Cent Eur J Nurs Midw 2013, 4(2):554-565

The use of gum chewing in postoperative care of patients with abdominal surgery: developing an evidence-based clinical protocol - part II

Renáta Zeleníková1,*, Anthony Chao2, Gloria Enright2, Mary Rogers Schubert2, Kaitlin Shotsberger2, Cecelia Wise2, Elizabeth A. Schlenk2
1 University of Ostrava Faculty of Medicine Department of Nursing and Midwifery, Ostrava, Czech Republic
2 University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania

Aim: The aim of this paper is to develop an evidence-based clinical protocol for the use of gum chewing in postoperative care to reduce the risk of paralytic postoperative ileus in patients who have undergone abdominal surgery.

Methods: A clinical question (For adult patients who have undergone abdominal surgery, does the use of gum chewing postoperatively reduce the risk of paralytic postoperative ileus in comparison with the usual care regimen?) was formulated, a population and setting were defined, and the databases OVID Medline®, CINAHL, and PubMed were searched for relevant material. Six data-based research articles were chosen for review: four randomized controlled trials and two meta-analyses. Finally, the articles were critically appraised to generate evidence on which to base the clinical protocol.

Results: The development team created a detailed description of the clinical protocol as well as a protocol algorithm to assist clinicians in determining patient eligibility. In addition, protocol implementation and evaluation plans were proposed.

Conclusion: An evidence-based clinical protocol was developed to provide a template for identification of patients eligible for gum chewing, implementation, and evaluation of this intervention to reduce the risk of paralytic postoperative ileus after abdominal surgery.

Keywords: gum chewing, postoperative care, abdominal surgery, paralytic postoperative ileus, time to first flatus, time to first bowel movement, evidence-based clinical protocol

Published: September 30, 2013  Show citation

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Zeleníková R, Chao A, Enright G, Rogers Schubert M, Shotsberger K, Wise C, Schlenk EA. The use of gum chewing in postoperative care of patients with abdominal surgery: developing an evidence-based clinical protocol - part II. Ošetřovatelství a porodní asistence. 2013;4(2):554-565.
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