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Aim Many patients who are critically ill develop faecal incontinence associated with diarrhoea, and require a bowel management system (BMS) to prevent skin excoriation. Following guidelines produced by the National Institute for Health and Care Excellence, early rehabilitation has resulted in a reduction in the number of days that patients receive mechanical ventilation. However, patients with a BMS are potentially mechanically ventilated for longer because they are cared for in bed. The aim of this evaluation was to investigate whether patients with a BMS are mechanically ventilated for longer than those without a BMS. Method This was a retrospective service evaluation, in which a database search was conducted to identify patients admitted to the critical care department in one healthcare organisation during 2013. The search was narrowed to identify patients admitted to the critical care department who had received advanced respiratory support (mechanical ventilation), to compare the mean number of mechanically ventilated days between patients with and without a BMS (n = 122). Data were analysed using the Mann-Whitney U test. Results There was a significant difference in the number of mechanically ventilated days (P <0.01), with patients with a BMS being ventilated for an average of 5 days longer than those without a BMS. Conclusion The difference in the number of mechanically ventilated days may be a result of the patient having difficulty mobilising with a BMS in situ. Subsequently, critically ill patients with a BMS are placed in a sitting position for short periods of time. Further research should explore alternative bowel care options for patients who are critically ill. [ABSTRACT FROM AUTHOR]

Faecal incontinence is common in acutely ill patients, and has many predisposing factors. It is important that nursing staff understand the process of normal defecation as well as the adverse effects faecal incontinence has on patients, relatives and carers. New techniques are emerging for the management of faecal incontinence and it is important that nurses are aware of these. [ABSTRACT FROM AUTHOR]

While faecal incontinence is a common problem, many people may be embarrassed to admit having the condition. An understanding of the various factors that contribute to faecal incontinence can increase nurses' awareness of potential continence problems. Nurses can assess patients for faecal incontinence, provide valuable information and implement a range of management strategies to support patients and improve their quality of life. This article explains the reasons for incontinence, outlines comprehensive patient assessment and discusses the various treatment options to help patients overcome or manage the problem. The author describes the role of continence advisers and clinical nurse specialists who can offer additional expertise. [ABSTRACT FROM AUTHOR]

This article examines the experiences of an older patient with, constipation to illustrate the importance of thorough assessment. The interaction between another medical condition and constipation is discussed, and indications for laxative use are outlined. The current evidence base for bowel care is limited. Tools for risk assessment are required and further research is needed to improve patient care in this area. [ABSTRACT FROM AUTHOR]