{"id":3240,"date":"2020-10-22T10:27:21","date_gmt":"2020-10-22T10:27:21","guid":{"rendered":"\/?p=3240"},"modified":"2020-10-22T10:27:21","modified_gmt":"2020-10-22T10:27:21","slug":"diagnostic-reform-the-impact-on-endoscopy","status":"publish","type":"post","link":"https:\/\/www.vanguardhealthcare.co.uk\/bs_ba\/diagnostic-reform-the-impact-on-endoscopy\/","title":{"rendered":"Dijagnosti\u010dka reforma: utjecaj na endoskopiju"},"content":{"rendered":"

Zaostatak pacijenata koji \u010dekaju vi\u0161e od \u0161est sedmica na endoskopiju zna\u010dajno se pove\u0107ao od po\u010detka pandemije Covid-19, a liste \u010dekanja sada treba hitno rije\u0161iti. A\n\n nedavno objavljen izvje\u0161taj\n<\/a>\nNHS Engleske, poziva na reformu i predla\u017ee uvo\u0111enje mre\u017ee dijagnosti\u010dkih centara u zajednici, od kojih \u0107e neki sadr\u017eavati endoskopske prostorije.<\/p>\n

A\n\n mobilna ili modularna endoskopija\n<\/a>\nJedinica se mo\u017ee koristiti u me\u0111uvremenu ili zajedno sa sredi\u0161tem zajednice, kako bi se stvorila samostalna ustanova koja pru\u017ea poseban put za elektivne endoskopske usluge.\n\n Hitna potreba za rje\u0161avanjem vremena \u010dekanja\n<\/strong>\nPotra\u017enja za endoskopijom zna\u010dajno je porasla u posljednjih pet godina, i iako je aktivnost porasla, vrijeme \u010dekanja se pove\u0107ava br\u017ee, uzrokuju\u0107i zaostatak. Fleksibilne procedure sigmoidoskopije zabilje\u017eile su najve\u0107e stope rasta, uglavnom zbog uvo\u0111enja programa skrininga crijeva.<\/p>\n

Tokom Covid-19, potreba za dubljim \u010di\u0161\u0107enjem opreme i objekata izme\u0111u pacijenata dovela je do pada produktivnosti i otkazivanja procedura i, kao rezultat, sve ve\u0107eg i du\u017eeg \u010dekanja. Sveukupno, nivoi endoskopske aktivnosti smanjeni su za preko 90% na vrhuncu pandemije.<\/p>\n

Hitne endoskopske procedure na vrhuncu pandemije, gdje god je to bilo mogu\u0107e, poduzete su u operacionim salama s negativnim tlakom zraka. Gastroskopija je tako\u0111er prvobitno bila ozna\u010dena kao postupak stvaranja aerosola (AGP), koji nosi rizik za endoskopiste ako su pacijenti pozitivni na Covid-19 ili nesigurni na Covid-19, ali se gastroskopija vi\u0161e ne smatra AGP pod vodstvom PHE.\n\"\"\nNajnoviji podaci NHS Engleske pokazuju da je endoskopska aktivnost zna\u010dajno porasla od aprila, ali je stopa oporavka zna\u010dajno usporila. Aktivnost u avgustu iznosila je oko dvije tre\u0107ine one u normalnom mjesecu. Ovo, u kombinaciji sa \u010dinjenicom da liste \u010dekanja nisu zna\u010dajno pove\u0107ane u avgustu, uprkos niskom nivou aktivnosti, sugeri\u0161e da i dalje postoji zna\u010dajan 'skriveni' zaostatak ljudi koji jo\u0161 nisu u\u0161li na liste \u010dekanja.\n\n Potreba za sigurno\u0161\u0107u u budu\u0107nosti\n<\/strong>\nSada postoji hitna potreba za uspostavljanjem minimalnih endoskopskih objekata Covid-19 kako bi se pomogao oporavak. U izvje\u0161taju se priznaje da je pristup endoskopskoj opremi i objektima, posebno onima za kolonoskopiju, ve\u0107 bio pod velikim pritiskom prije pandemije. Pored ograni\u010denja radne snage, program Get it Right First Time (GIRFT) tako\u0111er je otkrio da \u0107e oko 20 fondova NHS-a vjerovatno zahtijevati potpunu obnovu svojih endoskopskih objekata, dok je ostalima potrebno pobolj\u0161anje.<\/p>\n

U izvje\u0161taju NHS England-a, procjenjuje se da je potrebno oko 200 novih prostorija za endoskopiju u NHS Trustovima kako bi se pokrio trenutni rast endoskopije i omogu\u0107ila planirana pro\u0161irenja programa skrininga crijeva. Potrebne su i nove jedinice za endoskopsku dekontaminaciju, a izvje\u0161taj tako\u0111er preporu\u010duje da se sva postoje\u0107a oprema za snimanje starija od 10 godina zamijeni.<\/p>\n

Na\u017ealost, ne postoji nacionalni registar imovine za endoskopske ustanove, a izvje\u0161taj preporu\u010duje da se hitno poduzmu pregledi opreme\/postrojenja i osoblja kako bi se olak\u0161alo i kratkoro\u010dno i dugoro\u010dno planiranje. Izvje\u0161taj predla\u017ee u\u010de\u0161\u0107e u Nacionalnoj bazi podataka endoskopije (NED) od strane 20% fondova NHS koji to ve\u0107 ne \u010dine.<\/p>\n

Izvje\u0161taj koji je objavio Public Policy Projects u partnerstvu sa\n\n Vanguard\n<\/a>\nprije dvije godine, pokazalo je da vi\u0161e od tre\u0107ine bolnica ima endoskopske dekontaminacijske pakete sa opremom koja se pribli\u017eava ili prema\u0161uje preporuke proizvo\u0111a\u010da, te da oko 25% bolnica ima pakete za endoskopsku dekontaminaciju koji su stari vi\u0161e od deset godina.\n\n Prakti\u010dno rje\u0161enje za endoskopiju\n<\/strong>\nNadamo se da \u0107e uspostavljanje endoskopskih objekata bez Covida u nekim od predlo\u017eenih centara dijagnosti\u010dke zajednice ili\n\n one-stop-shops\n<\/a>\n, zajedno sa testiranjem pacijenata i osoblja prije svih procedura, mo\u017ee zna\u010diti da \u0107e zahtjevi za dubinskim \u010di\u0161\u0107enjem izme\u0111u pacijenata biti znatno smanjeni, omogu\u0107avaju\u0107i pove\u0107anje protoka bli\u017ee normalnom nivou. Pacijenti koji su pozitivni na Covid-19 i oni kojima je potrebna hitna endoskopija prije nego \u0161to se mo\u017ee utvrditi status Covid-19 trebali bi nastaviti da se rade u ustanovama s negativnim tlakom zraka (obi\u010dno operacione sale).<\/p>\n

\u0160to se ti\u010de radne snage, izvje\u0161taj preporu\u010duje osnivanje akademija za obuku kako bi se pove\u0107ao broj nemedicinskih kolonoskopista i kako bi se postoje\u0107im kolonoskopistima omogu\u0107ilo da pre\u0111u na skrining kolonoskopiju. Tako\u0111er \u0107e biti potrebno vi\u0161e endoskopskih medicinskih sestara kako bi se zadovoljila dodatna potra\u017enja.<\/p>\n

Bez ulaganja ili reformisanog pru\u017eanja usluga, po sopstvenom priznanju, NHS rizikuje da ne bude u stanju da ispuni ciljeve, uklju\u010duju\u0107i ambiciju da dijagnostikuje 75% ljudi sa rakom u ranoj fazi, i pobolj\u0161a ishode pacijenata. \u010cak i ako planovi budu brzo odobreni, za implementaciju preporuka u izvje\u0161taju trebat \u0107e vrijeme. Ali s obzirom da zaostatak raste svakog mjeseca, da li je \u010dekanje opcija?<\/p>\n

Za svaki mjesec ugro\u017eena produktivnost, lista \u010dekanja raste iznad nivoa koji se lako mo\u017ee oporaviti bez prelaska iznad 100% postoje\u0107eg kapaciteta. Potrebno je privremeno rje\u0161enje, i\n\n fleksibilna klini\u010dka infrastruktura\n<\/a>\nmogao dati odgovor. Mobilne i modularne endoskopske jedinice mogu se kombinirati s fleksibilnim endoskopskim jedinicama za kontaminaciju i postaviti na gotovo bilo kojoj lokaciji \u2013 u blizini dijagnosti\u010dkog \u010dvori\u0161ta ili drugdje u zajednici \u2013 kako bi se stvorila samostalna stranica bez Covida za elektivnu endoskopiju.<\/p>\n

Pro\u010ditajte izvje\u0161taj, koji uklju\u010duje detaljan pregled endoskopske aktivnosti,\n\n ovdje\n<\/a>\n.<\/p>\n

Kopija izvje\u0161taja\n\n 'Pogled iznutra: stanje endoskopije u Engleskoj'\n<\/em>\n, koju proizvodi Public Policy Projects u partnerstvu sa Vanguard, mo\u017ee se zatra\u017eiti od strane\n\n kontaktirajte nas\n<\/a>\n.<\/p>","protected":false},"excerpt":{"rendered":"

Zaostatak pacijenata koji \u010dekaju vi\u0161e od \u0161est sedmica na endoskopiju zna\u010dajno se pove\u0107ao od po\u010detka pandemije Covid-19, a liste \u010dekanja sada treba hitno rije\u0161iti.<\/p>","protected":false},"author":1,"featured_media":1347,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2,119,115],"tags":[131,137,5,4],"class_list":["post-3240","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","category-procedures","category-products-and-services","tag-endoscope-decontamination","tag-endoscopy-suite","tag-mobile","tag-modular"],"acf":[],"yoast_head":"\nDiagnostic reform: the impact on endoscopy - Vanguard Healthcare Solutions<\/title>\n<meta name=\"description\" content=\"The impact of diagnostic reform in reducing patient backlog for endoscopy treatment using mobile or modular Vanguard facility\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.vanguardhealthcare.co.uk\/bs_ba\/diagnostic-reform-the-impact-on-endoscopy\/\" \/>\n<meta property=\"og:locale\" content=\"bs_BA\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Diagnostic reform: the impact on endoscopy - 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