An article in the latest issue of The International Journal of SPHM (Safe Patient Handling and Mobility) investigates a significant but rarely publicized problem—musculoskeletal disorders (MSDs) among endoscopy nurses and technicians. “Endoscopy Staff Injury: A Serious Problem Hiding in Plain Sight” provides specifics on the extent, nature, and root causes of endoscopy staff MSDs and includes data compiled from various studies.
Waiting is hating
Americans hate to wait, whether it’s for food, Internet connectivity, or a green light. So it should come as no surprise that the more time patients spend waiting to see a physician, the more dissatisfied they are. What might be surprising is that longer wait times have a negative impact on other, potentially more consequential aspects of the patient experience, specifically patients’ confidence in their physician and how they perceive their quality of care.
Topics: colorectal cancer, CRC, colonoscopy, screening, ColoWrap, cecal intubation time, patient experience, hospital costs, tortuous colon, gastroenterologist, endoscopy nursing, GI nursing, endoscopist, looping in colonoscopy, healthcare costs, difficult colonoscopy, endoscopy
Research consistently shows that the adenoma detection rate (ADR) is higher the more time spent withdrawing the scope. In fact, a presentation at the 2018 meeting of the American College of Gastroenterology indicated a significantly higher adenoma detection rate when the withdrawal time in the right colon was greater than three minutes. The reverse is true as well; in a review of 76,810 screening colonoscopies, faster withdrawal times were independently associated with lower ADRs.
Topics: gastroenterologist, colorectal cancer, CRC, endoscopist, adenoma, endocopy, tortuous colon, difficult colonoscopy, abdominal pressure colonoscopy, looping in colonoscopy, cecal intubation time, withdrawal time
All physicians want to provide superior care for their patients, but practicing medicine today can be complicated. In the last decade, doctors have been tasked with navigating new technologies, government mandates, and payment guidelines, all of which can detract from caring for patients.
Topics: gastroenterologist, colorectal cancer, CRC, endoscopist, adenoma, endocopy, women in GI, patient experience, nurse injury, GI injury, injury endoscopist, tortuous colon, difficult colonoscopy, bowel prep colonoscopy, abdominal pressure colonoscopy, looping in colonoscopy, safe patient hadling, screening
Nurses who handle patients on a regular basis are likely to get injured, sooner or later. According to the U.S. Bureau of Labor Statistics, nursing has the highest rate of nonfatal occupational injuries of any profession, (yes, even higher than construction workers or factory employees), and an American Nursing Association survey revealed that 62 percent of nurses indicated that the risk of developing a disabling musculoskeletal disorder was a top health and safety concern.
The safety and comfort of patients undergoing colonoscopy is of paramount importance to hospitals, providers, and of course, the patients themselves. But what about the physicians performing the procedure? It might be news to those outside the field, but gastroenterologists are commonly injured on the job. A review of current literature found that musculoskeletal complaints are extremely common among GIs; the incidence of pain and injuries ranges from 29% up to 89%. Another study indicated that 45% of endoscopists undergo physical therapy to combat pain, 26.8% get steroid injections, and 13.3% require surgery.
Observational studies indicate that colonoscopy lowers colorectal cancer (CRC) rates and mortality in the general population. In support of these findings, a large-case control study showed that the procedure can significantly reduce the incidence of CRC and CRC-related mortality. However, colonoscopy may not be optimally effective for right-sided lesions. This might be due, in large part, to sessile serrated adenomas (SSAs).
The Definition of “Difficult”
A difficult colonoscopy is one “in which the endoscopist has trouble getting through the entire colon or fails to do so,” said Dr. Jerome Waye, in an interview with the journal Gastroenterology & Hepatology. Difficult colonoscopies are problematic because they can result in longer-than-expected procedure times, incomplete procedures, and higher risks.
What is looping?
During colonoscopy, looping is a frequent challenge. It occurs when the colonoscope stretches and distends the colon in response to the physician’s efforts to advance the scope forward. Typically once a loop has formed, it must be straightened before the procedure can continue. Looping is most common in the sigmoid colon, although it can occur anywhere the scope encounters a barrier.