Experience of nurse practitioners performing colonoscopy after endoscopic training in more than 1,000 patients.
Identifieur interne : 000211 ( Main/Exploration ); précédent : 000210; suivant : 000212Experience of nurse practitioners performing colonoscopy after endoscopic training in more than 1,000 patients.
Auteurs : Monica Riegert [États-Unis] ; Monica Nandwani [États-Unis] ; Bonny Thul [États-Unis] ; Angela Chang Chiu [États-Unis] ; Simon C. Mathews [États-Unis] ; Mouen A. Khashab [États-Unis] ; Anthony Nicholas Kalloo [États-Unis]Source :
- Endoscopy international open [ 2364-3722 ] ; 2020.
Abstract
Background and study aims The demand for screening colonoscopy has continued to rise over the past two decades. As a result, the current workforce of gastroenterologists is unable to meet the needs for colorectal cancer (CRC) screening. Therefore, solutions are needed to improve this disparity, with non-physician endoscopists being a potential option. However, current literature on the performance of non-physicians in endoscopy is limited. The aim of this study was to assess the quality of colonoscopy performed by three gastrointestinal fellowship-trained nurse practitioners (NPs). Methods This was a retrospective study performed at a single tertiary academic medical center. Colonoscopies performed by three gastrointestinal-specialized NPs after having completed training of at least 140 supervised colonoscopies were reviewed for analysis. Inclusion criteria were patients undergoing colonoscopy for colorectal cancer screening purposes. Outcomes included colonoscopy quality indicators as defined by the American Society for Gastrointestinal Endoscopy/American College of Gastroenterology Taskforce (ASGE/ACG) Taskforce. Results The study included 1,012 subjects (mean age 56.2 years, female 51.5 %, African American 73.9 %) who underwent screening colonoscopies by three NPs. Cecal intubation was successful in 997 subjects (98.5 %). Mean adenoma detection rate was 35.6 %. Mean withdrawal time was 18.9 minutes. There were no adverse events including colonic perforations or delayed post-polypectomy bleeding. Conclusions Three fellowship-trained NPs in colonoscopy in the United States satisfied the quality indicators proposed by the ASGE/ACG Task force, demonstrating that adequately trained NPs can perform colonoscopy safely and effectively. With the demand for colonoscopy exceeding the supply, non-physicians could be part of the solution to meet the demands for CRC screening.
DOI: 10.1055/a-1221-4546
PubMed: 33015346
PubMed Central: PMC7508647
Affiliations:
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Mathews</name><affiliation wicri:level="2"><nlm:affiliation>Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, Baltimore, Maryland, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, Baltimore, Maryland</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Khashab, Mouen A" sort="Khashab, Mouen A" uniqKey="Khashab M" first="Mouen A" last="Khashab">Mouen A. Khashab</name><affiliation wicri:level="2"><nlm:affiliation>The Johns Hopkins Hospital, Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>The Johns Hopkins Hospital, Division of Gastroenterology and Hepatology, Baltimore, Maryland</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Kalloo, Anthony Nicholas" sort="Kalloo, Anthony Nicholas" uniqKey="Kalloo A" first="Anthony Nicholas" last="Kalloo">Anthony Nicholas Kalloo</name><affiliation wicri:level="2"><nlm:affiliation>The Johns Hopkins Hospital, Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>The Johns Hopkins Hospital, Division of Gastroenterology and Hepatology, Baltimore, Maryland</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author></analytic><series><title level="j">Endoscopy international open</title><idno type="ISSN">2364-3722</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><b>Background and study aims</b> The demand for screening colonoscopy has continued to rise over the past two decades. As a result, the current workforce of gastroenterologists is unable to meet the needs for colorectal cancer (CRC) screening. Therefore, solutions are needed to improve this disparity, with non-physician endoscopists being a potential option. However, current literature on the performance of non-physicians in endoscopy is limited. The aim of this study was to assess the quality of colonoscopy performed by three gastrointestinal fellowship-trained nurse practitioners (NPs). <b>Methods</b> This was a retrospective study performed at a single tertiary academic medical center. Colonoscopies performed by three gastrointestinal-specialized NPs after having completed training of at least 140 supervised colonoscopies were reviewed for analysis. Inclusion criteria were patients undergoing colonoscopy for colorectal cancer screening purposes. Outcomes included colonoscopy quality indicators as defined by the American Society for Gastrointestinal Endoscopy/American College of Gastroenterology Taskforce (ASGE/ACG) Taskforce. <b>Results</b> The study included 1,012 subjects (mean age 56.2 years, female 51.5 %, African American 73.9 %) who underwent screening colonoscopies by three NPs. Cecal intubation was successful in 997 subjects (98.5 %). Mean adenoma detection rate was 35.6 %. Mean withdrawal time was 18.9 minutes. There were no adverse events including colonic perforations or delayed post-polypectomy bleeding. <b>Conclusions</b> Three fellowship-trained NPs in colonoscopy in the United States satisfied the quality indicators proposed by the ASGE/ACG Task force, demonstrating that adequately trained NPs can perform colonoscopy safely and effectively. With the demand for colonoscopy exceeding the supply, non-physicians could be part of the solution to meet the demands for CRC screening.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">33015346</PMID><DateRevised><Year>2020</Year><Month>10</Month><Day>06</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">2364-3722</ISSN><JournalIssue CitedMedium="Print"><Volume>8</Volume><Issue>10</Issue><PubDate><Year>2020</Year><Month>Oct</Month></PubDate></JournalIssue><Title>Endoscopy international open</Title><ISOAbbreviation>Endosc Int Open</ISOAbbreviation></Journal><ArticleTitle>Experience of nurse practitioners performing colonoscopy after endoscopic training in more than 1,000 patients.</ArticleTitle><Pagination><MedlinePgn>E1423-E1428</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1055/a-1221-4546</ELocationID><Abstract><AbstractText><b>Background and study aims</b> The demand for screening colonoscopy has continued to rise over the past two decades. As a result, the current workforce of gastroenterologists is unable to meet the needs for colorectal cancer (CRC) screening. Therefore, solutions are needed to improve this disparity, with non-physician endoscopists being a potential option. However, current literature on the performance of non-physicians in endoscopy is limited. The aim of this study was to assess the quality of colonoscopy performed by three gastrointestinal fellowship-trained nurse practitioners (NPs). <b>Methods</b> This was a retrospective study performed at a single tertiary academic medical center. Colonoscopies performed by three gastrointestinal-specialized NPs after having completed training of at least 140 supervised colonoscopies were reviewed for analysis. Inclusion criteria were patients undergoing colonoscopy for colorectal cancer screening purposes. Outcomes included colonoscopy quality indicators as defined by the American Society for Gastrointestinal Endoscopy/American College of Gastroenterology Taskforce (ASGE/ACG) Taskforce. <b>Results</b> The study included 1,012 subjects (mean age 56.2 years, female 51.5 %, African American 73.9 %) who underwent screening colonoscopies by three NPs. Cecal intubation was successful in 997 subjects (98.5 %). Mean adenoma detection rate was 35.6 %. Mean withdrawal time was 18.9 minutes. There were no adverse events including colonic perforations or delayed post-polypectomy bleeding. <b>Conclusions</b> Three fellowship-trained NPs in colonoscopy in the United States satisfied the quality indicators proposed by the ASGE/ACG Task force, demonstrating that adequately trained NPs can perform colonoscopy safely and effectively. With the demand for colonoscopy exceeding the supply, non-physicians could be part of the solution to meet the demands for CRC screening.</AbstractText><CopyrightInformation>The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Riegert</LastName><ForeName>Monica</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>The Johns Hopkins Hospital, Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nandwani</LastName><ForeName>Monica</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Stanford Health Care, Center for Advanced Practice, Division of Gastroenterology and Hepatology, Stanford, California, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Thul</LastName><ForeName>Bonny</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Winona Health, Winina, Minnesota, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chiu</LastName><ForeName>Angela Chang</ForeName><Initials>AC</Initials><AffiliationInfo><Affiliation>The Johns Hopkins Hospital, Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mathews</LastName><ForeName>Simon C</ForeName><Initials>SC</Initials><AffiliationInfo><Affiliation>Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, Baltimore, Maryland, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Khashab</LastName><ForeName>Mouen A</ForeName><Initials>MA</Initials><AffiliationInfo><Affiliation>The Johns Hopkins Hospital, Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kalloo</LastName><ForeName>Anthony Nicholas</ForeName><Initials>AN</Initials><AffiliationInfo><Affiliation>The Johns Hopkins Hospital, Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>09</Month><Day>22</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Endosc Int Open</MedlineTA><NlmUniqueID>101639919</NlmUniqueID><ISSNLinking>2196-9736</ISSNLinking></MedlineJournalInfo><CoiStatement>Competing interests Ms. Nandwani was on the Salix Pharmaceuticals Speakers Bureau.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>02</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>06</Month><Day>24</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>10</Month><Day>5</Day><Hour>6</Hour><Minute>22</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>10</Month><Day>6</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>10</Month><Day>6</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33015346</ArticleId><ArticleId IdType="doi">10.1055/a-1221-4546</ArticleId><ArticleId IdType="pmc">PMC7508647</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Gastrointest Endosc. 2009 Apr;69(4):767-70</Citation><ArticleIdList><ArticleId IdType="pubmed">19327469</ArticleId></ArticleIdList></Reference><Reference><Citation>Am J Gastroenterol. 2006 Apr;101(4):873-85</Citation><ArticleIdList><ArticleId IdType="pubmed">16635231</ArticleId></ArticleIdList></Reference><Reference><Citation>Ann Intern Med. 2018 Apr 3;168(7):481-488</Citation><ArticleIdList><ArticleId 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IdType="pubmed">22356322</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>Californie</li><li>Maryland</li><li>Minnesota</li></region></list><tree><country name="États-Unis"><region name="Maryland"><name sortKey="Riegert, Monica" sort="Riegert, Monica" uniqKey="Riegert M" first="Monica" last="Riegert">Monica Riegert</name></region><name sortKey="Chiu, Angela Chang" sort="Chiu, Angela Chang" uniqKey="Chiu A" first="Angela Chang" last="Chiu">Angela Chang Chiu</name><name sortKey="Kalloo, Anthony Nicholas" sort="Kalloo, Anthony Nicholas" uniqKey="Kalloo A" first="Anthony Nicholas" last="Kalloo">Anthony Nicholas Kalloo</name><name sortKey="Khashab, Mouen A" sort="Khashab, Mouen A" uniqKey="Khashab M" first="Mouen A" last="Khashab">Mouen A. Khashab</name><name sortKey="Mathews, Simon C" sort="Mathews, Simon C" uniqKey="Mathews S" first="Simon C" last="Mathews">Simon C. Mathews</name><name sortKey="Nandwani, Monica" sort="Nandwani, Monica" uniqKey="Nandwani M" first="Monica" last="Nandwani">Monica Nandwani</name><name sortKey="Thul, Bonny" sort="Thul, Bonny" uniqKey="Thul B" first="Bonny" last="Thul">Bonny Thul</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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