Digital Recording and Documentation of Endoscopic Procedures: Do Patients and Doctors Think Alike?

Aims and Methods.Conducting a survey study of a large number of patients and gastroenterologists aimed at identifying relevant predictors of interest in digital recording and documentation (DRD) of endoscopic procedures. Outpatients presenting to the endoscopy unit at our institution for an endoscopy examination were anonymously surveyed, regarding their views and opinions of a possible recording of the procedure. A parallel survey for gastroenterologists was conducted.Results.417 patients and 62 gastroenterologists participated in two parallel surveys regarding DRD of endoscopic procedures. 66.4% of the patients expressed interest in digital documentation of their endoscopic procedure, with 90.5% of them requesting a copy. 43.6% of the physicians supported digital recording while 27.4% opposed it, with 48.4% opposing to making a copy of the recording available to the patient. No sociodemographic or background factors predicted patient’s interest in DRD. 66% of the physicians reported having recording facilities in their institutions, but only 43.6% of them stated performing recording. Having institutional guidelines for DRD was found to be the only significant predictor for routine recording.Conclusions.Our study exposes patients’ positive views of digital recording and documentation of endoscopic procedures. In contrast, physicians appear to be much more reluctant towards DRD and are centrally motivated by legal concerns when opposing DRD, as well as when supporting it.

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Respiratory Complications in Outpatient Endoscopy with Endoscopist-Directed Sedation

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.233.kf1 ◽

2014 ◽

Vol 23 (3) ◽

pp. 255-259 ◽

Cited By ~ 11

Author(s):

Kilian Friedrich ◽

Sabine G. Scholl ◽

Sebastian Beck ◽

Daniel Gotthardt ◽

Wolfgang Stremmel ◽

...

Keyword(s):

Antibiotic Treatment ◽

Respiratory Infection ◽

Endoscopic Procedure ◽

Shortness Of Breath ◽

Respiratory Complications ◽

Endoscopic Procedures ◽

Increased Risk ◽

High Incidence ◽

Respiratory Complaints

Background & Aims: Respiratory complications represent an important adverse event of endoscopic procedures. We screened for respiratory complications after endoscopic procedures using a questionnaire and followed-up patients suggestive of respiratory infection.Method: In this prospective observational, multicenter study performed in Outpatient practices of gastroenterology we investigated 15,690 patients by questionnaires administered 24 hours after the endoscopic procedure.Results: 832 of the 15,690 patients stated at least one respiratory symptom after the endoscopic procedure: 829 patients reported coughing (5.28%), 23 fever (0.15%) and 116 shortness of breath (SOB, 0.74%); 130 of the 832 patients showed at least two concomitant respiratory symptoms (107 coughing + SOB, 17 coughing + fever, 6 coughing + coexisting fever + SOB) and 126 patients were followed-up to assess their respiratory complaints. Twenty-nine patients (follow-up: 22.31%, whole sample: 0.18%) reported signs of clinically evident respiratory infection and 15 patients (follow-up: 11.54%; whole sample: 0.1%) received therefore antibiotic treatment. Coughing or vomiting during the endoscopic procedure resulted in a 156.12-fold increased risk of respiratory complications (95% CI: 67.44 - 361.40) and 520.87-fold increased risk of requiring antibiotic treatment (95% CI: 178.01 - 1524.05). All patients of the follow-up sample who coughed or vomited during endoscopy developed clinically evident signs of respiratory infection and required antibiotic treatment while this occurred in a significantly lower proportion of patients without these symptoms (17.1% and 5.1%, respectively).Conclusions: We demonstrated that respiratory complications following endoscopic sedation are of comparably high incidence and we identified major predictors of aspiration pneumonia which could influence future surveillance strategies after endoscopic procedures.

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Home Mechanical Ventilation: A Patient’s Perspective Survey Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084048 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4048

Author(s):

Magdalena Kwiatosz-Muc ◽

Bożena Kopacz

Keyword(s):

Health Care ◽

Mechanical Ventilation ◽

Alternative Methods ◽

Survey Study ◽

Home Mechanical Ventilation ◽

Patient’S Satisfaction ◽

Satisfaction Index ◽

Number Of Patients ◽

The Difference

Background: An increasing number of patients included in home mechanical ventilation (HMV) care has been under observation for many years. The study aimed to assess the patients opinion concerning the expected and perceived quality of care in an HMV system and a patient’s satisfaction with care. Methods: In 2017, patients treated with HMV were surveyed in Poland with the modified SERVQUAL questionnaire. Results: One hundred correctly completed surveys were analyzed. Patient Satisfaction Index was high. In every examined area, the expectations were statistically significant larger than the perception of the services. The biggest gap was in the tangibility dimension and the smallest gap was in the empathy dimension. Perceived respect and understanding for a patient’s needs are close to the expectations. Conclusions: The level of satisfaction with health care among patients treated with HMV in majority of investigated components is high. Moreover, the difference between perceived and expected quality of health care in the HMV system was relatively small in the opinion of the patients themselves. Further investigations with alternative methods are needed.

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Staffing at Ambulatory Endoscopy Centers in the United States: Practice, Trends, and Rationale

Gastroenterology Research and Practice ◽

10.1155/2018/9463670 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Deepak Agrawal ◽

Rajeev Jain

Keyword(s):

United States ◽

Patient Care ◽

Response Rate ◽

The United States ◽

Survey Study ◽

Moderate Sedation ◽

Endoscopic Procedures ◽

Staffing Patterns ◽

And Training

Background. Endoscopy nurse (RN) has a pivotal role in administration and monitoring of moderate sedation during endoscopic procedures. When sedation for the procedure is administered and monitored by an anesthesia specialist, the role of an RN is less clear. The guidelines on this issue by nursing and gastroenterology societies are contradictory. Methods. Survey study of endoscopy lab managers and directors at outpatient endoscopy units in Texas. The questions related to staffing patterns for outpatient endoscopies and responsibilities of different personnel assisting with endoscopies. Results. Responses were received from 65 endoscopy units (response rate 38%). 63/65 (97%) performed at least a few cases with an anesthesia specialist. Of these, 49/63 (78%) involved only an endoscopy technician, without an additional RN in the room. At 12/49 (25%) units, the RN performed tasks of an endoscopy technician. At 14/63 (22%), an additional RN was present during endoscopic procedures and performed tasks not directly related to patient care. Conclusions. Many ambulatory endoscopy units do not have an RN present at all times when sedation is administered by an anesthesia specialist. An RN, when present, did not perform tasks commensurate with the education and training. This has implications about optimal utilization of nurses and cost of performing endoscopies.

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Patient Portal Barriers and Group Differences: Cross-Sectional National Survey Study (Preprint)

10.2196/preprints.18870 ◽

2020 ◽

Author(s):

Kea Turner ◽

Alecia Clary ◽

Young-Rock Hong ◽

Amir Alishahi Tabriz ◽

Christopher M Shea

Keyword(s):

Patient Characteristics ◽

Survey Study ◽

Patient Portal ◽

Older Individuals ◽

Patient Portals ◽

Cross Sectional ◽

Number Of Patients ◽

Multiple Variable ◽

Nationally Representative ◽

National Trends

BACKGROUND Past studies examining barriers to patient portal adoption have been conducted with a small number of patients and health care settings, limiting generalizability. OBJECTIVE This study had the following two objectives: (1) to assess the prevalence of barriers to patient portal adoption among nonadopters and (2) to examine the association between nonadopter characteristics and reported barriers in a nationally representative sample. METHODS Data from this study were obtained from the 2019 Health Information National Trends Survey. We calculated descriptive statistics to determine the most prevalent barriers and conducted multiple variable logistic regression analysis to examine which characteristics were associated with the reported barriers. RESULTS The sample included 4815 individuals. Among these, 2828 individuals (58.73%) had not adopted a patient portal. Among the nonadopters (n=2828), the most prevalent barriers were patient preference for in-person communication (1810/2828, 64.00%), no perceived need for the patient portal (1385/2828, 48.97%), and lack of comfort and experience with computers (735/2828, 25.99%). Less commonly, individuals reported having no patient portal (650/2828, 22.98%), no internet access (650/2828, 22.98%), privacy concerns (594/2828, 21.00%), difficulty logging on (537/2828, 18.99%), and multiple patient portals (255/2828, 9.02%) as barriers. Men had significantly lower odds of indicating a preference for speaking directly to a provider compared with women (odds ratio [OR] 0.75, 95% CI 0.60-0.94; P=.01). Older age (OR 1.01, 95% CI 1.00-1.02; P<.001), having a chronic condition (OR 1.83, 95% CI 1.44-2.33; P<.001), and having an income lower than US $20,000 (OR 1.61, 95% CI 1.11-2.34; P=.01) were positively associated with indicating a preference for speaking directly to a provider. Hispanic individuals had significantly higher odds of indicating that they had no need for a patient portal (OR 1.59, 95% CI 1.24-2.05; P<.001) compared with non-Hispanic individuals. Older individuals (OR 1.05, 95% CI 1.04-1.06; P<.001), individuals with less than a high school diploma (OR 3.15, 95% CI 1.79-5.53; P<.001), and individuals with a household income of less than US $20,000 (OR 2.78, 95% CI 1.88-4.11; P<.001) had significantly higher odds of indicating that they were uncomfortable with a computer. CONCLUSIONS The most common barriers to patient portal adoption are preference for in-person communication, not having a need for the patient portal, and feeling uncomfortable with computers, which are barriers that are modifiable and can be intervened upon. Patient characteristics can help predict which patients are most likely to experience certain barriers to patient portal adoption. Further research is needed to tailor implementation approaches based on patients’ needs and preferences.

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Digital recording and documentation of endoscopic procedures: physicians’ practice and perspectives

Israel Journal of Health Policy Research ◽

10.1186/s13584-019-0332-6 ◽

2019 ◽

Vol 8 (1) ◽

Author(s):

Maya Peled-Raz ◽

Nadav Willner ◽

Dan Shteinberg ◽

Keren Or-Chen ◽

Tova Rainis

Keyword(s):

Digital Recording ◽

Endoscopic Procedures

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Prevalence of Neuropathic Pain Symptoms in Foot and Ankle Patients

Foot & Ankle International ◽

10.1177/1071100719838302 ◽

2019 ◽

Vol 40 (6) ◽

pp. 629-633 ◽

Cited By ~ 3

Author(s):

Eliezer Sidon ◽

Ryan Rogero ◽

Elizabeth McDonald ◽

Annemarie Daecher ◽

Rachel Shakked ◽

...

Keyword(s):

Decision Making ◽

Neuropathic Pain ◽

Survey Study ◽

Long Term Results ◽

Tarsal Tunnel ◽

Foot And Ankle ◽

Number Of Patients ◽

Increased Risk ◽

Patient Reported ◽

Moderate Effect

Background: The management of pain in patients with foot and ankle pathology can be challenging. Cumulative data suggest that, in addition to nociceptive mechanisms, other neuropathic mechanisms can contribute to pain in a subset of people with orthopedic conditions, and can be found in 10.5% to 53% of patients with chronic pain, depending on the location of the pathology. Preoperative diagnosis of neuropathic pain (NP) can potentially change decision making and management of foot and ankle pathologies. Methods: We used a validated patient-reported pain questionnaire (painDETECT) as a cross-sectional study to investigate the prevalence of NP symptoms in a population of patients undergoing foot and ankle surgery. A total of 533 patients were prospectively included and completed the painDETECT questionnaire. Results: Sixty-six patients (12.4%) were classified as having a component of NP symptoms according to their painDETECT score. Current smokers (23.2%) had a significantly higher rate of developing NP symptoms than current nonsmokers (11.1%) ( P = .016). The location of the pathology and obesity had a moderate effect on the prevalence of NP symptoms. Patients with ankle-level pathology, excluding tarsal tunnel syndrome, had a marginally increased risk of having NP symptoms (15.4%) compared to patients with forefoot pathologies, excluding Morton’s neuroma (7.5%, P = 0.06). Obesity also had a moderate effect on the NP risk, with 15.6% risk of NP symptoms for patients with BMI of 30 or more compared to 10% risk for patients with a BMI of less than 30 ( P = .06). Patients with NP symptoms reported significantly higher levels of current pain (7.2 vs 4.6, P < .001). Conclusion: A considerable number of patients with foot and ankle problems requiring surgery had a neuropathic component of pain. Evaluation of their risk factors and level of pain may help with the diagnosis, decision making, and pain control. Further research is needed to evaluate the effect of preoperative NP on the short- and long-term results of surgeries. Level of Evidence: Level II, prospective cohort survey study.

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Implementation of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) sedation training course in a regular endoscopy unit

Endoscopy ◽

10.1055/a-1197-6762 ◽

2020 ◽

Vol 53 (01) ◽

pp. 65-71

Author(s):

Mauro Manno ◽

Simona Deiana ◽

Tommaso Gabbani ◽

Matteo Gazzi ◽

Alessandro Pignatti ◽

...

Keyword(s):

Adverse Events ◽

Training Program ◽

European Society ◽

Gastrointestinal Endoscopy ◽

Deep Sedation ◽

Safe Procedure ◽

Moderate Sedation ◽

Endoscopic Procedures ◽

Endoscopy Unit ◽

Electronic Reporting

Abstract Background Several scientific societies have endorsed non-anesthesiologist sedation (NAS) during gastrointestinal endoscopy, considering it a safe procedure when administered by adequately trained personnel. This study aimed to evaluate the occurrence of adverse events after implementation of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) sedation training program. Methods From January 2017 to August 2018, data from all consecutive endoscopic procedures in adults (≥ 18 years) performed at our endoscopy unit were collected using an electronic reporting system. Results All staff (physicians and nurses) completed the ESGE-ESGENA sedation course. In total, 12 132 patients underwent endoscopic procedures, 10 755 (88.6 %) of which were performed in a non-anesthesiological setting. Of these, about 20 % used moderate sedation with midazolam + fentanyl and 80 % used deep sedation with additional propofol. No sentinel, 5 (0.05 %) moderate risk, and 18 (0.17 %) minor risk adverse events occurred, all during moderate or deep sedation, and all managed by endoscopy staff without the need for anesthesiologist assistance. Conclusions After completing the ESGE-ESGENA sedation training program, the rate of adverse events was very low in our institution. The findings support implementation of the program in all digestive endoscopy units and inclusion in the curriculum for physicians and nurses to ensure safe endoscopic procedures.

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Endoscopic and angiographic management of lower gastrointestinal bleeding: Review of the published literature

United European Gastroenterology Journal ◽

10.1177/2050640617746299 ◽

2017 ◽

Vol 6 (3) ◽

pp. 337-342 ◽

Cited By ~ 4

Author(s):

David J Werner ◽

Hendrik Manner ◽

Marc Nguyen-Tat ◽

Roman Kloeckner ◽

Ralf Kiesslich ◽

...

Keyword(s):

Gastrointestinal Bleeding ◽

Standard Procedure ◽

Lower Gastrointestinal Bleeding ◽

Endoscopic Procedures ◽

Number Of Patients ◽

Rising Incidence ◽

The Subject ◽

Lower Gastrointestinal Tract Bleeding ◽

Gastrointestinal Tract Bleeding ◽

Patients Experience

Lower gastrointestinal bleeding is common and occurs often in elderly patients. In rare cases it is associated with hemorrhagic shock. A large number of such bleedings, which are often caused by colon diverticula, subside spontaneously. Alternatively they can be treated by endoscopic procedures successfully. Given the aging population of our society, the rising incidence of lower gastrointestinal tract bleeding and new anticoagulant therapies, some of the bleedings tend to be severe. Colonoscopy is the established standard procedure for the diagnosis and treatment of lower gastrointestinal bleeding. However, a small number of patients experience re-bleeding or shock; their bleeding does not resolve spontaneously and cannot be treated successfully by endoscopic procedures. In such patients, interventional radiology is very useful for the detection of bleeding and the achievement of hemostasis. Against this background we performed a literature search using PubMed to identify all relevant studies focused on the endoscopic and radiological management of lower gastrointestinal bleeding and present recent conclusions on the subject.

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A point prevalence survey study (PPS) of antimicrobial consumption in a tertiary care super-speciality hospital of West Bengal

Indian Journal of Pharmacy and Pharmacology ◽

10.18231/j.ijpp.2021.034 ◽

2021 ◽

Vol 8 (3) ◽

pp. 200-204

Author(s):

Raja Chakraverty ◽

Kalyan Samanta

Keyword(s):

West Bengal ◽

Tertiary Care ◽

Point Prevalence ◽

Survey Study ◽

Care Hospital ◽

Antimicrobial Consumption ◽

Prevalence Survey ◽

Record System ◽

Point Prevalence Survey ◽

Number Of Patients

Antimicrobial resistance (AMR) is an emerging global health issue. Resistance occurs when bacteria, parasites, viruses or fungi are exposed to antimicrobials but not killed by them. The study was conducted to gather baseline information to assess the antimicrobial consumption practices across six departments in a tertiary care super speciality hospital of West Bengal. Modified version of a patient data collection form proposed by Global PPS was developed on Epi Info software version 7 (CDC). Data of all patients in ward at 08.00 am data were studied. The use of antimicrobials was categorized as empiric, prophylactic or lab based. This classification is not mentioned in the files, so a response from the doctor taking care of the patient was noted.A total of 85 patient related data was collected in the designated survey form. Total beds covered was 340 and the number of patients on antimicrobials was found to be low at 21.27 %. The patients surveyed were predominantly female (78.8 %). The mean number of antimicrobials per patient was found to be 1.62 (range of 1.4 to 2.2) Relatively low number of patients were found to be on 2 or more antimicrobials. Double gram negative and Double anaerobic coverage of AM used varied across departments covered.:Our point prevalence study was able to facilitate conducting of point prevalence survey in high patient volume tertiary care hospital with paper based medical record system and also depicted the baseline parameters of intervention for instituting future action and policy changes.

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A multinational e-survey on the delivery of cardiology services in Africa during the COVID-19 pandemic: what should we expect after this pandemic?

10.1101/2020.07.24.20160390 ◽

2020 ◽

Author(s):

Chris Nadege Nganou-Gnindjio ◽

Mazou Ngou Temgoua ◽

Liliane Mfeukeu Kuate ◽

Clovis Nkoke ◽

Joel Noutakdie Tochie ◽

...

Keyword(s):

Care Delivery ◽

Cardiovascular Complications ◽

Survey Study ◽

African Countries ◽

Cross Sectional ◽

Outcomes Measures ◽

Number Of Patients ◽

Secondary Outcomes ◽

The Impact ◽

Study Setting

Abstract Objective: To evaluate the impact of the COVID-19 pandemic on the delivery of cardiology services in Africa. Design: Cross-sectional e-survey study. Setting: African countries Participants: Cardiologists Primary and Secondary outcomes measures: The primary outcome was the change in service delivery in African cardiology units during the on-going COVID-19 pandemic. The secondary outcomes were the satisfaction of cardiologists with regards to the workload and factors associated with this satisfaction. Results: There was a significant reduction in working time and the number of patients consulted by week during this pandemic (p<0.001). In general, there was a decrease in the overall activities in cardiovascular care delivery. The majority of cardiology services (76.5%) and consulting programs (85%) were adjusted to the pandemic. Only half of the participants were satisfied with their workload. Reconfiguration of the consultation schedule was associated with a reduced satisfaction of participants (p=0.02). Conclusions: COVID-19 is associated with an overall reduction in cardiology services rendered in Africa. Since the cardiovascular burdens continue to increase in this part of the World and the risk of cardiovascular complications linked to SARS COV2 remains unchanged cardiology, departments in Africa should anticipate a significant surge of cardiology services demanded by patients after the COVID-19 pandemic.

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