title: Pilot evaluation of a nurse-administered carepath for successful colonoscopy for persons with spinal cord injury.
abstract: Due to ongoing improvements in medical care, the life expectancy of persons with spinal cord injury (SCI) continues to improve and approach that of the able-bodied population. As the SCI population ages, cancer would be expected to increase as a cause of death. When a patient presents with occult fecal blood and anemia, colonscopy to the cecum is often pursued. It has been our experience that 80 percent of patients are found to have inadequate bowel preps resulting in suboptimal colonoscopy when the prep is attempted at home. Because of this, we developed a nurse-administered carepath necessitating a 48-hour admission for bowel prep and colonoscopy. The bowel prep consists of magnesium citrate, polyethylene glycol-electrolyte solution, and sodium phosphate/biphosphate enemas. Throughout hospitalization, the patient receives a clear liquid diet. Eighteen patients have been placed on the carepath. At the time of colonoscopy, all 18 were noted to have received an acceptable bowel prep allowing vizualization to the cecum. A description of the carepath and its benefits is presented.
authors.affiliation: Spinal Cord Injury Center, South Texas Veterans Health Care System, USA.
authors.forename: D B
authors.initials: DB
authors.lastname: Barber
authors.forename: S J
authors.initials: SJ
authors.lastname: Rogers
authors.forename: J T
authors.initials: JT
authors.lastname: Chen
authors.forename: D E
authors.initials: DE
authors.lastname: Gulledge
authors.forename: A C
authors.initials: AC
authors.lastname: Able
mesh_terms: D002400:Cathartics / Q000627:therapeutic use; D019343:Citric Acid / Q000627:therapeutic use; D003113:Colonoscopy / Q000451:nursing*; D019091:Critical Pathways / Q000458:organization & administration*; D004733:Enema; D006760:Hospitalization; D006801:Humans; D015403:Nursing Evaluation Research; D009942:Organometallic Compounds / Q000627:therapeutic use; D010865:Pilot Projects; D011092:Polyethylene Glycols / Q000627:therapeutic use; D013119:Spinal Cord Injuries / Q000150:complications* / Q000451:nursing*
chemical_list: D002400:Cathartics; D009942:Organometallic Compounds; D019343:Citric Acid; D011092:Polyethylene Glycols; C110422:magnesium citrate