Adult Bowel Care Policy.pdf - NHS North Somerset

More documents

Recommendations

Info

Turn the control unit to the water symbol and start to pump water into the rectum. About one pump each two seconds is the usual speed to avoid discomfort. People with a high spinal injury may need to pump more slowly than this. Continue pumping until the required volume has been instilled it may take up to 10 to 15 minutes to pump in all the water. Turn the control unit style to the air symbol to deflate the balloon. To avoid autonomic dysreflexia. To allow the fluid into the rectum The catheter is likely to drop out under gravity. If not a gentle pull will remove it. For safe disposal Use the catheter package to dispose of the catheter in a rubbish bin Water and stool should start to pass To facilitate bowel emptying into the toilet very soon after the catheter is removed. Abdominal massage or pressure on the abdomen may help this process. Avoid the temptation to strain. It is better to be patient and wait. It can take 10 to 20 minutes for the bowel to stop emptying. With practice you will learn when you have finished and it is safe to leave the toilet. Clean and dry the anal area To prevent soreness Empty any remaining water from the The equipment needs to be cared for bag and tubing carefully to continue working properly. The equipment can be cleaned using warm soapy water and must be dried thoroughly Turn the control unit dial to the finish position for storage Store the equipment in a dry place away from direct heat sources Remove and discard gloves if worn. To promote hygiene Wash and dry hands. The tube with the blue connector is changed as required. The rectal catheter is single use only. If using the system every other day the reservoir should be changed once or twice a month. This is done by removing the cap, discarding the bag and attaching the cap to a new bag. The controller should be changed every six months or 90 uses. Troubleshooting Doc File Reference Issuer: Policy No: Issue Date: Issue No: Review Date: Page: Adult Bowel Care Policy PS 337 06/2009 1 06/2010 34 of 42 34
Problem Advice Pain occurs when pumping water If pain should occur when pumping water, pause for a while and then continue. If the pain is acute or severe STOP IMMEDIATELY, DEFLATE THE BALLOON AND REMOVE THE CATHETER. If the pain persist for more than a few minutes, or is accompanied by a lot of bleeding seek medical assistance immediately Bleeding Occasional spots of bright red blood may be seen on the catheter, especially if the patient has haemorrhoids. This is not a cause for concern. If bleeding is occurring regularly, this needs to be reported to the medical team. If a sudden major bleed occurs, urgent medical attention must be sought. More major or regular bleeding should lead to a referral for a flexible sigmoidoscopy. Altered (dark red) bleeding should prompt urgent referral to colorectal services. If the patient experiences a haemorrhage with or without pain, emergency care is indicated as the rectum could theoretically be perforated. This might necessitate emergency surgery and the patient should know to gain emergency medical help in the VERY UNLIKELY event. Abdominal cramps If these occur, then pumping the water more slowly may help. It may be worth stopping pumping the water for a minute and then re-start when cramps subside. Cramps may also be a sign that the irrigation water is too cool or is stimulating the gut to contract. Cramps can indicate that the irrigation is working well. Feeling unwell Occasionally irrigation can make the patient feel unwell during or after irrigation. It is not uncommon for the patient to sweat a little or have palpitations. They may also feel a little lightheaded when first using the procedure. This should settle with time. If the patient is affected in this way it would be helpful for them to have someone nearby that they could call for help. Difficult to insert catheter Catheter expelled during pumping Difficult catheter insertion may be due to anorectal abnormalities or impaction If the balloon is deflated check the balloon for signs of impairment. The patient could practice the inflation technique with the catheter outside the body to ensure the balloon Doc File Reference Issuer: Policy No: Issue Date: Issue No: Review Date: Page: Adult Bowel Care Policy PS 337 06/2009 1 06/2010 35 of 42 35
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 and 28: Appendix 4 Insertion of Suppository
Page 29 and 30: Inform patient of insertion of supp
Page 31 and 32: abnormalities observed. anal skin t
Page 33: Equipment required Coloplast Perist
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

Create successful ePaper yourself

Delete template?

Save as template?