Date of Award

Summer 2022

Project Type


College or School




Program or Major


Degree Name

Master of Science

First Advisor

Pamela Kallmerten

Second Advisor

Maryanne Plamondon




High-quality bowel preparations are essential for colonoscopies. Helping patients enhance prep quality can help increase the early detection of colorectal cancer, improving patient outcomes. A quality improvement (QI) project was introduced to increase the bowel prep quality at a Veterans Health Administration ambulatory surgery center.


Bowel prep quality descriptors were collected from a chart audit collected for the year 2021 to establish a baseline. In addition, the patients were queried regarding their perceptions on how easy the instructions were to follow.


New prep instructions were created with feedback from the clinic gastroenterology registered nurses. The new instructions were then implemented to see whether there was an impact on the patient’s perception of the ease of the instructions and the bowel prep quality rating by the gastroenterologist. Post-intervention data were collected after the implementation of the new instructions.


The prep quality rated by the gastroenterologist improved from 72.8% to 77.7% rated as good, remained relatively unchanged for the fair quality rating, and improved from 4.4% to 0% rated as poor. For the Likert scale that patients were surveyed with pre-and post-intervention, with 1 being very easy and 5 being very hard, the mean answer went from 1.99 pre-intervention (SD=1.17, range 1-5) to 2.06 post-intervention (SD=1.18, range=1-5).


Overall, implementation of the new instructions did impact the prep quality, however not the patient’s perception regarding the ease of the instructions. There are many suggested next steps for the facility to take to continue with this quality improvement project including a longer intervention phase to collect more data, and continue getting feedback on how to improve the instructions from patients.