Administration of Suppository is a new skill added to NMC OSCE. Time limit for this station is 10 minutes. Moreover, this will be one of the six skills added in NMC OSCE from November 14, 2022. Thinking of how to perform this station? This article is your answer.

Administration of Suppository – Skills Station

There will be a manikin provided for the procedure and the examiner will be giving voice over for the patient,

Like any other skills performed in NMC OSCE, this skill can also be divided into three phases which are Introduction phase, Procedural phase and Post procedural phase. Lets see one by one

Introduction Phase

In this phase, you will

• Introduces self, explains procedure and gains consent.

(Hello, my name is Miss X and i am the nurse caring for you today, can i confirm you name please? What’s your date of birth? Confirms this with the id tag. Following this you need to tell the patient “I am here to administer the suppository prescribed by the doctor for your constipation issue”. Gains consent by asking “Is that ok with you? can i proceed?

• Ensures that a bedpan, commode or toilet is readily available or verbalise that “i have kept bedpan/commode/toilet (depends on scenario) ready to be used after the procedure”

Procedural Phase

• Dons a disposable plastic apron and non-sterile gloves.
• Verbalises that “i would request or assist the person to lie on their left lateral side with knees flexed, feet level or slightly raised, buttocks near to the edge of the bed” (This is because the manikin should not be moved into position for health and safety reasons).
• Places a disposable incontinence pad beneath the patient’s hips and buttocks.

ID Check/Medicine Check

• Before administering any prescribed drug, looks at the person’s prescription chart and checks that ALL of the following are correct:
  • person (checks ID with person: verbally, against wristband (where appropriate) and documentation)
  • drug
  • dose
  • date and time of administration
  • route and method of administration
  • diluent (as appropriate).
  • Asks patient if they have any allergies.

• Correctly checks ALL of the following:

  • validity of prescription
  • signature of prescriber
  • prescription is legible.
  If any of these pieces of information is missing, unclear or illegible, the nurse should not proceed with administration and should consult the prescriber.

• Prior to inserting the suppository, verbalise that you are observing the anal area for evidence of skin soreness, excoriation, swelling, haemorrhoids, rectal prolapse or infestation.
• Now, you place some lubricating jelly on a gauze square and lubricates the suppository. Separates the patient’s buttocks and inserts the suppository using the correct end (referring to the manufacturer’s instructions), advancing it approximately 2cm to 4cm. Repeats this procedure if additional suppositories are to be inserted.
• Post insertion, you need to ceans any excess lubricating jelly from the patient’s perineal and perianal areas using gauze squares.
• You will ask the patient to remain lying down and retain the suppository for about 20 minutes or until they are no longer able to do so. Also, Informs the patient that there may be some discharge as the medication melts in the rectum.
• Verbalises that you would assist the patient into a comfortable position and offers a bedpan, commode or toilet facilities, as appropriate.
• Maintains patient dignity: arranges the bedcovers to keep the patient covered as much as possible during the procedure and replaces patient’s bedclothes and covers once the suppository has been inserted.

Post Procedural Phase

• Disposes of waste appropriately and cleans any equipment used.
• Cleans hands with alcohol hand rub, or washes with soap and water, and dries with paper towels following WHO guidelines – verbalization accepted.
• Dates and signs medicines administration record.
• Reassures the person appropriately. Closes the interaction professionally and appropriately.

This one of the newly introduced 6 skills in NMC OSCE which is also said to be added from November 14 2022. Hopes this article helps you to pass this skill in NMC OSCE.