Use of a Fecal Management System (FMS) for Fecal Containment in the ICU: A Clinician's Perspective

  Fecal incontinence management (FIM) is an important issue in acute care as suboptimal management can lead to skin breakdown, spread of infection, and patient discomfort.

A survey was conducted to assess clinician satisfaction with an FMS with advanced features including a balloon volume indicator designed to assist clinicians in determining optimal retention balloon volume (FMS-S*). Overall, 67 surveys were completed from 47 ICUs in the United States. 

The clinicians surveyed reported that 81% used traditional FIM methods (incontinence briefs and pads) and 93% used an FMS.  When looking at the features of FMS-S, the most liked features were the retention balloon fill indicator (90%), blue finger pocket allowing easy insertion (84%), collection bags with integrated filter designed to contain, lock in odor (79%) and enlarged irrigation line (75%).  The features regarded as less liked were the label site for clinicians’ notes (21%), the beaded hanging strap (15%) and other (22%) such as “odor” and amount of lubrication provided.

With regards to device performance, 94% of respondents agreed that the fill indicator improved ease of use.  The mean ratings ranged from 8.06 to 9.08 when FMS-S was rated on a scale from 1 (poor) to 10 (great) on criteria including prevention of skin breakdown, stool containment, ease of use, odor management, reduction of nursing time, patient comfort and reducing risk of infection spread.

In conclusion, survey results suggested overall clinician satisfaction with the features and performance of the device.  Ninety eight percent of the survey respondents said that they would use the FMS-S instead of their current method and all survey respondents said that they would recommend this product to their colleagues. Therefore, FMS-S provides a valuable option for FIM that may provide potential benefits for the patient and nursing staff.