IRISH RESEARCH NURSES NETWORK

8th ANNUAL NATIONAL CONFERENCE & AGM

Changing Times in Healthcare Research

Centre for Learning and Development, St James’s Hospital,

DUBLIN 8

Thursday 12th November 2015

09.00 – 16.00

Programme Agenda

09.00 –10.15 Registration & Refreshments; Poster Viewing

09.15 – 10.00 Annual General Meeting Open to all registered IRNN Members

Chairperson: Robert O’Connor, Irish Cancer Society

10.15 – 10:20 Welcome and Opening Remarks Prof Michael Gill Clinical Director of HRB CRF, St. James’s

Hospital

10.20 – 10.50 There is an eHealth capability out there, we just

need to find it and hitch it to the cart!

Richard Corbridge

Chief Information Officer HSE

11.50– 11.20 Patient Power – the importance of clinical research

from the patient perspective

Caitríona Dunne,

Communications and Advocacy

Executive, Fighting Blindness

11.20 – 11.50 Refreshments/Viewing of stands and posters

Chairperson: Ms Sinead Curran, HRB CRCI

11.50 – 12.20 HRB Clinical Research Coordination Ireland (CRCI)

– progress since last year

Dr Fionnuala Keane Chief

Operations Officer, HRB Clinical

Research Coordination Ireland

12.20– 12.50 Impact of legislative changes on conducting clinical

trials in Ireland Dr. Agnieszka Przybyszewska

Medical Officer, Health

Products Regulatory Authority

12.50-13.00 Questions and answers

Panel

13.00 – 13.15 Launch of Clinical Research Nurse Competency Framework

Dr Mary Clarke Moloney Chairperson, IRNN

1315 – 14.00 Lunch/Viewing of stands and posters

Exam Hall

14.00 Research Forum Chairperson: Dr Declan Devane, NUIG

14.00 – 14.20 A Universal Testing Programme for Blood Borne

Viruses in an Urban Emergency Department (ED) – An impetus for expanded testing.

Siobhan O’Dea, St James’s

Hospital, Dublin

1420 – 14.40 Appreciative Inquiry as an intervention to change

nursing practice focusing on in-patient settings: a systematic review

Sarah Watkins, University

Hospital Limerick

14.40 – 15.00 What have risk management, clinical information systems & networked point-of-care devices got in

common?

Lucy Kielty, St James’s Hospital, Dublin

15.00– 15.20 Nurses experience of supporting patients with a tracheostomy a descriptive qualitative enquiry

Jane Savage, University Hospital, Limerick

15.20 – 15.50 Presentation of Postgraduate Certificates

RCSI School of Nursing & Midwifery

15.50– 16.00 Presentation of poster prizes and close of conference

Chair: Dr Mary Clarke Moloney

WELCOME!

On behalf of the IRNN Organising Committee, it gives me great pleasure to welcome you to the

2015 Irish Research Nurses Network Conference. This, our 8th

annual conference, promises to

be a very exciting event with a great line up of speakers planned. I understand the practical

difficulties attached to attending conferences, from negotiating time off work to organising home

life to accommodate and I very much hope that this conference meets your expectations.

The IRNN Committee has taken great care in preparing a high-quality programme focusing on

this years theme; “Changing times in Healthcare Research”. The theme was chosen to highlight how international and national changes in the regulation and legislation underpinning clinical research, including the new EU Clinical Trials Directive and the Health Information Bill, will affect the clinical research environment in Ireland.

We have an exciting line up of invited speakers in the morning followed by the ever popular

nurses forum in the afternoon. Poster presentations will be on view from 9.00am, authors are

requested to be present at their posters during the lunch and coffee breaks so please take time to

view and discuss their work.

Finally, we are very grateful to our very generous sponsors whose continued support has made

this meeting possible.

Dr Mary Clarke Moloney

Chair IRNN

SPEAKERS PROFILES

Professor Michael Gill

Professor Michael Gill is the Clinical Director of the Wellcome Trust – HRB Clinical Research Facility at St. James’s Hospital. Professor Gill is Professor of Psychiatry at Trinity College Dublin and head of the Department of Psychiatry and the Neuropsychiatric Genetics Research Group, which was established in 1995. Professor Gill has an expertise in communication and interview skills in all aspects of healthcare.

Mr Richard Corbridge

Richard Corbridge is Chief Information Officer for the Health Service Executive in Ireland and Chief Officer of eHealth Ireland. He has specialised in IT strategy development, procurement, implementation and the assurance of benefit release across national and local health care arenas in the UK and across the globe for more than fifteen years making significant impact in both areas, delivering a wide range of systems and process to aid with the provision of integrated health care and clinical research. Richard took up the dual role within Ireland at the beginning of 2015. eHealth Ireland is a new organisation responsible for the delivery of an eHealth Eco-System for Ireland that will facilitate the health informatics innovation delivery country wide and is currently focused on the delivery of the published Knowledge and Information plan. In 2015 Richard was listed as the 5th most influential CIO in Europe by CIO magazine and in the top 10 most social CIOs in the world.

Ms Caitríona Dunne

Caitríona Dunne is Communications and Advocacy Executive with Fighting Blindness. She manages the organisations communications, education and outreach activities and is a patient advocate in the areas of vision and rare diseases. Caitríona has a BSc in Sport and Exercise Science from the University of Limerick and an MA in Health Promotion from the National University of Ireland, Galway. She is a trainee on the current European Patients' Academy expert training course for patients and patient representatives on the medicines research and development process. She is a board member of the Prader Willi Syndrome Association of Ireland (PWSAI).

Dr Fionnuala Keane Dr Fionnuala Keane graduated in 1994 with a B.Sc. Honours in Biochemistry and in 1999 with a PhD in Biochemistry from the National University of Ireland Galway. From Oct 1999 to Feb 2001 Fionnuala worked as a Postdoctoral Research Fellow in molecular biology and neurochemistry at the Department of Biochemistry, UCD. She joined Novartis Ireland Ltd in Feb 2001 and worked there as a Central Nervous System Hospital Specialist with the sales and marketing team until June 2003. At this point Fionnuala joined ICORG, the All Ireland Co-operative Oncology Research Group and she remained in ICORG from July 2003 to May 2014. Fionnuala was appointed to the role of Development Lead for the HRB CRCI in May 2014 to develop and deliver a 5 year business plan in line with the HRB strategic objectives, working in close collaboration with the CRF/C directors. In May 2015 Fionnuala was appointed to the role of Chief Operations Officer for the HRB CRCI.

Dr Agnieszka Przybyszewska

Agnieszka Przybyszewska received M.D. and Ph.D. degrees in medicine from the Medical University of Lodz, Poland. She also has a M.Sc. degree in Molecular Medicine and a Post Graduate Diploma in Pharmaceutical Medicine from Trinity College Dublin. Agnieszka underwent her specialty training in the Third University Hospital, Department of Cardiology, Lodz, Poland and in 2005 she was accredited as a specialist in Internal Medicine. In 2009 Agnieszka joined the HPRA and she works as a clinical assessor in the Human Products Authorisation and Registration Department. In this role she is involved in the assessment of the clinical aspects of medicinal products in the context of new product authorization applications and clinical trials. Agnieszka is a member of the HMA’s Clinical Trials Facilitation Group (CTFG) and participant of the expert group meetings on clinical trials organized by the European Commission.

Dr Mary Clarke Moloney Dr Mary Clarke Moloney is the Clinical Operations Manager for the Health Research Institute (HRI), University of Limerick. Mary is a qualified registered nurse since 1994 and an experienced clinical researcher having worked in clinical research for the past 14 years. She was awarded her PhD from the University of Limerick in 2006 through the Dept of Electronic and Computer Engineering. She has worked on a wide range of research projects, both industry and investigator led, where she has been involved in the research process from concept to publication. This involvement is evidenced in a strong track record of authorship in over 50 publications. Mary was appointed to her current role as HRI Clinical operations manager in May 2014. Central to this is her management of the Clinical Research Support Unit (CRSU) which facilitates the delivery of clinical research projects with the support of an experienced research nursing team. Mary is the current chair of the IRNN and has been central to the development of the IRNN competency framework document, which is to be launched at today’s conference.

Nurses Forum Abstract 1

Name: Siobhan O Dea Occupation: Research Nurse

Qualifications: RGN, BSc, MSc

Institution: St James’s Hospital, Guide Clinic

Abstract Title: A Universal Testing Programme for Blood Borne Viruses in an Urban

Emergency Department (ED) – An impetus for expanded testing.

Authors: Siobhan O'Dea1

Sarah O'Connell1, Anne Moriarty

1, Aoife Cotter

1, Darren Lillis

2, ,Helen

Barry4, Linda Dalby

4, Darragh Shields

2, Suzanne Norris

3, Brendan Crowley

4, Patrick Plunkett

2,

Colm Bergin1, 5

Institutions:

1. Department of Genito-Urinary and Infectious Disease, 2. Emergency Department, 3. Hepatology

Department, 4. Microbiology Department, all St James’s Hospital, Dublin, Ireland.

5. Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland

Background: Studies suggest at least 2 per 1000 people in Dublin are living with HIV, the level

above which universal screening is advised. Prevalence of hepatitis C viral infection (HCV) in

Ireland is 0.5-1.2%. Hepatitis B viral infection (HBV) prevalence in Ireland is unknown. Given

recent improvements in treatment for HIV and HCV and consequences of late presentation of HIV,

we instituted a universal opt out blood borne virus (BBV) screening programme for patients

presenting to the Emergency Department (ED). We aimed to assess the feasibility and acceptability

of this screening approach and to describe the incidence and prevalence of new and known HIV,

HBV and HCV in this population.

Methods: An opt-out ED screening programme for HIV, HBV and HCV was piloted from March

2014 to January 2015. All patients undergoing blood sampling as part of routine clinical care were

offered HIV 1&2 antibody / antigen assay, HBV surface antigen (HBsAg) and HCV antibody

(HCVab) tests. Targets for uptake of BBV screening were set at 50% for month 1 and 2 and 80%

for month 3 onwards. Study incidence and prevalence were defined as the number of new cases per

1000 tested and number of positive tests per 1000 tested respectively. Linkage to care was co-

ordinated by the study team when appropriate.

Results: Over 45 weeks of testing, of 10,000 subjects tested, 9,918 results were available for

analysis. A sustained target uptake of >50% was obtained after week 3. Of these, the median (IQR)

age was 49(33, 67) years, ranging from 18 -102 years and 5034 (50.8%) were male. 1.11%, 0.47%

and 5.6% HIV, HBV and HCV tests were positive respectively. Cases were defined as either new

or known, 2.6% were undetermined new/known HCV cases and measures to contact the majority of

these cases are on-going. The majority of new cases were linked to care. Study incidence for HIV,

HBV and HCV were 0.7, 2.01 and 6.5 per 1000 respectively. Study prevalence of HIV, HBV and

HCV were 11, 4.7 and 47.1 per 1000 respectively. Retention in care and rates of initiation of

treatment are also reported.

Conclusion: Opt-out BBV screening was feasible and acceptable in an inner-city ED. BBV

infections were prevalent in this population and incident cases of HIV, HBV and HCV were

diagnosed and linked to care. These results suggest widespread ED testing in urban areas is

warranted. Further research is required to determine the cost-effectiveness of this strategy to

evaluate the incidence and prevalence of BBVs in other catchment areas and healthcare settings.

Nurses Forum Abstract 2

Name: Sarah Watkins Occupation: Nurse Researcher

Qualifications: RGN, BSc, MSc,

Structured PhD Candidate

Institution: HSE Emergency Department

University Hospital Limerick

Abstract Title: Appreciative Inquiry as an intervention to change nursing practice focusing

on in-patient settings: a systematic review

Author/s: Sarah Watkins, Belinda Dewar, Catriona Kennedy

Appreciative Inquiry (AI), a form of Action Research, is promoted as an approach to bringing

about change in social systems particularly those that are experiencing challenging and difficult

times (Bushe 2013). Healthcare contexts are multifaceted and complex. Contemporary

discourse speaks of a merging of strengths and collective experience in shaping transformative

change. Nurses must engage with a process that strives for service excellence and encourages a

brand of clinical practice that is borne of emergent alternatives for change.

This paper outlines the findings of a systematic review and discusses with participants the

criteria used to judge if participatory approaches are transformational. The review identifies how

AI has been used in clinical nursing practice, examines the use of AI as a paradigm for change,

examines the factors that impact on the implementation of AI and provides understanding of the

nature of change that has occurred.

Findings from this review will be discussed and shared. The presenters used criteria developed

by Bushe and Kassam (2005) to judge whether the reviewed studies achieved transformational

change. The criteria match AI practice and outcomes against the prescriptions of theorists who

surmise that the transformative potential of AI lies in the focus on changing how people think

and on supporting the ‘self organising’ change processes that flow from new ideas. The criteria

will be discussed with the participants to explore whether they accurately describe the nature of

transformative change and whether they are transferable across a range of settings including

education, health and social care.

This review is registered on PROSPERO International prospective register of systematic

reviews.

Nurses Forum Abstract 3

Name: Lucy Kielty Occupation: Clinical Informatics Manager

Qualifications: Registered General Nurse

Bachelor in Nursing Studies, MSc in Nursing,

MSc in Health Informatics

Institution: St James’s Hospital, Dublin

Abstract Title: What have risk management, clinical information systems & networked

point-of-care devices got in common?

Author/s: Lucy Kielty

Background

The increasing use of medical devices incorporated into the IT-network creates additional risks

to patient safety. The standard IEC 80001-1 (IEC 2010) addresses risk management of medical

IT-networks, but standard implementation has been slow.

Aims

To contribute to the development and validation of an assessment method for IEC 80001-

1 (IEC 2010)

To raise awareness of the standard and improve risk management processes related to

medical IT-network modification.

Methods

The assessment method was developed using the IEC 80001-1 Process Reference Model &

Process Assessment Model and in compliance with ISO/IEC 15504-2 (ISO 2003). The

assessment method was used in the context of a medical IT-network modification project.

Assessment feedback and findings were used to refine the question set.

Analysis

Descriptive statistics using MS Excel & thematic analysis.

Findings

While participants used standards, none had used IEC 80001-1 (IEC 2010). No formal risk

management resources were assigned to the project. Many risk management processes were

undertaken informally and documentation was mainly informal. The assessment identified

strengths, weaknesses, opportunities, and threats in the risk management processes of the project.

There was improved communication and collaboration among risk management stakeholders,

and increased knowledge and awareness of the standard. Implementation of recommendations

resulted in improvements in risk management processes and increased patient safety. Study

participants indicated they would use the assessment method in future projects increasing the

likelihood of IEC 80001-1 (IEC 2010) implementations. The developed assessment method has

been incorporated into a technical report (ISO/IEC TR 80001-2-7) for IEC 80001-1 by

MacMahon.

Nurses Forum Abstract 4

Name: Jane Savage Occupation:

Advanced Airway Clinical Nurse Specialist

Qualifications:

RGN, MSc in Adult Respiratory Nursing

Institution:

University Hospital Limerick

Title; Nurses experience of supporting patients with a tracheostomy: a descriptive

qualitative enquiry.

Author/s: Jane Savage

Introduction: The increasing incidence of tracheostomy formation is widely acknowledged

despite which there has been increasing concerns related to the standards of tracheostomy care

internationally (Randall 2014; Sodhi et al 2014, NCSP 2014;Cetto et al 2011).

This study aims: To describe nurses’ experiences of supporting patients with a tracheostomy

in order to identify potential changes in current healthcare practices to reduce the burden of

avoidable institutional harm and aid healthcare providers in their role of supporting this

vulnerable group.

The researcher acknowledges that while there is requirement to pursue research to identify and

develop evidence based practice, of equal imperative and weight is the need to pursue a line of

enquiry investigating our experiences of health in order to provide understanding in relation to

actual and potential alterations in practices.

Method and Analysis: A descriptive qualitative approach was used to describe seven nurses’

experiences using individual semi structured interviews. Data were analysed using Burnards

(2006) thematic analysis framework identifying three main themes namely a multifaceted role,

support and a complex and changing environment.

Findings and recommendations made: Findings indicate that considerable support is required

for participants to undertake this role. Support was considered in terms of resources, the multi

disciplinary team and education.

Resources; Additional resources are not provided despite the increasing numbers and

congregation of high acuity, high risk patients in one area and brings into question the need to

assess the acuity of these patient’s for the provision of an appropriate staff/patient ratio, this

finding was not previously identified in the literature. Organisational recording and coding of all

tracheostomy insertions is recommended which would contribute to future care planning and

facilitate benchmarking of standards nationally and internationally.

Education; Knowledge deficits concerning tracheostomy care were reported amongst nurses

and other members of the MDT. Identifying a need for changes to the current educational

curriculum. Education alone was found to be inadequate and the requirement for changes to

environmental structures and resources available to support staff in this undertaking

highlighted.

Multidisciplinary team: The MDT was found to be lacking in structure with inadequacies of

communication. Recommendation for a protocol involving an ENT MDT (with adequate cross

discipline representation) as part of the required pathway of care for all tracheostomy patients

would facilitate collaborative working. Additionally the initiation of a weekly tracheostomy

multidisciplinary review round is suggested to improve inter disciplinary communication.

Poster Presentations

1 Mohamad M. Saab Promoting Testicular Cancer Awareness and Screening: A Systematic Review of Intervention Studies.

Catherine McAuley School of Nursing and Midwifery University, College Cork,

2 Maria Gannon & Derval Reidy

Patient user satisfaction of a newly established Clinical Research Facility

Clinical Research Facility, St James’s Hospital, Dublin 8

3 Marcia Tavares Non critical care nurses knowledge of recognition and initial management of sepsis

St James’s Hospital Dublin

4 Linda O Connor A Survey Of Parents Experiences During Their Child’s Admission To The Paediatric Intensive Care Unit.

Our Lady’s Children’s Hospital for Children, Crumlin, Dublin 12

5 Siobhan O Dea & Kate Babineau

Smoking Behaviour among People Living with HIV: A Sub-Group Comparison Guide Clinic St. James’s Hospital; Tobacco Free Research Industry, DIT Kevin Street.

6 Hazel A Smith Are Formula-Fed Infants Following European Recommendations?

University College Cork

7 Hazel A Smith Do cross-over trials give accurate results?

University College Cork

8 Lorna Lombard Factors that Contribute to Sleep Problems in Older Irish Adults: The Irish Longitudinal Study on Ageing (TILDA)

RCSI Clinical Research Centre, Beaumont Hospital, Dublin

9 Niamh Keane The use of a risk-based decision aid to inform aftercare of Patients with Healed Venous Leg Ulcers ( PwHVLU)

Clare Public Health Nursing Department

10 Sinead Jordan Measuring sustained response in a small cohort of Fampridine-PR treated persons with Multiple Sclerosis.

St Vincent’s University Hospital, Elm Park, Dublin 4.

11 Catriona Murphy Statin Use In Adults At High Risk Of Cardiovascular Disease Mortality: Cross-Sectional Analysis Of Baseline Data From The Irish Longitudinal Study On Ageing (TILDA)

TILDA Study, Trinity College Dublin

12 Emily Naylor & Zieta O’Hagan

CERTAIN: A Checklist for Early Recognition & Treatment of Acute Illness in Critical Care

St James’s Hospital, Dublin

13 Swapnil Gaware A Retrospective Review Of Serious Adverse Event Reporting Between November 2007 – July 2015

NUI Galway

14

WELCOME TO THE IRISH RESEARCH NURSES NETWORKS

ANNUAL NATIONAL CONFERENCE

CHANGING TIMES IN CLINICAL RESEARCH

WITH THANKS TO OUR SPONSORS AND SUPPORTERS

Why We Do Research!

#WhyWeDoResearch is an

international twitter

campaign aimed at raising

research awareness for

healthcare professionals,

patients and public. The Irish

Research Nurses Network is

delighted to the first Irish

collaborators of this

campaign and invites all its

members and their friends to

take part.

To join in just pose for a

photograph holding a placard explaining in simple terms why doing

research is important for you using the hashtag #WhyWeDoResearch.

You can tweet the photography yourself or you can send it to

hello@irnn.ie and we can tweet for you from our account

@Irish_RNN!

Follow @Irish_RNN on twitter

for information on job vacancies,

conferences and other events that

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& midwives and all the latest

updates on clinical research