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H0600: Bowel Patterns

H0600: Bowel Patterns

 

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Item Rationale

 

DEFINITION

CONSTIPATION

If the resident has two or fewer bowel movements during the 7-day look-back period or if for most bowel movements their stool is hard and difficult for them to pass (no matter what the frequency of bowel movements).

Health-related Quality of Life

Severe constipation can cause abdominal pain, anorexia, vomiting, bowel incontinence, and delirium.

If unaddressed, constipation can lead to fecal impaction.

Planning for Care

This item identifies residents who may need further evaluation of and intervention on bowel habits.

Constipation may be a manifestation of serious conditions such as

dehydration due to a medical condition or inadequate access to and intake of fluid, and

side effects of medications.

 

 

DEFINITION

FECAL IMPACTION

A large mass of dry, hard stool that can develop in the rectum due to chronic

constipation. This mass may

be so hard that the resident is unable to move it from the rectum. Watery stool from higher in the bowel or irritation from the impaction may move around the mass and leak out, causing soiling, often a sign of a fecal impaction.

Steps for Assessment

Review the medical record for bowel records or flow sheets, nursing assessments and progress notes, physician history and physical examination to determine if the resident has had problems with constipation during the 7- day look-back period.

Residents who are capable of reliably reporting their continence and bowel habits should be interviewed. Speak with family members or significant others if the resident is unable to report on bowel habits.

Ask direct care staff who routinely work with the resident on all shifts about problems with constipation.

 

 

Coding Instructions

Code 0, no: if the resident shows no signs of constipation during the look-back period.

Code 1, yes: if the resident shows signs of constipation during the look-back period.

Coding Tips and Special Populations

Fecal impaction is caused by chronic constipation. Fecal impaction is not synonymous with constipation.

 

 

 

 

 

 

 

 

 

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