00:04
So, welcome to the skill enema administration.
00:07
So, let's talk about a few
times we're going to need this.
00:11
So, this is especially important
in treating constipation.
00:15
Now, we may need this if other avenues
of helping produce a bowel movement fails.
00:21
Enema, is usually one of our latter resorts.
00:24
But, extremely important especially in
your post-op or post-surgical patients,
that they have a bowel movement
to facilitate their recovery.
00:33
So, let's take a look at enema administration.
00:37
So, now let's take a look at
the solutions that you may need.
00:40
So, guys there's a whole host of those out there,
it could be a saline enema solution, a glycerin,
maybe even soap suds.
00:49
There's all kinds of different pieces out there
or different types of medications,
so, check your provider's orders.
00:56
Now, some of these come in a handy-dandy one-step,
all-inclusive administration piece.
01:03
So, what I mean by this if
you look at that first image,
some of them come in a
handheld bottle for home use.
01:10
Now, sometimes when we give these in the hospital,
we may need a different type of solution,
therefore, we're going to use
a full administration set,
so, it's going to have our bucket
and also have our catheter.
01:23
Now next, absorbent pads are
really important obviously.
01:27
You can get a lot of the
enema fluid all over the bed,
also, if the patient produces results,
we're going to need to protect
their sheets and their linens.
01:36
Let's look at some other equipment.
01:38
Now this is a biggie guys,
you want to have a bedpan
or a bedside commode already prepared and ready,
before you do the enema,
so, have this close.
01:48
Now, if the patient can get
to the bathroom, that's great.
01:51
But many times, when we give a patient an enema,
we can't get all the way the
bathroom, because the retaining fluid
and we'll talk about that soon.
02:01
Now, next, lubricant is important,
because when we insert the catheter,
we want to make sure we don't
cause trauma to the mucosa.
02:11
And lastly don't forget to
provide thorough perineal care,
after the enema administration.
02:18
Now, the whole goal of this again,
it's got to be ordered by a health care provider.
02:22
So, be conscious that there's
different solutions out there
and our whole goal is to produce
a bowel movement for a patient.
02:31
Now, before we get started as always,
we want to make sure we perform our hand hygiene
and absolutely provide privacy for our patient.
02:39
Now this procedure in particular,
is really important to explain to them,
because it's a little bit up close and personal.
02:47
Some patients may find it
a little bit embarrassing,
but this is perfectly normal
when a patient has constipation.
02:54
Now also, constipation can really
cause complications for our patient.
02:58
So, we want to definitely talk about the benefits
of the enema administration.
03:04
Now, his is a great idea for comfort,
because the patient's going to have some pressure
with that in the administration,
we want to encourage them to go
ahead and empty their bladder
before we start.
03:15
And again, don't forget, if we have
a bedpan or a bedside commode nearby,
we're going to have it handy,
when the patient's done with
the enema administration
and hopefully produce results.
03:29
Now, let's go ahead and
perform our hand hygiene again
and we're going to put on our gloves.
03:34
And of course, we're going to
need to get to our patient,
so, we want to raise that bed to
an appropriate working height.
03:41
Now, we want to take our enema kit
and if we're using a bucket
administration, like this,
make sure that tubing is clamped and
prepare the administration solution.
03:52
So, let's take a moment here
and take a look at this image.
03:55
So, you see here for gravity purposes,
most of the time we're going
to have that enema bucket,
we're going to hang it on an IV pole for gravity
and it's got all this tubing in it
and there is a clamp.
04:08
MAKE SURE guys make sure the tubing is clamped,
then we can pour in our solution.
04:15
If we don't clamp the tubing
and pour in the solution
and that tubing is open and unclamped,
we can lose all of our medication.
04:24
So be diligent here, to clamp
first and then add your medication.
04:32
So, let's take a look at how we
perform our enema administration.
04:37
So, before we get started, there's
a lot of things to consider here.
04:40
Make sure to perform your hand hygiene
and of course, especially with this skill,
provide privacy.
04:47
Now, explaining the procedure to the patient
is really critical in this type of skill.
04:52
You want to make sure you
communicate with the patient,
you let them know, if there's any discomfort,
that you let us know you.
04:59
You also want to let them know,
when the enema administration is flowing
and also, how long the patient
needs to retain the enema.
05:07
So, explanation before you
start really as a crucial step.
05:11
Now, here's also a great tip, you want
the patient to empty their bladder
for comfort if they can beforehand.
05:18
The reason why I’m saying when we give this enema,
you're going to have some excess pressure,
so, to help relieve that,
if the patient can empty their bladder
beforehand that's a great idea.
05:28
Also, to go ahead and get started,
be prepared, so, when we
give the patient the enema,
they're going to need to evacuate
their bowels pretty urgently
or to get rid of the fluid.
05:39
So, have a bedpan by or even a bedside commode.
05:43
Now, is a great time to go ahead
perform our hand hygiene again
and put on our gloves.
05:55
And once we've done that,
we want to put our bed to an
appropriate working height.
06:00
Then once we go ahead and prepare our enema kit,
we're going to make sure this tubing is clamped,
so, I'll walk you through that.
06:08
So, just know any time that
you're working with an enema,
there actually may be different
type of medications prescribed,
this is going to vary depending on the order,
so, there's going to be some variations to this.
06:22
So, let me take my bucket here.
06:24
This is really common setup
when you're using an enema kit.
06:27
So, you see here it's got this
really handy dandy handle,
that we can go ahead and put on our IV pole here.
06:36
This is the tubing piece that comes with it
and there's actually a little
bitty spicket, if you will,
you're just going to make sure
that this is seated in well.
06:47
So, with this once you've attached the tubing,
you have the actual enema tip itself.
06:55
And this is the piece for insertion,
also, you've got a clamp here,
now, this is really important,
that before you put anything in the enema bucket,
such as your prescribed medications,
this thing's got to be clamped.
07:10
So, how we do that again is just,
you can kind of hear it,
make sure that's clamped tightly
so that's really important.
07:18
So, for this particular skill a lot of the times,
you're going to get something like this.
07:23
This is just a simple soap suds enema
and again, it's going to vary
depending on physician's order.
07:30
This actually, usually comes with this bucket,
so, we'll add this in into
some lukewarm tap water,
for our patient.
07:37
So, I'll put this aside.
07:40
So, we're talking about lukewarm tap water,
guys that's really important,
the temperature of the water.
07:46
So, the reason being if I put
scolding hot water in here
and administer this to my patient
I can definitely cause harm.
07:54
The same thing if it's really cold,
you can imagine there's some
constriction that could occur,
which could also cause issues and complications
or even trauma when you try to
insert the tip of the tubing itself.