title: Prevalence, management and clinical challenges associated with acute faecal incontinence in the ICU and critical care settings: the FIRST cross-sectional descriptive survey.
abstract: OBJECTIVE
  To evaluate the prevalence, awareness and management of acute faecal incontinence with diarrhoea (AFId) in the Intensive Care Unit.
  
  
  METHODS
  Cross-sectional descriptive survey design of intensive care units across Germany, Italy, Spain and the United Kingdom.
  
  
  RESULTS
  962 questionnaires were completed by nurses (60%), physicians (29%) and pharmacists or purchasing personnel (11%). The estimated prevalence of AFId ranged from 9 to 37% of patients on the day of the survey. The majority of respondents reported a low-moderate awareness of the clinical challenges associated with AFId. Patients with AFId commonly had compromised skin integrity, which included perineal dermatitis, moisture lesions or sacral pressure ulcers. Reducing the risk of cross-infection and protecting skin integrity were rated as the most important clinical challenges. 49% had no hospital protocol or guideline for AFId management. There was also a low awareness of nursing time spent managing AFId; 60% of respondents estimated that 10-20 minutes are required for managing an AFId episode by 2-3 healthcare staff.
  
  
  CONCLUSIONS
  AFId in the critical care setting may be an underestimated problem which is associated with a high use of nursing time.
authors.affiliation: Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Bayón García
authors.forename: Rachel
authors.initials: R
authors.lastname: Binks
authors.forename: Enrico
authors.initials: E
authors.lastname: De Luca
authors.forename: Christine
authors.initials: C
authors.lastname: Dierkes
authors.forename: Andrea
authors.initials: A
authors.lastname: Franci
authors.forename: Elisabet
authors.initials: E
authors.lastname: Gallart
authors.forename: Georg
authors.initials: G
authors.lastname: Niederalt
authors.forename: Duncan
authors.initials: D
authors.lastname: Wyncoll
mesh_terms: D000208:Acute Disease; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology* / Q000628:therapy*; D005060:Europe / Q000453:epidemiology; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000628:therapy*; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017053:Infection Control; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D009726:Nurses; D010820:Physicians; D015995:Prevalence; D017592:Skin Care; D012871:Skin Diseases / Q000517:prevention & control