An evidence-based bowel preparation guideline to enhance quality of colonic cleansing for adult patients undergoing colonoscopy

Abstract

Colorectal cancer is one of the most common cancers in Hong Kong and there is an upward trend on the incidence rate. Lots of literatures found that colonoscopy is a relatively effective method for the screening of colorectal cancer. Optimal visualization of entire colonic mucosa is mainly affected by the quality of bowel cleansing. However, poor bowel cleansing is found to be a common problem for patients undergoing colonoscopy. As no evidence-based guideline was found on enhancing the quality of bowel cleansing, this dissertation aims at formulating an evidence-based guideline on it.

In constructing this guideline regarding the enhancement of quality of bowel cleansing, a systemic search of relevant literatures was performed in several databases. Six studies were identified and critically appraised by using quality appraisal tool.

Scottish Intercollegiate Guideline Network (SIGN). After that, the evidences were summarized, synthesized and translated into four recommendations. An evidence-based guideline to enhance the quality of colonic cleansing for adult patients undergoing colonoscopy was developed and its implementation potential was evaluated.

In the phase of implementation, a communication plan was developed to initiate, guide and sustain the change. A pilot test was then established to examine the feasibility of actual implementation. An evaluation plan was made to assess the effectiveness of the proposed guideline on achieving the expected main outcomes, in patient, healthcare provider and system aspects.

It is anticipated that with the use of this guideline, the quality of colonic cleansing for adult patients undergoing colonoscopy will be enhanced. The hospital involved will thus improve the quality of care and contribute to the whole health care system.