Effectiveness of nurse delivered endoscopy: findings from randomised multi-institution nurse endoscopy trial (MINuET)

Williams, John; Russell, Ian; Durai, Dharmaraj; Cheung, Wai Yee; Farrin, Amanda; Bloor, Karen; Coulton, Simon; Richardson, Gerry

doi:10.1136/bmj.b231

Cited by 52 publications

(34 citation statements)

References 33 publications

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“…In this field, nurse empowerment is crucial. It has already been proven that nurses can be very effective in gastrointestinal endoscopy, nuclear medicine, computed tomography, echography and mammography procedures (10)(11)(12)(13)(14)(15). Because of their clinical training and basic skills and abilities, they represent ideal partners for urologists in a 'one-stop' clinic setting.…”

Section: Discussionmentioning

confidence: 99%

The one-stop clinic as the standard of out-patient care in a hospital urology department

et al. 2011

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Purpose: To evaluate the performance of a 'one-stop' clinic in terms of proportion of discharges or inclusion in surgical waiting lists. Materials and Methods: All patients were referred from primary care facilities (population 220.646) and from different departments in the hospital. Eight senior urologists, two registered nurses and two nurse attendants participated in the experience. Prior to the start of the project, referral protocols had been agreed with the primary care physicians involved. Compliance with the protocols was periodically tested. Eventually 5537 first visits (January-December 2009) where evaluable. Results: Overall, the 'one-stop' format proved feasible in 74.2% of the patients (4108/5537). Patients, who successfully used the 'one-stop' format, were significantly younger than those who required additional consultations (43 vs 50 years old, respectively, Student's t test < 0.001). For obvious reasons the 'one-stop' format was universally possible in male sterilization and penile phimosis patients. Similarly, the 'one-stop' policy was applied in most consultations due to male sexual dysfunction (75%) and urinary tract infection (73%). Other health problems, such as haematuria (62%) and renal colic (46%), required more than one visit so that care of the patient reverted to the traditional, outpatient care model. Conclusion: A 'one-stop' philosophy is feasible for a number of procedures in a urological outpatient clinic. The costs to implement such an approach would be limited to managerial expenditure.

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Section: Discussionmentioning

confidence: 99%

The one-stop clinic as the standard of out-patient care in a hospital urology department

et al. 2011

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“…No differences in patient satisfaction were registered in the area of gastroscopy [15,16]. The studies von Koornstra et al [19], Limoges-Gonzales et al [20] und Hui et al [21] report a particularly high patient satisfaction when nurse staff and physicians are directly compared.…”

Section: Current Scientific Positionmentioning

confidence: 99%

“…DiSario and Sanowski [7], Maule [8] und Schönfeld et al [9] analyzed the examination results obtained by doctors and nurse endoscopists conducting flexible sigmoidoscopy and found no significant differences. In reviews and studies of endoscopies in the upper and lower gastrointestinal tract [10,11,12,13,14,15], examination quality and diagnostic precision were also not significantly different. Equally, in gastroscopy studies by Wildi et al [16] and Smale et al [17] no significant differences were recognized in terms of the actual result or anxiety of the patients (p = 0.67), entering of the endoscope (p = 0.97) or diagnostic quality (p = 0.90).…”

Section: Current Scientific Positionmentioning

confidence: 99%

Non-Physician Endoscopy: How Far Can We Go?

Pfeifer

Schilling

2016

Visc Med

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Background: The delegation of medical tasks to trained nurses is still little discussed in Germany. Methods: To get a picture of the current extent of non-physician endoscopy worldwide, we performed a systematic literature research. The following databases were used: CINAHL®, Cochrane Library, the German National Library of Medicine (ZB MED), OPAC, DIMDI, PubMed and MEDLINE. The research words were: nurse and practitioners or nurse clinician and diagnosis and organization and administration. Actual journals and references were used to find relevant studies (hand research). Results: Non-physician endoscopy has been well established in some European countries, in the USA and in several other countries in the western world. Conclusion: The implementation of such programs should be based on solid scientific consideration and evaluated within the framework of the ‘delegation rights'.

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“…Por otro lado, la HCE única (un único instrumento para todos los estamentos profesionales involucrados en la prestación) constituye un elemento dinamizador de la actividad asistencial; la permanente disponibilidad de todos los registros de los profesionales implicados en la producción asistencial (con el consiguiente control de calidad continuo) permite delegar tareas tradicionalmente reservadas a los especialistas 3 . En este sentido, el personal de enfermería bien entrenado es capaz de producir registros en todo superponibles a los obtenidos por los especialistas [3][4][5][6] .…”

Section: Cambios Organizativosunclassified

“…En este sentido, el personal de enfermería bien entrenado es capaz de producir registros en todo superponibles a los obtenidos por los especialistas [3][4][5][6] . Entre los aspectos que pueden ser delegados con toda garantía figuran la ecografía urológica, algunos aspectos de la endoscopia urológica terapéutica (retirada de catéteres ureterales), los estudios de diná-mica miccional, la gestión de la patología quirúrgica menor y el seguimiento de patologías de curso previsible (revisión de seminogramas posvasectomía, entre otros) 7,8 .…”

Section: Cambios Organizativosunclassified