Aims Adequate bowel preparation is a key factor for high quality colonoscopy. Patients undergoing outpatient colonoscopy assess bowel preparation without enhanced instructions or help, while nurses provide structured education, follow the administration of colonoscopy preparation in hospitalized patients, as these patients are likely to be older and have significant comorbities. Therefore, aim of this study was to analyze the effect of enhanced instructions and surveillance for inpatients on the quality of bowel preparation for patients undergoing screening colonoscopy.
Methods 184 consecutive screening colonoscopies of in- and outpatients in a single center between February and April 2019 were analyzed. Nurses provide structured education, follow the administration of colonoscopy preparation for hospitalized patients Quality of bowel preparation was measured according to the Boston Bowel Preparation Scale (BBPS).
Results 87 (47%) outpatients underwent screening colonoscopy and 97 (53%) were hospitalized for other indications during the time of bowel preparation. Mean age in outpatients was 57,77 (95% CI 54,79–60,75) and 69,62 (67,01–72,23) in hospitalized patients (p = 0,004). Patients sex were distributed equally (p = 0,462). Mean BPPS differed significantly in outpatients compared to colonoscopy in inpatients with a mean of 8,00 (SD1,61) vs. 6,72 (SD 2,29) in total, 2,69 (SD 0,51) vs. 2,30 (SD 0,80) in the left, 2,68 (SD 0,56) vs. 2,23 (SD 0,80) in the transversal and 2,63 (SD 0,63) vs. 2,20 (SD 0,837) in the right colon (p < 0,001). Examination had to be repeated due to inadequate bowel preparation in 8,77% (n = 5) among outpatients and 12,37% (n = 12) within hospitalized patients (p = 0,121).
Conclusions Despite additional instructions for inpatients provided by the nurses regarding preparation for colonoscopy, BBPS in total, as well as for each colon segments was significant lower in hospitalized patients than those who underwent ambulatory colonoscopy, Factors limiting the success of preparation like higher age and comorbidities cannot be overcome by structured information and surveillance.
