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Irish Street Medicine Symposium 

Trinity College Dublin School of Medicine
28 – 29 September

2018

Venue: Institute of Population Health, 

School of Medicine, 

Trinity College Dublin, 

Russell Building, Tallaght Cross,

Dublin 24

 

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The Symposium is an excellent opportunity to join a growing community of health and social care workers, academics, policy makers and planners working together to improve health outcomes for the most vulnerable in our society – homeless people, drug users, prisoners and migrants.

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After 3 successful Symposiums where our community presented examples of innovative practice and research, this year’s Symposium aims to facilitate people from different professions and perspectives to work together on solutions to reoccurring problems or to develop areas of practice. In this way participants will be actively engaged in contributing to solutions.

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Friday 

 

Morning working groups:​

Improving care and protection for Rough Sleepers in Extreme Weather Conditions

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This is a practical and thought provoking workshop that seeks to develop system wide capacity to protect the health and wellbeing of rough sleepers in extreme cold weather. Specifically the aim is:

  1. Develop systems to ensure access to shelter and support to all during the period of extreme weather

  2.  Protect health and wellbeing for those who stay out

1.

Clinically assessing complex homeless patients and maintaining engagement: key nursing skills

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Inclusion health is emerging as a distinct discipline as it is recognized that excluded groups may require different or enhanced approaches to meet their health needs effectively across all healthcare settings There will be a presentation from the workshop leaders who are experienced senior clinicians in the field of inclusion outline some innovative approaches that have changed practice and engagement such as – 

1) RUDAS and assessing mental capacity and functionality 

2) use of peer advocacy

3) case management working with a cross speciality MDT-This will include case examples

2.

Identification and first line management of adults at risk of malnutrition

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The workshop will be split into three parts:

Part A: Education update and Case Study Discussion

Part B: Practical workshop on malnutrition screening and use of oral nutritional supplements (ONS) and Further Case study  examples.

Part C: Group Discussion and recommendations

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Proposed Outcomes:

  • Explain what groups are at potential risk of malnutrition and discuss common nutrition issues seen in adult homeless    population in both acute and community settings.

  • Explain the underlying causes of malnutrition.

  • Explain how to use the Malnutrition Universal Screening Tool ‘MUST’ to identify nutritional risk

  • Explain first line management for adult patients at risk of malnutrition.

  • Explain role of dietitian and routes of referral to dietitian

  • Explain basics of high protein high calorie dietary advice for patients at risk of malnutrition

  • Explain main principles of appropriate prescribing of Oral Nutritional Supplements ONS

  • Explain about procedures for monitoring patients at risk of malnutrition

  • Practical workshop to practice nutrition screening skills and appropriate use of ONS

  • At the end of the workshop the group will come forward with recommendations on the management of malnutrition within the adult homeless community

3.

Hospital to home: Integrated solutions to enhance safe, appropriate and efficient discharges for people experiencing homelessness in Ireland

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Participants attending this workshop will gain a deeper understanding of personal experiences, service challenges and positive developments in relation to hospital discharge for people experiencing homelessness in Ireland. Participants will actively and collaboratively contribute to identifying solutions that will enhance integrated approaches to ensure people in homelessness are experiencing safe, appropriate and efficient discharges from hospital and are accessing appropriate follow-up care and accommodation in the community.

4.

How can the Mobile Health and Screening Unit improve health protection among vulnerable groups: a public health perspective

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The session will include presentations from Safetynet introducing the mobile health and screening unit and the work it does, focusing on the recent tuberculosis active case finding campaign in homeless hostels in Dublin. The HSE West Galway/Roscommon/Mayo Public Health department will present on their work with the MHSU in Galway as a case study. There will then be a focused discussion around the following issues

 

  • What are the biggest health protection and preventative health challenges among vulnerable groups?

  • How could the MHSU help to meet these challenges?

  • How can public health departments, the homeless sector and other agencies working with vulnerable groups support the work of the MHSU?

  • How can Safetynet MHSU, public health departments and others work best together?

5.

Afternoon working groups:​

Development of the Irish Forum on Inclusion Health

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This workshop will explore possibilities and interest in developing an inclusive forum encompassing a wide range of disciplines with the aim of sharing and forwarding the knowledge base to improve inclusion health practice

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6.

Change Management

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We are constantly seeking to improve services. This can include huge or tiny changes in service provision. Often we know we want to bring about an improvement but are unsure how  to make this improvement happen. Even if a change makes sense often individuals will resist it due to fear of the unknown and comfort with the status quo. Also change that makes sense often has unforeseen consequences that can cause individuals and organisations discomfort.

7.

Developing Ireland’s First Step Up Step Down Intermediate Care Centre for Homeless People

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Dublin Simon and SafetyNet are working together to open a 12 bedded unit for people who are homeless and in need of medical or nursing care that can safely be provided outside an acute hospital. This working group will be a forum where all potential stakeholders can learn about and contribute to the development of the centre.

Dr Austin O’Carroll, founder of SafetyNet , will talk about the background to the centre, then groups will focus on issues such as:

  • Arranging admission (Clinical criteria, who can refer, Information gathering/sharing)

  • Establishing/maintaining accommodation on discharge

  • Managing substance misuse/dependence, both treated and untreated

  • Mental Health and how the ICC can augment/facilitate existing services.

8.

Assessing Capacity

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There are times when homeless patients fail to engage with our proposed treatment plan, and times when medical or support teams are concerned re their ability to make their own decisions. This workshop will look at ways of assessing a patients capacity, using best practice. it is hoped this will help us know when it is appropriate for us to allow patients make personal decisions and when it is appropriate for us to intervene.

9.

Saturday

Symposium

 

CPD Recognition

5.5 external credits/day

GMS study leave allocation: 1/day

 

Contact: Please contact Kate Tierney with any queries at:

Kate@primarycaresafetynet.ie

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