Who can carryout DRF? DRF can be both uncomfortable and embarrassing for patients (Association 5 key points 1 Digital removal of faeces (DRF) can be used as an acute intervention for patients who have impaction of stool that cannot be resolved with medication 2 Symptoms of impaction may include: absent orb breduced stool evacuation; abdominal bloating/distension; nausea; and pain 3 DRF is rarely undertaken in NHS acute settings and many nurses are unfamiliar with the procedure 4 If DRF is part of the individual’s bowel care, it is essential that the routine is not interrupted 5 Failing to support those people with ab bspinal cord injury who need DRF results in ineffective bowel management for Continence Advice, 2011), so receiving well informed and compassionate care for this is essential (Coggrave, 2010). It is recommended that only health professionals who can demonstrate competence to the level determined by the Nursing and Midwifery Council (2008) should carryout this procedure however, a qualified nurse who can demonstrate competence to this professional level maybe expected to delegate care delivery to others who are not registered, such as healthcare assistants or carers. Such delegation must not compromise existing care, but must be directed to meeting the needs and serving the interests of patients (Royal College of Nursing, All nurses should have successfully completed bowel-dysfunction training that includes theoretical and practical aspects of digital rectal examination (DRE) and DRF. Ideally this training should be based on the RCN (2012) guidelines and Skills for Health’s National Occupational Standards on bowel dysfunction (Box 2).