Advancing Health Professionals’ Knowledge of Liver Disease

Over the last 50 years, mortality and morbidity from liver disease has increased and is a global health concern (Global Burden of Disease, 2020). In the United Kingdom, within this time frame, liver mortality has risen by 500% in the under 65-year age group (British Liver Trust, 2019). Treating and caring for patients with liver disease is complex, therefore it is imperative to educate health care professionals regarding the different types of liver conditions, the treatments and care required to support patients. The critical appraisal spans over 14 years of research and will examine 19 publications which details the impact of the author’s research on their academic journey, from a student nurse to the present day; underpinned by Benner’s (1984) five stage theoretical framework. This appraisal demonstrates how the impact of the author’s research, nursing practice and published papers is advancing health professionals’ knowledge of liver disease within national and international arenas. It additionally evidences how the research has improved standards of medical and nursing care for patients receiving treatment for liver disease and establish how, by listening and responding to patient experiences, guided the research and assisted in the development of educational resources. The research chronologically encompassed positivist, interpretivist, and latterly pragmatic paradigms and utilised both quantitative and qualitative research methodologies. The research generated new knowledge regarding patients’ lived experiences of haemochromatosis, generated data submitted to Parliament and highlighted the requirement for venesection guidelines. The principal findings of the research demonstrated that there was a disparity of care across the British Isles, for people undergoing therapeutic venesection for haemochromatosis. This prompted the development of the venesection guidelines to standardise practice. A further finding demonstrated that less than 27,000 people were being treated for genetic haemochromatosis when the numbers should be nearer to 400,000 indicating that the condition is underdiagnosed. A further qualitative study highlighted that many General Practitioners take years to diagnose the condition, and some were unaware of its existence. The author’s expertise and research reputation, as evidenced by the collection of published research, has been sought by the National Institute of Health and Care Excellence (NICE) for the development of national guidelines and quality standards. The contribution from the author was recognised by NICE by the conferment of the title, NICE Expert. Research findings were presented to Parliament via an All-Party Parliamentary Group in 2020, to highlight the condition, genetic haemochromatosis and to lobby for increased awareness. The Venesection Best Practice Guide received Royal College of Nursing endorsement and was published as and eBook which has been downloaded by many countries, evidencing worldwide dissemination. This project won the National Patient Safety Learning Award in 2018 and in addition, the co-authors have been awarded winners of Nurse of the Year, 2021 by the British Journal of Nursing. This clearly demonstrates how the author has advanced health professionals’ knowledge of liver disease by informing and influencing local, national, and international policy to improve or even transform lives for the better.

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