FLEET ENEMA

Name:________________________________________________________Grade:__________________

Year and Section:_____________________ ___________Date:___________________________

Legend:
1- Excellent
2- Very Satisfactory
3- Satisfactory
4- Needs Improvement
5- Poor
PROCEDURE RATIONALE 1 2 3 4 5
PLANNING
1. Before administering enema, determine that there is a
primary care provider’s order
2. Equipment:

2.1 Fleet Enema

2.2 Disposable linen-saver pad/incontinent pad

2.3 bath blanket

2.4 clean gloves

2.5 bedpan or commode

2.6 water-soluble lubricant

2.7 paper towel

IMPLEMENTATION
3. Prior to performing the procedure, introduce yourself and
verify the client’s identity.

4. Perform hand hygiene. Wear clean gloves and observe

appropriate infection control procedure.

5. Provide privacy

6. Place the bedpan or commode in position for patient who

can’t ambulate to the toilet or have difficulty with sphincter
control.
7. Assist the client to the left lateral position with the right leg
as acutely flexed as possible.
8. Lubricate about 5cm (2inches) of the rectal tube. Some
commercially prepared enema set already have lubricated
nozzle.

9. Separate the buttocks and locate the rectum.

10. Instruct the patient that you will insert the nozzle and to
take a slow deep breath.
11. Insert the tube smoothly and slowly administer the
solution into the rectum directing towards the umbilicus.
12. Roll up the plastic container as the fluid is instilled.

13. Do after care.

14. Wash hands.

15. Document the procedure.

ATTITUDE

16. Accepts constructive suggestions and criticisms

17. Assume responsibility of his or her actions.

Scoring:

1x ____________ = __________

2x ____________ = __________

3x ____________ = __________

4x ____________ = __________

5x ____________ = __________

Total divided by no. of items = __________

Comments:
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_____________________________________________________________________________________
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Student’s Signature over Printed Name Clinical Instructor’s Signature and Date over

Printed name