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

• Main Authors: Noam Roth (Author), Claudia Moore-Gillon (Author), Nada Khalil (Author), David James (Author), Louis John Koizia (Author), Cerys Morgan (Author)
• Format: Book
• Published: Archive of Gerontology and Geriatrics Research - Peertechz Publications, 2022-10-13.
• Subjects: Research Article
• Online Access: Connect to this object online.

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