Klein Jennifer, Holowaty Sandra
J Gerontol Nurs. 2014 Aug;40(8):18-27; quiz 28-9. doi: 10.3928/00989134-20140501-01. Epub 2014 May 8.
This study examined the effect of implementing a constipation management protocol (CMP) within a geriatric rehabilitation setting. A convergent mixed-methods research design was used. Quantitative data on bowel activity, laxative use, opiate drug use, and nursing documentation regarding bowel care were gathered through a review of health records for 305 patients admitted to three geriatric rehabilitation units before (n = 137) and after (n = 168) protocol implementation over two 3-month periods. Focus groups were conducted examining nursing staff's experiences with such a protocol. Findings revealed that although implementation of the CMP did not reduce constipation rates among older patients, the average number of incidences of constipation per patient was reduced after implementation of the protocol. More importantly, it resulted in more due diligence by staff regarding patients' bowel patterns as well as improved bowel care documentation. Findings and recommendations extend current literature and have practical implications for nurses interested in improving management of patients' bowel care.
本研究考察了在老年康复环境中实施便秘管理方案（CMP）的效果。采用了收敛性混合方法研究设计。通过回顾三个老年康复单元收治的305例患者的健康记录，收集了关于肠道活动、泻药使用、阿片类药物使用以及肠道护理护理记录的定量数据，这些患者在两个3个月期间，方案实施前（n = 137）和实施后（n = 168）各有一部分。开展了焦点小组讨论，以考察护理人员对该方案的体验。研究结果显示，虽然实施CMP并未降低老年患者的便秘发生率，但方案实施后每位患者的便秘平均发生次数有所减少。更重要的是，它使工作人员在患者肠道排便模式方面更加尽职，并改善了肠道护理记录。研究结果和建议扩展了现有文献，对有志于改善患者肠道护理管理的护士具有实际意义。
