The implementation of a nurse-driven telephone education protocol significantly improved bowel preparation for colonoscopies, according to data from Digestive Disease Week.
“We demonstrated that using this brief phone call visit between a nurse and patients to review preparation instructions 1 week prior to their colonoscopies was effective in improving quality of bowel preparation at the institution level,” Sarabdeep Mann, MD, third year fellow at the University of Arizona College of Medicine, gastroenterology fellowship program, said during his virtual presentation.
The ASGE and ACG Task Force recommends that adequate bowel preparation should be achieved in at least 85% of examinations. However, the Carl T. Hayden Veterans’ Administration Medical Center in Phoenix, Arizona, fell short of that mark. To improve the quality of bowel preparation at the institution, Mann and colleagues developed a nurse-driven telephone education protocol was developed.
They instructed registered nurses to call patients 1 week prior to scheduled colonoscopy. Patients were educated on how to maintain a clear liquid diet the day before to the colonoscopy, when to stop clear liquids and maintain strict nothing by mouth status 2 hours prior to the colonoscopy and on timing of bowel preparation.
On the day prior to the coloscopy, 20 mg of oral bisacodyl was administered at 2 p.m. and a split dose MoviPrep bowel preparation the evening before and the morning of the colonoscopy. After implementation of the nurse-driven education protocol, patients were administered individualized plans for split dose prep, with the first dose at 6 p.m. the evening before and the second dose 4 hours before the colonoscopy. All colonoscopies were assessed 7 months before and 6 months after the start of intervention to evaluate the impact of the protocol.
Investigators collected data on bowel preparation, with adequate preparation defined as a Boston Bowel Prep Score of 2 or higher in each segment.
Results showed 2,115 of 2,569 (82%) colonoscopies achieved adequate bowel preparation 7 months before implementation of the protocol. After the implantation of the protocol, 2,272 of 2,384 (95%) colonoscopies achieved adequate preparation (P = .0001).
“Where resources allow, this can be a simple yet effective tool to improve quality and to reduce the cost and poor outcomes associated with rescheduled or incomplete examinations,” Mann said. – by Monica Jaramillo
Reference: Mann S, et al. Abstract 522. Presented at: Digestive Disease Week; May 2-5, 2020; Chicago (meeting canceled).
Disclosure: Mann reports no relevant financial disclosures.