Developing a resource for Nurses Caring for Children with liver disease or liver transplant in New Zealand

Abstract

Paediatric liver transplant has become an accepted mode of treatment in New Zealand for children with end stage liver disease and more recently to allow improved quality of life. The program is based at Starship but provides a national service. Currently 58% of the 140 children, pre and post liver transplant, case managed by the nurse specialist service live outside the greater Auckland region. They are cared for using a shared care philosophy by regional nursing and medical staff with Starship specialist support (Starship Gastroenterology Nurse Specialist Database June 2011).

Many centres have only one or two children and are being cared for by teams with limited experience of chronic liver disease and transplant. Due to the subspecialist nature of the patient group, accessing quality information can be time consuming and challenging for nurses. Increasing workload of the Starship specialist team has highlighted the need for a robust and relevant resource which is easily accessed by shared care nurses to guide patient care.

The aim of this practice project was to develop an evidence-based, peer-reviewed nursing resource which contains the related anatomy, physiology and pathophysiology, along with evidence-based monitoring and intervention recommendations. Best practice in Project Management (Australian College of Project Management, 2001) and Larrabee’s Model for Evidence-Based Practice Change (Larrabee, 2009) methodology were implemented to guide the project through a series of phases; from assessing the need for change, and development of the resource, through to planning for implementation and evaluation of the resource outcomes.