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https://www.readbyqxmd.com/read/29142513/sedation-for-routine-gastrointestinal-endoscopic-procedures-a-review-on-efficacy-safety-efficiency-cost-and-satisfaction
#1
REVIEW
Otto S Lin
Most gastrointestinal endoscopic procedures are now performed with sedation. Moderate sedation using benzodiazepines and opioids continue to be widely used, but propofol sedation is becoming more popular because its unique pharmacokinetic properties make endoscopy almost painless, with a very predictable and rapid recovery process. There is controversy as to whether propofol should be administered only by anesthesia professionals (monitored anesthesia care) or whether properly trained non-anesthesia personnel can use propofol safely via the modalities of nurse-administered propofol sedation, computer-assisted propofol sedation or nurse-administered continuous propofol sedation...
October 2017: Intestinal Research
https://www.readbyqxmd.com/read/29101563/the-use-of-high-definition-colonoscopy-versus-standard-definition-does-it-affect-polyp-detection-rate
#2
John Richardson, Anthony Thaventhiran, Hugh Mackenzie, Benjamin Stubbs
BACKGROUND: Polyp detection rate (PDR) during lower gastrointestinal endoscopy (LGIE) is of clinical importance. Detecting adenomatous polyps early in the adenoma-carcinoma sequence can halt disease progression, enabling treatment at a favourable stage. High definition colonoscopy (HDC) has been used in our hospital alongside standard definition equipment since 2011. We aim to determine what affect the use of HDC has on PDR. METHODS: Post-hoc analysis of a prospectively maintained database on all patients undergoing LGIE was performed (01/01/2012-31/12/2015), n = 15,448...
November 3, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29036747/prevention-of-multidrug-resistant-infections-from-contaminated-duodenoscopes-position-statement-of-the-european-society-of-gastrointestinal-endoscopy-esge-and-european-society-of-gastroenterology-nurses-and-associates-esgena
#3
Ulrike Beilenhoff, Holger Biering, Reinhard Blum, Jadranka Brljak, Monica Cimbro, Jean-Marc Dumonceau, Cesare Hassan, Michael Jung, Christiane Neumann, Michael Pietsch, Lionel Pineau, Thierry Ponchon, Stanislav Rejchrt, Jean-François Rey, Verona Schmidt, Jayne Tillett, Jeanin van Hooft
Patients should be informed about the benefits and risks of endoscopic retrograde cholangiopancreatography (ERCP)Only specially trained and competent personnel should carry out endoscope reprocessing.Manufacturers of duodenoscopes should provide detailed instructions on how to use and reprocess their equipment.In the case of modifications to their equipment, manufacturers should provide updated instructions for use.Detailed reprocessing protocols based on the manufacturer's instructions for use should clearly lay out the different reprocessing steps necessary for each endoscope model...
November 2017: Endoscopy
https://www.readbyqxmd.com/read/28974894/assessment-of-colon-polyp-morphology-is-education-effective
#4
Jae Hyun Kim, Kyoung Sik Nam, Hye Jung Kwon, Youn Jung Choi, Kyoungwon Jung, Sung Eun Kim, Won Moon, Moo In Park, Seun Ja Park
AIM: To determine the inter-observer variability for colon polyp morphology and to identify whether education can improve agreement among observers. METHODS: For purposes of the tests, we recorded colonoscopy video clips that included scenes visualizing the polyps. A total of 15 endoscopists and 15 nurses participated in the study. Participants watched 60 video clips of the polyp morphology scenes and then estimated polyp morphology (pre-test). After education for 20 min, participants performed a second test in which the order of 60 video clips was changed (post-test)...
September 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28957967/introduction-of-the-nurse-endoscopist-role-in-one-australian-health-service
#5
Nerissa Duncan, Deanne Bonney, Catherine Au, Cheyne Chalmers, Paul N Bennett
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...
September 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/28891855/patient-satisfaction-with-propofol-for-outpatient-colonoscopy-a-prospective-randomized-double-blind-study
#6
RANDOMIZED CONTROLLED TRIAL
Anantha Padmanabhan, Christoforos Frangopoulos, Lynn E T Shaffer
BACKGROUND: Previous literature has shown that propofol has ideal anesthetic properties for patients undergoing colonoscopy, a common procedure at outpatient surgery centers. However, there is a paucity of information regarding patient satisfaction with propofol. OBJECTIVE: The aim of this study was to evaluate patient satisfaction with propofol compared with nonpropofol (fentanyl/midazolam) anesthesia for outpatient colonoscopies. Safety and complications were secondary end points...
October 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28879227/assessment-of-quality-indicators-among-nurse-practitioners-performing-upper-endoscopy
#7
Jeffrey M Baumgardner, Justin L Sewell, Lukejohn W Day
BACKGROUND AND STUDY AIMS:  Limited international data have shown that non-physicians can safely perform upper endoscopy, but no such study has been performed in the United States. Our aim was to assess the quality of outpatient upper endoscopies performed by nurse practitioners (NPs). PATIENTS AND METHODS:  Retrospective chart review of upper endoscopies performed by 3 NPs between 2010 and 2013 was performed. Comparisons among all NPs performing upper endoscopy and assessment of individual NP performance over time with respect to quality indicators were performed...
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28873076/women-awaken-faster-than-men-after-electroencephalogram-monitored-propofol-sedation-for-colonoscopy-a-prospective-observational-study
#8
Andrea Riphaus, Mark Slottje, Jan Bulla, Carolin Keil, Christian Mentzel, Vera Limbach, Barbara Schultz, Christian Unzicker
BACKGROUND: Sedation for colonoscopy using intravenous propofol has become standard in many Western countries. OBJECTIVE: Gender-specific differences have been shown for general anaesthesia in dentistry, but no such data existed for gastrointestinal endoscopy. DESIGN: A prospective observational study. SETTING: An academic teaching hospital of Hannover Medical School. PATIENTS: A total of 219 patients (108 women and 111 men) scheduled for colonoscopy...
October 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28853136/reprocessing-practices-for-gastrointestinal-endoscopes-a-multicentre-study-in-egyptian-university-hospitals
#9
Rehab H El-Sokkary, Ahmed A Wegdan, Ahmed A Mosaad, Rasha H Bassyouni, Wael M Awad
The aim of this study was to assess the practices of health care workers during gasterointestinal endoscope reprocessing, evaluate their knowledge about reprocessing, and verify their compliance with laboratory and microbiological tests in endoscopy units at Zagazig University and Fayoum University hospitals. All nursing staff on duty from 10 endoscopy units, with 16 flexible endoscopes, were included. Knowledge and practice were assessed by a questionnaire and a checklist. The mean knowledge score was 7.5 (SD 1...
August 27, 2017: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
https://www.readbyqxmd.com/read/28839891/endoscopy-provision-meeting-the-challenges
#10
Edward Seward, Sophie Lumley
BACKGROUND: Endoscopy activity has been increasing in the UK for many years. However, the increasing demand is currently disproportionate to delivered capacity. This, in combination with mandatory efficiency savings, presents an ongoing challenge in the effective continued delivery of diagnostic endoscopy services. RECENT DEVELOPMENTS: New initiatives in the field of endoscopy that may impact on resource include: faecal immunochemical test, straight to test referral systems, nurse endoscopists, home enemas and split dose bowel preparation...
April 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28791330/computer-assisted-instruction-before-colonoscopy-is-as-effective-as-nurse-counselling-a-clinical-pilot-trial
#11
Govert Veldhuijzen, Michael Klemt-Kropp, Casper Noomen, Aura A Van Esch, Eric T Tjwa, Joost Drenth
BACKGROUND AND STUDY AIMS:  Better patient education prior to colonoscopy improves adherence to instructions for bowel preparation and leads to cleaner colons. We reasoned that computer assisted instruction (CAI) using video and 3 D animations followed by nurse contact maximizes the effectiveness of nurse counselling, increases proportion of clean colons and improves patient experience. PATIENTS AND METHODS:  Adults referred for colonoscopy in a high-volume endoscopy unit in the Netherlands were included...
August 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28730132/investigation-of-efficacy-of-lidocaine-spray-for-sedated-esophagogastroduodenoscopy-in-children
#12
Ahmet Basturk, Reha Artan, Aygen Yılmaz
PURPOSE: Our aim in this study is to investigate efficacy of topical lidocaine spray for sedated esophagogastroduodenoscopy (EGD) in children. METHODS: The endoscopy of children aged between 3-18 years who underwent EGD in our endoscopy unit. Intravenous (IV) midazolam and ketamine were used for sedation. Prior to sedation, endoscopy nurse applied topical lidocaine 10% with pump spray at 1 mg/kg dose in group 1, and distilled water via identically scaled pump spray in group 2, in a double blinded fashion...
June 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28558517/nurse-performed-endoscopy-implications-for-the-nursing-profession-in-australia
#13
Christine Duffield, Susan Chapman, Samantha Rowbotham, Nicole Blay
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...
February 2017: Policy, Politics & Nursing Practice
https://www.readbyqxmd.com/read/28551926/-the-failure-modes-and-effects-analysis-facilitates-a-safe-time-and-money-saving-open-access-colonoscopy-service
#14
Rachel Gingold-Belfer, Yaron Niv, Nehama Horev, Shuli Gross, Nadav Sahar, Ram Dickman
BACKGROUND: Failure modes and effects analysis (FMEA) is used for the identification of potential risks in health care processes. We used a specific FMEA - based form for direct referral for colonoscopy and assessed it for procedurerelated perforations. METHODS: Ten experts in endoscopy evaluated and computed the entire referral process, modes of preparation for the endoscopic procedure, the endoscopic procedure itself and the discharge process. We used FMEA assessing for likelihood of occurrence, detection and severity and calculated the risk profile number (RPN) for each of the above points...
April 2017: Harefuah
https://www.readbyqxmd.com/read/28474959/is-a-multidisciplinary-aerodigestive-clinic-more-effective-at-treating-recalcitrant-aerodigestive-complaints-than-a-single-specialist
#15
Janine M Rotsides, Gina M Krakovsky, Dinesh K Pillai, Sona Sehgal, Maura E Collins, Carolyn E Noelke, Nancy M Bauman
OBJECTIVE: To determine the utility of a pediatric multidisciplinary aerodigestive clinic (ADC) in treating recalcitrant aerodigestive conditions. METHODS: Longitudinal observational study of presenting complaints, evaluation, management, and outcome of patients seen during 12 monthly ADCs beginning August 2013. RESULTS: Fifty-five patients were seen by the ADC team (otolaryngology/gastroenterology/pulmonology/speech pathology/nurse practitioner) and followed for a mean 17...
July 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28425188/effects-of-age-and-viscosity-on-food-transport-and-breathing-swallowing-coordination-during-eating-of-two-phase-food-in-nursing-home-residents
#16
Tsuyoshi Yamada, Koichiro Matsuo, Masayuki Izawa, Shizuru Yamada, Yuji Masuda, Tadashi Ogasawara
AIM: When eating food that contains both liquid and solid phases, the liquid component frequently enters the hypopharynx before swallowing and can increase the risk of aspiration. Thus, we examined whether the initial viscosity of mixed consistency food could alter pre-swallow food transport and breathing-swallowing coordination in older adults. METHODS: Fiberoptic endoscopy was recorded while 18 healthy young adults and 19 older adults ate 5 g of steamed rice combined with 3 mL of blue-dye water...
April 20, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28365484/bolus-administration-of-fentanyl-and-midazolam-for-colonoscopy-increases-endoscopy-unit-efficiency-and-safety-compared-with-titrated-sedation
#17
R Thomas Finn, Amanda Boyd, Li Lin, Ziad F Gellad
BACKGROUND & AIMS: Guidelines recommend slow titration of sedatives for moderate sedation. Bolus sedation, in which a larger weight-based dose of medication is given upfront, has been shown in a single trial to be beneficial. We evaluated the effects of bolus sedation on procedural safety, efficiency, and patient experience. METHODS: We performed a retrospective analysis of colonoscopies performed between April 2010 and April 2011 at Duke Medical Center. Colonoscopies before October 2010 were performed with nurse-directed titration of sedative (n = 966); colonoscopies performed after October 2010 were performed with physician-directed administration of bolus sedative (n = 699)...
September 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28210707/assessing-the-safety-of-physician-directed-nurse-administered-propofol-sedation-in-low-risk-patients-undergoing-endoscopy-and-colonoscopy
#18
Dharshan Sathananthan, Edward Young, Garry Nind, Biju George, Angelie Ashby, Sharon Drummond, Kasia Redel, Neville Green, Rajvinder Singh
Background and study aims Physician-directed nurse-administered balanced propofol sedation (PhD NAPS) in patients undergoing endoscopy and/or colonoscopy is being increasingly utilized worldwide. However, this method of sedation is not universally employed in Australian hospitals due to concerns surrounding its safety. The aim of this study was to assess the safety of PhD NAPS in low-risk patients undergoing endoscopy and/or colonoscopy. Patients and methods This study was conducted at a single tertiary teaching hospital in Adelaide, Australia...
February 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28191498/a-prospective-study-of-patient-safety-incidents-in-gastrointestinal-endoscopy
#19
Manmeet Matharoo, Adam Haycock, Nick Sevdalis, Siwan Thomas-Gibson
Background and study aims Medical error occurs frequently with significant morbidity and mortality. This study aime to assess the frequency and type of endoscopy patient safety incidents (PSIs). Patients and methods A prospective observational study of PSIs in routine diagnostic and therapeutic endoscopy was undertaken in a secondary and tertiary care center. Observations were undertaken within the endoscopy suite across pre-procedure, intra-procedure and post-procedure phases of care. Experienced (Consultant-level) and trainee endoscopists from medical, surgical, and nursing specialities were included...
January 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28188978/split-dose-bowel-preparation-with-polyethylene-glycol-for-colonoscopy-performed-under-propofol-sedation-is-there-an-optimal-timing
#20
Alaa Alghamry, Sureshkumar K Ponnuswamy, Aditya Agarwal, Hadi Moattar, Stephanie T Yerkovich, Ann E Vandeleur, James Thomas, John Croese, Tony Rahman, Ruth Hodgson
OBJECTIVE: Aspiration risk, especially with propofol sedation, remains a concern after split-dose bowel preparation of up to 1 L polyethylene glycol for the procedure. We aimed to identify the ideal timing of bowel preparation to achieve optimal colon cleansing with no increased risk of aspiration. METHODS: A total of 892 consecutive patients undergoing simultaneous esophagogastroduodenoscopy (EGD) and colonoscopy were prospectively recruited. Residual gastric volume (RGV) and pH of gastric contents were measured at EGD, and patients' characteristics, runway time (duration between completion of the final liter of bowel preparation and colonoscopy commencement), and cleansing quality were recorded...
March 2017: Journal of Digestive Diseases
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