Consulta de enfermería para la preparación de colonoscopia virtual. Ensayo clínico abierto, aleatorizado y controlado / Nursing consultation for the preparation of virtual colonoscopy. Open, randomized and controlled clinical trial

Las limitaciones de la colonoscopia virtual radican en la complejidad del cumplimiento de las instrucciones de preparación previa, con modelos diferentes para diabéticos y no diabéticos, y diferente producto laxante empleado, sintomatología y duración. Este estudio diseña una intervención enfermera que minimiza los rechazos de pacientes que, por mala limpieza del colon, no pueden realizar la colonoscopia virtual. Método. Se distribuyen de forma aleatoria los pacientes que cumplen los criterios de inclusión en dos grupos: • Grupo control: se siguen según el protocolo previo del servicio. • Grupo intervención: acudieron a una consulta de enfermería previa a la colonoscopia virtual, donde se les realiza una encuesta sobre su salud y se determina y explica detalladamente el mejor protocolo de preparación del colon para cada paciente, así como el proceso de colonoscopia virtual. Objetivo. Comprobar la efectividad de una consulta de enfermería para la preparación de colonoscopias virtuales en términos de aumento de la tasa de colonoscopias virtuales interpretables o de calidad. Resultados. Se redujo significativamente la puntuación en ansiedad de los pacientes tras la consulta (6.5 +/-2.5 antes frente a 5.5+/-2.4 después; p < 0.001). El grupo intervención redujo en casi un 4 % el número de pruebas complementarias precisadas por el grupo control. La recitación de pacientes fue un 6 % inferior en el grupo intervención que en el grupo control. Conclusiones. Se podría producir un ahorro de 15 990 euros anuales, puesto que se redujo la recitación de pacientes y la realización de pruebas diagnósticas complementarias al nivel del grupo intervención (AU)

The limitations of virtual colonoscopy lie on the complexity of patient’s previous preparation process. There are different models for diabetic and non-diabetic patients, and these models also differ depending on the laxative product used, the symptomatology and its duration. This study designs a nursing intervention to minimize refusal of patients who, due to bad colon cleansing, cannot be subject to a virtual colonoscopy. Method. Patients who met the inclusion criteria were randomized into two groups. • Control group: patients were treated according to the previous protocol of service. • Experimental group: patients attended a nurse consultation appointment prior to the virtual colonoscopy, where nurses implemented a questionnaire about the patients’ health and determined the best protocol for bowel preparation according to each patient, explaining the process in detail. The virtual colonoscopy procedure was also clarified during the nursing appointed consultation. Objective. To determine the effectiveness of nursing work in the preparation of virtual colonoscopy in terms of increasing the rate of interpretable or high-quality virtual colonoscopies. Results. The anxiety score for patients was significantly reduced after the nursing consultation (6.5 +/-2.5 before vs. 5.5 +/- 2.4 after; p < 0.001). The experimental group showed a reduction of almost 4 % in number of complementary tests necessary for the control group. The reappointment of patients in the experimental group was 6 % lower than in the control group. Conclusions. The experimental group showed that savings of 15.990€ a year could be achieved by reducing both: reappointment of patients and need for complementary diagnostic tests (AU)

Laboratory and diagnostic testing: a perioperative update.

Perioperative nurses are challenged to stay informed about the rapidly changing field of diagnostic and laboratory testing. The brain natriuretic peptide test primarily is used to differentiate dyspnea caused by heart failure from dyspnea that results from other causes. Virtual colonoscopy is a promising new alternative for detecting colorectal polyps and cancers. The microalbumin urine test provides an early indication of the development of diabetic complications. This update of relatively new laboratory tests and diagnostic studies also provides implications for perioperative nurses.