Poster Presentation
Thursday, 20 July 2006
10:00 AM - 10:30 AM
Thursday, 20 July 2006
3:00 PM - 3:30 PM
Using Evidence-Based Practice to Determine the Most Effective Bowel Program for Patients with Severe Traumatic Brain Injury
Linda A. Dufour, MSN, RN, Alexandra Lentz, BSN, RN, Gerald S. Bilsky, MD, and Kathleen Strauser, LPN. ABI Program, Shepherd Center, Atlanta, GA, USA
| Learning Objective #1: to explain important bowel elimination issues in patients with severe traumatic brain injury. |
| Learning Objective #2: to explain effective bowel elimination treatments in patients with severe traumatic brain injury. |
Little information exists in the scientific literature to support evidence based practice in the low level brain injury population. Most clinical practice guidelines suggest the use of “a suppository,” but do not provide treatment recommendations for the type, frequency or what constitutes success. Contrary to spinal cord injury literature, there is little to guide the brain injury practitioner in specific bowel management strategies. The purpose of this presentation is to discuss a current pilot study that compares the effectiveness of glycerin and bisacodyl suppositories in establishing scheduled bowel movements in this population. This is important because it has the potential to decrease caregiver burden after discharge by better regulating the timing of bowel elimination. The primary outcome measures are 1) the patient will have a scheduled bowel movement within 2 hours of suppository administration and 2) The patient will have one or less unscheduled bowel movements by the end of week three. Upon admission to inpatient rehabilitation, low level brain injury patients are randomly assigned to one of two bowel programs that use a suppository. One group receives glycerin while the other receives bisacodyl daily. The patient remains on the program for three weeks and data is collected daily regarding the timing and consistency of bowel movements. The investigators are using descriptive statistics to calculate means, standard deviations and median scores for all demographic and injury related points. A one way analysis of variance is being conducted to determine whether suppository type has a significant impact on the primary outcomes. The pilot study will be completed in the early spring of 2006. The results and implications for clinical practice will be explored in this presentation. The investigators propose that this research carries an excellent likelihood of yielding relevant data to support evidence based practice for bowel management in this population.
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See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)