END12 Perform diagnostic and therapeutic endoscopic procedures

Overview

This standard covers the performance of diagnostic and therapeutic endoscopic procedures.  This covers the use of endoscopes during a number of endoscopic procedures, including the insertion, guidance, manipulation, and withdrawal of the scope.  The scope has to be positioned in the appropriate place for the specific procedures to be carried out.  These procedures cover any activity relating to the use of the endoscope; however there are separate standards that complement this competence. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:

1. the ethics and responsibilities of practitioners, and relevant professional bodies, codes of conduct, and guidelines
2. evidence-based practice and its role in improving care
3. the legislation relating to the
1. role of practitioners and clinical practice
2. health and safety
3. the care of individuals, include impact of the Human Rights Act
4. freedom of information and data protection
4. government and organisational policies relating to the provision of endoscopy
5. aetiology, pathogenesis, and progress of specific conditions, including genetic or environmental factors
6. the anatomy, physiology, and pathology relevant to specific conditions
7. the methods for managing specific conditions
8. the short, medium, and long term effects of specific conditions on individuals and their carers
9. symptoms of specific conditions, and potential complications and outcomes
10. the signs of abnormalities revealed by endoscopic procedures
11. legislation and legal processes relating to consent
12. the principles of valid consent, including implied consent and expressed consent
13. the process and timing for obtaining valid consent during endoscopic procedures, and what to do if consent is withdrawn during procedures
14. the relevant national and organisational policies and guidelines on consent
15. statutory statements, living wills, advanced directives, and other expressions of an individual’s wishes
16. established and new endoscopic procedures and techniques that are available for use with specific conditions
17. the equipment and accessories to be used with specific endoscopic procedures
18. the suitability of endoscopic procedures and techniques for specific groups of individuals
19. the risks and complications of specific endoscopic procedures and techniques
20. the guidelines and procedures for quality assurance, and evidence of effectiveness of specific endoscopic procedures
21. the methods to assess and monitor the individual during endoscopic procedures
22. the needs of individuals and carers, including issues relating to dignity, confidentiality, and privacy
23. the role, responsibilities, needs, and relationships between individuals and carers
24. the services and assistance that the individual and their carers should be entitled to
25. the type of information that is most useful to individuals and their carers, their rights to obtain it, and how they can access it
26. how individuals and carers respond to endoscopic procedures
27. national and local policies and guidelines relating to the management and effective use of endoscopy resources
28. organisational management structures, roles, and responsibilities
29. procedures, protocols, and pathways for liaising with individuals, carers, practitioners, departments, and agencies
30. record keeping systems and policies
31. how to provide feedback on services
32. methods and equipment to monitor physiological condition
33. how specific endoscopic procedures require or cause a change in the physiological condition of an individual
34. responses of individuals, and signs of distress or complications
35. first aid and resuscitation methods
36. the procedures and methods relating to the coordination of inter-disciplinary and multi-disciplinary teams within and across services
37. the role of different types of practitioners and agencies in providing an endoscopy service
38. the services provided by relevant national, local, and voluntary social and health care agencies
39. sources of authoritative information on endoscopic procedures, including evidence based information
40. the centres of research and development on endoscopy, and the current issues and research debates
41. information and educational resources for practitioners, individuals, and carers, and methods for accessing them
42. journals, magazines, web-sites, and patient guidance notes and leaflets for specific endoscopic procedures
43. voluntary organisations, charities, and interest groups relating to different conditions

Performance Criteria

You must be able to do the following:

1. respect the individual’s rights and wishes relating to their consent, privacy, beliefs, and dignity
2. confirm the diagnostic or therapeutic purpose of the endoscopic procedure, and ensure that valid consent has been obtained
3. ensure that health and safety measures relevant to the endoscopic procedure are undertaken
4. ensure that the condition of the individual has been assessed, and that it is monitored at all times throughout the endoscopic procedure
5. ensure that all preparation procedures relating to the endoscopy equipment are undertaken before and after the endoscopic procedure
6. examine the relevant orifice to ensure that there are no blockages or difficulties, and that it is safe to proceed
7. insert the lubricated endoscope carefully using the appropriate technique for the endoscopic procedure being undertaken
8. ensure that any fluids or gases are introduced according to the requirements of the endoscopic procedure
9. guide the path of the endoscope by maximising mucosal visualisation to achieve the required position, as confirmed by the monitoring systems where possible
10. manipulate the endoscope by applying carefully controlled movements and appropriate speed and pressure
11. reposition the individual if necessary to assist the manipulation of the endoscope and the completion of the endoscopic procedure
12. utilise different accessories within the endoscope to provide diagnostic and therapeutic procedures if appropriate
13. record images of features required for clinical records and further diagnostic and therapeutic procedures
14. withdraw the endoscope by carefully guiding and manipulating it
15. keep accurate, legible, and complete records, and comply with all the relevant legal, professional, and organisational requirements and guidelines

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB7 Interventions and treatments planning