Liver and GI Day Case Service
The Liver and GI Day Case Unit was developed in New Cross Hospital over the years to address unnecessary hospital admissions and delays in treatment of our GI and liver patients. This novel service is fully nurse-led, nurse-managed and nurse-delivered which provides various intravenous infusions (including biologics), blood transfusions and abdominal paracentesis. It was initially a single room procedure area within the gastroenterology ward (C15) which later evolved into a purpose built 3-space area within the new GI ward (C41). Following its success and increase in patient uptake, the service expanded to the Ambulatory Emergency Care Unit in ED. In the wake of the Covid-19 pandemic when a number of NHS services were restructured, the day case service was relocated in Cannock Chase Hospital. Service continuance and delivery of treatment during the times of pandemic resulted to hospital admission avoidance and minimise the risk of cross-infection particularly with our vulnerable patients.
Our nursing team works closely with our liver and gastroenterology medical and CNS teams, including IBD and inpatient wards. Aside from the provision of ascitic fluid drainage, biologic infusions and various transfusions, our nurses are competent in providing paracentesis trainings to junior doctors and other members of the multidisciplinary team within and outside the Directorate. They are also trained to identify fluid build up in the abdomen (ascites) with the use of a portable ultrasound machine. The service is the portal for some regular patients who require advice from the other GI/liver teams. Our nurses are competent in reviewing blood results and escalate concerns as deemed necessary. From a monthly average of 20 patients who were seen at its infancy years, the service now provides 250 treatments on average per month.
Currently, the service runs from 9:00am to 5:00pm Monday to Friday with the plan to progress to a 7-day service in the future. We are proud to have a multicultural and dynamic nursing team whose ethos is to have the knowledge to treat and the passion to care, as our inpatient wards. The team comprise of Maria Tan (Advanced Clinical Practitioner), Sundeep Chahal (Liver Nurse Lead and Liver and GI Day Case Lead), Rosemarie Peralta and Rhodora Bloomfield (Junior Sisters), Gail Balgos, Olitha Dougall and JJ Givela (Staff Nurses), Justine Hammond (Health Care Assistant) and Cindy Puccio (Admin Staff). With the plans of service expansion, we are constantly training and recruiting nurses to build the team and service for the future.
This service is said to be a novel and first of its kind to be established in the Midlands in the year 2014. It also has several published papers attached to it. Aside from being awarded locally in the RWT’s Royal awards locally for Outstanding Service, it has been recognised nationally for Innovation and Hepatology Nurse (British Journal of Nursing), Managing Long Term Conditions and Patient Safety – Quality improvement (Health Service Journal), Service Development (British Society of Gastroenterology) and Gastroenterology Nurse of the Year (BJN). More importantly, the service consistently received excellent feedback from bi-annual patient satisfaction surveys.