Document Type

DNP Project

Department

School of Nursing

Date of Degree

Spring 2026

Degree

Doctor of Nursing Practice (DNP)

Primary Advisor

Laurie Posey

Keywords

Quality Improvement; Gastroenterology; Colonoscopy; Automated Electronic Messages; Colon Cancer Detection

Abstract

Background: To reduce the incidence of colorectal cancer, optimal bowel preparation is imperative. At an outpatient gastroenterology clinic has been experiencing an increased number of patients arriving for their colonoscopy with poorly prepped bowels.

Objectives: The purpose of this quality improvement project was to improve patient’s bowel preparation by augmenting paper-based instructions with an automated electronic messaging service that sent dietary, and bowel instructions tailored to patients.

Methods: This project used a quasi-experimental design to compare scheduling and bowel preparation outcomes of patients who received colonoscopies prior to the intervention (control group) with patients who received automated preparation messages (intervention group). Bowel preparation scores and procedure rescheduling data were gathered from the electronic medical record. Patient satisfaction was assessed with a post-intervention survey.

Results: Chi-Square analysis indicated the automated messaging was significantly associated with reduced procedure rescheduling, χ²(df = 1, N = 200) = 25.89, p = < .001, with a moderate effect (Cramér’s V =0.360). Patients who received text message reminders (M = 7.69, SD = 0.96) had higher bowel preparation scores than patients who did not receive reminders (M = 6.89, SD = 1.6), which was statistically significant, t(198) = -4.297, p = < .001. The effect size was moderate, Cohen’s d = 0.61. Eighty-nine percent of the participants reported they were satisfied or very satisfied with the messages (M = 3.081, SD = 0.72) and 78% of the participants reported the messages were clear or very clear (M = 3.24, SD = 0.64).

Conclusions/Implications: Automated electronic messages can effectively augment and increase patient adherence to print and verbal colonoscopy preparation instructions, reducing rescheduled procedures and improving bowel preparation scores. By offering this additional support to all colonoscopy patients, practices can improve colonoscopy outcomes and promote early colon cancer detection.

Open Access

1

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Available for download on Sunday, June 07, 2026

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