The purpose of this project was to assess the feasibility and cost of high-flow nasal oxygenation therapy for gastrointestinal procedures in an endoscopy clinic. An observational, convenience sample design was used to evaluate multiple variables, including the frequency of high-flow nasal oxygenation therapy utilization, clinician satisfaction, setup duration, airway interventions, complications, procedure length, and alternative airway device use. A cost analysis compared high-flow nasal oxygenation therapy to other commonly used airway devices at this site. High-flow nasal oxygenation therapy was frequently utilized and received high clinician satisfaction ratings. The median length of gastrointestinal procedures with high-flow nasal oxygenation therapy was 30 minutes, with a median setup time of 2 minutes between cases. Although high flow nasal oxygenation therapy had a higher fixed cost than traditional airway devices, the cost was comparable to that of a nasal ventilation mask. Despite the initial expense, high-flow nasal oxygenation therapy's rapid setup and clinician preference suggest it is feasible in the endoscopy setting. The high fixed cost may be offset by increased patient volumes and sustained device utilization.

Patient comprehension of bowel preparation instructions is essential for adherence to purgative and dietary requirements. Inadequate bowel preparation reduces visualization quality, increases procedure length, and diminishes both diagnostic accuracy and patient experience. Evidence supports the use of audiovisual (AV) education to improve comprehension and adherence compared to standard written instruction. This quality improvement project implemented an AV educational intervention in an outpatient endoscopy unit and evaluated its impact on bowel preparation adequacy and patient experience. Conducted at a 238-bed community hospital in Virginia, the project used two iterative Plan-Do-Study-Act (PDSA) cycles with a total of 121 patients. Data included demographics, bowel preparation adequacy using the Ottawa Bowel Preparation Scale, purgative type, viewing status, and procedure times. Patient experience was measured using standardized Press Ganey survey data. Bowel preparation adequacy improved from 80.4% at baseline to 90.5% in the second PDSA cycle, meeting the American Gastroenterological Association (AGA) benchmark. Patient experience scores improved from 82.39% to 90.96%, exceeding the institutional benchmark of 88%. Implementation of AV education improved bowel preparation adequacy and enhanced patient experience, supporting its integration into standard pre-colonoscopy education and quality improvement practices.

With the arrival of direct-acting antivirals, the implementation of universal hepatitis C virus screening, and simplified treatment protocols, the landscape for managing hepatitis C has become less complicated and more adaptable to primary care settings. In 2019, Washington State created and implemented a statewide comprehensive plan aimed at eliminating hepatitis C by 2030. This study aims to understand provider-based perceptions about screening and treating hepatitis C, and how these perceptions influence care across Washington State. This is a qualitative study using semi-structured in-depth interviews exploring screening and treatment practices of health providers across Washington State. Qualitative data collection was guided by the Updated Consolidated Framework for Implementation Research. Data was analyzed using thematic analysis to identify key factors. Fourteen providers participated in interviews. Most providers (86%) treated hepatitis C, and (71%) of those providers also treated substance use disorders. Emerging themes included organizational barriers, patient barriers, provider barriers, and stigma. Healthcare provider shortages, high turnover in rural parts of the state, lack of provider knowledge about current guidelines and access to information, patient competing priorities, and lack of updated screening and treatment care models were identified as strong barriers to treatment implementation.

Gastrointestinal (GI) endoscopy is performed to aid in diagnosing and treating several GI diseases. Although adult GI endoscopy has been applied in children, there are several differences regarding the technique and preparation. In this article, we review the preparation for pediatric GI endoscopy. In addition to specific considerations for each procedure, the preparation requires effective communication and collaboration from multidisciplinary health care providers, particularly gastroenterologists, endoscopic nurses, and anesthesia care teams. This article highlights key considerations for pediatric procedures including esophagogastroduodenoscopy and colonoscopy.

Vaccination rates remain low despite the influenza vaccine's proven safety and efficacy in protecting vulnerable groups, such as individuals diagnosed with liver disease. This cross-sectional study investigated influenza vaccination coverage, attitudes, beliefs, and influencing factors among 152 patients with liver disease in Greece. Over half (53.6%) were diagnosed with hepatitis, and 40.4% with cirrhosis. Overall, 58.6% of participants received the seasonal influenza vaccine. Multivariate logistic regression showed that older age (OR = 1.07, 95% CI: 1.02-1.11, p = .002), prior pneumococcal vaccination (OR = 17.98, 95% CI: 6.66-48.52, p < .001), and COVID-19 vaccination (OR = 5.77, 95% CI: 1.17-28.46, p = .031) were significantly associated with influenza vaccination in the current season. Similarly, older age (OR = 1.09, 95% CI: 1.04-1.14, p < .001) and pneumococcal vaccination (OR = 25.75, 95% CI: 9.20-72.05, p < .001) were linked to annual influenza vaccination. About half of the participants are vaccinated yearly. These findings highlight the need for targeted public health strategies to improve vaccination rates among patients with liver disease. Gastroenterology healthcare professionals, as trusted information sources, can play a key role in promoting vaccine uptake and improving immunization coverage in this high-risk population.

Liver cirrhosis is a devastating and costly disease that impacts patients' quality of life. Given the severe symptoms associated with this diagnosis, such as sarcopenia and loss of appetite, an educational intervention was designed to limit the impact of the disease on patients' lives. The intervention emphasizes dietary modifications with the goal of decreasing symptom severity. Thirty-six patients with a diagnosis of liver cirrhosis who met inclusion criteria agreed to participate in the study. The major variable of interest was assessed using an investigator-designed 10-item questionnaire, pre- and post-intervention. Results revealed a significant difference and meaningful clinical change in knowledge of recommended dietary modifications pre- ( M = 4.1, SD = 3.1) and post- ( M = 9.8, SD = 0.43) ( t = -5.7, p < .001) intervention. Future plans of participants regarding dietary modifications were also assessed. Given these findings, an educational intervention addressing knowledge related to the nutritional needs of these individuals is recommended.

Transitioning to practice as a newly graduated registered nurse (NGRN) is becoming increasingly more challenging as our patients and the healthcare environment grow in complexity. Many NGRNs report feeling low confidence levels, increased stress, and a general lack of knowledge about various specialty areas of nursing when entering practice, which can result in poorer patient outcomes and may contribute to increased attrition rates in nursing. Exploring new ways to create positive transitions into practice for NGRNs remains crucial. Targeted experiences, focusing on knowledge gaps, such as in the field of gastroenterology, may enhance learning, increase confidence levels, and improve patient care. For this reason, an innovative Gastroenterology Experience Project (GEP), including targeted simulations and didactic content, was developed and implemented in a transition to practice program for NGRNs. The purpose of the GEP was to enhance NGRN knowledge of the most common gastrointestinal (GI) diagnostic tests and procedures, understand the nurse's role as an effective team member, and promote safe and high quality nursing care before, during, and after GI interventions. This article discusses a unique collaboration between nurses from the education, simulation, and gastroenterology departments and NGRNs participating in a new nurse residency program at a large metropolitan health care system in the Midwest. The implementation of the GEP, as well as quantitative findings and NGRN reflections, will be discussed.

Enteral nutrition is delivered through a gastrostomy tube to provide nutritional support to patients with amyotrophic lateral sclerosis (ALS) who have developed severe dysphagia at home. Complications may arise from gastrostomy and enteral nutrition when family caregivers do not provide adequate care. This study identifies key areas of educational content that can improve the care of patients with ALS requiring gastrostomy and home enteral nutrition. We conducted a modified three-round e-Delphi survey with health care experts to clarify their perspectives on the educational content regarding gastrostomy and home enteral nutrition disseminated among patients with ALS and their family caregivers. The experts provided their opinions on specific educational content areas, and their responses were analyzed to identify areas of consensus and divergence. Accordingly, in Rounds 1-3 of the survey, 16 experts, including registered nurses ( n = 6), advanced practice registered nurses ( n = 3), clinical neurologists ( n = 3), and dieticians ( n = 4), participated. In Round 3, four categories and 39 educational components reached consensus. The results provide a framework for developing educational nursing interventions for family caregivers of patients with ALS receiving home enteral nutrition through gastrostomy tubes and for defining the essential elements of the educational content of such interventions.

Each year, an average of 700,000 endoscopic retrograde cholangiopancreatography procedures are performed. Patients may be at risk of duodenoscope-associated infections caused by multiple drug-resistant bacteria, with 10.8% of infections being linked to the use of reusable duodenoscopes. Since 2013, reusable duodenoscopes have appeared in more Federal Drug Administration Safety Communications than any other medical device due to design challenges and reprocessing concerns. Reusable duodenoscopes have continued to show areas of contamination despite updated decontamination protocols. Implementing the use of single-use duodenoscopes can effectively break the chain of infection and significantly lower the incidence of duodenoscope-associated infections. This literature review analyzes the impact of single-use duodenoscopes on infection control and increasing protection for the immunocompromised patient. By adopting single-use duodenoscopes for all endoscopic retrograde cholangiopancreatography procedures performed on immunocompromised patients, health care providers provide an additional layer of safety and significantly reduce the risk of infections. Endoscopy nurses and technicians are empowered to advocate for their immunocompromised patients by increasing their knowledge around the benefits and cost-effectiveness of the single-use duodenoscope.

Budd-Chiari Syndrome (BCS), a rare vascular disorder of the liver characterized by obstruction of hepatic venous outflow, has an estimated prevalence of approximately 1 in 100,000 in the general population. Among its various etiologies, coagulation factor deficiencies are uncommon. This case, following Case Report (CARE) guidelines, describes a case of BCS associated with protein C deficiency resulting in a thrombus in the inferior vena cava. The patient was an unmarried Indian woman in her 40s who presented with progressive pedal edema and abdominal distension for 6 months. She was evaluated thoroughly, and other causes were excluded. Imaging showed classical features of BCS, including complete fibrotic occlusion of all three hepatic veins, intrahepatic venous and splenorenal collaterals, caudate lobe enlargement, and a 5.2 cm thrombus in the inferior vena cava. She was treated with interventional angioplasty along with anticoagulation and diuretic therapy. She is under regular follow-up and has been counseled for liver transplantation for liver cirrhosis. This case highlights the rare association of protein C deficiency with BCS and emphasizes the need for early recognition, multidisciplinary management, and supportive nursing care to improve outcomes and quality of life.

The American Cancer Society predicts 158,850 new cases of colorectal cancer and 52,230 deaths in 2026. Rates have declined for both men and women since 2011, particularly among those over age 65. This decline is likely due to reduced smoking and increased uptake of screening. Unfortunately, there has been an increase among those younger than age 55 years since the mid-1990s, likely due to the lifestyle of those born after 1950. Early-onset colorectal cancer is defined as a diagnosis before the age of 50 years. Guidelines now recommend screening for average-risk patients begin at age 45 years (formerly 50 years). High-risk patients should start screening at age 40 years, and possibly earlier. Patients need to learn about this recent change. A high index of suspicion is helpful when any patient presents with complaints of unexplained weight loss, abdominal pain, bloating, change in bowel habits, or rectal bleeding. These patients should be referred, regardless of age, for a diagnostic colonoscopy. Primary care providers can improve their practice's screening rates using evidence-based strategies. The gastroenterology nurse is in a key position to implement lead-time messaging with tailored messages to promote on-time screening and primary prevention through diet and lifestyle.