care of patients with one disease aetiology. It is
important that all hepatology nurses, regardless of
their clinical setting or speciality, are aware of the
nursing management of hepatitis B, hepatitis C,
ALD and HCC to ensure a holistic approach and
continuity of care throughout the spectrum of liver
disease. As such, the four disease-specific documents
are designed to be considered concurrently.
Limitations to the implementation of the AHA
Guidelines arise at the individual level and consideration
of the organisational culture in which the
individual nurse works. The hepatology nurse’s
employing organisation must be open to changes in
clinical practice and foster an environment in which
nurses feel empowered to instigate changes to reflect
the evolution of evidence-based care, or where evidence
is lacking the evolution of thinking documented
in consensus-based guidelines. Although
the AHA Guidelines were developed through
national consultation and are broadly representative,
the settings in which nurses care for patients
with hepatitis B, hepatitis C, ALD and HCC
are diverse, and it is unrealistic to summarise the
expected responsibilities of nurses in each of these
settings. These issues rely on the capacity of individual
hepatology nurses to institute change and
consider the AHA Guidelines from the perspective
of their own setting and organisational culture.
An important finding of this study was the
lack of empirical evidence to support hepatology
nursing practice. This deficit highlights the urgent
need for nurse-led research to ensure optimal
healthcare for patients with liver disease, appropriate
resourcing and workforce development initiatives,
are documented and shared internationally.
Implementation of the AHA Guidelines will
be supported by the development of practicerelated
tools such as nursing care plans, or locally
relevant policies and procedures for individual
clinics/services. From a broader perspective, the
AHA Guidelines will inform the development of
educational activities and guide hepatology nurses
to identify their professional development needs.
In addition, colleagues working in other clinical
settings, and outside the clinical arena, will
find the AHA Guidelines useful in clarifying and
understanding the role of hepatology nurses in
T
caring for patients with liver disease.