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A new liquid formulation of hGH (Norditropin SimpleXx) has been developed to avoid the need for reconstitution before administration. In addition, the liquid GH formulation has been combined with an advanced pen delivery system, either with or without a needle auto-insertion mechanism. This study was designed to assess the acceptability of the new system compared with the patient's previous system. A total of 103 children with GH deficiency received a daily injection of Norditropin liquid GH for 12 weeks with a choice of a pen/auto-insertion system. Acceptability was determined by nurse-supervised questionnaires administered to the patients and parents. Following treatment, 94% of patients preferred the Norditropin liquid GH system. This preference was irrespective of the previous system in use, patient age or length of GH therapy. More patients found it the less painful system (50% vs 13%), 92% of patients found it more convenient, and the formulation was well tolerated. In conclusion, Norditropin liquid GH was very well accepted and preferred by the majority of patients. It avoided reconstitution which had been a major cause of dissatisfaction with the patients' previous systems, and resulted in greater convenience and reduced levels of pain associated with injection.

Nursing practice demands a range of problem-solving skills and abilities, and preregistration courses may only provide limited preparation. Clinicians need to draw on the skills and expertise of experienced colleagues in order most effectively to use their time and energies in a new role or clinical area. Experienced staff may enhance both their clinical expertise and their support of colleagues through the role of clinical supervisor. Clinical supervision has benefits for the supervisor in terms of professional development and for the supervisee as regards identifying and addressing clinical problems. According to the position statement on clinical supervision for nurses and health visitors published by the UKCC (UKCC, 1996) clinical supervision aims to identify solutions to problems, improve practice and increase understanding of professional issues. This article examines roles and responsibilities in clinical supervision and discusses the benefits for individuals and for health services.

Nursing has developed considerably in recent years in a multidisciplinary context, acknowledged in the setting up of nursing and practice development units. The aim of this article is to demonstrate to readers how the effective implementation of decentralised management theory and clinical leadership can facilitate practice development and how interdisciplinary collaboration is an integral feature of this.

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