Systematic ReviewResearchWorkflowQuality Improvement

Patient navigation improved colonoscopy completion after an abnormal stool test

Journal of general internal medicine (PubMed)Aug 19, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A systematic review of 10 controlled studies found that patient navigation increased diagnostic-colonoscopy completion after an abnormal stool-based screening test in health-disparity populations.

What NurseJet pulled from the source

Eight studies evaluated navigation. Across each study's follow-up window, navigation improved completion versus usual care by a pooled risk ratio of 1.27 (95% CI 1.10 to 1.46), with moderate-certainty evidence. Registry-based quality improvement and low-touch result notification were each represented by one study.

Why this matters for nurses

An abnormal stool test is not a completed colorectal-cancer evaluation. Oncology, medical-surgical, and ambulatory nurses can help prevent loss to follow-up by identifying barriers, making the next step explicit, and routing unresolved scheduling or preparation needs through an established navigation pathway.

Bedside takeaway

Close the loop after an abnormal stool test: navigation improved diagnostic-colonoscopy completion, while other follow-up strategies had much thinner evidence.

How This Applies in Practice

Use this when: Communicating or following up an abnormal FIT or fecal occult blood test that requires diagnostic colonoscopy.

On your shift

Confirm that the patient understands the abnormal result and that diagnostic colonoscopy, not repeat screening, is the planned next step.
Assess scheduling, transportation, language, preparation, cost, and caregiving barriers and route them to the approved navigation resources.
Keep the referral open in the tracking workflow until completion or a documented clinical disposition.

Keep in mind: Navigation models and follow-up windows varied across studies. Follow the colorectal-screening pathway, facility policy, and provider orders.

Key takeaways

The review included 10 controlled studies of follow-up after an abnormal FIT or fecal occult blood test in health-disparity populations.
Eight studies evaluated patient navigation, which increased colonoscopy completion versus usual care with a pooled risk ratio of 1.27.
The navigation result was rated moderate certainty and remained stable across the review's registered pooled analyses.
Evidence for registry-based quality improvement and low-touch result notification came from one study each.

Practice implications

At result communication or transition of care, verify that the patient understands the need for diagnostic colonoscopy, who will arrange it, and how preparation or transportation barriers will be addressed. Track open referrals according to the organization's follow-up process rather than treating an abnormal screening result as a closed task.

Limitations & cautions

Interventions and follow-up intervals varied, relatively few studies informed each intervention type, and detection data were sparse. The review supports navigation for completion, but it does not identify one universally effective navigation model or establish effects on cancer stage or mortality.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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Journal of general internal medicine (PubMed)

Journal of general internal medicine (PubMed). Improving Diagnostic Colonoscopy Completion After Positive Stool-Based Screening in Health-Disparity Populations: A Systematic Review and Meta-analysis.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42618855/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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Renal failure (PubMed)Sep 7, 2026Research Article

A single-center retrospective cohort found that approximately one quarter of laboratory-defined acute kidney injury cases on internal medicine wards were not documented, particularly when maximal creatinine was lower.

Med-SurgAI summaryReview source

Research ArticleResearchQuality ImprovementAI summary · original source linked below

Among 161 adult hospitalizations meeting serum-creatinine criteria for acute kidney injury, 39 cases (24.2%) were undocumented. Length of stay and in-hospital mortality did not differ significantly by documentation status.

Key takeaways

In the 149 hospitalizations with a demonstrable creatinine change, 33 cases (22.1%) were undocumented.
Higher maximal creatinine was associated with lower adjusted odds of underdocumentation.
The study did not test whether a detection or documentation intervention improves care or outcomes.

Why this matters on shift

A smaller creatinine rise may receive less attention even when it meets the study's laboratory definition of acute kidney injury, which can affect how renal risk is communicated across the inpatient team.

Bedside takeaway

Trend ordered renal-function results and communicate clinically important changes through local escalation and documentation workflows.

Nursing implications

Trend ordered renal-function results and communicate clinically important changes through the care team according to local escalation and documentation workflows.

Limitations & cautions

Abstract-only summary. This was a retrospective, single-center study of 161 hospitalizations; urine-output criteria and reliable preadmission creatinine values were unavailable, and the reference creatinine method may affect case classification.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Renal failure (PubMed). Underdocumentation of laboratory-defined acute kidney injury in internal medicine wards: a retrospective cohort study.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

European heart journal (PubMed)Sep 6, 2026Research Article

In the pragmatic TARGET-D randomized trial, vitamin D dosing titrated to a serum target did not significantly reduce the composite of death, recurrent myocardial infarction, heart-failure hospitalization, or stroke after myocardial infarction.

Telemetry Med-SurgAI summaryReview source

Research ArticleResearchMedication SafetyPatient EducationAI summary · original source linked below

Among 630 participants followed for an average of 4.2 years, major cardiovascular events occurred in 15.7% with targeted vitamin D management and 18.4% with usual care (hazard ratio 0.85, 95% CI 0.58 to 1.24; P=0.40).

Key takeaways

At baseline, 87% of participants had a 25-hydroxyvitamin D level of 40 ng/mL or lower.
The primary composite outcome and the individual outcomes of death, heart-failure hospitalization, and stroke were not significantly different.
A lower recurrent-MI rate was a secondary finding and should not override the nonsignificant primary result.

Why this matters on shift

The trial cautions against presenting targeted vitamin D supplementation as a proven strategy for reducing major cardiovascular events after myocardial infarction.

Bedside takeaway

Present vitamin D as prescribed supplementation, not as a replacement for established post-MI secondary prevention.

Nursing implications

Reinforce the prescribed secondary-prevention plan and avoid implying that vitamin D replaces therapies with established post-MI benefit.

Limitations & cautions

Abstract-only summary. The trial included 630 participants, 78.1% were men, the primary confidence interval included benefit and no benefit, and individual secondary outcomes were not the primary endpoint.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

European heart journal (PubMed). Targeted vitamin D supplementation and major adverse cardiovascular events after myocardial infarction: the TARGET-D trial.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Supportive care in cancer (PubMed)Sep 5, 2026Research Article

A small randomized trial found larger one-month reductions in reported supportive-care needs among colorectal cancer caregivers who received smartphone-based education than with routine care.

OncologyAI summaryReview source

Research ArticleResearchPatient EducationAI summary · original source linked below

Eighty family caregivers at two teaching hospitals in Tehran were randomized. Compared with routine care, the intervention group reported larger reductions in total needs and in health-service, psychological-emotional, work-social, and information domains after four weeks.

Key takeaways

The intervention was designed around family caregivers' supportive-care needs.
All four measured need domains favored the smartphone-education group at four weeks.
The abstract reports statistical significance but does not provide effect sizes or describe the educational content in detail.

Why this matters on shift

Caregiver education is part of oncology care, and mobile delivery may extend structured support beyond brief in-person teaching encounters.

Bedside takeaway

Ask caregivers about unmet information and support needs, then reinforce teaching with approved digital resources.

Nursing implications

Assess what caregivers still need to know and use approved digital education as a supplement to individualized teaching and follow-up.

Limitations & cautions

Abstract-only summary. The trial included 80 caregivers at two hospitals, assessed self-reported needs after only four weeks, and did not report patient outcomes or effect sizes in the abstract.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Supportive care in cancer (PubMed). The effect of a smartphone-based educational intervention on the supportive care needs of family caregivers of patients with colorectal cancer: a randomized controlled trial.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

One in four laboratory-defined AKI cases went undocumented on medicine wards

Targeted vitamin D did not significantly reduce major cardiovascular events after MI

Smartphone education reduced reported support needs among colorectal cancer caregivers