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CONSTIPATION PROPHYLAXIS IN CHILDREN UNDERGOING ORTHOPEDIC
SURGERY: A QUASI-EXPERIMENTAL STUDY
Laila MANTEGAZZI
1
, Brigitte SELINER
1
and Lorenz IMHOF
2
1) Children's University Hospital Zurich, Zurich, SWITZERLAND - 2) Zurich University of Applied Sciences, Institute of
Nursing, Winterthur, SWITZERLAND
INTRODUCTION
Orthopedic patients are prone to constipation due to immobility, opiate administration, dehydration, and the lack of
privacy. Given that constipation can have physical and psychological consequences, prevention in orthopedic pediatric
patients is paramount. Therefore a standardized nursing assessment and intervention for constipation prophylaxis,
including ensuring privacy, fluid intake, mobility and bathroom training, as well as administering stool softener and
suggesting a proper diet, were developed with the support of an Advanced Practice Nurse. Additionally nursing trainings
about constipation were performed.
This study evaluated the effectiveness of the implementation of the newly developed nursing constipation prophylaxis
METHODS
A quasi-experimental study with an historical control group was performed. The control group consisted of 112
consecutive records of orthopedic patients (47.3% boys, range 4-17 years) who had been hospitalized in the surgical
ward before the intervention was implemented. The intervention group included 59 patients (35.6% boys, range 1-18
years) admitted in the seven months following the training and the introduction of the constipation prophylaxes
program.
RESULTS
The implementation of the constipation prophylaxis program resulted in an absolute risk reduction (27%) of developing
constipation. In the intervention group, 50.8% patients developed constipation, compared to 77.7% in the historical
group. Fisher's Exact Test showed a significant difference between the two samples (p = .001), giving a number needed
to treat of 3.7.
CONCLUSIONS
This study demonstrated the effectiveness of the program with the support of an Advanced Practice Nurse. Therefore it
is necessary to implement a constipation prophylaxis program on a pediatric orthopedic unit.