Abstract: Implementation of Bowel Management Program in Critical Care (45th Annual Conference (June 22-26, 2013 ))

Terrie Beeson, MSN, RN, CCRN, ACNS-BC, Indiana University Health, Clinical Nurse Specialist, Indianapolis, IN, Joyce Pittman, PhD, FNP-BC, CWOCN, Indiana University Health- Methodist Hospital, Wound/Ostomy Team Leader, Indianapolis, IN, Lisa M. Kirk, MSN, RN, CWOCN, Riley Hospital for Children, Wound, Ostomy, G-tube Clinician, Indianapolis, IN, Colin Terry, MS, Indiana University Health, Bio Statistician, Indianapolis, IN and Brandt Carter, Indiana University Health, Instructional Designer, Indianapolis, IN

Title: Implementation of Bowel Management Program in Critical Care:

Introduction/Significance

Critical care staff nurses identified fecal incontinence and IAD as a patient safety and care issue. An evidence-based bowel management system (BMS) program was developed that included; usual care, rectal trumpet, and internal fecal device¹,². Critical care nurses collaborated with WOC nurses and CNS’s to design a structured, educational, evidence based, BMS program into practice for critical care units.

Purpose

This study examined the effectiveness of a unit-based educational program that implemented an evidence based bowel management program into critical care.

Method

Design/Sample/setting-Using a quasi-experimental pre/post design, more than 270 nurses in six critical care units in a large teaching healthcare system participated.

Procedures- Pre- and post-test data were collected at the time of the web-based educational module, unit-based skills acquisition sessions verified competency, and self-efficacy determined content and skills mastery one month later.

Analyses-Descriptive analyses were completed using frequencies and percentages. Pre and post-test scores and self efficacy scores were summarized using mean and standard deviation and two-sided paired Student t-test. Exploratory analyses examined relationships among variables.

Findings- The web-based interactive education module pre and post tests scores for 225 participants showed significant (p<0.001) improvement in scores. The skills acquisition sessions were completed successfully by 100% of the participants. Enhanced collaboration with the WOC nurses and CNS’s was reported by 86% (n=125) of the nurses. Approximately 305 BMS order sets were implemented consulting the WOC nurses and CNS’s, in addition informal collaboration at bedside during daily rounds, telephone consultation, and emails. Self efficacy scores will be reported at a later date.

Conclusion- This structured and sustainable BMS education program translated evidence based practice into the critical care setting. This study adds to the growing body of knowledge, representing unit-based educational methods for translation of evidence into nursing practice.

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