Nurse endoscopy in a district general hospital.
BACKGROUND
This study describes the first full year of independent practice by a newly appointed nurse endoscopist in a district general hospital.


METHODS
Patients underwent either 'one stop' flexible sigmoidoscopy and barium enema or flexible sigmoidoscopy alone. Barium enema results, video photography, clinical follow-up, and histology were used to validate the results of the flexible sigmoidoscopy. One stop clinic: 161 endoscopies were performed, with 104 female patients (65%), and a mean age of 64 years. There was one failed endoscopy due to poor bowel preparation. Abnormalities were identified in 84% of endoscopies. Flexible sigmoidoscopy detected abnormalities not seen on the barium enema in 28 cases, all of which were polyps (18%). Barium enema identified one abnormality within reach of the flexible sigmoidoscope not identified at endoscopy (small polyp in sigmoid; 1%). Elective flexible sigmoidoscopy list: 121 endoscopies were performed, with 65 female patients (54%), and a mean age of 59 years. There were two failed endoscopy procedures, both attributed to poor bowel preparation. Two-thirds of patients had an abnormality on investigation. There were no complications in either group of patients.


CONCLUSIONS
The nurse-led endoscopy service has been successfully initiated with a high completion rate for flexible sigmoidoscopies. All significant conditions were identified with 99% sensitivity. Nurse endoscopy is a safe, useful and practical procedure in the setting of this district general hospital.
Goodfellow
P B
PB
Department of Surgery, Royal Hospital, Chesterfield & North Derbyshire NHS Trust, Chesterfield, Derbyshire, UK. petegoodfellow@bigfoot.com
Fretwell
I A
IA
Simms
J M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001466:Barium Sulfate; D003111:Colonic Polyps / Q000175:diagnosis / Q000451:nursing; D003287:Contrast Media; D004241:Diverticulum, Colon / Q000175:diagnosis / Q000451:nursing; D016099:Endoscopy, Gastrointestinal / Q000379:methods / Q000451:nursing; D004733:Enema / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006767:Hospitals, District; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners; D011446:Prospective Studies; D012810:Sigmoid Diseases / Q000175:diagnosis / Q000451:nursing*; D012812:Sigmoidoscopy / Q000379:methods / Q000451:nursing*
D003287:Contrast Media; D001466:Barium Sulfate