Educating School Nurses to Improve Bowel Continence in Children with Spina Bifida

Children born with spina bifida, a neural tube defect, can have associated loss of bowel control resulting in bowel incontinence. The National Patient Spina Bifida Registry found that 87% of those living with spina bifida had bowel incontinence, and less than 30% were bowel continent (Sawin et al., 2015; Wiener et al., 2017). Unfortunately, providers may never start a child living with spina bifida on a bowel management program. Evidence suggests that children with spina bifida should begin a bowel management program early, using a stepwise approach. School nurses, who interact with children living with spinal bifida while attending school, have an opportunity to provide support to children living with bowel incontinence but may lack knowledge and skills on bowel management. This evidence-based practice project aimed to educate school nurses in a county school district about the best bowel management guidelines for children attending school with spina bifida. The project’s goal was to improve the lives of children with spina bifida, especially in school, by motivating school nurses to play a more active role in the child’s bowel management routines towards increasing bowel continence. The Iowa Model of Evidence-Based Practice guided the steps of the project. Eighty-six school nurses received education about spina bifida and bowel management asynchronously via an online voiceover PowerPoint presentation. Nurses completed a pre-and post-knowledge test, and a significant improvement (p < 0.001) in test scores by approximately three points was seen from the pre-test to the post-test. Educating school nurses about spina bifida and bowel management made them better prepared to support and manage bowel incontinence in children living with spina bifida.