P154 Development of a nurse delivered therapeutic upper GI endoscopy service

Abstract

<h3>Introduction</h3> We describe the development of nurse delivered advanced upper GI therapeutic endoscopy service, which has ensured timely and efficient access to urgent and elective therapeutic procedures. <h3>Methods</h3> We utilised the HEE accelerated Clinical endoscopist training programme to train a nurse in diagnostic upper GI endoscopy. Training commenced Apr ‘16 with JAG accreditation in diagnostic OGD achieved Oct ‘16. From ’17 we began regular weekly therapeutic training lists, initially in observer role but progressing to hands on training (on top of the 4 job planned independent diagnostic lists/week + other duties). The Clinical endoscopist attended a weekly specialist upper GI clinic with a consultant gastroenterologist, progressing to an allocated patient list after 6 months. This training was supplemented with regular attendance at MDTs, national conferences and external courses as well as a Master’s Degree in Advanced clinical practice. Over a 4 year period, competency was attained in multimodal assessment of Barrett’s oesophagus, HALO radiofrequency ablation, endoscopic mucosal resection, pneumatic dilatation of oesophageal strictures, placement of oesophageal stents, the assessment and multi-modal treatment of emergency upper GI bleeding (and delivery of daily inpatient emergency endoscopy lists), and placement of percutaneous endoscopic gastrostomy feeding tubes. Furthermore the Clinical endoscopist is “train the trainer’s” accredited and is a now major provider of upper GI endoscopy training to SpRs and consultants in our unit. <h3>Results</h3> No. of independent lists delivered over the most recent 12 month period: TOTAL: 126 independent therapeutic/inpatient lists and 15 continued training lists Compared to a gastroenterology consultant’s endoscopy commitment, this is the equivalent of 3 endoscopy lists per week over 42 weeks i.e. approximately the total amount of endoscopy that a consultant is contracted to deliver in a year. Procedures performed in same time period: <h3>Conclusions</h3> We have shown that with the appropriate structured training, mentoring and clinical governance, nurse endoscopists can successfully and safely deliver an independent upper GI therapeutic service.