National Rehabilitation Hospital

Paediatric Family-Centred Rehabilitation

NRH Paediatric Family Centred Programme

NRH Paediatric Family Centred Programme

Paediatric Family-Centred Rehabilitation services at the NRH

The Paediatric Family-Centred Rehabilitation (PAEDS) Programme is the national medical rehabilitation service for children and young people up to the age of 18 requiring a complex specialised rehabilitation service.

Referrals for the service are received from across the Republic of Ireland. The rehabilitation needs of each person referred can be assessed on an inpatient/day patient or outpatient basis.

Therapeutic interventions can be offered on an inpatient/day patient or on a limited outpatient and outreach basis.

The Paediatric (PAEDS) Programme at NRH has 8 beds (6 inpatient beds and 2 day places).

In effect the Paediatric Programme is a microcosm of the three adult Programmes at NRH, providing rehabilitation services to children and young people who have significant who require medical rehabilitation as a result of conditions such as a brain injury, stroke, spinal cord injury, neurological disorders or limb absence.

The Objectives of the Paediatric Programme Are:

  • To achieve the maximum rehabilitation potential of each child – physically, emotionally and cognitively.
  • To involve the children/young people and their families/carers in the rehabilitation process.
  • To support the reintegration of the child/young person into his/her home, school and the wider community.
  • To help and support the child/young person and his/her family to adjust to loss, changed self image and abilities.
  • To liaise and advocate with Health, Therapeutic and Education Authorities in the young person’s local communities regarding their ongoing rehabilitation needs.
  • To offer rehabilitation training and education to family/carers/Teachers/Special Needs Assistants and Personal Assistants and other service providers.

The Rehabilitation Team

Rehabilitation treatment and care for the Paediatric Programme is delivered by the Rehabilitation Team.

Dr. Susan Finn is the Consultant in Paediatric Medicine responsible for the overall delivery of paediatric medical care to children and adolescents receiving rehabilitation services at the NRH. Dr. Finn’s primary medical position is with the National Children’s Hospital at Crumlin.

Additional medical rehabilitation care and consultation to children and young people in the Paediatric Programme is provided by:

  • Dr. Jacqui Stow for patients with needs in relation to limb absence.
  • Dr. Éimear Smith for patients with spinal cord injuries.
  • Dr. Mark Delargy for paediatric patients referred to the NRH by Beaumont Hospital while they receive acute care and progress to admission to the paediatric programme.
  • Ghyslaine Brophy is Programme Manager for the Paediatric Family Centred Rehabilitation Programme. A primary focus of the Programme Manager’s role is to facilitate, with and on behalf of the team, the development and delivery of effective and efficient rehabilitation services and standards for our paediatric and adolescent patients.

The Paediatric Programme at NRH accesses a full complement of support from:

  • Medical
  • Nursing
  • Clinical and Therapy Services
  • Administration

Continuous Improvement

Improving the quality of patient care and improving access for children and young people on the waiting list is of the highest priority at the NRH.

Clinical & Therapy Services Within The Paediatric Programme

Nursing

Ward Manager: Rita O’Connor, CNM II

Paediatrician Liaison Nurse: Angela O’Riordan

Ward: St. Agnes’ Ward on 3rd Floor

Clinical Neuropsychology

Clinical Neuropsychology provides in-depth reports vital to the young persons’ successful return to, and continuation in, education frameworks that are appropriate to individual need, and liaises closely with the Team and the School at NRH.

Social Work

Social Workers provide a service to: inpatients; the outpatient clinic; and an outreach service to many of the families attending the Paediatric service. Many parents and children visit the unit prior to admission and are introduced to the service by the social workers and nursing staff.

Nutrition & Dietetics

The Dieticians provide a service to the Paediatric Programme. The main reasons for referral include overweight, malnutrition, enteral tube feeding and other food-related issues.

Core Clinical and Therapy services provided to the Paediatric Programme also include:

  • Occupational Therapy
  • Physiotherapy
  • Prosthetics and Orthotics
  • Speech & Language Therapy

Music Therapy

Feedback from service users, their families and the paediatric rehabilitation team members about the pilot Music Therapy Service has indicated that there have been significant benefits for patients from this new service. These benefits include encouraging and motivating desired movements, to communicate more effectively with non-verbal children and to build therapeutic relationships.

Children in Hospital Ireland – Volunteers

The children and young people continue to benefit from the reliable and supportive play activities three evenings each week provided by the Children in Hospital Ireland play volunteers.

Demographics & Activity For The Paediatric Programme – 2016

Demographics & Activity

In 2016 the Paediatric Family-Centred Rehabilitation (PAEDS) Programme discharged 148 patients from the service. Of these, 43 were new patients (PAED 1 and PAED 2 patients) to the programme and 105 had been previously admitted.

  • PAED 1 denotes: Children and young persons discharged from the Comprehensive Integrated Inpatient Rehabilitation Programme (CIIRP) which includes assessment followed by a period of intensive rehabilitation.
  • PAED 2 denotes: Initial assessment only.

The average waiting time for admission to the Paediatric Comprehensive Integrated Rehabilitation Programme (CIIRP) in 2016 was 90 days (the waiting time for a review or follow up service is not reflected in this figure).

The average length of stay for patients discharged from the Paediatric Programme (CIIRP) in 2016 was:

  • Lower range –  15 days
  • Higher range – 81 days
  • Average range – 42 days

Attendance at Clinics

In 2016, 29 Children and young people attended the Paediatric Spinal Cord Injury Multidisciplinary and 11 attended the newly established Paediatric Non-Consultant Led Acquired Brain Injury Clinic.

 

The following tables show the breakdown of pre-hospital HSE areas of residence, gender and age profile of children and adolescents discharged from the Programme in 2016

Pre-hospital HSE areas of residence of all patients discharged from the PAEDS Programme in 2016
HSE Dublin Mid-Leinster 44%
HSE Dublin North East 19%
HSE South 15%
HSE West 22%
Gender of patients discharged from the PAEDS Programme – 2016
Male 61%
Female 39%
Age Profile of patients discharged from the PAEDS Programme in 2016
Average age 12 years
Lower age range 4 years
Higher age range 17 years
 
 Of the 34 new patients seen and discharged from the PAEDS programme in 2016, the diagnoses are as follows:
Traumatic Brain Injury 8
Brain Infection 0
Stroke 0
Tumour 0
Other Brain Injury 21
Traumatic Spinal Injury 0
Neurological Disorders 0
Other Spinal Injury 4
Limb Absence 1
Total 34