BOWEL MANAGEMENT-LEVEL OF ASSISTANCE

Let's talk bowels, seems to be the Rehab RN's favorite subject. :)

BOWEL MANAGEMENT - Level of Assistance: Bowel Management - Level of Assistance includes use of equipment or agents for bowel management. 

NO HELPER

7 Complete Independence—The patient controls bowels completely and intentionally without equipment or devices, and does not have any bowel accidents.

6 Modified Independence—The patient requires a bedpan, bedside commode, digital stimulation or stool softeners, suppositories, laxatives (other than natural laxatives like prunes), or enemas on a regular basis; alternately, the patient uses other medications for control. If the individual has a colostomy, (s)he maintains it.

HELPER

5 Supervision or Setup—The patient has required supervision (e.g., standing by, cueing, or coaxing) or setup of equipment necessary for the individual to maintain either a satisfactory excretory pattern or ostomy device. 

4 Minimal Contact Assistance—Patient requires minimal contact assistance to maintain a satisfactory excretory pattern by using suppositories, enemas, or an external device. Patient performs 75% or more of bowel management.

3 Moderate Assistance—The patient requires moderate assistance to maintain a satisfactory excretory pattern by using suppositories, enemas, or an external device. The patient performs 50 to 74% of bowel management tasks.

2 Maximal Assistance—Patient performs 25-49% of bowel management tasks.

1 Total Assistance—Patient performs less than 25% of bowel management tasks.

COMMENT: The functional goal of bowel management is to open the anal sphincter only when needed and to keep it closed the rest of the time. This may require devices, medications (agents), or assistance in some individuals. This item deals with the level of assistance required to complete bowel management tasks.