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Using Performance Management to Implement a Preprocedural Checklist for Gastrointestinal Endoscopy Procedures

Wittren, Susan P., MSN, RN; Cunningham Gregor, Stephanie R., APRN, CNP, CNS; Niesen, Cynthia R., DNP, MA, RN, NEA-BC

doi: 10.1097/SGA.0000000000000353

Providing safe patient care is an important focus of healthcare organizations. In surgical settings, mortality rates have been shown to decrease from 1.5% to 0.8% and complication rates from 11% to 7% when institutions use the World Health Organization's Surgical Safety Checklist. In our hospital-based gastrointestinal endoscopy unit, we recognized that inconsistencies in the preprocedural readiness of patients were causing inefficiencies in scheduling. Therefore, we initiated a quality improvement project to determine whether a preprocedural checklist and positive reinforcement for the nurses in the units could improve endoscopy preparation of patients. The checklist was used to prepare patients and to facilitate nurse-to-nurse communications. We completed a 6-week pilot study (preintervention and postintervention). The results demonstrated the importance of having nurses use a checklist in hospital care units to adequately prepare patients and to accurately communicate patient readiness before gastrointestinal endoscopy procedures. Nursing leadership used positive reinforcement as a strategy to encourage the use of the preprocedural checklist. A postpilot survey of nurses involved in the study show that the preprocedural checklist enhanced care and communication between the patient care units and resulted in direct and indirect benefits for nurses and patients.

Susan P. Wittren, MSN, RN, Nurse Manager, Instructor of Nursing, Department of Nursing, Mayo Clinic, Rochester, Minnesota.

Stephanie R. Cunningham Gregor, APRN, CNP, CNS, Instructor of Nursing, Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minnesota.

Cynthia R. Niesen, DNP, MA, RN, NEA-BC, Director of Nursing, Assistant Professor of Nursing, Department of Nursing, Mayo Clinic Health System - Franciscan Healthcare, La Crosse, Wisconsin.

Correspondence to: Susan P. Wittren, MSN, RN, Department of Nursing, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (

Poster presentation at the American Academy of Ambulatory Care Nursing (AACN) 40th Annual Conference, Lake Buena Vista, FL, April 15–18, 2015.

The authors declare no conflicts of interest.

Received March 29, 2016

Accepted December 20, 2016

© 2019 by the Society of Gastroenterology Nurses and Associates, Inc.