Bon Secours Hospital Cork

This mixed methods systematic review explored the effect of education on the implementation of evidence-based practice among nurse leaders within healthcare settings. Education influences nurse leaders' ability to implement evidence-based practice. Successful implementation requires multifaceted strategies, including organisational support and leadership engagement, to overcome persistent challenges and ensure evidence-based knowledge is translated into high-quality, person-centred care. This review followed Joanna Briggs Institute(JBI) guidance and was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. CINAHL, PubMed, Cochrane Central Register of Controlled Trials, Web of Science, ClinicalTrials.gov, and Google Scholar were searched without language or year limits to June 2025. Studies were double screened, appraised using the Mixed-Method Appraisal Tool, and synthesised using convergent parallel synthesis. A total of 3,646 records were identified, with nine studies included. Education positively influenced nurse leaders' knowledge, attitudes, beliefs, clinical skills, and leadership behaviours regarding evidence-based practice. Perceptions of leadership support improved following interventions. However, evidence on long-term sustainability was limited. Organisational culture, resourcing, communication, and collaboration acted as both barriers and facilitators to implementation. Education strengthens nurse leaders' capacity to support evidence-based practice but is most effective when embedded within supportive organisational contexts. Education alone is insufficient without alignment with culture, resources, and leadership structures. Education enhances nurse leaders' ability to implement evidence-based practice, but sustained impact requires organisational readiness and ongoing support. Targeted education, combined with organisational support, can strengthen leadership capacity and improve care quality and patient outcomes. Policies that invest in structured evidence-based practice education for nurse leaders, alongside organisational infrastructure and protected time, may enhance sustainable evidence-based care delivery.

49 Background: ASCO Certified is a flagship quality program with the goal of ensuring every patient with cancer has access to high quality, patient-centered, coordinated cancer care. This program is based on the Oncology Medical Home (OMH) standards developed by ASCO and the Community Oncology Alliance (COA) and was launched in the United States in 2023. In line with ASCOs mission to enhance and promote quality care globally, an international pilot program was launched one year later. The pilot was established to assess feasibility and determine what, if any, adaptations should be considered. Applications were welcomed from international practices to pursue certification. Methods: A local working group was established and conducted self-assessment to identify gaps in meeting the standards in preparation for the on-site review. The group met on a frequent basis compiling evidence that demonstrated compliance with the OMH standards as well as following ongoing measurement and continuous quality improvement standards. Results: In August 2024 we applied to the ASCO Certified international pilot. Following approval, a working group was established to formulate team leads focusing on the seven different domains including patient engagement; availability and access to care; evidence-based medicine; comprehensive team-based care; quality improvement; goals of care, palliative and end-of-life care discussions; and chemotherapy safety. Evidence was uploaded to the ASCO portal for review. We completed a patient experience survey. An on-site review took place in December 2024. All 39 standards in care delivery were achieved. In January 2025, the hospital learned that they had achieved ASCO Certification as a practice participating in the International Pilot. Conclusions: ASCO Certified was a rewarding experience which affirmed that the cancer care delivered in our institution met established international standards. ASCO Certified aligned with the Bon Secours Hospital group mission to deliver exceptional quality care with compassion, dignity, integrity, and stewardship while identifying areas where improvements could be achieved. During the process the value for our patients, their families and the staff was evident. ASCO Certified recognizes the need for a collaborative approach to align with local legislative, regulatory, and cultural differences that exist globally while remaining cognizant of available resources.

Introduction:Venous thromboembolism (VTE), mainly deep vein thrombosis (DVT) and pulmonary embolism (PE), persists as a critical contributor to hospital-acquired mortality. Despite its largely preventable nature, early 2024 data from Bon Secours Hospital in Cork revealed alarmingly low compliance with VTE prophylaxis protocol.Aim: This study evaluated the implementation efficacy of VTE risk assessment and prophylaxis in adult hospitalised patients at Bon Secours Hospital, Cork, according to National Institute for Health and Care Excellence (NICE) guidelines.Methodology: Adult patients (127) at increased risk of VTE, specifically individuals aged ≥60 years, patients undergoing major surgical procedures, and/or patients with comorbidities including active cancer, hypertension, diabetes, immunological disorders, immobility or haematological disorders, across nine wards were included in this study. We also checked for any kind of bleeding risk, like active bleeding or low platelets. Each point was given 1 mark if present, which added to increase risk of VTE. We analysed the data to check the compliance with accurate prescription and completeness of the forms according to the NICE guideline. Exclusion criteria included paediatric, gynaecological, day-case admissions, and discharges within 24 hours of admission. The incomplete/inaccurate risk assessments were reported to improve timely and correct prophylaxis prescription. Results: Compliance surged with assessment completion, reaching 111 out of 127 (87.39%) with prescription accuracy. Timely assessments within 24 hours accounted for 101 (79.52%), yet 16 (12.64%) remained unassessed. A substantial proportion (103, 80.23%) exhibited one or more VTE risk factors, predominantly advanced age and multiple comorbidities. Anticoagulants, particularly tinzaparin, constituted the principal prophylactic measure, with mechanical prophylaxis employed in only 15 (11.81%). Alarmingly, 22 (17.32%) of high-risk individuals were not prescribed any form of prophylaxis.Conclusion:This study underscores the transformative impact of enforced protocol adherence and targeted multidisciplinary staff education on VTE prevention. The integration of an electronic health record system with real-time prompts could further ensure prophylaxis within the critical 24-hour window.

The European Society of Endocrinology (ESE) and the Union Européenne des Médecins Spécialistes (U.E.M.S.) Section and Board of Endocrinology have produced a Curriculum and Training Recommendation in Endocrinology to provide updated recommendations concerning the content and structure of postgraduate training. Cornerstones of the Curriculum are the integrity of Endocrinology not to be divided into subspecialties such as diabetology or thyroidology, recommendation of 6 years full-time training comprising 1-3 years (preferably 2-3 years) of General Internal Medicine followed by 3-5 years of specialist training in Endocrinology across 13 core areas. In addition to knowledge and experience in the many fields of Endocrinology, the Curriculum includes specific attitudes, communication skills, training to work in and lead multidisciplinary teams, resource management, quality assurance, human-error management, and critical incidents reporting as well as the commitment to life-long learning expected from a trainee and from an Endocrinologist. The Curriculum also includes requirements for training centres, for assessment of training and for competencies of trainers. The aim of the ESE Curriculum and Training Recommendation in Endocrinology is to harmonise postgraduate training and help provide the best medical care for patients with endocrine diseases across Europe.

Congenital adrenal hyperplasia (CAH) is an uncommon genetic disorder which affects cortisol production in the adrenal glands. It is usually treated with glucocorticoids. We present a case of non-classical CAH caused by the partial deficiency of 11 beta-hydroxylase (11βOH) which was treated with aldosterone antagonist (eplerenone) monotherapy. An adolescent male was diagnosed with 11 beta-hydroxylase deficiency (11βOHD) at 13 years of age when he presented with hypertension, fatigue and headaches. He was initially treated with glucocorticoids, but requested an alternative therapy. Eplerenone was commenced at 25 mg with subsequent dose increases to 100 mg daily. His hypertension was controlled on this regimen, achieving a 24 h average blood pressure of 124/81 mmHg. CAH caused by 11βOHD is a known cause of hypertension. It is usually managed with glucocorticoids, and antihypertensives are added if blood pressure remains uncontrolled. In this case, glucocorticoid therapy was not tolerated and treatment with aldosterone antagonist monotherapy was effective in controlling his hypertension.

A growing sense of the need to define good-quality cancer care has emerged in the past decade of the 20th century. The goals were to assess, improve, and reward quality. Animated debates between cancer care delivery academic and community organizations, governmental agencies, and insurance companies have led to multiple initiatives and pilot projects. ASCO was on the cutting edge of quality in oncology movement. We can define three phases, overlapping rather than sequential, in ASCO's journey. The first phase was generating definitions of good-quality care characterized by the publication of ASCO guidelines. The second phase was the creation of the tools to measure the implementation of standards of care with the creation of the Quality Oncology Practice Initiative (QOPI). The third phase was the launch of a comprehensive approach to cancer care quality as illustrated by QOPI Certification, then the more complete iteration, ASCO Certified Program. The latter is the most elaborate program to define quality from the patient and health care providers' perspective on one hand and governmental agencies and insurance providers' perspective on the other. Since the publication of the Ensuring Quality Cancer Care Report in 1998 to the ASCO Certified in 2023, a quarter century has elapsed. ASCO did not operate in a vacuum. Through collaborative efforts, reacting to and interacting with various players, it has advocated for positive change. During this period, ASCO has led the movement of quality in oncology intelligently and with the upmost sense of responsibility toward the patients, health care professionals, and society at large. While many of these efforts began domestically, their reach is extending globally through research, education, and the promotion of equitable care.

El Dr. José Gregorio Hernández nació el 26 de octubre de 1864 en Isnotú, estado Trujillo. Estudió sus primeras letras en su pueblo natal y se trasladó posteriormente a Caracas para estudiar en el Colegio “Villegas”, graduándose de Bachiller en Filosofía en el año de 1884. Antes de comenzar a hablar su destacada carrera médica, es importante mencionar su formación académica, la cual soldó los pilares para el inicio de la misma. Se doctoró en medicina en la Universidad Central de Venezuela el 29 de junio de 1888. Su tesis la defendió ante Jurado y presentó sobre dos temas: La Doctrina de Laennec y la Fiebre Tifoidea en Caracas, ambos temas relacionados con enfermedades bacterianas, campo en el cual se verá centrada su profesión médica posteriormente. Es considerado fundador de la Bacteriología en Venezuela

Background: With the increase in the obesity epidemic, bariatric surgery rates have escalated exponentially. Despite this, a large proportion of those referred for bariatric consultation fail to follow through with surgery. Methods: A retrospective case note and database review was carried out on a consecutive series of patients attending a single centre of excellence. All patients completed the psychological assessment tools—Beck Depression Index (BDI) and Hospital Anxiety Depression Score (HAD), prior to consultation. Demographic and clinical data were recorded. Results: Between January 2017 and January 2021, 234 patients attended for an initial bariatric consultation and completed pre-consultation questionnaires. A total of 172 questionnaires were available for subsequent assessment. Seventy four percent (n=128) were female. Fifty four percent (n=93) underwent subsequent surgery. Private insurance cover had a significant influence on whether patients proceeded with surgery 81 (80%) vs. 13 (12%), P<0.05, Chi square. The overall BDI and HAD scores for the group were 14.63±10 and 6.34±10.5, respectively, indicating moderate depression. Patients not proceeding with surgery had a significantly higher BDI (16.2±10.1 vs. 13.2±10.5, P=0.04) and HAD score (7.2±4.6 vs. 5.5±4.2, P=0.01) than those who ultimately proceeded to surgery. Conclusions: Unsurprisingly private insurance cover has a significant influence on the decision to proceed with bariatric surgical intervention, reaffirming that a much larger number of severely obese patients would likely undergo surgery if it were within their financial remit. Patients who decline subsequent bariatric surgical intervention have significantly higher initial depression and anxiety scores, suggesting a possible benefit for early psychological/psychiatric intervention in this group.