PIEDMONT ACCESS TO HEALTH SERVICES, INC.

Policy Number: 01-10-010

SUBJECT: Pelvic & Rectal Exams

EFFECTIVE DATE: 3/2010

REVIEWED/REVISED: 01/19/2011, 05/29/2012, 08/22/2013, 10/24/2014, 05/16/2016, 03/06/2017

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PROCEDURE:

1. Assemble equipment/materials:

A. For PAP

a. Vaginal speculum (large, medium or small) for pelvic exam

b. Gloves, appropriate size for provider

c. Lubricant (K-Y jelly)

d. Cervical brush

e. Liquid PAP containers

f. Pap Light

g. Normal saline and/or KOH as needed as well as two glass slides

h. Appropriate lab forms

i. Sufficient labels for specimens and forms

B. For rectal:

a. Gloves, appropriate size for provider

b. Lubricant (K-Y jelly)

c. Occult Blood Card/Test Bottle

2. Place patient in Sims position for PAP or place patient on side and slide knee to chest for rectal exam

3. The nurse should wear gloves while assisting with a pelvic or rectal exam

4. Rinse speculum in warm water or lubricate (provider preference) prior to examination for patient comfort.

5. Adjust light as needed.

6. Assist provider in obtaining needed specimens by holding the equipment needed ready for use.

7. A female staff member stays with patient during pelvic examine for all providers.

8. Provide patient with materials necessary for patient to clean self

9. Take all lab specimens to lab

a. with appropriate slips filled out

b. Patient labels in place

c. Maintain universal precautions

10. For rectal exam

a. assist with obtaining specimens

b. take hemoccult slide to lab for developing

11. Discard gloves, drape, and all disposable appropriately

12. Clean room

13. Replace equipment

SIGNATURES:

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Chief Medical Officer Date

______/ ___ /______

Chief Clinical Officer Date

01-10-010 Pelvic and Rectal Exams

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