Friday, July 18, 2014

Nurse Endoscopy

In June I attended the Victorian Health Care Quality Association showcase on award winning innovative practice. My previous report is on the HCCA blog.
The innovation showcase was an event put on by the Victorian Healthcare Quality Association, the Centre of Research Excellence in Patient Safety, the Victorian Department of Health and the Australasian Association for Quality in Health Care. It was held in St Kilda over two days, and show cased quality improvement initiatives which have won major awards across Australia over the previous 12 months

Sylvia Constantinou, a Nurse Endoscopy at the Austin Hospital, gave an overview of the nurse endoscopy services in Victoria. This is related to the Health Workforce Australia work on Extended Scope of Practice for health professionals.

In the state of Victoria endoscopy nurses are advance practice nurses and have been credentialed to deliver this service. They scope independently and with access to gastroenterologists. They are not nurse practitioners. This is a new pathway for nurses in Australia but has been happening overseas for some time (the UK has been doing this for 20 years.)

Why nurse endoscopists?
Bowel cancer is a preventable disease. Early detection results in cure. There has been a bowel cancer screening program put in place but there I an increasing number of requiring screening with a colonoscopy. There is a growing awareness in the community of familial links. Yet with this awareness it is the second most common cancer in men and women in Australia.

Austin Health was part of the National Bowel Cancer Screening Program since 2002, when the pilot. In Victoria there were 188,000 screened. 6000 were faecal occult blood positive. Of these one third will show cancerous cells.

This year there will be 4.8 million people eligible for screening.

Austin, Alfred, Monash and Western have all been implementation sites as part of Health Workforce Australia program. The Victorian Government funded the State Endoscopy Training Centre (SETC) and the goal is to train 15 nurse endoscopists to work at ten public hospitals.

The Austin Hospital has a large gastro hospital and perform almost 3000 colonoscopies per year with more than 2000 people waiting. At the Austin 12% of colonoscopies are completed by the There are 29 doctors and colorectal surgeons and they perform 79% of the colonoscopies

There are two nurse endoscopists in Victoria and independently practices and there are three trainees as part of the HWA project. The theoretical training is provided by University of Hull in the UK.

Austin Health have a useful FAQ on nurse endoscopy online.

It seems clear that there is a role for nurses working in this area with extended scope. We need them to be safe and procedurally efficient. We also need a career path as well as need for education, support and supervision.  With the demise of HWA I hope this program of work is not shelved as the functions are absorbed into the Department of Health

Darlene Cox

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