P-829: Unblocking the drain: a Quality Improvement Project on constipation

摘要

Introduction: Constipation is a common problem among the elderly and if not promptly addressed, can lead to serious consequences including urinary retention and bowel obstruction, leading to invasive interventions and delays to discharge. Prompt and effective bowel management is therefore essential in this group. Ensuring that daily documentation of stool charts occurs and that clinicians monitor the stool chart facilitates early identification of constipation. Methods: All patients over 75 admitted to the ward for at least 7 days were included. The medical records over a one week period were interrogated. A predetermined proforma was populated reporting on demographics, presenting complaint, documented diagnosis of constipation, number of days stool chart completed, number of days ward round entries commented on bowels, laxative use and outcomes during admission. Results: Average age was 86 years and 62% female vs 38% male. 85% of patients were admitted with a presenting complaint for which constipation was a risk factor (54% were admitted with confusion). Constipation was diagnosed in 23% of patients, but 84% of patients were on regular oral laxatives. All patients had a stool chart, however, none of the patients had entries for all days of the week (average = 5 of 7 days), nor did they have ward round entries commenting on bowels (average = 2 of 5 days). Conclusion: Documentation of stool charts is the first step in allowing identification of constipation. We produced a poster which highlights the need for daily stool chart entries and this will be re-audited in the future.