A UK training programme for nurse practitioner flexible sigmoidoscopy and a prospective evaluation of the practice of the first UK trained nurse flexible sigmoidoscopist

摘要

Background—Flexible sigmoidoscopy is a technicalskill that has been successfully performed by suitably trainedcolorectal nurse practitioners in the USA. However, no recognisedtraining course exists for nurse practitioners in the UK. 
Aims—To design and evaluate a training programmefor nurse endoscopists. 
Methods—A multidisciplinary committee of nursesand clinicians developed a structured programme of study and practice.This involved a staged process of observations, withdrawals, andultimately, full procedures. Once training had been completed the nursepractitioner was permitted to practice independently. Patients withcolorectal symptoms referred for flexible sigmoidoscopy were examinedfor the final stages of training and independent practice. Aprospective evaluation of the training and practice of the firsttrained nurse flexible sigmoidoscopist was performed. Barium enema,video, clinical follow up, and histology were used to validate theresults of the flexible sigmoidoscopies. 
Results—The training programme required that 35 observations, 35 withdrawals, and 35 supervised full procedures wereperformed prior to the development of independent practice. Subsequentto the completion of this programme 215 patients have been examined independently by the nurse practitioner. Ninety three per cent of theexaminations were judged successful and pathology was identified in51%. The nurse endoscopist successfully identified all"significant" pathology whereas barium enema failed to identifypathology in 12.5%. There were no complications. 
Conclusion—With suitable training nurseendosocopists are able to perform flexible sigmoidoscopy safely and effectively.