New-Onset Constipation After Stroke: Caspian Nursing Process Project (CNP2) (Delphi and RAND Methods)

Background and Aim: New- onset constipation is one of the most common complications of acute stroke but its impacts on outcome of these patients remain unclear. Updating the role of nursing interventions in constipation after stroke seems to be useful. Current study aimed to define a care plan on new-onset constipation in stroke clients. Materials and Methods: Current study was conducted on 2019 with combination of Delphi and RAND methods(RAM), with several phases which include of: Searching for scientific sources, formal-content validity, RAND and Delphi methods, Results and changes made at the Delphi stage and the panel of experts. The drafted of clinical guideline include of priority, usefulness, conceptualization and nurses are allowed to provide services qualified individuals were required to rating (1 to 5) in four domains of each recommendation Results: Regarding the priority, the highest agreement was found on patient and companion education (98%) and the lowest on disability in daily activity (75.6%). According to a survey of authorized people to who provide services, with less than 50% agreement being reached with the BSc nursing in the following items. In Assessment section (constipation diagnosis by IV Rome criteria, constipation risk by Norgine instrument, Tenderness in physical examination, Taking client medication), target setting and outcome (Prevention of bowel dysfunction, Stable water and electrolyte status, client placement in types 3 and 4 of the Bristol criteria and no evidence of constipation according to the Rome IV criteria), nursing diagnosis and intervention (initiating constipation management protocol, identifying pattern of excretion, fiber intake, adjusting patient physical activity, walking, pursuing constipation remedies, laxative use, training manual and educational booklet and pamphlet) and evaluation (evaluating client response to interventions, The level of awareness of intestinal care, evaluation of care performed and the use of Barthel index. Conclusion: All recommendations had reached over 70% agreement in all four areas of the initial draft and some care should be taken only by stroke nurses or MSc of Critical Care Nursing.

New-Onset Constipation After Stroke: Caspian Nursing Process Project (CNP2) (Delphi and RAND Methods) Keywords:

Constipation , Iran , Nursing , Stroke