The role of scrub nurses in caring for patients undergoing endoscopic examination of the bile ducts and pancreas : A case study.

Abstract

      This case study aimed to examine the role of scrub nurses in caring for patients undergoing Endoscopic Retrograde Cholangiopancreatography (ERCP), compare nursing care among patients of different ages, pathophysiology, and comorbidities, and analyze individualized nursing problems and appropriate nursing management. Two patients receiving ERCP treatment at Kalasin Hospital were selected as case studies. Data were collected from medical records, direct observation during practice, patient and family interviews, and laboratory findings. Data analysis was conducted using the nursing process integrated with holistic nursing care and Orem’s self-care theory.

      The findings revealed that both patients had biliary obstruction caused by common bile duct stones with cholangitis; however, they differed in age, comorbidities, and complexity of health conditions. Case 1 was a 57-year-old male diagnosed with acute cholangitis. Nursing care focused on infection control, monitoring vital signs, preventing hypoxia, maint aining airway security, and observing post-ERCP complications such as pancreatitis and bleeding. Case 2 was a 75-year-old female with multiple comorbidities, including diabetes mellitus, hypertension, chronic kidney disease, and atrial fibrillation receiving Warfarin therapy. Nursing care for this patient was more complex and required close monitoring for post-EST bleeding, cardiac arrhythmia, hemodynamic instability, and acute kidney injury, as well as continuous monitoring of INR, electrolyte levels, renal function, and urine output.