Intensive and Critical Care Nursing (2012) 28, 242—250 Available online at www.sciencedirect.com j o ur nal homepage: www.elsevier.com/iccn ORIGINAL ARTICLE Prevalence, management and clinical challenges associated with acute faecal incontinence in the ICU and critical care settings: The FIRST TM cross-sectional descriptive survey Cristina Bayón García a , Rachel Binks b,* , Enrico De Luca c , Christine Dierkes d , Andrea Franci e , Elisabet Gallart f , Georg Niederalt d , Duncan Wyncoll g a Hospital Universitario Ramón y Cajal, Madrid, Spain b Airedale NHS Foundation Trust, West Yorkshire, UK c Policlinico Tor Vergata, Rome, Italy d University of Regensburg, Regensburg, Germany e Azienda Ospedaliero Universitaria Careggi, Florence, Italy f Hospital Universitario Vall d’Hebron, Barcelona, Spain g Guy’s & St Thomas’ NHS Foundation Trust, London, UK Accepted 15 January 2012 KEYWORDS Acute faecal incontinence; Prevalence; Skin breakdown; Faecal management system Summary Objective: To evaluate the prevalence, awareness and management of acute faecal inconti- nence with diarrhoea (AFId) in the Intensive Care Unit. Design: Cross-sectional descriptive survey design of intensive care units across Germany, Italy, Spain and the United Kingdom. Results: 962 questionnaires were completed by nurses (60%), physicians (29%) and pharma- cists or purchasing personnel (11%). The estimated prevalence of AFId ranged from 9 to 37% of patients on the day of the survey. The majority of respondents reported a low-moderate awareness of the clinical challenges associated with AFId. Patients with AFId commonly had compromised skin integrity, which included perineal dermatitis, moisture lesions or sacral pres- sure ulcers. Reducing the risk of cross-infection and protecting skin integrity were rated as the most important clinical challenges. 49% had no hospital protocol or guideline for AFId management. There was also a low awareness of nursing time spent managing AFId; 60% of * Corresponding author at: Critical care-Airedale NHS Trust, Airedale General Hospital, Skipton Road, Steeton, Keighley, West Yorkshire BD20 6TD, UK. Tel.: +44 01535 29 2268. E-mail address: Rachel.Binks@anhst.nhs.uk (R. Binks). 0964-3397/$ — see front matter © 2012 Elsevier Ltd. All rights reserved. doi:10.1016/j.iccn.2012.01.005