[Phosphate containing enemas: one undervalued risky practice? The management of an adverse event]

Assist Inferm Ric. 2013 Apr-Jun;32(2):84-91. doi: 10.1702/1304.14418.
[Article in Italian]

Abstract

Introduction: The phosphate-containing enemas are widely used, both to manage constipation and as a preparation for endoscopic procedures and surgery in adults and children. Many studies report that the use of these laxatives can be dangerous.

Objective: To identify possible prevention strategies starting from a severe adverse reaction due to repeated administrations of phosphate enemas.

Methods: A working group was started, the literature was reviewed and recommendations for an appropriate use of enemas were discussed and implemented, to improve patients' safety.

Results: Phosphate-containing enemas were replaced with 125 ml water enemas; recommendations were spread to strongly limit the use of phosphate containing enemas and the use of laxative in the first and second semester of 2012, were confronted showing a change in habits and a reduction in the use of phosphate containing enemas.

Conclusions: The implementation of several strategies, originated from an adverse event, succeeded in modifying the use of laxatives and phosphate-containing enemas.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Child, Preschool
  • Constipation / nursing*
  • Constipation / therapy
  • Enema / adverse effects
  • Enema / nursing*
  • Female
  • Humans
  • Laxatives / administration & dosage
  • Laxatives / adverse effects*
  • Nursing Audit
  • Phosphoric Monoester Hydrolases / administration & dosage
  • Phosphoric Monoester Hydrolases / adverse effects*
  • Practice Guidelines as Topic
  • Risk Assessment
  • Risk Factors

Substances

  • Laxatives
  • Phosphoric Monoester Hydrolases