Development of a Practice Guideline for Patient Preparation for Colonoscopy, Tapan Hin Crown Prince Hospital, Phichit Province

Abstract

        Colorectal cancer is a significant public health issue. Colonoscopy is an effective screening method that reduces mortality rates. However, its success relies heavily on adequate bowel preparation. Inadequate bowel preparation may hinder the physician’s ability to detect abnormalities in the colon effectively. Objective: To develop a clinical practice guideline for bowel preparation in patients undergoing colonoscopy for colorectal cancer screening and to assess its feasibility in application at Tapan Hin Crown Prince Hospital, Phichit Province. Methods: This developmental research was conducted from February to April 2025, utilizing the One Day Surgery (ODS) concept from the Department of Medical Services, Ministry of Public Health, in combination with the NHMRC clinical practice guideline development framework from Australia. The participants included 5 healthcare professionals involved in developing the guidelines, 10 healthcare providers who piloted its implementation and 10 patients who received the implemented guidelines. The research instruments included the Appraisal of Guidelines for Research and Evaluation II (AGREE II), the feasibility assessment form of the guideline, and the bowel cleanliness assessment form. All instruments were evaluated for content validity by five experts, an index of item-objective congruence (IOC) of 1.00. Reliability analysis using Cronbach’s alpha coefficient demonstrated a reliability value of 0.87. Results: The developed guideline consists of two phases: (1) Pre-colonoscopy phase, which includes FIT test screening, patient education for bowel preparation, and bowel cleanliness assessment; and (2) Post-colonoscopy phase, which includes post-procedural care and the provision of discharge instructions. The guideline was evaluated for quality by five experts using the Appraisal of Guidelines for Research and Evaluation II (AGREE) criteria. The quality scores ranged from 95.00% to 97.77%. The overall quality score of the guideline was 96.66%. All experts agreed that the guideline was appropriate for implementation. All participants involved in the implementation of the guideline agreed that the protocol demonstrated clarity, promoted consistent understanding among healthcare teams, was easy to implement, exhibited practical feasibility within clinical settings, and was associated with a high level of user satisfaction. Intestinal cleanliness was at a very good level ( = 3.90, SD = .316). Conclusion: The developed guideline was found to be appropriate and feasible for implementation at Tapan Hin Crown Prince Hospital, Phichit Province. Recommendation: The guidelines should be implemented to evaluate its effectiveness and extended to hospitals with similar contexts.