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Summary of the Causative and Treatment Factors of Diarrhea and the Use of a Diarrhea Assessment and Treatment Tool to Improve Patient Outcomes

Bisanz, Annette MPH, RN; Tucker, Anne M. PharmD, BCNSP; Amin, Daxaben M. MS, RD; Patel, Dina PharmD, BCOP; Calderon, Bianca B. PharmD; Joseph, Mini M. PA-C; Curry, Eardie A. III PharmD, BCOP, MBA

Gastroenterology Nursing:
doi: 10.1097/SGA.0b013e3181e94307
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Abstract

This article is a review of the causative factors and pharmacologic treatments of diarrhea. This information was incorporated into a Diarrhea Assessment and Treatment Tool (DATT) to guide clinicians on comprehensive diarrhea assessment and current treatment recommendations. The tool was utilized at a university-affiliated oncology institution by a clinical nurse specialist on 26 patients as a performance improvement project. Ease of use and efficacy of DATT were tested. Eighty-one percent of patients were assessed using DATT in 30 minutes or less. Seventy-nine percent of the 57 identified diarrhea classifications were not being treated upon initial assessment. Diarrhea control was achieved in 73% of the patients within 7 days or fewer when DATT was utilized. The premise of diarrhea management is that if all the causative factors are not treated, diarrhea will persist. The conclusions are that this tool will aid the clinician in a comprehensive assessment of diarrhea and provide a systematic approach to diarrhea treatment. The need for research on best practice for management of the various causative factors of diarrhea is needed.

Author Information

Annette Bisanz, MPH, RN, is Advanced Practice Nurse, Department of Nursing Administration, The University of Texas MD Anderson Cancer Center, Houston.

Anne M. Tucker, PharmD, BCNSP, is Clinical Associate Professor, Department of Clinical Sciences and Administration, University of Houston College of Pharmacy, Houston, Texas.

Daxaben M. Amin, MS, RD, is Senior Clinical Dietitian, Department of Clinical Nutrition, The University of Texas MD Anderson Cancer Center, Houston.

Dina Patel, PharmD, BCOP, is Clinical Pharmacy Specialist, Pharmacy Clinical Programs, The University of Texas MD Anderson Cancer Center, Houston.

Bianca B. Calderon, PharmD, is Clinical Pharmacy Specialist, Pharmacy Clinical Programs, The University of Texas MD Anderson Cancer Center, Houston.

Mini M. Joseph, PA-C, is Physician Assistant, Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston.

Eardie A. Curry III, PharmD, BCOP, MBA, is Pharmacy Director, University Medical Center at Brackenridge, Austin, Texas.

Correspondence to: Annette Bisanz, MPH, RN, Department of Nursing Administration, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 0082-47, Houston, TX 77030 (e-mail: abisanz@mdanderson.org).

For more than 33 additional continuing education articles related to gastroenterology, go to NursingCenter.com/CE.

Received October 30, 2009

Accepted May 22, 2010

© The Society of Gastroenterology Nurses & Associates 2010. All Rights Reserved.