Patient comfort and quality in colonoscopy

Ekkelenkamp, Vivian E.; Dowler, K; Valori, Roland; Dunckley, Paul

doi:10.3748/wjg.v19.i15.2355

Cited by 64 publications

(47 citation statements)

References 31 publications

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“…Comfort levels are affected by many factors including technique and some evidence suggests that endoscopists performing better on other KPI also provide a more comfortable patient experience with less sedation 190. A national audit10 demonstrated that moderate or severe discomfort was experienced by approximately 10% of 20 000 cases recorded.…”

Section: The Standardsmentioning

confidence: 99%

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Expert opinions and scientific evidence for colonoscopy key performance indicators

Rees

Bevan

Zimmermann-Fraedrich

et al. 2016

Gut

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Colonoscopy is a widely performed procedure with procedural volumes increasing annually throughout the world. Many procedures are now performed as part of colorectal cancer screening programmes. Colonoscopy should be of high quality and measures of this quality should be evidence based. New UK key performance indicators and quality assurance standards have been developed by a working group with consensus agreement on each standard reached. This paper reviews the scientific basis for each of the quality measures published in the UK standards.

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Section: The Standardsmentioning

confidence: 99%

“…Several systems for scoring patient comfort exist, such as the Gloucester nurse-reported 5-point scale,190 which combines features of pain, frequency of pain and distress. Patient-reported comfort scores use either 4-point Likert scales or 100 mm visual analogue scales in lightly or unsedated patients 191.…”

Section: The Standardsmentioning

confidence: 99%

Expert opinions and scientific evidence for colonoscopy key performance indicators

Rees

Bevan

Zimmermann-Fraedrich

et al. 2016

Gut

View full text Add to dashboard Cite

show abstract

“…[10] Comfort during colonoscopy was reported by the nurse-assessed modified GCS. [23] Achieving an adequate PICI was defined as a procedure with cecal intubation, delivery of a maximum dose of 2.5 mg midazolam and Gloucester Comfort Scale (GCS) between 1 and 3 (no to mild discomfort) . We adjusted the maximum dose of 2 mg midazolam (used by Valori et al) [8] to 2.5 mg for practical reasons.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Impact of sedation on the Performance Indicator of Colonic Intubation

et al. 2020

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Background: Performance Indicator of Colonic Intubation (PICI) has been introduced as new measure of high-quality colonic intubation. Adequate PICI was defined as cecal intubation without significant discomfort and use of minimal sedation. In a UK national audit, adequate PICI was achieved in 54.1% of colonoscopies and associated with higher polyp detection rates. In this study, achievement of PICI was assessed within the Dutch colorectal cancer (CRC) screening program and the association between PICI and the adenoma detection rate (ADR) was determined. Furthermore, we assessed the achievement of the performance indicator using the Dutch median midazolam dose. Methods: This retrospective study was conducted within the Dutch FIT-based CRC screening program. Colonoscopy and pathology data were prospectively collected in a national database. Data between 01-01-2016 and 01-01-2018 were analyzed. Adequate PICI was defined as successful cecal intubation, Gloucester Comfort Scale (GCS) between 1 - 3 and use of ≤ 2.5 mg midazolam. Results: During the study period, 107.328 colonoscopies were performed. Adequate PICI was achieved in 49.500 (46.1%) colonoscopies. In the colonoscopies with inadequate PICI, this was due to higher sedation dosages in 87.8%. Adequate PICI was associated with higher ADR (OR: 1.16; 95%CI: 1.12-1.20). When using a cut-off of 5 mg midazolam, median dose in this Dutch population, adequate PICI was achieved in 95.410 colonoscopies (88.9%). Conclusion: PICI appears to be an indicator that is heavily dependent on sedation practice. Because of wide variation in sedation practice between individual endoscopists and countries, the benefit of PICI as quality indicator is limited.

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“…Education and training are key for quality and patient safety. Serious issues regarding gastrointestinal endoscopy quality have been demonstrated in several studies, mainly related to missed lesions, adverse events (AEs), and poor patient experiences [1,2]. To improve the quality of endoscopy procedures, the European Society of Gastrointestinal Endoscopy (ESGE) has during the last decade developed recommendations for quality targets and quality performance indicators (KPI) [3].…”

mentioning

confidence: 99%