UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE
TITLE: ADMINISTERING A FLEET ENEMA
Effective Date: February, 2002 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education
Reviewed March, 2005 March, 2008 May 2010 September 2012
PURPOSE: To provide guidelines for administering an enema to patients at University of Wisconsin Medical
Foundation (UWMF) or Department of Family Medicine (DFM) clinics.
POLICY: The clinical staff will utilize the following guidelines to administer an enema to a patient.
DEFINITION: Enema administration involves the instillation of a solution into the rectum and colon. They are
used to relieve distention and promote expulsion of flatus, to lubricate the rectum and colon, and to soften
hardened stool for removal.
SUPPLIES: Prepackage Fleet Enema
1. Check provider’s order and clarify any inconsistencies.
NOTE: Enemas are contraindicated in patients with recent colon or rectal surgery, or myocardial infarction,
and in patients with an acute abdominal condition of unknown origin. They should be administered
cautiously in patients with arrhythmias.
2. Wash hands and gather equipment.
3. Provide good light and privacy by closing curtains or door.
4. Explain procedure and the purpose of the enema to patient.
5. Position waterproof pad under patient.
6. Position and drape patient on the left side (Sims position) with anus exposed or on back, as dictated by
patient comfort and condition.
7. Apply gloves.
8. Remove protective shield/cap from enema comfort-tip before inserting. Be sure that tip is lubricated prior to
9. Separate the patient’s buttocks and touch the anal sphincter with the enema tip to stimulate contraction.
Then as the sphincter relaxes, tell the patient to breathe deeply through his/her mouth as you gently advance
10. Advance the tip, aiming it toward the umbilicus. Avoid forcing it to prevent rectal wall trauma.
11. Squeeze bottle until nearly all liquid is gone. It is not necessary to empty the bottle completely as it contains
more liquid than needed.
12. Remove comfort-tip from rectum and maintain position until patient urge to evacuate is strong, usually 1-5
13. Assist patient to use bathroom to release enema.
13. Change water proof pad and exam paper if wet. Dispose of equipment properly.
14. Leave patient clean and comfortable.
14. Wash hands.
15. Documentation in Progress Notes section of patient record using smartphrase .medinclinic
Patient education provided
How patient tolerated the procedure
WRITTEN BY: Ronnie Peterson, R.N., M.S., Manager of Clinical Support
REVISED BY: Carol Decker, RN, MSN, Clinical Staff Educator
REVIEWED BY: Laurie Woodhouse, Manager, UWMF Gastroenterology
Kowalak, J. P. (Ed.). (2009). Lippincott’s nursing procedures (5th ed.). Ambler, PA: Lippincott Williams & Wilkins.
Perry, A.G. & Potter, P.A. (2002). Clinical nursing skills & techniques. (5th ed.). St. Louis, MO: Mosby.
Perry, A.G. & Potter, P.A. (2009). Fundamentals of nursing. (7th ed.). Hall, A. & Stockert, P.A. (Eds.). St. Louis, MO: Mosby
AUTHORIZED BY: Richard Welnick, MD, Medical Director, Ambulatory Clinic Operations, UWMF
Sandra A. Kamnetz M.D., Vice Chair, Department of Family Medicine
Medical Director, UWMF Date
Vice Chair, Department of Family Medicine Date