Adult Bowel Care Policy.pdf - NHS North Somerset

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When there is doubt about the mental capacity of a patient to make decisions relating to the procedure the PCT guidelines for assessing capacity and determining best interests must be followed. Consent policy should be followed at all times. See appendix 10 for suggested type of consent required for bowel management. 7 Bowel Assessment Bowel care deals with intimate and private parts of the body. All interventions relating to assessment and treatment require discretion and sensitivity. Assessment of bowel continence and function should form part of the holistic patient assessment. Bowel assessment includes obtaining a history and carrying out relevant clinical examinations. It also includes carrying out and interpreting relevant baseline observations and tests. Bowel assessment should be completed using the Continence Assessment Form, and using information in the Appendices of the Continence Care Pathways. Doc File Reference Issuer: Policy No: Issue Date: Issue No: Review Date: Page: Adult Bowel Care Policy PS 337 06/2009 1 06/2010 6 of 42 6
8 Acute Bowel Care Problems Nurses need to know what constitutes a bowel care emergency, and be able to act without delay to prevent further complications. The table below lists the most common bowel care emergencies, presentation and management. Type of Emergency Autonomic Dysreflexia. Life- threatening complication of spinal injury , level T6 or above. Abnormal response to pain/ stimulus may result in seizure, stroke and death. Triggers include constipation, digital stimulation, manual evacuation and enemas and irrigation. Bowel Obstruction No bowel activity Abdominal pain & Distension Vomiting Possible dehydration Serious condition requiring immediate medical attention If untreated, bowel may rupture, leak its contents causing peritonitis. Perforation Hole in the bowel - allows leakage of intestinal contents into abdominal cavity. High fever Nausea Severe abdominal pain, worse on movement Intense vomiting leading to dehydration If untreated causes peritonitis. Management Management plan for all patients at risk. Patient and all care staff should be aware of triggers, symptoms and management plan. Refer to Autonomic Dysreflexia Policy. Seek urgent medical attention Seek urgent medical attention Doc File Reference Issuer: Policy No: Issue Date: Issue No: Review Date: Page: Adult Bowel Care Policy PS 337 06/2009 1 06/2010 7 of 42 7
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: 5 Training and Competence 5.1 All p
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 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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