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Rectal Tube, Insertion Of

Rectal Tube Insertion Policy 

Purpose: 

  • To relieve abdominal distention and expulsion of flatus. 

  • To relieve pain. 

Equipment: 

  • Rectal tube (#22 to #24). 

  • Lubricant. 

  • Bedpan or urinal containing approximately 50 cc’s of water. 

  • Toilet tissue. 

  • Bedpan cover. 

  • Plastic bag. 

Procedure: 

I. Preparation: 

  • Assist the resident to Sim’s position. 

  • Place the end of the rectal tube into the bedpan. Ensure the end of the tube is covered by water. 

  • Lubricate the tip of the rectal tube. 

II. Insertion: 

  • Insert the lubricated tip gently into the rectum, approximately three to four inches. 

  • Note: Do not force the tube into the rectum. 

  • Cover the bedpan. 

  • Leave the rectal tube in place for approximately 20 minutes. 

  • Observe for expulsion of flatus. 

III. Completion: 

  • Remove the rectal tube gently. 

  • Clean the anal area. 

  • Position the resident comfortably with the call light within reach and side rails up. 

Documentation: 

  • Date, time, and procedure. 

  • Amount of flatus expelled, condition of the abdomen. 

  • How well the resident tolerated the procedure. 

  • Monitoring and observation of bowel patterns and any changes. 

  • Preventive skin care provided. 

  • Monitoring for abdominal discomfort. 

References: 

  • Centers for Medicare & Medicaid Services (CMS), Requirements of Participation for Long-Term Care Facilities. 

  • State Operations Manual (SOM), CMS. 

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