Comparison of economic impact of bed linen changes per day of two indwelling bowel management systems

Fecal incontinence is prevalent in 18% to 33% of patients in the acute/ICU setting.^1,2 The use of indwelling bowel management systems to divert, collect, and contain liquid stool may provide an economic advantage for hospitals in this patient population. The primary objective of this study was to assess and compare the economic impact of fecal containment with use of catheter A or catheter B in 12 acute/ICU settings (A,7;B,5). Linen change visits per patient day (frequency of nursing visits per day spent changing bed linens due to fecal contamination) can be used as an indirect economic measure of fecal containment. Varying catheter characteristics, such as the presence of anchor straps on catheter A, may have an impact on the number of linen change visits due to fecal leakage.

Patients were followed, while either catheter A (n=76) or catheter B (n=70) was in place, for 29 days or until they were discharged from the ICU, which ever came first. A 93 patient (A,35;B,58) interim analysis at 7 sites compared the number of linen change visits per day. Routine daily bedding changes were not included, only catheter-related (fecal leakage) linen changes were recorded. For catheter A, 177 linen change visits occurred over 253 patient days for a rate of 0.70 nursing visits per patient day. For catheter B, 468 linen change visits occurred over 336 patient days for a rate of 1.39 nursing visits per patient day. Of clinicians surveyed, 96% (n=26) who used catheter A and 82% (n=17) who used catheter B responded that they experienced less or about the same leakage as other products.

The preliminary results indicate catheter A may have a greater economic value compared to catheter B by decreasing the number of additional nursing visits per patient day and the associated cost of linens per patient.