Bowel management systems in critical care: a service evaluation
Evidence & Practice    

Bowel management systems in critical care: a service evaluation

Jennifer Ritzema Critical care research sister, Critical Care Department/Research and Development, Queen Elizabeth Hospital, Gateshead Health NHS Foundation Trust, Gateshead, Tyne and Wear, England
Aim

Many patients who are critically ill develop faecal incontinence associated with diarrhoea, and require a bowel management system (BMS) to prevent skin excoriation. Following guidelines produced by the National Institute for Health and Care Excellence, early rehabilitation has resulted in a reduction in the number of days that patients receive mechanical ventilation. However, patients with a BMS are potentially mechanically ventilated for longer because they must be cared for in bed. The aim of this evaluation was to investigate whether patients with a BMS are mechanically ventilated for longer than those without a BMS.

Method

This was a retrospective service evaluation, in which a database search was conducted to identify patients admitted to the critical care department in one healthcare organisation during 2013. The search was narrowed to identify patients admitted to the critical care department who had received advanced respiratory support (mechanical ventilation), to compare the mean number of mechanically ventilated days between patients with and without a BMS (n = 122). Data were analysed using the Mann-Whitney U test.

Results

There was a significant difference in the number of mechanically ventilated days (P < 0.01), with patients with a BMS being ventilated for an average of 5 days longer than those without a BMS.

Conclusion

The difference in the number of mechanically ventilated days may be a result of the patient having difficulty mobilising with a BMS in situ. Subsequently, critically ill patients with a BMS are placed in a sitting position for short periods of time. Further research should explore alternative bowel care options for patients who are critically ill.

Nursing Standard. doi: 10.7748/ns.2017.e10594

Correspondence

jenny.ritzema@ghnt.nhs.uk

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software

Received: 23 June 2016

Accepted: 09 September 2016

Published online: 16 January 2017