Effect of Low-Volume Split-Dose Purgative on the Quality of Bowel Prep for Colonoscopy on the Hospitalized Patient

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Abstract

Although colon cancer is preventable, it is still the second leading cause of cancer death in both men and women in the United States (CDC, 2014). Colonoscopy is as yet the gold standard for colon cancer prevention (ASGE, 2015). The success of colonoscopy is dependent upon the quality of the bowel prep. The problem addressed in this study was the impact of hospitalization on bowel prep quality. The participants in this study were 54 consecutive inpatients older than 18 years and 52 consecutive outpatients older than 18 years who were scheduled for colonoscopy in the Endoscopy Lab at Santa Barbara Cottage Hospital. Convenience sampling was used to collect sample data utilizing the Boston Bowel Prep Scale (BBPS). The study group contained 48.1% of the inpatients who had a BBPS of less than seven (out of nine total possible points with a score of nine representing the most optimal prep outcome) compared to 19.2% of the outpatients. Efforts to improve bowel prep palatability, decrease cost, and decrease side effects while improving quality should be continued. Split-dosing is a best practice recommendation. This researcher hypothesized that an intervention in the form of a lower-volume, split-dosage prep would improve the quality of bowel prep in the inpatient population. There was a statistically significant improvement noted with the intervention group in the follow-up study, which indicates potential for improving the quality of bowel prep for screening colonoscopy, thus a possibility for better colon health surveillance.

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