The university endoscopy unit : The standard of care ?

In an attempt to investigate practice patterns of the modern 
gastrointestinal endoscopy unit, a survey was undertaken in 10 university-affiliated 
endoscopy units in three Ontario cities. The results showed that there 
was a wide range of premedications used, a nd that there was variation tn the 
extent of patient monitoring, the method of endoscope sterilization and the 
degree of safety precautions. This survey provides information on the 'standard 
of care' in the university endoscopy unit and provides a framework for discussion 
for the establishment of guidelines for the modern gastrointestinal endoscopy 
unit.

enterology has hccomc m creastngly dominated hy end11su1pic procedures performed tn nut p.n1ent and mp,rnent 1ctt1ngs in modern l.'ndoscop1c 11n11s w1thtn hospitals.T he d esign and daily func u un of tlw se uni ts varies depend m g o n personnel, expen ence, budget and m her fac tors.\V11h the tnc rea-, 111g emphasis o n qunln y of care evaluat1 cms Dc/>ar1men1 uf Gcl\lro,'1Hl.'rn/c,/f\,l 1 n11•cr111y / fm/lllcrl, l 1111•n111, 11f \X'c..mJmed1coleg;1l issues, the nnus 1s cm the prac.t1s111g gast roentcmlogbt to prov ide a level of safety and serv ice wh ich ts compa rable to the 'srandartl of earl.' ' avatlahl e 111 the community.In an effort to d efin e this standard further, pracu ce pa tt e rn s 111 IO un1 ve rstt y-a ffi l1ated gastro1ntest1nal endoscopy units we re stud ied .T his survey reviewed the procedures tn IO dtffr rent cndmcopy unns wn h rl'gard to pre-e ndoscopy asse:,sment, patie nt mon noring and safet y, .mde ndoscnpy h yg iene.

METHODS
T en endu~cor y units 111 uni verstly te,1c h 1ng hospu als 111 three O ntario c 11ie~ we re v1s1ted.Data were obtained fro m se nior nurs111g personnel 111 the endoscopy unit us111g a standa rd q uestio n na ire.Da ta, therefore, were based o n the d1111ca l im prc~sio n of these personnel , a nd nc1 fo rmal ,1udtt of the fa cilities o r cltn1u1l o m comes was perfo rmed.

RESULTS
T he survey revealed tha t esophagogastroduod cnoscopy was the mnst commo n e ndoscopic procedu re performed with a wide range o f va riabtltt y evident hetween ind iv idual un1b (Table I) .S imil a rl y, ther e was cons id c rah le varia bi l tl y 111 the use of pre-endnswpy sed ation (  units and v ital signs were recorded heforc and after the pnKl'dure.Therl' wa:, consiJcrnhle variability in pmien1 monitoring, avai lability of re:,usl 1tat1on equipment, and endoscopic hygiene (Table 3).

Table 2 )
. A rre-entloscopy history wa, o hwim•d hy th e nurse in a ll

TABLE 1
Patterns of care in university hospital endoscopy units