title: The implementation of a bowel management protocol in an adult intensive care unit.
abstract: OBJECTIVE
  A study to explore the impact of implementing a bowel management protocol in a tertiary referral intensive care unit (ICU) in the West of Scotland.
  
  
  METHODS
  A three phase study was implemented. Phase 1 - a baseline audit reviewing 26 patients' medical notes and a baseline focus group reviewing the multidisciplinary team's (MDT's) opinions with regard to bowel care management in the ICU. Phase 2 - the implementation of a protocol, updated bowel care chart and education sessions for members of the MDT. Phase 3 - an end of study audit reviewing 27 patients' notes after the implementation of phase 2. Additionally, a further focus group examined the MDT's experiences of the protocol in clinical practice.
  
  
  RESULTS
  During the phase 1 data collection period, it was evident that there was a haphazard approach to bowel care in the ICU, resulting in poor bowel care documentation and a high incidence of constipation and diarrhoea days. After the interventions of phase 2, bowel care documentation days increased by 13% (p = 0.0003), constipation incidence decreased by 20.7% (p = 0.13) and diarrhoea days reduced by 15.2% (p = 0.18).
  
  
  CONCLUSIONS
  Although further evaluation is planned, the protocol implemented in this particular study appears to be a useful tool for the delivery of bowel care in the ICU.
  
  
  CONCLUSIONS
  Ensuring appropriate and timely bowel care in the ICU has major implications for the critically ill patients.
authors.affiliation: Intensive Care Unit, Glasgow Royal Infirmary, Glasgow, UK. j.mcpeake@clinmed.gla.ac.uk
authors.forename: Joanne
authors.initials: J
authors.lastname: McPeake
authors.forename: Harper
authors.initials: H
authors.lastname: Gilmour
authors.forename: Graham
authors.initials: G
authors.lastname: MacIntosh
mesh_terms: D000328:Adult; D002985:Clinical Protocols; D003248:Constipation / Q000628:therapy*; D003422:Critical Care / Q000379:methods*; D003967:Diarrhea / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units; D012606:Scotland