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Application of care bundles in bowel preparation for colonoscopy in children
Yuanyuan Liang1, Wenqiong Xin1, Yang Yang1
1Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Insights
Care bundles significantly improved bowel preparation quality for pediatric colonoscopies. This approach reduced the need for enemas and lowered family anxiety, increasing patient satisfaction.
Area of Science:
- Pediatric Gastroenterology
- Clinical Nursing Research
- Healthcare Quality Improvement
Background:
- Colonoscopy is a crucial diagnostic tool in pediatric care.
- Effective bowel preparation is essential for successful colonoscopy outcomes.
- Current bowel preparation methods in children may have limitations.
Purpose of the Study:
- To evaluate the effectiveness of care bundles (CBs) in pediatric bowel preparation for colonoscopy.
- To compare the outcomes of care bundles versus conventional nursing in children undergoing colonoscopy.
Main Methods:
- A comparative study enrolled children undergoing colonoscopy, divided into a conventional nursing (CN) group and a care bundle (CB) group.
- Both groups received polyethylene glycol electrolyte lavage solution (PEG-ELS) for bowel preparation.
- The CB group received enhanced interventions including nurse education, risk assessment, and family education.
Main Results:
- The CB group required significantly fewer additional enemas (2 vs. 12) compared to the CN group.
- Family anxiety scores were significantly lower in the CB group (3.28±0.85) versus the CN group (5.45±1.78).
- Patient satisfaction rates were higher in the CB group (97.62%) compared to the CN group (85.00%).
Conclusions:
- Care bundles enhance the quality of bowel preparation for pediatric colonoscopy.
- Implementing care bundles reduces patient and family anxiety and improves overall satisfaction.
- This structured approach offers a valuable improvement over conventional nursing methods for pediatric bowel preparation.
Background:
To explore the value of care bundles (CBs) in bowel preparation for colonoscopy in children.
Methods:
Children who underwent electronic fiberoptic colonoscopy or enteroscopic surgery in our hospital from September 2016 to October 2017 were enrolled as the conventional nursing (CN) group and children who received such procedures from November 2017 to December 2018 were enrolled as the care bundle group. Polyethylene glycol electrolyte lavage solution (PEG-ELS) was used for bowel preparation in all children. The CBs included nurse education, risk evaluation of inadequate bowel preparation, education of children and families, and observation and assessment during preparation. The quality of bowel preparation, tolerance and safety, families' anxiety score, and degree of satisfaction with hospitalization were compared between these two groups.
Results:
Eighty-two children were enrolled in this study, with 42 cases in the CB group and 40 cases in the CN group. Symptoms of distension, abdominal pain, vomiting, and fatigue, along with intragastric feeding, were compared between the two groups. An additional enema was performed in 2 cases in the CB group and in 12 cases in the CN group, demonstrating a significant difference between the groups. The Aronchick score and anxiety score of families were 1.24±0.85 vs. 2.35±1.76 (t=-3.477, P=0.001) and 3.28±0.85 vs. 5.45±1.78 (t=-3.473, P=0.001) in the CN group and CB group, respectively. The satisfaction rate was 97.62% vs. 85.00% (χ2=6.764, P<0.001).
Conclusions:
Implementation of the care bundles in the bowel preparation of children planning to receive colonoscopy can improve the quality of preparation and the satisfaction with hospitalization while alleviating the anxiety of patients and their families.
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