FOR TODAY,, I AM GOING TO PERFORM IRRIGATING A

COLOSTOMY AND STOMA BAG CHANGE

SO FIRST WE ARE GOING TO IRRIGATE THE COLOSTOMY

- SO WE DO THIS PROCEDURE TO EMPTY THE COLON OF
FECES, GAS OR MUCUS
- TO CLEANSE THE LOWER INTESTINAL TRACT
- AND TO ESTABLISH REGULAR PATTERM OF
EVACUATION
 - THIS PROCEDURE MAY ALSO BE APPLIED WHEN
TEACHING A PATIENT HOW TO CARE FOR THEIR
STOMA.
- THE AIM OF GOOD STOMA CARE IS TO RETURN
PATIENTS TO THEIR PLACE IN SOCIETY.
- ALSO IN PROVIDING CARE, WE MUST PROMOTE
PATIENT INDEPENDENCE

OKAY SO LET’S START

GREET THE PATIENT AND INTRODUCE YOURSELF AND
EXPLAIN THE PROCEDURE

GATHER ALL YOUR MATERIALS FOR THE PROCEDURE

PERFORM HAND HYGIENE

IDENTIFY THE PT TO MAKE SURE YOU HAVE THE RIGHT

PATIENT
ASK THE PT FOR CONSENT WHEN WE ARE TO EXPOSE
THEIR ABDOMEN TO GAIN ACCESS ON THEIR STOMA

PLACE THE PT IN A COMFORTABLE POSITION FOR THEM

APPLY THE IRRIGATION SLEEVE TO THE STOMA

PLACE THE BEDPAN UNDER THE END OF THE IRRIGATION
SHEATH OR SLEEVE FOR DRAINAGE

GET THE IRRIGATION BAG AND ADD OR PUT THE

IRRIGATION SOLUTION FOR ABOUT HALF A LITER OR 500
ML

THE SOLUTION SHOULD NOT BE TOO COLD OR TOO HOT;

IT SHOULD BE IN ROOM TEMPERATURE TO AVOID
ABDOMINAL CRAMPING; THEN HANG THE IRRIGATION
BAG ON TO THE POLE

NOW, OPEN THE FLOW METER TO RUN THE IRRIGATION

SOLUTION ON THE TUBING TO AVOID THE PRESENCE OF
AIR IN THE TUBING AND TO CHECK FOR ITS PATENCY. LET
SOME OF THE IRRIGATING SOLUTION DRAIN IN TO THE
BED PAN TO FULLY FILL THE IRRIGATING TUBING
WE DO THIS STEP TO PREVENT INSERTING AIR INTO THE
PATIENT’S GI SYSTEM BECAUSE IT MAY CAUSE
IRRITATION

APPLY LUBRICATION TO THE CONE SO WE COULD EASILY

INSERT I TOT THE STOMA

INSERT THE COME TO THE STOMA

OPEN THE FLOW RATE REGULATOR SLOWLY

HOLD THE CORE BETWEEN 5 TO 10 MINUTES AS LONG AS

ALL THE IRRIGATION SOLUTION IS ADMINISTERED

SLOWLY WAIT FOR 10 SECONDS BEFORE PULLING OUT

THE CONE INTO THE STOMA
DRY, ROLL AND CLIP THE BOTTOM OF THE SLEEVE UP
INTO THE STOMA BUT ALLOWING A FEW INCHES TO
HAVE CONSIDERABLE AND ENOUGH SPACE FOR THE
EFFLUENT TO FILL

WE MAY NOW INSTRUCT THE CLIENT FOR 30-45 MINUTES

TO PROMOTE PERISTALSIS

AFTER THE PT HAS FINISHED WALKING FOR 30-45

MINUTES AS TOLERATED, WE’RE NOW GOING TO
UNWRAP THE IRRIGATION SLEEVE OR AND UNCLIP THE
END OF THE SLEEVE TO LET THE EFFLUENT DRAIN INTO
THE BED PAN

AFTER DRAINING ALL THE EFFLUENT, REMOVE THE

IRRIGATION SLEEVE

CLEAN THE STOMA AROUND THE AREA WITH WATER

AND MILD SOAP
DISCARD ALL THE MATERIALS USED TO PROPER DISPOSAL
AND REMOVE THE GLOVES

PERFORM HAND HYGIENE

ASK FOR THE PATIENT EXPERIENCE OR FEELING WITH THE

PROCEDURE

PLACE THE PT AGAIN IN THEIR COMFORTABLE POSITION

DOCUMENT WHAT HAS BEEN DONE

AFTER IRRIGATING, WE MAY NOW PROCEED WITH

CHANGING THE OSTOMY BAG OF THE PATIENT

INTRODUCE SELF AND EXPLAIN THE PROCEDURE

GATHER THE MATERIALS NEEDED

PEFORM HAND HYGEINE

IDENTIFY PT

PLACE PT IN COMFORTABLE POSITION

PUT ON GLOVES
PLACE PAD UNDER THE STOMA BAG

REMOVE ALL THE DRAIN

OPEN THE COLOSTOMY BAG AND COLLECT ALL THE

EFFLUENT ON THE KIDNEY BASIN/BED PAN

SLOWLY REMOVE THE BAG AND DISCARD IT PROPERLY

REMOVE ANY FECES THAT IS ON THE STOMA

IF YOU FEEL ANY PAIN, JUST LET ME NOW

OBSREVE THE APPEARANCE OF THE STOMA

CLEAN THE STOMA WITH WARM WATER

TAKE A DRY COTOON TO DRY THE STOMA

GET TEMPLATE TO MEASURE COLOSTOMY/STOMA

USE PEN TO TRACE THE APPROPRIATE SIZE AND CUT IT

PLACE THE NEW APPLIANCE IN TO THE STOMA

REMOVE THE TOWEL OR PAD

ASK FOR ANY DISCOMFORT

PLACE PT IN COMFORTABLE POSITION AGAIN

REMOVE GLOVES

HAND HYGEINE

FINISHED CHANGE
DISCARD ALL

DOCUMENT
BYE BYE