Improving Quality of Bowel Preparation Through Digital Innovation in the Gastroenterology Clinic

Authors

Arlena S. Grays, University of Texas Health Science Center at HoustonFollow

Author Biographical Info

Arlena Grays, MS, APRN, FNP-C

Arlena Grays is a graduate of the University of Texas Health Science Center at Houston. She graduated Magna Cum Laude with a Bachelor of Science in Nursing. 

After 13 years as a registered nurse, she obtained a master’s in science at Texas Woman’s University. She is a Board-Certified Family Nurse Practitioner who specializes in gastroenterology. Arlena is an active member of multiple professional organizations as outlined below.   

She enjoys educating patients, building trusting relationships and providing holistic care. 

HONORS

• Magna Cum Laude, University of Texas Health Science Center-Houston 

LICENSURE

• Texas -2018

BOARD CERTIFICATION

• American Academy of Nurse Practitioners 

PROFESSIONAL SOCIETIES

• American College of Gastroenterology
• American Academy of Nurse Practitioners, specialty practice group-gastroenterology

EDUCATION

• DNP Candidate 
• 2015-2018, MS, Texas Woman’s University
• 2010, RN, BSN, University of Texas Health and Science Center-Houston
• 2005, RN, ADN, San Jacinto College

Date of Doctor of Nursing Practice Project Completion

Spring 5-1-2026

Faculty Advisor

Dr. Linda Cole

Abstract

Improving Quality of Bowel Preparation Through Digital Innovation in the Gastroenterology Clinic

Purpose

This quality improvement project (QIP) aimed to enhanced bowel preparation quality by supplementing traditional verbal and written instructions with digital guidance using quick response (QR) code access and artificial intelligence (AI).

Background

The project was implemented at an outpatient gastroenterology practice within a medical center, which encompasses an outpatient endoscopy center in Houston, Texas.

Methodology

The project utilized the Boston Bowel Preparation Scale (BBPS) to evaluate the impact of the intervention on bowel preparation scores. The study used a 5-point Likert questionnaire to assess perceived ease of use and users’ attitudes and behaviors towards bowel preparation instructions before and after (QR) code access.

Dynamic QR Codes were used to track metrics including the percentage of scans for the QR code. Patient results were evaluated over seven weeks and compared to pre-intervention data. The Plan Do Study Act method was utilized for this quality improvement initiative.

Results

The highest average BBPS score of 9 was achieved after implementation of the QR code, surpassing scores using traditional written and verbal instructions alone. The QR code was utilized between 47%- 100% each week of implementation. There was an overall improvement of patient satisfaction scores, reaching 94% and qualitative data included staff comments that the new process was positive after the intervention.

Implications

QR code instructions improve patient satisfaction and bowel preparation quality. Improved preparation allows healthcare professionals to address challenges resulting in colonoscopy cancellations.

The sustainability of digital innovation was supported by easy access to smartphones, continuous monitoring of BBPS scores and integration of the QR code into standard policy at the local practice.

Keywords: mobile applications, digital programs, bowel prep

Keywords

mobile applications, digital programs, bowel prep

Recommended Citation

Arlena S. Grays, "Improving Quality of Bowel Preparation Through Digital Innovation in the Gastroenterology Clinic" (2026). Doctor of Nursing Practice Final Project Abstract. 143.
https://digitalcommons.library.tmc.edu/dnp_abstract/143