Enhanced Ward Rounds for Bowel Preparation Quality in Hospitalized Patients Undergoing Colonoscopy

Starting soon · Not applicable

Conditions studied: Colonoscopy, Bowel Preparation, Quality of Healthcare

In brief

Adequate bowel preparation is critical for successful colonoscopy, yet inadequate preparation remains a significant clinical challenge, occurring in 20-30% of procedures. In hospitalized patients undergoing therapeutic colonoscopy, suboptimal preparation leads to increased costs, prolonged hospital stay, and potential procedure cancellation or rescheduling. Current standard care involves resident ward rounds twice daily. This cluster-randomized crossover trial aims to evaluate whether increasing the frequency of structured resident ward rounds from 2 to 4 times per day can improve bowel preparation quality in hospitalized patients scheduled for therapeutic colonoscopy. The enhanced ward round intervention includes standardized checklist review, medication verification, dietary compliance confirmation, adverse event screening, and timely intervention when needed. Three hospital wards will be randomly assigned to different sequences of intervention and control periods using a crossover design with washout periods. The primary outcome is adequate bowel preparation quality assessed by Boston Bowel Preparation Scale (BBPS ≥6 with each segment ≥2), evaluated by blinded endoscopists. Secondary outcomes include procedure quality metrics (cecal intubation rate, examination duration), safety endpoints (electrolyte disturbances, aspiration events), health economics measures (length of stay, total costs), and healthcare worker burden (nursing workload, night-time call frequency). Subgroup analyses will examine intervention effects across age groups, cognitive function levels, prior colonoscopy experience, and comorbidity burden to identify populations most likely to benefit from enhanced monitoring. This pragmatic trial addresses a clinically relevant question using a real-world implementation strategy designed to minimize workflow disruption. Results will inform evidence-based policies regarding optimal ward round frequency for colonoscopy preparation in hospital settings.

Key facts

Study ID

NCT07263867

Run by

LanZhou University

People needed

300

Starts

2026-03-28

Expected to finish

2026-12-30

Last updated by the study team

2026-03-06

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age ≥18 years
• Hospitalized patients (inpatients)
• Scheduled for therapeutic colonoscopy (polypectomy, endoscopic mucosal resection [EMR], endoscopic submucosal dissection [ESD], or biopsy for diagnosis)
• Time from admission to scheduled colonoscopy ≥48 hours (allowing adequate preparation time)
• Patient or legal representative able to provide written informed consent
• Able to understand and follow bowel preparation instructions (with assistance from caregivers if needed)

You may not qualify if…

• Emergency gastrointestinal conditions: bowel obstruction, acute lower gastrointestinal bleeding requiring urgent intervention, suspected or confirmed perforation
• Emergency or same-day colonoscopy (scheduled <24 hours after admission)
• History of total colectomy or current colostomy/ileostomy
• Severe cognitive impairment (Mini-Cog score 0-1 or MMSE <18) without available caregiver
• Severe cardiopulmonary disease: New York Heart Association (NYHA) Class IV heart failure, chronic kidney disease (CKD) stage 4-5 (eGFR <30 ml/min/1.73m²) unable to tolerate PEG-based preparation
• Known or suspected pregnancy, currently breastfeeding
• Previous severe allergic reaction to PEG or bowel preparation agents
• Current participation in another interventional clinical trial
• Unable to provide informed consent and no legal representative available
• Patient or legal representative declines participation

Where it is running

• The First Hospital of Lanzhou University — Lanzhou, Gansu, China

Full record on ClinicalTrials.gov

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