Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 23 February 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

National Confidential Enquiry into Patient Outcome and Death calls for further national guidelines on endoscopy procedures

In its first major report involving patients under the care of both physicians and surgeons, the National Confidential Enquiry into Patient Outcome and Death has made a critical appraisal of gastrointestinal (GI) therapeutic endoscopy procedures in Britain.

News image

fiogf49gjkf04

NCEPOD have issued strong recommendations, including calls for further national guidelines, to improve the management, optimization, treatment and sedation of what are often seriously ill, elderly patients.

The report, 'Scoping our practice'carried out in Britain examines in detail 1,818 inpatient deaths within 30 days of the procedure.

This sample of patients represented just under 50% of all deaths in this category and these are only a small proportion (3%) of the total endoscopies performed during a year in England, Wales and Northern Ireland (136,000 in 2002/2003).

NCEPOD found that the procedure performed in 14% of cases was inappropriate and of these more than half were deemed 'futile'.

In 14% of cases, patients were judged to have received an overdose of sedation, and monitoring of the patient in 23% of cases was judged to be deficient.

NCEPOD also found that 62% of hospitals do not operate a dedicated out of hours rota for emergency cases.

In 19% of people who died, NCEPOD advisors considered the procedure futile
NCEPOD

Only 47% had ECG monitoring in every room, and 37% had no ECG monitors in the endoscopy unit at all.

NCEPOD recommended that hospitals should ensure that appropriate monitoring and resuscitation equipment is available in each of their endoscopy rooms and recovery areas.

In addition, hospitals should consider establishing formal on-call arrangements.

NCEPOD advisers expressed disquiet over the extent and quality of information that some patients may have received before entering the endoscopy room.

The investigators found that 2/3 patients who had dementia or acute confusion provided written consent.

NCEPOD recommended that the risks and benefits of therapeutic endoscopy be explained to the patient.

Consultants performed 3/4 of procedures in this study. However, some only performed a few procedures per year, often less than 20.

Dr Anthony Gray, lead clinical coordinator for NCEPOD said, "There are detailed guidelines on the numbers of procedures required to establish initial competence, but nothing on how many endoscopies doctors need to perform each year to maintain competence".

NCEPODwebsite, online publication
22 October 2004

Go to top of page Email this page Email this page to a colleague

 23 February 2018 
MRI and NAFLD
 23 February 2018 
Heavy metals on a gluten-free diet
 23 February 2018 
Patients on antithrombotic agents undergoing emergency and elective endoscopy
 22 February 2018 
Autophagy enhancers
 22 February 2018 
Outcomes with Crohn’s after infliximab withdrawal
 22 February 2018 
Elderly onset of IBD

 21 February 2018 
Adalimumab and infliximab in biologic-naïve Crohn's
 21 February 2018 
Cystic fibrosis and colorectal cancer
 21 February 2018 
Management of hemorrhoids in the USA
 20 February 2018 
Treatment algorithm for polyp cancers
 20 February 2018 
Predictors of postoperative infection in Crohn's
 20 February 2018 
Complications and surveillance colonoscopies
 19 February 2018 
Screening colonoscopy in the right and left colon
 19 February 2018 
NAFLD prevalence in the USA
 19 February 2018 
Fructans in children with IBS

 16 February 2018 
Undetected celiac in the elderly
 16 February 2018 
Inflammatory bowel diseases are global diseases
 16 February 2018 
Fructans induce non-celiac gluten sensitivity
 15 February 2018 
NSAIDS and GI damage
 15 February 2018 
Oral direct-acting antiviral treatment for Hep C virus genotype 1
 15 February 2018 
Primary vs secondary surgery for the presence of lymph node metastasis
 14 February 2018 
Predicting adenoma detection rate
 14 February 2018 
Normal bowel frequency characterization in the USA 
 13 February 2018 
Personalising treatment options for IBS
 13 February 2018 
Prebiotics improve endothelial dysfunction
 13 February 2018 
Diagnostic criteria for a Rome IV functional gastrointestinal disorders
 12 February 2018 
Visceral hypersensitivity and functional GI disorders
 12 February 2018 
Depression and aggressive IBD
 12 February 2018 
Variability in interpretation of endoscopic findings impacts patient management
 09 February 2018 
Treatment of choice for anastomotic stricture in IBD
 09 February 2018 
PRO measurement information system 
 09 February 2018 
Overall disease severity indices for IBD
 08 February 2018 
Prediction of endoscopically active disease

 08 February 2018 
Steroid-refractory acute severe ulcerative colitis
 08 February 2018 
Decision aid used by IBD patients
 07 February 2018 
Ursodeoxycholic acid combined with bezafibrate for itching
 07 February 2018 
Change in microbiome in gastritis vs gastric carcinoma
 07 February 2018 
Colorectal cancer and primary sclerosing cholangitis-IBD
 06 February 2018 
Risk of death after liver transplantation
 06 February 2018 
Crohn’s disease vs refractory pouchitis
 06 February 2018 
Support for functional dyspepsia symptom diary
 05 February 2018 
Helicobacter spp influence on GI tract 
 05 February 2018 
No link found between severe reflux and all-cause mortality 
 05 February 2018 
Psychological distress in PPI non-responders
 02 February 2018 
Assessing psychosexual impact of IBD
 02 February 2018 
Decrease in overall mortality with cholera vaccination
 02 February 2018 
Diagnostic performance of fecal immunochemical tests
 01 February 2018 
Screening frequency with family histories of colorectal cancer
 01 February 2018 
IBD and sport participation
 01 February 2018 
Life with a stoma 
 31 January 2018 
Aprepitant and gastroparesis 
 31 January 2018 
Anesthesia risk in colonoscopy
 31 January 2018 
GED-0301 for Crohn's Disease
 30 January 2018 
Intestinal dysbiosis and allergic diseases in infants
 30 January 2018 
Fructans and IBS symptoms in children
 29 January 2018 
Dosing calculator for therapy optimization in IBD
 29 January 2018 
Glecaprevir–pibrentasvir for in HCV
 29 January 2018 
Food allergen injections in eosinophilic esophagitis
 29 January 2018 
Reliability of the IBD index
 26 January 2018 
Tofacitinib vs biological therapies for ulcerative colitis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us