Digital Rectal Exam

Introduces self	0	1
Confirms name & age of patient	0	1
Explains & gains consent	0	1
Arranges chaperone, closes curtains/sign/locks door	0	1
Washes hands	0	1
Gathers equipment (tissues, gloves, lubricant) and wears gloves	0	1
Positions patient correctly (lie on left, knees drawn to their chest)	0	1
Exposes patient correctly maintaining dignity	0	1
Asks if patient is in pain	0	1
Lifts cheek & inspects for skin tags, haemorrhoids, fissures, fistulae, ulcers, warts	0	1
Lubricates index finger	0	1
Warns patient before insertion. Inserts finger in correct position asking patient to breathe deeply	0	1
Checks anal tone and asks patient to bear down	0	1
Sweeps clockwise and anticlockwise checking for masses, polyps, faeces, ulcers	0	1
Feels for prostate (midline groove, size, consistency, symmetry)	0	1
Examines examining finger for faeces (commenting on colour), blood, mucus	0	1
Cleans off lubricant and disposes of gloves correctly	0	1
Thanks patient and offers tissues and help to redress	0	1
Washes hands	0	1
Requests abdominal exam and examination of sensation to perianal area	0	1
Summarises appropriately with only key findings	0	1
Offer appropriate differential diagnoses.	0	1
Patient global score	0	1	2

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