Bowel Evaluation
UPDATED JULY 2023
Evaluate a resident’s overall status and risks for bowel incontinence with Briggs Bowel Evaluation form. Use this form to document:
• | Contributing Factors/Conditions |
• | Mental, Functional, Vision and Hearing Status |
• | Usual Elimination Pattern |
• | History |
• | Enema/Laxative Use |
• | Medication Regimen |
• | Hydration |
• | Eating Habits |
• | Environmental Factors that Facilitate Resident's Toileting Ability |
• | Environmental Factors that Restrict Resident's Toileting Ability |
• | Evaluation for Bowel Training Potential |
• | Clinician notes/comments |
• Size: 8 ½” x 11”
• Prints 2-sides, black ink
• 5-hole punched top and side
• 100 per pad