Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates最新文献

Nasogastric intubation is a common procedure in hospitals that causes adverse outcomes if performed incorrectly. There is currently insufficient guidance for patient positioning, which increases the success of nasogastric intubation at the bedside. Therefore, a systematic review with a meta-analysis was performed to determine the effectiveness of changing an unconscious adults' positions compared with the supine position to improve the correct placement of a nasogastric tube, intubation time, and complications. The Cochrane Library, MEDLINE, Embase, PubMed, and CINAHL databases were searched from inception to April 2019 for randomized controlled trials. The Cochrane Collaboration Risk of Bias tool was used to assess the quality of eligible studies. Cochrane Review Manager 5.3 software was used to analyze the data. A total of 288 articles were obtained in the literature search, 10 of which were included in the analysis. Most of the included trials were at low risk of bias. All postures were significantly effective, though neck flexion had the highest success rate (odds ratio = 4.87, 95% confidence interval [2.48, 9.57], Z = 4.6, p < .00001, I2 = 0%) for nasogastric intubation. In terms of the time required for the procedure, compared with the usual posture, although the total effects were significant ( MD =-10.33, 95% confidence interval [-15.38, -5.29], Z = 4.02, p < .00001, I2 = 98%), only neck flexion and lifting of the larynx reduced the time. The meta-analysis suggests that patient positioning improves the success rate of nasogastric intubation and increases safety. Finally, the authors developed a procedural instruction sheet to aid practitioners with nasogastric intubation.

The quality of bowel preparation is an extremely important determinant of colonoscopy results. However, the efficacy of senna regimens in improving bowel cleanliness is uncertain. We conducted a systematic review and meta-analysis to synthesize data on whether using a senna bowel preparation regimen enhances the bowel cleanliness. We searched Web of Science Core Collection, MEDLINE, PubMed, Embase, Cochrane Library, and Scopus databases (from the inception to August 2021). The primary efficacy outcome was bowel cleanliness. Secondary outcomes included patient compliance, tolerance, and adverse events. Eleven trials fulfilled the inclusion criteria (3,343 patients. Overall, we found no significant differences in bowel cleanliness between the senna regimen and other bowel preparation regimens (odds ratio [95% confidence interval]: 1.02 [0.63, 1.67], p = 0.93). There was significant difference in tolerance (odds ratio [95% confidence interval]: 1.66 [1.08, 2.54], p = .02) and compliance (odds ratio [95% confidence interval]: 3.05 [1.42, 6.55], p = .004). The senna regimen yielded a significantly greater proportion of no nausea (odds ratio [95% confidence interval]: 1.84 [1.45, 2.32]) and vomiting (odds ratio [95% confidence interval]: 1.65 [0.81, 3.35]). Compared with other bowel preparation regimens, the senna regimen may be effective and safe in bowel cleaning before colonoscopy, with superior compliance and tolerance.

Liver cirrhosis is a chronic and relatively common disease without a definitive cure in most cases. Few studies have investigated affected individuals perceptions of the disease. This qualitative study aimed to describe the perceptions of individuals ( n = 27) with liver cirrhosis toward their disease. Interview data was analyzed using conventional content analysis. Data analysis revealed two main themes: the first theme was "perceived sensitivity to the cirrhosis," which was characterized by concerns about disease transmission to others, concerns about seeing symptoms as a reason in referring to medical centers, hiding disease from others, feeling remorse or guilt in having disease, and personal beliefs about cause of disease. The second theme was the "perceived severity of the cirrhosis," which was characterized by feelings of disease exacerbation due to tension and stress, discomfort due to continuation of annoying symptoms, discomfort due to ascites, and fear and hope while waiting for liver transplantation. The findings indicate a perceived threat from liver cirrhosis. Such perceived threats and their characteristics could help nurses and other healthcare providers to be aware of this perception in their care of individuals living with liver cirrhosis.

Inflammatory bowel disease (IBD) is a painful chronic gastrointestinal disease associated with diminished quality of life. No research documents IBD body pain or the associations of pain patterns to outcomes. Objectives were to map patient body pain areas and examine the associations between pain patterns with depression, catastrophizing, pain severity, and quality of life. A cross-sectional survey was collected from consecutive tertiary-care IBD clinic patients ( n = 255). Patients were classified into three pain pattern groups (No Pain; Localized Pain Only; and Widespread Pain) with more than 40% reporting widespread pain. The Localized Pain Only and Widespread Pain groups reported pain in the abdomen, the uterus/testes, vagina/penis, bladder, and pelvis/buttock areas. The body area most often reported was the anterior abdomen for the Localized Pain Only and Widespread Pain groups, with additional endorsement of lower back and anterior thigh and knees for the Widespread Pain group. The pain versus no pain patients reported greater depressive symptoms, catastrophizing, and diminished quality of life. Patients reported a variety of pain patterns during clinic visits. Widespread pain is associated with greatest pain and poorest psychosocial outcomes.

Colorectal cancer is the third most commonly diagnosed cancer in men and women in the United States. Small polyps are slow to grow and turn to cancer, which provides time for screening and removal of the precancerous polyps so that colorectal cancer is prevented. Quality colonoscopy services are essential to ensure all polyps are found and removed as the final step of colorectal cancer screening. The American Society for Gastrointestinal Endoscopy Quality Assurance in Endoscopy Committee developed quality indicators for colonoscopy services. The Committee prioritized 3 quality indicators for screening colonoscopies: the frequency of (1) adenoma detection in asymptomatic patients at average risk; (2) adherence to the surveillance intervals for postpolypectomy, postcancer resection, or the 10-year interval for the average-risk patients with good bowel preparations who had negative colonoscopies; and (3) visualization of the cecum by notation and landmark photographic documentation. Gastroenterology nurses, endoscopists, and the quality management team can use the Plan-Do-Study-Act method of quality improvement to meet the established performance targets and prevent interval cancers.

The Annie application (Annie app) prompts patients to track and guide their adherence to colonoscopy bowel prep protocol referred to as nothing by mouth (NPO) instructions. The app is a series of timed educational text messages geared toward colonoscopy preparation. This quality improvement project aimed to establish whether implementing a short message service (SMS) application (Annie app) would decrease the same-day cancellation rate among individuals receiving a nonemergent colonoscopy in a large Houston hospital clinic. Most same-day cancellations are related to failure to follow NPO instructions provided by the clinic nursing staff. All patients received the standard 14-day call, as well as the 3-day nurse reminder calls. The Annie app SMS was in addition to the standard nurse reminder calls. There were significant associations between using the Annie app and cancellations. Cancellation rates decreased by 21% when patients elected to receive the Annie app messages versus receiving voice-mail-only messages. African American individuals benefitted the most from the Annie app decreasing from 28.4% to 17.9%.