Adult Bowel Care Policy.pdf - NHS North Somerset

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patient’s dignity. Document if the patient is unable to give valid consent because of unconsciousness, sedation or confused state. Reasons why the procedure is in the patient’s best interest must be documented. Record if the patient refuses the procedure. Take the patient’s pulse at rest prior to the procedure. Place protective pad under the patient and ensure a suitable receiver is to hand. Assist patient to adopt, if possible, the left lateral position with knees flexed. A sitting position should be avoided. Observe the perineal and perianal area. Document and report any abnormalities. Wash hands, put on a disposable apron and non- latex gloves of a suitable thickness. Place water- based lubricating gel on gloved index finger. Inform patient of imminent examination. Insert non- latex gloved, lubricated index finger slowly and gently, encouraging the patient to relax. Use one finger only. Assess for faecal matter noting against the Bristol Stool Chart. Assess need for medication. embarrassment (NMC 2008, SFH CC01). Professional accountability must be maintained and clear, accurate, current records must be kept (NMC 2008). To obtain a baseline of the patient’s condition prior to the procedure as vagal stimulation can slow the heart rate. To protect bedding from faecal matter. To expose anus and allow easy access to carry out the procedure. To prevent overstretching of the anal sphincter and discomfort for the patient. To check for rectal prolapse, haemorrhoids, anal skin tags, wounds, discharge, anal lesions, gaping anus, bleeding, foreign bodies To minimise cross infection and to protect your hands. To facilitate easier insertion of index finger. To ensure the patient is prepared and relaxed. To avoid trauma to the anal mucosa and prevent forced over dilation of the anal sphincter. Document stool type in patient’s notes later. Lubricate the end of suppository. For easier insertion. To support individual bowel management. Doc File Reference Issuer: Policy No: Issue Date: Issue No: Review Date: Page: Adult Bowel Care Policy PS 337 06/2009 1 06/2010 28 of 42 28
Inform patient of insertion of suppository Gently insert the suppository via anus into the rectum. Remove gel by wiping residual from area. Clean anal area. Help patient into comfortable position. Dispose of equipment as per local policy. Inform the patient of outcome and ensure procedure and outcomes are documented. Adapted from To ensure patient is prepared and relaxed. To relieve patient’s discomfort. To leave the patient clean and comfortable. To preserve patient dignity. To prevent spread of infection. Documentation should provide clear evidence of planned care, decisions made and care delivered. (NMC 2008, SFH CC09). Higgins, D. (2007) Bowel care Part 6 – Administration of a suppository. Nursing Times; 103: 47: 26-27. Doc File Reference Issuer: Policy No: Issue Date: Issue No: Review Date: Page: Adult Bowel Care Policy PS 337 06/2009 1 06/2010 29 of 42 29
Page 1 and 2: Adult Bowel Care Policy Author(s):
Page 3 and 4: 1. Purpose of the policy 1.1 To ens
Page 5 and 6: 5 Training and Competence 5.1 All p
Page 7 and 8: 8 Acute Bowel Care Problems Nurses
Page 9 and 10: Recent Change In Bowel Habit. Can i
Page 11 and 12: 10 Understanding Faecal Incontinenc
Page 13 and 14: 11 Understanding Procedures involve
Page 15 and 16: 11.5 Insertion of Enema Before cons
Page 17 and 18: • anorectal conditions that could
Page 19 and 20: 13 References Chelvanayagam S, Nort
Page 21 and 22: Any of the above abnormalities shou
Page 23 and 24: Appendix 2 Procedure for Undertakin
Page 25 and 26: eak it up, stop and refer to the me
Page 27: Appendix 4 Insertion of Suppository
Page 31 and 32: abnormalities observed. anal skin t
Page 33 and 34: Equipment required Coloplast Perist
Page 35 and 36: Problem Advice Pain occurs when pum
Page 37 and 38: Norton C 2008. Guidelines for the u
Page 39 and 40: on the tip of the Peristeen anal pl
Page 41 and 42: Appendix 9 Specific competencies re

Adult Bowel Care Policy.pdf - NHS North Somerset

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