In this edition of Expert Picks from the 2025 Society of Gastroenterology Nurses and Associates Annual Course, Cynthia M. Friis, MEd, BSN, RN, the associate executive director of clinical affairs at SGNA, highlights five noteworthy abstracts from the meeting.
Abstract R12. Simulation-based endoscopy nurse training program to improve competency and expand patient access (Stefani)
This project explored the use of simulation-based training to boost endoscopy nurse competency and enhance patient care. Recognizing that endoscopy nurses often face complex, high-risk procedures without adequate preparation, Allison Stefani, RN, CGRN, a DNP student at Washington State University Vancouver, implemented a standardized training program using simulation to address this gap.
Endoscopy nurses at a military gastroenterology clinic (n=47) participated in four half-day training sessions covering topics including scope cleaning and reprocessing procedures, capsule endoscopy, endoscopic retrograde cholangiopancreatography, tools for bleeding management, and more. The goal was to create a safe, controlled environment where nurses could build skills and receive immediate feedback before applying them in clinical practice.
Ms. Stefani measured success using pre- and post-implementation data, focusing on nurse competency rates, job satisfaction, patient wait times and access to care. She showed that the training sessions resulted in an 10% increase in skills/knowledge, flexibility and peer collaboration and a 20% increase in management and interprofessional collaboration. Competency compliance increased from 42% to 92%. Ms. Stefani noted that additional studies are “needed to analyze the effect of EN training on patient outcomes and access to care.”
Ms. Friis: Effective continuing education is something that continues to elude even the most stalwart nurse educators. Given the chaos and challenges surrounding training in a fast-paced clinical environment, we must continue to explore ways to provide education in an efficacious manner. This study found simulation training to be a viable option for meeting continuing education needs.
Abstract R5. ErgoEndo initiatives: supporting staff well-being in GI endoscopy (So et al)
This initiative focused on improving staff satisfaction and comfort in the endoscopy unit by introducing ergonomic interventions to reduce physical strain during procedures.
Recognizing that endoscopy staff often face fatigue, discomfort and musculoskeletal challenges, Loretta So, PhD, RN, CGRN, and her co-investigators from Cedars Sinai Medical Center aimed to boost staff satisfaction by 20% over baseline by the end of the study period. The project rolled out ergonomic interventions in phases, including anti-fatigue mats, patient positioning rolls, specialty chairs for double balloon enteroscopy and devices designed to reduce strain during colonoscopies. The researchers collected staff feedback through a custom satisfaction and ergonomics survey, as well as the Quebec User Evaluation of Satisfaction with Assistive Technology.
Overall, 85% of participants reported that the initiative improved job satisfaction, 67% reported that it had a positive effect on the work environment and 54% reported that they felt more valued due to the attention placed on ergonomics in the workplace.
Ms. Friis: In the fast-paced gastroenterology environment, prolonged repetitive strain due to continuous delivery of complex endoscopic procedures may enhance the risk for ergonomic injuries among staff. In addition to the physical implications, these challenges can diminish the overall satisfaction of the staff. In this important study, the researchers address key methods to mitigate ergonomic strain and injury.
Abstract R6. GLP-1 medications and anesthesia: a literature review (Joven et al)
With the rising use of glucagon-like peptide-1 receptor agonists (GLP-1s) for diabetes management and weight loss, the effect these medications have on patients during GI procedures is an important consideration for clinicians.
In this literature review, Jemell Joven, DNP-FNP-BC, and Geraldina Douglas, FNP-BC, from University of California Irvine Health, searched PubMed for studies on GLP-1s and anesthesia and used Melnyk’s Rapid Critical Appraisal tool to assess the literature.
They included 11 studies in their review. Of those, all noted gastroparesis as an adverse effect, and 55% noted aspiration but did not clearly associate duration of drug cessation and aspiration risk/events. Only four of the articles noted the percent of patients with food retention on the day of surgery/esophagogastroduodenoscopy, and of those reporting a percentage, 18.3% of patients had food retention.
The researchers noted that 64% of the articles recommend stopping GLP-1s for at least 3 weeks before procedures and 27% recommend following the American Society of Anesthesiologists guidance to stop for one week.
The team concluded that although the risk for aspiration is not clear in this setting, “morbidity necessitates cessation for prevention.” They also suggested that preprocedural gastric ultrasound and use of rapid sequence anesthesia, regardless of duration of cessation of GLP-1s, can enhance patient safety and noted that if GLP-1s are stopped for three weeks or more, clinicians should consider bridging with liraglutide to avoid poor glycemic control.
They emphasized the need for future studies to assess the effectiveness of these strategies in preventing complications.
Ms. Friis: The rapid rise in popularity of GLP-1 medications has posed a challenge in gastroenterology as we learn more about the implications of these drugs on our specialty practice. Various experts addressed the complications related to GLP-1 medications (see related article, page 12), and the researchers share a summary of their findings to help keep us all abreast of the most current literature available.
Abstract R11. Shooting for 5 stars: improving colonoscopy follow-up metrics (Keith et al)
A team at Baylor St. Luke’s Medical Center, in Houston, led by Clay Keith, MHA, RN, CGRN, CSSGB, aimed to enhance the hospital’s overall star rating by addressing a key endoscopy quality measure, OP-29, which tracks appropriate follow-up intervals for normal colonoscopies in average-risk patients. Historically, the hospital’s performance on this metric had been low, negatively affecting its Centers for Medicare & Medicaid Services star rating.
In July 2023, the team launched a targeted quality improvement initiative. They found that the top two reasons for OP noncompliance were lack of physician awareness and incorrect documentation practices. They implemented strategies to improve their compliance, including sharing compliance data at monthly gastroenterology meetings, posting reminder signage at documentation stations, conducting compliance audits and providing follow-up education when needed, setting a goal for 91% compliance.
Compliance improved dramatically with implementation of these measures—from 66% in fiscal year (FY) 2023 to 89% in FY 2024. Between February 2024 and September 2024, the hospital had eight months of 100% compliance. The hospital was upgraded that year from a three-star CMS organization to four-star organization. The FY 2025 average (as of when the poster abstract was finalized) was 95%.
Ms. Friis: Appropriate follow-up intervals for normal colonoscopy is a typical metric for all gastroenterology units. The impetus to close the gap on this compliance rating with action items proved a worthy task, as the team at Baylor St. Luke’s successfully improved their ratings.
Abstract R8. Metals matter: improving MRI safety after endoscopic metal device placement (Simoneaux et al)
In another project out of Baylor St. Luke’s, the endoscopy team recognized a critical safety gap for patients undergoing MRI after placement of metal clips, coils or stents. In fiscal year 2023, the department purchased more than 3,700 metal devices, and with around 3,500 cases performed, many patients likely left with an implant. However, there was no consistent way for patients to track what device was placed or where it was placed.
To address this, Jennifer Simoneaux, RN, CRN, and her co-investigators launched a quality improvement project to enhance MRI safety. They introduced medical device ID cards documenting the type and location of metal implants and provided education to patients on the importance of sharing this information with future care providers. The initiative aimed to ensure that every patient receiving a metal device left with clear, accessible documentation to support safer diagnostic testing down the line.
Ms. Friis: Metals are used frequently in the therapeutic treatment of gastroenterology patients, so the team at Baylor St. Luke’s worked to ensure any future healthcare providers were cognizant of metal implants in their patients to better avoid unnecessary complications from MRIs. Their interventions offer simple but effective means for keeping all healthcare providers in the loop.
—Compiled and written by Meg Barbor, MPH
This article is from the October 2025 print issue.