This study evaluated the efficacy and safety of endoscopic pneumatic balloon dilatation as the initial treatment for achalasia of the cardia. 15 patients with achalasia underwent a total of 19 dilatations using the new polyethylene dilator (Microvasive Rigiflex Balloon Dilator) over the last 6 years. An overall treatment success rate of 93% was achieved. 11 patients (73.3%) have not required a further dilatation and 3 patients (20%) required between 1 and 2 further dilatations. Elective surgery was necessary in 1 patient. The mean follow-up period was 31.5 months. There was no complication or death attributable to the procedure. Endoscopic pneumatic balloon dilation is a safe and effective treatment for achalasia and should be considered as the initial treatment of choice in most patients with achalasia.
Advanced nursing practice involves higher level of knowledge and skills of nurses to perform autonomous practice in clinical settings in order to meet the needs of individuals, families and communities. Advanced practice in nursing is also known as adjusting boundaries for future practice, pioneering and developing new roles of nurses in clinical practice, research and education. Advanced practice of nursing in the developed countries are recognized with different nomenclatures such as advanced nurse practitioner, clinical nurse specialist, specialized nurse practitioner, nurse practitioner, certified nurse practitioner and advanced practice registered nurse. Malaysia is one of the pioneering Asian countries to introduce clinical nurse specialist in hospital settings, which is a stepping stone for the development of advanced nursing practice.
Keywords: Nurses in Malaysia, Clinical Nurse Practitioner, Advanced Nurse Practice