Advanced nursing practice in paediatric critical care.

Following the successful implementation of High Dependency Care: a model for development at King's College hospital in 2005, the authors wished to consider the addition of a fourth tier to the model. A review of the clinical environment was undertaken and it was suggested that the introduction of an advanced nurse practitioner could contribute to the education and continuation of the outreach service detailed in the model, as well as to the improvement of critical care services and career development opportunities for nurses within the unit. A survey was undertaken to identify the views of medical and nursing staff about essential roles and responsibilities of advanced nurse practitioners in this area.

The liver. Part 6: Liver transplantation.

Advanced surgical techniques and the development of effective immunosuppressive therapies have enabled liver transplantation to be performed in any age group with a high graft and patient survival rate.

The liver. Part 5: acute liver failure.

Clinical complexity presents health professionals with a significant challenge if a patient with ALF is to survive. While efforts to develop pharmacological therapies and biomechanical techniques serve as a bridge to spontaneous recovery, liver transplantation is the most successful treatment for most cases.

The liver. Part 4: chronic liver disease.

Chronic liver disease and associated signs and symptoms present a challenge for clinical management as liver failure affects all body systems. While this part of the series concentrates on the physical symptoms of chronic liver disease, it needs to be remembered that these can also have many far-reaching implications for the patients' psychosocial well-being.

The liver part l: anatomy.

Understanding the anatomy of the hepatobiliary system provides the basis for the holistic care of patients with a liver disorder. In the second part of this series of articles, the functions of the liver will be examined.