Rehabilitation Services

Respiratory Rehabilitation Service

In-patient Services

Services within Respiratory are provided by a multi-disciplinary team from the areas of Nursing, Medicine,
Physiotherapy, Speech & Language, Occupational Therapy, Nutrition & Dietetics and Social Work. Clinical Governance is provided by Prof Stephen Lane and Prof Edward Moloney and Dr Minesh Kooball Consultant Respiratory Physicians

Active In-Patient Respiratory Care

This care package is designed to provide the most appropriate form of care to patients with exacerbations of their chronic lung disease, in particular C.O.P.D. Patients are admitted from the acute hospital within four days of their admission there, or from the out-patients department.

Sleep Diagnosis & Treatment

Full polysomnography is available on the Respiratory Unit where up to five sleep studies per week are performed. Patients are referred from out-patients for an overnight stay for polysomnography. Peamount also offers treatment for patients with a diagnosis of obstructive sleep apnoea/hypopnoea syndrome. Treatment consists of delivering continuous, positive airway pressure via a mask to the patient. Multidisciplinary team input is also provided as indicated.

Chronic Lung Infections

The service aims to reduce infective exacerbations of bronchiectasis and other chronic lung infections, to reduce hospital admissions and to improve the general quality of life of these patients. Patients are admitted from the acute hospital or from OPD.

Chronic Hypoventilatory Respiratory Failure (CHRF)

The aim of this service is to clinically assess patients to qualify and quantify the degree of nocturnal CHRF and to treat appropriately with non-invasive Ventilation in order to correct their failure. Patients are admitted for a 2–3 day period.

Out-patient Respiratory Service

The Management of patients with respiratory disease are provided in 3 weekly consultant led clinics: Sleep and Ventilatory Clinic (Monday PM) Patients are referred to the Clinic by their GPs and other health care professionals. The skill mix offered at the clinic allows the completion of a sleep questionnaire, an Epworth Sleepiness Score and patients are furnished with portable oximeters which they can take home, return the next day and have the data downloaded. BMI is recorded, sleep hygiene advice given and patients are referred on for full sleep studies if appropriate. This service is provided on Monday afternoons but nurses are available for ‘drop-in’ consultations throughout the week. COPD Clinic (Wednesday PM) This clinic focuses on those patients with milder disease, with an overall strategy of preventing disease progression. Services provided include smoking cessation, annual monitoring of FEV1, and adherence to the GOLD Guidelines approach to management. Advice and motivation is given on vaccinations, nebulisers, oxygen therapy, recognition and treatment of exacerbations, compliance and inhaler technique. Asthma Allergy Service (Friday AM) Skin prick allergen testing is provided. The outpatient staff is skilled in the use of domiciliary peak flow monitoring and interpretation thereof. Specific issues addressed are diagnosis, establishing on initial therapies, compliance, inhaler technique, allergen avoidance and emergency treatment of exacerbations.

Pulmonary Function Laboratory

Services provided by the Pulmonary Laboratory include:

• Full Pulmonary Function Testing
• Methacholine Challenge Testing
• Skin Allergy Testing
• Cardiopulmonary Exercise Testing (for Vo2 max)
• Full Polysomnography Testing (Sleep Studies)

Referral Process

Referral to the Pulmonary Function Laboratory is by Consultant.

Age Related Rehabilitation Service

Rehabilitation is a holistic process delivered by the multi-disciplinary team, led by Professor Desmond O Neill, Dr. Sarah Mello and Dr. Dan Ryan, Consultants in Age Related Health Care. The service comprises 50 in-patient beds for both male and female clients. Currently, rehabilitation places are allocated to patients from the Dublin Midland hospitals group mainly Tallaght University Hospital and Naas General Hospital.

Referral Process

All clients must be referred to the rehabilitation unit by a Consultant Geriatrician. The applications are then forwarded to the admissions team for prioritisation. When a bed becomes available, and bearing in mind current unit dependency levels, an assessment is undertaken by Peamount Healthcare. Following the assessment process, the multi-disciplinary team will determine suitability and the referred client is then offered a period of in-patient rehabilitation.

Neurological Rehabilitation Services

This 10 bedded service offers direct admission and timely access to neuro-rehabilitation to patients from acute hospitals in DMHG/CHO 7 under the governance of Dr. Eugene Wallace Consultant in Rehabilitation Medicine, Dr Karen O’ Connell, Consultant Neurologist and Dr Jacinta McElligott Consultant in Rehabilitation Medicine.

Patients outside of this area were considered on a case by case basis and agreement made with referring hospital regarding repatriation if required upon completion of their rehabilitation. Service provision is for patients with a sudden onset neurological illness/injury and / or sudden onset neurological conditions/syndromes which are not progressive in nature.

The rehabilitation service design is interdisciplinary and service planning has been underpinned by evidence-based practice and specialist expertise. Through an interdisciplinary team (IDT) model, each patient identifies their own goals that are meaningful to them and their families.