Suppository Administration

Suppositories: Medications administered by insertion into the rectum.

CSS Considerations

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  • A request to implement this task must be specifically stated in the client’s HPG/referral from the HCCSS.
  • Ensure a doctor’s order and prescription indicating the medication name and frequency has been received to administer the medication.
  • Verify that suppository administration has been part of the client’s routine for a minimum of 3 months with an established stable or predictable outcome.
  • The client’s condition must be stable with no hospitalizations for a minimum of 3 months. The client must be considered low risk with no immediate changes expected, and there should be a predictable outcome of the treatment.
  • If client is unwell or unable to direct care, the client is not eligible for PSW delegation as the risk level is increased and an assessment may be required.
  • Identify the client’s support systems and establish well-defined care needs and coping mechanisms.
  • The client or representative may direct their own care.
  • Ensure there is an ongoing assessment of the client’s condition and healthcare needs. Initiate a supervision plan to determine the ongoing effectiveness of the intervention.
  • The client must be in agreement to participate; the treatment should not be forced if the client is resisting.
  • Any concerns or complications encountered must be reported to the HCCSS CC and continuation with supporting the delegated task must be reassessed.
  • The client should have a visit at a minimum of 2 hours to allow the PSW sufficient time to complete a suppository delegation; connect with the HCCSS CC and Service Coordinator to ensure this happens.
  • A back-up plan needs to be in place. If the PSW is unable to provide the service, the client’s back-up plan is to be activated (i.e. family or contacts). Include this information in the client’s service plan.
  • Implement a plan with the client/family in the case that the suppository is not successful.
  • At this time, the Circle of Care Delegation Policy does not permit PSWs to administer suppositories for reasons other than an established bowel routine which is a part of client’s ADLs.

Risks Assessment

  • The activity and client response has been established over a 3 month period at minimum prior to delegation
  • There are identifiable negative outcomes that are easily recognized
  • There are no negative systemic effects
  • The client’s response to the procedure is predictable
  • The activity will be performed frequently enough by the PSW to maintain competence
  • Determine if there are any surrounding wounds or skin integrity issues that need to be protected during the procedure

PSW Considerations

  • Understands the reason for the procedure
  • Provide a brief explanation of the client’s related medical conditions
  • The extent of their responsibility in performing the procedure
    • Cannot insert a finger, hand, or instrument beyond 1.5-2 inches (about 3-5 cm)
    • Perform the task as taught by the CSS
    • Must report any abnormal outcomes/complications
    • Determine if there are any surrounding wounds or skin integrity issues that need to be protected during the procedure
  • Knows where to find the necessary supplies and materials
  • Confirm a designated spot to store supplies/materials (e.g. suppositories, lubricant, soaker pads etc.)
  • Knows the frequency at which the procedure must be performed
    • CSS must enter frequency details in the client’s care plan
    • PSW is responsible for checking the care plan daily and following the instructions provided
  • Knows when and who to ask for assistance
    • Phone the Circle of Care office at 416-635-2860 for immediate assistance and to provide a report about the client’s condition
    • Reach out to your CSS if you have questions or concerns about the suppository administration, the client’s condition, or need more training
  • Knows when, how, and who to report unexpected outcomes of the procedure to ensure the client understands the following:
    • Client and family are aware of PSW’s scope in administering the suppository
    • Client and family has a response plan in case of unexpected outcomes of the procedure
    • Client and family has a contingency plan in place
  • Understand side effects:
    • Abdominal pain such as cramps
    • Itchiness around the rectum
    • Rectal bleeding

Required Supplies

  • Suppository
  • Gloves
  • Soaker pads or extra towels
  • Bed pan or commode
  • Plastic apron or gown

Procedure for Suppository Administration

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Video Resource

Please click on the video link below for a visual demonstration of the procedure.