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Nurse endoscopy

Ramón E Ruiz-Curiel, Ydaly Bonilla H, Alberto Baptista, Manuel Bronstein
OBJECTIVES: propofol is a rapid acting hypnotic that is becoming the drug of choice for sedation in digestive endoscopy worldwide. There is some controversy with regard to the use of propofol by physicians who are not anesthesiologists. We present our experience of the administration of propofol by endoscopist and nursing personnel. METHODS: this was a retrospective study of sedation in endoscopy. Propofol was exclusively used and administered by the endoscopist who performed the procedure and the nursing staff...
March 15, 2018: Revista Española de Enfermedades Digestivas
Weihong Wang, Lu Xu, Zhenfei Bao, Linyin Sun, Chunyan Hu, Feng Zhou, Lei Xu, Dingmei Shi
OBJECTIVES: This study aims to evaluate whether the participation of an experienced endoscopy nurse in colonoscopy increases the polyp detection rate (PDR) and adenoma detection rate (ADR) of experienced colonoscopists. METHODS: This study was a randomized controlled trial. Patients were randomly assigned to the experienced colonoscopist alone (single observer) group, or experienced nurse participation (dual observer) group. The primary outcome was the PDR and ADR...
March 14, 2018: International Journal of Colorectal Disease
Emanuele Rondonotti, Cristiano Spada, Samuel Adler, Andrea May, Edward J Despott, Anastasios Koulaouzidis, Simon Panter, Dirk Domagk, Ignacio Fernandez-Urien, Gabriel Rahmi, Maria Elena Riccioni, Jeanin E van Hooft, Cesare Hassan, Marco Pennazio
SMALL-BOWEL CAPSULE ENDOSCOPY (SBCE): 1: ESGE recommends that prior to SBCE patients ingest a purgative (2 L of polyethylene glycol [PEG]) for better visualization.Strong recommendation, high quality evidence.However, the optimal timing for taking purgatives is yet to be established. 2: ESGE recommends that SBCE should be performed as an outpatient procedure if possible, since completion rates are higher in outpatients than in inpatients.Strong recommendation, moderate quality evidence...
March 14, 2018: Endoscopy
Victoria Gibson, Stephanie Needham, Manu Nayer, Nick P Thompson
Objective: To determine whether development of localised protocol could reduce the number of non-targeted gastric biopsies taken at endoscopy, without risking harm from non-detection of malignant conditions. Design: Retrospective analysis of patient records over a 3-month period in 2013, repeated in 2015 following intervention. Setting: Two UK teaching hospitals. Patients: Patient record data on indication for endoscopy, endoscopy findings, histopathology results and patient outcome...
January 2018: Frontline Gastroenterology
Cristina López Muñoz, Andrés Sánchez Yagüe, Jose Carlos Canca Sánchez, José Antonio Reinaldo-Lapuerta, Ana Belén Moya Suárez
INTRODUCTION: research has shown that an endoscopist-nurse clinical team can perform sedation with propofol effectively, safely and efficiently. To do so, it is essential to provide specific and appropriate training in the necessary skills. The main aim of the present study was to evaluate the quality of the sedation procedure administered by non-anesthetists in a digestive endoscopy unit, one year after its introduction. METHODS: a prospective cohort study was performed in patients given propofol sedation by non-anesthetists...
February 21, 2018: Revista Española de Enfermedades Digestivas
Leopoldo López Rosés, Beatriz Álvarez, Abel González Ramírez, Alina López Baz, Alexia Fernández López, Sara Alonso, Andrés Dacal, Eva Martí, Gino Albines, Julieta Fernández Molina, Ángel Lancho
INTRODUCTION: there is a lot of controversy with regard to who should be responsible for sedation during digestive endoscopy, particularly in advanced procedures that require deep sedation such as enteroscopy. The aim of this study was to evaluate the endoscopist-directed sedation viability during single balloon enteroscopy. MATERIAL AND METHOD: this was a prospective, observational study of a series of consecutive enteroscopies. The clinical staff included an endoscopist, scrub nurse and a nurse in charge of monitoring and sedative administration...
February 21, 2018: Revista Española de Enfermedades Digestivas
Lara Luzón Solanas, Leticia Ollero Domenche, Eva María Sierra Moros, José Val Pérez, María Teresa Soria San Teodoro, Teresa Giménez Júlvez, Rafael Uribarrena Amezaga
INTRODUCTION: propofol administered by an endoscopist with a trained nurse has evolved as an alternative to anesthesia monitoring and is increasingly common in the routine clinical practice, even in advanced endoscopy. OBJECTIVE: to evaluate the safety of deep sedation with endoscopist-controlled propofol in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). MATERIAL AND METHODS: this was a prospective study in patients undergoing ERCP under deep sedation with propofol...
February 9, 2018: Revista Española de Enfermedades Digestivas
Maqsood Ahmed Khan, Kevin B Patel, Mohammed Nooruddin, Garth Swanson, Louis Fogg, Ali Keshavarzian, Michael Brown
BACKGROUND/AIMS: Polyethylene glycol (PEG)-3350, approved by Food and Drug Administration (FDA) only for constipation, combined with 1.9 L of sports drink (SD) (GatoradeR) and bisacodyl (B) is commonly used in outpatient practice for bowel preparation due to cited patient satisfaction and tolerability of this specific regimen. We aim to compare PEG-3350 (MiralaxR) with PEG-AA-based (MoviPrepR) in terms of efficacy, patient satisfaction, and the effects of these two regimen on serum electrolytes...
January 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
S H Walker, L Gokhale
Background: The purpose of this study is to evaluate current practice amongst gynaecologists across the UK, regarding safety aspects of inpatient hysteroscopy under anaesthesia, specifically in relation to entry and specimen retrieval.A survey was created using survey monkey. The first round was circulated to all registrar trainees and consultant gynaecologists across Wales. Following a good response, the survey was then circulated to all members of the British Society of Gynaecological Endoscopy (BSGE)...
2018: Gynecological Surgery
Sol Yu, Young Sook Roh
The optimal performance of gastrointestinal (GI) endoscopy nurses is required for patient safety and quality improvement. The aim of the present study was to assess the educational needs for simulation-based training for Korean GI endoscopy nurses using importance-performance analysis. A cross-sectional survey was conducted with 238 Korean nurses from 25 endoscopy units. The educational needs of these nurses were identified using the 35 item clinical competence importance-performance scale. Exploratory factor analysis of the scale identified the following eight factors: emergency care, patient monitoring, evidence-based practice, documentation and referral, patient safety, nursing process, patient assessment, and infection control...
January 29, 2018: Nursing & Health Sciences
Sang Pyo Lee, In-Kyung Sung, Jeong Hwan Kim, Sun-Young Lee, Hyung Seok Park, Chan Sup Shim
OBJECTIVE: Midazolam sedation during elective endoscopy is widely performed, and flumazenil is frequently administered after endoscopy for the reversal of sedation in clinical practice. This study aimed to investigate the safety and efficacy of flumazenil injection after elective endoscopy under midazolam sedation. METHODS: Patients who underwent upper endoscopy under midazolam sedation were randomly divided into two groups. In group I, flumazenil was intravenously administered 10 min after patient transfer to a recovery room, and no antidote was injected in group II...
January 23, 2018: Journal of Digestive Diseases
Hanna Dubois, Peter T Schmidt, Johan Creutzfeldt, Mia Bergenmar
AIM: To describe the development and implementation of a person-centered endoscopy safety checklist and to evaluate the effects of a "checklist intervention". METHODS: The checklist, based on previously published safety checklists, was developed and locally adapted, taking patient safety aspects into consideration and using a person-centered approach. This novel checklist was introduced to the staff of an endoscopy unit at a Stockholm University Hospital during half-day seminars and team training sessions...
December 28, 2017: World Journal of Gastroenterology: WJG
Danai Khemasuwan, Krittika Teerapuncharoen, David C Griffin
BACKGROUND: The propofol use for moderate sedation (MS) during endobronchial ultrasound (EBUS) bronchoscopy is primarily restricted for use by an anesthesiologist because of safety concerns. The goals of this study were to demonstrate the safety and the diagnostic yield of the use of propofol by bronchoscopists and trained endoscopy nurses during EBUS bronchoscopy without intubation. METHODS: We tested a bolus propofol administration protocol targeting MS for EBUS bronchoscopy...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
Rahul Pannala, Bruce Baldwin, Vijay Aluru, Thomas E Grys, Jordan Holmes, Laurence J Miller, M Edwyn Harrison, Cuong C Nguyen, Fred C Tenover, David Persing, Douglas O Faigel
Background/aims:  In an investigator-initiated, prospective study, we evaluated the feasibility of a five-gene sequence point-of-care (POC) testing strategy (Xpert CARBA-R Assay, Cepheid Inc., Sunnyvale, CA, USA), compared to reference laboratory PCR (48 - 72 hours turnaround time, two gene sequences), in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) and in a hospital outbreak investigation. Methods:  After informed consent, patients undergoing ERCP (September 2015 - April 2016, n = 191) at Mayo Clinic and potential hospital contacts (n = 9) of an index carbapenem-resistant organism (CRO)-positive inpatient were included...
January 2018: Endoscopy International Open
Angelika Behrens, Anton Kreuzmayr, Hendrik Manner, Herbert Koop, Albrecht Lorenz, Claus Schaefer, Mathais Plauth, Jens-Uwe Jetschmann, Christian von Tirpitz, Marcus Ewald, Michael Sackmann, Wanja Renner, Martin Krüger, Dieter Schwab, Werner Hoffmann, Olaf Engelke, Oliver Pech, Frank Kullmann, Sonja Pampuch, Berthold Lenfers, Uwe Weickert, Dieter Schilling, Stephan Boehm, Susanne Beckebaum, Vito Cicinnati, Joachim F Erckenbrecht, Franz Ludwig Dumoulin, Claus Benz, Thomas Rabenstein, Georg Haltern, Martin Balsliemke, Christian de Mas, Gerhard Kleber, Christian Pehl, Christoph Vogt, Ralf Kiesslich, Wolfgang Fischbach, Irmtraut Koop, Jens Kuehne, Matthias Breidert, Nils Lennart Sass, Andrea May, Christian Friedrich, Ronni Veitt, Rainer Porschen, Mark Ellrichmann, Alexander Arlt, Wolfgang Schmitt, Markus Dollhopf, Werner Schmidbaur, Axel Dignass, Volker Schmitz, J Labenz, Gernot Kaiser, Alexander Krannich, Nico Barteska, Christian Ell
OBJECTIVES: Sedation has been established for GI endoscopic procedures in most countries, but it is also associated with an added risk of complications. Reported complication rates are variable due to different study methodologies and often limited sample size. DESIGNS: Acute sedation-associated complications were prospectively recorded in an electronic endoscopy documentation in 39 study centres between December 2011 and August 2014 (median inclusion period 24 months)...
January 3, 2018: Gut
Johann Dreanic, Maximilien Barret, Marion Dhooge, Marianne Gaudric, Sarah Leblanc, Vered Abitbol, Frederic Prat, Stanislas Chaussade, Romain Coriat
AIM: Small bowel capsule endoscopy (CE) is a non-invasive and validated technique allowing the visualization of the small intestine mucosa. It generated more than 40,000 images per examination and induced a long median time of medical reading that may exceed 1 hour. In a transfer of skills' program, the CE reading might be transferred to nurses. We herein evaluate and present a feasibility study of the CE to nurses. METHODS: Nurses experienced in endoscopy were trained for small bowel CE reading, selection and interpretation of pathological images...
November 24, 2017: Clinics and Research in Hepatology and Gastroenterology
Diana E Yung, Ignacio Fernandez-Urien, Sarah Douglas, John N Plevris, Reena Sidhu, Mark E McAlindon, Simon Panter, Anastasios Koulaouzidis
Introduction: Increasing demands on healthcare systems mean that nurses are taking on more roles as physician extenders. Capsule endoscopy (CE) is a laborious procedure where specialist nurses could reduce physician workload and rationalise resource utilisation. The aim of this review and meta-analysis is to consolidate data on nurses' performance in small bowel CE (SBCE). Materials and methods: A comprehensive literature search was conducted for randomised controlled trials and comparative studies on nurses in SBCE reading compared to physicians...
December 2017: United European Gastroenterology Journal
Omar Kherad, Sophie Restellini, Charles Ménard, Myriam Martel, Alan Barkun
Background and study aims Checklists can prevent errors and have a positive impact on patient morbidity and mortality in different surgical settings, and possibly also in gastrointestinal endoscopy. The aims of this study were to reinforce commitment in safety culture and better communication among team members in endoscopy, and to prove the feasibility of successful checklist adoption before colonoscopy. Patients and methods The study involved a pre - post quality improvement intervention involving all consecutive patients undergoing a colonoscopy at a single academic endoscopy unit...
December 13, 2017: Endoscopy
Brian P H Chan, Amanda Hussey, Natalie Rubinger, Lawrence C Hookey
Introduction : Patient comfort is an important part of endoscopy and reflects procedure quality and endoscopist technique. Using the validated, Nurse Assisted Patient Comfort Score (NAPCOMS), this study aimed to determine whether the introduction of NAPCOMS would affect sedation use by endoscopists. Patients and methods : The study was conducted over 3 phases. Phase One and Two consisted of 8 weeks of endoscopist blinded and aware data collection, respectively...
December 2017: Endoscopy International Open
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
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