Fecal Containment in Bedridden Patients: Economic Impact of 2 Commercial Bowel Catheter Systems

Abstract

Background Fecal contamination is a major challenge in patients in acute/critical care settings that is associated with increased cost of care and supplies and with development of pressure ulcers, incontinence dermatitis, skin and soft tissue infections, and urinary tract infections. Objectives To assess the economic impact of fecal containment in bedridden patients using 2 different indwelling bowel catheters and to compare infection rates between groups. Methods A multicenter, observational study was done at 12 US sites (7 that use catheter A, 5 that use catheter B). Patients were followed from insertion of an indwelling bowel catheter system until the patient left the acute/critical care unit or until 29 days after enrollment, which ever came first. Demographic data, frequency of bedding/dressing changes, incidence of infection, and Braden scores (risk of pressure ulcers) were recorded. Results The study included 146 bedridden patients (76 with catheter A, 70 with catheter B) who had similar Braden scores at enrollment. The rate of bedding/dressing changes per day differed significantly between groups (1.20 for catheter A vs 1.71 for catheter B; P = .004). According to a formula that accounted for personnel resources and laundry cycle costs, catheter A cost $13.94 less per patient per day to use than did catheter B. Catheter A was less likely than was catheter B to be removed during the observational period (P = .03). Observed infection rates were low. Conclusion Catheter A may be more cost-effective than catheter B because it requires fewer unscheduled linen changes per patient day. C E 1.5 Hours Notice to CE enrollees:A closed-book, multiple-choice examination following this article tests your under standing of the following objectives:1. Understand the economic impact of 2 commercial bowel catheter systems.2. Determine if it is possible to state with statistical significance that the 2 commercial bowel catheter systems affect the incidence of skin/soft tissue and urinary tract infections.3. Recognize if the 2 commercial bowel catheter systems affect pressure ulcer risk.

Tensile properties of the rectal and sigmoid colon: a comparative analysis of human and porcine tissue

“…Similar in concept to the urinary catheter, rectal catheters can reduce the incidence of fecal contamination by directly channeling stool from the colon to a collection bag. When compared to pads, the use of rectal catheters to mange fecal incontinence has been shown to reduce both the incidence of incontinence associated dermatitis and the overall cost of treating these patients (Kowal-Vem et al 2009 ; Pittman et al 2012 ).…”

Clinical evaluation of a temporary fecal containment device for non-surgical fecal diversion in perineal burns

“…Economic impact of these two commercial bowel catheter systems was compared in a multicenter, observational study including 146 bedridden patients, and Zassi BMS was found more costeffective than Flexi-Seal FMS. [10] Although Bordes et al [11] reported 8 burned patients in whom they used both types of catheters (Zassi BMS in 6 patients and Flexi-Seal in 2 patients), they could not draw a conclusion on the differences in safety or effectiveness between these two models of catheters due to the low number of patients.…”

Methods of Bowel Management in Critical Care

“…11 Variation in savings occurred when comparing fecal incontinent devices, linen changes, and patient care. Financial benefi ts have been observed by other researchers as noted by Kowal-Vern and colleagues.…”