LHCH nurse drives policy change for prescribing HRT in Acute Coronary Syndrome

Jan Green (pictured) is a Cardiology Advanced Nurse Practitioner at Liverpool Heart and Chest Hospital NHS Foundation Trust (LHCH). 

Jan, having worked as a Hospital Coordinator at LHCH previously, re-joined as a trainee in her current role in 2019.  In 2023, Jan observed that there were inconsistencies in practice for the prescribing and continuation of Hormone Replacement Therapy (HRT) in women undergoing treatment for Acute Coronary Syndromes (ACS).  This, coupled with Jan’s personal experience, meant Jan was particularly passionate and driven to take on a quality improvement project to make a difference to the future and quality of life of this group of patients.

HRT is recommended for use in women who are perimenopausal or menopausal for symptom relief.  Jan noticed that women, whilst in hospital, were often very anxious about the prospect of not being able to continue their HRT.  The purpose of this project was to reach a consensus amongst clinicians to provide all patients with accurate, balanced and evidence-based information on the individualised risks and benefits of HRT after having an ACS. 

Through discussion with clinicians, it was agreed that HRT will not be routinely stopped in patients admitted with ACS.  Women will be encouraged and enabled to participate in shared decision making and to make informed choices about their HRT in the context of their cardiovascular disease and their quality of life.  This change has become embedded in the ACS policy here at LHCH.

It doesn’t stop here though for Jan who has already made an impressive impact on the patients experience at LHCH.  Jan was selected to present a poster at the national British Menopause Society Annual Scientific Conference on 27th and 28th June this year.  This was an opportunity for Jan to share what had been learnt and subsequently implemented here at LHCH on a national stage with other healthcare professionals. 

Following on from this Jan was invited to write an abstract for publication to the Post Reproductive Health Journal which was published in September 2024.  These forums will enable this learning to be shared with other healthcare providers. 

There are more projects in the pipeline too.  Jan is currently undertaking formal training with the British Menopause Society; has been invited to teach at Liverpool John Moores University for undergraduate pharmacists as part of their women’s health topic and is working on improving information and resources available for our patients and colleagues.

Congratulations and thank you to Jan for this amazing work. 

Jan was awarded Employee of the Month earlier this year for her starring role in this fantastic project.