The implementation of a bowel management protocol in an adult intensive care unit

McPeake, J. , Gilmour, H. and MacIntosh, G. (2011) The implementation of a bowel management protocol in an adult intensive care unit. Nursing in Critical Care, 16(5), pp. 235-242. (doi: 10.1111/j.1478-5153.2011.00451.x)

Abstract

Aim: A study to explore the impact of implementing a bowel management protocol in a tertiary referral intensive care unit (ICU) in the West of Scotland. Methods: A three phase study was implemented. Phase 1 - a baseline audit reviewing 26 patients' medical notes and a baseline focus group reviewing the multidisciplinary team's (MDT's) opinions with regard to bowel care management in the ICU. Phase 2 - the implementation of a protocol, updated bowel care chart and education sessions for members of the MDT. Phase 3 - an end of study audit reviewing 27 patients' notes after the implementation of phase 2. Additionally, a further focus group examined the MDT's experiences of the protocol in clinical practice. Results and Findings: During the phase 1 data collection period, it was evident that there was a haphazard approach to bowel care in the ICU, resulting in poor bowel care documentation and a high incidence of constipation and diarrhoea days. After the interventions of phase 2, bowel care documentation days increased by 13% (p = 0.0003), constipation incidence decreased by 20.7% (p = 0.13) and diarrhoea days reduced by 15.2% (p = 0.18). Conclusion: Although further evaluation is planned, the protocol implemented in this particular study appears to be a useful tool for the delivery of bowel care in the ICU. Relevance to Clinical Practice: Ensuring appropriate and timely bowel care in the ICU has major implications for the critically ill patients.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: MacIntosh, Mr Graham and McPeake, Dr Jo
• Authors: McPeake, J., Gilmour, H., and MacIntosh, G.
• Subjects: R Medicine > R Medicine (General)
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
• Journal Name: Nursing in Critical Care
• ISSN: 1362-1017
• Published Online: 08 August 2011