165 Constipation in the palliative care unit

<h3>Background</h3> Constipation is a common issue in palliative care, often causing significant pain and distress. This audit aimed to assess how well constipation is identified and managed at the North Tyneside Palliative Care Unit (PCU) according to local guidelines. <h3>Methods</h3> A retrospective review was conducted on 40 patients admitted to the PCU in October 2023, excluding one patient with C. difficile. We identified constipated patients using the ROME IV Criteria, comparing this to clinical team recognition. Management practices were reviewed against the North East and North Cumbria Palliative and End of Life Care Symptom Control Guidelines. <h3>Results</h3> 19 of 40 patients were identified as constipated by the audit team. The clinical team identified only 12 of these patients (63%). Identification methods included patient self-reporting, clinician recognition and Nervecentre documentation. Of the 12 patients identified by the clinical team, 11(92%) received treatment and subsequent reviews in line with guidelines, although management choice varied. <h3>Conclusions/Recommendations</h3> The audit reveals a gap the clinical team’s identification of constipation, with 37% of constipated patients going unrecognised. This may be due to the lack of a standardised definition of constipation in the palliative care setting. Treatment was compliant but variations in medication choice suggest a need for clearer guidelines. To address these issues, the audit recommends a review of local constipation guidelines to include a clearer definition, and the incorporation of patient self-reporting as part of standard assessment. Additionally, the feasibility of integrating daily bowel documentation into Nervecentre should be considered to improve identification and management.