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Endoscopy nurse-administered propofol sedation performance. Development of an assessment tool and a reliability testing model

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  1. Quality of life, performance status, and work capacity after post-endoscopic retrograde cholangiopancreatography pancreatitis

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  3. Direct acting antiviral treatment of chronic hepatitis C in Denmark: factors associated with and barriers to treatment initiation

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  1. Rebound pain following peripheral nerve block anaesthesia in acute ankle fracture surgery: An exploratory pilot study

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  2. Subtyping of intraductal papillary mucinous neoplasms - pitfalls of MUC1 immunohistochemistry

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  3. Exploring Shared Mental Models of surgical teams in Video-Assisted Thoracoscopic Surgery lobectomy

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  4. A multi-institution consensus on how to perform EUS-guided biliary drainage for malignant biliary obstruction

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  5. A novel endoscopic ultrasound-guided through-the-needle microbiopsy procedure improves diagnosis of pancreatic cystic lesions

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OBJECTIVE: A gold standard of skills required for nurse-administered propofol sedation (NAPS) for gastroenterological endoscopic procedures has been proposed but not established. Due to the potentially hazardous nature of NAPS, an assessment tool is needed to objectively judge the adequacy of training and for future certification. The aim of this study was to develop an assessment tool for measuring competency in propofol sedation and to explore the reliability and validity of the tool.

MATERIAL AND METHODS: The nurse-administered propofol assessment tool (NAPSAT) was developed in a Delphi-like fashion. Consensus was achieved on 17 items. Validity evidence was gathered in a case-control study in a full-scale simulation setting. Six experienced nurses and six novice nurses were filmed in two scenarios for assessment according to the assessment tool by three content expert raters.

RESULTS: A total of 72 NAPSAT assessment forms were analyzed. Inter-rater reliability, Cronbach's α = 0.54 and generalizability coefficient = 0.68. The experienced nurses scored higher than the novices, 52.8 versus 62.7, p = 0.009. The provided pass/borderline/fail assessment showed significant difference, p = < 0.001, Cronbach's α = 0.80, with the novices being more likely to fail and the experienced more likely to pass.

CONCLUSION: Assessing sedation skills in a simulator is possible. Video assessment requires expert knowledge of the procedure and the rating matrix. Overall, NAPSAT showed fair inter-rater reliability and good construct validity. This makes NAPSAT fit for formative assessment and proficiency feedback; however, high stakes and summative assessment cannot be advised.

Original languageEnglish
JournalScandinavian Journal of Gastroenterology
Volume49
Issue number8
Pages (from-to)1014-9
Number of pages6
ISSN0036-5521
DOIs
Publication statusPublished - Aug 2014

ID: 44860323