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Position
The Canadian Society of
Gastroenterology Nurses and Associates support the position that staffing
patterns must reflect the responsibilities in the expanded role of the
registered nurse in the performance of therapeutic Endoscopy procedures.
The registered nurse in this
expanded role must also have skills in delegation and knowledge in the
patient monitoring requirements.
The expanded role of the nurse
is only to be carried out under the direct supervision of the attending
physician. Responsibilities while assisting the physician with the equipment
and performing specific actions will be in accordance with the provincial
licensing body and the employer. Each nurse is accountable for the
responsibilities they accept.
During therapeutic Endoscopy
procedures as identified by the Society a minimum of two nurses is
recommended to be in attendance. One nurse would be an educated registered
nurse experienced in gastroenterology and Endoscopy nursing and a second
registered nurse to monitor the patient pre procedure, during the procedure,
and post-procedure.
Definition
Therapeutic endoscopy procedures include but are not limited to: Emergency
Endoscopy for control of bleeding (esophageal variceal banding, fundal
variceal gluing, variceal sclerotherapy, esophageal gastric tamponade,
heater probe/bicap/argon plasma coagulation, endolooping, endoclipping),
Pneumatic Dilatation, ERCP (diagnostic and therapeutic), Stent placement
(esophageal and enteral), Laser therapy, Photodynamic therapy, Endoscopic
Mucosal resection, PEG/PEJ insertion, Colonic decompression and Bronchoscopy.
Background
Gastroenterology nursing has
witnessed significant evolutionary changes in the past 15 - 20 years.
Factors such as an aging population, advanced technology and the
specialization of gastroenterology medicine have all had an impact on
nursing practice. In the specialty of Gastroenterology, the factors that
have influenced staffing include the performance of more complex diagnostic
and therapeutic procedures, the changes in the physician practice (where one
physician often performs the procedure with a nurse assisting, rather than
another physician), and the resultant impact on the expanded role of the
nurse.
The primary role of the
registered nurse during endoscopy procedures is the maintenance of patient
safety through continuous assessment of the patient’s condition and
intervention as necessary. Therapeutic endoscopy procedures involve
advanced knowledge and technical skill in order to safely perform/assist
with procedures to achieve desired patient outcomes.
Most patients undergoing
therapeutic Endoscopy procedures will require “Conscious Sedation” (see
position statement related to conscious sedation).
Accurate documentation is
required that reflects that the standards of care have been met.
Disclaimer
Canadian Society of
Gastroenterology Nurses and Associates does not assume any responsibility
for the practices or recommendations of any member or other practitioner or
for policies and practices of any endoscopy unit.
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