A comprehensive training programme for nurse endoscopist performing flexible sigmoidoscopy in Hong Kong

Abstract

AIMS: To describe the process and explore the feasibility of training a colorectal nurse in Hong Kong to perform flexible sigmoidoscopy. BACKGROUND: Given the shortage and high turnover rate of medical staff, a pilot programme was designed to train and expand the role of colorectal nurse clinicians. It was hoped that such nurses could share some of the clinical duties of the medical staff. An advanced practice nurse was selected for the programme. One of the training components was the performance of flexible sigmoidoscopy. DESIGN: This was a descriptive, case review study. METHOD: A one-year-structured endoscopic training programme was designed for the nurse clinician. Weekly sessions were conducted by one of the trainers. The training process included the following: (1) procedural observation; (2) supervised withdrawal, advancement and manipulation of the sigmoidoscope and (3) a final assessment of the nurse's competency in performing sigmoidoscopy independently. RESULTS: In total, 119 outpatients (58 male and 61 female) with a mean age of 57.02 years (SD 14.6 years; range: 18-83 years) underwent flexible sigmoidoscopy by the nurse over 11 months. The mean procedural time was 9.38 minutes (SD 3.5 minutes; range 3-26 minutes). The procedure was terminated prematurely if it could not be tolerated by the patient or if the bowel preparation was inadequate. The mean depth of insertion was 53.5 cm (SD 12.2 cm; range 6-60 cm). In total, 82 patients had a normal exam, 32 patients had abnormalities. There were no procedural complications, and no patient required an unplanned hospital admission after the procedure. CONCLUSION: In Queen Mary Hospital, nurses can be trained to perform flexible sigmoidoscopy in a safe and effective manner. RELEVANCE TO CLINICAL PRACTICE: Nurse endoscopists could increase the use of flexible sigmoidoscopy in colorectal cancer screening and can also enhance the professional development of colorectal nurses.