805 Improving Chromoendoscopy Utilization in Dysplasia Surveillance of Patients With Inflammatory Bowel Disease

Abstract

INTRODUCTION: Given the increased risk of colon cancer, patients with longstanding inflammatory bowel disease (IBD) of at least 8 years are recommended to undergo screening every 1-2 years. Chromoendoscopy has been shown to provide up to 9-fold detection of dysplastic lesions versus standard-definition endoscopy. However, it has not yet been widely adopted. A background needs assessment at our institution suggested that lack of familiarity and comfort with chromoendoscopy in our endoscopy ancillary staff had contributed to its low implementation rate. Our baseline data also showed that a majority of endoscopy ancillary staff preferred in-person, small group educational sessions to learn more about chromoendoscopy, as opposed to mandatory online training. We aim to improve the implementation of chromoendoscopy at our institution via in-person, small group education of endoscopy ancillary staff. METHODS: Two in-service small group sessions with endoscopy nurses at Rhode Island Hospital (RIH) focusing on chromoendoscopy were held in December 2016 and January 2017. A pre-intervention survey was sent to the staff. Staff were asked whether they had ever heard of/personally participated in chromoendoscopy and how comfortable they were with it. Possible concerns, including safety, time constraint, and cost of procedure, were also evaluated in the pre-intervention assessment. A post-intervention survey, consisting of the same questions, was sent after the two education sessions. The number of chromoendoscopy performed over a 22-month period prior to the sessions and following the sessions were evaluated. RESULTS: Prior to the intervention, 31% staff had never heard of chromoendoscopy and 22% reported feeling very uncomfortable with it. Post-intervention, less than 10% reported never having heard of chromoendoscopy or feeling very uncomfortable with it. While less than half of the staff reported they would want a physician to use chromoendoscopy for dysplasia surveillance if they themselves had IBD prior to the educational sessions, more than two-thirds after the sessions reported they would. Three cases of chromoendoscopy were done in the 22 months prior to the sessions, compared to 16 cases in the 22 months following. CONCLUSION: In-person, small group education of endoscopy ancillary staff on chromoendoscopy decreased their unfamiliarity and discomfort with assisting physicians in chromoendoscopy procedures. The number of chromoendoscopies done at our institution was also higher post-intervention.