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


CIRCUMSTANCES WHEN EXTRA CARE IS REQUIRED



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CIRCUMSTANCES WHEN EXTRA CARE IS REQUIRED

Nurses should exercise particular caution when performing this procedure with patients who have the following diseases and conditions. Active inflammation of the bowel, including Crohn’s disease, ulcerative colitis and diverticulitis

In those patients with active bowel infections eg. Clostridium Difficile. Trust guidelines for infection control should apply.

Patients with latex allergies

Recent radiotherapy to the pelvic area

Rectal anal pain

Obvious rectal bleeding or patient taking anti-clotting medication

Patients with spinal injury above Thoracic T, because of risk of autonomic dysreflexia.

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 5 of 10

Patients with known history of abuse.


Introduction
Exclusions: staff caring for children purpose:
Indications for manual evacuation of faeces
Exclusions / contraindications
Appendix ab btraining and competence assessment
Action rationale



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