Completed Research Project
Development and evaluation of a screening, management and education program for older patients admitted to an acute care setting, to prevent or minimise bowel problems
Investigators: Nikoletti, S., Young, J., Levitt, M., King, M.,
Chidlow, C., & Hollingsworth, S.
Funding: National Continence Management, Strategy Grants Program ($164,500).
Abstract: The aim of this project was to develop a screening, management and education program to prevent or better manage faecal incontinence and related bowel problems of patients admitted into an acute care tertiary hospital setting. Stage 1 involved face-to-face interviews with 101 patients from the target population to determine the types and prevalence of bowel problems, self care practices and information needs. In Stage 2, the educational resources and data collection tools were developed for nursing staff and patients, based on findings from stage 1 and from the literature. The resources included an education booklet and pamphlet for patients and an educational seminar and self-directed learning package for nurses. A bowel management algorithm developed by clinicians within the hospital was included, to guide treatment of faecal incontinence and constipation. Nurses’ knowledge about bowel function was assessed before and after their education session (n=105). In Stage 3, a quasi-experimental pretest-posttest study design was used to implement the patient education program. Outcomes for the intervention (n=200) and control (n=99) groups were measured at three time points: baseline, one week and eight weeks after discharge. The outcomes measured were (1) knowledge of bowel function and bowel care; and (2) patients’ self-reports of bowel habits and bowel problems. Findings from this study revealed that patients from the general population admitted to acute care experience many bowel problems and potentially harmful bowel habits. They also lack knowledge about how to prevent or manage their bowel problems. The results showed that patients’ knowledge of bowel function was significantly improved by providing a simple educational booklet and pamphlet developed in this study. Resources developed for nurses also resulted in significantly improved knowledge. In both groups, however, knowledge scores at the posttests indicated that there was some room for improvement. Improvements in bowel habits and problems were observed for both the intervention and control patient groups, but there were a greater number of statistically significant improvements observed for the intervention group. It is anticipated that the resources developed for this study will be made available nationally through the National Continence Helpline.
