Unsedated colonoscopy introduced to ensure access is acceptable to a subgroup of veterans.
BACKGROUND
Nurses for monitoring and recovery are required for sedated colonoscopy. A nursing shortage necessitated discontinuation of sedated colonoscopy at a VA academic training program.


OBJECTIVE
Elements of a case series that documented acceptance of unsedated colonoscopy are reviewed to raise awareness of the feasibility of this option.


METHODS
The pros and cons of sedation and no sedation were summarized. After discussion, patients who chose the unsedated option were scheduled for examination locally while those who desired sedation were scheduled at another VA site. Colonoscopy was performed by supervised trainees.


RESULTS
From September 2002 to June 2005 scheduled unsedated colonoscopy was accepted by 145 of 483 veterans. Cecal intubation was achieved in 81%. Thus, of the cohort 30% had local access to and 24% completed unsedated colonoscopy. Implementation of unsedated colonoscopy obviated the need for two registered nurses previously required for sedated colonoscopy.


CONCLUSIONS
Unsedated colonoscopy offered as an option to ensure access was acceptable to a subgroup of our veteran patients. Implementation required less nursing resources. Techniques to enhance the cecal intubation rate of unsedated colonoscopy performed by supervised trainees deserves to be assessed in future studies.
Leung
Felix W
FW
Research and Medical Services, Sepulveda Ambulatory Care Center, West Los Angeles Veterans Affairs Medical Center, Veterans Affairs Greater Los Angeles Healthcare System, Sepulveda, Los Angeles, CA, USA. felix.leung@va.gov
D003113:Colonoscopy / Q000379:methods* / Q000451:nursing*; D016292:Procedural Sedation / Q000451:nursing*; D005240:Feasibility Studies; D006297:Health Services Accessibility; D006787:Hospitals, Veterans; D006801:Humans; D008888:Military Nursing; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D040841:Resource Allocation; D014728:Veterans