Scribd Logo
Upload

Welcome to Scribd!

  • Administering Rectal Medications

    Uploaded by

    Rudy Duterte
    36 views3 pages
    The field of gastroenterology and the number of procedures performed continues to expand each year. With growth brings new challenges in technology and infection prevention. It is imperative to understand each requisite step in reprocessing and understand the transmission of infection to ensure safety in the GI setting. The Spaulding classification system is universally used to determine what type of disinfection or sterilization is appropriate for medical devices (Peterson et al., 2011; Rutala & Weber, 2013). These three classes –critical, semi-critical, and non-critical –stratify the risk of infection associated with each device. Critical devices break the mucosal barrier and should be sterilized (e.g., reusable biopsy forceps). Semi-critical devices (e.g., endoscopes) come in contact with mucous membranes or non-intact skin and should be sterilized or receive high-level disinfection. Non-critical devices are those that come into contact with intact skin such as blood pressure cuffs and stethoscopes. These items can be cleaned with soap and water or disinfected with a germicide. Endoscopes are considered semi-critical and should receive high-level disinfection with an FDA-approved high-level disinfectant (Petersen et al., 2011; Rutala & Weber, 2013). Since endoscopes are used repeatedly, they must undergo reprocessing to ensure that all pathogenic microorganisms are removed before the endoscope is used on the next patient. Every patient must be considered a potential source of infection, and all endoscopes must be decontaminated with the same degree of rigor following every endoscopic procedure. Increased awareness of the challenges in reprocessing has occurred because of high-profile reprocessing breaches that may have exposed patients to bloodborne pathogens and confirmed outbreaks of bacterial infections that are resistant to even the most powerful antibiotics. The true rate of transmission during endoscopy may go unrecognized because of inadequate or nonexistent surveillance, difficulty connecting an infection to endoscopy because of the passage of time, and absence of clinical symptoms (Rutala & Weber, 2015). Reprocessing is highly effective when used appropriately, but several factors impact its effectiveness (Edmiston & Spencer 2014; Dirlam Langlay, Ofstead, Mueller et al., 2014; Petersen et al., 2011; Rutala & Weber, 2015). These factors can be considered in relation to the endoscope itself, the reprocessing personnel, the reprocessing steps, and the equipment.

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    The field of gastroenterology and the number of procedures performed continues to expand each year. With growth brings new challenges in technology and infection prevention. It is imperative to understand each requisite step in reprocessing and understand the transmission of infection to ensure safety in the GI setting. The Spaulding classification system is universally used to determine what type of disinfection or sterilization is appropriate for medical devices (Peterson et al., 2011; Rutala & Weber, 2013). These three classes –critical, semi-critical, and non-critical –stratify the risk of infection associated with each device. Critical devices break the mucosal barrier and should be sterilized (e.g., reusable biopsy forceps). Semi-critical devices (e.g., endoscopes) come in contact with mucous membranes or non-intact skin and should be sterilized or receive high-level disinfection. Non-critical devices are those that come into contact with intact skin such as blood pressure cuffs and stethoscopes. These items can be cleaned with soap and water or disinfected with a germicide. Endoscopes are considered semi-critical and should receive high-level disinfection with an FDA-approved high-level disinfectant (Petersen et al., 2011; Rutala & Weber, 2013). Since endoscopes are used repeatedly, they must undergo reprocessing to ensure that all pathogenic microorganisms are removed before the endoscope is used on the next patient. Every patient must be considered a potential source of infection, and all endoscopes must be decontaminated with the same degree of rigor following every endoscopic procedure. Increased awareness of the challenges in reprocessing has occurred because of high-profile reprocessing breaches that may have exposed patients to bloodborne pathogens and confirmed outbreaks of bacterial infections that are resistant to even the most powerful antibiotics. The true rate of transmission during endoscopy may go unrecognized because of inadequate or nonexistent surveillance, difficulty connecting an infection to endoscopy because of the passage of time, and absence of clinical symptoms (Rutala & Weber, 2015). Reprocessing is highly effective when used appropriately, but several factors impact its effectiveness (Edmiston & Spencer 2014; Dirlam Langlay, Ofstead, Mueller et al., 2014; Petersen et al., 2011; Rutala & Weber, 2015). These factors can be considered in relation to the endoscope itself, the reprocessing personnel, the reprocessing steps, and the equipment.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    36 views3 pages

    Administering Rectal Medications

    Uploaded by

    Rudy Duterte
    The field of gastroenterology and the number of procedures performed continues to expand each year. With growth brings new challenges in technology and infection prevention. It is imperative to understand each requisite step in reprocessing and understand the transmission of infection to ensure safety in the GI setting. The Spaulding classification system is universally used to determine what type of disinfection or sterilization is appropriate for medical devices (Peterson et al., 2011; Rutala & Weber, 2013). These three classes –critical, semi-critical, and non-critical –stratify the risk of infection associated with each device. Critical devices break the mucosal barrier and should be sterilized (e.g., reusable biopsy forceps). Semi-critical devices (e.g., endoscopes) come in contact with mucous membranes or non-intact skin and should be sterilized or receive high-level disinfection. Non-critical devices are those that come into contact with intact skin such as blood pressure cuffs and stethoscopes. These items can be cleaned with soap and water or disinfected with a germicide. Endoscopes are considered semi-critical and should receive high-level disinfection with an FDA-approved high-level disinfectant (Petersen et al., 2011; Rutala & Weber, 2013). Since endoscopes are used repeatedly, they must undergo reprocessing to ensure that all pathogenic microorganisms are removed before the endoscope is used on the next patient. Every patient must be considered a potential source of infection, and all endoscopes must be decontaminated with the same degree of rigor following every endoscopic procedure. Increased awareness of the challenges in reprocessing has occurred because of high-profile reprocessing breaches that may have exposed patients to bloodborne pathogens and confirmed outbreaks of bacterial infections that are resistant to even the most powerful antibiotics. The true rate of transmission during endoscopy may go unrecognized because of inadequate or nonexistent surveillance, difficulty connecting an infection to endoscopy because of the passage of time, and absence of clinical symptoms (Rutala & Weber, 2015). Reprocessing is highly effective when used appropriately, but several factors impact its effectiveness (Edmiston & Spencer 2014; Dirlam Langlay, Ofstead, Mueller et al., 2014; Petersen et al., 2011; Rutala & Weber, 2015). These factors can be considered in relation to the endoscope itself, the reprocessing personnel, the reprocessing steps, and the equipment.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 3

    ADMINISTERING RECTAL MEDICATIONS

    IMPLEMENTATION
    Preparation
    1. Check the MAR.
    Check the MAR for the drug
    name, strength, and
    prescribed frequency.
    Check client allergy status.
    If the MAR is unclear or
    pertinent information is
    missing, compare it with the
    most recent primary care
    providers written order.
    Report any discrepancies to
    the charge nurse or primary
    care provider, as agency
    policy dictates.
    2. Know the reason why the client
    is receiving the medication, the
    drug classification,
    contraindications, usual dose
    range, side effects, and nursing
    considerations for administering
    and evaluating the intended
    outcomes of the medication.
    Performance
    3. Compare the label on the
    medication container with the
    medication record and check the
    expiration date.
    4. If necessary, calculate the
    medication dosage.
    5. Explain to the client what you
    are going to do, why it is
    necessary, and how she can
    participate. Explain to the client
    that a rectal suppository is
    normally a painless procedure,
    and in fact may bring relief from
    itching and burning if an
    infection is present. Many people
    feel embarrassed about this
    procedure, and some may prefer
    to perform the procedure
    themselves if instruction is
    provided. Discuss how the
    results will be used in planning
    further care or treatments.
    6. Perform hand hygiene and
    observe other appropriate

    infection prevention procedures.


    7. Provide for client privacy.
    8. Prepare the client.
    Prior to performing the
    procedure, introduce self and
    verify the clients identity
    using agency protocol.
    Rationale: This ensures that
    the right client receives the
    right medication.
    9. Assist the client to a left lateral
    or left Sims position, with the
    upper leg flexed.
    10. Fold back the top bedclothes to
    expose the buttocks.
    11. Put a glove on the hand used to
    insert the suppository.
    12. Unwrap the suppository and
    lubricate the smooth rounded
    end, or see the manufacturers
    instructions. The rounded end is
    usually inserted first and
    lubricant reduces irritation of the
    mucosa.
    13. Lubricate the gloved index
    finger.
    14. Encourage the client to relax by
    breathing through the mouth.
    This usually relaxes the external
    anal sphincter.
    15. Insert the suppository gently into
    the anal canal, rounded end first
    (or according to manufacturers
    instructions), along the rectal
    wall using the gloved index
    finger. For an adult, insert the
    suppository beyond the internal
    sphincter (i.e., 10 cm [4 in.]).
    16. Avoid embedding the
    suppository in feces in order for
    the suppository to be absorbed
    effectively.
    17. Press the clients buttocks
    together for a few minutes.
    18. Ask the client to remain in the
    left lateral or supine position for
    at least 5 minutes to help retain
    the suppository. The suppository
    should be retained for varying
    lengths of time according to the
    manufacturers instructions.
    INFANTS/CHILDREN

    Obtain assistance to immobilize an


    infant or young child. This
    prevents accidental injury due to
    sudden movement during the
    procedure.
    For a child under 3 years of age,
    the nurse should use the gloved
    fifth finger for insertion. After this
    age, the index finger can usually
    be used.
    For a child or infant, insert a
    suppository 5 cm (2 in.) or less.

    Other comments:
    _____________________________________________________________________________________________
    _____________________________________________________________________________________________
    _____________________________________________________________________________________________
    _____________________________________________________________________________________________
    _____________________________________________________________________________________________

    Name of Student

    Assessors Name

    Signature
    Clinical Instructor
    Position

    Date

    Signature

    Date

    You might also like