Timely access to quality colonoscopy
Bowel Cancer Australia advocates for prompt access to diagnostic colonoscopy.
Clinically significant symptoms, such as rectal bleeding, require investigation via colonoscopy within 30 days.
Similarly, a positive faecal immunochemical test (FIT) means blood, invisible to the naked eye, has been detected in the bowel movement, which requires further investigation via colonscopy within 30 days.
Bowel Cancer Australia representatives are working towards improving the quality of colonoscopy in Australia.
They have been instrumental in establishing and implementing the Train-the-Colonoscopy-Trainer Project under the umbrella of the National Endoscopy Training Initiative. This comprises a series of practical workshops aimed at registrars and fellows who are in the process of learning colonoscopy.
Bowel Cancer Australia specialist doctors are also contributing to the federal Colonoscopy Quality Working Group. Both initiatives are important to the long-term success of the National Bowel Cancer Screening Program, since safe accurate colonoscopy is vital if the benefits of the program are to be realised and maximised.
The adequacy of training of endoscopists has a direct bearing on the quality of endoscopic care.
A two-year program training nurses to help meet the growing demand for colonoscopy services is now in the evaluation stage.
The $2.6 million program by Health Workforce Australia has trained nurse endoscopists across a number of sites including the Logan and Beaudesert Hospitals in South-east Queensland and the Austin, Alfred and Heidleberg Repatriation hospitals in Victoria.
The Expanded Scope of Practice: Advanced Practice in Endoscopy Nursing program includes 100 hours training under medical supervision.
Bowel Cancer Australia chief executive Mr Julien Wiggins said the issue of access to colonoscopy services was identified many years ago in the early days of the National Bowel Cancer Screening Program (NBCSP).
"There was always a concern that the health system would need to ramp up access to colonoscopies as the National Bowel Cancer Screening Program got underway. In particular, there was a need to ensure timely access to colonoscopies for people who returned a positive screening test," Mr Wiggins said.
While the medical profession responded with additional colonoscopy training for their colleagues, medical workforce shortages and increasing demand have created a need for additional strategies.
"Bowel cancer is already our second most common cancer and with an ageing population there will be an ongoing demand for colonoscopy services."
"Quality, consistency and availability of colonoscopy have always been the agreed goal and Bowel Cancer Australia is supportive of initiatives that can help deliver on that," Mr Wiggins said.
A proposal from the Grattan Institute by former health department secretary, Stephen Duckett, has identified the potential role of nurses in bowel cancer screening.
Under the plan, about 2,000 registered nurses would receive extra training to conduct 40 per cent of endoscopies that screen for bowel cancer.
While the plan is relatively new for Australia, endoscopy nurses in the United States have been practicing since the 1970s and more than 300 practice in the United Kingdom. Canada has also recently introduced this expanded role for nurses.
In November 2014, Queensland Health and Queensland University of Technology have partnered to deliver the Master of Nursing with a specialty focus on Nurse Endoscopy, the first program of its kind in Australia.
With public demand for endoscopies set to double over the next five years, the masters program will help build a workforce of senior nurses able to perform the procedures.
The course builds on the clinical experience of previous pilots in Victoria and Queensland where nurses were trained in endoscopy through the University of Hull in the United Kingdom.
The new masters level course is based on the national standards for gastroenterology meaning that nurses will need to reach the same level of competency as doctors in order to become qualified.
Queensland's Chief Nursing and Midwifery Officer Dr Frances Hughes said the partnership would lead to better health outcomes for Queenslanders.
The course has been developed by QUT in consultation with senior medical and nursing gastroenterology specialists to ensure that the procedures are performed safely.
Professor Yates said the program would provide a pathway for experienced and specialised nurses in the field to advance their skills through formal qualifications so that they meet all necessary professional and higher education standards.
The first cohort of up to 15 nurses will commence study in the masters program in January 2015.
Colonoscopy is a procedure to look inside the colon and rectum for polyps, abnormal areas, or cancer.
A colonoscope is inserted through the anus and rectum and into the colon.
A colonoscope is a thin, tube-like instrument with a light and a lens for viewing.
It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.
Polyps can also be removed by a procedure known as polypectomy.
A colonoscopy takes around 30 minutes and sedation is given to help people relax.