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P-145 Managing changes in condition: using a rectal administration catheter to reduce hospital utilisation
  1. Robert Parker
  1. Hospice and Palliative Nurses Association, Pittsburgh, USA


Background Options to treat patients’ change in condition are limited when the oral route is compromised. Parenteral or hypodermoclysis administration of fluids and medication is possible; however, these methods have limitations, and require alternate forms of medications that can be costly. Delays in obtaining orders, equipment and supplies has the potential to increase hospital utilisation.

Aim Pilot research study looking at the feasibility of the intervention to facilitate safe, easy, comfortable and effective enteral hydration and medication delivery via the rectal route, and the ability to treat changes in patients’ condition while decreasing the need for parenteral therapy and hospital utilisation.

Results Ten of 10 (100%) participants completed the study with 11 total use cases. Hydration was effective in all 11 use cases, with all participants tolerating the intervention without signs of discomfort or expulsion of fluids. The APN and attending physician who performed the prospective chart reviews deemed the patient’s change in condition serious enough in nine of the 11 use cases to warrant hospital utilisation had an intervention not been successfully performed. Of the nine use cases deemed serious enough to warrant hospital utilisation, seven (78%) avoided a transfer to an acute setting after successful intervention with the catheter. Each of these patients returned to their previous oral medications and hydration regimen. For the two patients transferred to the hospital it was necessary for acute care services that mandated a transfer and not the failure of the intervention.

Conclusion In all 11 use cases, the catheter provided a safe, easy, comfortable and effective alternative to parenteral and previous enteral delivery options. This intervention may provide an effective and efficient way to treat patients’ changes in condition leading to improved quality metrics and reduced hospital utilisation.

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