Ward nurses-focused educational intervention improves the quality of bowel preparation in inpatients undergoing colonoscopy

Liu, Aihong; Shu-hong, Yan; Wang, Huashe; Lin, Yujun; Wu, Junkui; Fu, Liping; Wu, Qin; Lü, Yi; Liu, Yanan; Chen, Honglei

doi:10.1097/md.0000000000020976

Cited by 8 publications

(6 citation statements)

References 71 publications

(87 reference statements)

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“…Previous studies had explored the impact of education on the quality of bowel cleansing (20)(21)(22), which confirmed the effectiveness of patient education programs. Liu's study (23) also revealed that inpatients under the care of nurses who underwent enhanced education on bowel preparation had a significantly better bowel preparation quality, and ward nurses' education was the only independent risk factor, considering that the bowel preparation of inpatients was often guided by the nurses whereas that of outpatients was always guided by the referring physicians. We believed that verbal instructions accompanying written ones for outpatients seem to ameliorate the results.…”

Section: Discussionmentioning

confidence: 99%

Real-word evaluation of differences in bowel preparation for colonoscopy between the digestive and the non-digestive physicians: A retrospective study

Liu

Yuan²,

Gao³

et al. 2022

Front. Gastroenterol.

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IntroductionUsing real-world data, we compared the quality of bowel preparation instructed by the digestive and non-digestive physicians in outpatients for colonoscopy and identified potential risk factors.MethodsThis was a retrospective study based on real-world data, which were collected from the Ningbo First Hospital in China from December 2019 to October 2020. Outpatients included were classified into the digestive and the non-digestive physician groups according to the referring physician. The primary outcome was adequate bowel preparation measured by the Boston Bowel Preparation Scale (BBPS), namely, a BBPS score of 2 or higher in any colonic segment and a total score ≥ 6. Secondary outcomes included the total mean BBPS scores and possible risk factors associated with poor bowel preparation.ResultsThere were 671 outpatients included, with 392 in the digestive physician group and 279 in the non-digestive physician group. Adequate bowel preparation was 84.2% in the digestive physician group and 71.0% in the non-digestive physician group (odds ratio [OR]: 1.50, p < 0.001), and the latter had lower total mean BBPS scores (6.12 ± 1.33 vs. 6.66 ± 1.29, p < 0.001). The non-digestive physician was an independent risk factor according to the multivariate logistic regression analysis (OR: 0.45, p < 0.001).ConclusionThe quality of bowel preparations instructed by non-digestive physicians was inferior to digestive physicians, which was a factor potentially associated with poor bowel preparation (ClinicalTrials.gov number: NCT04738578).

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Section: Discussionmentioning

confidence: 99%

Real-word evaluation of differences in bowel preparation for colonoscopy between the digestive and the non-digestive physicians: A retrospective study

Liu

Yuan²,

Gao³

et al. 2022

Front. Gastroenterol.

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“…One potential solution to improve ABP in the hospital setting is to prioritize preprocedural clinician meetings [12]. Ongoing clinical education is also recommended and can include hospital lectures and initiatives on prompt symptom identification, appropriate referrals, standardized order sets, and improved preprocedural readiness assessments [19][20][21]. Further research in this topic is warranted and these results suggest interventions may be increasingly effective when identifying hospitalized patients with a history of opioid use, laxative use, or constipation.…”

Section: Discussionmentioning

confidence: 99%

Effect of acuity level and patient characteristics on bowel preparation quality: a retrospective cohort study of inpatient colonoscopies

et al. 2023

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Background and aims Colonoscopy is the primary method to detect mucosal abnormalities in the colon, rectum, and terminal ileum. Inadequate bowel preparation is a common problem and can impede successful visualization during colonoscopy. Although studies identified hospitalization as a predictor of inadequate bowel preparation, acuity of care vary greatly within this patient population. The current study aims to examine the effect of patient characteristics and care level predictors on inadequate bowel preparation quality within the inpatient setting. Methods This retrospective study was conducted in a single urban level 1 trauma medical center and included adult patients undergoing diagnostic colonoscopy while admitted in the hospital from January 1, 2015 to June 30, 2020. We examined the level of inpatient care between the General Medical Floor (GMF), Intensive Care Units (ICU) and Telemetry Unit (TU) and assessed this association with bowel preparation quality, adjusting for known and unknown predictors. Results Of 538 patients undergoing colonoscopy, 47.4% were admitted into TU, 43.7% into GMF and 8.9% into ICU. For the entire sample, 72.7% of patients achieved good or excellent preparation and quality of bowel preparation differed by care level (P = 0.01). Patients from the critical care units were less likely to achieve adequate bowel preparation when compared to GMF (Odds Ratio [OR] 0.36; 95% Confidence Interval [CI] 0.17,0.77), after adjusting for patient characteristics, medications, physical status, and preparation regimen. No significant difference in Bowel Preparation Quality (BPQ) was identified between patients from GMF and TU (OR 0.96; 95%CI 0.61, 1.52). Furthermore, adequate BPQ was associated with withdrawal time and cecal intubation, but not higher adenoma detection rates. Conclusions Results suggest the ICU setting is an independent predictor for inadequate bowel preparation and patients with prior opioid and laxative use may be more likely to have inadequate bowel preparation in the hospital. Future interventions should prioritize preprocedural clinician meetings for critical care unit patients, including a more detailed readiness assessment and thorough medication history.

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“…We did not have this for our study; however, we believe this would be helpful for other institutions when implementing research or evidence-based practice projects related to inpatient colonoscopies. Another study also looked at an educational intervention focused on ward nurses (Liu et al, 2020). Their education was similar to ours although they had a physician teach inpatient nurses.…”

Section: Discussionmentioning

confidence: 99%

An Educational Intervention to Improve Patient Outcomes for Colonoscopy

Janik

Heitschmidt

Gascon

et al. 2023

Gastroenterology Nursing

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Inpatients often need to complete bowel preparation for colonoscopies. Typically, it takes 8-11 hours from the start of a bowel prep regimen to initiation of colonoscopy for bowel preparation to be effective. Multiple factors affect quality of preparation. Some studies suggest that age, height, weight, preprocedure diet, previous surgeries, and immobility can lead to poor preps. Medical conditions or patients' comorbidities such as diabetes, chronic obstructive pulmonary disease, stroke, dementia, cirrhosis, chronic constipation, and renal insufficiencies also play a role. In addition, medications including narcotics and laxatives have shown to affect poor bowel preps (Reilly & Walker, 2004). Other studies have suggested that the interval between bowel preparation and the start of colonoscopy has a significant impact on the adequacy of bowel cleansing (Bryant, Schoeman, & Schoeman, 2013;Chambers, Whiteman, Stephens, Goodloe, & Kirsteen, 2016). according to Krygier and Enns (2008), inpatient status and patient colonoscopy perceptions are predictors of incomplete bowel preparations, and they suggest educating staff members and patients about the importance of taking the bowel preparation is needed to obtain effective bowel cleansing. BackgroundOur Midwestern endoscopy unit is small but busy and part of a two-time Magnet-recognized community hospital. We have two main procedure rooms, one an Educational Intervention to Improve Patient Outcomes for Colonoscopy

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Ward nurses-focused educational intervention improves the quality of bowel preparation in inpatients undergoing colonoscopy

Cited by 8 publications

References 71 publications

Real-word evaluation of differences in bowel preparation for colonoscopy between the digestive and the non-digestive physicians: A retrospective study

Real-word evaluation of differences in bowel preparation for colonoscopy between the digestive and the non-digestive physicians: A retrospective study

Effect of acuity level and patient characteristics on bowel preparation quality: a retrospective cohort study of inpatient colonoscopies

An Educational Intervention to Improve Patient Outcomes for Colonoscopy

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