Applying a Fecal Incontinence Pouch

Goal: The patient expels feces into the pouch and maintains intact perianal skin.

1. Bring necessary equipment to the bedside stand or overbed table.

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.

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. Cleanse perianal area. Pat dry thoroughly.

7. Trim perianal hair with scissors, if needed.

8. Apply the skin protectant or barrier and allow it to dry.

9. Remove paper backing from adhesive of pouch.

10. With nondominant hand, separate buttocks. Apply fecal pouch to anal area with dominant hand, ensuring that opening of bag is over anus.

11. Release buttocks. Attach connector of fecal incontinence pouch to urinary drainage bag. Hang drainage bag below patient.

12. Remove gloves. Return the patient to a comfortable position. Make sure the linens under the patient are dry. Ensure that the patient is covered.

13. Raise side rail. Lower bed height and adjust head of bed to a comfortable position.

14. Remove additional PPE, if used. Perform hand hygiene.