Evaluating the Applicability of a Bowel Preparation Care Bundle Protocol for Pediatric Endoscopic Surgery: Randomized Controlled Trial

Abstract

Background: Enteroscopy is an important diagnostic and therapeutic procedure. In children, adequate bowel preparation is mandatory for imaging and surgery, but tolerability as well as efficacy must be considered. As a result, good bowel preparation before to such procedures is a critical element in the diagnosis, monitoring, and lowering the risk of probable contamination. Aim:The purposes of this study were to assess the efficacy, and safety of care bundles (CBs) in bowel preparation for pediatric enteroscopy, also evaluate the patients' tolerance and safety regarding it, in addition to assess families' anxiety level, and their satisfaction with hospitalization. Methods: Between July 2019 and December 2019, Mansoura University Children Hospital enrolled children who underwent electronic enteroscopic surgery in a randomized controlled trial (RCT) under conventional nursing (CN), and between January 2020 and June 2020, children who had the surgery were enrolled under the care bundle trial (CG). This study enrolled a total of 83 children, 44 in the CB group and 39 in the CN group as well as included 80 nurses with 40 nurse in each group e. All children in both previously mentioned groups were lavaged with a polyethylene glycol electrolyte solution to prepare their bowels (PEG-ELS). The CBs included education for nurses, risk assessment for inadequate bowel preparation, education for children and families, and observation and assessment during preparation. We compared the two groups' satisfaction with hospitalization, comfort and safety, family anxiety levels, and quality of bowel preparation. Results: The CB group outperformed the CN group in terms of bowel preparation quality [(8.35±6.86) vs. (4.34±02.75) at P<0.001]. Furthermore, the CB group's anxiety score was substantially lower than the CN group's (3.28±0.85 vs. 5.45±1.78 respectively at P>0.001. Conclusions: The use of care bundles in the bowel preparation of children undergoing enteroscopy had a highly statistical significance on the quality of preparation and satisfaction with hospitalization, as well as reducing the anxiety of patients and their families. Recommendation: Intensive training and educational programs about the evidence bowel preparation protocols should be considered for surgical nurses and all children and their parents undergoing such procedure as a standard of practice.