Introduction (Use the acronym WIPER to prepare for the examination)
- W - Wash your hands
- I - Introduce yourself and confirm patient details
- P - Permission - gain consent to proceed with the examination, including explaining relevant details
- E - Expose the patient appropriately, gather Equipment
- R - Position the patient lying back at 45 degrees comfortably
- Positions correctly (lying on left side, fetal position with hips and knees flexed)
- Check patient is comfortable and aware of procedure
- Offer a chaperone and ensure total privacy - screen at the door
- Wash hands and don gloves and apply lubricating gel to index finger of gloves
- Gently parts buttocks and inspects for
- Skin tags, ulcers, abnormal growth
- Warts, fissures, fistulas
- External haemorrhoids and any bleeding
- Tells patient before inserting finger Inserts one lubricated finger into anus
- Examines sensation of the perianal skin
- Ask patient to 'bear down' and squeeze on finger to examine anal tone
- Explain need to feel
- Entire wall of rectum by moving finger 180 degrees in either direction:
- Polyps
- Lumps
- Faecal impaction/hard stool
- Prostate: Comments on:
- Size
- Symmetry
- Midline sulcus
- Texture
- Gently parts buttocks and inspects for
- Tell patient before removing finger
- Inspects glove of finger for melaena, mucus, fresh blood
- Dispose of gloves