TRAIN THE TRAINER: THE NURSE MANAGER'S GUIDE TO THE REPROCESSING COMPETENCY

Jane Allaire, RN, CGRN

James Collins, BS, RN, CNOR

Michelle E. Day, MSN, RN, CGRN

Cynthia M. Friis, MEd, BSN, RN, BC

Patricia Maher, RN, CGRN

Joan Metze, BSN, RN

The process for reprocessing flexible gastrointestinal endoscopes, as outlined by the Society of Gastroenterology Nurses and Assocciates, will be thoroughly reviewed. You will have the opportunity to practice your skills with guidance from our knowledgeable trainers. Tips on how to develop, manage, and deliver the reprocessing competency also will be discussed.

IMPROVING EFFICIENCY

Phea Anderson, MS, RN, CGRN

Karen Laing, MA, RN, CGRN

The evolving healthcare industry is shaped by a variety of factors and challenges, including government mandates for staff efficiency. A high demand for improved customer service due to increased public scrutiny of quality of care and patient safety; and a growing need to solve the fiscal dilemma of meeting the significant care demands of the patients we serve are just some of the drivers for improved performance. In an effort to improve efficiency, numerous facilities have begun to use Lean methods. These methods have been successful in eliminating waste and redundancy in endoscopy work processes resulting in improved financial, patient satisfaction, and safety performance. Identifying the waste, creating standard work processes, and using data which also serve as benchmarks will provide a baseline for the implementation of Lean methods. An important part of implementing new processes in the gastrointestinal unit is facilitating the change process. We will provide tips for creating your own project plan and include change management principles to support your team and make the most of your change efforts.

WHY WE DO WHAT WE DO

Kristine Arnell

Cynthia Di Venti

Jennifer Schabatka

Share our purpose and passion of becoming competent and proficient gastrointestinal technicians. We will explore our roles as part of the endoscopy team in both the ambulatory and hospital settings. Our discussion will include what we do as technicians, how we do it, and most importantly, why we do it.

BOWEL DYSFUNCTION ASSOCIATED WITH PARKINSON DISEASE

Jason Baker, BS

A variety of chronic gastrointestinal problems commonly occur in neurodegenerative disorders such as Parkinson Disease (PD). PD is a progressive disorder of the central nervous system of unclear etiology, although strongly associated with the degeneration of dopaminergic neurons in the substantia nigra. Although PD is marked by cardinal motor features including tremor, bradykinesia, rigidity, and postural instability, there are a number of common non-motor symptoms including autonomic dysfunction, cognitive dysfunction, psychosis, and mood disorders. These motor and non-motor disturbances can lead to significant gastrointestinal problems including dysphasia, constipation, and pelvic floor dysfunction. Constipation is the most well-known gastrointestinal symptom, although its true prevalence and underlying physiology remain poorly described in PD. These gastrointestinal symptoms can contribute considerably to the disability and decreased quality of life in such individuals. Moreover, gastrointestinal symptoms are not always voiced by PD patients or addressed completely by healthcare providers. Given our aging population and the increased prevalence of PD with advancing age, it is essential for healthcare providers to be more aware of the gastrointestinal problems associated with PD, the underlying pathophysiology, and effective treatment strategies.

WRITING FOR PUBLICATION WORKSHOP

Kathy A. Baker, PhD, RN, ACNS-BC, CGRN, FAAN

This presentation by the Gastroenterology Nursing editor will discuss the "how-to" of writing for publication including tips for increasing the success of being published. Gastroenterology nurse authors and members of the editorial board will be present to talk one-on-one with workshop attendees. Participants will leave with the beginnings of a published manuscript.

ADVANCED AUTHOR AND REVIEWER WORKSHOP

Kathy A. Baker, PhD, RN, ACNS-BC, CGRN, FAAN

This workshop, facilitated by the Gastroenterology Nursing editor and editorial board, will offer experienced authors and manuscript reviewers (or those who want to be) insight into what a peer-reviewer looks for in a quality manuscript. The reviewer perspective of how to critique a manuscript will assist experienced manuscript reviewers to refine their review skills as well as promote more successful outcomes for authors submitting manuscripts for peer review.

AN EVIDENCE-BASED RESOURCE FOR GASTROENTEROLOGY NURSES: THE JOANNA BRIGGS INSTITUTE

Kathy A. Baker, PhD, RN, ACNS-BC, CGRN, FAAN

Susan Mace Weeks, DNP, RN, CNS, LMFT, LCDC

This session provides an overview of evidence-based resources and tools available through the Joanna Briggs Institute to support nurses in developing and utilizing evidence-based nursing practices.

LIVER LOGIC

Barb Bancroft, MSN, RN, PNP

Did you know that your liver has over 500 functions? The liver synthesizes proteins; stores blood; secretes bile; metabolizes hormones, drugs and alcohol; and even has the capability to regenerate! Barb will discuss the signs and symptoms of liver disease, diseases specific to the liver, and the liver as an innocent bystander in conditions such as heart failure and autoimmune disease.

GI PROCEDURES FROM A TECH PERSPECTIVE

Heith Battles, LPN

How important is your gastroenterology technician? What purpose does she serve in your endoscopy lab? The endoscopy technician is an important part of the healthcare team, relating to the whole function of the endoscopy lab. Through proper training and continuing education, the endoscopy technician plays an important role in patient safety, improved customer service, and overall efficiency of the endoscopy lab. This presentation will shed both light and life to the endoscopy technician focusing on endoscopic procedures including the definition of the endoscopy technician's role in the endoscopy lab, training of new endoscopy technicians, evaluating new personalities in the endoscopy lab, and problem solving strategies.

CURRENT EVIDENCE REGARDING HEALTH-RELATED QUALITY OF LIFE (HRQoL) IN HEPATITIS C PATIENTS

Patricia Bauch, PhD

Lynn Clement, MPH

Maureen Cormier, MS, RN, NP-C

Richard Sterling, MD, MSc, FACP, FACG

Tiffany Taskaya, PA-C

Fulton Velez, MD

Lauri Welch, RN, NP

We reviewed studies reporting primary HRQoL data among Hepatitis C virus (HCV) patients and assessed relationships between RHQol, adherence, work productivity, and sustained virological response (SVR). PubMed search (4/16/2009) terms were: Hepatitis C OR HCV; AND Quality of Life OR QoL OR Health Related Quality of Life OR hrQoL; AND Productivity OR Adherence OR Compliance OR General Health Status OR Treatment History. Interferon-based therapies were included. Twenty-nine of 105 articles met inclusion criteria: 14/19 (74%) found significantly lower pre-treatment HRQoL among HCV patients compared to controls. Significant on-treatment HRQoL reductions were observed in 13/14 studies testing for significance. Significant associations were found between HRQoL and both on-treatment productivity and adherence to therapy. Seven of 9 studies that assessed post-treatment HRQoL differences tested for significance; 6/9 (86%) found significantly better RHQoL among patients achieving SVR than those who did not respond to treatment. In conclusion, HCV patients exhibited poorer baseline HRQoL than healthy individuals and frequently reported diminished on-treatment HRQoL versus baseline. Most SVR patients experienced HRQoL improvements that approached healthy/well norms. Though data were robust for pre-/post-treatment HRQoL, many studies were not adequately powered to study on-treatment HRQoL or its relationship to adherence. While managing HCV patients, nursing professionals could communicate HRQoL benefits of achieving SVR.

CORNELIA DE LANGE SYNDROME AND THE GASTROINTESTINAL ANOMALIES

Sanjay Bhat, MD

Shelley Riddle, MBA, BA, LPN, CGN

This presentation will address Cornelia de Lange Syndrome including its causes, history, diagnosis, features, characteristics, and treatment support. The effects on the gastrointestinal system, care and treatment of these patients, and family teaching and support will also be addressed. A case study and live interview with a family member will contribute to a unique experience.

ADVANCED HANDS-ON ERCP

Jeanetta Blakely

Catherine Collins, BSN, RN, CGRN

Teri Derimanoczy, MSN, RN, FNP-BC, CGRN

Deborah Gates, MS, RN, CGRN

Maria Paulter, BSN, RN, CGRN

Jeanine Penberthy, MSN, RN, CGRN

Susan Rivers, BS, ADN, RN, CGRN

Christopher Robbins, BSN, RN, CGRN

Sandra Schneider, RN, CGRN

Linda Wiebold, BSN, RN, CGRN

Heather Yount, RN

This session will center on a hands-on equipment demonstration, focusing on advanced endoscopic retrograde cholangiopancreatography (ERCP) and its accessories, using a step-by-step approach, and discussing equipment use and potential complications. The therapeutic components associated with ERCP can be both complex and challenging. Return demonstration and discussion will center on lithotripsy, entrapped stones, and biliary dilation. Cholidochoscopy, self-expanding metal stents, and pancreatic therapies such as stenting and dilation will also be discussed.

GI AND LIVER MANIFESTATIONS OF CYSTIC FIBROSIS

Molly Bozic, MD

Jean Pappas Molleston, MD

This session will review the gastrointestinal and liver manifestations of cystic fibrosis including pancreatic insufficiency, pancreatitis, liver dysfunction, cirrhosis, and bowel obstruction.

ENDOSCOPY ON THE HIGH SEAS: A NURSE'S EXPERIENCE

Debra Brendley, BSN, RN, CGRN

Endoscopy under normal circumstances presents many challenges; however, endoscopy aboard the United States Naval Ship Mercy multiplied and magnified these challenges. Some of these challenges included untrained staff, limited supplies, no technological support, lack of disinfecting machines, language barriers, and cultural differences. One Naval Reserve Nurse was chosen to support Pacific Partnership 2008 on a naval hopital ship as a medical-surgical nurse and found herself in the middle of an unusually complex situation. The space for a unit, gastroenterologist, $250,000 worth of state of the art equipment, and her expertize was all she had to work with. Hear how one Navy Nurse and her new team built a state of the art gastroenterology suite from the bottom up that served over 300 underserved people from Southeast Asia.

BASIC HANDS-ON ERCP

Judith Burris, RN, CGRN

Deborah Gates, MS, BS, RN, CGRN

Joan Metze, BSN, RN

Jeanine Penberthy, MSN, RN, CGRN

Linda Wiebold, BSN, RN, CGRN

Heather Yount, RN

This session will center on a hands-on equipment demonstration focusing on basic endoscopic retrograde cholangiopancreatography (ERCP) and its accessories. The diagnostic and therapeutic components associated with ERCP will be broken down using a step-by-step approach. Through return demonstration, attendees will develop an understanding of the equipment used and its effects. Demonstrations will include initial cannulation, catheter and guidewire exchanges, guidewire manipulations, plastic stent placement, tissue sampling, sphincterotomy, and occlusion retrieval balloons.

PREVENTION AND CONTROL OF INFECTIONS ASSOCIATED WITH ENDOSCOPY

Beverly Burt, BS, RN, CIC

This session will discuss endoscopy-associated infection transmission with specific pathogens such as Clostridium difficile, Hepatitis B and C, pseudomonas, mycobacterium, and what you can do to prevent this. This session will also discuss how you can minimize the risk of infection by ensuring equipment is designed and maintained properly and that guidelines are strictly followed. The financial impact of healthcare acquired infections will be discussed as well.

COLLABORATING TO LINK THE WORLD OF PH AND BEST PRACTICES

Rebecca A. K. Chandler, BSN, RN, CGRN

Ellen Fern, BSN, RN

Janet King, BSN, RN, CGRN

This session will address the use of pH testing as a tool to effectively diagnose and document abnormal esophageal acid exposure. This class will focus on pH testing and will link an overview of gastroesophageal reflux disease (GERD) to the clinical setting. We will discuss the importance of testing on or off medications, and will review how the nurse can individualize each study for their particular patients symptoms. We will review three ways catheter based testing are used today in selected cases. In addition, we will focus on Bravo wireless pH testing with updates on the latest information. Finally, we will review pH impedance and how this newer testing is being used. The faculty will collaborate to provide the best practices in pH testing for this class using a variety of teaching methods including lecture, looking at pH tracings, video clips, hands-on, and breakout round table discussions to assist in this learning process.

LINK YOUR COMMITMENT OF OPTIMAL PATIENT CARE BY EXPANDING YOUR NURSING PRACTICE IN ESOPHAGEAL MOTILITY

Rebecca A. K. Chandler, BSN, RN, CGRN

Ellen Fern, BSN, RN

Janet King, BSN, RN, CGRN

This session will provide hands on experience in the motility room setting. Contents will include review of the swallowing process (anatomy and physiology, and motility images both contour and wave forms), ergonomic setup of the motility equipment, techniques used for successful catheter placement, the use of an educational video pre procedure, and a live demonstration of an esophageal motility procedure using high resolution.

COURAGE TO BEGIN: NOVICES JOURNEY INTO NURSING RESEARCH AND BEST PRACTICE

Cheri Coleman, BSN, RN

Maria Millan, BSN, RN

The goal of this presentation is to encourage nurses to begin nursing research and best practice projects. The presentation will summarize our search for a best practice that utilizes a standard simethicone and sterile water combination for gastroenterology endoscopic irrigations. Question formation, literature review, abstract development, collaboration with providers, and formation of a consensus statement will be presented utilizing an interactive skit. The progress through various hospital committees and end results that include a standard dose of simethicone and sterile water for gastroenterology endoscopic irrigations, a standarized data entry for providers, and compliance with The Joint Commission standard for labeling on and off the sterile field will be shared. This presentation is fun and informative with practical tips and tools.

HOUSE OF DELEGATES WORKSHOP

Catherine Collins, BSN, RN, CGRN

Kimberly Foley, BSN, RN, CGRN

This workshop is designed to introduce Delegates and Alternates to the workings of a House of Delegates and its role in a professional society. Basics of parliamentary procedure will be reviewed and attendees will participate in mock sessions of both a House of Delegates and a Reference Hearing. Find out what happens and how you can participate.

SAFETY IN THE GI UNIT: ARE YOU PREPARED?

James Collins, BS, RN, CNOR

This goal of this presentation is to familiarize the Associate, Gastroenterology Technical Speciallist (GTS) and Advanced Gastroenterology Technical Specialist (AGTS) with various safety related topics when providing care for the patient in the Gastrointestinal/Endoscopy Unit. Central themes of the program will address emergency preparedness, general safety principals, and risk management concerns related to the associate and their role in the unit.

SNAP, CRACKLE, AND POP: MANAGEMENT OF THE DIFFICULT HEPATOBILIARY STONE WITH ELECTROHYDRAULIC LITHOTRIPSY (EHL) AND LASER LITHOTRIPSY

James Collins, BS, RN, CNOR

Endoscopic retrograde cholangiopancreatography (ERCP) has proven to be a safe and effective method of managing pancreaticobiliary stones over conventional open surgical procedures, making it the predominant method of choice in the treatment of choledocholithiasis. Upon completion of a sphincterotomy, 85% to 90% of stones can be easily removed with either a simple basket or balloon catheter; however, clearance of large or impacted stones may be quite challenging and require more than traditional endoscopic maneuvers to clear the duct, such as intraductal shock lithotripsy and/or holmium laser lithotripsy. This presentation will acquaint the participant with relevant pancreaticobiliary anatomy, the physiology of stone formation, devices utilized during stone extraction from customary balloons to laser technology, as well as the teamwork necessary for successful performance of stone extraction.

LEGAL AND ETHICAL CONSIDERATIONS IN THE GI PROCEDURAL AREA

Donna A. Conroy, RN

Catherine Yows, RN, CGRN

This presentation will address legal and ethical considerations in the gastroenterology procedural area. Professional responsibilities and liabilities associated with gastroenterology procedures will be discussed. Upon completion, attendees will be able to identify the differences between legal and ethical issues, identify governing bodies that regulate licensing issues, identify three ethical principals commonly associated with GI procedures, and identify resources available to assist with legal or ethical concerns

ENDOSCOPIC LUMEN RESTORATION/ANTEGRADE-RETROGRADE ESOPHAGEAL DILATION

Rhonda DelCampo, RN, CGRN

Esophageal strictures causing complete obstruction are often difficult to treat using standard dilation techniques. Completely occlusive strictures may develop after head and neck radiation therapy or esophagectomy. Lumen restoration may be achieved endoscopically via antegrade-retrograde techniques. In some cases, however, patients may need to undergo a collaborative effort by the gastroenterologist and the ENT surgeon in the operation room for lumen restoration. We will explore the antegrade-retrograde dilation in the GI lab as well as the surgical procedure to facilitate alimentary tract patency.

AMBULATORY NURSING: NEW COMMITMENT TO PRACTICE AND CARE

Nancy DeNiro, RN, CGRN

Recent nursing surveys reveal over 25% of nurses plan to reduce their current role in the next three years, and 15 percent say they will also make a change in their career path. A change of course can offer lifestyle changes, a new focus, or at least a refocus of their nursing career. This session examines reasons to consider ambulatory nursing, how ambulatory nurses rely on community and commercial resources, and what new roles are available for the nurse in the ambulatory setting.

SPEAK EASY: COURAGE AND COMMITMENT TO PRESENT A SUCCESSFUL PROGRAM

Nancy DeNiro, RN, CGRN

Cathy Dykes, MS, RN, CCRC, CCRP, CGRN

Do you have good information to share with your colleagues? Are you passionate about something specific in gastroenterology? Are you involved in research? Are you struggling for the best way to present your story? Learn some techniques to help you deliver a successful program including advice on writing an abstract, preparing your talk, and how to best use humor, eye contact, timing, and voice inflection in a presentation.

ENDOSCOPIC ULTRASOUND: LINKING THE COMMITMENT TO PROVIDE THE LATEST TECHNOLOGY

Teri Derimanoczy, MSN, RN, FNP-BC, CGRN

Judy P. Lindsay, MA, BSN, RN, CCRN, CGRN

Endoscopic ultrasound (EUS) is different from any other gastrointestinal procedure, but need not be bewildering or panic provoking. In this two hour informative session, we will share numerous tips, and "dos and don'ts" gleaned from starting and building an EUS program over the past six years. The presentation will address what EUS is and why it is important, what is required for an EUS program (i.e. training of staff, off-site and on-site training), differences between radial and linear echoendoscopes, fine needle aspiration/FNA), differences between needles, mini probes, and equipment inventory. Staff selection, terminology, pathophysiology, and administrative aspects will also be addressed.

THE POWER OF ONE: THE COURAGE AND COMMITMENT TO ABOLISH INCIVILITY IN THE WORKPLACE

Teri Derimanoczy, MSN, RN, FNP-BC, CGRN

A costly and detrimental phenomenon is plaguing our endoscopy departments ... bullying, incivility, lateral work violence, and work place road rage are just a few of these negative behaviors that are affecting the health and safety of our patients, co-workers, and even ourselves. In this session, you will learn why endoscopy nurses terrorize each other and what each of us as an individual can do to end these hostilities and toxic behavior.

EUS, VARIX GLUE, COIL, ETC.

Thomas DeSimio, RN, CGRN

This session will highlight the role of echoendoscopy in the treatment of various disease processes. Novel therapies being used in a handful of centers around the world will be presented.

THE ROLE OF THE REGISTERED NURSE IN ENDOSCOPIC ULTRASOUND (EUS) DURING PANCREATIC PSEUDOCYST DRAINAGE

Thomas DeSimio, RN, CGRN

This presentation will addres various methods of performing pancreatic pseudocyst drainage using a variety of available tools and modes.

STRATEGIES FOR SAFE AND EFFECTIVE SEDATION

Deborah Dlugose, RN, CCRN, CRNA

Providing safe and effective sedation for patients undergoing gastrointestinal procedures is a challenging part of our practice. Changes in sedation practice are driven by the increasing number of cases done each year and the increasing level of responsibilities of nursing roles in these procedures. New definitions and standards are being promulgated by various groups while pharmacology and technology for sedation care are advancing. This full-day workshop will focus on topics including strategies for patient selection, assessment, and preparation; planning for clinical safety; making sense of monitoring; rational titration of medication; rapid response to emergency events; effective documentation; and risk management strategies from bedside to manager levels. Seminar content emphasizes critical thinking and problem-solving skills. Case illustrations from the instructor's experiences in sedation care and legal nurse consulting will also sharpen participants' abilities to provide sedation care which is both safe and effective. Is your practice ready to evolve?

THE GI ASSOCIATE: A VITAL LINK BETWEEN PRACTICE AND CARE

Kate Donovan, BS, GTS, AGTS

The gastroenterology associate is an integral part of the healthcare team in the gastroenterology and endoscopy practice settings. They perform a variety of delegated technical and patient care related activities to contribute to optimal patient outcomes. This interactive session will give an in depth overview of the field of gastroenterology as it pertains to the associate role. Topics covered will include gastroenterology anatomy and physiology, infection control, endoscopic reprocessing, specimen acquisition, and team communication.

DEEP ENTEROSCOPY: THE FUTURE IS HERE

Sharon Downey, BSN, RN

This session will describe the dawn of deep enteroscopy. It will review the anatomy of the normal small bowel and the surgically altered small bowel. Applications for deep enteroscopy will be discussed. Various techniques for accessing and performing intervention in the small bowel, including balloon methods, will be demonstrated. Equipment available on the market today will be presented. Devices still in the developmental stages will be described.

COURAGE, COMMITMENT, COLLABORATION AND TWO MORE CS: COLORECTAL CANCER SCREENING AND THE COLON HEALTH INITIATIVE

Cathy Dykes, MS, RN, CCRC, CCRP, CGRN

Approximately 150,000 people are diagnosed with colorectal cancer each year resulting in 50,000 deaths. As the number of people who undergo colorectal cancer screening increases, there is a corresponding increase in the rate of colorectal cancer found at an earlier stage, along with a decrease in the number of deaths from colorectal cancer. Optical colonoscopy is the gold standard for colorectal cancer screening; however, my gastrointestinal unit serves a population of 250,000 with only six gastroenterologists. Sentinel research on virtual colonoscopy (e.g. computed tomographic colonography [CTC]) has been conducted at our facility with equivalent rates of polyp detection on polyps 6 mm in size as compared with optical colonoscopy. A Congressional grant established the Colon Health Initiative with the goal of offering the option of CTC to appropriate patients to increase the rate of colorectal cancer screening. The outcome was a multidisciplinary team that has facilitated a 36% increase in colorectal cancer screening. It took courage to think outside the box as we are committed to colorectal cancer screening and the collaboration between the radiology and gastroenterology departments.

RECERTIFICATION INFORMATION SESSION

Jeanie Ebbert, RN, CGRN

Shirley Flowers, BSN, RN, CGRN

Virginia Parkhurst, RN, CGRN

Nancy Todd, RN, ARNP, NP-C, CGRN, RN-BC

Kendall Yoshisato, BA, RN, CGRN

This session will cover information on recertifying for CGRN status. Updates, tips, and helpful information will be provided.

INFECTION CONTROL: WHAT ROLE DOES THE TECHNICIAN PLAY?

Cynthia Edgelow, MSN, RN, CGRN

Kimberly Richarson

Infection control continues to play a significant role in healthcare. Current statistics estimate that there are thousands of deaths each year attributed to hospital-acquired infections. What role does the gastrointestinal tech have in attempting to decrease these infections? What types of infections are seen in gastroenterology? What is the current approach towards these using evidence based practice-what do we know, what have we learned? What works and what doesn't in personal protective equipment choices? What's new?

UNDERSTANDING THE VALUE AND OPPORTUNITIES OF PROFESSIONAL NURSING CERTIFICATION

Nancy Eisemon, MPH, RN, CNS, CGRN

Learn the benefits of CGRN Certification. This session will discuss eligibility requirements, how the test plan is used in the construction of the exam, how the passing score is set, and options for taking the exam. Test-taking tips will be discussed and attendees will have the opportunity to ask questions.

AMERICAN BOARD OF CERTIFICATION FOR GASTROENTEROLOGY NURSES (ABCGN) ITEM WRITERS WORKSHOP

Nancy Eisemon, MPH, RN, CNS, CGRN

Learn how to write and critique items for the certification examination. Participants will be guided through a step-by-step process to develop quality items (questions). This is a unique opportunity for professional growth and challenge. All attendees will meet the volunteer eligibility requirements for ABCGN's Item Review Committee, Item Writing Panel, or Panel of Experts for the Role Delineation.

OBESITY AND BARIATRIC SURGERY

Christopher M. Evanson, MD, FACS, FASMBS

This session will be a comprehensive overview of obesity and bariatric surgery. Discussion topics include medical comorbidities related to obesity as well as weight related mortality statistics. We will discuss the most common bariatric procedures in detail, as well discuss post-op statistics and potential issues in bariatric surgical patients.

UNDERSTANDING AND COPING WITH BULLYING IN THE WORKPLACE

Bonnie Fisher, BSN, RN, CGRN

Workplace bullying is a problem often not addressed resulting in unhappiness or fear in the workplace, change of position to another area, or leaving the field of nursing altogether. This presentation intends to address the following: the definition of what is and what is not a workplace bully, a profile of the bully and the victim, what to do and how to interact with the bully (what works), what to report to management, and management's responsibilities. The author's own story of bullying will be presented.

IS YOUR PATIENT VENTILATING? CAPNOGRAPHY USE DURING ENDOSCOPY

Julie Flamm, BS, ADN, RN, CGRN

Karyn Pechinski, BSN, RN, CGRN

Cecelia Pezdek, BS, ADN, MSHA, CGRN

A research study was conducted comparing capnography and pulse oximetry on 47 randomly selected colonoscopy patients receiving moderate sedation. The study determined that capnography identifies disordered breathing (hypoventilation, stridor, apnea) up to two minutes before desaturation occurs. Pulse oximetry detected 13 episodes of desaturation, whereas capnography detected 29 episodes of apnea and 64 episodes of hypoventilation. The study also examined the correlation between apneic events and age, gender, smoking history, past medical history, history of sleep apnea, current daily medications, body mass index (BMI), and American Society of Anesthesiologists (ASA) class and dosage of versed and fentanyl. A relationship between lower BMI and increased apneic events was identified. Forty-five percent of normal or overweight subjects had at least one apneic event. Eleven percent of patients classified as obese experienced apnea (classified according to the World Health Organization BMI classification system). Other factors showed minimal to no correlation. Due to the small sample size, we view this as an opportunity to expand research for factors that may indicate a higher risk for disordered breathing during endoscopy. For gastrointestinal patients, capnography is clearly the best method for ensuring patient safety during moderate sedation and should be the primary tool nurses use to monitor patient ventilation.

THE PANCREAS IS A HARSH MISTRESS

Joyce Flueckiger, RN, APRN BC, CGRN

This session will review endocrine and exocrine functions of the pancreas; the etiology of acute, chronic pancreatitis and neoplasms; diagnostic criteria; and treatment of acute and chronic disease and neoplasms.

PANCREATIC STENTS FOR PREVENTION OF POST-ERCP PANCREATITIS

Martin L. Freeman, MD, FACG, FASGE

This session will review rationale, technique, outcomes, evidence, and pitfalls of pancreatic stents. The session will utilize a video and visually-based talk aimed at all levels, from novice to expert.

APPLYING FOR NURSING CONTACT HOURS

Cynthia M. Friis, MEd, BSN, RN, BC

This presentation will focus on the fundamental elements of completing the Application for Nursing contact hours through the SGNA Approver Unit. Participants will receive helpful hints on how to best meet the criteria for approval and tips on creating an effective educational experience.

NATURAL THERAPIES FOR GI AILMENTS

Yvonne Garcia, MSN, MBA, ND

This session will review the pathology of common gastrointestinal ailments and the natural therapies recommended for management such as acupuncture, chiropractic, nutritional counseling (foods and drinks to consume or avoid), detoxification, enzymes and antioxidants: vitamins, minerals, supplements, herbs, and remedies.

THE ROLE OF THE NURSE DURING INTERVENTIONAL BRONCHOSCOPY

Elsa Garza, ACNP

Mark J. Rumbak, MD

After this session, attendees will be able to appreciate what an interventional pulmonologist does and how she or he can assist during procedures. Topics discussed during this session will include bronchoscopy in both intubated and non intubated patients; thorocentesis and chest tube insertion and removal; ultrasound guidance for central lines and line changes; pleuroscopy; pulmonary arterial hypertension (PAH); cardiopulmonary stress tests; obtaining access and doing heart catheterizations in patients with PAH; planning and assistance in the operating room for total lung washout; Wang biopsies; stent placement; balloon dilatation; narrow band imaging; electrocautery, argon plasma coagulation and laser; rigid bronchoscopy; and pleur-X catheters.

THERAPEUTIC BRONCHOSCOPY AND THE MODALITIES OF TREATMENT

Theresa Geil, RN, CGRN

Designed for the experienced pulmonary nurse, this course is designed to provide insight into the different modalities available in the endoscopy suite to successfully treat various pulmonary disorders. Diseases, disorders, and the use of ancillary equipment such as the argon plasma coaulator, cryotherapy, and stents will be discussed, as well as patient considerations throughout the entire pulmonary procedure process.

NASH: NOT JUST A CAR YOUR GRANDMOTHER DROVE

John Goff, MD

Learn about NASH (nonalcoholic steatohepatitis) liver disease including how to recognize it, how to confirm a diagnosis, how it is affecting many of our patients, and how we are treating it.

LIVING AN OPTIMAL LIFE: HOW TO HAVE YOUR CAKE, AND EAT IT TOO!

David W. Grotto, RN, LDN

Being tired, stressed, or forgetful; having low libido; or being in pain are just a few of the descriptors for not being at the top of your game. Boomers are ranking life's inconveniences and not feeling good as a greater concern to them than the health challenges that threaten their very existence. David Grotto, RD, LDN, author of 101 Optimal Life Foods, will review an add-in more sustainable approach for tackling those challenges that get in the way of living.

THE EVIDENCE THAT ISN'T

Richard Hader, PhD, RN, FAAN, CHE, NE, BC, CPHQ

Why is there a surging interest in evidence based care? Haven't we always practiced based within the framework of tested science? The answer might surprise or scare you. This presentation will focus on why evidence based practice is more important than ever, how we need to think, act, and work differently in a complex environment, and why research and innovation may be the tactical strategy of survival.

THE LINK BETWEEN DIVERTICULA AND THE GASTROINTESTINAL TRACT

Janet Hannah, RN, CGRN

Gastrointestinal (GI) tract diverticula are outpouchings in the lining of an organ. They are mostly found in the large intestine. We are familiar with diverticulosis and diverticulitis of the colon. But did you know that diverticula are found in other parts of the gastrointestinal tract? This presentation will review colon diverticulosis and diverticulitis, followed by a trip through the rest of the GI tract to discover the classifications, histopathology, and pathogensesis of other diverticuli. The esophagus, stomach, and small bowel will be covered. Zenkers and Meckels diverticua are two of the main types that will be included. Locations, signs and symptoms, and treatments will be discussed. At the end of the presentation, the attendee will understand that diverticula are not just in the colon.

SURVIVING AN INFECTION PREVENTION SURVEY

Marcia Hardick, BS, RN, CSPDT

Patient safety initiatives include a focus on decreasing the incidence of healthcare-associated infections (HAIs). Decreasing the incidence of HAIs continues to be a major focus as regulatory agencies survey areas at risk for transmission of infection. Creating a culture of safety should encompass infection prevention initiatives to protect patients, their families, and healthcare workers (HCWs). Performing infection prevention rounds within a patient care area can identify areas of risk and address opportunities for improvement in infection control practices. Studies now confirm that the environment plays a role in the transmission of infections. The HCW must be continually cognizant of an awareness of dirty/clean and work flow processes to assist with decreasing the risk of transmission of infection and provide a safe environment. This presentation will provide the healthcare worker with a tool to identify the areas of potential risk within the patient care and reprocessing areas. It will review the chain of infection, common microorganisms, and their hierarchy of resistance. Examples of procedural barriers and work flow to decrease the risk of transmission of infection will also be presented.

SIMULATION BASED TRAINING IN THE GASTROENTEROLOGY PROCEDURE UNIT

Lisa Heard, BSN, RN, CGRN, CPN

The use of simulation-based training (SBT) provides healthcare teams with opportunities to practice managing complications of endoscopy without risk to patients. The aviation industry has effectively used SBT and crew resource management to help teams perform effectively in crisis situations. The healthcare world has adapted this training and effectively utilized it to assist teams to manage critical events and improve communication and teamwork among caregivers. This session will describe the benefits and rationale for the use of SBT, highlighting adult learning theory. Our experience of performing SBT in the pediatric endoscopy unit, review of lessons learned, and benefits of this specialized team training will be presented.

DAN'S STORY: THE TRAINING OF AN ENDOSCOPY TECHNICIAN WITH LIMITED MEDICAL EXPERIENCE

Sheenagh Hirsch, RN, CGRN

Karen Zervopoulos, CMA, CSPDT, CFER, GTS, AGTS

This presentation will follow the story of a young man (21 years old) who works in a gastroiontestinal (GI)-specific ambulatory surgical center in Central New Jersey. Dan was hired as a unit clerk and immediately became a popular young man due to his hard work, dedication, and positive attitude with staff and patients. Gradually, Dan became interested in our GI procedures, and when an endoscopy technician position became available, he stated his strong interest in obtaining this new position. The Director of Nursing and lead endoscopy technician agreed Dan was a wonderful worker, but his lack of medical experience was hard to overlook. After discussion, the decision was made to train Dan, someone we knew who had worked hard and deserved a chance. The SGNA Associates Program/Guidelines and our department endoscopy technician competencies were reviewed about how to approach our special training of Dan. A preceptor will be assigned to help Dan whose training has just begun. I believe SGNA members will be interested in Dan's story and the path it takes. A big part of our consideration for Dan and this new endoscopy technician position are the possibilities this job can bring to his future and the future of gastroenterology!

LEAP AND MRT: THE LINK BETWEEN INFLAMMATORY DISORDERS AND FOOD SENSITIVITIES

Patricia Holland, BSN, RN, CGRN

This session will describe the Lifestyle Eating And Performance (LEAP) program. The program utilizes Mediator Release Testing (MRT) to identify Type IV cell-mediated food intolerance or hypersensitivity reactions and implement dietary modification for relief of associated symptoms. Attend this session to learn how this program can be effective for Irritable Bowel Syndrome (IBS) as well as many other conditions that may be associated with immunologically-related food sensitivity.

ABDOMINAL PRESSURE DURING COLONOSCOPY LECTURE AND HANDS-ON

Raymond Hucke, MPH, OTR

James Prechel, GTS

Sara San Miguel, GIA

Catherine Yows, RN, CGRN

This four hour class will incorporate a formal one hour lecture along with three hours of hands on experiences. The lecture will cover the theory behind the hands on application, and will provide informative visual guidance to achieve the objective of each technique. In the hands on portion of the class, the attendees will get a chance to demonstrate up to 12 techniques (time permitting). The lecture and hands on portion of the course will offer the attendee proper ergonomics with focus on safety and comfort for the patient as well as the caregiver. The goal of this course is that all attendees will learn and perform each technique and be able to take the skill back to their department to perfect and share with coworkers. It is our suggestion that each attendee wear comfortable clothing as we will be performing the techniques on each other.

DYSPHAGIA: WHY SPEECH PATHOLOGISTS HAVE GONE ESOPHAGEAL

Gerriann Jackson, MS, CCC-SLP

The relationship between gastroenterology and speech pathology is important for our patients. Our ability to provide cross-disciplinary diagnostic evaluation and treatment planning is critical to our success in treating dysphagia. This presentation addresses the the benefits of such a partnership and provides an overview of how gastrointestinal (GI) disease impacts the oral pharyngeal phase of the swallows. Video clips of fiberoptic endoscopic evaluation of swallowing studies and videoflouroscopic swallow studies of patients whose primary dysphagia etiology was the esophagus will be viewed. The presentation connects the functional swallowing behaviors evaluated by speech pathologists to GI/esophagogastricduodenoscopy (EGD) findings.

ENDOSCOPIC POLYPECTOMY AND MUCOSAL RESECTION

Tonya Kaltenbach, MD, MS

Participants will enhance their knowledge and technical skills in the endoscopic polypectomy and mucosal resection of gastrointestinal neoplasia and early cancer. We will demonstrate using slides, images, and video to document the importance of endoscopic detection and diagnosis of gastrointestinal lesions. Contributing factors of interval cancers; necessary detection, diagnosis and resection tools and equipment; indications for polypectomy and mucosectomy; and practical pearls of detection, diagnosis and resection techniques will also be addressed.

DO YOU HAVE THE COURAGE AND COMMITMENT TO MAKE YOUR PRACTICE EVIDENCE BASED? WHAT IS THE PROCESS INVOLVED IN DOING A RESEARCH POSTER?

Janet King, BSN, RN, CGRN

This session will address the process used to develop a research poster. Discussion will focus on a research poster displayed at the 2010 SGNA National Conference. Review of the steps used in reaching the research outcome will be presented.

UNDERSTANDING ESOPHAGEAL MANOMETRY WITH CASE PRESENTATIONS

Linda Knight, BSN, RN

Corinne Pavesic, RN, CGRN

This lecture will provide a brief overview of esophageal manometry followed by case presentations. Presentation of actual patient procedures will allow for the discussion of indications for performing esophageal manometry, understanding waveform patterns and interpretation of the findings, trouble shooting abnormal findings with difficult studies, and gaining knowledge of esophageal disorders. Group interaction and questions will be encouraged throughout the lecture. Case presentations will include examples from several different catheter types including high resolution manometry, impedance, and five-channel manometry.

ENDOSCOPE CLEANING VERIFICATION TEST STUDY

Stephen Kovach, BS

Natalie Whitfield, PhD

Widespread use of endoscopes has increased the risk of transmission of infections, making reprocessing critical to routine care of rigid and flexible endoscopes and infection prevention. The objective of the study presented was to determine the real-world effectiveness of healthcare facilities' flexible endoscope cleaning procedures by utilizing a residual soil verification test. Healthcare centers across the United States were recruited to test the biopsy/suction channel of 10 endoscopes before and after cleaning, but prior to high level disinfection/sterilization, and record the results. Of the 103 endoscopes tested, cleaning removed the majority of the residues found prior to cleaning the endoscopes. The most common residue found before cleaning was blood (56%); however, after pre-cleaning, only 4% of the endoscopes yielded a positive result for blood. We concluded that the residual soil verification test is a simple, effective, and easy-to-interpret addition to the cleaning process that allows users to demonstrate competency with proper reprocessing methods of endoscopes.

THE NEW FACE OF GLUTEN SENSITIVE CONDITIONS: CELIAC DISEASE AND BEYOND

Cynthia Kupper, RD

In this session, you will learn about advances in the differences between celiac disease and non-celiac gluten sensitivity and their presentation, diagnosis, treatment, and management guidelines. Learn how the quality of life of persons is impacted by following a gluten-free diet and about potential future treatment options.

BENCHMARKING: DATA-DRIVEN BEST PRACTICES

Karen Laing, MA, RN, CGRN

Nancy Schlossberg, BA, BSN, RN, CGRN

Healthcare reform and accreditation requirements increasingly challenge gastrointestinal (GI) nurses and associates to focus on the delivery of evidence-based, outcome-oriented, cost-effective quality care. Benchmarking establishes standard metrics and enables an endoscopy facility to convert numbers, such as cost per procedure and staff ratios, into meaningful information for more effective management of a GI lab. After first identifying and describing basic principles of benchmarking, this session then offers attendees basic tools, tips, and strategies for developing a simple benchmarking program in their own endoscopy suite. Learning from others can help guide us in our decision-making and commitment to identify areas warranting improvements in quality, efficiency, and productivity of physicians, staff, and overall clinical and financial operations.

ENGAGING YOUR PATIENTS: SUREFIRE STRATEGIES TO RAISE SATISFACTION SCORES, DECREASE MISCOMMUNICATION, AND DRAMATICALLY ENHANCE EDUCATIONAL METHODS

Edward Leigh, MA

Learn what to say to patients and what never to say to patients! This high-energy interactive program will empower gastroenterology professionals with skills to dramatically improve the quality of interactions with patients leading to highly satisfied patients and improved compliance. This workshop covers: opening/closing patient interviews, listening skills, empathic responding, questioning techniques, and top tips to educate patients with impact. Communicate your way to success!

ANAL INCONTINENCE: THE "UNVOICED" COMPLAINT

Judy P. Lindsay, MA, BSN, RN, CCRN, CGRN

Anal incontinence affects as many as 5 to 20 million people with devastating consequences such as depression, social withdrawal, and poor quality of life. Learn more about this overlooked, under-diagnosed condition and what can be done to reach out and help these individuals.

NEWLY DIAGNOSED IBD PATIENTS: WHAT THEY NEED TO KNOW

Isabelle Lynch, MBA, BSN, RN

Within the inflammatory bowel disease (IBD) healthcare community, compliance in newly diagnosed patients is often problematic. Part of the problem is lack of knowledge of their disease, its process, and/or prescribed medications, or an overall lack of knowledge of a combination of these. This presentation will provide information to providers of care for this patient population, which will be helpful in increasing compliance and appreciation that a diagnosis of IBD is not a deal-breaker for a well lived life.

ENDOBRONCHIAL ULTRASOUND (EBUS): THE ALTERNATIVE TO TRANSBRONCHIAL NEEDLE ASPIRATION (TBNA) AND MEDIASTINOSCOPY?

Shannonlee Maialetti, BSDI, RT(R), RDMS

Participants will be able to understand the basics of EBUS, as well as how it relates to alternative studies, such as TBNA and mediastinoscopy. Discussed will be anatomy and physiology, physics, ultrasound imaging, TBNA, mediastinoscopy, and EBUS procedures.

FLORENCE NIGHTINGALE: APPRECIATING OUR LEGACY, ENVISIONING OUR FUTURE, CONNECTING OUR WORLD

Phyllis Malpas, MA, RN, CGRN

Gayle Mullins, BA, RN

Florence Nightingale is the gold standard for the historical role of nursing as a profession. She is credited with the origination of its art and science. Her vision, however, went far beyond the well known traditional role. Nightingale's dedication and determination encompassed holistic care from the individual to the community, then out to the world. Through a dialogue between Nightingale and a modern nurse, the link between Nightengale's purpose and each of us in the healthcare community becomes clear. The topic leads the attendees to an understanding of their historic but holistic role and its current application in healthcare.

INTESTINAL TRANSPLANTATION IN INFANTS YOUNGER THAN ONE YEAR OF AGE

Richard S. Mangus, MD, MS, FACS

A. Joseph Tector, PhD, MD

Rodrigo Vianna, MD

Parenteral nutrition (PN)-dependent infants with short gut are at high risk of cholestatic liver disease, cirrhosis, and death. Intestinal transplantation may be indicated for these children if they develop PN-related complications. This presentation reports study results for infants undergoing intestinal transplantation. Management options for infants with short gut syndrome who are candidates for or who undergo intestinal transplantation will be highlighted. Review of outcomes for intestinal transplant patients less than 1-year of age will be reviewied along with the primary study outcomes including PN-independence and patient survival. Results demonstrated that infants less than 1-year of age can successfully undergo intestine transplantation with good outcomes. Intestinal transplantation is a viable alternative for young infants with life-threatening complications of intestinal failure.

INTESTINAL TRANSPLANTATION IN THE CURRENT ERA

Richard S. Mangus, MD, MS, FACS

The indications for intestinal transplantation (IT) continue to broaden and include intestinal failure, certain non-resectable tumors, and portomesenteric thrombosis. This study reviews the changing indications for IT and current outcomes including an update regarding the current status of intestinal transplantation. Nurses will be able to identify patients that may benefit from intestinal transplantation following a review of indications and outcomes for intestinal transplant patients at a single center over a 7-year time period. Study results demonstrate continued improvement in IT outcomes for both adult and pediatric patients. An increasing number of patients can benefit from this option. Intestinal transplantation is a viable option for many patients with otherwise terminal diseases including short gut, certain non-resectable tumors and portomesenteric thrombosis.

LONG-TERM LIVING WITH A PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG) TUBE

Terry Markiewicz, MS, RN, CGRN

Gastrointestinal nurses routinely assist in the placement of PEG feeding tubes. Many of the recipients are no longer functional in their activities of daily living and received a PEG as a result of stroke or other debilitating entity. What happens, however, to the patient who is highly functional but cannot eat? This presentation will focus on one woman's journey after multiple surgeries for oral carcinomas, dealing with the multitudes of complications that can and do arise as the result of artificial feeding methods. Lessons learned can be applied to persons of any age with a PEG. Many of the complications necessitate a team approach (collaboration) in developing a resolution.

COURAGEOUSLY NAVIGATING REGULATIONS FOR AN EFFECTIVE INFECTION CONTROL PROGRAM

Rhonda Maze-Buckley, RN, CGRN

This presentation will discuss current guidelines and regulations as they pertain to an effective infection control program. The speaker will discuss current practices as required by Medicare, The Joint Commission (TJC), and the Accreditation Associaiton of Ambulatory Health Care (AAAHC).

PEDIATRIC SEDATION AND ANALGESIA

Michael Mazurek, MD

This presentation will address the requirements for providing safe pediatric sedation including pre-sedation, intra-procedure sedation, and post-sedation requirements. Included in this presentation will be definitions of various levels of sedation, appropriate monitoring techniques, and specific case discussions.

GASTROINTESTINAL AND LIVER DISEASE IN CHILDREN

Jean Pappas Molleston, MD

This session will provide an overview of pediatric gastroenterology disorders including abdominal pain, gastro-esophageal reflux, liver disease, and non-bleeding gastrointestinal emergencies in children.

WHEN TWO HALVES ARE GREATER THAN ONE WHOLE: LIVING LIVER DONATION

Denise S. Morin, MSN, RN

Although liver transplantation (LT) is the best treatment for patients with liver failure, the scarcity of deceased donor organs has resulted in a surgical innovation: living donor liver transplantation (LDLT). This surgical alternative is possible because of the liver's ability to regenerate and advances in imaging technology. Priority concerns regarding LDLT include ensuring donor safety and selecting appropriate LDLT recipients. This presentation will build on previously presented content and includes discussion of donor quality of life, identified medical conditions in the "healthy" living liver donor, and variations on living liver donation including the urgent living liver donor evaluation and simultaneous living liver and kidney donation.

COURAGE AND COMMITMENT TO COLLABORATE WITH CLIENTS REGARDING THEIR CELIAC CONDITION

Lea Anne Myers, BS, RN, CGRN

This session will provide you with a general understanding of celiac disease and provide you with additional knowledge to use when educating your clients with celiac disease. We will also review tips and resources to use to collaborate with your clients to help them manage their celiac condition more effectively while maintaining a "close to normal" lifestyle.

WHAT IS THE EVIDENCE BEHIND OUR SEDATION PRACTICE?

Susan Nuccio, MSN, RN, ACNS-BC, CGRN

This presentation will take a look at present moderate sedation nursing practices. Evidence-based nursing practice concepts will be discussed along with the evidence we have in support of our sedation pratices. The presentation will include professional, regulatory, research, and best-practice resources. Areas of pre-assesment, intra-procedure monitoring, and post-procedure care will be addressed.

THE BEGINNING LINKS OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)

Jeanine Penberthy, MSN, RN, CGRN

This session will start at the very beginning-the why's, how come's, and what are we looking at will be covered including basic biliary anatomy, physiology, and pathophysiology. The equipment commonly used during ERCP will be discussed, and fluoroscopic images of biliary anatomy and common biliary diseases will be reviewed.

ENDOSCOPIC ULTRASOUND: BACK TO BASICS

Jeanine Penberthy, MSN, RN, CGRN

The use of endoscopic ultrasound (EUS) has become more and more common over the last few years. This lecture will cover endoscopic ultrasound from its humble beginnings (i.e. basic EUS anatomy, the functions of the ultrasound scopes and processors) to the current treatments modalities (i.e. fine needle aspiration, fine needle injections, celiac plexus blocks, and neuorolysis, along with pseudocyst drainage. We will also review how the technology of EUS has evolved, making it a very effective means of evaluation of the gastrointestinal tract and treatment.

ADVANCING NURSING: SHARED GOVERNANCE AND PROFESSIONAL PRACTICE

Tim Porter-O'Grady, DM, EdD, ScD(h), GCNS-BC, NEA-BC, FAAN

This session will specifically focus on the transformation of the clinical provider's and manager's role within an effective shared governance system. The focus will reflect the principles and protocols related to effective and sustainable shared decision-making models. Implications are included for the provider with regard to shifting shared governance structures to support a continuum of care.

COMPLEXITY AND NURSING PRACTICE: NEW RULES FOR LEADERSHIP

Tim Porter-O'Grady, DM, EdD, ScD(h), GCNS-BC, NEA-BC, FAAN

This session will specifically focus on the transformation of the healthcare leader's role with a new set of leadership expectations. The focus will reflect the introduction of healthcare transformation realities and post reform concerns confronting leadership in healthcare. Implications will be discussed for these organizations with regard to shifting post-reform social economic and technical forces, as well as the accountability of the role in a complex environment.

COLON CANCER METASTASIZED TO THE LIVER: NOW WHAT?

Janice A. Provenzano, MSNED, RN, CGRN

According to the American Cancer Society, nearly 50,000 people died of colorectal cancer in 2009. Endoscopy and gastrointestinal (GI) nurses and associates participating in screening and diagnostic colonoscopies believe in the American Cancer Society's Colorectal Cancer Screening Saves Lives campaign. Relief is the emotion experienced by the patient who can get his tumor removed; dismay is the emotion when follow-up care or symptoms reveal that the cancer has metastasized to the liver. Evidence demonstrates that treatment options can appreciably prolong a satisfying, productive life. How and when does colon cancer progress so that the patient succumbs to the disease? The purpose of this presentation is to outline the evolution of colon cancer, treatment options, management, and prognosis. The role of the GI nurse in the interdisciplinary care of the patient to achieve optimal outcomes will be presented.

BOWELS GONE WILD: DIARRHEA DILEMMAS

Patricia Raymond, MD, FACP, FACG

Loose watery stools: there's a lot more to the diagnosis and management of this process than just a colonoscopy and biopsy. We'll talk about the differential diagnosis of diarrhea; clinical clues that you might be dealing with a diarrheal syndrome such as glucagonoma, pancreatic insufficiency, or carcinoid syndrome; and symptom management including the proper selection and use of probiotics.

COMMIT TO QUALITY ENDOSCOPY: THE LINK BETWEEN PRACTICE AND CARE

Patricia Raymond, MD, FACP, FACG

Studies have shown that a cecal withdrawal of >6 minutes leads to finding twice the number of polyps than withdrawals under 6 minutes. A study at a teaching hospital revealed that one attending had a cecal intubation of an appalling 63% You want to do good endoscopy in your suite; in fact, you are pretty sure you do-or are you? Do you insist on photodocumentation of the cecum? Measurement of withdrawal time? Can't get your physicians on board? This presentation will arm you with ammunition to address these issues and more.

ENDO MANAGEMENT SKILLS: FORGING THE LINKS/BREAKING THE CHAINS

Patricia Raymond, MD, FACP, FACG

In this collaborative session, Dr. Patricia Raymond facilitates a roundtable discussion with both experienced endoscopy managers and those new to the position, mining your colleagues years of experience for time-tested ideas to forge your own amazing suite. Get your management questions answered, or offer your expertise to your colleagues, or both!

WHATS NEW IN INFLAMMATORY BOWEL DISEASE (IBD)? INCREASED UNDERSTANDING: IDENTIFICATION OF BIOLOGIC TARGETS AND EMERGING THERAPIES

Laryl Riley, MSN, RN, RNP, CGRN

IBD is a chronic, lifelong disease with no medical cure. Multiple modalities are required to aid in treatment. Newer therapies have now been shown to alter the natural history of the diseases or to maintain stable remission. We will discuss emerging biologic agents, their potential targets, and the supporting data justifying their use including the clinical precautions that should be taken for patients receiving biologics and safety monitoring concerns.

WHAT DOES ELEVATED LIVER ENZYMES MEAN? A FUN APPROACH TO THE DIAGNOSIS AND MANAGEMENT OF THE PATIENT WITH ELEVATED LIVER ENZYMES

Laryl Riley, MSN, RN, RNP, CGRN

An elevation in the amount of enzymes released by the liver is a symptom with a myriad of causes. When the liver is inflamed or damaged, it secretes an excessive amount of these enzymes. Most cases of elevated liver enzymes are merely temporary and not something to be overly concerned about, but there are instances when an elevation in liver enzymes needs to be treated as a serious problem. Eliminate the feeling of uneasiness the next time your patient presents with elevated liver enzymes or any form of liver disease. This session will review the normal function of the liver and most causes of elevated liver enzymes, including examination tools, current management, as well as incorporating memory aides and helpful pearls. Attendees will be able to use newly acquired skills to manage case studies.

BASIC GI REIMBURSEMENT

Nancy Schlossberg, BA, BSN, RN, CGRN

Economic changes continue to impact gastrointestinal (GI) and endoscopy practice for physicians, nurses, associates, and patients. This session introduces GI nurses and associates to basic elements of how and why GI facilities and physicians get paid to deliver endoscopic patient care and services. The presentation defines basic reimbursement vocabulary and concepts including Current Procedural Terminology (CPT), International Classification of Diseases (9th ed.), Clinical Modification (ICD-9)-CM), relative value unit (RVU), and modifier and payer mix. The session then applies these fundamentals to reading and interpreting a fee schedule. Learning these "ABCs" equips all GI nurses and associates with another tool to enhance commitment and collaboration with staff, physicians, and patients.

NEW FRONTIERS IN INTERVENTIONAL EUS

Janak N. Shah, MD

The session will focus on cutting edge advances in interventional endoscopic ultrasound (EUS). Specific topics that will be covered will include: EUS-guided endoscopic retrograde cholangiopancreatography (ERCP), EUS-guided treatment of tumors, EUS-guided therapy of varices, and new EUS technology.

IBD FROM A TO Z

Shamita B. Shah, MD

An overview of inflammatory bowel disease (IBD) will be given to the audience including definitions of the disease, proposed etiologies, triggers, diagnostic studies including endoscopy, and overview of management.

FROM THE OFFICE TO THE ENDO LAB AND BACK: WHAT YOU AND YOUR PATIENT NEED TO KNOW

Jo Sienknecht, RN, CGRN

This presentaiton will address various aspects of nursing assessment and patient education that takes place in the office and endoscopic setting. Basic pharmacology, laboratory, and radiological tests; endoscopy procedures; and other diagnostic tests will be discussed along with common disease processes and how they relate to the plan of care. The value of collaboration between the provider office staff and the endoscopic staff is essential. The presentation will include ways to foster the team approach between these entities.

CLUES FOR UNDERSTANDING GASTROINTESTINAL MANIFESTATIONS OF INBORN ERRORS OF METABOLISM

Megan M. Skinner, MGC, CGC

This session will focus on different metablism disorders and their presentations, emphasizing their GI symptoms.

PULMONARY MEDICINE: AROUND THE WORLD IN ONE HOUR

Jason T. Smith, MD

We will take a tour of pulmonary medicine, highlighting disease processes, diagnosis, and management.

BRONCHOSCOPY CSI

Jason T. Smith, MD

We will cover emerging technology of diagnosing disease by bronchoscopy. Also addressed is the preparation of samples for pathology and microbiology.

COMMITMENT TO SAFETY: PROTECTING PATIENTS FROM CLOSTRIDIUM DIFFICILE DURING ENDOSCOPY

Paulette Smith, BSN, RN, CGRN

Clostridium difficile (C. diff), a spore forming bacteria, is carried by 15-53% of asymptomatic people. Its ability to cause diarrhea has been known for over 30 years, yet recently this organism has emerged as a serious health threat. The current standard for endoscope reprocessing is high level disinfection, which does not kill all bacterial spores. This presentation will review the history, transmission, and risk factors for C. diff infection and key reprocessing steps which reduce the risk of cross contamination from the endoscope when using high level disinfection.

FINDING THE LEADER IN YOU: MAKING THE CHOICE TO LEAD

Leslie E. Stewart, BA, RN, CGRN

Leadership is both a role and "life changing" personal decision. You need no title to be a leader, for it has less to do with the size of your professional position and more to do with your commitment to excellence. Leadership is about your impact and the choices you face in order to influence others by doing your best work each and every day, regardless of where you are planted. Leadership is the recognition of a desire not found in a name or a position. It is the ability to see opportunity amid crisis and guide a situation towards a positive outcome. Distributed leadership, or leader democratization, is a powerful idea that calls upon personal empowerment to lead with the authority of knowledge founded in experience and evidence. As we face the demands of change in the coming years, identify your potential and the difference you make. Step into SGNA leadership! Commit to the variety of challenges that face our organization and help SGNA add value through your extraordinary contribution to our future growth. "Find the Leader in You and Make the Choice to Lead!"

TELEPHONE LEGAL SAVVY: LINKING TELEPHONE PRACTICE WITH BETTER PATIENT CARE

Carol Stock, JD, MN, RN

This session will explore the use of the telephone, email, and other communication technologies in gastrointestinal (GI) practice with a special emphasis on legal ramifications in regard to proper patient care. How much information can you share via non face-to-face communications? Pre/post procedure telephone calls, leaving messages, follow-up calls, and emails, in the era of the Health Insurance and Portability Accountability Act (HIPAA) will be discussed. What can you do to reduce communications liability exposure in practice, yet safely prepare patients for procedures? This interactive session will review actual GI telephone calls pre and post procedure and analyze scenarios for legal compliance. Communication practice guidelines will be suggested for implementation into GI practice. At the conclusion of the session, you will be able to identify telephone practice risks and be equipped with several communication guidelines to assist you in creating a more legally defensible telephone GI practice.

KEEPING CURRENT ON PATIENT SAFETY IN ELECTROSURGERY

Susan Teague, BS, RN, CGRN

The technology of electrosurgery has become an indispensible component of interventional and therapeutic gastroenterology procedures in the 21st century. Safe clinical use of electrosurgery requires much more than turning the electrosurgical unit on and connecting the accessories. The history of electrosurgery, its evolving significance, its current uses, and how to apply it safely will be discussed. This presentation will focus on the fundamental elements of electrosurgery and the best electrosurgery practices for assuring patient and staff safety during its use, as well as exploring the challenges of electrosurgical use often seen in patients with implanted electronic devices. This session is designed to empower the healthcare provider in the role of patient advocate by acquainting them with essential electrosurgery knowledge, emphasizing the importance of nursing competency in electrosurgery, and reinforcing the necessary critical skills for safe electrosurgical patient care during clinical applications.

ELEMENTS OF THE ALIMENTARY TRACT

Diane K. Theisen, BSN, RN

Let's take a journey. Start at the mouth and travel through the gastrointestinal (GI) tract. For the first part of the presentation, anatomy and physiology of the upper GI tract and small intestine will be explored. Then we discuss the most common diseases seen in our department, how they change function, and current treatment options. This session provides a strong base for a better understanding of these common GI diseases.

COLLABORATING WITH THE CHIEF FINANCIAL OFFICER (CFO) FOR CAPITAL EQUIPMENT

Lynne A. Thomas, BSN, RN, CGRN

This program is designed to increase the knowledge base of endoscopy nurses with a responsibility for, or an interest in, the use or purchase of capital equipment. It will provide elements of a capital equipment proposal, the importance of due diligence when purchasing, and collaborative ways to impact the CFO or corporate executive committee's purchasing decisions.

PRACTICAL TOOLS TO HIGHLIGHT YOUR CARE OF PATIENTS

Lynne A. Thomas, BSN, RN, CGRN

Mela Tucker, MBA, BSN, RN

Bunny Twiford, RN

This session is designed to guide participants through the elements of Centers for Medicare and Medicaid Services (CMS) survey preparation, benchmarking, and risk management.

BARRETT'S ESOPHAGUS HANDS-ON

Ada Turner, BSN, RN, CGRN

Ingrid K. Watkins, MSN, RN, CGRN

This presentation will provide an overview of the pathophysiology, diagnosis, statistics, and evidence-based management of Barrett's esophagus. The audience will be provided with procedural skills needed in the management of Barrett's as it relates to ground breaking technological advances pertaining to the disease.

THE LINK BETWEEN ORIENTATION AND SGNA STANDARDS AND RESOURCES

Kimberly F. Venturella, RN, CGRN

Have you struggled with creating an orientation program for new registered nurses (RNs) or Associates? Have you suddenly found yourself responsible for your staff's orientation and not had much to work with? We have a wealth of resources at our fingertips as SGNA members. Find out how to incorporate SGNA standards, procedures, and training modules into your orientation program. Design an orientation program that is specific for your center or facility. What about your preceptors? Do they see orientation through your eyes? How do you keep them on your page. What about continuity in preceptors? That's the ideal, but what if it's just not possible. How do you keep all your preceptors on the same page? Principals of adult learning and orientation development will be discussed, expained, and demonstrated in this timely presentation.

RADIOFREQUENCY ABLATION: THE LINK BETWEEN TREATMENT AND BARRETT'S ESOPHAGUS

Kimberly F. Venturella, RN, CGRN

Esophageal cancer is on the rise. Barrette's esophagus occurs in about 15% of gastro-esophageal reflux disease patients. That equals about 3.3 million people in America. Gastro esophageal reflux disease patients are at risk for developing intestinal metaplasia in the esophagus as a protective reaction to the exposure to gastric acid in the esophagus. The problem with this sort of cellular proliferation is that this metaplasia can turn into cancer. Historically, treatments have had risk and side effects that compromised quality of life. Radio frequency ablation has had demonstrated success as a treatment method to eradicate the presence of metaplasia and the risk of developing cancer. This one hour presentation will explain Barrett's esophagus, historical treatment options, and focus on radio frequency ablation as a safe and effective treatment for all types of Barrett's tissue.

"MOMMY, I CAN'T GO:" PEDIATRIC CONSTIPATION

LeAnne Vitito, MS, RN, FNP-BC, CGRN

Constipation is a decrease in the frquency of stools or the painful passage of stools. This is a common pediatric problem that about one-third of 4 to 7 year olds experience at any given time. Approximately 5% of primary school children get constipation for more than a six months. At least 25% of visits to the gastrointestinal (GI) clinic are due to problems with constipation. This problem often requires frequent follow up visits and extensive patient/parent education in order to overcome this issue. The pathophysiology, symptoms, diagnostic work-up, and management plan for pediatric constipation will be explored. The management plan is multimodal to include behavioral modification, medications, and physical therpy intervention. Nurses play a key role in the treatment of chronic constipation through education and patient/family support.

ALLERGY IN THE GASTROINTESTINAL TRACT: EOSINOPHILIC ESOPHAGITIS

LeAnne Vitito, MS, RN, FNP-BC, CGRN

Eosinophilic esophagitis (EE) is an emerging disease in both pediatric and adult populations related to food ingestion or aeroallergens. It is characterized by inflammation of the esophagus that is caused by eosinophils. Recent data suggests the that this disease occurs in 1 in 10,000 people; however, it is speculated that the number of affected individuals is higher due to increasing incidence and improved awareness. Often, the clinical symptoms of EE mimic gastroesophageal reflux disease (GERD) and thus patients are not appropriately treated. Clinical symptoms include dysphagia, heartburn, food impaction, vomiting, food refusal, and abdominal pain. Diagnosis of EE is made by endoscopy and esophageal biopsy that confirms greater than 15 eosinophils per high power field. Characteristic endoscopic features (pictures) of EE will be presented. Because management of EE is a multifacorial process, options for treatment will be explored along with the controversy surrounding disease management.

INFLAMMATORY BOWEL DISEASE MEDICATION UPDATE

LeAnne Vitito, MS, RN, FNP-BC, CGRN

Inflammatory bowel disease (IBD) is a complex disease often requiring multiple medications to induce and maintain remission. The goal is to effectively treat the disease, but avoid complications that can be associated with medications, and improve the quality of life. This lecture will address the indication, side effects, and expected outcomes while using these IBD medications. It will also look closely at the nurse's role in monitoring patients while on therapy. Content will include information regarding mesalamine, corticosteroids, immunomodulators, biologic agents, and antibiotics.

ADVANCED THERAPEUTIC ENDOSCOPY

Theresa Vos, MS, BSN, RN, CGRN

This presentation highlights the advancements in endoscopy as it addresses each organ of digestion. Through the use of schematics, videos, and didactic lecture, an update of what's new in therapeutic modalities will be presented. Topics to be discussed include Barrett's esophagus, hiatal hernia, small bowel therapy, biliary and pancreatic disease, and the treatment of a colonic bleed.

ERCP: FROM START TO FINISH

Theresa Vos, MS, BSN, RN, CGRN

This newly revised optional session will address endoscopic retrograde cholangiopancreatography (ERCP) focusing on normal anatomy and physiology, abnormalities of the biliary system, abnormalities of the pancreatic system, and a review of normal versus abnormal anatomical structures as viewed through radiological imaging. The use of procedural videos, equipment discussion, and didactic presentation will address ERCP from the very basic to the advanced level. Audience participation is encouraged as part of the learning process.

OPTIMAL CARE FOR INFLAMMATORY BOWEL DISEASE PATIENTS: A MULTIDISCIPLINARY TEAM MODEL

Julianne H. Wagnon, JD, RN, FNP-BC

This lecture examines the etiology, epidemiology, diagnosis, and treatment of inflammatory bowel disease. Within the treatment section of the lecture, in addition to current medical options and investigational agents, there will be an in depth discussion of the multi-disciplinary model in place at the Vanderbilt Inflammatory Bowel Disease Center. The five key elements of the model are: (1) Psychology, (2) Dietary, (3) Education, (4) Medication, and (5) Adherence. Attendees understanding and application of information covered in the lecture will be reviewed by interactive case studies.

BARRETT'S ESOPHAGUS HANDS-ON

Ingrid K. Watkins, MSN, RN, CGRN

This presentation will provide an overview of the pathophysiology, diagnosis, statistics, and evidence-based management of Barrett's esophagus. Furthermore, the audience will be provided with procedural skills needed in the management of Barrett's as it relates to ground breaking technological advances pertaining to the disease.

DUCTOSCOPY: BEYOND THE BREAD AND BUTTER ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)

Frank Weilert, FRACP, MBBCh, BSc

This session will review the visualization of the common bile duct (CBD) with standard ERCP techniques and direct cholangioscopy including Spyglass, mother-baby cholangioscopy, and cholangioscopy using standard endoscopes. We will also discuss intra-ductal interventions including electro-hydraulic lithotripsy and intra-ductal ultrasound.

ABDOMINAL PRESSURE ASSISTANCE: THE LINK TO SUCCESSFUL COLONOSCOPY

Dorie Werner, BSN, RN, CGRN

This lecture will include the presentation of studies to help understand why loops form during colonoscopy and how to manage them. Discussion will include why colonoscopy is more difficult in women, factors affecting insertion time and patient discomfort, and a description and demonstration of techniques that will facilitate successful, efficient, complete colonoscopy. This presentation is directed to those who are ready to understand the relationship between proper application of abdominal pressure during colonoscopy and the practice and care of the patient.

WHAT YOU ALWAYS WANTED TO KNOW ABOUT PULMONARY PROCEDURES...BUT WERE AFRAID TO ASK

Keri White, BSN, RN

This presentation focuses on pulmonary procedures including bronchoscopies, thoracenteses, and chest tube placements. The presentation goes through the typical preparation of a pulmonary patient including acceptable lab values and medications. Additionally, it discusses anesthesizing a patient's airway, sedating the patient, and different therapies utilized during bronchoscopy including bronchalveolar lavage, transbronchial and endobronchial biopsies, fine needle aspirations, and brushings. The presentation explains what these therapies entail and the nurse's role. Additionally, bronchoscopy recovery and possible complications during recovery (pneumothorax, stridor, bleeding, intubation) will be addressed. The presentation also talks about specific newer interventions such as endobronchial ultrasound, electromagnetic navigation, pleuroscopy, and pleurx catheters.

FROM IDEA TO RESEARCH

Donna Zucker, PhD, RN, FAAN

The purpose of this presentation is to share strategies that will help generate nursing ideas resulting in researchable projects. Many excellent clinical questions go unanswered for a variety of reasons. Facilitators and barriers to this process need to be understood to be successful. In order to develop a good research idea, the following questions will be addressed: What is the topic or issue? Is the topic researchable? Is your question too broad/too narrow? Has it been done before? Review of the literature will be emphasized with the aim of making this a standard activity in evidence based practice. Interactive opportunities for the audience will include coming up with a problem statement and exploring the steps to overcome in their agency/institution to bring their idea to reality. Issues to be analyzed include the passion for the topic, availability of project mentors, and requirements of institutional review boards. Team work, as an exemplar, will be discussed as a prescription for success. Evidence based research is an important nursing activity requiring knowledge, accuracy, and team work. Continued interest in nursing research will build our knowledge base and provide excellence in clinical practice.