Curriculum on management of acute upper gastrointestinal bleeding: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.

Key Takeaways for GI Nurses

• This ESGE position statement establishes a structured curriculum for trainees learning upper GI bleeding (UGIB) management, and GI nurses play a central role in supporting this training through periprocedural care, device handling assistance, and patient monitoring during high-acuity cases.
• Trainees must demonstrate foundational technical skills—scope handling, intubation, washing/suctioning, mucosal examination, and accessory handling—before progressing to UGIB-specific training, meaning nurses will often be working alongside less experienced endoscopists during these preparatory stages and should be prepared to reinforce safety checks.
• Competency is assessed individually via a framework rather than fixed procedure counts, which underscores the value of nurse observations and feedback as part of the broader team-based competency assessment process.
• Non-technical skills such as situational awareness, team communication, and leadership are explicitly identified as essential for UGIB management—skills that are inherently team-dependent and rely heavily on effective nurse-physician collaboration during emergent bleeding cases.

Clinical Relevance

Acute upper GI bleeding remains one of the most time-critical and high-stakes indications in endoscopy, often requiring rapid mobilization of skilled staff, specialized equipment, and clear communication under pressure. This ESGE curriculum reinforces that trainees should not be thrust into UGIB cases without first mastering core technical competencies and demonstrating baseline proficiency across standard key performance indicators (KPIs) in upper GI endoscopy. For nursing teams, this means UGIB cases involving trainees will typically occur only after a foundational skill level has been verified, which should translate into more predictable, better-organized procedures—though nurses should remain vigilant, as trainees are still developing hemostasis-specific skills such as device deployment and vessel identification.

The statement's emphasis on integrative, non-technical skills is particularly relevant to nursing practice because these competencies are enacted in real time through the nurse-endoscopist dynamic. Situational awareness, role clarity during emergent bleeding, and closed-loop communication are not abstract concepts—they directly affect how quickly a unit can respond to hemodynamic instability, coordinate blood product administration, or escalate care. Nurses are often the ones who first flag deteriorating vitals or assist in prioritizing next steps, making them integral partners in reinforcing the "team leadership" and "collaboration" domains this curriculum identifies as essential trainee competencies.

From an operational standpoint, units training endoscopists in UGIB management should anticipate more structured, competency-based supervision models rather than reliance on volume-based thresholds alone. This shift may involve nurses contributing to informal or formal feedback on trainee readiness, particularly regarding scope handling, accessory use, and response to procedural complications. Additionally, as KPIs become a prerequisite benchmark before UGIB training begins, nursing staff may notice more consistent baseline skill levels among trainees entering these emergent case rotations, potentially reducing procedural delays and improving overall patient throughput and safety during bleeding emergencies.

Bottom Line

For GI nurses, this ESGE statement signals that trainees should arrive at UGIB cases with verified foundational endoscopic skills and documented KPI achievement, but successful bleeding management still depends heavily on real-time teamwork, communication, and situational awareness—areas where experienced nursing staff provide essential support and safety oversight during these high-risk, time-sensitive procedures.