Evaluation and Improved Use of Fecal Occult Blood Test in the Constipated Child

Area of Science:

• Pediatric Gastroenterology
• Quality Improvement Science
• Clinical Diagnostics

Background:

• Constipation is a common pediatric gastroenterology complaint.
• Fecal occult blood testing (FOBT) is sometimes used in evaluating constipated children.
• Adherence to established guidelines for FOBT use can optimize diagnostic utility.

Purpose of the Study:

• To evaluate and improve the appropriate use of fecal occult blood tests (FOBTs) in constipated children within a pediatric gastroenterology outpatient clinic.
• To assess the impact of an educational intervention on FOBT utilization and appropriateness.
• To enhance the quality and safety of care for pediatric patients with constipation.

Main Methods:

• Retrospective chart review of 100 children with constipation.
• Comparison of FOBT performance against North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) recommendations.
• Implementation of an educational intervention for pediatric gastroenterology providers.
• Post-intervention chart review to assess changes in FOBT use and appropriateness.

Main Results:

• A 19.6% decrease in overall FOBT performance was observed post-intervention.
• Appropriateness of FOBT use increased by 71.4% when aligned with NASPGHAN guidelines.
• Educational intervention successfully optimized FOBT utilization in pediatric gastroenterology.

Conclusions:

• Provider education on NASPGHAN guidelines significantly improves appropriate FOBT use in constipated children.
• Optimizing FOBT application enhances the quality and safety of care in pediatric gastroenterology settings.
• Targeted quality improvement initiatives can effectively refine diagnostic test utilization.