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.

This study aimed to identify factors influencing intention to undergo colonoscopy reexamination regardless of the colonoscopy results based on Pender's Health Promotion Model. The study included 152 individuals who had undergone colonoscopy at Chonnam National University Hospital in Gwangju City, South Korea. Data using structured self-administered questionnaires were collected from participants who were alert after the completion of the procedure. The factors associated with the intention to undergo colonoscopy reexamination were perceived benefits (β = 0.33, p < .001, 95% CI = 0.10 to 0.30), perceived self-efficacy (β = 0.19, p = .021, 95% CI = 0.02 to 0.18), employment status (β = 0.18, p = .010, 95% CI = 0.25 to ~1.83), and marital status (β = 0.16, p = .018, 95% CI = -1.87 to -0.17). These variables explained 33.9% of the variance in the intention to reexamine. The study revealed that individuals who perceived benefits and had high self-efficacy related to colonoscopy were more likely to have an intention to undergo colonoscopy reexamination. It is essential to emphasize the benefits of colonoscopy and to encourage and support examinees' confidence in undergoing colonoscopy, thereby increasing the intention and actual rate of colonoscopy reexamination every 5-10 years.

Flexible endoscopes used in gastrointestinal procedures possess long, narrow channels that complicate decontamination and high-level disinfection. Infections may occur even with proper execution of all reprocessing stages, particularly as the endoscope ages or in the presence of biofilm. Effective reprocessing improves when the nurses and associates handling endoscopes are knowledgeable and well-trained, have sufficient time to complete all steps correctly, and work in a clean environment equipped with the right tools. Audits evaluate endoscope reprocessing to confirm the presence of necessary conditions and verify the correctness of procedures. This article details the implementation of endoscope reprocessing audits in five clinical sites, which resulted in an increase of all audited items being compliant in 296 out of 325 audits to 317 out of 325 audits. A consistent improvement in the audit compliance score through audit and feedback indicates the project's moderate influence on overall endoscope reprocessing, consistent with the anticipated impact described in the literature.

Endoscopy departments tend to prioritize task efficiency, which may sometimes limit individualized and patient-centered nursing care. Structured workflows and time constraints can make it challenging for nurses to fully address patients' needs and ethical concerns. However, the ethical issues specific to endoscopic nursing remain largely unexplored. This study aims to clarify ethical issues perceived by nurses involved in endoscopic practices. A qualitative study was conducted with 14 nurses working in departments performing endoscopic practices in 3 hospitals in Japan. Data were collected using semi-structured interviews and analyzed using qualitative content analysis. Eight key ethical issues emerged: (1) Lack of Ethical Consideration in Physical Restraints; (2) Unalleviated Patient Pain; (3) Undervalued Patient Autonomy; (4) Disregard for Patient Dignity and Privacy; (5) Involvement Amid Professional Uncertainty and Ethical Concerns; (6) Inability to Provide Ideal Nursing Care; (7) Lack of Respect for Nurses; and (8) Inequity in Patient-Centered Care Delivery. These findings indicate that endoscopy departments face ethical challenges, including inadequate informed consent, routine sedation and restraints, time constraints, and a physician-centered hierarchy. Addressing these issues requires enhancing ethical sensitivity and competence, fostering interdepartmental and interprofessional collaboration, developing systems for patient-centered care, and setting ethical practice goals.