47SIMPLE GUIDANCE CAN IMPROVE THE ASSESSMENT OF FAECAL INCONTINENCE IN GERIATRIC REHABILITATION

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Abstract

Introduction: Faecal incontinence (FI) affects ∼3% of community-dwelling adults over 65years and 10–30% of those living in care homes. Research has shown that when assessed and managed appropriately the number of episodes can be reduced and in some cases continence restored in the elderly. NICE guidance exists to guide our assessment and management of faecal incontinence. Sadly, it remains an area of care which is poorly managed.

Methods: The TRAK care system was used to review the printed nursing handover to identify patients with documented faecal incontinence in a Geriatric Rehabilitation Hospital. The multi-disciplinary meeting sheets were reviewed to determine whether faecal incontinence had been highlighted at these meetings. If so then case notes were reviewed. Following the first audit cycle results were presented at a lunchtime meeting and simple written guidance was developed for junior staff in the department. The audit was then repeated 6 months later with new junior staff who had been given the written guidance only at induction. Results:

Conclusion: In both audit cycles, the management of faecal incontinence was suboptimal. However following the intervention approximately twice the number of patients had their faecal incontinence assessed, cause documented and management plan formed. The simple written guidance given at induction is likely to have had a significant impact on this as the majority of assessments and management plans were performed by the junior doctors.

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