Sections News

Meeting the Demand for Endoscopy Services

Monday, 30 April 2012 11:12

Steve Hughes, BSG Vice-President Endoscopy & Roland Valori National Clinical Director for Endoscopy

There will be a 75% increase (on 2010/11 activity) in lower GI endoscopy demand in England in the next four years, on top of the 50% increase in activity achieved in the last four years. This extra demand arises from screening and symptomatic work. Most services have just been coping with increasing demand in recent years, but waiting lists initiatives remain common place and a few sites have perpetually long waits. Long waits is the most common reason sites struggle to maintain JAG accreditation. There is an urgent need to do things differently to respond to the increase in demand and to make 'just coping' a thing of the past. Learning from sites that maintain low waits indicates there are two key factors that determine how well a service keeps in control of its demand: effective planning and high productivity.

In anticipation of the increasing demand for endoscopy, and appreciation of the pressures endoscopy teams are under, the JAG, in collaboration with the Bowel Cancer Screening Programme, is delivering a series of ten workshops throughout England to help endoscopy teams plan better and be more productive. The principal objective of the workshops is to enable teams to present more effective business plans to their trust boards. They are aimed at the medical and nurse lead, and their manager, and a representative of their PCT. They will be delivered in the next six months and be led by Roland Valori, NCD for endoscopy. You are strongly encouraged to attend. For more details please visit the JAG website: www.thejag.org.uk

Reducing risk of harm caused by bowel cleansing medication

Tuesday, 08 March 2011 16:39

This resource is one of a series produced by the Medicines Use and Safety Division of the East and South East England Specialist Pharmacy Services. These resources aim to support NHS organisations and practitioners from all sectors of care in implementing and assuring medication-related requirements published by the NPSA (Rapid Response Report RRR012: 'Reducing risk of harm from oral bowel cleansing solutions') to ensure that they are embedded in practice over time: a do-once-and-share approach.

Statement on Entonox and Fitness to Drive

Tuesday, 06 July 2010 09:01

The BSGE has recently received an enquiry into the use of Entonox and fitness to drive. Entonox (50% nitrous oxide, 50% oxygen, manufactured by BOC) is mainly used in obstetric units and by the ambulance service, but its analgesic and sedative properties with rapid onset and offset make it a potentially attractive agent in patients having colonoscopy and it is already in use in many units. A number of publications in the 1990s showed that it is safe and effective, with reduced discomfort and nausea compared to IV agents and allows earlier discharge from the recovery unit. It is perhaps surprising that it is not more widely used.

As for the question of fitness to drive: the recently revised product licence states that patients are fit to drive a vehicle (or operate machinery) after only 30 minutes. Used in combination with a rapidly acting bowel cleansing agent, this could mean that for patients whose colonoscopy is to be done mid-week, only half a day away from work is required – a major advantage for the self-employed. A pdf file, "Entonox: Information for the User" is available from BOC (and on the BSG website)

Alistair McNair, Secretary BSG Endoscopy

Reducing risk of overdose with midazolam injection in adults

Sunday, 15 March 2009 00:47

National Patient Safety Agency Rapid Response Report Issued: Reducing risk of overdose with midazolam injection in adults

Some adult patients are being overdosed with midazolam injection when used for conscious sedation. The presentation of high strength midazolam as 5mg/ml (2ml and 10ml ampoules) or 2mg/ml (5ml ampoule) exceeds the dose required for most patients. There is a risk that the entire contents of high strength ampoules are administered to the patient when only a fraction of this dose is required. Doses often exceed that required, are not titrated to the patient’s individual needs, do not take into account concurrent medication (e.g. opioids) and may involve high risk groups for example, the frail or the elderly. There is frequent reliance on injectable flumazenil (antagonist/reversing agent) for reversal of sedation in patients that have been over sedated.

Attachments:
Download this file (midazolam_rrr_08.pdf)Reducing risk of overdose[Reducing risk of overdose with midazolam injection in adults ]44 Kb

Page 2 of 2