Room for Quality Improvement in Endoscopist-Directed Sedation: Results from the First Nationwide Survey in Korea.
- Author:
Chang Kyun LEE
1
;
Seok Ho DONG
;
Eun Sun KIM
;
Sung Hoon MOON
;
Hong Jun PARK
;
Dong Hoon YANG
;
Young Chul YOO
;
Tae Hoon LEE
;
Sang Kil LEE
;
Jong Jin HYUN
Author Information
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords: Gastrointestinal endoscopy; Sedation; Health care surveys; Propofol; Non-anesthesiologist-administered propofol
- MeSH: Adult; Aged; Aged, 80 and over; Colonoscopy/methods/psychology; Conscious Sedation/*methods/psychology/standards; Endoscopy, Digestive System/methods/psychology; Endoscopy, Gastrointestinal/*methods/psychology; Female; Gastroenterology/methods; Humans; Hypnotics and Sedatives; Male; Middle Aged; Patient Satisfaction; Practice Patterns, Physicians'/standards/*statistics & numerical data; Propofol; Quality Improvement; Republic of Korea; Surveys and Questionnaires
- From:Gut and Liver 2016;10(1):83-94
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: This study sought to characterize the current sedation practices of Korean endoscopists in real-world settings. METHODS: All active members of the Korean Society of Gastrointestinal Endoscopy were invited to complete an anonymous 35-item questionnaire. RESULTS: The overall response rate was 22.7% (1,332/5,860). Propofol-based sedation was the dominant method used in both elective esophagogastroduodenoscopy (55.6%) and colonoscopy (52.6%). The mean satisfaction score for propofol-based sedation was significantly higher than that for standard sedation in both examinations (all p<0.001). The use of propofol was supervised exclusively by endoscopists (98.6%). Endoscopists practicing in nonacademic settings, gastroenterologists, or endoscopists with <10 years of endoscopic practice were more likely to use propofol than were their counterparts (all p<0.001). In total, 27.3% of all respondents performed sedation practices without having undergone sedation training, and 27.4% did so without any formal sedation protocols. The choice of propofol as the dominant sedation method was the only significant predictor of endoscopist experience with serious sedation-related adverse events (odds ratio, 1.854; 95% confidence interval, 1.414 to 2.432). CONCLUSIONS: Endoscopist-directed propofol administration is the predominant sedation method used in Korea. This survey strongly suggests that there is much room for quality improvement regarding sedation training and patient vigilance in endoscopist-directed sedation.
