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Discussion

Bowel protocol

Hello,

I am a rehab nurse at an acute care hospital. Although I am not a new nurse, I am new to this facility, about two months. The hospital is also brand new, being up and running for only four months.

Last week the CCO of the company suggested that I be in charge of the bowel protocol at the hospital since they do not have one yet. I said yes. I have reached out to one of the main internist for his advice. However I would like some ideas from other rehab nurses. I guess I'm looking for a template to work off of . I will be reaching out to our physiatrist as well, but I wanted to start on something before I bring it to him .

Thanks! Theresa

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    All of our patients are automatically started on Colace 100mg twice daily regardless of their admission diagnoses. In addition, the PRN regimen is:

    1. Dulcolax suppository 10mg daily PRN

    2. Milk of Magnesia 30mL daily PRN

    3. Colace 100mg BID PRN

    Patients who are admitted s/p CVA receive a special 'stroke set' of additional PRN orders such as Senna 17.2mg daily PRN. All patients, regardless of diagnosis, must receive a suppository or 1/2 bottle of Magnesium Citrate if they have not had a BM in excess of 72 hours.

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    Ours is similar to above but we also have bowel programs for our spinal cord patients who get a bowel program in the morning or afternoon based on what's convenient to them. The program is then based on their injury and how it relates to sphincter control... Some will get suppositories and more and some will just get disempacted.

  • Quote
    Ours is similar to above but we also have bowel programs for our spinal cord patients who get a bowel program in the morning or afternoon based on what's convenient to them. The program is then based on their injury and how it relates to sphincter control... Some will get suppositories and more and some will just get disempacted.

    Yes, it depends on if the patient is in need of an Upper motor neuron (umn) or lower motor neuron (lmn) bowel program for evacuation. You need to know the level of injury and should have a protocol in place.

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    The rehab I work at gives everyone Colace and then adds Milk of Magnesia if no BM in 48 hours and a suppository if no BM in 72 hours. If it goes longer than that then the patient (or Guest as we call them) gets all of the above and if it goes 96 hours then they are scheduled for disempaction.

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