Chapters Transcript Dignishield™ Stool Management System mm hmm. Mhm. Yeah. Okay. Hello and welcome to the dignity shield stool management system. Training video as caregivers. We are faced with many challenges in the hospital environment. Our patient population is aging and acuity is increasing because of heightened concerns about healthcare associated infections and antibiotic resistant organisms. There is growing emphasis on infection control protocols and strategies. All of these challenges result in increased care demands. This video will provide training on the dignity shield stool management system, which has been designed to help manage issues related to fecal incontinence and diarrhea for bedridden patients. The bard dignity shield stool management system sMS with odor barrier properties is intended for fecal management by diverting and collecting liquid or semi liquid stool to minimize skin contact and bedridden patients and to provide access for the administration of medications dignity shield sms provides a number of benefits to enhance patient care in your I see you by diverting feces away from the patient's buttocks and perino area. It may help to reduce skin irritation and breakdown by containing stool in a closed system. It helps reduce the risk of exposure to potentially infectious microorganisms and may reduce environmental contamination. Using the dignity shield system can improve efficiency by reducing the time and staff required to manage fecal incontinence in more traditional ways such as under pads or diapers. This also helps to maintain patient dignity. The front label of the dignity shield system includes patient selection parameters and contraindications which assist in confirming proper utilization and patient selection before opening the product. To use the device. First remove the dignity shield from the exterior packaging. Please note this is not a sterile product. There is no need to store in a sterile environment. The dignity shield stool management system contains a number of components, documentation stickers, a patient, family education flyer and extended care information flyer with daily care and maintenance instructions as well as directions for use the fecal catheter, A tube clamp the fecal collection bag, A 60 CC Lure Lock Syringe a lubrication syringe instructions for use, Medicare biological odor eliminator and a quick reference guide for insertion and medication delivery. The dignity shield catheter consists of a low pressure inflatable contoured cuff, which is designed to conform to patient anatomy and facilitate seating. An anti twist tube constructed from proprietary perm align technology, which is designed to improve drainage and minimize odor. A green inflation ports, allows for easy inflation with a pilot balloon to provide guidance on cuff pressure. A purple flush sport designed to improve drainage and reduce maintenance by evenly dispersing water through the entire length of the catheter. A clear irrigation ports designed to decrease cuff obstructions by infusing water directly into the bow and to allow for administration of medication. A sample report provides closed system access for fecal sample collection and a self locking connector at the distal end of the catheter is designed to help maintain a closed system along with a self sealing collection bag to set up the system, attach the collection bag to the catheter by inserting the socket connector into the collection bag hub. Note that the self locking valve connector and self sealing bag hub are designed to maintain a closed system and minimize contact with stool. When the bag is replaced. The catheter should be completely unfolded and the collection bag should be extended toward the end of the bed. Prior to patient preparation. A rectal exam should be performed to ensure the patient does not have fecal compaction position the patient on his or her side with their knees tucked to their chest in the fetal position, attach a depressed syringe to the green inflation Report, ensure removal of any air which has been trapped in the cuff or tubing by pulling on the syringe plunger, Detach The Syringe and fill with 45 ml of water. Next reattach the filled syringe to the green inflation report. To insert the catheter, the cuff must be folded first, flatten the cuff, holding the left point of the cuff between your thumb and index finger Fold the top right point of the cuff down and to the left at a 45 degree angle. This will create a cone shape which will allow for easy insertion generously coat the Parrino area with lubricating jelly from the lubrication syringe, gently insert the cuff through the anal sphincter until the cuff is beyond the external orifice and as well inside the rectal vault. Once the cuff is inserted, you should inflate it. Slowly depress the syringe plunger on the inflation. report, the inflation report has an external pilot balloon which should be used as a guide to determine proper cuff inflation. As the cuff inflates the pilot balloon also inflates. Once all of the water is infused into the cuff, remove the syringe gently pull on the catheter to check that the cuff is secure in the rectum and that it is positioned against the rectal floor. Roll the patient onto their back and position the length of the flexible catheter along the patient's leg. Take note of the position indicator line as a means to measure movement of the device in the patient's rectum, ideally. The catheter should be placed between the legs and not over or under them. To avoid catheter obstruction. Make sure there are no kinks in the catheter and that it is fully extended. Complete the insertion date label located near the piston valve connector, or add the orange insertion date sticker using the hook or cord. Hang the bag at a convenient location at the foot of the bed or on the bedside. Place the bag below the level of the patient's rectum as the patient's bow fills with fecal matter stool is diverted directly down the cuff into the catheter for improved drainage as stool drains down through the catheter. Bards proprietary Permal in polymer tubing helps minimize blockages and reduces odor stools should freely flow through the catheter into the collection bag. However, in the event that the cuff becomes obstructed the patient's bowel can be irrigated by filling a syringe with water and attaching it to the clear irrigation ports, depress the syringe plunger to irrigate the bow, repeat as often as needed to clear the obstruction, ensure that water drains If the catheter itself needs to be flushed, attach a syringe filled with water to the purple flush ports and depress the plunger if repeated, flushing with the water does not return the flow of stool through the catheter and an obstruction of the device is detected. Use of the device should be discontinued. The dignity shield systems, innovative flush mechanism disperses water throughout the entire length of the tube. The system is designed to improve drainage and maintain an unobstructed flow of stool into the collection bag. To obtain a stool sample, remove the white cap from the sample ports, gently kink the catheter segment between the piston valve connector and sample ports, tilt or milk the catheter to collect fecal matter around the sample ports, insert a slip tip syringe into the sample ports, valve and draw the appropriate sample of fecal matter into the syringe, secure the white cap back onto the sample ports to remove the collection bag, grab the piston valve connector and gently pull backward on the switch located on the slide of the connector until the piston ejects from the collection bag hub, the piston valve and bag hub should close off automatically in this process. To minimize inadvertent exposure to feces. Once the bag is removed, insert the bag cap into the hub connector and dispose of the collection bag in accordance with institutional protocol for disposal of medical waste. Closing the bag not only minimizes spillage, but also reduces contact with potentially infectious microorganisms. If possible, remove the bag from the patient room to eliminate odor. Date the new collection bag and replace it by securely snapping a new bag to the connector. The dignity shield SMS can also be used to provide access for the administration of liquid rectal medications medication is delivered through the clear irrigation ports and then the tubing clamp to allow medication to be retained for the prescribed dwell time. First gather the supplies a syringe filled with the prescribed amount of medication. one empty water syringe a container of room temperature water and the tube clamp that is provided with the product position the patient according to your facilities protocol for rectal medication delivery, locate the clear irrigation ports and confirmed the line is clear by attaching a leur lock syringe to the ports and flushing the system with water. Address any leakage around the cuff prior to moving forward if present, locate the tube clamp that comes pre attached to the piston valve hanger string. Place it near the patient, attach a leur lock syringe with the medication to be delivered dosage as indicated and as prescribed by the treating physician to the clear irrigation ports. Elevate the drainage tubing to facilitate medication retention and infuse the prescribed amount of medication To ensure delivery of medication into the rectum. Immediately flush the irrigation line with at least 10 ml of water or volume per physician's orders. Note that some medication will reside between the clamp and the device opening, slide the tube clamp onto the drainage tubing until the drainage tube contacts the hinge. Position the tube clamp as close to the patient's buttocks as possible without touching the patient's skin using two hands to facilitate ease of closure. Place thumb on thumb to snap the tube clamp shut, ensure the patient does not lie on the tube clamp. If the clamp is difficult to close or excessive leakage is observed. Reposition the tube clamp on the drainage tube, dispose of the syringe according to facility policy. After the prescribed dwell time, remove the clamp and re attached to the piston valve hanger string, verify unobstructed flow from the patient into the collection bag to remove the device. Slowly pull back on the plunger to withdraw all fluid from the retention cuff. Once the inflation report pilot balloon is completely flat, gently pull the catheter out of the patient's rectum if possible. Ask the patient to bear down to facilitate removal. Dispose of the used catheter according to hospital policy for contaminated waste the dignity shield systems, unique combination of features are designed to contain fecal matter and reduce odors, reduce risk of skin breakdown associated with a lack of fecal containment, helped to limit patient and nurse exposure to infectious microorganisms, improved nurse efficiency and maintain patient dignity by following the instructions of this video. Hopefully you will be able to more effectively manage these issues within the hospital environment. On behalf of Bard Medical, I would like to thank you for taking the time to listen to this training demonstration of the dignity shield stool management system. If you have any questions or require additional information, please contact your local area sales rep for ordering information, please contact 1 805 264455. Please consult product label and insert for any indications contra indications, hazards warnings and directions for use. Yeah. Mm hmm. Yeah. Yeah. Yeah. Mhm, mm hmm. Mhm. Yeah. Mm hmm, mm hmm. Mhm. Together. Bard dignity shield and Perm align our trademarks and or registered trademarks of C. R. Bard inc or an affiliate. All other trademarks are property of their respective owners. Created by
