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Published on: August 1, 2019
Clinical utility and economic impact of introducing a bowel management system
Jane Echols1, Bruce C Friedman, Robert F Mullins
1Joseph M. Still Burn Center, Doctors Hospital, Augusta, Georgia.
Purpose:
The primary objective of this study was to compare rates of urinary tract and soft tissue infections in critically ill burn patients before and following introduction of a Bowel Management System (BMS). We also analyzed the economic impact of the BMS as compared to reactive management of fecal soiling via cleansing and dressing changes.
Methods And Materials:
A retrospective case-matched before-after study was completed. Critically ill burn patients using a BMS were matched with similar patients managed before introduction of the device based on gender, total body surface area burned, burn location, ventilation days, and hospital length of stay.
Results:
Reductions in hospital-acquired urinary tract infections and skin and soft tissue infections were observed after introduction of the BMS. Despite its initial cost, it proved more cost effective than a reactive bowel management strategy based on cleansing and dressing changes when fecal soiling occurs.
Conclusions:
Proactive use of a bowel management device appears to reduce some infectious sequelae in a complicated burn care population and proved cost-effective for our facility.
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