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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