Contributing to the clinical skills series To write a clinical skills article, please email How.firstname.lastname@example.org with a synopsis of your idea. Review All articles are subject to external double-blind peer review and checked for plagiarism using automated software. Online This How to guide is available at rcni.com/how-to. For related articles search the website using the keywords above. Preparation and equipment The practitioner should have an understanding of the anatomy and physiology of the lower gastrointestinal tract before undertaking digital removal of faeces. The practitioner should ensure the necessary equipment is available, including Protective bed cover Non-latex gloves and an apron Lubricating gel Local anaesthetic gel, if prescribed Towel and wipes Hand-hot water in a washing bowl Suitable receiver for collecting faeces. – Clinical waste bags. The patient’s care plan should be available. There should be a good source of light. The practitioner should not undertake digital removal of faeces if the patient has recently undergone rectal surgery, or there is trauma to the anal or rectal area. Procedure 1. Confirm the patient’s identity. Explain the procedure, treatment options and potential risks, and obtain consent. If the patient lacks capacity, the practitioner must act in their best interests in accordance with the requirements of the Mental Capacity Act 2005. 2. Assess the patient’s needs, ascertaining if there are specific requirements that require attention. The patient should be offered a chaperone. Take the patient’s pulse as a baseline measurement. Assess the risk of autonomic dysreflexia inpatients with spinal cord injury at Tor above. If the patient has an injury of this nature, obtain and record a baseline blood pressure. Gather the necessary equipment. Ensure privacy and dignity screen the bed or close the door. Remove the patient’s clothing from the waist down, or if the patient is able to do this themselves ask them to do so, ensuring that they are not unnecessarily exposed. Peate I (2016) How to perform digital removal of faeces. Nursing Standard. 30, 40, 36-39. Date of submission March 3 2016; date of acceptance April 14 2016.