This are the steps taken by nurses during colostomy procedure of their patients in the hospital or clinics.
COLOSTOMY WASH OUT
- Daily irrigations are carried to established evacuation at a regular time each day.
- Irrigation should be done at the same time preferably at time when patient will find it convenient to do it at home.
- When the schedule is established in hospital it should not be changed at home.
- 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.
- The patient is taught to dilate the stoma himself when he is able.
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
- Gallipot with clean swabs.
- 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
- Explain the procedure to the patient
- The trolley is taken to the patient bedside or to dressing room depending on patient’s condition.
- Screen the patient and close nearby windows.
Put patient in a comfortable position.
- Put mackintosh and dressing towel in position.
- 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.
- Assemble tubing and funnel and clamp, expel air in tube by running through a little solution and clamp.
- Lubricate the tube and insert in the stoma.
- 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.
- 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.
- Observe the return fluid, note the amount administered and returned.
- After irrigation, the patient is given a receiver to hold under the stoma while equipment is being cleared.
- Clean dressing for plastic pouch are applied over the stoma after the area has been cleaned, dried and barrier cream applied around the wound.
- 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.