Impact of COVID-19 on the Diagnosis and Surgical Treatment of Colorectal Cancer: A National Perspective.

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A comparison of intra-operative diagnosis to histopathological diagnosis of acute appendicitis in paediatric and adult cohorts: an analysis of over 1000 patients.

Background: Appendicitis is a common general surgical emergency. The role of removing a normal appendix is debated. However, this relies on accurate intra-operative diagnosis of a normal appendix by the operating surgeon.

An analysis of the cost of postgraduate training in surgery in Ireland compared to other specialties.

Introduction: Postgraduate specialty training in Ireland is associated with considerable cost. Some of these are mandatory costs such as medical council fees, while others are necessary to ensure career progression, such as attendance at courses and conferences. In particular, surgical specialities are believed to be associated with high training costs.

Emergency urolithiasis management at a national level: exploring the need for a care pathway.

Background: Urolithiasis is a common urological presentation. A total of 25-49 million people in Europe live with symptomatic stone disease, with the incidence increasing.

Aims: To examine length of stay (LOS) and transfer patterns for patients presenting with urolithiasis to Irish Model 2/3 hospitals without a specialist urology service, compared with those who present to a model 4 hospital with an on-site urology service.

Predictive value of CRP/albumin ratio in major abdominal surgery.

Introduction: Surgical site infection (SSI) is a major cause of morbidity, resulting in significant healthcare and economic implications. The ability to predict patients at high risk of SSI may enable targeted follow-up and management. This study sought to examine the relationship between the CRP/albumin ratio in the prediction of SSI in patients undergoing emergency major abdominal surgery.

Does clinical validation and the implementation of new models of outpatient service delivery have the potential to reduce waiting lists? A pilot study in Letterkenny University Hospital.

Introduction: The traditional outpatient paradigm of seeing patients prior to diagnostic tests and treatment is unsustainable without additional funding. New models of service delivery such as "one-stop clinics", direct access to diagnostics and advanced nurse practitioner (ANP)-led clinics have the potential to improve the efficiency of existing services.

Methods: To determine the most effective changes to improve service provision, the reasons for encounter (RFE) to a urology clinic were assessed using the International Classification Primary Care.

Should all paediatric appendicectomies be performed in a specialist or high-volume setting?

Introduction: Acute appendicitis is a common surgical emergency in children. The majority of appendicectomies in children are performed by general surgeons, rather than specialist paediatric surgeons.

Aim: To assess the impact of hospital specialization, hospital volume, and surgeon volume on outcomes for children undergoing appendicectomy in Ireland.

The impact of hospital grade, hospital-volume, and surgeon-volume on outcomes for adults undergoing appendicectomy.

Introduction: Acute Appendicitis and appendicectomy are common surgical emergencies worldwide. However, there is a lack of published data on the impact of hospital grade, surgeon- and hospital-volumes on patient outcomes following appendicectomy.

Aim: To establish if hospital grade, hospital-volume, or surgeon-volume impacted patient outcomes following appendicectomy.

Volume and in-hospital mortality after emergency abdominal surgery: a national population-based study.

​OBJECTIVES: Emergency abdominal surgery (EAS) refers to high-risk intra-abdominal surgical procedures undertaken for acute gastrointestinal pathology. The relationship between hospital or surgeon volume and mortality of patients undergoing EAS is poorly understood. This study examined this relationship at the national level.

Exploring geographic variation in acute appendectomy in Ireland: results from a national registry study.

Objective: To explore geographic variations in Irish laparoscopic and open appendectomy procedures.

Design: Analysis based on 2014-2017 administrative hospital data from public hospitals.

Setting: Counties of Ireland.

Over-admission and over-treatment of patients with cellulitis: a 5-year audit against international guidelines.

Background/aims: Application of evidence-based guidelines in the management of cellulitis is poorly studied in Ireland and it is observed that current admission and prescription practices in this country vary widely from internationally accepted standards of care. We aimed to examine the management of cellulitis with regard to hospital admission and initial antibiotic therapy.

Methods: A retrospective audit of patients admitted with cellulitis from 2013 to 2017 in an Irish district general hospital.

Patient satisfaction reporting-a cohort study comparing reporting of patient satisfaction pre- and post-discharge from hospital.

Background: Patients' satisfaction reporting is important for assessing the quality of care in surgical practice. Post-discharge questionnaire reporting is considered best practice; however, the logistics of this method remains problematic.

Aims: To examine patient satisfaction response rates prior to and following discharge from the hospital in a general surgery department.

Audit of PPI Prescribing Practices: A Risk to Patient Safety?

Aim Proton pump inhibitors (PPIs) are frequently prescribed to surgical patients (50-60%) to prevent gastrointestinal bleeding. However, most surgical patients are at low risk of significant bleeds. The aim of this audit was to identify inappropriate PPI prescribing, if any, in a cohort of surgical inpatients.

Exploring geographical variation in access to general surgery in Ireland: Evidence from a national study.

Background: Improving the equity of surgical services is an important objective of all clinical programmes both local and overseas. Variations in access to care threaten to dismantle the structural paradigm of any health service and such information can aid in promoting quality and access to surgical services. The aim of this study was to explore the geographical variation in the utilisation of common general surgical procedures in Ireland as a measure of the population's access to surgical interventions.

Changing trends in age and stage of colorectal cancer presentation in Ireland - From the nineties to noughties and beyond.

Background: Recent studies report incidence of colorectal (CRC) in younger adults (<50 years old) is increasing, and these patients are more likely to present with advanced disease. We performed a population-based analysis of these trends in an Irish population.

Methods: A retrospective analysis was performed of all patients with histologically confirmed CRC in Ireland, using data from the National Cancer Registry of Ireland (NCRI) [1994-2012, inclusive].

A Socio-Technical Exploration for Reducing & Mitigating the Risk of Retained Foreign Objects.

A Retained Foreign Object (RFO) is a fairly infrequent but serious adverse event. An accurate rate of RFOs is difficult to establish due to underreporting but it has been estimated that incidences range between 1/1000 and 1/19,000 procedures. The cost of a RFO incident may be substantial and three-fold: (i) the cost to the patient of physical and/or psychological harm; (ii) the reputational cost to an institution and/or healthcare provider; and (iii) the financial cost to the taxpayer in the event of a legal claim.

Elective ambulatory surgical care in Ireland-why it needs to be better coded, classified and managed.

Background: In the year to July 2017, surgical disciplines accounted for 73% of the total national inpatient and day case waiting list and, of these, day cases accounted for 72%. Their proper classification is therefore important so that patients can be managed and treated in the most suitable and efficient setting.

Aims: We set out to sub-classify the different elective surgical day cases treated in Irish public hospitals in order to assess their need to be managed as day cases and the consistency of practice between hospitals.

Proceedings of resources for optimal care of acute care and emergency surgery consensus summit Donegal Ireland.

Background: Opportunities to improve emergency surgery outcomes exist through guided better practice and reduced variability. Few attempts have been made to define optimal care in emergency surgery, and few clinically derived key performance indicators (KPIs) have been published. A summit was therefore convened to look at resources for optimal care of emergency surgery.

What is the future for General Surgery in Model 3 Hospitals?

Background: General Surgery consultant recruitment poses considerable challenges in Model 3 Hospitals in Ireland.

Aim: The aim of this paper is to examine General Surgery activity and consultant staffing in order to inform future manpower and service planning.

Methods: General surgical activity in Model 3 Hospitals was examined using the validated 2014 Hospital Inpatient Enquiry (HIPE) dataset.

Risk factors for surgical site infection following colorectal resection: a multi-institutional study.

Introduction: Surgical site infection (SSI) is an infection occurring in an incisional wound within 30 days of surgery and significantly affects patients undergoing colorectal surgery. This study examined a multi-institutional dataset to determine risk factors for SSI following colorectal resection.

Methods: Data on 386 patients who underwent colorectal resection in three institutions were accrued.

Implementing Major Trauma Audit in Ireland.

Background: There are 27 receiving trauma hospitals in the Republic of Ireland. There has not been an audit system in place to monitor and measure processes and outcomes of care. The National Office of Clinical Audit (NOCA) is now working to implement Major Trauma Audit (MTA) in Ireland using the well-established National Health Service (NHS) UK Trauma Audit and Research Network (TARN).

Characteristics of patients who are acutely admitted to hospital under surgical care and do not have a surgical procedure - Is there an alternative to admission?

Introduction: Previous work has shown that 56% of all acute surgical admissions in Ireland in 2012 did not have a formal surgical procedure. In light of the pressures on health systems internationally and the lack of relevant data on this topic in the literature, we examined the characteristics of this cohort of patients in Ireland.

Methods: Discharge data on acutely admitted patients who did not undergo a surgical procedure was extracted from the Hospital Inpatient Enquiry (HIPE) database for the year 2013.