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E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

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Implementation of the victoria bowel performance scale.

Philippa Hawley¹, Doris Barwich, Lisa Kirk

¹BC Cancer Agency, Vancouver, British Columbia, Canada. pippahawley@shaw.ca

Journal of Pain and Symptom Management

|May 31, 2011

Summary

The Victoria Bowel Performance Scale (BPS) is a useful tool for managing constipation in palliative care. Its implementation improved bowel function documentation and laxative adjustments, aiding clinical decision-making.

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Published on: August 1, 2019

Area of Science:

Palliative Care Medicine
Clinical Audit
Symptom Management

Background:

Constipation management in palliative care lacks evidence-based guidance.
Validated assessment tools are crucial for effective data collection and care.
The Victoria Bowel Performance Scale (BPS) is a potential tool for this purpose.

Purpose of the Study:

To evaluate the Victoria Bowel Performance Scale (BPS) as an audit tool for constipation in palliative care settings.
To assess the scale's utility in improving documentation and guiding treatment adjustments.

Main Methods:

The Victoria BPS was implemented across multiple oncology pain and symptom management clinics, palliative care units, and hospices.
Chart reviews were conducted pre- and post-implementation to assess scale usage and impact.
A control unit used alternative assessment tools without the BPS.

Main Results:

The Victoria BPS was used in 86% of outpatient visits, demonstrating ease of use and improving bowel performance documentation from 44% to 66%.
Laxative adjustments increased significantly (14% to 39%) post-implementation.
Inpatient use varied (21%-55%), but analysis of BPS scores identified deficiencies in bowel care, leading to management changes.

Conclusions:

The Victoria BPS is an acceptable and effective tool for assessing bowel function in palliative care, incorporating patient-specific usual function.
Modifications were made to the scale for end-of-life care considerations.
The proportion of revised BPS scores between -1 and +1 is proposed as a key indicator for satisfactory bowel management in clinical audit and research.