Authors (including presenting author) :
Salim A (1), Kung WC (1), Lee KF (1), Wong SL (1), Chui ST (1)
Affiliation :
(1)Department of Surgery, Prince of Wales Hospital
Introduction :
Surgical resection remains the cornerstone for liver cancer treatment with curative intent. Indocyanine green (ICG) clearance test is an integral part of preoperative assessment of liver function. However, ICG clearance test is a time-consuming procedure, which on average takes 20-30 minutes per patient. At the PWH HBP unit, up to 5 patients are admitted every Monday for ICG clearance test, totalling up to 2.5 hours of clinical time. ICG clearance test was previously performed by a surgeon on the hepatobiliary-pancreatic (HBP) team, however, the HBP clinical nurse specialist has taken up this role since November 2021. Not only does this save time for surgeons for other advanced tasks, but it also helps enhance the professional development for the HBP clinical nurse specialist.
Objectives :
1. To enhance interdisciplinary collaboration and communication through skills transfer. 2.To expand the nursing role and professional development in the HBP specialty 3.To deliver ICG clearance test to patients by trained HBP nurses in a safe manner
Methodology :
The HBP medical and nursing staff worked together to prepare the ICG clearance test guidelines and designed an audit form. Through multidisciplinary discussions, guidelines and audit form were prepared and endorsement was obtained from a Consultant HBP Surgeon. Three HBP clinical nurse specialists were trained by the HBP surgeon, the observation and return-demonstration training method was adopted. The ICG test procedure has been done by the trained HBP nurse independently since November 2021.
Result & Outcome :
One hundred and eighty-eight patients had undergone ICG clearance tests during the 13-month period between November 2021 to November 2022. All ICG tests were safely performed with no documented adverse reactions and no complaints were reported. The ICG results aided the surgeons in considering the suitability of liver resection for each patient. The time involved in the ICG test procedure in the said period was 63 to 94 hours, which was significant time saved for surgeons on more advanced tasks. Furthermore, the ICG test helped expand the nursing role amongst the HBP team and enhanced the nursing development with specialized skills and knowledge. In addition, it fostered staff engagement and improved job satisfaction. The transfer of skills and knowledge as well as reallocation of duties among the HBP healthcare team helped enhance patient care and satisfaction.
