Education for Ward Nurses Influences the Quality of Inpatient's Bowel Preparation for Colonoscopy

Although adequate bowel preparation is a prerequisite for colonoscopy, preparation among inpatients is often suboptimal. This study aimed to evaluate the impact of ward nurse education on the quality of bowel preparation of inpatients. A prospective, double-blinded, non-randomized, controlled study was performed. Expert endoscopists provided enhanced education to nurses who belonged to an "educated ward" followed by training that was repeated every week for 1 month. The primary outcome was the quality of the bowel preparation, which was based on the Ottawa Bowel Preparation Scale (OBPS). Patient compliance and their subjective feelings and the factors affecting inadequate bowel preparation were also analyzed. One hundred three inpatients in the educated ward and 102 patients in the control ward were enrolled. Baseline data were comparable between the 2 wards. The mean values of the total OBPS scores were 4.42±2.23 and 6.15±2.38 in the educated and control wards, respectively (P<0.001). The rate of poor preparation (OBPS≥6) in the educated ward was significantly lower than that in the control ward (31.1% vs 58.8%, P<0.001). Compliance with preparation and diet instructions in the educated ward was superior to that in the control ward (P<0.001). Control patients were more likely to be anxious before colonoscopy (P<0.001), whereas patients in the educated ward showed higher level of satisfaction (P=0.001) and better sleep quality (P<0.001). A lack of ward nurse education (OR 2.365, P=0.025), constipation (OR 6.517, P<0.001), and insufficient water ingestion (OR 2.044, P=0.042) were independently associated with inadequate bowel preparation among inpatients. Ward nurse education effectively improved the quality of bowel preparation, and relevant colonoscopic outcomes among inpatients. Additional efforts are needed to control constipation and to encourage additional water ingestion in inpatients for better bowel preparation.