Colonoscopes are a valuable commodity. Just weeks after $450,000 of scopes were stolen from a Philadelphia hospital, thieves struck again. This time they took two scopes valued at $24,000 each from a nearby medical center. Who knew that these medical devices are a popular black-market item?
What Is Endoscopy?
For those not immersed in the world of gastroenterology (GI), endoscopy refers to nonsurgical procedures that allow a physician to examine the digestive tract. In these procedures, a flexible tube with a small light and camera attached (an endoscope) is inserted into the mouth or the rectum. Physicians can then inspect, take pictures, and perform therapies like removing polyps and taking biopsies. The two most common endoscopic procedures are 1) upper endoscopy, which looks at the first part of the small intestine and 2) colonoscopy, which examines the lower intestine (colon).
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: colonoscopy, endoscopy, screening, healthcare costs, GI nursing, endoscopy nursing, looping in colonoscopy, endoscopist, difficult colonoscopy, gastroenterologist, CRC, colorectal cancer, tortuous colon, hospital costs, patient experience, cecal intubation time, ColoWrap
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: endocopy, adenoma, abdominal pressure colonoscopy, looping in colonoscopy, endoscopist, difficult colonoscopy, gastroenterologist, CRC, colorectal cancer, tortuous colon, 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: endocopy, screening, adenoma, safe patient hadling, abdominal pressure colonoscopy, looping in colonoscopy, bowel prep colonoscopy, endoscopist, difficult colonoscopy, gastroenterologist, CRC, colorectal cancer, tortuous colon, injury endoscopist, GI injury, nurse injury, patient experience, women in GI
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.