Previous studies have shown that non-medical endoscopists are able to perform lower gastrointestinal endoscopy safely and effectively.
However, whether upper gastrointestinal endoscopy performed by medical and non-medical endoscopists yield similar results is not clear.
In this study, investigators from London, England, assessed the differences in the yield of diagnosis for significant disease during upper GI endoscopy performed by nurse and medical endoscopists. They also measured patient discomfort, satisfaction, and attitudes towards future endoscopy.
The team included 3009 patients in a retrospective analysis, as well as 480 in a prospective study.
|Discomfort and satisfaction were similar in both groups.|
In the first part of the study, the team assessed indications for endoscopy, diagnoses, and procedures performed by medical and nurse endoscopists.
In the second part, they determined the association between endoscopist type and sedation, patient anxiety, discomfort, satisfaction, and attitudes towards future sedation.
The researchers found that there were no patients who refused endoscopy, by either a nurse or medical endoscopist. In addition, there were no complications observed in either group.
Overall, nurses performed 1487 procedures. They reported fewer endoscopies as "normal", than the medical staff.
Using multivariate analysis, the team found that male sex, older age, inpatient status, dysphagia, and gastrointestinal bleeding were associated with significant disease.
The investigators determined that discomfort and satisfaction were similar in both groups.
They were unable to identify any differences in pre-procedure anxiety, discomfort during intubation or examination, or post-procedure examination rating between the groups.
Dr Smale's team concluded, "Experienced nurses perform routine diagnostic gastroscopy safely in everyday clinical practice and with as little discomfort and as much patient satisfaction as medical staff".