TBA (25W172)

Utilizing a dedicated nurse specialist improves quality of ERCP service delivery

Author(s)

Muhammad Ahmed Saif Ullah,Harvey Martir, Shreyashee Sengupta, Mohamed W.Mohamed, Navneet Ramlaul,Jan Leyden, Barry Kelleher, Stephen Stewart

Department(s)/Institutions

Gastroenterology department, Mater Misericordiae University Hospital, Dublin.

Introduction

ERCP is a high risk procedure which involves a multidisciplinary team of endoscopists, nurses and radiographers. A dedicated ERCP nurse specialist can support quality assurance and service improvement. BSG (2024) recommends that each ERCP department should have an ERCP nurse specialist.

Aims/Background

To analyse impact of nurse specialist in quality improvement of ERCP service.

Method

1640 ERCPs were reviewed from our prospective database between 2022 and 2025. Standard KPIs were calculated and complications were noted from the database collected by our ERCP nurse specialist. Results were compared with KPIs published by ESGE, BSG and JAG.

Results

Our nurse specialist achieved follow up rates of 98% (2024/25), 95% (2023/24) and 75% (2022/23) for ERCP procedures performed in the last 3 years. Out of total 1640 ERCPs, 60% of procedures (n=981) were performed for patients from other institutions and 6% of procedures were performed under GA. Our CBD cannulation (88.5%, 89.9% and 90.5% in serial studied years) and stone clearance (74 to 84.4% in serial studied years) rates achieved the standard recommended KPIs. Complications - post-ERCP pancreatitis (5.5%), bleeding in 0.63%, perforation 0.27% (1). Overall complication rate was 5.6%, meeting the recommended KPIs.

Conclusions

Over half of the ERCP procedures were transfers from other institutions. Having a dedicated nurse specialist in our department facilitates timely triage, pre-assessments and meticulous post-procedural follow-ups, especially for patients referred from other institutions. Continuous monitoring of KPIs from the maintained database aids quality improvement and service improvement.