Development of a nursing practice model for safely glycerin enema and digital extraction of feces for elderly people who require at-home nursing care

2019 Fiscal Year Final Research Report

• Project/Area Number: 18K17625
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58080:Gerontological nursing and community health nursing-related
• Research Institution: University of Human Environments
• Principal Investigator: Kurita Ai 人間環境大学, 看護学部, 講師 (50759149)
• Project Period (FY): 2018-04-01 – 2020-03-31
• Keywords: グリセリン浣腸 / 摘便 / 看護技術 / 便秘 / フィジカルアセスメント / 在宅要介護高齢者 / 訪問看護

Outline of Final Research Achievements

The purpose of this study was to structure a model for the assessment and implementation of safe glycerin enemas (hereinafter, GE) and stool extraction by nurses among elderly individuals who are recuperating at home. The study consists of three parts: 1. First we compiled cases by home-visiting nurses regarding defecation. The compiled data was organized from the perspective of avoiding adverse events by GE and a model design was created; 2. Next, the model design was reviewed by examining documents. Furthermore, an anatomist and a home visiting nurse were asked to examine the model design, after which we made revisions thereto; and 3. We implemented the revised model among elderly individuals requiring long term care at home, then again evaluated and revised the model. Taking into consideration the fact that nurses will utilize it at home, we confirmed the safety of the model with a doctor and completed the exemplary model.

Free Research Field

基礎看護学

Academic Significance and Societal Importance of the Research Achievements

グリセリン浣腸（以下、GE）は、カテーテルなどによる直腸粘膜の損傷や、損傷部から血管内にGE液が移行し、赤血球が破壊される溶血が問題となっている。この問題は、GEと摘便の併用が危険性を高めると指摘されており、GEや摘便の実施頻度は在宅で多い。本研究で作成したモデルは、在宅において自力で排便できない高齢者に対して、看護師が身体診察によりGEや摘便の必要性を判断するための見本である。そして、GEや摘便を実施する際には、安全に行う見本ともなる。このモデルにより、在宅で療養する高齢者の排便に伴う負担が減り、安全な排便の一助となると考える。また看護師の判断力と看護技術の水準の向上にも貢献すると考える。