Effectiveness of nurse delivered endoscopy: findings from randomised multi-institution nurse endoscopy trial (MINuET) - art. no. b231

Williams, J. and Russell, I. and Durai, D. and Cheung, W.Y. and Farrin, A. and Bloor, K. and Coulton, S. and Richardson, G. (2009) Effectiveness of nurse delivered endoscopy: findings from randomised multi-institution nurse endoscopy trial (MINuET) - art. no. b231. British Medical Journal, 338 . B231-B231. ISSN 0959-535X. (Full text available)

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Abstract

OBJECTIVE: To compare the clinical effectiveness of doctors and nurses in undertaking upper and lower gastrointestinal endoscopy. DESIGN: Pragmatic trial with Zelen's randomisation before consent to minimise distortion of existing practice. SETTING: 23 hospitals in the United Kingdom. In six hospitals, nurses undertook both upper and lower gastrointestinal endoscopy, yielding a total of 29 centres. PARTICIPANTS: 67 doctors and 30 nurses. Of 4964 potentially eligible patients, we randomised 4128 (83%) and recruited 1888 (38%) from July 2002 to June 2003. INTERVENTIONS: Diagnostic upper gastrointestinal endoscopy and flexible sigmoidoscopy, undertaken with or without sedation, with the standard preparation, techniques, and protocols of participating hospitals. After referral for either procedure, patients were randomised between doctors and nurses. MAIN OUTCOME MEASURES: Gastrointestinal symptom rating questionnaire (primary outcome), gastrointestinal endoscopy satisfaction questionnaire and state-trait anxiety inventory (all analysed by intention to treat); immediate and delayed complications; quality of examination and corresponding report; patients' preferences for operator; and new diagnoses at one year (all analysed according to who carried out the procedure). RESULTS: There was no significant difference between groups in outcome at one day, one month, or one year after endoscopy, except that patients were more satisfied with nurses after one day. Nurses were also more thorough than doctors in examining the stomach and oesophagus. While quality of life scores were slightly better in patients the doctor group, this was not statistically significant. CONCLUSIONS: Diagnostic endoscopy can be undertaken safely and effectively by nurses. TRIAL REGISTRATION: International standard RCT 82765705.

Item Type: Article
Additional information: Article No. B231.
Subjects: R Medicine > R Medicine (General)
R Medicine > RT Nursing
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Simon Coulton
Date Deposited: 26 Nov 2009 14:44
Last Modified: 14 Feb 2013 16:48
Resource URI: http://kar.kent.ac.uk/id/eprint/17001 (The current URI for this page, for reference purposes)
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