Improving Bowel Preparations in Southern Appalachia: A Quality Improvement Initiative

Background: Bowel cleansing is essential to the completion of colonoscopy. Inadequate bowel preparations were occurring below the local site's goals of 95%. Inadequate bowel preparations run the risk of bowel perforation and missed detection of abnormal tissue. Objective: The aim of this quality improvement (QI) initiative was to improve adequate bowel preparation to 95%. Methods: Through the utilization of technology, a QI initiative was instituted at the local level to improve adequate bowel preparation rates. Results: Results demonstrated an average of 91% adequate bowel preparations in the 6-month postintervention period compared to 89% adequate bowel preparations in the preintervention period. Conclusions: Evidence-based interventions to improve bowel preparation quality should be implemented for all individuals undergoing colorectal cancer screening with colonoscopy to improve patient outcomes. Implications for Nursing: Evidence supports the use of both nurse-led education and technology-based interventions for the reinforcement of education prior to beginning bowel preparation for colonoscopy.