Evaluation Of Patient Satisfaction Of An Outpatient Gastroscopy Service In An Asian Tertiary Care Ho

Gastro-oesophageal reflux disease





Moreover, there are limited published studies on patient satisfaction towards endoscopy from Asian countries. Many studies on patient satisfaction were carried out immediately after the procedure [ 7 - 9 ]. Sedation given during the procedure may affect patient satisfaction score and this raises the question on whether answering a questionnaire immediately after the procedure may yield different satisfaction scores compared to administering the questionnaire at a later date. In a study by Lin et al [ 10 ], on-site survey resulted in higher satisfaction scores compared to mail back survey. Besides the possible influence of sedation, it was hypothesized that patients may feel disinclined to give low satisfaction scores in the presence of endoscopy unit staff. Another study by Harewood et al [ 11 ] reported that survey methods that involved more personal interaction such as on-site surveys and phone interviews tend to generate higher response rates than less personal methods such as mail back surveys and electronic mail surveys. To the best of our knowledge, there is till date no study comparing on-site interview and phone interview in terms of success rate and patient satisfaction score of endoscopy services. Thus, the secondary aim of our study is to compare the results of immediate on-site interview and delayed phone interview in these aspects. Outpatient gastroscopy Service in University of Malaya Medical Centre Our center practices an open-access outpatient gastroscopy service receiving patients from primary care clinics, other specialist clinics and those discharged from in-patient wards in addition to patients from the gastroenterology clinic. Gastroscopy appointments are given on a first-come-first-serve basis. When a patient is deemed to require an earlier gastroscopy appointment, the doctor-in-charge would negotiate the patients appointment to an earlier date. Appointment time on gastroscopy day is staggered fifteen minutes per patient per room to reduce waiting time. A support staff will register patients and a staff nurse will help patients prepare for the procedure. super fast reply http://www.biomedcentral.com/1471-230X/12/96





SKILLS - Gastroscopy





Manometry can be performed to determine lower oesophageal sphincter pressure and identify any oesophageal motility disorders. Oesophageal pH monitoring may be performed in some patients. This can help to confirm the diagnosis in patients in whom the history is not clear, if they have atypical symptoms, or if an endoscopy is normal. 4. Treatment Lifestyle modification is important, including weight loss and smoking cessation (if necessary), avoidance of certain foods (for example, chocolate, citrus juice, tomato-based products), and eating smaller meals. Eating the evening meal at least three hours before going to bed is often beneficial. The most common medications given to patients with GORD are PPIs. However, antacids are still recommended first line. They can also be used in conjunction with other medication, for example PPIs. H2 receptor antagonists, such as ranitidine, remain a useful choice for some patients. PPIs have been shown to be more effective than H2 receptor antagonists in relieving heartburn in patients with GORD who are treated empirically and in those with normal gastroscopy findings.2 PPIs can be given at a healing dose for one to two months, which can be reduced once symptoms improve. The lowest effective dose can then be given as maintenance treatment. Patients should have a trial without treatment once their symptoms completely improve. The dose of the PPI is gradually reduced before stopping it. in the know http://www.gponline.com/Clinical/article/1135254/gastro-oesophageal-reflux-disease/









- Patient is nil by mouth for four to six hours before the procedure. - Patients should be offered the choice of intravenous sedation or local lignocaine throat spray. Sedation is given in incremental doses with time given to assess the effect of the sedation. - The patient is positioned in the left lateral position, head slightly flexed and a mouth guard is inserted. - The equipment is checked. Oxygen is on hand if necessary. - The endoscope is lubricated and inserted into the mouth guard, over the tongue to the oropharynx. The patient is asked to swallow to assist the advancement of the endoscope. - The endoscope is passed down the oesophagus, through the lower oesophageal sphincter and into the stomach. Water may be passed down the endoscope to act as a wash and improve views. Air may be insufflated within the stomach, to aid views. - The endoscope is passed via the pyloric sphincter into the duodenum. look these up http://www.nursingtimes.net/nursing-practice/clinical-zones/gastroenterology/skills-gastroscopy/205528.article