Bowel Preparation: Nursing Assessment, Patient Education, and Evidence-Based Perioperative Management
Abstract
Background: Bowel preparation is essential for high-quality colonoscopy, enabling accurate mucosal visualization and reducing missed lesions. Inadequate cleansing compromises diagnostic reliability, increases procedural risks, and necessitates repeat examinations.
Aim: To review nursing roles in bowel preparation, focusing on assessment, patient education, and evidence-based perioperative management to optimize outcomes.
Methods: This narrative review synthesizes current evidence on bowel preparation regimens, contraindications, risk factors, and nursing interventions. It examines pharmacologic classifications (isosmotic, hypoosmotic, hyperosmotic), dosing strategies, and interprofessional collaboration.
Results: High-volume polyethylene glycol (PEG) remains the safest option for complex patients, while low-volume PEG with ascorbic acid improves tolerability but requires caution in G6PD deficiency. Sulfate-free PEG enhances palatability without compromising efficacy. Hyperosmotic agents (magnesium citrate, sodium sulfate) and sodium phosphate carry significant risks, particularly in renal impairment and electrolyte imbalance. Split-dose regimens consistently outperform single-dose schedules in cleansing quality and adenoma detection. Nursing interventions—risk assessment, education reinforcement, hydration monitoring, and early escalation for intolerance—are pivotal for success.
Conclusion: Effective bowel preparation is a structured, team-based process integrating individualized regimen selection, patient-centered education, and vigilant nursing oversight. Optimizing preparation quality improves diagnostic accuracy, reduces repeat procedures, and enhances patient safety.
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References
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Copyright (c) 2025 Asya Ali Almuairfi, Murifah Dhahi Aljohani, Norah Muhaysin Sawwan Alanazi, Mona Hamad Ahmad Awaji, Abduallaziz Jarallah Obied Alenzi, Nahed Thani Alruwaili, Jawharah Abdulrhman Hamad Bin Muaddi, Zahra Kadim Ibrahim Alhalal, Joudi Ahmed Zayed Asiri, Eman Abdulmohsen Alsaleh, Raed Naji Alhayder
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