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. 1998 Nov;43(5):711–714. doi: 10.1136/gut.43.5.711

A UK training programme for nurse practitioner flexible sigmoidoscopy and a prospective evaluation of the practice of the first UK trained nurse flexible sigmoidoscopist

G Duthie 1, P Drew 1, M Hughes 1, R Farouk 1, R Hodson 1, K Wedgwood 1, J Monson 1
PMCID: PMC1727331  PMID: 9824356

Abstract

Background—Flexible sigmoidoscopy is a technical skill that has been successfully performed by suitably trained colorectal nurse practitioners in the USA. However, no recognised training course exists for nurse practitioners in the UK. 
Aims—To design and evaluate a training programme for nurse endoscopists. 
Methods—A multidisciplinary committee of nurses and clinicians developed a structured programme of study and practice. This involved a staged process of observations, withdrawals, and ultimately, full procedures. Once training had been completed the nurse practitioner was permitted to practice independently. Patients with colorectal symptoms referred for flexible sigmoidoscopy were examined for the final stages of training and independent practice. A prospective evaluation of the training and practice of the first trained nurse flexible sigmoidoscopist was performed. Barium enema, video, clinical follow up, and histology were used to validate the results of the flexible sigmoidoscopies. 
Results—The training programme required that 35 observations, 35 withdrawals, and 35 supervised full procedures were performed prior to the development of independent practice. Subsequent to the completion of this programme 215 patients have been examined independently by the nurse practitioner. Ninety three per cent of the examinations were judged successful and pathology was identified in 51%. The nurse endoscopist successfully identified all "significant" pathology whereas barium enema failed to identify pathology in 12.5%. There were no complications. 
Conclusion—With suitable training nurse endosocopists are able to perform flexible sigmoidoscopy safely and effectively. 



Keywords: nurse endoscopists; flexible sigmoidoscopy

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Figure 1 .

Figure 1

Validation of nurse flexible sigmoidoscopy results.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Atkin W. S., Cuzick J., Northover J. M., Whynes D. K. Prevention of colorectal cancer by once-only sigmoidoscopy. Lancet. 1993 Mar 20;341(8847):736–740. doi: 10.1016/0140-6736(93)90499-7. [DOI] [PubMed] [Google Scholar]
  2. Austoker J. Screening for colorectal cancer. BMJ. 1994 Aug 6;309(6951):382–386. doi: 10.1136/bmj.309.6951.382. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Brewster N. T., Grieve D. C., Saunders J. H. Double-contrast barium enema and flexible sigmoidoscopy for routine colonic investigation. Br J Surg. 1994 Mar;81(3):445–447. doi: 10.1002/bjs.1800810341. [DOI] [PubMed] [Google Scholar]
  4. Cass O. W., Freeman M. L., Peine C. J., Zera R. T., Onstad G. R. Objective evaluation of endoscopy skills during training. Ann Intern Med. 1993 Jan 1;118(1):40–44. doi: 10.7326/0003-4819-118-1-199301010-00008. [DOI] [PubMed] [Google Scholar]
  5. Denner S. Extending professional practice: benefits and pitfalls. Nurs Times. 1995 Apr 5;91(14):27–29. [PubMed] [Google Scholar]
  6. Hawes R., Lehman G. A., Hast J., O'Connor K. W., Crabb D. W., Lui A., Christiansen P. A. Training resident physicians in fiberoptic sigmoidoscopy. How many supervised examinations are required to achieve competence? Am J Med. 1986 Mar;80(3):465–470. doi: 10.1016/0002-9343(86)90721-7. [DOI] [PubMed] [Google Scholar]
  7. Hughes M. Key issues in the introduction of nurse endoscopy. Nurs Times. 1996 Feb 21;92(8):38–39. [PubMed] [Google Scholar]
  8. Maule W. F. Screening for colorectal cancer by nurse endoscopists. N Engl J Med. 1994 Jan 20;330(3):183–187. doi: 10.1056/NEJM199401203300307. [DOI] [PubMed] [Google Scholar]
  9. Rosevelt J., Frankl H. Colorectal cancer screening by nurse practitioner using 60-cm flexible fiberoptic sigmoidoscope. Dig Dis Sci. 1984 Feb;29(2):161–163. doi: 10.1007/BF01317059. [DOI] [PubMed] [Google Scholar]
  10. Schroy P. C., Wiggins T., Winawer S. J., Diaz B., Lightdale C. J. Video endoscopy by nurse practitioners: a model for colorectal cancer screening. Gastrointest Endosc. 1988 Sep-Oct;34(5):390–394. doi: 10.1016/s0016-5107(88)71402-9. [DOI] [PubMed] [Google Scholar]

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