Routine intervention While undertaking a manual evacuation as a routine intervention you should be careful to observe for distress, pain, discomfort rectal bleeding signs and symptoms of autonomic dysreflexia – headache, flushing, sweating, hypertension collapse stool consistency
Bladder and Bowel Nursing Team Page 4 of 5 June 2016 Procedure for digital removal of faeces (DRF) Prior to examination Explain the procedure to the patient. Obtain informed consent and document. Ask the patient if they wish to have a chaperone present in nursing notes. Give the patient the opportunity to empty their bladder as a full bladder may cause discomfort during the procedure. Ensure privacy and dignity is maintained at all times. A bedpan, commode or toilet should be readily available. Please note that you should exercise caution for patients who have a spinal cord injury (SCI. Observe the patient throughout the procedure for signs of autonomic dysreflexia. Ask the patient to remove clothing from the waist down. Offer assistance if required. Ask the patient to lie in the left lateral position with knees flexed (if possible) so that the anal area can be easily visualised. Wash your hands (refer to hand hygiene in National Infection Prevention and Control Manual. Place a protective pad under the patient’s hips and buttocks. Wash your hands again. Put on a disposable apron and gloves.
Bladder and Bowel Nursing Team Page 5 of 5 June 2016