Sessions

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Metal Stenting and Hemostasis

Dr. Lawrence Hookey, Medical Director of Endoscopy, Kingston Health Sciences Centre.
Join us for some hands-on education. With the aid of GI models, you will review the process of deploying a metal stent allowing you to become more comfortable with both the product and procedure. In addition, we will be discussing hemostasis and our exclusive product Hemospray. Finally, you will have access to Dr. Lawrence Hookey and the Cook Medical team who will be available to answer any of your questions.
An overview of stenting in the GI tract, including biliary, esophageal, duodenal, and colonic stents.
At the end of the session, participants will be able to:

  • List three common indications for enteral stenting
  • Describe two benefits and drawbacks of covered and uncovered stents
  • List two contraindications to stenting
  • Gain confidence in metal stenting through hands-on education.
  • Obtain additional knowledge on hemospray and the direction it is going in the future.

Dr. Lawrence Hookey
“I completed my medical school training at Memorial University, and then did Internal Medicine and Gastroenterology training at Queen's University. From there I went to Belgium and France for a two-year clinical research fellowship in advanced therapeutic endoscopy. I returned to Queen's in 2005 and was the Program Director for the GI training program for 7 years. I am the Medical Director of the endoscopy units of KHSC. I love clinical research and am currently supervising 10 residents and three medical students in clinical research.”

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Bariatric Surgery - Considerations and Complications

Speaker: Dr. Chris Smith, MD MSc FRCSC, General and Bariatric Surgery, Eastern Health

Learning Objectives:

  • Discuss anatomical considerations for patients who have had bariatric surgery
  • Summaraize potential complications of bariatric surgery
  • Review endoscopic considerations for patients who have had bariatric surgery

Description:
Overview of common bariatric surgical procedures and some related epidemiology. Plan to review anatomical considerations of patients having had bariatric surgery and compare the differences between procedure types. Review endoscopic considerations and management of patients who have had bariatric surgery and complications thereof.

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Bowel Preps-Circling the bowl

Speaker: Sandra Stone, Follow-up Coordinator, NL Colon Screening Program

Learning Objectives:

  • Importance of adequate bowel preparation
  • Types of bowel praparations
  • Importance of split dosing

Description:
This presentation will review the types, methods and importance of adequate bowel preparation prior to colonoscopy to ensure complete visualization of the mucosal surface. An adequate bowel preparation is related to completing a high quality, safe, comfortable procedure in an efficient time while providing diagnostic accurate outcomes.

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Cannabis and Inflammatory Bowel Disease Does it work and why?

Speaker: Dr. Alia Norman, Lead Physician, Newfoundland, Canabo Medical Clinic

Learning Objectives:

  • Explain the differences between THC, THCa, nabilone and CBD
  • Discuss the challenges of conducting cannabis trials (interactive)
  • List the components of the endocannabinoid system involved in IBD pathology and symptoms.
  • Counsel patients on safer cannabis use
  • Discuss your experience with patients reporting benefit from cannabis

Description:
Our understanding of the role of the endocannabinoid system in inflammatory disease is rapidly changing. We are simultaneously learning from patient reports and bench research, but there is a gap between these experiences and the limited observational studies and randomized trials. How do we move the evidence forward? How do we guide our patients who are currently self-medicating?

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CAG SEE Course

Speaker: Dr. Mark Borgaonkar, Professor of Medicine, Memorial University

Learning Objectives:

  • Summarize the key elements of the SEE program.
  • Explain the importance of quality in colonoscopy.
  • Discuss the variation in quality outcomes among endoscopists.
  • List quality measures in colonoscopy.
  • Summarize the role of the endoscopy nurse in quality colonoscopy

Description:
In Canada and around the world, outcomes during and after colonoscopy vary. As a result, patients have different levels of discomfort, require different amounts of sedation, and have different willingness to repeat the procedure. Importantly, some patients may not have complete detection and removal of polyps. The Canadian Association of Gastroenterology (CAG) has developed the Skills Enhancement in Endoscopy (SEE) program to address these needs. This presentation will discuss in more detail the elements of high quality colonoscopy, challenges in achieving high quality colonoscopy and what is taught in the SEE program to help endoscopists improve their colonoscopy quality. The important role of the endoscopy nurse will be highlighted as it relates to colonoscopy quality and how nursing roles may be effected by techniques promoted in the SEE course.

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The Changing Landscape of Colorectal Cancer Screening

Speaker: Dr. Jerry Shane McGrath

Learning Objectives:

  • To review the process of colon screening in Newfoundland and Labrador and the rest of Canada.
  • Review current international literature on CRC screening.
  • Review Newfoundland and Labrador’s experience with the FIT kit.

Description:
Most provinces in Canada have organized Colon Cancer Screening program. The FIT test allows for a non-invasive means to screen patients at average risk. The FIT test will be compared to other available tests such as colonoscopy and CT colonography. Comparison will be made between screening in Canada, USA and Internationally.

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CNA Exam Certification Information & Preparation

Speaker: Gail Mason, Charge Nurse Clinic E and Education Director, The Moncton Hospital
Cathy Arnold Cormier

Description:
An informal question and answer period covering exam like questions, writing dates, education material available etc.

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ERCP Basic Training/Refresher

Speaker: Rayleen Hogan, Regional Waitlist manager for the medicine program at Eastern Health

Learning Objectives:

  • list key points of patient preparation for procedure.
  • explain nursing assessment and intervention required.
  • explain an ERCP procedure
  • summarize and explain treatments of complications during ERCP

Description:
This is an ERCP presentation for the novice nurse or nurse new to ERCP procedures. It provides the basic knowledge of the procedure and what is required of the nurse to assist during an ERCP. It also reviews common equipment used. It also provides information on how to respond if complications occur during an ERCP.

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ERCP for the Intervention and Treatment

Speaker: Dr. Michael Hogan, Associate Professor of Surgery, Memorial University

Learning Objectives:

  • Discuss indications and contraindications of ERCP
  • Understand complications of ERCP and how to avoid them
  • Discuss quality assurance in the practice of ERCP
  • Appreciate the "art" of ERCP and its effect on a GI unit

Description:
ERCP in 2019 is a therapeutic procedure rather than a diagnostic one. We will discuss the current indications, therapeutic benefits, and complications of the procedure. In addition, we will discuss the impact of ERCP on nursing resources, training, and some quality assurance issues around this procedure.

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Hemospray/Metal Stenting

Speaker: Dr. Lawrence Hookey, Medical Director of Endoscopy, Kingston Health Sciences Centre.

Learning Objectives:

  • Discuss the different therapy options for Hemospray
  • Summarize the most recent study on hemospray
  • Explain the different Stenting options

Description:
Dr. Hookey will present his recent study on hemospray. The discussion will cover the safety and performance of hemospray not only as a rescue therapy but as a monotherapy or combination therapy as well. He will also be available for questions. This will be followed by a general presentation on metal stenting

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The Importance of Celebrating Joy in Our Lives at Work (and Outside!)

Speaker: Sheila Williams , Music Therapist, Eastern Health

Description:
Emphasizing the positive in your work life can sometimes be challenging. As we travel every day, we need to ensure that we are giving it our all – this is not an audition! Sometimes life is hard. Everyone experiences challenges for a myriad of reasons, in various forms. In this keynote, discover how laughter can light up your life. Looking through another lens allows you to embrace the significance of seemingly little things and their potential to positively impact you!


Increasing Patient Safety with Capnography?

Speaker: Marleen Spencer

The role of procedural sedation has been growing as sedation outside the operating room becomes more common. Capnography monitoring provides an early warning of respiratory compromise, offering clinicians in Gastroenterology suites the opportunity to provide care sooner and quickly determine how to intervene, reducing risk and saving time by alerting them earlier.

At the end of the session, participants will be able to learn how to interpret capnography in monitoring ventilation during sedation more effectively and safely.

Educational Topics - Ventilation monitoring, capnography, procedural sedation

Target Audience - Any nurse involved in the care of a patient during the administration of sedative agents

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Inflammatory Bowel Disease in Children and Adolescents

Speaker: Dr. Jeff Critch, Associate Professor of Pediatrics, Memorial University

Learning Objectives:

  • Understand unique features of very early onset inflammatory bowel disease (VEO-IBD).
  • Recognize the impact that pediatric IBD may have on growth.
  • Learn about management considerations in pediatric IBD.

Description:
The presentation will highlight some unique aspects of childhood-onset inflammatory bowel disease (IBD), in comparison to adult-onset IBD. Recent epidemiology of pediatric-onset IBD in Canada will be reviewed. Very early onset IBD (VEO-IBD) will be reviewed to highlight the higher possibility of monogenic forms of IBD in this group. The impact of childhood IBD on growth, pubertal development and the impact on the patients (and their families) quality of life will be reviewed. Specific treatment options will be reviewed including the use of exclusive enteral nutrition in pediatric Crohn's disease and the use of biologics.

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LPN Practice: Let's Talk About Scope

Speaker: Wanda Squires, Practice Consultant, College of Licensed Practical Nurses of NL

Learning Objectives:

  • Define the factors that influence scope of practice.
  • Distinguish between professional scope of practice and individual scope of practice.
  • Discuss the LPN assignment of care

Description:
This presentation will focus on the decision making framework for LPN scope of practice (what LPNs are educated and authorized to do). The differences between the scope of practice of the profession and the scope of practice of an individual LPN will be explored. Three factors (the client, the environment, the nurse), which help determine the most appropriate care provider for the client, will be discussed.

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Principals of Modern Electrosurgery: Polypectomy

Speaker: Santino Beninato, Regional Sales Manager - Central and Atlantic Canada,Vantage Endoscopy

Learning Objectives:

  • Discuss the impact of snare design on polypectomy techniques
  • Apply the use of argon plasma coagulation to deliver non-contact monopolar electrosurgical energy
  • Identify principals for safely performing electrosurgery

Description:
The overarching theme of this session will be that the use of the appropriate tools and techniques is important for minimizing the risk of complications associated with polypectomy, as well as recurrence in residual lesion rates which can be high - primarily due to incomplete resection. This session will be based around the accredited program that we have designed with the Canadian Association of Gastroenterology. Information specific to the role voltage, current, and impedance serves in administering power toward a therapeutic effect within a dynamic anatomy will be emphasized. Understanding these principles within the framework of differing waveforms used to create different tissue effects cutting / coagulation will better enable staff to make informed decisions regarding ESU settings, accessory selection and duration of the therapeutic effect.
Proper snare placement and polyp entrapment techniques will be discussed, as well as the conductive properties of differe nt designs of snares to better illustrate the occurrence and management of tissue resistance and progressive desiccation leading to resection.
Another topic of discussion is the role of Argon Plasma Coagulation in influencing tissue effect via a non-contact method of delivering monopolar electrosurgical energy. Subject matter will include the role duration, power setting or wattage and distance between the APC probe and the target tissue play in the pursuit of hemostasis, tissue ablation and tumor debulking.
No instructional program concerning electrosurgical devices is complete without a discussion of safety. This component will review the basic principles of safe use including discussion of: pad placement, grounding principles, alarms and error handling, monopolar vs. bipolar circuits, pacemakers.

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Pyxis: Supply Automation Technology (Pyxis) in Healthcare - A story on Supply Chain Management & Cost savings

Speaker: Gary Stone, Project Manager, Eastern Health

Learning Objectives:

  • Discuss how Inventory Management TEchnology enables supply and product management
  • Understand what comes with deploying Inventory Management Technology in a clincial environment
  • Understand Case Costing (linking supplies for patients procedures to understand procedure costs)

Description:
This presentation will provide a Project overview of the benefits, challenges, and cost savings that was associated to deploying inventory management technology (Pyxis) in procedure based clinical environments. Specifically, an overview will be provided of the Pyxis Project deployment in the Endo/GI departments at Eastern health and how this concept was introduced and adopted.

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Quality in Endoscopy

Speaker: Jane Smallwood, Senior Nurse Educator/ Consultant, Olympus Canada

Learning Objectives:

  • Associate the link between qualtiy and efficiency in endoscopy
  • Discuss technological advances in endoscopy to support quality measures

Description:
Quality improves productivity.
This presentation today will focus on quality components in the GI unit and explore the link between quality and efficiency. The provision of high quality endoscopic care is complex, involving a myriad of people, processes, and equipment. Healthcare professionals work hard to deliver this service, yet failure of any aspect may result in suboptimal care, lack of traceability, high costs and poor health outcomes.

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Radiofrequency Ablation for Management of Barrett’s Esophagus

Speaker: Gail Mason
Barrett’s Esophagus intestinal metaplasia is a precursor to esophageal cancer. As endoscopic therapies have evolved, resulting in improved efficacy and safety, their use in the management of Barrett’s Esophagus has increased significantly.
This program aims to increase knowledge of Barrett’s Esophagus and expand understanding of the role endoscopic therapy plays in the treatment of Barrett’s Esophagus. This, in turn, will enable improved communication with patients about their disease.Target Audience - Nurses involved in the management of patients with Gastroesophageal Reflux Disease GERD or Barrett’s esophagus.At the end of this course, nurses will be able to:

  • Discuss the precursors of Barrett`s Esophagus
  • Understand the progression of Barrett’s Esophagus
  • Describe radiofrequency ablation for treatment of Barrett’s Esophagus
  • Understand nursing involvement in radiofrequency ablation procedure

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Social Media and the Digital Professional

Speaker: Dr. Gerard Farrell, Director, eHealth Research Unit, Memorial University of Newfoundland

Learning Objectives:

  • Identify how social media evolved and how that evolution impacts our use of it.
  • Be able to demonstrate an appreciation for the impact of social media on our interactions with others.
  • Explore the issues involved in and develop strategies for being a digital professional.

Description:
As providers of health care, we have a responsibility to maintain professional decorum to the general public. As more information is shared online through social media (and more actors are watching what we share online), being a professional and being online are increasingly difficult. This talk looks at how Social Media have evolved and discusses the impact of this evolution on professionals online.

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WAIT! Is your Scope Clean? Is it Dry?

Speaker: Merlee Steele-Rodway, Reg. Nurse, Consultant- IPAC/MDR

Learning Objectives:

  • Review the current research on the importance of performing cleaning efficacy testing and drying of flexible endoscopes.
  • Review flexible endoscope cleaning efficacy methods that will ensure quality in cleaning of flexible endoscopes.
  • Validate the importance of ensuring flexible endoscopes are completely dry before storage.

Description:
This presentation will discuss the importance of flexible endoscope cleaning efficacy testing and why drying is critical to prevent replication of and survival of pathogens during storage. It will also discuss information on new evolving research specific to the drying of flexible endoscopes.

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What to do When your Endoscopy Wait List is 25,000?

Speaker: Rayleen Hogan, Regional Waitlist manager for the medicine program at Eastern Health

Learning Objectives:

  • Summarize process of intense review of a wait list.
  • Discuss pitfalls and challenges with high volume wait lists.
  • Compare pre and post review data.

Description:
This session is an overview of a 2 year wait list review project completed at Eastern health to help maximize efficiency, reduce patient risk, increase and then maintain compliance to recommended guidelines within its endoscopy service. It is geared towards nurse managers and clinical leaders within endoscopy, risk management, and clinical efficiency.

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