Rectal tubes, often part of a Fecal Management System (FMS), are used for temporary fecal diversion and containment, particularly for patients with severe diarrhea or liquid stool incontinence. This system helps protect the skin from breakdown and prevents the spread of infection by collecting waste in a sealed external bag. Regular changing of the collection bag is necessary to maintain proper hygiene, prevent bag overfilling, and ensure the system functions correctly.
Preparation and Necessary Supplies
Begin the process by performing thorough hand hygiene, washing hands with soap and water before gathering supplies. You will need a clean, new collection bag, non-sterile gloves, a protective pad or “chux,” and a disposal container or biohazard bag for the soiled materials. It is helpful to have antiseptic wipes or cleaning solution available, depending on the facility’s protocol. Before donning gloves, ensure the replacement collection bag is within easy reach and the protective pad is placed underneath the catheter connection site to contain any potential spills. Patient positioning can also aid the process, often involving a left side-lying position with the hips slightly flexed, which provides better access and comfort for the patient.
Step-by-Step Procedure for Changing the Bag
The bag exchange involves stabilizing the catheter and preparing the soiled bag for detachment. If the old bag contains significant stool, drain it first to prevent spillage. Put on non-sterile gloves and carefully rest the elbow bag connector on the protective pad.
Focus on the connection point, which is typically a snap or twist-lock mechanism. Gently unsnap or twist the soiled pouch away from the catheter connector, keeping the connector stable to avoid pulling on the rectal tube. Immediately snap the dedicated cap onto the opening of the soiled pouch to contain the collected stool and minimize odor exposure.
Take the clean, replacement collection bag and align its connector with the elbow bag connector remaining attached to the rectal tube. Firmly snap or twist the clean pouch onto the catheter connector, ensuring a tight seal is achieved.
Check the connection by gently tugging to confirm the bag is securely fastened, preventing accidental detachment and leakage. Adjust the entire unit so the bag is positioned lower than the patient’s rectum to allow gravity to facilitate proper drainage.
Post-Procedure Care and Waste Disposal
After attaching the new collection bag, assess and clean the area around the rectal tube insertion site. Gently clean the skin around the anus using a mild cleanser and protective barrier product, as small amounts of seepage are expected and can cause skin irritation. Confirm that the catheter tubing is lying smoothly along the patient’s body without kinks, twists, or external pressure that could obstruct the flow of stool.
The new collection bag must be hung from the bedside frame using its strap, ensuring it remains below the level of the patient’s rectum to promote continuous drainage. The used collection bag, now sealed with its cap, and all soiled materials, including gloves and the protective pad, must be disposed of safely. Place the used materials into a designated biohazard bag or follow the institution’s protocol for medical waste disposal.
Identifying Complications and Urgent Care
Caregivers should observe the patient and the system for signs that indicate a complication or malfunction. Persistent leakage of stool around the catheter, even after a bag change, may suggest improper balloon placement or poor skin integrity. Look for signs of local skin breakdown, redness, or irritation near the insertion site, which requires attention.
Other indications include a sudden obstruction of the flow, caused by a kink in the tubing or a blockage from solid fecal particles. If the patient develops a fever, experiences severe abdominal pain or cramping, or if any bleeding is observed from the rectum, a healthcare professional must be notified immediately.