Aims
To analyse impact of nurse specialist utilization in quality improvement of ERCP service
Methods
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 ERCP nurse specialist. The results then were compared with KPIs published by ESGE, BSG and JAG guide to quality and safety standards.
Results
Our nurse specialist followed and maintained database of 98% (2024/25) , 95% ( 2023/24) and 75% ( 2022/23) of ERCP procedures done in last 3 years. Out of total 1640 ERCPs , 60% of procedures ( n=981) were performed for patients out of our hospital and 6% of procedures were done under GA in endoscopy department.
Our CBD canulation ( 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. Also post ERCP pancreatitis (5.5%) , bleeding (0.63%) , cholangitis (3.5%) , perforation (0.27%) ,mortality (0.48%) (1) and overall complication in 5.6% of patients fulfilled the recommended KPIs.
Conclusions
More than half of ERCPs performed in our hospital were external referrals. Presence of a dedicated nurse specialist in our department ensured timely triage, pre-assessments and meticulous post-procedural follow-ups, especially for out of hospital patients. Continuous monitoring of KPIs from the database, maintained by nurse specialist in accordance with international guidelines, helped in quality improvement and better service delivery to the patients.