THE PROPOSAL EXAM

Factors affecting bowel movement in critically ill patients

Name : Ryan Andeska Artha

NIM : 14031042
Majors : Program Studi Ilmu Keperawatan
 BACKGROUND

Patients who were on mechanical ventilator had higher number of

absence of daily bowel movements and it was found statistically
significant (P < 0.05). however, patients with 24 hours negative fluid
balance had higher percentage of absence of daily bowel movement
but it was not found statistical significant (P> 0.05). It is
recommended that patients with above said predisposing conditions
should be intensively monitored by nurses and effective intervention
need to be planned and implemented in collaboration with physicians
promptly. There is a need to develop and empirically test a specific
constipation prevention protocol for these vulnerable patients.
 LITERATURE REVIEW

The body must remove waste products of metabolism to sustain healthy functions. Attention to bowel functions
occurs when there is deviation from what is perceived as normal elimination1. Effect of uncontrolled bowel action
is threat to person's independence and well-being1. Defecation is a basic body function that affects the quality of
life. Dietary intake and gastrointestinal motility functions are important in critically-ill patients. However, scant
attention has been given to motility disorders of lower gastrointestinal tract and problems of failure to defecate in
critically-ill patients.
Constipation is a common complaint among critically ill patients. Poor dietary and fluid intake, impaired mobility
leads to decreased muscle tone and decreased peristalsis, thus, contributing to development of constipation1.
Hospitalised critically-ill patients receiving opiates, sedatives, anticonvulsants and many others drugs are more likely
to develop lower gastrointestinal motility disorders. However, a study conducted by Zeilman & Grote (1995),
revealed that motility disorder is common problem among persons receiving sedatives4. The incidence of
constipation is high in this population; which is further supported by a Mostafa et al's study, reflecting that
constipation occur in 83% of critically-ill patients
RESEARCH METHODS
Location and Time of
Type and Research Design Population research Large Sample Sampling Technique
Research

1 2 3 4 5

A total of 50
consequently
purposively selected
patients were
studied in seven
selected ICUs
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