BAY AREA COLLEGE OF NURSING Nursing Assistant Program Module 9: Resident Care Procedures
EQUIPMENT: commercial enema bed protector bedpan toilet tissue gloves BEGINNING STEPS: 1. 2. 3. 4. 5. 6. 7. 8.
MANUAL SKILL: Administering the Commercially Prepared Enema (Cleansing and/or Oil Retention)
Wash hands. Knock and pause before entering the residents room. Introduce self. Identify resident. Explain procedure. Gather equipment, if applicable. Provide for privacy. Apply gloves, if necessary.
SKILL STEPS: 1. 2. 3. 4. 5. 6. 7. 8. 9. Raise bed to working level. Lower side rail nearest you. Cover resident with blanket or sheet, fold remaining linen to foot of bed. Position resident in left Sims position. Place bed protector under buttocks. Expose buttocks by raising edge of blanket. Remove cap from enema. Raise upper buttock so you can see anal area. Gently insert tip of enema 2 through anus into rectum.
_________________________________________________ Do Not Reproduce. BACN Property/2010
BAY AREA COLLEGE OF NURSING Nursing Assistant Program Module 9: Resident Care Procedures
MANUAL SKILL: Administering the Commercially Prepared Enema (Cleansing and/or Oil Retention)
10. Squeeze and roll the plastic bottle gently until all solution enters rectum. 11. Remove tube from residents anus and place bottle in box for disposal. Stop if the resident complains of pain, if you feel resistance, or if bleeding occurs. a. For oil retention encourage resident to hold solution for 20 minutes (or time ordered) before placing on bedpan or assisting resident to toilet. b. For cleansing enema assist resident onto bedpan or to toilet. Encourage resident to retain enema until urge to defecate is felt. 12. Remove gloves. 13. Wash hands. 14. Provide toilet tissue and make sure call bell is within reach. 15. Discard disposable enema equipment. 16. Return to room when resident signals. 17. Put on gloves. 18. Check contents of bedpan or toilet for color of stool, consistency, amount, unusual material, or anything abnormal. 19. Empty bedpan, clean and return to proper place. 20. Remove disposable bed protector and discard. 21. Remove any soiled linen. 22. Remove gloves. 23. Provide material for resident to wash hands. ENDING STEPS: 1. 2. 3. 4. 5. 6. 7. 8. Clean and return equipment and supplies, if applicable. Remove gloves, if wearing. Position resident comfortably. Place call light within reach. Lower bed to safe position for the resident. Leave room neat. Wash hands. Document.
_________________________________________________ Do Not Reproduce. BACN Property/2010
BAY AREA COLLEGE OF NURSING Nursing Assistant Program Module 9: Resident Care Procedures
9. Report abnormal findings to licensed nurse. CLEANSING ENEMA EQUIPMENT:
MANUAL SKILL: Administering the Commercially Prepared Enema (Cleansing and/or Oil Retention)
bedpan or commode enema container, tubing with clamp bed protector water-soluble lubricant gloves enema solution (soapsuds, tap water, or normal saline as ordered by physician) toilet tissue BEGINNING STEPS: 1. 2. 3. 4. 5. 6. 7. 8. Wash hands. Knock and pause before entering the residents room. Introduce self. Identify resident. Explain procedure. Gather equipment, if applicable. Provide for privacy. Apply gloves, if necessary. SKILL STEPS: 1. 2. 3. Place disposable bed protector under buttocks. Assist resident to turn to left side (left Sims position). Place bedpan at foot of bed within reach.
_________________________________________________ Do Not Reproduce. BACN Property/2010
BAY AREA COLLEGE OF NURSING Nursing Assistant Program Module 9: Resident Care Procedures
4.
MANUAL SKILL: Administering the Commercially Prepared Enema (Cleansing and/or Oil Retention)
5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25.
In bathroom or utility room: a. Make sure that tubing is connected to enema container. b. Close clamp on tubing. c. Fill container with prescribed amount of solution. Add necessary ingredients as above. d. Run small amount of solution through tubing into sink, reclamp tubing. Raise bed to working level and lower side rail. Expose residents buttocks by raising edge of blanket. Put on gloves. Apply lubricant to tip of enema tubing. Raise upper buttock so you can see anal area. Gently insert tip of tubing 2 to 4 inches into rectum. (If you feel resistance, or resident complains of pain, stop, remove tubing, and report to RN). Open clamp and raise enema container 12 above anus. Tell resident to take slow deep breaths to relax abdomen. If cramping occurs, clamp tubing until cramping stops, then open tubing and resume enema. When most of the solution has flowed into the residents rectum, close the clamp to avoid air in the tubing. Slowly withdraw the tubing from the rectum. Wrap tip of tubing in paper towel. Encourage resident to hold solution for as long as possible. When resident is ready to expel enema, assist resident onto bedpan; if allowed, raise head of bed. Place toilet tissue and signal cord within reach of resident. Check on resident every few minutes. If resident is allowed to go to the bathroom to expel enema, assist to bathroom and stay near in case resident needs help. Tell resident not to flush toilet. Discard disposable equipment, or clean for reuse according to facility policy, while resident is on bedpan. Remove bedpan and assist resident to return to bed. Cleanse resident as necessary. Observe contents of bedpan or toilet. Cover bedpan. Dispose of contents according to facility policy or flush toilet. Remove bed protector. Remove and dispose of gloves. Provide resident with soap, water, and towel to wash hands. Assist resident to comfortable position, air room, unscreen unit, lower bed, and raise side rails.
_________________________________________________ Do Not Reproduce. BACN Property/2010
BAY AREA COLLEGE OF NURSING Nursing Assistant Program Module 9: Resident Care Procedures
ENDING STEPS: 1. 2. 3. 4. 5. 6. 7. 8. 9.
MANUAL SKILL: Administering the Commercially Prepared Enema (Cleansing and/or Oil Retention)
Clean and return equipment and supplies, if applicable. Remove gloves, if wearing. Position resident comfortably. Place call light within reach. Lower bed to safe position for the resident. Leave room neat. Wash hands. Document. Report abnormal findings to licensed nurse.
_________________________________________________ Do Not Reproduce. BACN Property/2010
