G_CS_53 Guidelines for Lower Bowel Dysfunction in Adults within Primary Care

This policy aims to standardise care and provide an agreed framework for referral from primary to secondary care, in line with the concept of integration required by Good Practice in Continence Services (DH, 2000), the National Service Framework for Older People (DH, 2001a) & NICE guidelines (DH,2006, DH, 2010).

During recent years, bowel continence has seen its profile raised with the publication of two new documents, Skills for Health (SfH) (2008) and the RCN guidance for nurses on bowel care (2012) an updated and more comprehensive guide to bowel dysfunction that incorporates the national occupational standards for continence care outlined in SfH (Ness 2009). Community nurses have a pivotal role in the promotion of bladder/bowel continence with particular emphasis on supporting patients and their caregivers to manage these intractable symptoms. Thereby nurses are ideally placed to initiate conservative management and treatment and to refer for appropriate investigations and treatment (Chelvanayagam & Norton 1999).

This document is underpinned by the current available evidence, or where this is lacking, expert opinion. Evidence-based health care is defined as the conscientious, explicit and judicious use of current best evidence in making decisions about patient care (Sackett et al, 1996). The application of the best available evidence is a recognised method of improving clinical outcomes for individual patients (Williams et al, 2002).

This document is intended as a guide for practitioners, in order to enhance the care provided to patients with lower bowel dysfunction.

This guidance does not obviate the requirement to exercise clinical judgement, or to recognise the patient as an individual.

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