Admissions To Endoscopy/Colon Preps

[LynMichelRN]

I work in a small hospital and we admit our own patients to our unit. Our basic admission consists of a Surgical Admission assessment which includes things like past medical history, a small physical assessment, a medication reconciliation sheet etc. Our hospital is now talking about adding a DVT risk assessment to the admission. Personally, I think it is unecessary, since the DVT risk assessment on inpatient is performed so the nurse can implement some interventions. I don't think we should be putting ted hose, scd's and recommending anticoagulant therapy on outpatients.

I would really like to know what other hospitals or centers on doing for an admission.

Also, we still give enemas, a few doctors have agreed to let us do a study where we don't tell them if the patient had an enema or not to see the difference. I am interested to know if everyone else out there has stopped giving enemas. This is a small town and change takes forever! Thanks for any input you can give!

[core0]

I work in a small hospital and we admit our own patients to our unit. Our basic admission consists of a Surgical Admission assessment which includes things like past medical history, a small physical assessment, a medication reconciliation sheet etc. Our hospital is now talking about adding a DVT risk assessment to the admission. Personally, I think it is unecessary, since the DVT risk assessment on inpatient is performed so the nurse can implement some interventions. I don't think we should be putting ted hose, scd's and recommending anticoagulant therapy on outpatients.

I would really like to know what other hospitals or centers on doing for an admission.

Also, we still give enemas, a few doctors have agreed to let us do a study where we don't tell them if the patient had an enema or not to see the difference. I am interested to know if everyone else out there has stopped giving enemas. This is a small town and change takes forever! Thanks for any input you can give!

I would agree that there is no need to do DVT risk assessment. There are studies in day surgery on when it is needed. They are all on longer cases than endoscopy. The other thing you should think about is what are you going to do with the information. If you do the assessment and identify someone at risk then don't do anything, what happens if god forbid the patient gets a DVT. Probably better to not do the assessment.

As far as preps, we haven't used enemas in more than six years. We use PEG almost exclusively. Take a look at this from ASGE:

http://www.askasge.org/pages/tech/nt_colonoscopy.cfm

Notice that none of these look at enemas for preps.

If they like phospo preps (my personal bugaboo) show them this:

http://www.yourlawyer.com/topics/overview/fleet_enema

:)

David Carpenter, PA-C

[LynMichelRN]

David ,

Thank you so much for your response and the links, they are very helpful.

Lyn

[meandragonbrett]

Enemas? I haven't seen enemas used for preps and I certainly wouldn't be having one!! We use pills the night before or they can drink golytely