Although these new standards are aimed specifically to reduce incidents related to invasive surgical procedures there are “take home” messages for all Clinical Physiologists, but especially those working in Gastroenterology and Cardiology.
These new standards set out broad principles of safe practice and advise healthcare professionals on how they can implement best practice, such as through a series of standardised safety checks and education and training. The standards also support NHS providers to work with staff to develop and maintain their own, more detailed, local standards and encourage the sharing of best practice between organisations.
WHAT DOES THIS MEAN FOR ME?
The standards published provide a framework for local standards to be established. The recommendations which impinge on the work of Clinical Physiologists come under the following headings:
- If you are the managerial or clinical leader of a service that performs invasive procedures, you should work with those Healthcare Professionals directly involved in the performance of invasive procedures to create Local Safety Standards for Invasive Procedures that are deliverable and practicable, and support safe patient care rather than distract people from it. You should ensure that time is available for team training in the delivery of safe care.
- If you are a healthcare professional who is a member of an invasive procedure team (or carrying out an invasive procedure), you are the one who should feel a real sense of ownership of the local standards. You should contribute towards their creation, documentation, audit, review and development. You should participate fully in the safety checks and steps built into the standards. You are also the one who should speak up if they have any concerns at all about the care that the patient is getting. You are the one who makes safer patient care a reality.
The National Institute for Health and Care Excellence (NICE) defines an “interventional procedure” as a procedure used for diagnosis or for treatment that involves:
- Making a cut or a hole to gain access to the inside of a patient's body – for example, when carrying out an operation or inserting a tube into a blood vessel
- Gaining access to a body cavity (such as the digestive system, lungs, womb or bladder) without cutting into the body – for example, examining or carrying out treatment on the inside of the stomach using an instrument inserted via the mouth
- Invasive cardiological procedures such as cardiac catheterisation, angioplasty and stent insertion
- Endoscopic procedures such as gastroscopy and colonoscopy
- Interventional radiological procedures.
All those involved in the performance of the procedures, including doctors, nurses, midwives, operating department practitioners (ODPs), healthcare assistants (HCAs), technicians, scientists (clinical physiologists) and any others directly involved in the performance of the procedure.
WHO IS AN OPERATOR?
Includes the surgeon, endoscopist, cardiologist, obstetrician, midwife, radiologist or other healthcare professional or practitioner performing the invasive procedure.
COMMENT/ TAKE HOME MESSAGE
Most established Clinical Physiology units offering diagnostic and therapeutic services will have established these standards and, through RCCP and the Professional Bodies, will be ensuring the highest standard of training of physiologists delivering these invasive procedures.
However this publication not only reinforces our individual responsibilities but also provides us with a tool to counteract the growing number of employers who set up these services without reference to established practice. Healthcare Professionals in such services often approach established services for advice and can now be referred to these standards. NICE intends to publish Guidance and Guidelines for Diagnostic Services by 2017.
Hopefully these tools will ensure that all Diagnostic and Therapeutic Services in Clinical Physiology comply with established national standards of practice and education and training of staff.
Reviewed by: Professor G Duthie, President AGIP and Patricia Vales, RCCP representative GI Physiology.