Sacred Cow
Summary of evidence presented
Rectal tubes to
manage fecal
 Rectal tubes are the least safe intervention for fecal
incontinence and the procedure is poorly defined.
 Fecal containment devices may be indicated when
incontinence associated dermatitis is extensive or
 Evidence based management for fecal incontinence is
focused on accurate assessment of risk, early
proactive skin care and critical evaluation of when a
fecal collection devise is needed.
Evidence based interventions for fecal incontinence:
 Evaluate cause of diarrhea (patient history, medications,
treatments) using a designated risk assessment tool
 Implement interventions to protect skin
 moisturizers and moisture barrier products
 use no-rinse bath products and wipes (rather than soap and
 use single moisture-absorbing underpads
 limited layers of bedding
 avoid diapers in immobile patients.
Use fecal collectors (self-adhering, external devices) when
incontinence is excessive or incontinence-associated dermatitis is
Avoid using traditional rectal tubes (i.e. mushroom catheter, urinary
catheter with balloon) as they are the least safe approach to
managing diarrhea.

Sacred Cow Summary of evidence presented Recommendations