Introduction Bowel Screening Wales utilises nurse-led telephone assessments pre-colonoscopy for screening participants following a positive faecal occult blood test (FOBt) result. This approach has been shown to optimise colonoscopy uptake.
Methods A literature review was carried out to determine the cost effectiveness and efficiency of telephone assessment as indicated by overall screening colonoscopy appointment uptake. Nurse-led telephone assessment is an advanced practice. Nurses undertaking this form of assessment should have undergone suitable training and supervision, be competent in their practice and accountable for their actions. Advanced assessment is the detailed, systematic collection of relevant information about the patient's problems and health status which requires a specialist knowledge, skill and extensive experience to uncover the relevant information being given and discard the irrelevant.1 Bowel Screening Wales was introduced nationally in October 2008 and operates from a single hub which is responsible for inviting participants, processing completed kits and providing results for participants. There are 13 Local Assessment Centres (LAC) which have a responsibility to provide endoscopy, pathology and radiology services for participants who have had a positive FOBt result. Specialist Screening Practitioners are based in each LAC. In Wales each Health Board covers a large geographical area therefore telephone assessments are a more effective method of pre-colonoscopy assessment in terms of cost, time and travel requirements. It has also been found that this approach results in a lower colonoscopy default rate due to improved participant involvement in the decision making process.
Results Data published in the Bowel Screening Wales First Round Report dated 29 September 2011 shows that 6493 (82.2%) of SSP appointments were completed by telephone. 0.5% of participants required or requested a face to face assessment. 90% of participants assessed were fit for colonoscopy of which 89.4% attended a procedure. The 10% of participants found not fit were offered an alternative to colonoscopy such as CT colonography.
Conclusion The literature reviewed clearly shows that telephone assessment for Bowel Screening Wales participants following a positive FOBt is an effective and acceptable form of information gathering and provision. Good attendance rates for assessment appointments and colonoscopy procedures are evidenced by the Bowel Screening Wales first round report.
Competing interests None declared.
Reference 1. McGee P, ed. Advanced assessment and differential diagnosis. Advanced Practice in Nursing and the Allied Health Professions. Oxford: Wiley-Blackwell, 2009.
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