A nursing sedation model is allowing thousands of low-risk endoscopy patients to be treated without an anaesthetist in a novel approach to care that is shortening procedure wait lists in regional Queensland.
The Endoscopy Unit at Cairns Hospital has used the EDNAPS (endoscopists directed nurse administered Propofol sedation) model of care for more than 40,000 patients, according to local gastroenterologists.
They say this model allows nurses to work to their full scope of practice and the treating doctor to titrate the level of sedation to the patient – reducing the number of staff required for the procedure to just one doctor and two nurses.
Cairns Hospital Director of Gastroenterology Dr Peter Boyd said Cairns Hospital was one of a handful of places in Australia to use an EDNAPS model and it had proven to be an effective model of care for patients and staff.
“It’s safer for patients and it’s better for patients. It’s obviously efficient for the health system, it’s cost effective and I believe it will be the future,” he said.
“In most endoscopy units in Australia sedation for endoscopy is delivered by specialist anaesthetists, which is clearly much more expensive and labour intensive.
“We have excellent patient satisfaction data with well over 90% of people experiencing no discomfort or no recollection of the procedure.”
Cairns Hospital Endoscopy Unit Acting Nurse Unit Manager Rebecca Healy said the clinical nursing team assess patients who have been referred by their general practitioner or physician to the unit.
“Our team triages whether the patient is appropriate for nursing sedation or if they have multiple co-morbidities that then need an anaesthetist,” she said.
For patients who do not require an anaesthetist, it is the endoscopist who drives the provision of sedation, supervising a registered nurse who monitors the patient and administers the sedation.