positive attitudes towards these patients, despite organisational and environmental constraints. The findings further identify that staffing levels are inadequate and that nurses require specific education on dementia. Furthermore, the organisational culture and environmental design are not conducive for patients with dementia and changes need implementing in line with the Irish National Dementia Strategy and the Dementia Friendly Hospital Design Guideline. Conclusion These findings have provided a current view of nurses’ experiences and perceptions of caring for patients with dementia in an acute medical ward and support previous study findings. Strategies are now required to address these issues, with a focus on the six priority action areas from The Irish National Dementia Strategy.
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Fernández, Eluska. "No smoke without fire: Public health, morality, and the civilized self." Irish Journal of Sociology 24, no. 2 (February 3, 2016): 155–74. http://dx.doi.org/10.1177/0791603515625588.
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The implementation of the smoking ban in Ireland has been championed as one of the major achievements of public health policy. Studies on the smoking ban have predominantly been undertaken from a public health perspective and have pointed out the associated health benefits of the ban, especially in terms of the reduction of second-hand smoking. While the rationale for the smoking ban was founded on health and medical reasons, this paper contends that going beyond health concerns, a collective process which drew upon notions of progress, purity and order was central to the introduction and successful implementation of the smoking ban. The relevance of discourses around the “civilized self” in tobacco control is also discussed in the context of recent debates over the use and regulation of electronic cigarettes in public spaces.
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Murphy, K., and L. Kelly. "494 A Qualitative Analysis of Barriers and Facilitators to Documentation in Community Pharmacy Electronic Patient Records in Ireland." International Journal of Pharmacy Practice 31, Supplement_1 (April 1, 2023): i34—i35. http://dx.doi.org/10.1093/ijpp/riad021.040.
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Abstract Introduction An Electronic Patient Record (EPR) is a repository for medical and pharmaceutical information in Community Pharmacies. Studies have shown that almost three-quarters of EPRs have at least one discrepancy between information documented in the EPR and patient-reported information, while drug therapy alerts failed to appear for about one-third of patients due to a lack of documented medical and/or pharmaceutical data(1). More complete documentation in Community Pharmacy EPRs could improve the quality of patient care provided. To-date, there is limited research available concerning documentation in Community Pharmacy EPRs in Ireland. Aim The aim of this study was to identify the key barriers and facilitators to documentation in Community Pharmacy EPRs in Ireland. Methods Registered Community Pharmacists were invited to participate via email using convenience sampling. Participant Information Leaflet and Consent Forms were emailed to each community pharmacist at least 24 hours prior to each interview explaining why and how the research study was being carried out. Semi-structured interviews were carried out until theoretical saturation was reached. 11 interviews were conducted virtually through the UCC-approved Google Meet and two interviews took place by telephone. Finally, the audio recordings from interviews were transcribed verbatim and then analysed using Braun and Clarke’s thematic analysis(2). Results A total of 13 Community Pharmacists were interviewed. The majority of participants were female (n=9), supervising pharmacists (n=8), and had greater than 10 years community pharmacy experience (n=8). All pharmacists document the basic personal and clinical patient information necessary for safe supply as advised by the Pharmaceutical Society of Ireland (PSI), but most did not document additional information such as morbidities or over-the-counter medication. The key barriers identified were accessing information from Healthcare Professionals and patients, software limitations and time. The key facilitators identified were Standard Operating Procedures and a centralised Electronic Health Record system. Most pharmacists were willing to participate in a training program to enhance documentation practices. Conclusion This study highlighted the key barriers that need to be addressed to facilitate more complete documentation. A limitation is the potential for social desirability bias in participants in minimising the extent of negative documentation practices. Comprehensive interventions combining more guidance from the PSI, webinars on utilising the EPR, and software modifications could encourage practice change. Future research should evaluate the impact of these measures on documentation completeness in Community Pharmacy EPRs in Ireland. References 1. Floor-Schreudering A, Heringa M, Buurma H, Bouvy ML, De Smet PAGM. Missed drug therapy alerts as a consequence of incomplete electronic patient records in Dutch community pharmacies. Ann Pharmacother. 2013;47(10):1272–9. 2. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol [Internet]. 2006 [cited 2022 Apr 21];3(2):77–101. Available from: https://www.tandfonline.com/doi/abs/10.1191/1478088706qp063oa
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McGennis, Aidan. "Psychiatric units in general hospitals — the Irish experience." Irish Journal of Psychological Medicine 9, no. 2 (November 1992): 129–34. http://dx.doi.org/10.1017/s0790966700013653.
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AbstractObjective: Psychiatric units in general hospitals are becoming a key feature of Irish psychiatric practice. This is in accordance with national policy as laid down in “Planning for the Future” in 1984. To date these units have not been the subject of much research. This paper presents baseline data, gives some clinical impressions of how these units are operating, and discusses the implications of these findings. Method: Questionnaires were sent to the medical directors of all 12 psychiatric units in general hospitals in Ireland. In addition, statistical data was collected from the Health Research Board and from the Mental Health Services Section of the Department of Health. Results: All the questionnaires were returned and the results showed that these units were operating in a largely self sufficient way with little usage of local psychiatric hospitals. Outside Dublin 35% of all Health Board admissions are now going to such units, a figure comparable to England and Wales. There was little evidence of patient selectivity as units seemed to be treating the full range of psychiatric disorders. Conclusion: The picture given of general hospital units in Ireland is, in the main, very encouraging. The main problems encountered were the management of disturbed patients and the heavy demands of liaison psychiatry and these two areas would need to be further researched.
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Shanagher, D. "70 NURSING HOME MODEL OF CARE POST COVID-19." Age and Ageing 50, Supplement_3 (November 2021): ii9—ii41. http://dx.doi.org/10.1093/ageing/afab219.70.
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Abstract Background The COVID-19 pandemic is recognised as having a significant impact on older people, particularly on those within nursing homes. Prior to the pandemic, a significant focus was placed on the application of a social model of care within nursing homes. We know that COVID-19 has required the stringent application of infection prevention and control measures as well as the provision of increased amounts of clinical care. This has resulted in the recent stronger application of a medical model of care within nursing homes. Methods A roundtable event attended by twenty-six people took place. Attendees represented clinical Gerontology, the Irish College of General Practitioner, Sage Family Forum, The Health Information and Quality Authority, Nursing Homes Ireland and nursing home providers. A number of presentations were made, and a roundtable discussion took place about the model of nursing home care post pandemic. Key messages from presentations and the discussion were captured. A report was compiled and shared with attendees to check for accuracy. Results The following key messages were identified: 1. Social care is a cornerstone of nursing home care 2. Increased integration of nursing homes within the wider health and social care system is required 3. Increased access to services for nursing home residents is required 4. Regulatory reform is required 5. Resourcing of nursing home care needs to be appropriately addressed 6. The nursing home sector need to be included in conversations around policy and service development affecting nursing home care in Ireland. Conclusion Nursing homes are an essential part of the healthcare system in Ireland and have been shown to be adaptable throughout the course of the pandemic. A one size fits all approach is an unlikely fit for purpose approach as we look towards the future with COVID-19.
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Cummins, Niamh, Ann-Marie Bright, Edel Burton, Brian Doyle, Damien Gaumont, and Michelle O'Toole. "Development of the Irish Paramedicine Education and Research Network (IPERN): Overview of Activity 2021-2022." Prehospital and Disaster Medicine 38, S1 (May 2023): s197. http://dx.doi.org/10.1017/s1049023x23005058.
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Introduction:The Irish Paramedicine Education and Research Network (IPERN) is dedicated to collaboratively building research culture and research capacity for out-of-hospital care in Ireland and internationally. IPERN is led by an inter-professional team of paramedics, nurses, doctors, allied health professionals and scientists. IPERN supports clinicians to bridge the theory-practice gap through involvement in research training, knowledge generation, knowledge translation, evidence implementation, policy setting, research partnerships, co-production and research leadership. The aim of this study is to quantitatively describe the activity of IPERN in the first two years of it’s foundation (2021-2022).Method:This is an observational study and data was collected prospectively throughout 2021 and 2022. Data on event attendance was collated via the Event management software EventBrite and supplemented with minutes from IPERN Committee meetings. Data analysis was performed in Microsoft Excel and comprised descriptive statistics.Results:The IPERN Team comprises 14 inter-professional members of whom nine (64%) are paramedics. To date IPERN has launched seven special interest groups; Medical, Trauma, Pediatrics, Mental Health, Human Factors, Medical Logistics and Equality Diversity & Inclusion. The network hosted 14 CPD events from March 2021 to November 2022. In terms of research capacity building, the work of IPERN has been presented at six international conferences and the IPERN Team has successfully secured four grants since the foundation of the network.Conclusion:Due to the complex and multidisciplinary nature of out-of-hospital care a strategic and collaborative approach to research capacity-building is essential. Underpinning evidence-based practice is a strong research culture and it is imperative that all clinicians involved in out-of-hospital care have the opportunity to develop knowledge and expertise. IPERN takes a participatory approach to research and our events provide an open and friendly platform for members to engage in research, building a vibrant research community both in Ireland and internationally.
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Gleeson, Aoife, and Faye Johnson. "Assisted ventilation in motor neurone disease during inpatient palliative care: barriers and utilisation." BMJ Supportive & Palliative Care 10, no. 3 (February 2, 2019): 358–62. http://dx.doi.org/10.1136/bmjspcare-2018-001672.
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ObjectivesAn increasing number of patients with motor neuron disease (MND) in the UK and Ireland use assisted ventilation, and a small proportion of these use long-term tracheostomy ventilation (TV).1 2 NICE guidelines recommend that patients with MND should routinely receive specialist palliative care input.3 The aim was to establish the extent to which hospices and specialist palliative care units (SPCUs) in the UK and Ireland currently manage patients with MND using assisted ventilation especially TV and to identify any associated barriers.MethodsA 25-item questionnaire was developed in Survey Monkey. A link to the questionnaire was emailed to every medical director (n=185) of inpatient hospices/SPCUs in the UK and Ireland.ResultsThe response rate was 42.4% (n=78). 97.4% of units admit patients with MND on non-invasive ventilation (NIV), but only 28.2% admit those using TV. 80.8% of units have adequate expertise in the management of NIV, compared with 7.7% for managing TV. 35.9% and 2.6% of units have a policy for managing patients using NIV and TV, respectively. 14.1% respondents had been involved in the care of patients with MND using TV, in the specialist palliative care setting in the last 5 years.ConclusionsA minority of UK and Irish hospices/SPUs provide support to TV MND patients and few units currently have management or admission policies for this cohort of patients. Respondents indicated a lack of appropriate expertise and experience. Further exploration of these barriers is required to establish how to optimise care for TV MND patients in this setting.
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Vaughan, Muireann, Siobhán Lucey, and Laura J. Sahm. "Prevalence and Cost of Antipsychotic Prescribing, within the Context of Psycholeptic Prescribing, in the Irish Setting." Healthcare 12, no. 3 (January 29, 2024): 338. http://dx.doi.org/10.3390/healthcare12030338.
Full textAbstract:
Psycholeptic and specifically antipsychotic prescribing is increasing worldwide each year. This study aims to investigate the prevalence and cost of antipsychotic prescribing, within the wider frame of psycholeptic prescribing, in the Irish context. Quantitative analysis of a dataset from the Primary Care Reimbursement Service relating to cost and prescribing frequency of ATC Class N05 psycholeptic drugs from January 2020–August 2022 inclusive was conducted using Microsoft® Excel® for Microsoft 365 MSO (Version 2311) and STATA 18. Descriptive statistics and time-trend regression analysis were used to investigate the prescribing prevalence of psycholeptics and antipsychotics licensed for use in the Republic of Ireland, and the total cost per funding scheme. The prevalence of psycholeptic prescribing increased yearly from 2020–2022, peaking at 328,572 prescriptions in December 2020 with a total cost of psycholeptic drugs to the State in 2021 of €57,886,250, which was 0.5% of an increase on 2020. Over the 32-month time period, the average monthly cost of psycholeptic drugs was €4,436,469 on the General Medical Services (GMS) scheme and €369,154 on the Drug Payment Scheme (DPS). In 2021, quetiapine, olanzapine, and risperidone were the most prescribed antipsychotics, accounting for 66.58% of antipsychotics prescribed on the GMS scheme. This study identified the large expenditure on psycholeptics and antipsychotics in Ireland, with a higher proportion of the Irish healthcare budget spent on antipsychotics than that of the UK and the USA. The development of Irish antipsychotic prescribing guidelines may allow for structured, cost-effective prescribing.
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Miller, Ian. "The Chemistry of Famine: Nutritional Controversies and the Irish Famine, c.1845–7." Medical History 56, no. 4 (October 2012): 444–62. http://dx.doi.org/10.1017/mdh.2012.27.
Full textAbstract:
AbstractThe activities of Irish medical practitioners in relieving the impact of the Irish Famine (c.1845–52) have been well documented. However, analysis of the function of contemporary medico-scientificideasrelating to food has remained mostly absent from Famine historiography. This is surprising, given the burgeoning influence of Liebigian chemistry and the rising social prominence of nutritional science in the 1840s. Within this article, I argue that the Famine opened up avenues for advocates of the social value of nutritional science to engage with politico-economic discussion regarding Irish dietary, social and economic transformation. Nutritional science was prominent within the activities of the Scientific Commission, the Central Board of Health and in debates regarding soup kitchen schemes. However, the practical inefficacy of many scientific suggestions resulted in public associations being forged between nutritional science and the inefficiencies of state relief policy, whilst emergent tensions between the state, science and the public encouraged scientists in Ireland to gradually distance themselves from state-sponsored relief practices.