Nurses and other health professionals may be necessary to meet demand for colonoscopies as colorectal cancer screening programs grow to meet needs. Being sure that they can meet standards for quality exams is critical.
In the Netherlands, five nurse endoscopists were trained to do colonoscopies under the supervision of a senior gastroenterologist. Each had 100 consecutive procedures evaluated for both quality and patient satisfaction.
During the study their exams met international standards for quality, and 95 percent of patients said that, overall, they were satisfied with their experience.
Before the study began, the nurse endoscopists (NE) had already completed a median of 550 procedures, ranging from 260 to 2000 colonoscopies. Each NE then had her next 100 consecutive exams compared to standards for quality colonoscopy.
In addition, 3 out of 4 patients completed a questionnaire about their experience.
Colonoscopies were performed with conscious sedation. Two out of five (39 percent) were done for screening or surveillance; the remaining (61 percent) because of symptoms.
- The cecum was reached in 92 percent of cases.
- Average time to reach the cecum was 15 minutes.
- Average withdrawal time was 10 minutes.
- Polyps were found in 1 out of 4 cases (24.8 percent)
- About a third of the time (31 percent) the nurse endoscopists asked for help during removal of a polyp from the supervising gastroenterologist.
- There was one complication, a perforation, in the 500 exams.
In the questionnaires, patients reported:
- Overall, 95 percent were satisfied with their experience.
- 67 percent said they had no pain, 27 percent had mild to moderate pain, 6 percent had substantial pain.
- 99 percent were satisfied with NE communicative skills and 95 percent with their technical skills.
- 71 percent had no preference for NE or physician, 15 percent would prefer a doctor, and 13 percent would prefer a nurse endoscopist.
Concluding, Paul G. van Putten and the Netherlands team said,
Nurse endoscopists perform colonoscopies according to the international recognized quality standards, with high patient satisfaction.