Liver Disease and Dysfunction Conference
- : Melbourne VIC 3000
Liver disease affects millions of Australians. As a nurse, you are likely caring for people with liver conditions. Attend this conference and ensure your nursing knowledge is up-to-date. It includes:
- The personal cost of liver disease
- Back to basics – how to assess liver function
- A practical guide to non-alcoholic fatty liver disease
- Alcohol and the liver
- From cirrhosis to cancer
- Modern management of hepatitis and much, much more …
Schedule Day One
8:30AM REGISTRATION FOR DAY ONE
Welcome and Introduction to Conference
Tracey Hughes and a Donor Recipient
Living Proof – Loving Life after Liver Disease
This introductory session will reveal the personal cost of liver disease. You will hear how liver disease deeply affects a person’s emotional, psychological, and physical health. It will share a story of hope to explain how nurses made a difference to the care of a person with serious liver disease who required then successfully recovered from a liver transplant. Discover:
- What is liver disease?
- What diseases does it encapsulate?
- Is liver disease in Australia increasing?
- Why is preventing the progression of liver disease to cirrhosis so important?
- What are the personal costs of liver disease?
- How do nurses make a difference to people with liver disease?
Dr Jacqui Richmond
Assessing Liver Function – Introduction to Diagnostic Testing
Vague symptoms may make it difficult to diagnose liver disease. A range of diagnostic tests can investigate liver function further. Understanding the rationales for the main diagnostic tests will assist nurses to form a clear clinical picture of the person they are caring for and assist with patient education and health literacy. This session aims to explain the following:
- What are the common blood tests performed to investigate liver function?
- When are they indicated?
- How do you interpret the pathology of liver function tests (LFTs)?
- What are the indications for an ultrasound or other imaging tools?
- When might a liver biopsy be required?
- Putting it all together – a look at how clinical pictures of common liver diseases can be formed
10:30 MORNING TEA
Non-Alcoholic Fatty Liver Disease – A Practical Guide for Nurses
While some degree of fat in the liver is normal, it only takes a small increase in percentage of fat for disease to occur. Non-alcoholic fatty liver disease (NAFLD) is becoming increasingly common. It is considered to be the most prevalent cause of liver disease in Australia. Many people with this disease have an increased risk of cirrhosis and liver-related death. This insightful session will discuss:
- What is non-alcoholic fatty liver disease?
- Why does NAFLD commonly exist alongside obesity, type II diabetes, cardiovascular disease, and metabolic syndrome?
- Which type of NAFD is most likely to progress to cirrhosis?
- What are the evidence-based treatments to prevent progression of disease?
- How can nurses support the treatment and management of NAFLD?
Associate Professor Louis Roller
Paracetamol Overdose and Toxicity
Paracetamol remains one of the most common agents used in overdose. It’s ease of access and potential for significant harm, in particular to the liver, either through abuse or unintentional overdose demands that all nurses must be familiar with:
- What constitutes a toxic dose of paracetamol in adults and children
- Stages of paracetamol intoxication, including respective symptoms and associated severity
- Current Guidelines for treatment, including the use of n-acetylcysteine and concurrent investigations
- Prognostic factors – the risk factors for toxicity that affect health outcomes
- Novel therapies that may facilitate liver detoxification e.g albumin dialysis
- When to consider liver transplant
12:45PM LUNCH AND NETWORKING
Dr Jacqui Richmond
Damage and Destruction? Alcohol and the Liver
For centuries alcohol has been recognised as a contributor and cause of liver dysfunction and disease. How does this actually occur and what level of alcohol causes this damage? This important session will explain how alcohol-related liver disease develops and progresses and will introduce some of the complications associated with alcoholic-related liver disease. Find out:
- How does alcohol damage the liver?
- What level of drinking is known to cause liver disease?
- How does alcoholic fatty liver disease progress to alcoholic hepatitis to cirrhosis?
- Is abstinence always effective at reversing disease?
- What are the serious consequences of alcohol-related liver disease?
- What do the Guidelines recommend as a safe level of alcohol consumption?
2:45 AFTERNOON TEA
Dr Jacqui Richmond
The ABC of Hepatitis B and C
Hepatitis refers to inflammation of the liver. As we saw throughout day one, hepatitis is caused by a number of factors and can progress to cirrhosis, a late stage of liver disease. This comprehensive session focuses on viruses, in particular Hepatitis B and C. It will ensure you are clear on the facts and recent discoveries in relation to the transmission, progression, and treatment of hepatitis B and C. It includes:
- What’s the difference between Hepatitis B and C?
- How are they transmitted and who is most vulnerable?
- A look at testing and disease courses/stages of Hepatitis B and C
- What is new about our knowledge of these diseases?
- What are the aims of modern treatment?
- How do the new medications for chronic Hepatitis C work?
- What are the current challenges for health professionals working with people with Hepatitis B and C
4:30 CLOSE OF DAY ONE OF CONFERENCE
9:00AM COMMENCEMENT OF DAY TWO
A Concerning Cascade? Advanced Liver Disease
While preventing progression of liver disease is imperative, it is not always the outcome we achieve. It is an inevitable and worrying reality for many that advanced liver disease (cirrhosis of the liver) develops. Day two of the conference will begin with a recap of the common causes of advanced liver disease. It will briefly inform you of some of the less common causes and describe the pathogenesis of advanced liver disease in more detail. In so doing it will introduce complications of advanced liver disease, beginning with portal hypertension. It includes:
- How do the causes of cirrhosis progressively damage the liver?
- How long does this process take?
- What are the signs, symptoms, and pathogenesis of advanced liver disease?
- What about decompensated liver disease?
- How does advanced liver disease lead to portal hypertension?
- What is the appropriate nursing management, including care plans and referral pathways for advanced liver disease?
From Cirrhosis to Cancer? Consequences of Chronic Liver Disease
Cirrhosis of the liver poses the greatest threat to the development of liver cancer. Referred to as hepatocellular carcinoma (HCC), it is most commonly seen in a person with chronic liver disease and less likely to arise as a malignancy in itself. The prognosis varies significantly between people, impacting the treatment options. In some cases, liver transplantation may be indicated for people with HCC. This session considers:
- How does liver cancer develop as a consequence of chronic liver disease?
- Is the incidence of HCC rising?
- How are the stages of HCC determined?
- When may a person with hepatocellular cancer be eligible for a liver transplant?
10:45 MORNING TEA
Ascites – Nursing Management
A further complication of advanced liver disease and relating to the development of portal hypertension is ascites. The collection of fluid in the peritoneal cavity can be distressing and uncomfortable for a person and a clinical indicator of deterioration. Despite ascites being a common major complication of advanced liver disease, symptoms vary between people. Managing the fluid and electrolyte changes in a person with ascites, in the context of a person suffering a chronic disease, can be challenging for nurses. This session aims to improve your knowledge of and confidence in the following:
- What does the presence of ascites tell us about the progression of liver disease?
- What are the medical treatments for ascites?
- When are surgical procedures such as ascitic taps indicated?
- what can the type of ascitic fluid reveal and why is it important to note this?
- What is the nursing role in managing a person with ascites, e.g. fluid and electrolyte balance?
Hepatic Encephalopathy – A Case Study
Nurses who have cared for patients with hepatic encephalopathy will testify that it is essential to understand the basic pathophysiology of what is occurring and why certain treatments are indicated, as is a team approach given the complexities of the care required. Using a case scenario, this session will walk you through a realistic situation of a person being admitted with hepatic encephalopathy to help you understand:
- What can precipitate hepatic encephalopathy in a person with advanced liver disease?
- How does hepatic encephalopathy develop?
- Why is the accumulation of ammonia neurotoxic?
- What subtle neurological changes do nurses need to look out for?
- How does lactulose work to reduce ammonia?
- What are the practical nursing considerations? Supportive care, prevention of falls, staffing levels, escalation criteria, etc.
1:15PM LUNCH AND NETWORKING
Prophylaxis of Variceal Bleeding
Oesophageal or gastric varices are another complication associated with advanced liver disease. Not every person with a varices will bleed, however it can be frightening to experience as bleeding may be compounded by poor clotting function. Importantly, primary prevention is key. This session reviews:
- What causes varices to develop?
- What are the signs, symptoms, and risk factors for varices?
- How is primary prophylaxis achieved and why is this essential?
- What are the current treatments for active variceal bleeding?
3:15 AFTERNOON TEA
Malnutrition in Advanced Liver Disease
The crucial role of the liver in the metabolism of nutrients means that nurses must be aware of how a person’s nutritional status is impacted by advanced liver disease. This final session considers:
- Why is malnutrition common in advanced liver disease?
- What are easy and reliable ways to assess a person’s nutritional status?
- When may supplementation be required?
- What practical tips nurses can be implemented to promote nutrition?
4:30 CLOSE OF CONFERENCE AND EVALUATIONS
The Goal Need for Program
In Australia, hepatic disease is the 11th commonest cause of early death.There are a wide range of other liver diseases some of which are very complex and life reducing. For instance, liver cancer is the most rapidly increasing cause of cancer death in Australia today. Liver disease can affect every organ system in the body because of the complexity of liver function. These relationships make clinical assessment difficult and confusing - particularly because early manifestations of liver disease may be subtle. Given the diversity of liver disease it is likely that most nurses will care for acute and chronically unwell people with this condition. Evidenced knowledge relating to prevention as well as management of the condition will assist nurses to achieve best patient outcomes.
Purpose of Program
The purpose of this education is to provide knowledge relating to the prevention, causes and management of liver disease in order to achieve best nursing outcomes.
Your learning outcomes:
Assist a person to avert long term liver disease through preventive measures
Apply knowledge relating to the identification of liver dysfunction to prevent complications
Improve nutritional status of a person with advanced liver disease
Prioritise the holistic care of a person who has advanced liver disease
Jacqui Richmond commenced working as a hepatology nurse in 1998 at St. Vincent’s Hospital, Melbourne, Australia. Jacqui has had a ... Read More
Tracey Hughes,MSc, RN is the intestinal transplant coordinator, and liver transplant assessment coordinator at the Austin Hospital. She also contributes ... Read More
Sherryne Warner has been a strong advocate for patients with liver disease. Sherryne co-founded the Australasian Hepatology Association for Nurses, ... Read More
Associate Professor Louis Roller has been an academic at the Faculty of Pharmacy and Pharmaceutical Sciences Monash University for over ... Read More
Sally Watkinson is a Nurse Practitioner Candidate for the Victorian Infectious Diseases Service at Melbourne Health. Sally has worked ... Read More
Angela Xiriha is a clinical nurse specialist who has worked in the Gastrointestinal Care Centre at St Vincent's Hospital for ... Read More
Jamee Barugh is a clinical dietitian at Alfred Health, Melbourne. Jamee graduated in 2007 with a Postgraduate Diploma in Dietetics ...Read More
To Be Determined