title: Gastrointestinal endoscopy nurse experience and polyp detection during screening colonoscopy.
abstract: OBJECTIVE
  The effect of gastrointestinal endoscopy nursing experience on polyp detection is unknown. The aim of this study was to determine whether nurse experience is associated with odds of polyp detection.
  
  
  METHODS
  We performed a retrospective analysis of screening colonoscopies performed by attendings at University of North Carolina hospitals between August 2003 and 2005. Nurse experience was dichotomized at 6 months. The primary outcome was polyp detection, with secondary analysis by histologic type. Descriptive statistics, bivariate analysis, and multivariable logistic regression were performed.
  
  
  RESULTS
  Any polyp was detected in 44% of the eligible 3631 colonoscopies. Multiple polyps were detected in 23%, adenomas in 25%, advanced lesions in 5%, and hyperplastic polyps in 11%. Twenty-nine nurses were employed during the study period, 19 of whom were new to endoscopy nursing. For nurses with 6 months of experience or less, any polyp was detected in 40.3% of procedures compared with 46.0% of procedures for nurses with more than 6 months of experience (odds ratio [OR], 1.26; 95% confidence interval [CI], 1.09-1.46). Similar results were seen for multiple polyps (OR, 1.54; 95% CI, 1.29-1.84) and hyperplastic polyps (OR, 1.47; 95% CI, 1.22-1.76), but not for adenomas (OR, 1.10; 95% CI, 0.93-1.30) or advanced lesions (OR, 0.99; 95% CI, 0.71-1.36). These relationships were unchanged after adjusting for potential confounding patient and procedure variables.
  
  
  CONCLUSIONS
  Procedures staffed by less-experienced gastrointestinal endoscopy nurses have increased odds of not detecting polyps. Subanalysis suggests that detection of hyperplastic polyps explains much of this relationship.
authors.affiliation: Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599-7080, USA. edellon@med.unc.edu
authors.forename: Evan S
authors.initials: ES
authors.lastname: Dellon
authors.forename: Quinn K
authors.initials: QK
authors.lastname: Lippmann
authors.forename: Robert S
authors.initials: RS
authors.lastname: Sandler
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Shaheen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000175:diagnosis*; D003113:Colonoscopy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D009720:Nurse Clinicians; D012189:Retrospective Studies; D055815:Young Adult
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