The researchers investigated a nurse-led direct access endoscopy clinic, with regard to its efficacy and cost effectiveness. They also monitored patient satisfaction and direct referrals from the primary health sector.
The findings of the study were published in the January 2002 issue of Surgical Endoscopy.
A nurse-led open-access flexible sigmoidoscopy (OAFS) service for patients reporting fresh rectal bleeding was established at the authors' center in February 1996.
The team conducted a prospective audit of sigmoidoscopic findings and a retrospective analysis of referral patterns from local general practitioners.
A questionnaire survey of both patient and general practitioner satisfaction also was conducted at the same time.
Since the clinic was first established, 706 patients were referred to the service.
Rectal bleeding was by far the most common cause for referral, representing the dominant symptom in 92% of the referrals received.
|99% of patients were satisfied with the nurse-led service.
| Surgical Endoscopy |
Although 99% of the patients underwent a complete sigmoidoscopic examination, 16% of these examinations were limited because of several factors combined.
A cause for bleeding was identified in 91% of the patients, with 24% of them experiencing subsequent significant pathology.
The researchers found that, of the patients surveyed, 99% were satisfied with the service provided.
The results also showed nurse-led OAFS to be a more effective use of financial resources, costing $90 less per patient than general practitioner referrals sent to a consultant for further action.
Author P.S. Basnyat, of the Department of Surgery, at the Royal Glamorgan Hospital, said on behalf of the group, "Rectal bleeding is a good indicator of underlying colorectal disease.
"Most of the significant lesions presenting with this symptom are found in the left side of the colon."
"A nurse-led OAFS is safe, effective, and acceptable to patients. It also is more cost effective than a consultant-led service," it was concluded.