End-stage liver disease (ESLD) is a leading cause of digestive disease deaths in the United States and continues to increase exponentially every year. Best practice does not currently recognize or utilize a clinic practice model for ESLD management. Advanced practice registered nurses (APRNs) can impact ESLD disease management by implementing an outpatient clinic care model to focus on treatment compliance, patient education, improvement of patient outcomes, and reduction in hospital admission rates for ESLD patients. A review of 15 research articles was completed to determine the impact APRNs can make on chronic care of ESLD patients. Results from the review support APRN analysis, assessment, diagnosis, treatment, intervention, and evaluation of ESLD patients. The literature reviewed also demonstrates that ESLD patients have improved symptom management when maintained in an outpatient setting, allowing for decreased hospital and insurance expenditures. Following evaluation of the evidence, it was concluded that an APRN-led ESLD clinic merits further study.
Jean L. McAfee, MSN, RN, CMSRN, is Transplant Unit Staff Nurse, Baylor All Saints Medical Center, Adjunct Nursing Faculty, Texas Christian University, Saginaw, Texas.
Correspondence to: Jean L. McAfee, MSN, RN, CMSRN, Baylor All Saints Medical Center, Adjunct Nursing Faculty, Texas Christian University, 901 Sherry Lane, Saginaw, TX 76179 (e-mail: Jean.firstname.lastname@example.org).
The author declares no conflict of interest.
Received June 20, 2011
Accepted September 05, 2011