A study to assess the Nurses knowledge & compliance to the protocol of adequate bowel preparation for colonoscopy
Authors: Swarnalata Patro  , Maryline Flinsi  
Published: March 2023

Introduction: Cleansing the colon before a colonoscopy is called bowel preparation, or “prep.” It involves taking medication that causes frequent, loose bowel movements to empty the colon. The medication is taken by mouth and typically comes in liquid form. Bowel cleansing is one of the most important parameters included in the evaluation of colonoscopy quality. The available evidence suggests that inadequate bowel preparation reduces the diagnostic yield of colorectal neoplasia and increases post-colonoscopy colorectal cancer risk. Nowadays, up to 30% of patients referred for colonoscopy have poor bowel cleansing. Recently, several studies have analyzed the risk factors for inadequate bowel cleansing as well as the strategies to optimize bowel preparation. Poor bowel preparation has been shown to be associated with low lower-quality dilators of colonoscopy performance. Patients with Personal History of Inadequate Bowel Preparation, Diabetes Mellitus, Chronic Constipation, and a History of Colorectal Resection are at risk of inadequate bowel preparation for colonoscopy. Methodology: In November 2022, there was an increase in consultant complaints about inadequate Bowel preparation for the patient in the ward & ICU which impacted on proper diagnosis of the actual reason the patient took admitted at Apollo Hospitals, Bhubaneswar. So on basis of the complaints, a quasi-experimental group pre-test was conducted & found the less compliance. To look forward to checking the compliances, training & educational materials were prepared on basis of protocol of adequate bowel preparation for colonoscopy (education materials contained agents, methods (single/split) of preparation, dietary patterns, stool consistency assessment) & started implement from December 2022 onwards in both one to one & group teaching. And by end of February 2023, a post-test was conducted to assess the improvement of knowledge of Nurses. To collect the data of their practices on adequate bowel preparation a structured PIP (performance Improvement Project) tool was used & total sample took 100 assigned Register Nurses who all were assigned the In-patients for Colonoscopy. Results: With constant reinforcement, educational materials on adequate Bowel preparation of Colonoscopy & knowledge assessment of assigned nurses made an impact on the effective intervention in adequate Bowel preparation. The impact of compliance to assess the knowledge & interventions of nurses in adherence to the protocol of Adequate Bowel preparation for colonoscopy. The knowledge of Nurses found less compliance in the Pre-Test which was conducted after consultant’s complaints in the month of November 2022 with 55.83% & then after training & educational materials were prepared on basis of protocol of adequate bowel preparation for colonoscopy {education materials contained agents, methods (single/split) of preparation, dietary patterns, stool consistency assessment)} & started implement from December 2022 onwards in both one to one & group teaching. And by end of February 2023, a post-test was conducted to assess the improvement of knowledge of Nurses & found compliance percentage of 78.33%. And Compliance with adherence to the proper method of Bowel Preparation Protocol found compliances month on month, in December 2022 it was 30.29%, in January 2023 it improves to 55.26% & reaches with compliances of 78.94% by the end of February 2023. Conclusion: In patients under the care of nurses who underwent enhanced education on bowel preparation had significantly better bowel preparation quality and higher compliance rates than those in inpatients of the control group. Nurses’ education was identified as an independent risk factor for bowel preparation quality. To make bowel preparation adequate & sufficient frequent updating on knowledge of the recruited nurses need to be done on regular basis.