irrigation colostomy

1.	Goal: The patient expels soft formed stool Assemble necessary equipment. Verify the order for the irrigation. Identify the patient. Explain the procedure to patient. Plan where he or she will receive the irrigation. Assist the patient onto a bedside commode or into a nearby bathroom.
2.	Pull the curtains around the bed and close the room door. Drape the patient to keep him/ her covered.
3.	Warm the solution in the amount ordered, and check the temperature with a bath thermometer if available. If a bath thermometer is not available, warm to room temperature or slightly higher, and test on inner wrist. If tap water is used, adjust temperature as it flows from the faucet.
4.	Perform hand hygiene.
5.	Add irrigation solution to the container. Release the clamp and allow fluid to progress through the tube before reclamping.
6.	Hang the container so that bottom of bag will be at the patient’s shoulder level when the patient is seated.
7.	Put on nonsterile gloves.
8.	Remove the ostomy appliance and attach the irrigation sleeve. Place drainage end into the bedpan, toilet bowl, or commode.
9.	Lubricate the end of the cone with water-soluble lubricant.
10.	Insert the cone into the stoma. Introduce solution slowly over a period of 5 to 6 minutes. Hold tubing (or if patient is able, allow patient to hold tubing) all the time that the solution is being instilled. Control the rate of flow by closing or opening the clamp.
11.	Hold cone in place for an additional 10 seconds after fluid is infused.
12.	Remove the cone. The patient should remain seated on the toilet or bedside commode.
13.	After the majority of the solution has returned, allow the patient to clip (close) the bottom of the irrigating sleeve and continue with daily activities.
14.	After the solution has stopped flowing from the stoma, put on clean gloves. Remove the irrigating sleeve and cleanse the skin around stoma opening with mild soap and water. Gently pat the peristomal skin dry.
15.	Attach a new appliance to the stoma or stoma cover (see Skill 44-2) as needed.
16.	Remove gloves. Return the patient to a comfortable position. Make sure the linens under the patient are dry, if appropriate. Ensure that the patient is covered.
17.	Raise side rail. Lower bed height and adjust head of bed to a comfortable position.
18.	Perform hand hygiene.