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Related Experiment Videos

Nurse-led direct access endoscopy clinics: the future?

P S Basnyat1, K F Gomez, J West

  • 1Department of Surgery, Royal Glamorgan Hospital, Llantrisant CF72 8XR, Wales, United Kingdom.

Surgical Endoscopy
|April 19, 2002
PubMed
Summary

A nurse-led direct-access flexible sigmoidoscopy service is safe and effective for investigating rectal bleeding. This approach is more cost-effective than traditional consultant-led services and highly satisfactory for patients.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Health Services Research

Background:

  • Rectal bleeding often indicates colorectal pathology, with lesions typically located in the left colon.
  • The rise of nurse practitioners supports the development of nurse-led endoscopy services.
  • Evaluating nurse-led direct-access endoscopy is crucial for efficacy and cost-effectiveness.

Purpose of the Study:

  • To audit a unique nurse-led direct-access flexible sigmoidoscopy (OAFS) service.
  • To assess the service's efficacy, cost-effectiveness, and patient satisfaction.
  • To monitor direct referrals from primary health sector.

Main Methods:

  • Established a nurse-led OAFS service for fresh rectal bleeding in February 1996.
  • Conducted a prospective audit of sigmoidoscopic findings.

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  • Performed retrospective analysis of referral patterns and satisfaction surveys for patients and general practitioners.

    • Main Results:

    • 706 patients referred, with rectal bleeding in 92%.
    • A cause for bleeding identified in 91% of patients; 24% had significant pathology.
    • 99% patient satisfaction; service cost $90 less per patient than consultant referrals.

    Conclusions:

    • Rectal bleeding is a key indicator of colorectal disease, often localized to the left colon.
    • Nurse-led OAFS is a safe, effective, and patient-acceptable method for investigating rectal bleeding.
    • Nurse-led OAFS offers superior cost-effectiveness compared to consultant-led services.