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Digital Rectal Examination: Why, Who, How?


Author: Sharon Holroyd
 
JCN
Rectal interventions are a fundamental part of nursing care across all settings aimed at establishing whether effective bowel emptying is taking place. Functional bowel disorders, including constipation, are common conditions affecting many of the general population and often go undetected by both patients, who perceive it as their normal, and healthcare professionals, who may not include a thorough bowel assessment at every clinical contact due to time restraints, lack of knowledge, or fear of intimate procedures causing harm or embarrassment. An inaccurate or complete lack of appropriate bowel assessment can increase risk of harm or ill health for many patients and therefore should be an intrinsic part of everyday clinical contact. The Royal College of Nursing (RCN) recently reviewed its bowel care guidance (Fenton et al, 2019) to address some of the concerns around bowel assessment and management. With an ever changing workforce, multiple grades of registered and non-registered staff taking on additional tasks, it is prudent for all clinicians to review their current knowledge and practice to ensure that they are following the latest evidence-based guidance for safe and effective practice. 

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