Nielsen Knud Thygesen, Langer Sonja, Neumann Rikke, Krarup Niels
Randers Centralsygehus, Organkirurgisk Afdeling, Endoskopisk Afsnit, Randers.
Ugeskr Laeger. 2005 Sep 12;167(37):3494-6.
A new diagnostic strategy for evaluation of patients with symptoms suggestive of colorectal cancer involves an increased use of flexible sigmoidoscopy. The number of endoscopists is declining, and therefore we found it interesting to describe a endoscopy training programme for the first two Danish nurses.
Two nurses were enrolled in a five-module practical training programme including a multiple-choice test and simulator training. After their completion of at least 100 sigmoidoscopies, a questionnaire on patient satisfaction was administered together with recording of technical details of the sigmoidoscopies during a three-month period.
During the three-month period, the nurses performed 69 sigmoidocopies. Of these, 88% reached a triangular lumen, the median examination time was 25 minutes, intubation of the sigmoid was successful in all cases and video review of the sigmoidoscopies revealed that no significant pathology had been misdiagnosed. Patient satisfaction among those examined by nurses showed that fewer patients experienced pain during the endoscopy than those examined by doctors.
The training programme was completed as planned, and the nurses obtained endoscopic skills comparable to that of doctors concerning patient satisfaction. Sigmodoscopy can be performed at an acceptably high standard by nurses. Training nurses to perform endoscopy requires a significant number of teaching hours and close supervision.
一种用于评估有结直肠癌症状患者的新诊断策略涉及增加使用乙状结肠镜检查。内镜医师的数量正在减少，因此我们觉得描述一项针对丹麦首批两名护士的内镜培训计划很有意思。
两名护士参加了一个包含五个模块的实践培训计划，该计划包括多项选择题测试和模拟器训练。在她们完成至少100例乙状结肠镜检查后，发放了一份关于患者满意度的问卷，并在三个月期间记录乙状结肠镜检查的技术细节。
在这三个月期间，护士们进行了69例乙状结肠镜检查。其中，88%达到了三角形腔道，检查时间中位数为25分钟，所有病例乙状结肠插管均成功，对乙状结肠镜检查的视频回顾显示没有重大病变被误诊。护士检查的患者的满意度表明，与医生检查的患者相比，在内镜检查期间经历疼痛的患者更少。
培训计划按计划完成，护士们在患者满意度方面获得了与医生相当的内镜技能。护士可以以可接受的高标准进行乙状结肠镜检查。培训护士进行内镜检查需要大量的教学时间和密切监督。
