1074 QUALITY IMPROVEMENT PROJECT AIMED TO REDUCE THE AVERAGE NUMBER OF PATIENTS DEVELOPING CONSTIPATION ON BOURNVILLE WARD IN QEHB

Abstract

Abstract Introduction Constipation is an overlooked but frequent problem in elderly patients on geriatrics wards. The prevalence in inpatients aged over 65 years is estimated at about 50%.There are many reasons for this: reduced oral intake due to illness, delirium, immobility, and constipating drugs. If constipation is addressed correctly, we can reduce the rate of unpleasant complications and prolonged hospital stay by increasing awareness of non-laxative methods to be advocated initially to avoid worsening poly-pharmacy with side effects. Queen Elizabeth Hospital Birmingham guidelines advocates use of conservative measures. However these methods can be frequently underutilized and cause of constipation rarely considered to treat. We aimed to identify the barriers to our outcome by tackling lack of awareness, utilization of non-laxative method DRE prior to rapid relief. This included teaching sessions, MDT, posters, introducing constipation booklets. Method We used prospective data collection with a standardized questionnaire having a mix of descriptive and quantitative questions based on SMART Aims for the project. This was carried out once a week on alternate beds. Baseline data n44,2ndcycle n44,3rd cycle n43,4thcycle n42.With each cycle we used following interventions to improve constipation prevalence in Bournville ward i.e. individually educate patient/staff during ward rounds, MDT presentations, improve documentation of constipation causes, addition of separate educational posters for staff/patients,identification of at risk patients. Introduced Patient information booklet with documented discussion on hospital online record system. Results Following interventions from 1st-4th cycle inpatient constipation prevalence was reduced by 13%,Increased consideration of cause by 38%, significant increase in education by 65%,Increased use of non-laxative approach by 35%,Increased rates of DRE by 35%,reduced use of x-ray prior to DRE by 8.3%,reductions in complication rate by 9%. Conclusion Despite increased education, cause consideration, utilization of conservative non-laxative approaches, introduction of new constipation booklet in welcome pack to all new patients a small impact was made in reducing inpatient constipation prevalence and associated complications occurring.