Policy Manual sample

MDT Home Health Care Agency, Inc. 143 VAGINAL IRRIGATION PURPOSE: Vaginal irrigations are performed by home health care personnel in accordance with specific physician's orders for solution, amount and frequency. An irrigation is performed in order to remove odor or discharges, disinfect the vagina by instilling of antiseptic or pH altering solutions or to relieve pain, discomfort and inflammation. Solutions most commonly used are saline, sodium bicarbonate, vinegar or betadine. RESPONSIBLE PERSONNEL: RN, LPN EQUIPMENT: Gloves, bedpan, irrigation bag with tubing and nozzle, Chux pad SPECIAL CONSIDERATIONS: The normal amounts of these solutions range from 1000 to 2000 cc. The usual temperature is tepid. PROCEDURE: 1. Explain procedure to the patient. 2. Wash hands. 3. Screen patient for privacy. Instruct the patient to void. 4. Have patient lie on back with hips higher than shoulders. Support head with pillow. Place Chux pad between buttocks. 5. Position patient on bedpan. Place pillow under back as needed for comfort and positioning. 6. Drape the legs with a sheet to expose the pelvic area. 7. The irrigation solution temperature should be lukewarm unless otherwise ordered. 8. Position bottom of irrigation bag about 12 inches above the level of the hips. Keep tubing clamped. 9. Put on examination gloves. 10. Separate the labia and allow a small amount of water to flow over the meatus into the bedpan. 11. Gently insert the nozzle into the vagina at a 45 degree angle, upward and backward, usually two to four inches. 12. Allow all of solution to flow into vagina while gently rotating nozzle. 13 . When irrigating container is empty, clamp tube and remove nozzle from vagina. 14. Assist patient to a sitting position on the bedpan. 15. Remove bedpan and inspect return flow for color and odor. 16. Dry patient and assist her to a comfortable position. 17. Wash hands and allow patient to wash her hands. 18. Clean and store equipment. Discard gloves. 19. Wash hands. DOCUMENTATION: Document date, type and amount of irrigation solution used, characteristics of return and patient's tolerance to procedure on the Clinical Visit Note. If further action is indicated, document follow- up/notification of Clinical Manager and/or physician.