Lack of Evidence Based Criteria for Diarrhea: Implications for Management of Patients Receiving Enteral Nutrition

2.50
Hdl Handle:
http://hdl.handle.net/10755/148325
Type:
Presentation
Title:
Lack of Evidence Based Criteria for Diarrhea: Implications for Management of Patients Receiving Enteral Nutrition
Abstract:
Lack of Evidence Based Criteria for Diarrhea: Implications for Management of Patients Receiving Enteral Nutrition
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:November 10 - 14, 2001
Author:Eisenberg, Patti
P.I. Institution Name:Community Hospitals Indianapolis
Diarrhea is a frequent and potentially serious complication in hospitalized patients in the United States. The etiology of diarrhea is often multifactorial and the severity as defined by frequency or volume of stool output is influenced by many conditions including: co-morbid medical conditions, nutritional status, drug therapy, malabsorption and infections. Unfortunately, the management of diarrhea is difficult, because there is a lack of well-defined criteria for diagnosing diarrhea. The definitions for diarrhea used in research studies are variable with some investigators using frequency of stool as a diagnostic criteria, while others use consistency, volume or a combination of these. For most patients the nurse is the most critical assessor in the diagnosis of diarrhea. The North American Nursing Diagnosis Association (NANDA) defines diarrhea as the passage of loose, unformed stools; whereas, the Society of Gastroenterology Nurses and Associates use the abnormally frequent and liquid fecal discharges a their definition. The studies related to diarrhea that have been reported are also variable with respect to research design, and study populations. It is not clear hat results are transferable among different populations. Presently there are only three tools that allow the nurse to qualify and quantify stool output. One is the grading system, Common Toxicity Criteria, developed from the National Cancer Institute. The advantage of this system is that it separates patients with and without a colostomy and those with graft versus host disease (GVHD) after a bone marrow transplant. Hart and Dobb developed a 9-category scale to calculate a diarrhea score using an estimated volume and consistency. In 1998, Guenter and Sweed modified this scale into a 6-category scale and described the validity and reliability of a Stool Output Assessment Tool ©. This is the only scale that is based on nursing research to define criteria for diagnosis of diarrhea. The lack of an evidence-based approach to defining criteria for the diagnosis of diarrhea has important implications for the practitioner in their management of patients receiving enteral nutrition. Incorrect assessment of suspected diarrhea in patients receiving enteral nutrition often results in inappropriate management of patients. Applications of the tools Guenter and Sweed have proposed into daily practice are recommended.
Repository Posting Date:
26-Oct-2011
Date of Publication:
10-Nov-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleLack of Evidence Based Criteria for Diarrhea: Implications for Management of Patients Receiving Enteral Nutritionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/148325-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Lack of Evidence Based Criteria for Diarrhea: Implications for Management of Patients Receiving Enteral Nutrition</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">November 10 - 14, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Eisenberg, Patti</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Community Hospitals Indianapolis</td></tr><tr><td colspan="2" class="item-abstract">Diarrhea is a frequent and potentially serious complication in hospitalized patients in the United States. The etiology of diarrhea is often multifactorial and the severity as defined by frequency or volume of stool output is influenced by many conditions including: co-morbid medical conditions, nutritional status, drug therapy, malabsorption and infections. Unfortunately, the management of diarrhea is difficult, because there is a lack of well-defined criteria for diagnosing diarrhea. The definitions for diarrhea used in research studies are variable with some investigators using frequency of stool as a diagnostic criteria, while others use consistency, volume or a combination of these. For most patients the nurse is the most critical assessor in the diagnosis of diarrhea. The North American Nursing Diagnosis Association (NANDA) defines diarrhea as the passage of loose, unformed stools; whereas, the Society of Gastroenterology Nurses and Associates use the abnormally frequent and liquid fecal discharges a their definition. The studies related to diarrhea that have been reported are also variable with respect to research design, and study populations. It is not clear hat results are transferable among different populations. Presently there are only three tools that allow the nurse to qualify and quantify stool output. One is the grading system, Common Toxicity Criteria, developed from the National Cancer Institute. The advantage of this system is that it separates patients with and without a colostomy and those with graft versus host disease (GVHD) after a bone marrow transplant. Hart and Dobb developed a 9-category scale to calculate a diarrhea score using an estimated volume and consistency. In 1998, Guenter and Sweed modified this scale into a 6-category scale and described the validity and reliability of a Stool Output Assessment Tool &copy;. This is the only scale that is based on nursing research to define criteria for diagnosis of diarrhea. The lack of an evidence-based approach to defining criteria for the diagnosis of diarrhea has important implications for the practitioner in their management of patients receiving enteral nutrition. Incorrect assessment of suspected diarrhea in patients receiving enteral nutrition often results in inappropriate management of patients. Applications of the tools Guenter and Sweed have proposed into daily practice are recommended.</td></tr></table>en_GB
dc.date.available2011-10-26T09:43:32Z-
dc.date.issued2001-11-10en_GB
dc.date.accessioned2011-10-26T09:43:32Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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