FP1.14 - A Re-audit of the prevalence of faecal incontinence in hospital inpatients

Abstract

Abstract Introduction Faecal incontinence (FI) is a common and under-reported problem, with many patients too embarrassed to seek help. Patients often do not receive optimal care due to lack of identification. In-hospital identification when they are admitted for other reasons may be one method of improving the care of such patients. Aims & Methods We had assessed the identification of continence problems in our hospital inpatients via a simple ‘spot check’ audit of the different wards in 2015; we used the case notes for checking the documentation by both nursing and medical staff. We looked at care plans, stool charts, follow up plans etc. We repeated this audit in 2023 to check for any improvement. Results Overall,132 (163 in 2015) patient case notes were examined. 94%(previously 90) had nursing documentation about bowels documented in comparison to 47% (48) for medical documentation. 5.3% (10.8) were found to have FI. Only 28% (31) of these patients would have been identified by medical documentation. Most of the patients identified with FI were elderly, as expected; surprisingly, 28.57% were on general surgical wards. All patients (100%) in 2015 were then referred appropriately for further management. In 2023, though some action for FI was taken in 71.42 % patients, no referral was apparently arranged in any. Conclusion It is important to identify patients with FI, establish cause and initiate appropriate management. The impact on the individual patient’s QOL needs assessment prior to planning management/specialist referral etc. We found that our nursing documentation was still better than medical documentation which needs to be improved; however, onward referral/management needs improving significantly.