Lothian primary care nhs trust


Exclusions and contra-indications



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Exclusions and contra-indications Registered nurses should not undertake a manual evacuation of faeces when

no consent has been obtained (NHS Lothian 2014) the patient’s doctor has given specific instructions that these procedures should not take place

the patient has recently undergone rectal/anal surgery or trauma (seek medical advice)

the patient gains sexual satisfaction from this procedure (open discussion between doctor and patient is advised and a chaperone facility offered)

they do not feel competent to perform the procedure (NMC 2015)


Bladder and Bowel Nursing Team Page 2 of 5 June 2016
Precautions Registered nurses should exercise particular caution when performing these procedures on patients who have the following diseases and conditions

active inflammation of the bowel, including Crohn’s disease, ulcera tive colitis and diverticulitis

recent radiotherapy to the pelvic area

rectal/anal pain

surgery/trauma to the anal/rectal area

tissue fragility due to age, radiation, loss of muscle tone in neurological diseases or malnourishment

obvious rectal bleeding

patient has a known history of abuse

spinal injured patients (due to autonomic dysreflexia)

patient has known history of allergies (for example latex)


Requirements
Routine intervention



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