Nurse Endoscopist Model of Care - Consumer Information Sheet
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SA Health has introduced an advanced practice Nurse Endoscopist Model of Care Pilot Project into a public hospital setting. Three nurses are being trained to perform low-risk, non-complex colonoscopy as part of a multidisciplinary team.
In this age of changing health care needs there is a global need to find innovative, cost-effective ways of delivering care.Increasingly around the world, experienced nurses are trained to practice at an advanced level, providing clinical expertise in a variety of settings. The scope of advanced practice means greater and increasing complexity, an increase in clinical skills, reasoning, critical thinking, knowledge, expertise and experience.
Health professionals advance their practice through continuing education, experience, and ongoing development. Nurses practising at an advanced level incorporate leadership, education and research into their practice. Research evidence shows that advanced practice nursing roles are safe, effective and well received by clients. A variety of titles are used throughout the world to denote advanced practice nursing roles, one of which is the role of Nurse Endoscopist.
An advanced practice, specialised registered nurse, trained under the supervision of medical specialists to perform endoscopic examinations, such as that of the lower intestinal tract (colonoscopy).
Bowel cancer is the second most commonly diagnosed cancer, affecting one in 12 of the population by the age of 85, with the majority of cases diagnosed in patients aged over 50 years. However, it can be treated effectively in 90 per cent of cases if detected early. In 2012 it was projected that 431 South Australians would die from bowel cancer and 1,264 new cases would be diagnosed in 2015. Estimates indicate that every week, 22 South Australians are diagnosed with bowel cancer and eight die from the disease. Colonoscopy plays a crucial role in the diagnosis, treatment and ongoing surveillance of bowel cancer.
The growing demand for colonoscopy screening services in South Australia is driven by:
Advanced practice nurse endoscopy means real benefits to patients and public health services. Access to timely endoscopy services is necessary to support the delivery of high-quality health care to South Australians. Nurse Endoscopists can contribute to improving access to services for patients requiring follow up screening and review services. They will build workforce capacity in the form of extra, dedicated nurse endoscopy lists in addition to current medical endoscopy lists.
The introduction of advanced practice nurse endoscopy enables medical staff to better manage and treat patients by delegating appropriate cases to highly qualified advanced practice nurses. This in turn allows better access to medical specialists for complex and advanced endoscopic cases.
Nurse Endoscopists not only perform colonoscopy, they also work in collaboration with medical and allied health staff to enhance the patient journey from pre-admission to post procedure follow up.
Since 2010, both Victoria and Queensland have successfully implemented Nurse Endoscopist Models of Care and other jurisdictions are developing similar models. South Australia has previous experience of Nurse Endoscopists working in public settings (Repatriation General Hospital and Flinders Medical Centre) and was viewed as a pioneer in nurse endoscopy practice.
The introduction of the SA Health Nurse Endoscopist Model of Care Pilot Project is built on extensive international and national experience from the United States of America, United Kingdom, Netherlands, Canada, China, New Zealand, Victoria and Queensland. International experience in nurse endoscopy in the United States of America, United Kingdom and Europe demonstrate that health workforce reforms can be implemented without compromising patient safety. An abundance of evidence clearly articulates that Nurse Endoscopists, under proper supervision, can perform at the same level of procedural competency as doctors.
Under the Nurse Endoscopist Model of Care Pilot Project, three highly qualified and experienced nurses within the endoscopy field are undertaking a minimum of 12 months advanced skills training leading to a Certificate of Endoscopy. The training pathway involves a collaborative partnership between SA Health and Austin Health, Victoria through their state of the art State Endoscopy Training Center (SETC).
Training involves three concurrent learning modules;
By the end of the 12 month training period, it is anticipated that trainees will achieve the following proficiency requirements;
The pilot project and training commenced in June 2017.