Digital Disimpaction

[LisaJanae]

I know this is not done very often...but does it require an MD's order?

Thanks!

New Grad Lisa

[leslie :-D]

in my nearly 12 yrs of nsg, i've never seen an order to disimpact.

yet it is something i do, at least weekly.

enemas often will not work with the impairments of the pudendal nerve or internal sphincter muscle.

and that is when manual intervention is indicated.

sometimes, i do not have to remove all the stool.

sometimes, the stimulation is enough to get things moving.

but still, it has to be done.

my pts are always lying down (rather than sitting upright), and have never had any vagal incidences.

but i do use judgment, and if someone has a cancer that has infiltrated the colon, i won't mess with that.

that's when i turn to the md, for help.

leslie

[busy-bee]

Yes, I always get a Dr. order prior to attempting to remove a bm manually. Too many things can happen..CYA.

[dbsn00]

Also, you are never ever ever supposed to chart any form of the word impaction.

It's a facility policy where I work (as long as there are no cardiac problems) to remove the impaction & start on a bowel regime (we were cited during survey). However, we never chart the word "impaction" either - "assisted with manual removal" is the term we use.

I would LOVE to see the MD do this;) as it's something I get to do several times per week!