Help
Subscribe


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

 25 May 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

 25 May 2018 
Colorectal cancer–specific mortality
 25 May 2018 
Technology to increase colorectal cancer screening
 25 May 2018 
Post‐operative complications in elderly IBD
 24 May 2018 
Patient-reported outcome measures in IBD trials
 24 May 2018 
Alcohol consumption and outcomes in drug-induced liver injury
 24 May 2018 
Precision medicine for tumors
 23 May 2018 
Management of perianal fistulas in Crohn’s disease
 23 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 23 May 2018 
High body mass index is and ulcerative colitis
 22 May 2018 
Worldwide H.pylori prevalence
 22 May 2018 
PPI and risk of stroke
 22 May 2018 
Online tool predicts bowel dysfunction severity prior to anterior resection
 21 May 2018 
Depressive symptoms in IBD youth
 21 May 2018 
PPI use and cognitive decline
 21 May 2018 
Fecal incontinence and quality of life in IBD
 18 May 2018 
Esophageal dilatation in clinical practice 
 17 May 2018 
IBD and later extraintestinal manifestations
 17 May 2018 
Repeat stool DNA testing
 17 May 2018 
IBS and chronic fatigue following GI infection
 16 May 2018 
Factors associated with fecal incontinence
 16 May 2018 
Diagnostic delay in Crohn's disease
 16 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 15 May 2018 
Guidelines for management of Crohn's
 15 May 2018 
Hep B in the Grey Zone
 15 May 2018 
New therapies for CDI
 14 May 2018 
Blood test for the diagnosis of fibrotic NASH
 14 May 2018 
Outcomes at bariatric centers of excellence
 14 May 2018 
Management of perianal fistulas in Crohn’s
 11 May 2018 
Detection of undiagnosed celiac disease
 11 May 2018 
Alcohol consumption and drug-induced liver injury
 10 May 2018 
Colorectal cancer screening
 10 May 2018 
Fibrosis in patients with chronic hepatitis B
 09 May 2018 
Fecal incontinence
 09 May 2018 
Health problems and IBS
 09 May 2018 
Esophageal dilatation in clinical practice 
 07 May 2018 
Omitting antibiotics in uncomplicated acute diverticulitis
 07 May 2018 
Health problems and IBS
 07 May 2018 
Assessment of diminutive colorectal polyps
 04 May 2018 
National Institutes of Health workshop and obesity
 04 May 2018 
Factors associated with fecal incontinence
 04 May 2018 
Colorectal cancer screening and ethnic inequities
 03 May 2018 
Gastrointestinal ultrasound in IBD
 03 May 2018 
Ultransonography in postsurgical recurrence in Crohn's
 02 May 2018 
Symptom assessment in cirrhotic ascites
 02 May 2018 
Hep C antiviral treatment and liver cancer risk
 02 May 2018 
Chronic Hep B
 01 May 2018 
European guidelines on pancreatic cystic neoplasms
 01 May 2018 
Interferon‐free regimens in Hep C
 01 May 2018 
Age at IBD onset and extraintestinal complications
 30 April 2018 
Formula for preterm infants
 30 April 2018 
Primary antibiotic resistance and sequential therapy for H. pylori
 27 April 2018 
Eastern and western practices for endoscopic resection of colorectal lesions
 27 April 2018 
Anxiety scale for chronic esophageal disease
 27 April 2018 
Disease activity in eosinophilic esophagitis
 26 April 2018 
Obesity and physical activity in diverticulosis
 26 April 2018 
Primary sclerosing cholangitis in the USA
 25 April 2018 
Aspirin and pancreatic cancer
 25 April 2018 
Central mediators of irinotecan-induced steatohepatitis
 25 April 2018 
Neuroimaging in Hep C
 24 April 2018 
Scoring system identifies cancer risk in Barrett's

Blackwell Publishing


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