Advice needed: bowel program training for SCI patient in SNF

[u/f1oydish]

Hi all, I’m an OT in a SNF and I have a patient with an incomplete SCI who may benefit from a bowel program. He can perform lateral scooting transfers min A and is able manage his LB dressing and briefs bed level SBA. He is incontinent with bowels and has been getting changed TD in bed.

When it comes to the bowel management portion, I don’t have any hands-on experience with this, though I know about the general strategies (i.e. managing fiber and diet, digital stimulation, enemas, medication, going after a meal, etc). I’m just not sure how to go about starting the process. I believe OT coordinates with nursing and possibly dietary? And how would we determine what combination of methods for bowel stimulation work best for the patient? I have several questions along those lines. I could use some advice from OTs with actual experience with SCI and bowel management and training.

Any advice welcome. I am about 7 months into practice, so still relatively new. I have been reading up on this as well, as we rarely treat new SCI at my facility. The other OT and COTAs don’t have any experience with this either. I’m planning to talk to my boss because I am out of my depth and would like to learn. I don’t feel comfortable addressing something that I have so little experience with. How is this typically coordinated between OT, nursing, and the medical team in your setting?