Authors (including presenting author) :
Hui KMC, Hung SCV, Dao HY, Ho YYA
Affiliation :
Department of Medicine and Geriatrics (M&G), Tuen Mun Hospital (TMH)
Keyword 2: :
Nurses’ satisfaction
Keyword 3: :
Colonoscopy preparation recommendation
Keyword 4: :
Diabetes inpatient
Introduction :
Currently, there is no standardized practice in Hospital Authority for colonoscopy preparation for people living with diabetes. This gap increases the risk of hypoglycaemia due to laxative use for bowel preparation, fluid diet and fasting without adjustment of anti-diabetic medications during the peri-procedure period. Furthermore, there is no consensus regarding glucose monitoring frequency or management of hypoglycaemia and hyperglycaemia. To address the gap, a multidisciplinary team comprising endocrinologists, diabetes nurses, gastroenterologists, gastroenterology (GI) nurses, and dietitians developed a structured recommendation to enhance inpatient diabetes care during colonoscopy preparation.
Objectives :
To evaluate the satisfaction of medical ward nurses and GI nurses with colonoscopy preparation recommendation programme which enhances diabetes care practices and knowledge to support inpatient care.
Methodology :
The programme was implemented from January to November 2025 across 12 medical wards. Diabetes nurses provided on-site support using a checklist and workflow to guide ward nurses, while also assisted GI nurses in adjusting anti diabetic medications, especially for patients receiving insulin therapy. Two questionnaires (7 items for ward nurses, 6 items for GI nurses) were developed and validated by 12 experts (6 endocrinologists, 6 diabetes nurses). In the initial validation, the ward nurse questionnaire showed the average of Item-level Content Validity Index (I-CVI) was 0.92-1 and Scale-level Content Validity Index (S-CVI) value of 0.96. The GI nurse questionnaire had the average of I-CVI was 0.75-1 and S-CVI value of 0.93. Total three questions for both questionnaires were rephrased for clarity and brevity. In the second round of validation, all items achieved clarity and validity with an average I-CVI value become 1 and S-CVI of 1 on both questionnaires.
Result & Outcome :
From 26 November to 10 December 2025, 65 ward nurses and 5 GI nurses completed the questionnaires. 84.6% ward nurses reported that the overall pre-colonoscopy checklist was clear and easy to follow. 100% GI nurses agreed that the recommendation practices increased their confidence in providing pre-colonoscopy education for diabetes patients. Compliance challenges were noted, with 6.2% reporting limited adherence by doctors to use the checklist and reliance on nurse reminder. To strengthen implementation, further promulgation and reinforcement are recommended in various doctors’ meeting and communication platforms. The checklist for pre colonoscopy preparation was clear and easy for ward nurses to follow, while the recommendation enhanced the confidence of GI nurses in managing pre colonoscopy care. Structured colonoscopy preparation practices can enhance patient safety for diabetes patients in inpatient care and management. Wider implementation across surgical departments was planned to test the applicability to enhance patient outcomes.
