Policy for the digital rectal examination and manual removal of faeces in adults


Appendix Ab bTRAINING AND COMPETENCE ASSESSMENT



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Appendix Ab bTRAINING AND COMPETENCE ASSESSMENT
All staff performing this procedure should have received training in the techniques and be deemed competent before undertaking this procedure (NMC 2008, RCN 2008). Training can be achieved

In the clinical area whilst caring for patients with an already competent registered nurse to supervise and assess

Via theoretical and practical competencies in a formal taught programme, using clinical models in a skills lab to develop practical skills Core Skills and Knowledge requirement Before undertaking manual removal of faeces staff must be able to demonstrate

An understanding of the anatomy and physiology of the gastrointestinal tract

An understanding of the diseases of the rectum and colon

The use of medication in bowel dysfunction

Assessment of bowel dysfunction

Guidelines for digital rectal examination and manual evacuation of faeces including
- indications
- observation of the peri-anal area
- precautionary measures
- procedure

An understanding of autonomic dysreflexia, causes and management. Documentation Completion of eLearning package and been assessed as competent Issues of consent Circumstances for referral to specialist

Manual removal of faeces by nursing staff for adult patients who have an established bowel management plan
Musgrove Park Hospital is part of Taunton and Somerset NHS Foundation Trust Page 7 of 10


Introduction
Exclusions: staff caring for children purpose:
Indications for manual evacuation of faeces
Exclusions / contraindications
Circumstances when extra care is required
Action rationale



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