Quality improvement of pediatric colonoscopy by application of bundle and centralization: A single-center review
Background: To assess the quality change of our single-center pediatric colonoscopy after applying bundle for bowel preparation and general anesthesia and centralize the procedure using terminal ileum (TI) intubation rate as the main indicator. Methods: All elective colonoscopies performed for patie...
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| Format: | Article |
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Elsevier
2024-05-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957223001754 |
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| author | Shu-Chao Weng Hung-Chang Lee Chun-Yan Yeung Wai-Tao Chan Hsuan-Chih Lao Chuen-Bin Jiang |
| author_facet | Shu-Chao Weng Hung-Chang Lee Chun-Yan Yeung Wai-Tao Chan Hsuan-Chih Lao Chuen-Bin Jiang |
| author_sort | Shu-Chao Weng |
| collection | DOAJ |
| description | Background: To assess the quality change of our single-center pediatric colonoscopy after applying bundle for bowel preparation and general anesthesia and centralize the procedure using terminal ileum (TI) intubation rate as the main indicator. Methods: All elective colonoscopies performed for patients younger than 18 years old in MacKay Memorial Hospital from July 2015 through June 2020 (assigned to group 1, before bundle) and from August 2020 through July 2021 (assigned to group 2, after bundle) were retrospectively reviewed for demographic characteristics, indications, bowel preparation agent and cleansing level, diagnostic and therapeutic procedures, maximum intestinal level reached, and cecal intubation and total procedure time. Statistical analysis was done using P value < 0.05 considered to be significant. Results: Analysis included 45 and 32 colonoscopies in group 1 and 2, respectively. Bloody stool was the most frequent indication in both groups. Both TI intubation rate (42.2 % vs. 75.0 %, P = 0.004) and biopsy rate (45.0 % vs. 75.9 %, P = 0.01) increased significantly from group 1 to group 2. The narrower standard deviation of bowel preparation score (1.93 vs. 1.15) and total procedure time (37.71 vs. 22.29) in group 2 indicated a more stable quality, although the mean showed no difference. There was no statistical difference in age, gender, body weight, cecal intubation rate, or cecal intubation time. Conclusion: A higher TI intubation rate and biopsy rate indicated an improved quality of pediatric colonoscopy after applying bundle including bowel preparation and general anesthesia, with additional centralization. |
| format | Article |
| id | doaj-art-bb302b41a61e4aa9a8468dda6c237a44 |
| institution | DOAJ |
| issn | 1875-9572 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj-art-bb302b41a61e4aa9a8468dda6c237a442025-08-20T03:23:07ZengElsevierPediatrics and Neonatology1875-95722024-05-0165326026510.1016/j.pedneo.2023.05.009Quality improvement of pediatric colonoscopy by application of bundle and centralization: A single-center reviewShu-Chao Weng0Hung-Chang Lee1Chun-Yan Yeung2Wai-Tao Chan3Hsuan-Chih Lao4Chuen-Bin Jiang5Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children's Hospital, Taipei, TaiwanDepartment of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children's Hospital, Taipei, TaiwanDepartment of Medicine, MacKay Medical College, New Taipei City, Taiwan; Department of Pediatric Gastroenterology, Hepatology and Nutrition, Hsinchu Municipal MacKay Children's Hospital, Hsinchu City, TaiwanDepartment of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children's Hospital, Taipei, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, Taipei, TaiwanDepartment of Medicine, MacKay Medical College, New Taipei City, Taiwan; Department of Anesthesiology, MacKay Memorial Hospital, Taipei, TaiwanDepartment of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Corresponding author. No. 92, Sec. 2, Zhongshan N. Rd., Taipei City, 10449, Taiwan.Background: To assess the quality change of our single-center pediatric colonoscopy after applying bundle for bowel preparation and general anesthesia and centralize the procedure using terminal ileum (TI) intubation rate as the main indicator. Methods: All elective colonoscopies performed for patients younger than 18 years old in MacKay Memorial Hospital from July 2015 through June 2020 (assigned to group 1, before bundle) and from August 2020 through July 2021 (assigned to group 2, after bundle) were retrospectively reviewed for demographic characteristics, indications, bowel preparation agent and cleansing level, diagnostic and therapeutic procedures, maximum intestinal level reached, and cecal intubation and total procedure time. Statistical analysis was done using P value < 0.05 considered to be significant. Results: Analysis included 45 and 32 colonoscopies in group 1 and 2, respectively. Bloody stool was the most frequent indication in both groups. Both TI intubation rate (42.2 % vs. 75.0 %, P = 0.004) and biopsy rate (45.0 % vs. 75.9 %, P = 0.01) increased significantly from group 1 to group 2. The narrower standard deviation of bowel preparation score (1.93 vs. 1.15) and total procedure time (37.71 vs. 22.29) in group 2 indicated a more stable quality, although the mean showed no difference. There was no statistical difference in age, gender, body weight, cecal intubation rate, or cecal intubation time. Conclusion: A higher TI intubation rate and biopsy rate indicated an improved quality of pediatric colonoscopy after applying bundle including bowel preparation and general anesthesia, with additional centralization.http://www.sciencedirect.com/science/article/pii/S1875957223001754ColonoscopyGastroenterologyPediatricsQuality improvement |
| spellingShingle | Shu-Chao Weng Hung-Chang Lee Chun-Yan Yeung Wai-Tao Chan Hsuan-Chih Lao Chuen-Bin Jiang Quality improvement of pediatric colonoscopy by application of bundle and centralization: A single-center review Pediatrics and Neonatology Colonoscopy Gastroenterology Pediatrics Quality improvement |
| title | Quality improvement of pediatric colonoscopy by application of bundle and centralization: A single-center review |
| title_full | Quality improvement of pediatric colonoscopy by application of bundle and centralization: A single-center review |
| title_fullStr | Quality improvement of pediatric colonoscopy by application of bundle and centralization: A single-center review |
| title_full_unstemmed | Quality improvement of pediatric colonoscopy by application of bundle and centralization: A single-center review |
| title_short | Quality improvement of pediatric colonoscopy by application of bundle and centralization: A single-center review |
| title_sort | quality improvement of pediatric colonoscopy by application of bundle and centralization a single center review |
| topic | Colonoscopy Gastroenterology Pediatrics Quality improvement |
| url | http://www.sciencedirect.com/science/article/pii/S1875957223001754 |
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