Bowel Chart Template printable pdf download

Bowel Chart Template

BOWEL CHART

Name: _____________________________ DOB: __________ Month: _______________ Year: 20_____

REFER TO BOWEL MANAGEMENT PLAN AND MEDICATION ORDERS FOR CLIENT

Time

NIGHT

Comments

Supps

Date

Day

Amount

Signed

Amount

Signed

Amou

Signed

Consistency

Colour

Odour

Enema

given

KEY:

Day:

Enter the number of days since bowels last open

Amount:

NIL = no bowel movement SBO = smaller than an orange (Smear is also to be noted)

BO = the size of an orange BWO = larger than an orange

If suppository or enema given: Tick the relevant column and ALSO record on medica6on sign of

Staf sign of:

Put your inials under the relevant shif

Comments:

Consistency (loose, sof, !rm, hard, dry, pebbles). Colour (pale, yellow, brown, green, black)

Odour (faecal{usual}, foul, sweet)

Bowel Chart Template