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Upper gastrointestinal endoscopy performed by nurses: scope for the future?

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Experienced nurses perform upper gastrointestinal endoscopy as safely and effectively as medical doctors, with comparable patient comfort and satisfaction. This study confirms nurses

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Area of Science:

  • Gastroenterology
  • Endoscopy
  • Healthcare Professionals

Background:

  • Previous research indicated non-medical endoscopists' proficiency in lower gastrointestinal endoscopy.
  • The efficacy and patient experience of upper gastrointestinal endoscopy by non-medical versus medical endoscopists remained unexamined.

Purpose of the Study:

  • To compare diagnostic yield for significant diseases during upper gastrointestinal endoscopy performed by nurse and medical endoscopists.
  • To evaluate patient discomfort, satisfaction, and attitudes towards future endoscopy based on endoscopist type.

Main Methods:

  • A two-part study involving 3009 patients in a retrospective analysis and 480 in a prospective analysis.
  • Retrospective assessment of indications, diagnoses, and procedures by medical and nurse endoscopists.
  • Prospective evaluation of sedation, anxiety, discomfort, and satisfaction in relation to endoscopist type.

Main Results:

  • No significant differences in patient refusal or complications between nurse and medical endoscopists.
  • Nurse endoscopists reported fewer normal findings (p=0.006).
  • Endoscopist type did not influence the association between patient factors (sex, age, inpatient status, dysphagia, GI bleeding) and significant disease detection. No differences in patient anxiety, discomfort, or satisfaction were observed between groups.

Conclusions:

  • Experienced nurses can safely perform routine diagnostic gastroscopy in clinical practice.
  • Nurse-led gastroscopy offers comparable patient comfort and satisfaction to that performed by medical staff.