Two Tipperary-based advanced nurse practitioners at University Hospital Limerick have become the world’s first nursing team to carry out the surgical implant of a tiny monitor enabling stroke or syncope (sudden temporary loss of consciousness) patients to have their heart rate and rhythm monitored from their own homes.

The UHL ANP older person team of Nora Cunningham and Sheila Ryan are among the first nurses qualified to conduct the procedure, which previously had to be performed by cardiologists.

Nora, orginally from Limerick but who lives in Roseboro outside Tipperary Town, and Sheila from Cappawhite, who describes herself as “Tipperary through and through” have spent most of the past two years researching and training, after they proposed that a nurse-led service could relieve pressures on cardiologists in the hospital’s busy cardiology department and significant reduce wait times for patients in need of the implant.

With only one other cardiology nurse delivering the service in Ireland, Sheila is the only syncope nurse in the country qualified to carry out the implantation, and Nora becomes the world’s only stroke nurse qualified in the procedure.

Together, they are believed to be the only qualified nursing team that can perform the procedure.

In addition to the benefits of the implantable loop recorder device, which provides data on a patient’s heart rate and rhythm over an extended period, the pioneering ANP team is showing how nurse-led teams can enhance the patient experience and improve efficiency of service delivery at UHL.

For Nora and Sheila, the important achievement is what their qualification can deliver for patients.

“I’m delighted to be able to lead out on this service and to be the first stroke nurse in the world to take on this role. It will facilitate a fantastic service for patients at UHL, and it represents the future for our health service through innovation and the passion for change.

She said that none of this would have been possible without the tremendous support of senior nurse management and the hospital’s medical consultants.

Sheila added: “As ANPs, it’s great to be able to play a key role in the journey of patients through University Hospital Limerick.”

The implantable loop recorder monitors a patient’s heart rate and rhythm for up to three years, and provides the most reliable picture of the health of patients who have experienced strokes or loss of consciousness.

Without such data, clinicians are unable to reliably determine the cause of a stroke or a loss of consciousness in patients. Extended monitoring enables the cause to be determined and treated effectively.

Patients with the implant are monitored at home, and can contact the nursing team for advice if they experience symptoms. If an abnormal rhythm is detected, nurses will contact the patient to organise a management and treatment plan.

However until now, the implant procedure was completed in the cardiology department at the hospital, and so the Stroke and Syncope Service at UHL could do nothing to influence waiting lists for the implant.

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