Irrigating a Colostomy

Goal: The patient expels soft, formed stool.

1. Verify the order for the irrigation. 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. Plan where the patient will receive irrigation. Assist patient onto bedside commode or into nearby bathroom.

5. Warm solution in amount ordered and check temperature with a bath thermometer, if available. If bath thermometer is not available, warm to room temperature or slightly higher, and test on inner wrist. If tap water is used, adjust temperature as it flows from faucet.

6. Add irrigation solution to container. Release clamp and allow fluid to progress through tube before reclamping.

7. Hang container so that bottom of bag will be at patient’s shoulder level when seated.

8. Put on nonsterile gloves.

9. Remove ostomy appliance and attach irrigation sleeve. Place drainage end into toilet bowl or commode.

10. Lubricate end of cone with water-soluble lubricant.

11. Insert the cone into the stoma. Introduce solution slowly over a period of 5 to 6 minutes. Hold cone and tubing (or if patient is able, allow patient to hold) all the time that solution is being instilled. Control rate of flow by closing or opening the clamp.

12. Hold cone in place for an additional 10 seconds after the fluid is infused.

13. Remove cone. Patient should remain seated on toilet or bedside commode.

14. After majority of solution has returned, allow patient to clip (close) bottom of irrigating sleeve and continue with daily activities.

15. After solution has stopped flowing from stoma, put on clean gloves. Remove irrigating sleeve and cleanse skin around stoma opening with mild soap and water. Gently
pat peristomal skin dry.

16. Attach new appliance to stoma or stoma cover (see Skill 13-6), as needed.

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

18. Raise side rail. Lower bed height and adjust head of bed to a comfortable position, as necessary.

19. Remove gloves and additional PPE, if used. Perform hand hygiene.