Efficient Clinics. Happy Patients.

Managing the Balancing Act

Gastroenterology procedures like colonoscopies or upper GI endoscopies can be uncomfortable and anxiety-provoking for patients.([FOOTNOTE=Ferreira AO, Cravo M. Sedation in gastrointestinal endoscopy: Where are we at in 2014? World J Gastrointest Endosc. 2015 Feb 16;7(2): 102-109.],[ANCHOR=],[LINK=])  They number among the most commonly performed procedures in US hospitals.([FOOTNOTE=Pfuntner A, Wier LM, Stocks C. Most Frequent Procedures Performed in U.S. Hospitals, 2011. HCUP Statistical Brief #165. October 2013.],[ANCHOR=],[LINK=])

The number of GI procedures coupled with the need for safe, effective sedation present GI suites with sedation challenges.

Sedation in the GI Suite

Comprehensive Monitoring

One or more low respiratory rate alarm events occurred for 37% of patients with advanced monitoring and 59% of patients with standard monitoring.

Among patients undergoing advanced monitoring versus patients undergoing standard monitoring of procedure-related sedation, advanced monitoring correlated to fewer alarm events, fewer patients experiencing desaturation, and fewer patients experiencing respiratory depression alarm events.3

Reducing Recovery Times

Using one sedative agent in place of another showed a dramatic reduction in recovery times. After changing sedatives, three colonoscopies could be performed in the time it took for two previously.4

Tolerating advanced endoscopic procedures

In a study of 799 procedures, clinicians monitored patients using continuous electrocardiography, heart rate, pulse oximetry, nasal capnography, and intermittent blood pressure.6

Reducing sedation – not satisfaction

29.7% reduction in analgesics with music therapy.

21% reduction in procedure times with music therapy.([FOOTNOTE=Rudin D, Kiss A, Wetz RV, Sottile VM. Music in the endoscopy suite: a meta-analysis of randomized controlled studies. Endoscopy. 2007 Jun;39(6):507-10.],[ANCHOR=],[LINK=])

In one study, colonoscopy patients smelled Neroli oil, an essential oil produced from the blossom of the bitter orange tree. These patients needed less analgesics and had lower re- and post-procedure systolic blood pressure levels than the control group.7

Finding efficiency, improving sedation

Gastroenterology clinicians strive to save procedure time while maintaining patient safety and satisfaction. Inefficiencies can include underuse of endoscopy centers and staff.([FOOTNOTE=Gellad ZF. Endoscopy Unit Efficiency. Gastroenterol Hepatol (N Y). 2014 May;10(5):315-317.],[ANCHOR=],[LINK=])

Reducing sedation time, procedure time, and recovery room time can also improve efficiency throughout the GI suite.([FOOTNOTE=Day LW, Belson D. Studying and Incorporating Efficiency into Gastrointestinal Endoscopy Centers. Gastroenterology Research and Practice, 2015;2015, Article ID 764153.],[ANCHOR=],[LINK=]) To ensure patient safety, the Society of Gastroenterology Nurses and Associates states that capnography monitoring may reduce risks during moderate and deep sedation.([FOOTNOTE=Patient care & safety: patient monitoring. Society of Gastroenterology Nurses and Associates. http://www.sgna.org/GI-Nurse-Sedation/Patient-Care-Safety. ],[ANCHOR=],[LINK=])