Sacred Cow
Summary of evidence presented
Recommendations
Rectal tubes to
manage fecal
incontinence
 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
progressing.
 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
washcloths)
 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
progressing.
Avoid using traditional rectal tubes (i.e. mushroom catheter, urinary
catheter with balloon) as they are the least safe approach to
managing diarrhea.