Gut. 1991 Jan;32(1):95-105. doi: 10.1136/gut.32.1.95.
(1) The number of endoscopic examinations performed is rising. Epidemiological data and the workload of well developed units show that annual requirements per head of population are approaching: Upper gastrointestinal 1 in 100 Flexible sigmoidoscopy 1 in 500 Colonoscopy 1 in 500 ERCP 1 in 2000 (2) Open access endoscopy to general practitioners is desirable and increasingly sought. For a district general hospital serving a population of 250,000, this workload entails about 3500 procedures annually, performed during 10 half day routine sessions plus emergency work. (3) High standards of training and experience are needed by all staff, who must work in purpose built accommodation designed to promote efficient and safe practice. (4) The endoscopy unit should be adjacent to day care facilities and near the x ray department. There should be easy access to wards. (5) An endoscopy unit needs at least two endoscopy rooms; a fully ventilated cleaning/disinfection area; rooms for patient reception, preparation, and recovery; and accommodation for administration, storage, and staff amenities. (6) The service should be consultant based. At least 10 clinical sessions are required, made up of six or more consultant sessions and two to four clinical assistant, hospital practitioner, or staff specialist sessions. Each consultant should be expected to commit at least two sessions weekly to endoscopy. Extra consultant sessions may be needed to provide an efficient service. (7) A specially trained nursing sister (grade G or H) and five other endoscopy nurses are needed to care for the patients; their work may be supplemented by care assistants. (8) A new post of endoscopy department assistant (analogous to an operating department assistant) is proposed to maintain and prepare instruments, and to give technical assistance during procedures. (9) A full time secretary should be employed. Records, appointments, and audit should be computer based. (10) ERCP needs the collaboration of an interventional radiologist working with high quality x ray equipment in a specially prepared radiology screening room. This facility may need to serve more than one hospital. (11) A gastrointestinal measurement laboratory can conveniently be combined with the endoscopy unit. In some hospitals one or more gastrointestinal measurement technicians may staff this laboratory. (12) An endoscopy unit is a service department analogous to a radiology department. It needs an annual budget.
(1)内镜检查的数量在不断增加。流行病学数据以及成熟科室的工作量表明,人均年度检查需求接近:上消化道检查每100人中有1例;乙状结肠镜检查每500人中有1例;结肠镜检查每500人中有1例;内镜逆行胰胆管造影(ERCP)每2000人中有1例。
(2)希望向全科医生提供开放式内镜检查服务,且这种需求日益增加。对于一家服务25万人口的地区综合医院而言,这样的工作量意味着每年约需进行3500例检查,在10个半天的常规时段以及急诊工作时间内完成。
(3)所有工作人员都需要具备高标准的培训和经验,他们必须在专门设计的场所工作,以促进高效且安全的操作。
(4)内镜科室应毗邻日间护理设施且靠近X光科室。应便于通往病房。
(5)一个内镜科室至少需要两个内镜检查室;一个通风良好的清洁/消毒区域;患者接待、准备和恢复的房间;以及行政、储存和工作人员便利设施的空间。
(6)该服务应以顾问医生为主导。至少需要10个临床时段,包括六个或更多顾问医生时段以及两到四个临床助理、医院医生或专科工作人员时段。每位顾问医生预计每周至少投入两个时段用于内镜检查。可能需要额外的顾问医生时段以提供高效服务。
(7)需要一名经过专门培训的护士长(G级或H级)和另外五名内镜护士来护理患者;护理助理可协助他们的工作。
(8)提议设立一个内镜科室助理的新岗位(类似于手术室助理),以维护和准备器械,并在操作过程中提供技术协助。
(9)应雇佣一名全职秘书。记录、预约和审计应以计算机为基础。
(10)ERCP需要介入放射科医生与高质量X光设备协作,在专门准备的放射科筛查室进行操作。该设施可能需要为不止一家医院服务。
(11)胃肠测量实验室可方便地与内镜科室合并。在一些医院,可能有一名或多名胃肠测量技术人员负责该实验室。
(12)内镜科室是一个类似于放射科的服务科室。它需要年度预算。