Related Experiment Video
Updated: Oct 23, 2025
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Pediatric Endoscopy Quality Improvement Network Quality Standards and Indicators for Pediatric Endoscopic Procedures:
Jenifer R Lightdale1, Catharine M Walsh2, Salvatore Oliva3
1Department of Pediatrics, Division of Gastroenterology and Nutrition, UMass Memorial Children's Medical Center, University of Massachusetts Medical School, Worcester, MA, United States.
Insights
Pediatric Endoscopy Quality Improvement Network (PEnQuIN) developed 14 quality standards and 30 indicators for pediatric endoscopy. These guidelines aim to improve the safety and effectiveness of gastrointestinal procedures for children worldwide.
Area of Science:
- Pediatric Gastroenterology
- Medical Quality Improvement
- Endoscopic Procedures
Background:
- Pediatric endoscopy requires specific quality standards distinct from adult procedures.
- Existing adult endoscopy guidelines are unsuitable for pediatric care.
- High-quality pediatric GI procedures ensure patient safety and optimal outcomes.
Purpose of the Study:
- To develop and validate quality standards and indicators for pediatric endoscopic procedures.
- To establish a framework for assessing and improving the quality of pediatric endoscopy.
- To create guidelines applicable globally for pediatric gastroenterology practices.
Main Methods:
- An international working group, the Pediatric Endoscopy Quality Improvement Network (PEnQuIN), was formed.
- The Appraisal of Guidelines for REsearch and Evaluation (AGREE) II methodology was employed.
- Consensus was achieved through an online Delphi process and an in-person conference, using the GRADE approach for evidence and recommendations.
Main Results:
- Consensus was reached on 14 standards and 30 indicators for pediatric endoscopic procedures.
- These were categorized into Preprocedural (3 standards, 7 indicators), Intraprocedural (8 standards, 18 indicators), and Postprocedural (3 standards, 5 indicators) subdomains.
- A minimum target of ≥80% for adequate bowel preparation was established as a key indicator.
Conclusions:
- Facilities and providers performing pediatric endoscopy should adopt the PEnQuIN standards and indicators.
- Implementation of these guidelines will help identify quality gaps and drive improvements in pediatric GI procedures.
- These standards provide a global benchmark for high-quality pediatric endoscopy.
Introduction:
High-quality pediatric gastrointestinal procedures are performed when clinically indicated and defined by their successful performance by skilled providers in a safe, comfortable, child-oriented, and expeditious manner. The process of pediatric endoscopy begins when a plan to perform the procedure is first made and ends when all appropriate patient follow-up has occurred. Procedure-related standards and indicators developed to date for endoscopy in adults emphasize cancer screening and are thus unsuitable for pediatric medicine.
Methods:
With support from the North American and European Societies of Pediatric Gastroenterology Hepatology and Nutrition (NASPGHAN and ESPGHAN), an international working group of the Pediatric Endoscopy Quality Improvement Network (PEnQuIN) used the methodological strategy of the Appraisal of Guidelines for REsearch and Evaluation (AGREE) II instrument to develop standards and indicators relevant for assessing the quality of endoscopic procedures. Consensus was sought via an iterative online Delphi process and finalized at an in-person conference. The quality of evidence and strength of recommendations were rated according to the GRADE (Grading of Recommendation Assessment, Development, and Evaluation) approach.
Results:
The PEnQuIN working group achieved consensus on 14 standards for pediatric endoscopic procedures, as well as 30 indicators that can be used to identify high-quality procedures. These were subcategorized into three subdomains: Preprocedural (3 standards, 7 indicators), Intraprocedural (8 standards, 18 indicators), and Postprocedural (3 standards, 5 indicators). A minimum target for the key indicator, "rate of adequate bowel preparation," was set at ≥80%.
Discussion:
It is recommended that all facilities and individual providers performing pediatric endoscopy worldwide initiate and engage with the procedure-related standards and indicators developed by PEnQuIN to identify gaps in quality and drive improvement.
More Related Videos
06:15Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
15:18Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure
Published on: July 30, 2009
Related Concept Videos
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to:
01:26Endoscopic Procedures V: ERCP
Patient...
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:25Endoscopic Procedures II: Colonoscopy
01:28Endoscopic Procedures III: Video Capsule Endoscopy
01:30Endoscopic Studies I: Bronchoscopy and Thoracoscopy
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...