8.1.1 Developing and validating a risk assessment tool for constipation (12)

Gaye Kyle, Senior Lecturer, Faculty of Health & Human Science, Thames Valley University, Slough, United Kingdom

Abstract:

Constipation is a problem that can affect any person at anytime in their life. Constipation is rarely a life-threatening symptom yet the distress it causes leads to reduced patient comfort and diminished quality of life. Risk assessment tools have been described as the backbone of any prevention (Thompson 2005) therefore; a prerequisite for the prevention of constipation is the development of such a tool. This paper discusses the development and validation process of the Norgine Risk Assessment tool for constipation. Key risk criteria were identified through a systematic review of the literature. The Norgine risk assessment tool was developed in 2003 and a pilot study (n=29) undertaken to test the robustness of tool and practically evaluate the tool’s clinical usefulness. Descriptive statistics were used for the study analysis, 96% of nurses found the tool easy to use and 100% found the advice on the tool easy to follow. The predictive ability was tested in 2005 (n=120) using an apparently healthy subject group (n=56) i.e. those considered at low risk of being constipated and a group of patients (n=64) i.e. those considered at a high risk. 98% of the ‘healthy’ group registered below the ‘at risk of constipation’ suggesting the tool’s specificity whereas the patients group all presented with a risk of developing constipation suggesting predictive sensitivity. The inter-rater reliability (n=25) was tested in 2006. This demonstrated a strong valid strength of agreement. The validation studies suggest the tool is easy to understand, quick to use with good reliability (Kyle 2007). The absence of any risk assessment tool for constipation has meant that the Norgine tool cannot be judged against a gold standard tool. The Norgine risk assessment tool predicts a patient’s risk of constipation encouraging nurses to adopt a proactive approach with a focus on prevention.

Biography:

Gaye Kyle, RGN, BA (Hons) MA. is a Senior Lecturer at Thames Valley University specialising in teaching continence and palliative care to both pre and post qualifying nurses. Gaye has published extensively particularly in the field of bowel dysfunction. . She is currently involved in research into the efficacy of abdominal massage in reducing constipation symptoms.