Stools for Stools-combining a multi-disciplinary approach with conservative measures to reduce constipation in the elderly inpatient population

Noam Roth, Claudia Moore-Gillon, Nada Khalil, David James, Louis John Koizia* and Cerys Morgan

Introduction: Constipation is a common cause of morbidity in the elderly. Its management is particularly challenging in the inpatient population where many factors exacerbate constipation. We describe a Quality Improvement Project to reduce constipation in a Care of the Elderly ward, including conservative measures to complement medical treatment.

Aims: To increase bowel motion frequency to at least once every two days in elderly inpatients, and to increase bowel chart documentation.

Methods: Weekly monitoring of ward inpatients. Measurements taken were: days since last bowel motion, laxatives prescribed, documentation on bowel charts and ward rounds, and episodes of diarrhea. A new intervention was introduced every two weeks, over a total of 10 weeks.

Interventions: The 4 interventions introduced were: 1) Recording bowel motions at the daily ‘Board Round’ Multi-Disciplinary Meeting. 2) Ward staff education sessions. 3) Footstools for use with commodes and toilets. 4) High-fibre foods for patients with constipation.

Results: Bowel motion frequency improved, with 100% of patients moving bowels every 2 days from a baseline of 66.6%. Ward round and bowel chart documentation improved to 100% and 92.9% (from 41.6% and 33.3%). Laxative prescriptions increased from 50% to 78.6%, with no increase in episodes of diarrhea. 

Conclusions: Constipation improved with our interventions but was accompanied by increased laxative prescriptions, which carry a risk of side effects. Our next steps will be to optimize our conservative measures to reduce laxative prescriptions, and to this end, we have developed high-fiber snack boxes to aid constipation in elderly patients.

Keywords:

Published on: Oct 13, 2022 Pages: 1-3

Full Text PDF Full Text HTML DOI: 10.17352/aggr.000030
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