• Bowel Management Policy

Process - Step by Step 

• This process guides supporting clients in managing their bowels. A healthy bowel is integral to promoting a person's overall health. All staff supporting clients must demonstrate competence in bowel care assessment and intervention.
• While supporting clients with bowel care, our goals are:
  • normal elimination
  • regular defecation habits
  • achieving comfort
  • maintaining skin Integrity
  • accurate recording and reporting if needed.

• Bowel continence and function assessment is part of a holistic client assessment carried out during the initial client assessment and entry process.
• During entry and planning meetings, clients will be assessed and consulted on whether active bowel management is required. 
• Those who require bowel management will be involved in developing a management plan tailored for the individual client.

• Ongoing bowel management includes:
  • maintaining good hygiene
  • ensuring easy access to toilets, commode chairs, hoist equipment
  • encouraging each client to move their bowels at a regular time that is most appropriate to the individual
  • allowing client privacy, respect and dignity
  • Record details of each bowel movement in the client’s bowel management chart (daily)
  • reviewing bowel management charts (monthly or more often if required)
  • reviewing bowel management plans (quarterly or more often if required) and
  • Where required, the implementation of bowel movement monitoring through the creation and implementation of a client-specific Bristol Stool Chart

• Where appropriate, examine by palpation of the abdomen or inquire if the client has signs and symptoms of:
  • Discomfort or abdominal cramping
  • Abdominal distension, tenderness or rigidity
  • bowel sounds
  • flatulence.

• Yes 
  • Constipation - Step 4
  • Diarrhoea - Step 5
  • Faecal incontinence - Step 6
• No
  • No regular bowel movements at this time

• When a client experiences constipation:
  • Ensure the client is drinking enough water—increase fluids during hot weather or increase physical activity
  • Review the client’s daily activities—increase physical activity if possible
  • Review the client's diet.
• For chronic constipation, a health practitioner may suggest one or more of the following:
  • Administer stool softener tablets or bowel stimulants
  • Administer an enema
  • Administer a glycerol suppository
  • Collect a stool sample for pathology testing.

• When a client experiences diarrhoea:
  • Ensure the person stays hydrated by drinking extra fluids
  • Seek medical attention if diarrhoea is ongoing, i.e. more than a day.

• If a client suffers faecal incontinence:
  • Manage the symptoms while promoting good hygiene, e.g. promptly changing soiled underwear, washing skin that has come in contact with faecal matter
  • Review the client’s diet—avoid foods that may worsen symptoms, e.g. caffeine, spicy foods or anything else that may make it worse
  • if constipation is experienced, follow constipation interventions.

• Promptly seek medical attention if a client is experiencing:
  • vomiting blood or faecal matter
  • diarrhoea and/or vomiting that is more than a one-off event
  • bleeding from the bowel
  • fresh (red) or old (black) blood in faeces (note: a person may also have black faeces when taking iron supplements)
  • unusual pain before, during or after a bowel action
  • constipation not resolved by medication.

• Yes - Step 8
• No - End

• Contact a medical practitioner, take the client to the hospital, or if severe, call an ambulance.