New guidelines to improve patient experience

Dr Gail Ross-Adjie

Dr Gail Ross-Adjie

New guidelines have been created to treat severe constipation in patients after total hip and knee replacement operations.

The guidelines are the result of a PhD studied at the University of Notre Dame by Gail Ross-Adjie, Nurse Researcher at St John of God Murdoch Hospital. Her thesis evaluated the current bowel protocol developed and in use at the hospital to improve patients recovery.

The study involved testing a protocol developed by a multi-disciplinary team at St John of God Murdoch Hospital, including a clinical dietician, continence nurse specialist, orthopaedic learning and development nurse and coordinator of nursing research. It recruited 331 patients and was conducted at seven St John of God Hospitals across Victoria and WA.

“We know that this particular patient group is at high risk for severe constipation in the post-operative period but there were no evidence-based guidelines available to help guide management,” said Dr Ross-Adjie.

“The study investigated the effects of Movicol, an over-the-counter laxative, on patients who were recruited for the study.”

Of 331 patients, 171 acted as controls. On average, patients who took Movicol as per the study protocol returned to normal bowel function by day five, whereas patients in the control group who had routine bowel management  took on average 11 days to return to normal bowel function.

“We’ve had some very positive patient feedback particularly from those patients who have had similar procedures done twice,” said Dr Ross-Adjie.

“The second time round, when they took Movicol, was a much better experience for them.”

Dr Ross-Adjie’s research is soon to be published in the International Journal of Orthopaedic and Trauma Nursing.

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