Impact of the Magnesium Citrate Recall on Gastroenterology Nursing Procedural Process: Putting the "Prep" in Preparation.

Abstract

At a gastrointestinal endoscopy unit in a large, urban hospital system, the standard preparation (prep) for colonoscopy procedures was a combination of polyethylene glycol 3350 with electrolytes (Golytely) in addition to magnesium citrate until magnesium citrate underwent a national recall in July 2022. At the time of the recall, the facility had over 800 patients scheduled who had already received the recalled medication. The methods used in this project include collaboration with the interdisciplinary team to handle all aspects of the recall with a systematic approach and utilization of this unforeseen event to initiate tracking bowel prep compliance and prep quality with varied types of bowel preps utilizing a bowel prep rating scale. Of the over 800 patients scheduled at the time of the recall, 99.6% were prevented from ingesting the recalled medication. The colonoscopy prep compliance rate was 82.3%, and bowel prep quality was considered adequate in 97.7% of completed outpatient colonoscopies. This article highlights the importance of working with an interdisciplinary team during unplanned large-scale events to provide safe and effective care to patients, as well as finding positives in a challenging situation. This project includes the following commercial content: magnesium citrate, Golytely, MoviPrep, and Boston Bowel Preparation Score.