title: Clinical utility and economic impact of introducing a bowel management system.
abstract: OBJECTIVE
  The primary objective of this study was to compare rates of urinary tract and soft tissue infections in critically ill burn patients before and following introduction of a Bowel Management System (BMS). We also analyzed the economic impact of the BMS as compared to reactive management of fecal soiling via cleansing and dressing changes.
  
  
  METHODS
  A retrospective case-matched before-after study was completed. Critically ill burn patients using a BMS were matched with similar patients managed before introduction of the device based on gender, total body surface area burned, burn location, ventilation days, and hospital length of stay.
  
  
  RESULTS
  Reductions in hospital-acquired urinary tract infections and skin and soft tissue infections were observed after introduction of the BMS. Despite its initial cost, it proved more cost effective than a reactive bowel management strategy based on cleansing and dressing changes when fecal soiling occurs.
  
  
  CONCLUSIONS
  Proactive use of a bowel management device appears to reduce some infectious sequelae in a complicated burn care population and proved cost-effective for our facility.
authors.affiliation: Joseph M. Still Burn Center, Doctors Hospital, Augusta, Georgia.
authors.forename: Jane
authors.initials: J
authors.lastname: Echols
authors.forename: Bruce C
authors.initials: BC
authors.lastname: Friedman
authors.forename: Robert F
authors.initials: RF
authors.lastname: Mullins
authors.forename: Zaheed
authors.initials: Z
authors.lastname: Hassan
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Shaver
authors.forename: Claus
authors.initials: C
authors.lastname: Brandigi
authors.forename: Joan
authors.initials: J
authors.lastname: Wilson
authors.forename: Laura
authors.initials: L
authors.lastname: Cox
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000191:economics; D002053:Burn Units; D002056:Burns / Q000150:complications*; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000191:economics / Q000209:etiology / Q000517:prevention & control*; D003663:Decision Trees; D004322:Drainage / Q000191:economics / Q000379:methods / Q000451:nursing; D005242:Fecal Incontinence / Q000150:complications / Q000191:economics / Q000517:prevention & control*; D005260:Female; D006801:Humans; D017053:Infection Control / Q000191:economics / Q000379:methods; D007441:Intubation, Gastrointestinal / Q000191:economics / Q000379:methods* / Q000451:nursing; D007846:Laundering / Q000191:economics; D008297:Male; D008875:Middle Aged; D015403:Nursing Evaluation Research; D012007:Rectum; D012189:Retrospective Studies; D017592:Skin Care / Q000191:economics / Q000451:nursing; D018461:Soft Tissue Infections / Q000191:economics / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000191:economics / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents