Improving Patient Bowel Preparation Quality and Colonoscopy Preparedness

Area of Science:

• Gastroenterology
• Health Literacy
• Quality Improvement

Background:

• Effective colonoscopy bowel preparation is crucial for colon cancer and adenoma screening.
• Low health literacy complicates adherence to multi-step bowel preparation instructions.
• Patient understanding, compliance, and bowel cleanliness are vital for successful colonoscopies.

Purpose of the Study:

• To assess if health literacy-directed colonoscopy instructions improve patient understanding and bowel preparation.
• To evaluate the impact of multimedia instructions on patient compliance and bowel cleanliness.
• To determine the effect on nursing workflow, procedural times, and procedure cancellations.

Main Methods:

• A quality improvement project provided written (Flesch-Kincaid Grade Level 6.5) and video instructions to 1,031 patients.
• Instructions were targeted towards improving health literacy for colonoscopy preparation.
• Data collected over 12 weeks included phone calls, cancellations, preparation quality, and procedural times.

Main Results:

• An 83% reduction in nursing phone calls requesting additional bowel preparation instructions was observed.
• Less-than-ideal bowel preparations decreased by a relative 20%.
• Same-day procedure cancellations increased minimally (0.2%), with procedural times remaining largely unchanged.

Conclusions:

• Health literacy-directed multimedia instructions are a practical and cost-efficient method to enhance colonoscopy preparation.
• This approach reduces nursing workflow interruptions and improves bowel preparation quality.
• Patient confidence and adherence to colonoscopy preparations are increased through accessible instructions.