Fecal incontinence is often difficult to manage in patients in the intensive care unit. The authors of the preceding study, “Clinical Evaluation of a Flexible Fecal Incontinence Management System,”11 should be applauded for testing a promising new device to address this difficult problem. The study may have been further strengthened, however, with the addition of 2 evidence-based assessment scales: the Braden Scale for Predicting Pressure Ulcer Risk22 and the National Pressure Ulcer Advisory Panel’s (NPUAP’s) Staging System for Pressure Ulcers.33 Both tools have been tested repeatedly and have shown adequate validity and reliability.

The authors state that “[f]ecal incontinence is an established risk factor for pressure ulcers....”11,(p385) Of the 3 studies cited to support their assertion, one identified 21 additional pressure ulcer risk factors in the critically ill.4...

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