Bowel management with spinal cord injured people

Carol Macmillan made this Freedom of Information request to Humber Teaching NHS Foundation Trust

This request has been closed to new correspondence from the public body. Contact us if you think it ought be re-opened.

The request was successful.

Dear Humber NHS Foundation Trust,

By way of introduction, I work for the Spinal Injuries Association. Part of my role is to assist the Head of Public Affairs with FOI requests, such as the one that follows.

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,

Carol Macmillan

FOI (HUMBER NHS FOUNDATION TRUST), Humber Teaching NHS Foundation Trust

Dear Carol

Thank you for your request for information. It will be dealt with under the terms of the Freedom of Information Act 2000. In some circumstances a fee may be payable and if that is the case, we will let you know. A fees notice will be issued, which you will be required to pay before we proceed with your request.

We will respond to your request within 20 working days of it being received.

All information provided under Freedom of Information is deemed to be in the public domain. The Information Commissioner requires as good practice that organisations make public, information provided from Freedom of Information requests.

Any information we provide following your request under the Freedom of Information Act will not confer an automatic right for you to re-use that information, for example to publish it. If you wish to re-use the information we provide and you do not specify this in your initial application for information then you must make a further request for its re-use as per the Re-Use of Public Sector Information Regulations 2005 www.opsi.gov.uk . This will not affect your initial information request.

Yours sincerely

Kind Regards

Freedom Of Information Team
Humber NHS Foundation Trust
Mary Seacole Building, Willerby Hill,Willerby, HU10 6ED
Fax: 01482 477857

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FOI (HUMBER NHS FOUNDATION TRUST), Humber Teaching NHS Foundation Trust

2 Attachments

FOI 17 – 017

 

Dear Carole

 

I am writing to confirm that the Humber NHS Foundation Trust has now
completed its search for the information which you requested on 13^th
January 2017.  Sorry for the delay.

 

You asked for

 

+------------------------------------------------------------------------+
|  |
| |
|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 ? |
| |
|  |
| |
|The Humber NHS Foundation Trust (Trust) do not have a written policy we |
|have a written Procedure Guidance [attached] which includes digital |
|rectal examination, digital rectal stimulation and  Digital removal of |
|faeces |
| |
|  |
| |
|2.            If the Trust does, please supply a copy of this document. |
|As above |
| |
|3.            If the Trust does not, how is bowel care managed in the |
|above patient groups who present with this care need? N/A |
| |
|  |
| |
|  |
| |
|4.            Does the Trust employ a specialist continence nurse(s)? |
|Yes the Trust employs specialist continence nurses.  |
| |
|  |
| |
|5.                   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'? Yes we can undertake digital |
|rectal check, digital rectal stimulation and removal of faeces; yes we |
|can provide instruction to other nurses to enable them to perform the |
|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? N/A |
| |
|  |
| |
|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? The Trust does not have a |
|specific policy for Trans Anal Irrigation [our feeling is that this |
|comes under bowel care] Yes we have taught district nurses how to |
|perform the procedure. Specialist nurses will teach patients to perform |
|the procedure to themselves. If the district nurses are required to |
|perform the procedure we will initially go with them to the patient and |
|advise.  |
| |
|  |
| |
|  |
| |
|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? Yes we run a 2.5 day course |
|every 2 months, this includes assessment and management of all bladder |
|and bowel dysfunction including Digital Rectal examination, digital |
|rectal stimulation and  digital removal of faeces. We include Trans anal|
|irrigation show them the equipment and play a DVD which explains how it |
|is used and its benefits. This course also, neurogenic bowel and |
|autonomic dysreflexia. |
| |
|   |
| |
| Nurses are provided with 2 written Workbooks which cover the topics of |
|Anatomy and physiology, bladder dysfunction and management , bowel |
|dysfunction and management, transanal irrigation and  Digital Rectal |
|examination, digital rectal stimulation & digital removal of faeces. |
|Treatment guides for both bladder and bowel. |
| |
|  |
| |
|We provide the nurses with written competency records to complete. |
| |
|As a service we will also deliver bespoke Digital Rectal examination, |
|digital rectal stimulation and digital removal of faeces refresher |
|training to the nurses if they feel they require it prior to a patient |
|is being discharged into the community and they feel they need a refresh|
|before delivering the bowel care |
| |
|We will also provide support and advice as needed to the nurses |
| |
|We also supply staff with a copy of the 2012 Royal Collage of Nursing |
|Guidance on and  Digital Rectal examination, digital rectal stimulation |
|and digital removal of faeces and a copy of the Guidelines for |
|Management of Neurogenic Bowel Dysfunction in individuals with Central |
|Neurological conditions.  |
| |
|  |
| |
|  |
| |
|9.         If yes, please provide details. Please see above.   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? |
| |
|  |
| |
|  |
+------------------------------------------------------------------------+

 

I hope my response has covered all the information which you requested.

 

To help us measure our performance in responding to Freedom of Information
requests I wonder if you will take a little time to complete the attached
form and return it to me.

 

The information we have provided to you is copyrighted to the Humber NHS
Foundation Trust and provided to you free of charge for your personal use
or for other specific uses permitted in the Copyright Act. If however you
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you must ask us for permission to do so in respect of each specific piece
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licensing arrangement which may attract a fee.

 

All information provided under Freedom of Information is deemed to be in
the public domain. The Information Commissioner requires as good practice
that organisations make public, information provided from Freedom of
Information requests. The Trust will therefore place a copy of this
response on its website, [1]www.humber.nhs.uk.  This is to help anyone who
may have a similar enquiry. No personal information about you, such as
your name or email address will be shown on this posting.

 

If you have any other queries about this letter, please also contact me.

 

If you are unhappy with the service you have received in relation to your
request and wish to make a complaint or request a review of our decision
you should write to:

 

PALS and Complaints Manager

Trust Headquarters

Willerby Hill

Beverley Road

Willerby

HU10 6ED

[2][email address]

If you are not content with the outcome of your complaint, you may apply
directly to the Information Commissioner for a decision. Generally, the
ICO cannot make a decision unless you have exhausted the complaints
procedure provided by the Humber NHS Foundation Trust. The Information
Commissioner can be contacted at:

 

The Information Commissioner’s Office

Wycliffe House

Water Lane

Wilmslow

Cheshire

SK9 5AF

 

Yours sincerely

 

 

Information Governance and Legal Services

 

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