BACKGROUND: The effect of the GI endoscopy nurse experience on colonoscopy outcomes is unknown. OBJECTIVE: To determine whether the nurse experience was associated with screening colonoscopy complications, procedure length, and cecal intubation. DESIGN: A retrospective analysis of screening colonoscopies performed by attending physicians between August 2003 and August 2005. Nurse experience was measured in weeks. SETTING: University of North Carolina Hospitals. SUBJECTS: Twenty-nine nurses were employed during the study period, 19 of whom were newly hired. A total of 3631 eligible screening colonoscopies were analyzed. MAIN OUTCOME MEASUREMENTS: The primary outcome was any immediate complication; secondary outcomes included time to cecum, total procedure time, and cecal intubation rate. RESULTS: In procedures staffed by nurses with 2 weeks of experience or less, 3.2% had complications compared with 0.3% for procedures with more experienced nurses (odds ratio [OR] 10.4 [95% CI, 3.55-30.2]). For nurses with 6 months or less of experience, 18% of procedures had cecal-intubation times more than 1 standard deviation above the mean compared with 12% for more experienced nurses (OR 1.60 [95% CI, 1.30-1.97]). Similar results were seen for the total procedure duration (OR 1.61 [95% CI, 1.32-1.97]) and cecal-intubation rates (OR 1.81 [95% CI, 1.37-2.39]). All relationships held after adjusting for potential confounding factors. LIMITATIONS: A retrospective, single-center study. CONCLUSIONS: GI endoscopy nurse inexperience is associated with an increase in immediate complications, prolonged procedure times, and decreased cecal-intubation rates for screening colonoscopies. These findings have implications for nurse training, procedure efficiency, colonoscopy quality assessment, and patient safety.
BACKGROUND: The effect of the GI endoscopy nurse experience on colonoscopy outcomes is unknown. OBJECTIVE: To determine whether the nurse experience was associated with screening colonoscopy complications, procedure length, and cecal intubation. DESIGN: A retrospective analysis of screening colonoscopies performed by attending physicians between August 2003 and August 2005. Nurse experience was measured in weeks. SETTING: University of North Carolina Hospitals. SUBJECTS: Twenty-nine nurses were employed during the study period, 19 of whom were newly hired. A total of 3631 eligible screening colonoscopies were analyzed. MAIN OUTCOME MEASUREMENTS: The primary outcome was any immediate complication; secondary outcomes included time to cecum, total procedure time, and cecal intubation rate. RESULTS: In procedures staffed by nurses with 2 weeks of experience or less, 3.2% had complications compared with 0.3% for procedures with more experienced nurses (odds ratio [OR] 10.4 [95% CI, 3.55-30.2]). For nurses with 6 months or less of experience, 18% of procedures had cecal-intubation times more than 1 standard deviation above the mean compared with 12% for more experienced nurses (OR 1.60 [95% CI, 1.30-1.97]). Similar results were seen for the total procedure duration (OR 1.61 [95% CI, 1.32-1.97]) and cecal-intubation rates (OR 1.81 [95% CI, 1.37-2.39]). All relationships held after adjusting for potential confounding factors. LIMITATIONS: A retrospective, single-center study. CONCLUSIONS: GI endoscopy nurse inexperience is associated with an increase in immediate complications, prolonged procedure times, and decreased cecal-intubation rates for screening colonoscopies. These findings have implications for nurse training, procedure efficiency, colonoscopy quality assessment, and patient safety.
Authors: Douglas K Rex; John H Bond; Sidney Winawer; Theodore R Levin; Randall W Burt; David A Johnson; Lynne M Kirk; Scott Litlin; David A Lieberman; Jerome D Waye; James Church; John B Marshall; Robert H Riddell Journal: Am J Gastroenterol Date: 2002-06 Impact factor: 10.864
Authors: Douglas B Nelson; Kenneth R McQuaid; John H Bond; David A Lieberman; David G Weiss; Tiina K Johnston Journal: Gastrointest Endosc Date: 2002-03 Impact factor: 9.427
Authors: J C Anderson; C R Messina; W Cohn; E Gottfried; S Ingber; G Bernstein; E Coman; J Polito Journal: Gastrointest Endosc Date: 2001-11 Impact factor: 9.427
Authors: Sidney Winawer; Robert Fletcher; Douglas Rex; John Bond; Randall Burt; Joseph Ferrucci; Theodore Ganiats; Theodore Levin; Steven Woolf; David Johnson; Lynne Kirk; Scott Litin; Clifford Simmang Journal: Gastroenterology Date: 2003-02 Impact factor: 22.682
Authors: Edmund J Bini; Babak Firoozi; Rosa J Choung; Eyad M Ali; Mohamed Osman; Elizabeth H Weinshel Journal: Gastrointest Endosc Date: 2003-01 Impact factor: 9.427