Researching the management of constipation in long-term care. Part 2.

The management of constipation is a problem in any healthcare setting. Constipation can affect all individuals; older people and those suffering from disabilities and long-term chronic conditions, such as Parkinson's disease and rheumatoid arthritis, are particularly vulnerable. This two-part article is based on a research study carried out in nine care homes, among patients of various ages with a variety of chronic conditions. The aim of the study was to investigate and improve bowel care in long-term care settings. The background to the study, including the definition, causes, risk assessment and management of constipation, were discussed in Part 1 (Castledine et al, 2007). Part 2 presents the main part of the study. Results show that appropriate education of staff improves their knowledge and practice in dealing with constipation. The importance of educating and training all members of the care team, especially healthcare assistants, in the management of bowel care is highlighted. An evidence-based approach using a constipation risk assessment, management of constipation flow chart and an interventions tool are identified as key factors in the ongoing care of patients in long-term settings.