Policy Manual sample

MDT Home Health Care Agency, Inc. 90 OSTOMY-COLOSTOMY IRRIGATION PURPOSE: All patients with a descending or sigmoid colostomy will have the option of learning colostomy irrigations as a method of control and regulation. A physician’s order will be obtained for irrigations that specifies the amount and type of solution and the frequency with which an irrigation may be performed. RESPONSIBLE PERSONNEL: RN, LPN EQUIPMENT: • Irrigation sleeve • Chux pads or towel • Irrigation bag • Gloves • Toilet paper • Water soluble lubricant • Irrigation Solution PROCEDURE: 1. Have the patient sit in a chair or wheelchair facing the toilet. If the patient is bedridden, pad the bed and place a BSC or bedpan next to the bed. 2. Remove the pouch/bag from the flange. 3. If flange is secure, snap on the irrigation sleeve. If the patient is in bed, angle the sleeve off to the side. 4. Place the end of the sleeve in the toilet. If the patient is in bed, use the BSC or bedpan placed on a chair in which to drain the stool. 5. Through the top of the sleeve, gently insert the lubricated (use water soluble lubricant) cone into the stoma. 6. Allow the ordered amount of solution to flow into the stoma slowly (3 - 5 minutes). If the patient complains of cramping, slow down or stop the flow of water leaving the cone in place, and have the patient take deep breaths. After cramping subsides, resume inflow of water. Note: It is important to fill up the whole amount of the solution in the colon for good irrigation results. Do not allow water to flow out around the cone during the irrigation. 7. Remove the cone. Seat the top of the sleeve and allow water and stool to return. Rinse the stool through the sleeve as needed. May use the irrigation bag filled with water. 8. After one hour, rinse the stoma area with water. Remove the sleeve and dry the flange. If the flange is loose, remove the flange and apply a new one. Snap on a clean pouch. DOCUMENTATION: Document date procedure was performed, patient tolerance, and any side effects noted in the Clinical Visit Note. Document patient/caregiver education and response. Notify physician of any adverse side effects and document in clinical record.