South Australia established the Southern Co-operative Program for the Prevention of Colorectal Cancer in 1999 to improve surveillance colonoscopy rates. The model was originally physician-led in non-academic hospitals, where a physician managed the entire process. A nurse-led model adhering to Australian National Health and Medical Research Council guidelines was introduced in 2000, which saw guideline adherence rise from 46 percent to 96 percent.
In this study, Australian researchers audited 732 colonoscopies over a three-month period in 2015 to compare performance between the models.
The nurse-led model adhered to Australian surveillance guidelines 97 percent of the time, while physicians adhered to the guidelines 83 percent of the time. Adherence to the guidelines was associated with a lower number of cases that progressed to cancer and fewer unnecessary colonoscopies.
Compliance with the guidelines is traditionally low. Researchers said 89 percent of Australian patients received inappropriate surveillance. That surveillance was primarily conducted through unnecessary colonoscopies.
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