Skill Checklists for Taylor's Clinical Nursing Skills: A Nursing Process Approach

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Skill Checklists for Taylor's Clinical Nursing Skills:
A Nursing Process Approach, 3rd edition

Name Date

Unit Position

Instructor/Evaluator: Position

SKILL 13-4

Digital Removal of Stool

Goal:The patient expels feces with assistance and is free

from trauma with minimal patient discomfort. Comments

1. Verify the order. Bring necessary equipment to the bedside
   stand or overbed table.


2. Perform hand hygiene and put on PPE, if indicated.


3. Identify the patient.


4. Close curtains around bed and close the door to the room,
   if possible. Explain what you are going to do and why
   you are going to do it to the patient. Discuss signs and
   symptoms of a slow heart rate. Instruct patient to alert you
   if any of these symptoms are felt during the procedure.
   Have a bedpan ready for use.


5. Adjust bed to comfortable working height, usually elbow
   height of the caregiver (VISN 8 Patient Safety Center,
   2009). Position the patient on the left side (Sims’
   position), as dictated by patient comfort and condition.
   Fold top linen back just enough to allow access to the
   patient’s rectal area. Place a waterproof pad under the
   patient’s hip.


6. Put on nonsterile gloves.


7. Generously lubricate index finger with water-soluble lubri-
   cant and insert finger gently into anal canal, pointing
   toward the umbilicus.


8. Gently work the finger around and into the hardened mass
   to break it up and then remove pieces of it. Instruct patient
   to bear down, if possible, while extracting feces to ease in
   removal. Place extracted stool in bedpan.


9. Remove impaction at intervals if it is severe. Instruct
   patient to alert you if he or she begins to feel lightheaded
   or nauseated. If patient reports either symptom, stop
   removal and assess patient.


10. Put on clean gloves. Assist patient, if necessary, with clean-
    ing of anal area. Offer washcloths, soap, and water for
    handwashing. If patient is able, offer sitz bath.

Copyright © 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Skill Checklists for Taylor's Clinical Nursing Skills:

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