Clinical utility and economic impact of introducing a bowel management system

J Wound Ostomy Continence Nurs. Nov-Dec 2007;34(6):664-70. doi: 10.1097/01.WON.0000300279.82262.07.

Abstract

Purpose: The primary objective of this study was to compare rates of urinary tract and soft tissue infections in critically ill burn patients before and following introduction of a Bowel Management System (BMS). We also analyzed the economic impact of the BMS as compared to reactive management of fecal soiling via cleansing and dressing changes.

Methods and materials: A retrospective case-matched before-after study was completed. Critically ill burn patients using a BMS were matched with similar patients managed before introduction of the device based on gender, total body surface area burned, burn location, ventilation days, and hospital length of stay.

Results: Reductions in hospital-acquired urinary tract infections and skin and soft tissue infections were observed after introduction of the BMS. Despite its initial cost, it proved more cost effective than a reactive bowel management strategy based on cleansing and dressing changes when fecal soiling occurs.

Conclusions: Proactive use of a bowel management device appears to reduce some infectious sequelae in a complicated burn care population and proved cost-effective for our facility.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / economics
  • Burn Units
  • Burns / complications*
  • Cost of Illness
  • Cost-Benefit Analysis
  • Cross Infection / economics
  • Cross Infection / etiology
  • Cross Infection / prevention & control*
  • Decision Trees
  • Drainage / economics
  • Drainage / methods
  • Drainage / nursing
  • Fecal Incontinence / complications
  • Fecal Incontinence / economics
  • Fecal Incontinence / prevention & control*
  • Female
  • Humans
  • Infection Control / economics
  • Infection Control / methods
  • Intubation, Gastrointestinal / economics
  • Intubation, Gastrointestinal / methods*
  • Intubation, Gastrointestinal / nursing
  • Laundering / economics
  • Male
  • Middle Aged
  • Nursing Evaluation Research
  • Rectum
  • Retrospective Studies
  • Skin Care / economics
  • Skin Care / nursing
  • Soft Tissue Infections / economics
  • Soft Tissue Infections / etiology
  • Soft Tissue Infections / prevention & control*
  • Treatment Outcome
  • Urinary Tract Infections / economics
  • Urinary Tract Infections / etiology
  • Urinary Tract Infections / prevention & control*

Substances

  • Anti-Bacterial Agents