Goal: The patient retains the solution for the prescribed, appropriate length of time and experiences the expected therapeutic effect of the solution.
1. Verify the order for the enema. Bring necessary equipment to the bedside stand or overbed table. Warm the solution to body temperature in a bowl of warm water.
2. Perform hand hygiene and put on PPE, if indicated.
3. Identify the patient.
4. Close curtains around bed and close the door to the room, if possible. Explain what you are going to do and why you are going to do it to the patient. Have a bedpan, commode, or nearby bathroom ready for use.
5. Adjust bed to comfortable working height, usually elbow height of the caregiver (VISN 8 Patient Safety Center, 2009). Position the patient on the left side (Sims’ position), as dictated by patient comfort and condition. Fold top linen back just enough to allow access to the patient’s rectal area. Place a waterproof pad under the patient’s hip.
6. Put on nonsterile gloves.
7. Remove cap of prepackaged enema solution. Apply a generous amount of lubricant to the tube.
8. Lift buttock to expose anus. Slowly and gently insert rectal tube 3 to 4 inches (7 to 10 cm) for an adult. Direct it at an angle pointing toward the umbilicus. Ask patient to take several deep breaths.
9. If resistance is met while inserting the tube, permit a small amount of solution to enter, withdraw tube slightly, and then continue to insert it. Do not force entry of tube.
10. Slowly squeeze enema container, emptying entire contents.
11. Remove container while keeping it compressed. Have paper towel ready to receive tube as it is withdrawn.
12. Instruct patient to retain enema solution for at least 30 minutes or as indicated, per manufacturer’s direction.
13. Remove your gloves. Return the patient to a comfortable position. Make sure the linens under the patient are dry and ensure that the patient is covered.
14. Raise side rail. Lower bed height and adjust head of bed to a comfortable position.
15. Remove additional PPE, if used. Perform hand hygiene.
16. If the patient has a strong urge to dispel the solution, place him or her in a sitting position on bedpan or assist to commodeor bathroom. Stay with patient or have call bell readily accessible.
17. Remind patient not to flush commode before you inspect results of enema, if used for bowel evacuation. Record character of stool, as appropriate, and patient’s reaction to enema.
18. Put on gloves and assist patient, if necessary, with cleaning of anal area. Offer washcloths, soap, and water for handwashing. Remove gloves.
19. Leave patient clean and comfortable. Care for equipment properly.
20. Perform hand hygiene.
Subscribe to:
Post Comments (Atom)
0 comments:
Post a Comment