Date

Fall 2022

Document Type

Scholarly Project

Department

College of Nursing

First Advisor

Amy Dievendorf

Abstract

Over 17,000 Americans suffer from spinal cord injuries (SCI) annually. Although the loss of motor function is a blatantly obvious sequela, the loss of autonomic nervous system control, and its direct effects on various body systems, is scarcely understood. The most frequently reported impairment associated with SCI-related bowel dysmotility is Neurogenic Bowel Dysfunction (NBD), affecting approximately 20-60% of the SCI population. NBD is defined as slow colonic time and is hallmarked by constipation and often impaction, leading to life-threatening complications, such as bowel obstruction, fecal impaction, autonomic dysreflexia, and even death. Identifying dysmotility within the SCI patient population and early intervention utilizing a “stepwise bundle approach” has been widely accepted; however, the literature often lacks the effects of these interventions within the post-injury setting. Therefore, this Doctor of Nursing Practice (DNP) project incorporates the use and analysis of a “stepwise care bundle approach” to bowel evacuation techniques including, the use of abdominal massage, perianal and anorectal digitation, suppositories, rectal laxatives, manual evacuation, and oral laxatives, while measuring its impact on familiarity and comfortability of execution among nursing staff member, and its effects on the achievement of successful bowel movements among patients. The following results were noted by instituting a bowel management care bundle on SCI patients within a Surgical Trauma Intensive Care Unit: Note summary of results and follow implications for practice.

Rights

© 2022, Jessica Rene Baldwin

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