Evaluation for Bowel and Bladder Training Form

Evaluation for Bowel and Bladder Training form includes:

•Factors/Risks/Conditions Affecting Incontinence

•Current Medications

•Mental Status, Ability to Communicate, Hearing/Vision

•Mobility/Functional Status

•Previous B/B Training Program

•Clinical Prompts to Evaluate Current Bladder Status

•Clinical Prompts to Evaluate Current Bowel Status

•Documentation of Evaluation Results Including Resident/Representative Choice to Participate/Refuse Program

•Area for Clinical Comments

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