Abstract
BackgroundStudies examining organizational factors that may influence constipation management in long-term care (LTC) hospitals are lacking. This study aimed to clarify the practice of constipation management in LTC hospitals and to explore its factors, including ward manager’s perception, organizational climate, and constipation assessment.MethodsIn this cross-sectional questionnaire survey of ward managers and staff nurses working in LTC wards, we determined daily assessment and practices regarding constipation management. We also conducted multivariate analyses to examine factors related to constipation management.ResultsThere was a 20% response rate to the questionnaire. Nearly all LTC wards routinely assessed bowel movement frequency; other assessments were infrequent. Laxatives were used, but the use of dietary fiber and probiotic products was implemented in only 20–30% of wards. The implementation of non-pharmacological management and adequate use of stimulant laxatives were positively associated with the ward manager’s belief and knowledge, organizational climate, the existence of nursing records for constipation assessment, planned nursing care for constipation, and organized conferences and in-hospital study sessions on constipation management.ConclusionAreas to improve constipation management in LTC hospitals include altering the ward manager’s perception, improving hospital’s organizational climate, and introducing standardized assessment/care planning systems.
Highlights
Studies examining organizational factors that may influence constipation management in long-term care (LTC) hospitals are lacking
We aimed to assess the current constipation management practices in LTC hospitals and to explore the factors related to constipation management, individualized and daily constipation assessment in LTC hospitals, the ward managers’ perception, and the organizational climate
More than 70% of the LTC wards participating in this study were reimbursed using the type 1 reimbursement system, indicating that they had a higher number of inpatients with high medical acuity levels, such as patients with intractable disease and patients using ventilator
Summary
Studies examining organizational factors that may influence constipation management in long-term care (LTC) hospitals are lacking. Constipation can cause discomfort and abdominal pain [1], as well as serious conditions including megacolon, intestinal impaction, or volvulus [2]. LTC hospital nurses should focus on more technical or acute care procedures that have a direct and immediate impact on patients, as they can only provide minimal basic care due to their busy schedules [9]. It is difficult for LTC hospital nurses to perform additional assessment and management owing to their limited time
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