Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Sample Bowel Elimination Record

The following chart has been revised to reflect the type of stool as defined by the Bristol Stool Form Scale: 

Patient/Client Name: ________________

  Date:
Nights Days Evenings
BM      
Time      
Continent      
Type (see Bristol Stool Form Scale)       
Amount      
Toilet      
Fluid Intake      
Fibre intake      
Treatment      
Referrals / Consults      
Total # of BMs      
# Episodes of constipation/fecal soiling      
Initials      

Legend

  • BM (Bowel Movement):  Enter time
  • Continent = Continent; I = Incontinent
  • Amount: S = small (< 250 ml); M = normal ( > 250 - < 500 ml); L =large ( > 500 ml); FO = oozing; FS = staining
  • Type: 1= seperate hard lumps, hard to pass; 2= sausage-shaped but lumpy; 3= like a sausage but with cracks on its surface; 4= like a sausage or snake, smooth and soft; 5= soft blobs with clear-cut edges; 6= fluffy pieces with ragged edges, passed easily, a mushy stool; 7= watery, no solid pieces, entirely liquid.
  • Toilet: T = toilet; C = commode; B = bedpan; SL = side lying
  • Fluid intake: Record actual amount consumed per shift. Calculate 24-hour intake.
  • Fibre intake: Record number of fibre items consumed.
  • Treatments: PRN laxatives, suppositories, enemas, rectal stimulation. Enter time treatment given and initials. Regularly prescribed laxatives are recorded on Medication Administration Record (MAR).
  • Referrals: D = Dietitian; NCA = Nurse Continence Advisor; OT = Occupational Therapy; P = Pharmacy; PT = Physiotherapy
  • Enter total # of BMs:
  • Enter total episodes of constipation/fecal soiling: