Nursing Process Change with Task Reminder to Improve Inpatient Colonoscopies

Abstract

Problem: At a community hospital in the mid-Atlantic region, a pattern of frequent cancellations and repeated colonoscopies were identified due to inadequate bowel preparations. Root causes of poor practice included a gap in protocols, missing documentation, poor communication, leadership changes, budget, and high patient ratios. Purpose: This project aimed to increase the quality of bowel preparation and decrease canceled and rescheduled procedures through a nurse process change with a task reminder. Methods: Three units were identified with frequent colonoscopy orders. Nursing staff were educated about administration standards and the evidence supporting adequate bowel preparation. The task reminders include start/stop times, percentage consumed, and additional feedback. Charts were audited over eight weeks. The staff received documentation feedback and education weekly. Results: Due to many COVID-19 related barriers, only 27 percent of nurses were educated. Five percent of the task reminders were placed in the drop boxes during the eight weeks. The run charts revealed an upward trend of successfully completed colonoscopies over eight weeks Conclusion: Evidence has shown that nurse facilitated bowel prep and increased education increases successful bowel prep and decreases adverse events. Task reminder submissions were minimal; however, many nurses were further educated about bowel preparation and the number of inadequate bowel preparations decreased. A future recommendation is to adopt this project in the medication administration record, which will allow for simpler and easier documentation by nursing staff.