Low ERCP Volume Is Associated with More Industry Representative Interactions but Similar Training of Nurses

Rajesh N. Keswani*, Phyllis Malpas, Sheryl E. Lynch, Gregory A. Coté

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Data on ERCP nurses and associate (ERCP-NA) training and comfort are lacking. Healthcare industry representative (HCIR) influence may be greater in low-volume units (LVUs) due to decreased procedure and device familiarity. Aim: The aim of this study was to compare ERCP-NA training, safety, and HCIR relationships between LVU and high-volume unit (HVU) ERCP facilities. Methods: We conducted an electronic survey of all Society of Gastroenterology Nurses and Associates (SGNA) members assessing: (1) demographics and procedure volume, (2) ERCP training and radiation safety, and (3) HCIR interactions. Responses were stratified by ERCP volume. Results: Among 832 SGNA member respondents (median age 55), 615 (74 %) worked as an ERCP-NA; 41 % derived from LVUs. The majority of ERCP-NAs, irrespective of unit volume, had observed <50 ERCPs before starting. Except for lead glasses, the majority (>80 %) adhered to basic radiation safety, irrespective of unit volume. LVUs were more likely than HVU ERCP-NAs to agree that HCIRs were requested for intra-procedure assistance (24 vs. 19 %, p = 0.008), asked for input on the next choice of device (22 vs. 15 %, p = 0.01), and assist in device usage (27 vs. 22 %, p = 0.04). Irrespective of volume, 30 % agreed that they were more likely to utilize a company’s devices if that HCIR was present. Conclusions: ERCP-NA training before independent participation in ERCP is suboptimal. HCIRs are frequently requested for assistance during ERCPs, especially in LVUs. HCIR impact on ERCP outcomes and device utilization and whether enhanced ERCP-NA training will impact the role of HCIR, require further study.

Original languageEnglish (US)
Pages (from-to)713-721
Number of pages9
JournalDigestive diseases and sciences
Issue number3
StatePublished - Mar 1 2016


  • Device representatives
  • ERCP
  • Healthcare costs
  • Safety
  • Training

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

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