title: Managing diarrhoea in intensive care.
abstract: OBJECTIVE
  To assess the incidence of diarrhoea in intensive care patients with a length of stay (LOS) greater than 3 days who were receiving any type of enteral tube feeding, and to measure the effect of implementing a bowel management protocol.
  
  
  METHODS
  A 2-year prospective audit, with an intervention after 12 months. Diarrhoea was defined as bowel activity exceeding three stools of any consistency per day, or three or more unformed stools (or 300 mL) per day, for two consecutive days.
  
  
  METHODS
  A tertiary referral intensive care unit (ICU) in a large public hospital.
  
  
  METHODS
  Six hundred fifty-six consecutive patients admitted to ICU with a LOS >3 days.
  
  
  METHODS
  A bowel management protocol was implemented to address both diarrhoea and constipation.
  
  
  METHODS
  Number of patients who experienced diarrhoea during their ICU stay; number of ICU patient-days on which diarrhoea occurred.
  
  
  RESULTS
  After the protocol was implemented, diarrhoea was experienced by 13% fewer patients (p = 0.0002) and occurred on 8% fewer ICU days (p < 0.0001).
  
  
  CONCLUSIONS
  Use of an evidence-based protocol, and improved monitoring and reporting of bowel activity, can decrease the incidence of diarrhoea in ICU patients.
authors.affiliation: Intensive Care Service, Royal Prince Alfred Hospital, Camperdown, NSW 2042, Australia. suzie.ferrie@cs.nsw.gov.au
authors.forename: Suzie
authors.initials: S
authors.lastname: Ferrie
authors.forename: Vivienne
authors.initials: V
authors.lastname: East
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care / Q000379:methods*; D003967:Diarrhea / Q000453:epidemiology / Q000451:nursing*; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies