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Clinical Research
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Medication Delivery Via Indwelling Bowel Access System Plays Critical Role in Critical Care First Author: Tracey Wilds Authors: Mary D. Still, MSN, RN, ANP-C, CCRN Tracey A. Wilds, MSN, RN, ANP-C PROBLEM: Bowel access and fecal control are essential adjuncts to patient care. Control of fecal drainage assists with perineal and sacral wound healing and has safety implications for medical personnel. There is an increasing need for the administration and retention of medications rectally for treatment of liver failure, renal failure and gastrointestinal hemorrhage. PURPOSE: Delineate the therapeutic uses of an indwelling bowel access system* for inpatients in intensive care settings. METHOD: The product was used in 288 patients between September 2004 and November 2005; a retrospective review was performed on the charts of 111 consecutive patients. RESULTS: The mean dwell time was 10.9 days, with a range of 1-58 days. Indications for use include: control of diarrhea (60%), wound protection (26%), and medication administration (22%). There was only one adverse event: An ulceration of the rectal vault, which was discovered to be the result of over-inflation of the retention cuff. CONCLUSION: The bowel access system provided a safe and effective means of control of fecal drainage and the protection of wound and skin in a variety of patients. This particular product* provides the unique additional benefit of medication administration and retention, which was an important adjunct to care. *Zassiª Bowel Management System, Hollister Incorporated, Libertyville, IL. |
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