Title: The Impact of the Endoscopy Nurse on Colonoscopy Completion Rates
Abstract: Background: Colonoscopy is a technically demanding procedure, frequently requiring multiple maneuvers including change in patient's position and application of appropriate external abdominal pressure by the nurse to assist in completion of procedure. Hence, the endoscopy nurse may have an important role in colonoscopy completion rates. Aims: To determine and compare the colonoscopy incompletion rates among individual endoscopy nurses in our unit. Methods: Retrospective chart review of all colonoscopies performed in our endoscopy unit from November 2003 to October 2004 at MetroHealth Medical Center, Cleveland, Ohio. Colonoscopies are performed by either gastroenterology trainees under attending supervision or by attending physicians. There are a total of 12 endoscopy nurses who assist in colonoscopies, of which 5 are registered nurses (RN) and 7 are licensed practical nurses (LPN). Patient demographics, indications for procedure and colonoscopic findings were reviewed. Patients who had incomplete colonoscopy due to poor bowel preparation and colonic pathology precluding completion were excluded. Results: A total of 1896 colonoscopies were included in the analysis, of which 62 were incomplete (3.3%). Mean number of colonoscopies assisted by each individual endoscopy nurse was 158 (range 86-392). Mean endoscopy work experience of the nurses was 4.5 years (range 0.5-15 years). Incompletion rate of colonoscopies was similar among the individual nurses and ranged from 1.0% to 5.8% (p > 0.05). Incompletion rate did not correlate with either nurse's work experience or the level of education, LPN versus RN (p > 0.05). Conclusions: The endoscopy nurse assisting in colonoscopy does not impact colonoscopy completion rate. Also, there is no correlation between the nurse's work experience or the level of education (LPN versus RN) on colonoscopy completion rates.