Nurses role in advanced endoscopy Peggie Capecci, RN, BSN, CGRN Lead Nurse Endoscopy Silver Cross Hospital

Endoscopy is a subspecialty of Gastroenterology, dedicated to the diagnosis and treatment of digestive diseases, using endoscopic procedures. Advanced Therapeutic Endoscopy is a specialty within a specialty.

Medical Treatment Advanced Endoscopy Surgical Intervention

TRUST COMMITTMENT KNOWLEDGE RESPECT COMMUNICATION

Physician ↔Nurse SYNERGY!!!

Physician ↔ Nurse SYNERGY!!! “The interaction or co-operation of two or more……to produce a combined effect greater than the sum of their separate effects”

Silver Cross Endoscopy Special Forces

Anesthesia Pathology Pathology Radiology

Are You in the Know? Know your equipment Manufactures recommendations Set up / Take down Properly functioning Trouble shooting When to call for repair Saves the department on costly repairs

Know your product.... Sphinctertome from catheter 5-4-3, from UTS, from swing tip Short wire system from long wire system Balloons from baskets .018, .021, .025, .035 wires Most wires are hydrophilic FLUSH YOUR WIRES!!!! Know what you’re priming and what your flushing FLUSH YOUR WIRE PORT!!!! PRIME YOUR CONTRAST PORT!!!! Don’t get caught in a “sticky” situation Know your vendor, love your Rep

Know Your Patients… Review the History and Physical Know why you’re performing the procedure ERCP for SOD ERCP for Cholangiocarcinoma EUS for Pancreatitis or for staging FNA for cyst or tumor

Communicate

Knowing the why behind the procedure will help you interview your patient, as well as know what their mental state may be when you enter the room.

Intra procedure…. Have room therapeutic ready Have products in the room, organized and ready to go Have equipment checked and ready to go Base what you have in the room on the cases you’ll be doing that day

Proper wire exchanging technique When and how to strip the short wire Advancing with the long wire COMMUNICATE, COMMUNICATE!! Proper wire exchanging technique Separates the men from the boys and the women from the girls.

Know Your Location You Are Here

Anticipate Your Next Move

EUS-FNA Know the different types of needles Have supplies in the room Know the where and why of the FNA Notify pathology in a timely manner Having PATH in the room is safer practice for the patient (ROSE) Extra pair of experienced hands is always helpful COMMUNICATE, COMMUNICATE

Having Pathology in the room helps to ensure…. Adequate Sample & Preliminary Diagnosis

Post Procedure… Thorough report Be attentive to physician’s post op instructions Potential complications include Perforation Pancreatitis Infection Bleeding

Y’all be back in 15

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