Abstract
Introduction:
An accurate stool chart is crucial to the care of older patients. Monitoring of bowels movements can help to avoid complications such as constipation, urinary retention, delirium, faecal impaction, diarrhoea, dehydration and AKI which all can lead to extended hospital admissions and deconditioning. Clear recording of bowel movements might allow the medical team to recognise the problem and promptly take action. Our project aimed to increase the accuracy of stool chart documentation on geriatric medicine wards, promoting earlier recognition of these complications.
Methods:
Initial data collection aimed to record the documentation of stool charts in 2 medical wards, measuring the frequency and accuracy of the entries. Both wards then received posters and education for medical staff at MDT meetings and mid-day huddles to highlight the importance of accurate documentation. A second cycle audit was performed to re-evaluate the accuracy of documentation and to measure the effectiveness of the intervention.
Results:
Prior to intervention, 64.3% of patients had an accurately stool chart completed, with 35.7% of patients having no stool chart completed at all. Re-evaluation demonstrated a 10.7% improvement, with stool charts completed in 75% of patients.
Conclusion:
Our project has increased the awareness of stool chart documentation, and early data shows this has also improved accuracy and compliance with the need to contemporaneously record bowel movements. We hope this will positively impact patient outcomes and support effective clinical care. We will look to re-evaluate ongoing documentation post doctor-changeover to see if the change has been sustained.
Comments
Great project
Working in a community rehab hospital, monitoring bowels is a big part of my clinical practice and has a huge impact on my patients so it's great to see a project focused on improving documentation (this is the bane of my life). What do you feel are the next steps to further improve this outcome?
Thank you for your comment!…
Thank you for your comment! It’s great to hear that this reflects your clinical practice. Our next step is to keep educating the nursing staff and junior doctors about the importance of accurate stool charting and its impact on patient's care. Also, we may consider re-auditing to make sure that the improvement is sustained.
Importance of charting
I think something as simple as stool charting can make such a big impact on the way we treat out geriatric patients. As you said, sometimes the consistency of stool could be the only subtle indication of something being wrong. Great study!
Important Topic
This is such an important topic and can have a huge impact on patients of older years! Its great to see how interventions such as education can have such a huge impact on patient care. Great project!