High-Intensity Bowel Protocol for Trauma Patients

Background: Internal performance improvement data showed extended length of stay (LOS) in addition to an increased number of patients with constipation. This study was designed to evaluate the number of hospital days a trauma patient with opioid use had a bowel movement (BM) utilizing a high-intensity bowel protocol compared with the standard hospital bowel protocol. Methods: This was a retrospective analysis of the trauma registry at a Level I trauma center from 2 different time periods to assess the number of hospital days that patients had a BM. These patients had a traumatic mechanism of injury that required admission to the hospital with a LOS equivalent to 3 or more days. Other data analyzed included age, gender, injury severity score (ISS), morphine equivalents (ME), and hospital days with a BM. Results: A total of 282 patients were included in the final analysis. Group 1 represented the standard hospital bowel protocol (n = 166), and Group 2 represented the high-intensity bowel protocol (n = 116). No significant difference was calculated between age, gender, ISS, or ME per day. A significant difference was observed with the number of hospital days with a BM between these 2 groups. The group with the high-intensity bowel protocol exhibited more days with a BM than the standard bowel protocol group (p < .05). Conclusion: The high-intensity bowel protocol averaged 1 BM every 2 days, whereas the standard hospital bowel protocol averaged 1 BM every 3 days. There was no significant change in LOS.