Profile: The Liver Specialist Nurses delivering comprehensive care at Gloucestershire Hospitals
The Liver Specialist Team plays a vital role in the NHS, delivering comprehensive care to patients with liver diseases, and providing medical and emotional support throughout the treatment process. Since Debbie Durrant was appointed as the Trust’s first Liver Specialist Nurse in 2009, demand for the service has increased and we now have four specialist nurses at Gloucestershire Hospitals who manage a caseload of around 900 patients.
The team support patients suffering from liver diseases such as hepatitis, fatty liver disease, cirrhosis, and liver cancer due to factors such as alcohol consumption, obesity, viral infections and other lifestyle-related issues. The specialist nurses see patients on the wards during admission and then support around 25 a week for a variety of outpatient procedures in the clinic, currently at the Medical Day Unit (MDU) at Cheltenham General Hospital.
Gloucestershire Hospitals played a pivotal role in spearheading nurse-led ascites drainage, a procedure aimed at removing excess fluid from the abdomen. This innovative treatment not only aids in preventing prolonged hospital admissions but has also been widely embraced throughout the NHS. Presently, the Liver Specialist Team extends support to approximately four patients daily, with many attending follow-up appointments on a weekly or monthly basis. Alongside the drainage procedure, patients receive a course of Human Albumin to replenish the protein lost during the process.
Denise Walker, a Senior Liver Specialist Nurse said; "Our mission extends far beyond medical treatments. We strive to provide holistic, non-judgmental care that acknowledges and addresses the challenges our patients face. Whether it's supporting them through lifestyle changes, offering emotional support, or providing innovative treatments like nurse-led ascites drainage, our goal remains the same: to enhance their quality of life and journey towards better health."
"We strive to provide holistic, non-judgmental care that acknowledges and addresses the challenges our patients face. Whether it's supporting them through lifestyle changes, offering emotional support, or providing innovative treatments."
Denise Walker, Senior Liver Specialist Nurse
Their expertise extends beyond traditional liver care, encompassing services such as iron and blood transfusions, and providing stability through the Cirrhotic Clinic. In a bid to enhance patient outcomes and reduce readmissions, the team introduced the Discharge Clinic a year ago, a move that has had a significant impact on the continuity of care for discharged patients.
In a new initiative this year, a clinic will be opening at the Community Diagnostic Centre, where GPs can refer patients with incidental findings related to their liver function. Patients will then have a Fibro Scan, (Elastograph) which is more sensitive and specific than an Ultrasound in detecting fatty liver, if detected then the patient can be advised of suitable lifestyle changes and further safety-netted into the correct follow-up services if indicated in the result.
Deborah Durrant, a Senior Liver Specialist Nurse, said “A Fibroscan is an important diagnostic tool in the early prevention and prompt treatment of liver disease. This state-of-the-art equipment is able to provide a much more detailed picture of the health and stage of liver disease of a patient than a standard ultrasound. It is portable so can be easily moved around wards and helps not just our patients, but referrals from rheumatology, dermatology, cardiology, diabetes, haematology and renal departments if they have concerns regarding liver health .”
“Being able to provide patients with an accurate and prompt diagnosis is so important. Previously patients may have had to undergo a liver biopsy, have an inpatient stay or a longer wait for their results. With the Fibro Scanner the procedure is non-invasive, quick and informative, patients can then be guided to make lifestyle changes to optimise their liver health. This equipment really has made a huge difference to both staff and patients and we would like to say thank you to both the charity supporters and Norgine for making this possible.”