Gastroenterology/Endoscopy Nursing.

These nurses focus on the care of patients with gastrointestinal issues.

Effect of systematic nursing intervention on rehabilitation after colorectal polyps of endoscopic removal in children: A protocol for systematic review and meta-analysis.

BACKGROUND: Endoscopic removal is the main method for the treatment of colorectal polyps in children. Due to the small age of children, poor coordination, postoperative sensitive postoperative response, it is not good for postoperative recovery. Systematic nursing has an advantage in promoting the postoperative recovery of children with colorectal polyps of endoscopic removal, but it is lack of evidence-based basis. The purpose of this study is to evaluate the effect of systematic nursing intervention on the rehabilitation of children after colorectal polyps of endoscopic removal. METHODS: China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database and Chinese Biomedical Literature Database, PubMed, Embase, Web of Science, and the Cochrane Library databases will be searched by computer. A randomized controlled study is searched on the application of systematic nursing intervention of children with colorectal polyps of endoscopic removal from the establishment of the database in February 2021. The language is limited to English and Chinese. The quality of the included study is independently extracted and the literature quality is evaluated by 2 researchers. The RevMan5.3 software is used to conduct meta-analysis of the included literature. RESULTS: This study will evaluate the effect of systematic nursing intervention on the rehabilitation of children after colorectal polyps of endoscopic removal by the indexes of total effective rate, complication rate, and hospital stays. CONCLUSION: This study will provide reliable evidence-based basis for establishing a reasonable and effective nursing intervention for endoscopic removal of colorectal polyps in childhood. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/S57UX.

Safety and Effectiveness of Nurse-Administered Propofol Sedation in Outpatients Undergoing Gastrointestinal Endoscopy.

BACKGROUND & AIMS: Esophagogastroduodenoscopy (EGD) and colonoscopy are common outpatient gastrointestinal endoscopic procedures that frequently use sedation. We aimed to identify a protocol that combines safety with cost effectiveness. METHODS: We collected data from consecutive outpatients (age, 20-98 y) who underwent diagnostic EGD (n = 117,661) or colonoscopy (n = 32,550) with propofol sedation from January 2006 through December 2016. Propofol was administered by a nurse via bolus injection using an age-adjusted standard protocol, up to a total of 200 mg. The primary outcome measure was occurrence of adverse events within 24 hours. Secondary outcome measures included rates of procedure success, respiratory depression, and other procedure-related adverse events. RESULTS: The median dose of propofol administered for EGD was 77 mg (range, 20-160 mg) and for colonoscopy was 99 mg (range, 40-200 mg). Among patients undergoing EGD, those younger than 41 years required 1.5-fold more propofol than patients 61-80 years old. The only adverse event was the transient need for supplemental oxygen supply, required by 1950 patients (1.3%): 1689 undergoing EGD (1.4%) and 261 undergoing colonoscopy (0.8%). Patients were discharged after 60 minutes and at least 66,250 patients (44%) drove themselves from the hospital. None experienced a traffic accident within 24 hours after receiving propofol sedation. CONCLUSIONS: Nurse-administered propofol monosedation using an age-adjusted standard protocol up to a maximal of 200 mg is safe and practical for outpatient gastrointestinal endoscopy.

Calidad de la sedación con propofol administrada por personal no anestesiólogo en una unidad de endoscopia digestiva, resultados tras un año de implantación / Quality of sedation with propofol administered by non-anesthetists in a digestive endoscopy unit: the results of a one year experience

Introducción: existe evidencia de que un equipo formado por endoscopista y enfermera puede hacerse cargo de la sedación de un paciente con propofol de forma eficaz, segura y eficiente. Para ello, es fundamental una adecuada formación y entrenamiento específico que les otorgue las competencias necesarias. El objetivo principal de este estudio fue realizar, tras un año de implantación, una evaluación de la calidad del procedimiento de sedación administrada por personal no anestesiólogo en una unidad de endoscopia digestiva. Métodos: se realizó un estudio de cohortes prospectivo sobre los pacientes que recibieron sedación con propofol por personal no anestesiólogo. Posteriormente, se seleccionó una muestra aleatoria de registros clínicos para evaluar la adherencia de los profesionales a diferentes criterios de calidad, así como la aparición de eventos adversos relacionados con la sedación. Resultados: en el periodo de estudio se realizaron un total de 595 procedimientos bajo sedación con propofol. La tasa de eventos adversos fue del 2,4% (n = 507), principalmente episodios de hipotensión e hipoxemia. Los porcentajes de adherencia al procedimiento de sedación se situaron por encima del 80% en la mayoría de los criterios, aunque fue menor en la cumplimentación de la valoración del riesgo ASA. Conclusión: los resultados del estudio sugieren que el propofol puede ser administrado con seguridad y eficacia por un equipo cualificado de endoscopista y enfermera, en pacientes con un riesgo ASA I-II. Las auditorías sobre la adherencia de los profesionales al procedimiento permiten identificar necesidades de mejora para poder seguir trabajando sobre aspectos aún no consolidados

Introduction: research has shown that an endoscopist-nurse clinical team can perform sedation with propofol effectively, safely and efficiently. To do so, it is essential to provide specific and appropriate training in the necessary skills. The main aim of the present study was to evaluate the quality of the sedation procedure administered by non-anesthetists in a digestive endoscopy unit, one year after its introduction. Methods: a prospective cohort study was performed in patients given propofol sedation by non-anesthetists. Subsequently, a random sample of clinical records was selected in order to evaluate the adherence of professionals to the quality criteria and to assess the rate of adverse events related to sedation. Results: a total of 595 procedures were performed under propofol sedation during the study period. The rate of adverse events was 2.4% (n = 507), mainly involving hypotension and hypoxemia. Adherence to the sedation procedure was above 80% for most of the applicable criteria, although it was lower for the completion of ASA risk evaluation. Conclusions: the results of the study suggest that propofol can be administered safely and effectively by a qualified endoscopist-nurse team, in patients with an ASA I-II risk. Audits of adherence by medical staff to the recommended procedure facilitate the identification of areas for improvement; further work is needed on the aspects that have not yet been consolidated

Needs assessment survey for simulation-based training for gastrointestinal endoscopy nurses.

The optimal performance of gastrointestinal (GI) endoscopy nurses is required for patient safety and quality improvement. The aim of the present study was to assess the educational needs for simulation-based training for Korean GI endoscopy nurses using importance-performance analysis. A cross-sectional survey was conducted with 238 Korean nurses from 25 endoscopy units. The educational needs of these nurses were identified using the 35 item clinical competence importance-performance scale. Exploratory factor analysis of the scale identified the following eight factors: emergency care, patient monitoring, evidence-based practice, documentation and referral, patient safety, nursing process, patient assessment, and infection control. A significant overall mean difference was identified between importance and performance for all eight factors, with emergency care showing the largest difference. It was also ranked the highest priority for continuing education in the importance-performance analysis matrix. Therefore, simulation-based training should focus on enhancing emergency care competence for GI endoscopy nurses to improve patient safety and quality of care.

Introduction of the Nurse Endoscopist Role in One Australian Health Service.

In Australia, nurses performing endoscopic procedures is a recent phenomenon and is uncommon. Challenges include gastroenterologist and patient acceptance of the nurse endoscopist role. This article aims to explore Monash Health's experience with the introduction of a nurse endoscopist. A nurse endoscopist trainee undertook a comprehensive training program under the supervision of a gastroenterologist. All procedural data were collected, organizational policy and procedures were developed, and patients (n = 40) completed a telephone interview postprocedure. The nurse endoscopist trainee completed all training requirements during the 12-month program and was deemed competent for independent practice. The trainee performed 255 colonoscopies, with no complications reported. The organization successfully implemented the expanded scope of practice, established a new model of care for patients, and initiated a governance framework for this advanced practice role. Eighty percent of patients (n = 32) reported that overall, they had a very good experience with the nurse endoscopist trainee. A nurse endoscopist initiative can facilitate the expansion of endoscopy services to meet the growing need for gastroenterological procedures within the community. This pilot program has demonstrated that it is possible to integrate an advanced practice nurse role into an established endoscopy unit.

Nurse-Performed Endoscopy: Implications for the Nursing Profession in Australia.

Increasing demands for health care globally often lead to discussions about expanding the involvement of nurses in a range of nontraditional roles. Several countries have introduced nurse endoscopists as a means of easing the burden of demand for a range of endoscopic procedures. A shortage of medical staff in Australia combined with increasing demand for endoscopy led to the implementation of nurse endoscopists as a pilot program in the state of Queensland, where a nurse practitioner model was implemented, and Victoria, where an advanced practice model was used. This article will discuss the implementation of and responses from the nursing, medical, and policy community to nurse-performed endoscopy in this country. Regarding health policy, access to cancer screening may be improved by providing nurses with advanced training to safely perform endoscopy procedures. Moreover, issues of nurse credentialing and payment need to be considered appropriate to each country's health system model.

Toward Developing a Nurse Endoscopist Role in New Zealand.

The purpose of this exploratory descriptive mixed-method study was to explore the potential role of the nurse endoscopist as a part of the solution in fulfilling the workforce requirements of a bowel screening program, ascertain the possible enablers of a nurse endoscopist role in New Zealand, and determine whether there are endoscopy nurses who would wish to follow the nurse endoscopist/nurse practitioner pathway. A questionnaire with both open- and closed-ended questions gained in-depth information regarding the aspirations of New Zealand endoscopy nurses, their perceived enablers and barriers of a nurse endoscopist role, and statistical information on the New Zealand endoscopy nursing workforce. New Zealand has a highly experienced and educated endoscopy nursing workforce who supports the development of the nurse endoscopist role, some of whom expressed interest in a nurse endoscopist/practitioner pathway. It was concluded that with the addition of a specific education pathway and funding, standardization of training for endoscopists, and specific job description for nurse endoscopists, the future development of this role is possible in New Zealand.

Achados endoscópicos em usuários acometidos por hemorragia digestiva alta em situação de emergência / Endoscopic findings in patients affected by upper gastrointestinal bleeding in emergency situation / Hallazgos endoscópicos en pacientes afectados por hemorragia digestiva alta en situación de emergencia

Objetivo: identificar os principais diagnósticos endoscópicos de usuários portadores de hemorragia digestiva alta atendidos em situação de emergência. Método: estudo documental, prospectivo e exploratório com abordagem quantitativa. A coleta dos dados foi realizada entre agosto e novembro de 2014, por meio de formulário contendo questões sociodemográficas e clínicas, com a utilização de 76 prontuários de atendimento. Resultados: destacou-se o predomínio de pacientes do sexo masculino (63,2%), na faixa etária entre 61 aos 80 anos (48,7%), tendo como manifestação clínica mais comum a hematêmese (53,9%). O diagnóstico endoscópico prevalente foi úlceras pépticas (34,3%). O período de internação predominante foi entre quatro e 10 dias (40,8%) e 21% dos pacientes foram a óbito. Conclusão: o conhecimento das lesões que causam hemorragia digestiva alta e as características deste tipo de paciente podem auxiliar os gestores no planejamento de ações que repercutam na qualidade do tratamento empregado.(AU)

Objective: to identify the main endoscopic diagnoses in patients with gastrointestinal bleeding cared for in emergency situation. Method: documentary, prospective and exploratory study with a quantitative approach. Data collection was conducted between August and November 2014 using a form containing sociodemographic and clinical aspects from 76 medical records. Results: there was predominance of male patients (63.2%) aged 61 to 80 years (48.7%). Hematemesis was the most common clinical manifestation (53.9%). The prevalent endoscopic diagnosis was peptic ulcers (34.3%). The predominant length of hospital stay was between four and 10 days (40.8%) and 21% of the patients died. Conclusion: knowledge about the lesions that cause upper gastrointestinal bleeding and the characteristics of this type of patients can assist managers in planning actions that improve the quality of the treatment prescribed.(AU)

Objetivo: identificar los principales diagnósticos endoscópicos de pacientes con hemorragia digestiva alta en situación de emergencia. Método: estudio documental, prospectivo y exploratorio con enfoque cuantitativo. La recolección de datos se realizó entre agosto y noviembre de 2014, a través de un formulario conteniendo aspectos socio-demográficos y clínicos, con el uso de 76 registros médicos. Resultados: se destacó el predominio de pacientes masculinos (63.2%), de entre 61 a 80 años de edad (48,7%). Hematemesis fue la manifestación clínica más común (53,9%). El diagnóstico endoscópico más frecuente fue de úlceras pépticas (34.3%). El período predominante de hospitalización fue de entre cuatro y 10 días (40,8%) y el 21% de los pacientes falleció. Conclusión: el conocimiento de las lesiones que causan la hemorragia digestiva alta y las características de este tipo de pacientes pueden ayudar a los gerentes en la planificación de acciones que repercutan en la calidad del tratamiento usado.(AU)

Non-physician endoscopists: A systematic review.

AIM: To examine the available evidence on safety, competency and cost-effectiveness of nursing staff providing gastrointestinal (GI) endoscopy services. METHODS: The literature was searched for publications reporting nurse endoscopy using several databases and specific search terms. Studies were screened against eligibility criteria and for relevance. Initial searches yielded 74 eligible and relevant articles; 26 of these studies were primary research articles using original datasets relating to the ability of non-physician endoscopists. These publications included a total of 28883 procedures performed by non-physician endoscopists. RESULTS: The number of publications in the field of non-specialist gastrointestinal endoscopy reached a peak between 1999 and 2001 and has decreased thereafter. 17/26 studies related to flexible sigmoidoscopies, 5 to upper GI endoscopy and 6 to colonoscopy. All studies were from metropolitan centres with nurses working under strict supervision and guidance by specialist gastroenterologists. Geographic distribution of publications showed the majority of research was conducted in the United States (43%), the United Kingdom (39%) and the Netherlands (7%). Most studies conclude that after appropriate training nurse endoscopists safely perform procedures. However, in relation to endoscopic competency, safety or patient satisfaction, all studies had major methodological limitations. Patients were often not randomized (21/26 studies) and not appropriately controlled. In relation to cost-efficiency, nurse endoscopists were less cost-effective per procedure at year 1 when compared to services provided by physicians, due largely to the increased need for subsequent endoscopies, specialist follow-up and primary care consultations. CONCLUSION: Contrary to general beliefs, endoscopic services provided by nurse endoscopists are not more cost effective compared to standard service models and evidence suggests the opposite. Overall significant shortcomings and biases limit the validity and generalizability of studies that have explored safety and quality of services delivered by non-medical endoscopists.

Effect of Structured Teaching Programme on Knowledge, Anxiety and Behavioural Response of Patients Undergoing Endoscopy at a Tertiary Care Hospital.

Upper gastrointestinal endoscopy is a common OPD procedure carried out for diagnostic as well as therapeutic purpose. Limited time for interaction between patients and health workers leads to increased anxiety among patients. This study was carried among 50 patients undergoing planned, diagnostic upper GI endoscopy for the first time at a tertiary care hospital. A pre-experimental study was conducted using single group pre-test post-test design. On the day of appointment, their socio-demographic data, baseline knowledge and anxiety levels were assessed using the structured questionnaire and the State and Trait Anxiety Inventory. The patients were then imparted structured teaching programme on the various aspects of upper GI endoscopy using video, flash cards and flip charts and a pamphlet for later reference. On the day of the procedure, their knowledge and anxiety levels were reassessed using the same tool. The patients were provided another session of structured teaching programme using the same AV aids. The behavioural responses of the patients were then observed during the procedure using an observation checklist. Statistical analysis revealed that the knowledge score of the patients increased significantly following the structured teaching (p <0.0001). The mean pre-test anxiety score decreased significantly following the intervention (p<0.0001), only 4 percent had extreme responses like grabbing the endoscope and not maintaining the position.

Prognostic factors of surgically-treated patients with cancer of the right colon: a ten years' experience of a single universitary institution / Fatores prognósticos de pacientes com câncer de cólon direito tratados cirurgicamente: experiência de 10 anos de uma instituição universitária

BACKGROUND: Colorectal cancer is one of the most common malignancies in the world. There are many controversies in the literature about the prognostic value of primary tumor location. Many studies have shown higher survival rates for tumors in the right colon, and worse prognosis for lesions located more distally in the colon. AIM: To analyze the results of surgical treatment of right-sided colon cancers patients operated in one decade period and identify the prognostic factors that were associated with lower overall survival in stages I-IV patients. METHODS: A retrospective review from the prospectively collected database identified 178 patients with right-sided colon cancer surgically treated with curative intent. Demographic factors (gender and age), tumor factors (site, T stage, N stage, M stage, histological type and tumor differentiation), and lymph node yield were extracted to identify those associated with lower overall survival. RESULTS: Mean age was 65 (±12) years old, and 105 (56.1%) patients were female. Most common affected site was ascending colon (48.1%), followed by cecum (41.7%) and hepatic flexure (10.2%). Mean length of hospital stay was 14 (±2.8) days. T stage distribution was T1 (4.8%), T2 (7.5%), T3 (74.9%), and T4 (12.8%). Nodal involvement was present in 46.0%, and metastatic disease in 3.7%. Twelve or more lymph nodes were obtained in 87.2% of surgical specimens and 84.5% were non-mucinous tumors. Mean survival time was 38.3 (±30.8) months. Overall survival was affected by T stage, N stage, M stage, and final stage. Lymph node involvement (OR=2.06) and stage III/IV (OR=2.81) were independent negative prognostic factors. CONCLUSION: Right-sided colon cancer presented commonly at advanced stage. Advanced stage and lymph node involvement were factors associated with poor long term survival. .

RACIONAL: Câncer colorretal é o tipo mais comum das neoplasias gastrointestinais. Há muitas controvérsias na literatura acerca do valor prognóstico do sítio da neoplasia. Muitos estudos revelam maiores taxas de sobrevida para tumores em cólon direito, com piora do prognóstico à medida que as lesões se situam mais distalmente. OBJETIVO: Analisar os resultados do tratamento cirúrgico de pacientes com câncer de cólon direito estádios I-IV operados em um período de dez anos e identificar os fatores prognósticos que foram associados com menor sobrevida global. MÉTODOS: Em 10 anos, 187 pacientes foram submetidos à colectomia direita com intenção curativa. Foram estudados os seguintes fatores: gênero, idade, localização do tumor, o número de linfonodos obtidos no espécime, comprometimento linfonodal, estádio T e presença de metástases à distância. Estes fatores foram avaliados quanto à possibilidade de serem indicadores prognósticos na sobrevida em cinco anos. RESULTADOS: A idade média foi de 65 (±12) anos e 105 (56,1%) eram mulheres. A localização, mas comum foi o cólon ascendente (48,1%), seguido do ceco (41,7%) e o ângulo hepático (10,2%). A média de tempo de internação hospitalar foi 14 (±2.8) dias. A distribuição do estádio T foi T1 (4,8%), T2 (7,5%), T3 (74,9%) e T4 (12,8%). Acometimento linfonodal ocorreu em 46,0% e metástases à distância em 3,7%. Um mínimo de 12 linfonodos ressecados foram obtidos em 87,2% dos espécimes cirúrgicos. Em 84.5% os tumores eram não-mucinosos. A média de sobrevida foi de 38,3 (±30.8) meses. A sobrevida geral foi afetada pelo estádio T, N, M e pelo estádio final. O acometimento linfonodal (RR=2,06) e os estádios III/IV (RR=2,81) foram fatores prognósticos negativos independentes. CONCLUSÕES: Estádio avançado e envolvimento linfonodal foram os fatores associados com a pior sobrevida em longo prazo. .

In-hospital weight loss, prescribed diet and food acceptance / Perda de peso hospitalar, dieta prescrita e aceitação de alimentos

BACKGROUND: Weight loss and malnutrition may be caused by many factors, including type of disease and treatment. AIM: The present study investigated the occurrence of in-hospital weight loss and related factors. METHOD: This cross-sectional study investigated the following variables of 456 hospitalized patients: gender, age, disease, weight variation during hospital stay, and type and acceptance of the prescribed diet. Repeated measures analysis of variance (ANOVA) was used for comparing patients' weight in the first three days in hospital stay and determining which factors affect weight. The generalized estimating equation was used for comparing the food acceptance rates. The significance level was set at 5%. RESULTS: The most prescribed diet was the regular (28.8%) and 45.5% of the patients lost weight during their stay. Acceptance of hospital food increased from the first to the third days of stay (p=0.0022) but weight loss was still significant (p<0.0001). Age and type of prescribed diet did not affect weight loss during the study period but type of disease and gender did. Patients with neoplasms (p=0.0052) and males (p=0.0002) lost more weight. CONCLUSION: Weight loss during hospital stay was associated only with gender and type of disease. .

RACIONAL: A perda de peso e a desnutrição podem ser desencadeadas por vários fatores, além de estar relacionada com o tipo de doença e com a terapia empregada. OBJETIVO: Investigar a ocorrência de perda de peso e fatores relacionados, durante a internação. MÉTODO: Estudo transversal com 456 pacientes hospitalizados, sendo estudadas as seguintes variáveis: sexo, idade, doença, evolução de peso, tipo e aceitação da dieta prescrita. Para comparar o peso entre os três primeiros dias de internação e para o estudo dos fatores que interferiram na alteração do peso, foi utilizada a Análise de Variância (ANOVA) para medidas repetidas. Para comparar a proporção de respostas na aceitação da dieta, foi utilizado o método das Equações de Estimação Generalizadas (EEG), com nível de significância de 5%. RESULTADOS: A dieta mais prescrita foi a geral (28.8%) e 45.5% dos pacientes perderam peso durante a internação. A aceitação da dieta hospitalar melhorou do 1º para o 3º dia de internação (p=0.0022), mas mesmo assim, a perda foi significativa (p<0.0001). Verificou-se que a idade e o tipo de dieta prescrita não influenciaram na perda de peso no período; mas, o tipo de doença e o sexo, apresentaram influência nos pacientes portadores de neoplasias (p=0.0052) e o sexo masculino (p=0.0002) apresentou mais perda de peso. CONCLUSÃO: A perda de peso no decorrer da internação foi relacionada apenas ao sexo e ao tipo de doença. .

[Protocol for embracement and attention to users that underwent upper gastrointestinal endoscopy and persons accompanying them]. / Protocolo de acolhimento e atenção para usuários submetidos a endoscopia digestiva alta e seus acompanhantes.

This is a quantitative and qualitative research aimed at building a Welcome Protocol for users and their companions referred to the Endoscopic Centre at the University Hospital Dr. Polydoro Ernani São Thiago, at the Federal University of Santa Catarina (UFSC), and submitted to Upper Digestive Endoscopy. The research was elaborated in two stages. The first stage was the building of a collective protocol with a group of nurses; the second stage was the sending of this material, organized as a protocol, for validation by the three experts. The study's supporting theoretical background was the National Humanization Policy and the Basic Human Needs theory. The protocol built aims at detailing the procedures conducted in the pre, trans and post-endoscopy exam stages, permitting the organization of the service and the instrumentalization of the professional team and, thus, ensuring a safer welcome and service to the user and his/her companion.

Hemorragia gastrointestinal, antiinflamatorios no esteroideos, ácido acetilsalicílico y anticoagulantes / Gastrointestinal bleeding, NSAIDs, aspirin and anticoagulants

Los estudios presentados en el reciente congreso de la American Gastroenterological Association, en el campo de la hemorragia digestiva alta no varicosa asociada o no a la toma de antiinflamatorios no esteroideos o de ácido acetilsalicílico, no han sido numerosos pero sí interesantes. Las conclusiones fundamentales son: a) rabeprazol, el único inhibidor de la bomba de protones que tenía escasos estudios en este campo, es eficaz en la prevención de úlceras gastroduodenales; b) famotidina podría ser también eficaz en la prevención de complicaciones por ácido acetilsalicílico; c) los nuevos y potentes inhibidores de ácido competitivos de la bomba de potasio son eficaces (tanto como los inhibidores de la bomba de protones) en la recurrencia de úlceras pépticas por ácido acetilsalicílico; d) la endoscopia precoz (< 8 h) en la hemorragia digestiva alta no varicosa no parece ofrecer mejor resultado que la efectuada en las primeras 24 h; e) la terapia endoscópica en Forrest 1 a no consigue obliterar la arteria sangrante en el 30% de las ocasiones y es la causa de la recurrencia; f) las terapias alternativas con pegamento o productos coagulantes se van abriendo paso en la terapia endoscópica del sangrante; g) la administración liberal de sangre en el sangrante digestivo se asocia a peor pronóstico; h) las lesiones del intestino delgado son causa frecuente de hemorragia digestiva cuando la endoscopia alta no demuestra estigmas positivos, y i) el estudio con cápsula endoscópica tiene un rendimiento alto en la hemorragia digestiva de origen oscuro si se efectúa precozmente en los 2 primeros días tras el inicio del episodio

The studies presented at the recent American Congress of Gastroenterology in the field of non-variceal upper gastrointestinal bleeding (associated or not to NSAIDs or ASA use) have not been numerous but interesting. The key findings are: a) rabeprazole, the only PPI that had few studies in this field, is effective in the prevention of gastric ulcers; b) famotidine could also be effective in the prevention of complications by AAS; c) the new competitive inhibitors of the acid potassium pump are effective (as much as PPIs) on the recurrence of peptic ulcers by ASA; d) early endoscop (<8 h) in non-variceal upper gastrointestinal bleeding seems to offer no better results than those made in the first 24 h; e) endoscopic therapy in Forrest 1a ulcers does not obliterate the bleeding artery in 30% of cases and is the cause of bleeding recurrence; f) alternative therapies with glue or clotting products are being increasingly used in endoscopic therapy of gastrointestinal bleeding; g) liberal administration of blood in the GI bleeding is associated with poor prognosis; h) lesions of the small intestine are frequent cause of gastrointestinal bleeding when upper endoscopy shows no positive stigmata; and i) capsule endoscopy studies have high performance in gastrointestinal bleeding of obscure origin, if performed early in the first two days after the beginning of the bleeding episode

Protocolo de acolhimento e atenção para usuários submetidos a endoscopia digestiva alta e seus acompanhantes / Protocol for embracement and attention to users that underwent upper gastrointestinal endoscopy and persons accompanying them / Protocolo para el acogimiento y la atención a los usuarios que se sometieron a una endoscopia digestiva alta y sus acompañantes

Pesquisa quanti-qualitativa com o objetivo de construir um protocolo de acolhimento e atendimento para os usuários submetidos à Endoscopia Digestiva Alta e seus acompanhantes, num Centro Endoscópico de um hospital do sul do país. Esse protocolo foi elaborado através da construção coletiva de um grupo de enfermeiras, e validado posteriormente por três peritos. Os referenciais teóricos de sustentação da proposta foram a Política Nacional de Humanização e a Teoria das Necessidades Humanas Básicas de Wanda Horta. A institucionalização do protocolo possibilitou o acolhimento e o atendimento ao usuário submetido ao procedimento endoscópico e seu acompanhante nos períodos pré, intra e pós-exame. Propiciou ainda a instrumentalização e organização do processo de trabalho da equipe de enfermagem garantindo, assim, a segurança do paciente durante todo o processo.

This is a quantitative and qualitative research aimed at building a Welcome Protocol for users and their companions referred to the Endoscopic Centre at the University Hospital Dr. Polydoro Ernani São Thiago, at the Federal University of Santa Catarina (UFSC), and submitted to Upper Digestive Endoscopy. The research was elaborated in two stages. The first stage was the building of a collective protocol with a group of nurses; the second stage was the sending of this material, organized as a protocol, for validation by the three experts. The study's supporting theoretical background was the National Humanization Policy and the Basic Human Needs theory. The protocol built aims at detailing the procedures conducted in the pre, trans and post-endoscopy exam stages, permitting the organization of the service and the instrumentalization of the professional team and, thus, ensuring a safer welcome and service to the user and his/her companion.

Trata-se de una investigación cuantitativa y cualitativa con el objetivo de construir un protocolo de acogimiento para los usuarios - y sus compañeros - encaminados al Centro Endoscópico del Hospital Universitario Dr. Polydoro Ernani São Thiago de la Universidad Federal de Santa Catarina, para ser sometidos a Endoscopia Digestiva Alta. Fue elaborada en dos fases: la primera fue la construcción colectiva del protocolo con un grupo de enfermeras; la segunda fue el envío de ese material organizado bajo forma de protocolo, para validación junto a los tres peritos. El referencial teórico de sustentación de ese estudio fue la Política Nacional de Humanización y la teoría de las Necesidades Humanas Básicas. El protocolo construido tiene la pretensión de explicitar los procedimientos ejecutados en el período pre, trans y pos-examen de endoscopia, posibilitando la organización del servicio y la instrumentalización del equipo de profesionales garantizando, de esa manera, un acogimiento y atendimiento más seguro para el usuario y su compañero.