Quality standard
Quality statement 3: Reviewing disimpaction therapy
Quality statement 3: Reviewing disimpaction therapy
Quality statement
Children and young people with idiopathic constipation starting disimpaction therapy have their treatment reviewed by a healthcare professional within 1 week.
Rationale
Review of treatment within 1 week of starting disimpaction therapy should establish whether the treatment has worked and help prevent relapse. Children and young people with faecal impaction are at high risk of relapse and should be closely monitored. Faecal impaction should be resolved before maintenance therapy is started.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements to ensure that children and young people with idiopathic constipation starting faecal disimpaction therapy have their treatment reviewed by a healthcare professional within 1 week.
Data source: Local data collection.
Process
Proportion of children and young people with idiopathic constipation starting disimpaction therapy who receive a review of their treatment from a healthcare professional within 1 week.
Numerator – the number in the denominator who receive a review of their treatment from a healthcare professional within 1 week.
Denominator – the number of children and young people with idiopathic constipation starting disimpaction therapy.
Data source: Local data collection.
Outcome
a) Rates of reimpaction.
Data source: Local data collection.
b) Production of regular soft stools.
Data source: Local data collection.
c) Rates of unplanned hospital attendance for constipation.
Data source: Hospital Admitted Patient Care Activity from NHS Digital.
What the quality statement means for different audiences
Service providers ensure that staff perform a review of laxative treatment for disimpaction in children and young people with idiopathic constipation within 1 week.
Healthcare professionals review treatment within 1 week for children and young people with idiopathic constipation who are starting laxative treatment for disimpaction.
Commissioners ensure that they commission services from providers that can demonstrate that they provide treatment reviews within 1 week for children and young people with idiopathic constipation who are starting laxative treatment for disimpaction.
Children and young people starting laxative treatment for a blockage in the bowel caused by constipation (called faecal impaction) should have their treatment reviewed by a healthcare professional within a week.
Source guidance
Constipation in children and young people: diagnosis and management. NICE guideline CG99 (2010, updated 2017), recommendation 1.4.8
Definitions of terms used in this quality statement
Disimpaction therapy
Treatment with laxative stimulants for the evacuation of impacted faeces. [NICE's guideline on constipation in children and young people]
Idiopathic constipation
Constipation that cannot (currently) be explained by any anatomical, physiological, radiological or histological abnormalities. [NICE's guideline on constipation in children and young people, Introduction]
Healthcare professional
The review of laxative treatment can be undertaken by a number of healthcare professionals such as GPs, school nurses, health visitors, practice nurses, continence advisors and paediatricians. [Expert opinion]