Nursing Procedure During Colostomy Wash Out

This are the steps taken by nurses during colostomy procedure of their patients in the hospital or clinics.

COLOSTOMY WASH OUT

  1. Daily irrigations are carried to established evacuation at a regular time each day.
  2. Irrigation should be done at the same time preferably at time when patient will find it convenient to do it at home.
  3. When the schedule is established in hospital it should not be changed at home.
  4. Dilation of the stoma once a day in order to prevent excessive narrowing, a gloved lubricated finger is inserted gently into the stoma for a few minutes and rotated, usually this is done before the irrigation.
  5. The patient is taught to dilate the stoma himself when he is able.

Requirements:

Trolley with the following top shelf:

(a)  A bowl-containing funnel, rubber tubing catheter (No. 16 or 18), glass connection, gate clip.

  • Jug containing solution to be used
  • Lotion thermometer
  • Lubricant
  • Gallipot with clean swabs.

Bottom Shelf:

  • Mackintosh and dressing towel
  • Receiver for used swabs
  • Clean bed pan with cover
  • Pail with cover
  • Toilet roll of cellulose tissue in a receiver
  • A pair of glove
  • Colostomy bag if necessary

 

PROCEDURE:

  1. Explain the procedure to the patient
  2. The trolley is taken to the patient bedside or to dressing room depending on patient’s condition.
  3. Screen the patient and close nearby windows.

Put patient in a comfortable position.

  1. Put mackintosh and dressing towel in position.
  2. The fluid to be used is normally Luke-warm above 37oC. Tap water or normal saline can be used.  The amount varies from S00mls to several litres.
  3. Assemble tubing and funnel and clamp, expel air in tube by running through a little solution and clamp.
  4. Lubricate the tube and insert in the stoma.
  5. Open the clamp, and gradually pour the water or normal saline about 100ml, or more at a time, then siphon it back from the stoma into bedpan.
  6. Empty the bedpan when necessary into the pail at bedside, continue the process till return flow is clear. The irrigation takes about half to one hour.
  7. Observe the return fluid, note the amount administered and returned.
  8. After irrigation, the patient is given a receiver to hold under the stoma while equipment is being cleared.
  9. Clean dressing for plastic pouch are applied over the stoma after the area has been cleaned, dried and barrier cream applied around the wound.
  10. Make patient comfortable and allow him to rest.

 

CLEANSING OF RECTAL TUBES

Wipe off the grease and adherent facial matter with old linen square

Hold the tube eye upwards under a running tap

Wash thoroughly with a detergent and boil.

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