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https://hdl.handle.net/2440/126765
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Type: | Journal article |
Title: | A nurse-led model at public academic hospitals maintains high adherence to colorectal cancer surveillance guidelines |
Author: | Symonds, E.L. Simpson, K. Coats, M. Chaplin, A. Saxty, K. Sandford, J. Young, G.P. Cock, C. Fraser, R. Bampton, P.A. |
Citation: | Medical Journal of Australia, 2018; 208(11):492-496 |
Publisher: | Australasian Medical Publishing |
Issue Date: | 2018 |
ISSN: | 0025-729X 1326-5377 |
Statement of Responsibility: | Erin L Symonds, Kalindra Simpson, Michelle Coats, Angela Chaplin, Karen Saxty ... Peter A Bampton ... et al. |
Abstract: | OBJECTIVE:To examine the compliance of colorectal cancer surveillance decisions for individuals at greater risk with current evidence-based guidelines and to determine whether compliance differs between surveillance models. DESIGN:Prospective auditing of compliance of surveillance decisions with evidence-based guidelines (NHMRC) in two decision-making models: nurse coordinator-led decision making in public academic hospitals and physician-led decision making in private non-academic hospitals. SETTING:Selected South Australian hospitals participating in the Southern Co-operative Program for the Prevention of Colorectal Cancer (SCOOP). MAIN OUTCOME MEASURES:Proportions of recall recommendations that matched NHMRC guideline recommendations (March-May 2015); numbers of surveillance colonoscopies undertaken more than 6 months ahead of schedule (January-December 2015); proportions of significant neoplasia findings during the 15 years of SCOOP operation (2000-2015). RESULTS:For the nurse-led/public academic hospital model, the recall interval recommendation following 398 of 410 colonoscopies (97%) with findings covered by NHMRC guidelines corresponded to the guideline recommendations; for the physician-led/private non-academic hospital model, this applied to 257 of 310 colonoscopies (83%) (P < 0.001). During 2015, 27% of colonoscopies in public academic hospitals (mean, 27 months; SD, 13 months) and 20% of those in private non-academic hospitals (mean, 23 months; SD, 12 months) were performed more than 6 months earlier than scheduled, in most cases because of patient-related factors (symptoms, faecal occult blood test results). The ratio of the numbers of high risk adenomas to cancers increased from 6.6:1 during 2001-2005 to 16:1 during 2011-2015. CONCLUSION:The nurse-led/public academic hospital model for decisions about colorectal cancer surveillance intervals achieves a high degree of compliance with guideline recommendations, which should relieve burdening of colonoscopy resources. |
Keywords: | Digestive system diseases; health services administration |
Rights: | © 2018 AMPCo Pty Ltd. All rights reserved. |
DOI: | 10.5694/mja17.00823 |
Published version: | http://dx.doi.org/10.5694/mja17.00823 |
Appears in Collections: | Aurora harvest 8 Nursing publications |
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