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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024OP-04Improving the Percentage of Successful Bowel Cleansing among Patients Prescribedwith Polyethylene-Glycol (PEG)-4000 Powder for Colonoscopy in Hospital TuankuJa%u2019afar Seremban (HTJS)Ahmad Ridza AN1, Cheong JW1, Goh S1, Thanapriya A1, Tien JS1, Siti Nabilah MY1, Muhammad SahmiMS1, Adibah M1, Zaidah MA2, Norfarizan A2, Abdul Aziz AM2, Shamsul Akman A2, Fazliana M21Department of Pharmacy, Hospital Tuanku Ja%u2019afar Seremban, Negeri Sembilan2Department of Surgery, Hospital Tuanku Ja%u2019afar Seremban, Negeri SembilanSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Hospital Tuanku Ja%u2019afar Seremban (HTJS) data in June 2022 reported only 38.8% colonoscopy patientsprescribed with polyethylene-glycol (PEG)-4000 powder underwent successful bowel cleansing whichcan cause repeated colonoscopy, subsequently delayed in diagnosis and treatment. We aimed to improvethe percentage of successful bowel cleansing for colonoscopy in HTJS.KEY MEASURES FOR IMPROVEMENT:The indicator was the percentage of successful bowel cleansing, with a standard of %u226590%, based on theEuropean Society of Gastrointestinal Endoscopy Guideline 2019.PROCESS OF GATHERING INFORMATION:A quality improvement study was conducted (verification study in June 2022 and three remedial cycles inJuly 2022 - June 2023). Convenience sampling involved 49 patients prescribed with PEG-4000 powderfor bowel cleansing. A data collection form and patient database were used to determine the percentage ofsuccessful bowel cleansing, and contributing factors were identified from the patient's interview andcounselling observation.ANALYSIS AND INTERPRETATION:Verification study showed only 38.8% patients with successful bowel cleansing (ABNA 51.2%), with themost prominent contributing factor being 70% pharmacists performed unstandardised counselling. Othercontributing factors included poor compliance to PEG-4000 powder instructions (47%) and dietrestrictions (27%) and patients forgot to consume PEG-4000 powder (26%).STRATEGIES FOR CHANGE:A bowel preparation counselling with 3D-video and interactive focus group counselling wereimplemented. CLEAR2GO drinking pouch with reminder labels and video with QR code was introducedto assist patients consuming PEG-4000 powder. CLEAR2GO Alert Database (CRAD) tracked patient%u2019sbowel cleansing and colonoscopy dates, and SMS reminders for patients via CLEAR2GO ReminderSystem (CRES) were also implemented.EFFECT OF CHANGE:Percentage of successful bowel cleansing for colonoscopy improved to 86.7% (ABNA gap reduced to3.3%). Patients%u2019 compliance to PEG-4000 powder instructions and diet restrictions increased to 100% and98% respectively; 90% pharmacists successfully performed standardised counselling. Repeatedcolonoscopy reduced to 13.3%, saving MYR 8,000.00.THE NEXT STEP:This project would be replicated by Negeri Sembilan hospitals and shared with Malaysian hospitalsnationwide. CLEAR2GO commercialisation is ongoing.29 | Page