RECTAL SUPPOSITORY PROCEDURE

PROCEDURE
ASSESSMENT
1. Checked accuracy and completeness
of each MAR against medication order,
clarified incomplete and unclear orders
with healthcare provider.
2. Reviewed pertinent information related
to medication.
RATIONALE
The health care provider’s order is the
most reliable source and only legal record
of drugs that patient is to receive. Ensures
that patient receives correct medication.
Handwritten MARs are a source of
medication errors (ISMP, 2010; Jones and
Treiber, 2010)
Allows you to anticipate effects of drug
and observe patient’s response.

3. Assessed patient’s medical history for Conditions may contraindicate use of

rectal surgeries or cardiac or bleeding suppository
problems, history of allergies, and
medication history, listed drug allergies on
MAR and provided allergy bracelet if
necessary

4. Reviewed any presenting signs of GI Conditions indicate use of suppository

alterations.
5. Assessed patient’s ability to hold
suppository and position self to insert
medication.
6. Reviewed patient’s knowledge of
purpose of drug therapy and interest in
self-administering suppository
Mobility restriction indicates need for
nurse to help with drug administration
Indicates need for health teaching. Level
of motivation influences teaching
approach

PLANNING
1. Identified expected outcomes
2. Collected appropriate equipment and
MAR.
IMPLEMENTATION
1. Performed hand hygiene, prepared Reduces the transmission of
suppository for administration, checked microorganisms.
label of medication against MAR twice, These are the first and second checks for
checked expiration date. accuracy. Process ensures that right
patient receives right medication.

2. Took medication(s) to patient at correct
time, applied the six rights of medication
administration, performed hand hygiene.
3. Identified patient using at least two
identifiers, compared with information on
MAR
4. Compared MAR with medication labels
at patient’s bedside, asked patient if he or
she had allergies.
5. Explained procedure, discussed
purpose of each medication, action, and
possible adverse effects; allowed patient
to ask any questions; explained procedure
if patient planned to self-administer
medication
6. Arranged supplies at bedside, applied
clean gloves, provided privacy.
7. Assisted patient to proper position
8. Kept patient draped with only anal area
exposed.
9. Examined condition of anus externally,
palpated rectal walls as needed, disposed
of gloves properly if necessary.
Hospitals must adopt medication
administration policy and procedure for
timing of medication administration that
considers nature of the prescribed
medication, specific clinical application
and patient needs.
Ensures correct patient. Complies with the
Joint Commission standards and
improves patient safety.
This is to check for accuracy and ensures
that patient receives correct medication.
Confirms patient’s allergy history.
Patient has right to be informed, and
patient’s understanding of each
medication improves adherence to drug
therapy.
Reduces transfer of microorganisms.
Maintains privacy and minimizes
embarrassment.
Position exposes anus and relaxes
external anal sphincter.
Maintains privacy and facilitates
relaxation.
Determines presence of active rectal
bleeding. Palpation determines whether
rectum is filled with feces, which interferes
with suppository placement. Reduces
spread of infection
 Reduces transfer of microorganisms
10. Performed hand hygiene, applied
clean gloves if necessary.

Lubrication reduces friction as suppository

11. Removed suppository from wrapper,
enters rectal canal.
lubricated round end of suppository and
index finger, handled area gently if patient
had hemorrhoids.
Forcing suppository through constricted
12. Asked patient to take slow, deep sphincter causes pain
breaths through mouth and relax anal
sphincter.

Suppository needs to be against rectal

13. Retracted patient’s buttocks with mucosa for eventual absorption and
nondominant hand, inserted suppository therapeutic action.
properly.

14. Gave suppository through colostomy if

ordered

Provides comfort
15. Withdrew finger, wiped patient’s anal
area.

Prevents expulsion of suppository

16. Asked patient to remain flat for 5
minutes

Reduces transmission of microorganisms

17. Discarded gloves and supplies in
appropriate receptacle, performed hand
hygiene.

Ability to call for assistance provides

18. Placed call light with reach if patient with sense of control over
suppository contained laxative or fecal elimination.
softener.
19. Reminded patient not to flush Allows staff to evaluate results of
commode after bowel movement if suppository.
suppository was given for constipation.

EVALUATION
Determine if drug is distributed properly.
Reinsertion may be necessary.
1. Returned bedside within 5 minutes to
determine if suppository was expelled.

Determines whether insertion of

suppository was irritating.
2. Asked if patient experienced localized
anal or rectal discomfort during insertion.

Determines medication’s effectiveness

3. Evaluated patient for relief of symptoms
at appropriate time.

Reflects patient’s understanding

4. Asked patient to explain steps to insert
suppository

To determine related interventions

5. Identified unexpected outcomes.

RECORDING AND REPORTING

1. Recorded drug, dose, route and time

on MAR

2. Recorded patient response, teaching,

and validation of understanding and ability
to self-administer medication in
appropriate log.
3. Reported adverse effects/patient
response/withheld drugs to nurse in
charge or healthcare provider.