Return of bowel sounds indicating an end of postoperative ileus: is it time to cease this long-standing nursing tradition?

Evidence and rationale supporting return of bowel sounds as an unreliable indicator of the end of postoperative ileus after abdominal surgery are provided. A loss of gastrointestinal motility, commonly known as postoperative ileus (POI), occurs after abdominal surgery. Since the 1900s, nurses and other clinicians have been taught to listen for return of bowel sounds to indicate the end of POI. Evidence-based nursing literature has challenged this long-standing traditional nursing practice. The purpose of this study was to provide evidence from a randomized clinical trial and rationale supporting evidence-based inquiry concerning return of bowel sounds as an unreliable indicator of the end of POI after abdominal surgery. Time (days) of return of bowel sounds after abdominal surgery was compared to the time (days) of first postoperative flatus, an indicator of the end of POI, in 66 patients recovering from abdominal surgery randomized to receive standard care compared to those who received standard care plus a rocking chair intervention. Pearson's correlation between time to first flatus and return of bowel sounds for combined groups was not significant (r = 0.231, p = 0.062, p < 0.05) indicating that time to return of bowel sounds and time to first flatus were not associated. The results of this study provide support to evidence-based inquiry that questions the relevance of traditional nursing practice activities such as listening to bowel sounds as an indicator of the end of POI.