Elimination: Enema

Critical Elements

• Understanding of the importance and variations that can occur with administration of an enema.
• Create appropriate physical environment.
• Provide privacy.
• Explain procedure.
• Wash hands.

Procedure

Prior to Treatment: (Critical Thinking)

• Assess patient's need for treatment.
• Consider patient ability to retain enema.
• Confirm order.
• Gather appropriate supplies: enema bag, solution, IV pole, lubricant, waterproof pad, bedpan, bedside commode, or toilet.
• Consider age related variations for procedure.

Patient Interaction: (Safety)

• Patient identifiers.
• Create appropriate physical environment.
• Provide privacy.
• Explain procedure.
• Wash hands.

Procedure: (Patient Centered Care)

1. Place bedpan or bedside commode near patient.
2. Open supplies.
3. Warm solution to 105° to 110°F (40° to 43°C).
4. Attach tubing to the enema bag, close clamp.
5. Fill bag with the ordered amount of warm solution.
6. Add soap solution if indicated.
7. Hang bag on IV pole.
8. Hold the end of the tubing over the sink, priming the tubing.
9. Apply gloves, turn patient to left lying position with right knee flexed.
10. Place waterproof pad under hips.
11. Place bedpan flat on the bed beneath the rectum and up against the buttocks or place commode nearby.
12. Lubricate tip of tubing.
13. Slowly and gently insert tip of the tubing 3-4 inches (depending on size of patient).
14. Lower level of bag and steadily instill solution.
15. Monitor for discomfort until complete, slowing solution if necessary for cramping.
16. Once solution has been instilled, remove tubing, encouraging patient to retain solution as long as possible.
17. Clean equipment, staying close by patient until assistance is needed for bedpan, commode, or toilet.

After Procedure (Patient Centered Care, Safety)

• Provide appropriate nursing management for abnormal findings.

Documentation (Informatics, Communication)

• Outcome of procedure.
• Interventions used for nursing management of care.
• Patient’s response to interventions.

Resources

• Enema Administration