Bowel management for spinal cord injured people

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Dear Barnsley Hospital NHS Foundation Trust,

Bowel management for spinal cord injured people

Hello my name is Derry Felton and I work for the Spinal Injuries Association (SIA). I just have a few questions that need answering for our Public Affairs department.

As a request under the Freedom of Information Act, please provide the following information on bowel management for spinal cord injured people and others with neurogenic bowel dysfunction
1. Does the Trust have a formal written policy for digital rectal examination/check, digital rectal stimulation and the digital removal of faeces (manual bowel evacuation) in spinal cord injured and other patients with neurogenic bowel dysfunction ?
2. If the Trust does, please supply a copy of this document.
3. If the Trust does not, how is bowel care managed in the above patient groups who present with this care need?
4. Does the Trust employ a specialist continence nurse(s)?
5. If the Trust employs a specialist continence nurse(s) can they (a) undertake digital rectal checks, digital rectal stimulation and digital removal of faeces (manual bowel evacuation), otherwise known as 'intimate digital bowel care procedures' (b) provide instruction to other nurses to enable them to perform intimate digital bowel care procedures'?
6. If the Trust does not employ a specialist continence nurse, is there another health care professional who undertakes intimate digital bowel care procedures including manual bowel evacuation? If yes, who does this?
7. Does your Trust have a policy in place that will allow your staff to do trans-anal irrigation (TAI) of the bowel as a method of bowel care management for spinal cord injured patients? Do you train your staff to do TAI/ bowel irrigation?
8. Do you run bowel care courses for your staff that allows them to deliver the full range of bowel care required by spinal cord injured patients or others with a neurogenic bowel?
9. If yes, please provide details. If no, does the Trust have a policy which allows for the personal care assistants (PAs) of spinal cord injured patients to assist with this element of the patient's care?

Yours faithfully,

derry felton

barnsley@infreemation.co.uk, Barnsley Hospital NHS Foundation Trust

Dear Derry,

 

I can confirm that the Trust does hold the information you have requested.

Thank you for your request for information, details of which are below:

Freedom of Information Request

As a request under the Freedom of Information Act, please provide the
following information on bowel management for spinal cord injured people
and others with neurogenic bowel dysfunction

1.Does the Trust have a formal written policy for digital rectal
examination/check, digital rectal stimulation and the digital removal of
faeces (manual bowel evacuation) in spinal cord injured and other patients
with neurogenic bowel dysfunction ?
2.If the Trust does, please supply a copy of this document.
3.If the Trust does not, how is bowel care managed in the above patient
groups who present with this care need?

The Trust follow the online Royal Marsden nursing procedures. These are
the same as RCN for DRE and DRF. The trust has its own competency staement
for staff trained in DRE and DRF.

4.Does the Trust employ a specialist continence nurse(s)?

Yes. A continence nurse specialist and a continence support nurse, working
toward associate practitioner.

5.If the Trust employs a specialist continence nurse(s) can they (a)
undertake digital rectal checks, digital rectal stimulation and digital
removal of faeces (manual bowel evacuation), otherwise known as ''intimate
digital bowel care procedures'' (b) provide instruction to other nurses to
enable them to perform intimate digital bowel care procedures''?
6.If the Trust does not employ a specialist continence nurse, is there
another health care professional who undertakes intimate digital bowel
care procedures including manual bowel evacuation? If yes, who does this?

Yes the specialist nurse does. The continence support nurse is awaiting
futher role development. Training is given to senior nurse on the ward
areas. If a spinal injury patient is admitted to our trust who require
bowel management then they are referred to the continence nurse
specialist. A plan of care is estabilsihed, and ward staff are updated on
DRE and DRF.

7.Does your Trust have a policy in place that will allow your staff to do
trans-anal irrigation (TAI) of the bowel as a method of bowel care
management for spinal cord injured patients? Do you train your staff to do
TAI/ bowel irrigation?

TAI is used in outpatient continence clinics as part of bowels management
for all patients. If a patient is admitted to our trust who use TAI this
can be supported by both the continence nurse specialists and colorectal
nurses.

8.Do you run bowel care courses for your staff that allows them to deliver
the full range of bowel care required by spinal cord injured patients or
others with a neurogenic bowel?

Bowels care education is taught as part of continence training. More
indepth spinal injury bowel dysfuntion is taught when teaching DRE and
DRF.

9.If yes, please provide details. If no, does the Trust have a policy
which allows for the personal care assistants (PAs) of spinal cord injured
patients to assist with this element of the patient''s care?
Acute spinal injury patients are admitted/transferred to Sheffield,
therefore most spinal injury bowel dysfunction patients have an
established bowel management programme. If PAs play a role in personal
bowel care and the patient prefers this to continue in hospital then this
is documented and carers/family continue the role of PAs.

This completes the Trust’s response to your request.

As part of our on-going evaluation, we ask that you complete a
satisfaction survey found at the link below. This helps us to identify
areas of improvement and to highlight good practice to share with other
teams. [1]https://www.surveymonkey.co.uk/r/L3HLQV3

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If you are unhappy with the way we have handled your request, you may ask
for an internal review in accordance with Section VI Complaints Procedures
of the Section 45 Code of Practice of the Freedom of Information Act 2000:
and in accordance with the Trust’s Code of Practice for Responding to
Requests for Information.

If you wish to complain you should contact:

Katie Hunter

Information Governance Manager

Tel: 01226 432017

Information Governance Department

Admin Block

Barnsley Hospital NHS Foundation Trust

Gawber Road

Barnsley

S75 2EP

[email address]

If you are not content with the outcome of the internal review, you have
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If you have any queries about this letter, please contact me. Please
remember to quote the reference number above in any future communications.

 

Yours sincerely,

Information Governance Team

Information Governance Department

Ext: 2017 Direct Line: 01226 432017
Email: [4][email address]

Kind regards,

 

Information Governance Team

Information Governance Department

Email: [Barnsley Hospital NHS Foundation Trust request email]

Ext: 2017  Direct Line: 01226 432017
Email: [5][Barnsley Hospital NHS Foundation Trust request email]

References

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