Adult Bowel Care Policy.pdf - NHS North Somerset

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Balloon is immediately expelled after inflation Balloon is expelled once pumping has begun Female patients have a problem Nothing is passed from the rectum Water is passed but no stool Water or stool leakage after irrigation Adapted from symbol is used and enough air is instilled. Check that the dial is not accidentally being turned to the air symbol, when intending to use the water symbol to introduce water. The balloon is stimulating rectal contractions. Try inflating the balloon more slowly or inflate it a little less. Check that the water is not too hot or cold. Expelling the balloon is more likely to happen if irrigation is performed after meals. So try irrigation at other times. Ensure the catheter has not been inserted into the vagina by mistake. Check that the patient is not dehydrated. Encourage the patient to drink at least 1.5 litres per day, more if the weather is hot. (Unless otherwise directed by medical staff). The patient could be heavily constipated, this should be removed, as much as possible before commencing irrigation). Regular use of irrigation can be used to prevent constipation occurring in the future There may not be any stool passed if there was a good result at the last irrigation. The patient may need to irrigate less often if this is happening regularly, this needs to be discussed within the medical team. If the patient has not had any results for several days the stool may be very hard and impacted. A laxative may be required It may be necessary for the patient to wear a small continence pad when first carrying out irrigation. This may not be necessary once the patient is used to the irrigation. Maybe try some of the following – • Try sitting the patient on the toilet for longer to ensure they are empty. • Try using more water. • Try using less water. • If incontinent of faeces between irrigations, then more frequent irrigation may be required. An anal plug may be worth considering, please discuss with medical or continence team. Doc File Reference Issuer: Policy No: Issue Date: Issue No: Review Date: Page: Adult Bowel Care Policy PS 337 06/2009 1 06/2010 36 of 42 36
Norton C 2008. Guidelines for the use of Rectal Irrigation. Coloplast Doc File Reference Issuer: Policy No: Issue Date: Issue No: Review Date: Page: Adult Bowel Care Policy PS 337 06/2009 1 06/2010 37 of 42 37
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 and 34: Equipment required Coloplast Perist
Page 35: Problem Advice Pain occurs when pum
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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