145 Improvement of Bowel Monitoring in the Acute Stroke Unit

Introduction Constipation can lead to complications such as pain, acute kidney injury and delirium. This problem is more apparent in patients who are aphasic or frail, such as those suffering from stroke or have cognitive impairments. However, early recognition and timely prescription of laxatives can help prevent these complications and prevent unnecessary Per-rectal examination and exposure from radiation with abdominal X-rays. Methods This is a Quality Improvement Project that was carried out in the Acute Stroke Unit in Aberdeen Royal infirmary looking at the effectiveness of bowel monitoring and suggesting methods for improvement with the addition of an end-of-bed stool chart. The aims of the stool charts were to aid junior doctors in timely laxative prescription and to guide fluid management. The project was carried out from April to July 2020 using the PDSA cycle and presented to MDT in the ASU. Results show a 100% improvement in bowel monitoring with 67% compliance rate of the new stool charts. A survey was carried out and results show that 90% of the nursing team preferred the new stool chart. In conclusion, I think that the new stool chart serves its purpose in improving patient management amongst junior doctors. It should be implemented as standard care protocol in the acute stroke unit and definitely can be applicable in other wards.