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Administering a Fleet Enema (102.012)

Administering a Fleet Enema (102.012) - Policies, Clinical, UWMF Clinical, UWMF-wide, Clinical Policies and Procedures, Clinical Procedure

102.012

1
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

PROCEDURE:

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
insertion.

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
the tube.


2


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
minutes.

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
Results obtained
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

REFERENCES:

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
Elsevier.


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