Q1 2025: Progress update from Children's Health Ireland’s Spinal Surgery Management Unit
Friday, 11th April 2025
April 11, 2025
All CHI locations
News
Today, Friday 11th April 2025, Children's Health Ireland has published its monthly Spinal Surgery Waiting List & Activity Report for March on www.childrenshealthireland.ie/spinal.
Mr David Moore, Head of the Spinal Surgery Management Unit, says:
“Throughout the first three months of 2025, 123 surgeries have been carried out in Children's Health Ireland and through our associated initiatives. In the same timeframe, 144 additional spinal procedures have been added to the waiting list following outpatient assessment. We aim to have a new Consultant Spinal Surgeon in post in the summer, who will further bolster our efforts to reduce the waiting list for spinal surgery and the length of time that patients are waiting. We look forward to welcoming new members to the team, and recruitment is currently underway for a Clinical Nurse Specialist, an Advanced Nurse Practitioner in Tissue Viability and an Occupational Therapy Specialist.”
“We acknowledge the publication of HIQA report this week, and do not underestimate the impact that this has on the families affected. The Spinal Surgery Management Unit will continue to develop and implement important quality measures and patient education resources.”
Progress from the Spinal Surgery Management Unit for Q1 2025 includes:
HIQA Report
Note: Please find Children's Health Ireland’s full statement relating to the HIQA Report here.
Children's Health Ireland entirely accepts HIQA’s findings and recommendations in the independent review of governance at Children's Health Ireland in the use of implantable medical devices, including the use of non-CE marked springs in spinal surgery at CHI at Temple Street, published earlier this week.
An FAQ has been developed for families relating to HIQA’s report and findings, alongside a list of spinal service improvements relating to issues raised in the report.
A Quality Improvement Plan (QIP) is in development will be published on the Children's Health Ireland website within three months. Children's Health Ireland is committed to providing updates on the QIP quarterly.
Scoliosis Information Hub
We have launched a new scoliosis information hub on www.childrenshealthireland.ie/scoliosishub.
Thank you to all of the families who shared their experiences for these guides, and to members of the Patient Panel for Spinal Services for their collaboration.
Surgical Site Surveillance
Since 2022, a Surgical Site Surveillance team in CHI at Crumlin has been working to reduce surgical site infection rates for spinal surgery patients. Through dedicated surveillance, examining surgical practices, raising awareness, and improving screening processes, the Surgical Site Surveillance team have made a massive impact for patients.
CHI at Crumlin Surgical Site Surveillance team infection rate report, April 2025:
- All spinal surgery patients: 3.9%
- High-risk spinal surgery patients (spend longer hospital / comorbidities): 5.6%
- Adolescent Idiopathic Scoliosis: 0%
As a result of allocated funding, CHI is now in the process of hiring additional Infection Prevention and Control Clinical Nurse Managers. The Surgical Site Surveillance team will then be in a position to roll out the successfully trialled quality improvements in CHI at Temple Street also.
Malena McLoone, Clinical Nurse Manager 2 for Surgical Site Surveillance, explains:
“Everyone has bacteria on their skin. In one square centimetre of skin, I might have 10 thousand bacteria living happily, another person might have a million living in the same size. Having more bacteria increases the risk of developing an infection after surgery. So, all patients scheduled for spinal surgery must undergo a screening test for Staph aureus within 60 days of their surgery. For patients that we don’t see in clinic, we post them a screening kit and instructions how to perform the test at home. Parents and our patients can do simple but important things to prevent an avoidable infection. We emphasise the importance of washing with appropriate liquid soap before spinal surgery to reduce the risk".
For more advice, see page 23 of Guide to Spinal Surgery in Children's Health Ireland.
Halo Gravity Traction Walker pilot
Children and young people who require Halo Gravity Traction (HGT) often spend a number of weeks in hospital. Until now, patients on HGT have had limited mobility while they are confined to a HGT wheelchair or bed, which is understandably difficult and challenging for many patients.
The spinal team in CHI at Temple Street are pleased to pilot a HGT walker system, which allows the patient to walk (assisted) while in traction. This has the added benefit of promoting strength and conditioning during their hospitalisation and promotes quicker post-op rehabilitation and recovery post spinal surgery.
Kayleigh has taken part in this pilot and shares her experience:
Integrated Care Pathway (ICP) for Adolescent Idiopathic Scoliosis (AIS)
An Integrated Care Pathway (ICP) for Posterior Spinal Fusion (PSF) in Adolescent Idiopathic Scoliosis (AIS) is at the final stages of development.
Keelin Hession, Assistant Director of Nursing for Spinal Services, explains:
“This pathway aims to ensure standardised, high-quality care for our AIS patients. It outlines a structured plan for managing patient care from pre-operative preparation through post-operative recovery and discharge. A supporting Post-Operative Care Checklist for AIS spinal surgery has also been designed to ensure a structured recovery process, with standardised drug dosing and safety measures.”
Complex Care Patient Questionnaire
A new questionnaire document is in the sign-off stages for parents/guardians of children undergoing complex spinal surgery. It will assist in collecting detailed patient information for pre-operative assessment, including:
- Patient and family details
- Healthcare team contacts
- Medical history
- Mobility and daily care needs
- Medications and special requirements.
This aims to ensure a comprehensive evaluation before surgery and facilitates multidisciplinary care coordination.
Spinal Study Day with CHI’s Centre of Children’s Nurse Education (CCNE): Caring for the Child requiring Elective Spinal Surgery
The CCNE provides continuing education, training and professional development for registered children’s nurses and other children’s healthcare professionals.
This Spinal Study Day, attended by registered nurses working in the acute hospital setting, took place on 4th April and provided participants with the opportunity to develop the specific knowledge, skills and attitudes to enable them to adopt a therapeutic and holistic approach in managing the care of a child requiring elective spinal surgery. Topics on the day included pre-assessment, caring for the child pre and post spinal surgery, wound care and advances in wound care technology, physio lectures, and the MDT approach.
Galway Orthopaedic Nursing Conference:
Children's Health Ireland’s CNM2 of Complex Care in Spinal Surgery presented at the Galway Orthopaedic Nursing Conference on 27th March. Michelle shared her experience working in spinal services in Ireland and abroad in both public and private hospitals. The presentation focused on information for nurses taking care of spinal surgery patients at each stage of their treatment.
Paediatric Spinal Surgery Taskforce
Members of the Spinal Surgery Management Unit in Children's Health Ireland continue to work with members of the Paediatric Spinal Surgery Taskforce on improvements to spinal services.
Minutes of the Taskforce are published on www.gov.ie/en/publication/8ccd4a-patient-safety-surveillance/#paediatric-spinal-taskforce