Liver Nurse News
July 2022 – Welcome New CAHN Executive Team + HCC Competency, Cirrhosis Video Series & CAHNference 2022!
Board Member, Education Chair, Regional Events Co-Chair
Lindsay Myles is a primary care nurse practitioner who has developed a subspeciality in hepatology. Since graduating from the University of Toronto, she has practised in Barrie with a community group of gastroenterologists at the Simcoe Liver Centre. They see patients with all liver diseases in the Simcoe Muskoka region. She is particularly interested in optimizing community management of liver disease in order to reduce repeated hospital admissions and so patients can enjoy a better quality of life.
Stephanie Eiloart has worked in many different areas of nursing, including endoscopy, clinical research, and hepatology. For the past 20 years, I have been dedicated to treating patients with Hepatitis C and in the past three years I have worked with HepCure a non-for-profit organization, working with the homeless population and people with addictions. I cover mainly the Toronto area but also support our mobile units and clinics in other parts of Ontario. I enjoy being out on the street finding and helping this population achieve the best possible treatment outcomes despite the countless obstacles in their lives.
Sarah De Coutere
Board Member, Regional Events Co-Chair
Sarah obtained her diploma in nursing in Halifax, Bachelor of Nursing from the University of Calgary, and her Master of Nursing from Dalhousie University in Halifax. She is a hepatology nurse practitioner working in Halifax with people with end stage liver disease, hepatitis B and C, fatty liver disease and autoimmune liver diseases. She has been on local and national committees for promotion of hepatology practice and shares her knowledge freely and often with anyone who wants to know! She is passionate about encouraging nurses to share their stories with each other locally, nationally, and internationally, to appreciate each other’s successes and challenges, with the goal of ultimately influencing practice for overall improved health experiences for all. In her spare time, she is a proud mother of two engineering university students, a prolific knitter, telemark skier, hiker, camper and a sea kayak instructor and guide.
As a seasoned RN in the Hepatitis C field, Liza Abraham has worked in many different settings over the last several years. From community, Hospital, outreach, and virtual settings, she continues to expand with the rapidly changing Hepatitis C environment. Liza currently works with Omega Specialty Nurses as an Outreach RN, as well as True North Medical Treatment Centres in a pilot project for remote Hep C testing and Nursing care with the OAT population.
Elizabeth Martin has been a Nurse since 2007 and has worked in a variety of settings in Canada throughout Nova Scotia, Alberta, British Columbia, and Northwest Territories. She obtained her Master of Nursing- Nurse practitioner Stream through Dalhousie University and started her GI career in Yellowknife in 2013.
Since 2016 she has been in Southern Ontario working in Community GI/Hepatology clinics (primarily Hepatology). She supports Hepatologists and Gastroenterologist treating all liver diseases with a focus on cirrhosis, decompensated liver disease, NASH/NAFLD and viral hepatitis. She has recently become the Director of Outreach for a non-for-profit organization with a focus on identifying and treating priority populations at risk for hepatitis C infection.
HCC Competency Update
Thank you to the Standards and Competency Committee for their hard work and dedication. The updated competency on Hepatocellular Carcinoma Competencies is now live on CAHN’s website. Our Education Committee is in the process of mapping educational resources to each competency with the aim of finding and filling the gaps. If you have a suggestion on what area of hepatology is lacking educational resources, we would love to hear from you. Email [email protected].
Part two of CAHN’s Cirrhosis Series: Management of Hepatic Encephalopathy
On June 29th, Stephanie Tiffin and Elizabeth Lee led participants through a case-based discussion on the management of hepatic encephalopathy in patients with decompensated cirrhosis, drawing on inpatient and outpatient perspectives. The recording is available to all CAHN members.
Save the Date! November 18-19, 2022, in Vancouver, BC & online
CAHN’s own Liver Health Education Event
Please join us for the third annual CAHNference. CAHN’s own liver health education event!
CAHNference brings together healthcare professionals, from coast to coast, to share leadership stories, pandemic impacts, clinical best practices, innovative research, and scientific developments impacting hepatology nurses, their patients, and associated healthcare disciplines.
- CAHN is collaborating with the International Network on Health and Hepatitis in Substance Users (INHSU) to hold CAHNference 2022 adjacent to INHSU’s Intervention Implementation Symposia.
- This is a free event. We extend a warm welcome to members, non-members, affiliates, and guests who wish to join us!
- CAHN members who attended our annual general meeting in May are eligible for travel reimbursements as per the conference travel policy found in the member’s only section of CAHN’s website.
Watch for updates at www.cahnference.com.
High-level Combined Schedule (PST):
- Friday, Nov 18, 13:00-18:00 INHSU’s Intervention Implementation Symposia In-person only
- Friday, Nov 18, 18:00-21:00 INHSU & CAHN Networking and Dinner In-person only
- Saturday, Nov 19, 08:30-16:30 CAHNference 2022 Program Hybrid
Stay tuned for the CAHNference agenda and speaker announcements coming soon!
INHSU’s interactive face-to-face symposium will focus on the practical implementation and scale-up of evidence-based interventions that have been shown to enhance testing, linkage to care and treatment for HCV. Interventions will be selected in collaboration with local organizations and will include point-of-care testing, dried blood spot testing and peer support. This Symposium will be the first of its kind to provide participants with effective practical training in an accessible and highly interactive format.
The target audience will include healthcare providers, community members and policymakers from a variety of local settings, e.g. primary care, D&A, corrections, harm reduction, outreach, homelessness, and mental health.
- Understand evidence-based interventions demonstrated to enhance the HCV care cascade
- Describe how a range of interventions work and how they can be implemented to enhance models of HCV care
- Understand the HCV care cascade and be able to identify areas for enhancement in service delivery
- Identify suitable interventions to enhance service delivery
- Analyze barriers to implementing successful interventions and how to overcome them
October 14-16, 2022, at the Sheraton Wall Centre in Vancouver, BC. CAHN members receive a discounted registration fee of $125.00 (regular $400) until September 14.
The International Liver Congress (ILC) 2022 for the European Association for the Study of the Liver (EASL) was held in person (and online) from June 22-26, 2022, in London, UK.
It was wonderful to see a number of CAHN members attend in person overseas and connect, and also see the contributions of CAHN members to the scientific programme!
Highlights included Lesley Gallagher, a long-serving member of CAHN’s leadership team, who presented the findings from CAHN’s first supported study, “Impact of the Covid-19 on hepatology nurses in Canada,” in ILC’s Nurse and Allied Health Professional session on ‘Learnings on the COVID-19 pandemic on Liver Care.’
Of note, this study was also published in the Liver Nurse Supplement of Gastroenterology Nursing in July 2021.
CAHN members also contributed a number of poster presentations, including Leo Yamamoto, Kate Dunn, Tamara Barnett, Kellie Guarasci, Karen Lundgren, and Mia Biondi.
If we missed your contribution and have work featured at upcoming meetings- please do let us know so that we could feature your work in our upcoming newsletters!
Nurse practitioners as primary care site champions for the screening and treatment of hepatitis C virus
Quantitative Research Study authored in part by CAHN members Cheryl Dale and Mia Biondi.
Background: Primary care providers are often the first point of contact for hepatitis C virus (HCV) care, yet treatment initiation in primary care continues to be low. Nurse practitioners (NPs) are autonomous providers who, in Ontario, currently prescribe HCV therapy; however, methods to engage primary care NPs in HCV care have not occurred.
Purpose: To assess the feasibility of a systematic approach to train and support NPs in HCV testing, care, and treatment.
Methodology: Nurse practitioners from Canada’s largest family health team (FHT) were recruited. Nurse practitioners received six hours of training and develop approaches to screen and treat at FHT sites. Treatment algorithms were given, and the number and types of inquiries from NPs were recorded.
Results: Over 1 year, 9 NPs screened 1,026 patients; 87.4% were screened based on the identification of a risk factor. A mail-out approach for birth cohort screening occurred at a single site, resulting in rapid uptake in screening. Antibody prevalence was 1.66%, with 76.5% RNA positivity. All RNA-positive treatment-eligible individuals were treated by an NP and completed treatment. Thirty-eight consults occurred over 1 year, the majority related to HCV or liver disease staging.
Conclusions: Formalized initiatives to engage and educate NPs lead to innovative strategies to test for HCV. Nurse practitioners can safely and effectively treat HCV in primary care with minimal support.
Implications: This work could be extrapolated to NPs in other primary care settings. Implementing formalized strategies has the potential to create NP leaders in the treatment and elimination of HCV in Ontario, Canada, and globally.