QUALITY ASSESSMENT THROUGH PATIENT SELF-REPORT OF SYMPTOMS PREFIBEROPTIC AND POSTFIBEROPTIC BRONCHOSCOPY

Study objective: To apply the principles of quality improvement to mea sure the frequency and severity of symptoms that result from fiberopti c bronchoscopy (FOB), and to identify opportunities to improve FOE pra ctice by identifying factors about patients and the process of care th at predict these symptoms. Design: Concurrent longitudinal cohort stud y. Patients: Four hundred ninety-three adult patients who underwent FO E. Measurements and results: Patients completed questionnaires just pr ior to FOE and again at 48 h postprocedure. Patients were asked to rat e the severity of nose pain, throat pain, swallowing pain, and chest p ain, and the frequency of coughing, hemoptysis, phlegm, shortness of b reath, wheezing, difficulty swallowing, fever, and chills. Symptom sev erity was reported on a four-point ordinal scale. Findings: Significan t worsening was found for nose pain, throat pain, swallowing pain, and hemoptysis. Shorter patients experienced more throat pain and hemopty sis, and longer procedure time predicted nose pain and hemoptysis. Con clusions: Bronchoscopy causes nose pain, throat pain, swallowing pain, and hemoptysis to a larger extent than previously has been recognized . There are opportunities to improve the patient experience with bronc hoscopy by using smaller bronchoscopes in shorter patients, shortening the procedure length, and reanesthetizing the nares in longer procedu res.