title: Nurse endoscopists perform colonoscopies according to the international standard and with high patient satisfaction.
abstract: OBJECTIVE
  Colonoscopy is increasingly performed by nurse endoscopists. We aimed to assess the endoscopic quality and patient experience of these procedures.
  
  
  METHODS
  This prospective multicenter study analyzed 100 consecutive colonoscopies each for 10 trained nurse endoscopists with respect to endoscopic quality and patient experience. Colonoscopies were performed under the supervision of a gastroenterologist, using the techniques and protocols of the participating hospitals. Patient experience was assessed using a questionnaire.
  
  
  RESULTS
  Most nurse endoscopists were female (90 %; median age 43 [range 35 - 49]). Before the start of the study, they had performed a median of 528 colonoscopies (range 208 - 2103). For the 1000 patients, mean age was 56 ± 15 years; 55 % were women; and 96 % were in class I or II according to the American Society of Anesthesiologists' physical status classification system. Colonoscopies were performed for screening or surveillance in 42 %; for symptomatic indications in 58 % of patients. The unassisted cecal intubation rate was 94 %; the mean withdrawal time was 10 ± 5 minutes. The adenoma detection rate was 26.7 %. In 229 of the colonoscopies (23 %), the nurse endoscopists required assistance from the supervising gastroenterologist. The complication rate was 0.2 %: one perforation and one cardiopulmonary complication. The questionnaire was completed by 734 /1000 patients (73 %) and of these 694 /734 (95 %) were satisfied with the endoscopic procedure. Among the respondents 530 /734 (72 %) had no specific preference for a physician or nurse endoscopist, whereas 113 /734 (15 %) preferred a physician endoscopist, and 91 /734 (12 %) preferred a nurse endoscopist.
  
  
  CONCLUSIONS
  The nurse endoscopists performed colonoscopies according to the internationally recognized quality standards and with high patient satisfaction.
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. p.g.vanputten@erasmusmc.nl
authors.forename: P G
authors.initials: PG
authors.lastname: van Putten
authors.forename: F
authors.initials: F
authors.lastname: Ter Borg
authors.forename: R P R
authors.initials: RP
authors.lastname: Adang
authors.forename: J J
authors.initials: JJ
authors.lastname: Koornstra
authors.forename: M J L
authors.initials: MJ
authors.lastname: Romberg-Camps
authors.forename: R
authors.initials: R
authors.lastname: Timmer
authors.forename: A C
authors.initials: AC
authors.lastname: Poen
authors.forename: E J
authors.initials: EJ
authors.lastname: Kuipers
authors.forename: M E
authors.initials: ME
authors.lastname: Van Leerdam
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003111:Colonic Polyps / Q000175:diagnosis / Q000601:surgery; D003113:Colonoscopy / Q000193:education / Q000451:nursing*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000451:nursing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009723:Nurse-Patient Relations; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011446:Prospective Studies; D011786:Quality Control; D013041:Specialties, Nursing; D011795:Surveys and Questionnaires