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Unsedated Colonoscopy Introduced to Ensure Access is Acceptable to a Subgroup of Veterans

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Abstract

Background Nurses for monitoring and recovery are required for sedated colonoscopy. A nursing shortage necessitated discontinuation of sedated colonoscopy at a VA academic training program. Aim Elements of a case series that documented acceptance of unsedated colonoscopy are reviewed to raise awareness of the feasibility of this option. Method The pros and cons of sedation and no sedation were summarized. After discussion, patients who chose the unsedated option were scheduled for examination locally while those who desired sedation were scheduled at another VA site. Colonoscopy was performed by supervised trainees. Results From September 2002 to June 2005 scheduled unsedated colonoscopy was accepted by 145 of 483 veterans. Cecal intubation was achieved in 81%. Thus, of the cohort 30% had local access to and 24% completed unsedated colonoscopy. Implementation of unsedated colonoscopy obviated the need for two registered nurses previously required for sedated colonoscopy. Conclusion Unsedated colonoscopy offered as an option to ensure access was acceptable to a subgroup of our veteran patients. Implementation required less nursing resources. Techniques to enhance the cecal intubation rate of unsedated colonoscopy performed by supervised trainees deserves to be assessed in future studies.

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Abbreviations

VAGLAHS:

Veterans Affairs Greater Los Angeles Healthcare System

JCAHO:

Joint Commission on Accreditation of Healthcare Organizations

ANOVA:

Analysis of variance

VISN:

Veterans Integrated Service Network

DDW:

Digestive Disease Week

US:

United States

WLA VAMC:

West Los Angeles Veterans Affairs Medical Center

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Acknowledgement

This work was supported in part by the Veterans Affairs Medical Research Funds and ASGE Endoscopic Career Development Award (FWL 1985). The author has full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The author has no conflict of interest to declare.

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Authors and Affiliations

  1. Research and Medical Services, Sepulveda Ambulatory Care Center, West Los Angeles Veterans Affairs Medical Center, Veterans Affairs Greater Los Angeles Healthcare System, Sepulveda, Los Angeles, CA, USA

    Felix W. Leung

  2. 111G, Division of Gastroenterology, Sepulveda Ambulatory Care Center, VAGLAHS, David Geffen School of Medicine at UCLA, 16111 Plummer Street, Sepulveda, CA, 91343, USA

    Felix W. Leung

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Correspondence to Felix W. Leung.

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Leung, F.W. Unsedated Colonoscopy Introduced to Ensure Access is Acceptable to a Subgroup of Veterans. Dig Dis Sci 53, 2719–2722 (2008). https://doi.org/10.1007/s10620-007-0192-8

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  • DOI: https://doi.org/10.1007/s10620-007-0192-8

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