(^232) Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines, Third Edition
EBP project in search of a proactive treatment plan. The practice question posed
was this: What are the best practices for decreasing the incidence of constipation
post-UAE?
Evidence
As a part of the evidence search, the team surveyed six local hospitals. All six
stated that their UAE patients reported issues with constipation post-procedure,
but none of them had a pre-procedure protocol they followed to address this
common complaint. A literature search was conducted by using Cumulative In-
dex to Nursing and Allied Health Literature (CINAHL), PubMed, and JBI with
assistance from the medical librarian. The search yielded 33 articles, and the
team appraised and summarized 15 using the tools of the JHNEBP Model. After
a more critical review, the group determined that only 4 of the articles were rel-
evant to the EBP question. Although no articles dealt specifically with the topic of
constipation in the uterine fibroid patient population, they did provide evidence
to support and guide protocol development. The articles included one experi-
mental study, two non-experimental studies, and one expert opinion study. All
articles had an overall quality rating of high (A) or good (B) quality. All articles
supported the claim that the combination of narcotics and surgery was a major
contributor to constipation.Translation
Synthesis of literature for translation of pre-procedure constipation treatment in
pelvic surgery indicated that the laxative of choice for opioid-induced constipa-
tion was Senna-S. Based on summation of our literature search and collaboration
with the interventional radiologists, a pre-procedure protocol was developed.
Patients are assessed during procedural consultation for current bowel habits.
Patients are then given instructions for the laxative protocol, ordered by the phy-
sician, to take two Senna-S tablets twice daily for the two days immediately prior
to the UAE procedure. No laxatives are taken the day of the procedure due to
NPO status. Patients are admitted for 24 hours following the UAE, and current
admission orders include the use of Miralax or Colace.