Improving Patient Bowel Preparation Quality and Colonoscopy Preparedness.

Proper colonoscopy bowel preparation is critical for effective screening and surveillance of colon cancer and adenomas. Adhering to written multi-step, order-dependent bowel preparation instructions can be complex for patients with low health literacy. This quality improvement project aimed to demonstrate that offering written and video health literacy-directed colonoscopy instructions improves patients' understanding of bowel preparation, compliance, and subsequent bowel cleanliness, as evidenced by reduced phone calls to nursing staff, procedural times, and same-day procedure cancellations. Written instructions, targeted to a Flesch-Kincaid Grade Level 6.5, and an educational video were provided to 1,031 patients undergoing colonoscopy screening or surveillance over 12 weeks. The project resulted in an 83% reduction in phone calls to nursing staff requesting additional instruction. Same-day procedure cancellations increased minimally by 0.2%, but less-than-ideal bowel preparations (fair, poor/inadequate) had a relative decrease of 20%. Procedural times remained relatively unchanged (mean: 29.9; median: 28.5) post-intervention, with 59.9% of procedures completed within 30 minutes. Providing health literacy-directed multimedia instructions can be a convenient, practical, and cost-efficient approach to reducing nursing workflow interruptions, enhancing bowel preparation quality, and increasing patient confidence with colonoscopy preparations.

Duke Scholars

Author Kathleen Marie Turner School of Nursing

Author Elaine Dorean Kauschinger School of Nursing