Licensure, use, and training of paramedical personnel to perform screeningflexible sigmoidoscopy

Background: The purpose of this study was to assess the state board of nurs ing guidelines about the performance of flexible sigmoidoscopy by nurses an d to determine the current use and training of paramedical personnel in fle xible sigmoidoscopy at gastroenterology fellowship programs in the United S tates. Methods: Separate one-page questionnaires were sent to state boards of nurs ing and directors of endoscopy at gastroenterology fellowship programs in t he United States. Results: Twenty percent (10 of 50) of state boards of nursing explicitly ap prove the performance of sigmoidoscopy by registered nurses, and 50% (25 of 50) explicitly approve the practice by nurse practitioners. Forty-six perc ent (23 of 50) of state boards of nursing have no written policy but allow nurses to use a "decision making model" to determine whether the performanc e of sigmoidoscopy is allowed. Fifteen percent (24 of 164) of gastroenterol ogy fellowship programs in the United States use paramedical personnel to p erform flexible sigmoidoscopy. Sixty-three percent (15 of 24) of these prog rams started since 1995, and 67% (16 of 24) require that the paramedical pe rsonnel perform 50 or more supervised sigmoidoscopies during their training . Forty-five percent (5 of 11) of programs with physician assistants/nurse practitioners use these personnel to perform colonoscopy or endoscopy. Conclusions: Nurses are allowed to perform flexible sigmoidoscopy in most s tates based on current state board of nursing guidelines. The use of parame dical personnel to perform endoscopic procedures is increasing rapidly.