Norgineto Risk

Action take Assessment

when risk of Tool

for Constipation
constipation is identified
Medical Condition Toileting Facilities
The Norgine Risk Assessment Tool for Constipation was developed toBed
Cancer raisepan
awareness of a PATIENTS Advice if
THE BRISTOL STOOL
NAME FORM SCALE taking laxatives
patients risk of becoming constipated and to encourage proactive assessment and, if necessary,
Clinical depression Commode by bed in hospital/care
treatment. Healthcare professionals should monitor the risk assessmenthome/home
score and take reasonable Separate hard
Commence or
Diabetes
steps to reduce the score over time e.g. by increasing fluids, increasing fibre in diet, improving TYPE 1 lumps, like nuts Constipated
increase laxatives
Supervised use of lavatory/commode (hard to pass)
Haemorrhoids,
mobility, anal fissure, rectocele,
reducing polypharmacy etc. For patients with a Risk Assessment score greater than PATIENTS
local anal or rectal pathology Raised
4 ticks, it is recommended that the patient is fully assessed as outlined toilet seat,
in the check without foot stool
list below. DATE OF BIRTH
Sausage-shaped Commence or
TYPE 2 Constipated
History of constipation Mobility but lumpy increase laxatives
CH E C K L I S T Restricted to bed
Impaired cognition/dementia Like a sausage
PATIENTS Ideal stool Maintain
Complete full bowel assessment as per facility protocol
Multiple Sclerosis Restricted to wheelchair/chair TYPE 3 but with cracks
consistency laxative dose
RECORD
on its surface
Parkinsons disease Walks with aids/assistance NUMBER
Monitor and record bowel movements daily using the Bristol Stool Chart Like a sausage
and bowel record chart Walks short distances but less than Ideal stool Maintain
Post operative TYPE 4 or snake, smooth
consistency laxative dose
1/3 mile (0.5km) daily and soft
Stool type 1 orarthritis
Rheumatoid 2 prescribe appropriate laxative therapy
Nutritional Intake Soft blobs with
Decrease
Spinal on
Advise cord conditions
toileting position and establish regular toileting pattern At nutritional risk as identified byTYPE 5 clear-cut edges I N SSlightly
T R Utoo C Tsoft
I O N S laxative dose
local (passed easily)
(injury, disease or congenital)
nutritional screening tool
Review
Stroke medication including over the counter medicines 1. Fluffy
Tickpieces
all relevant
with categories in each table.
Fibre intake 6g or less per day1. TYPE 6 Decrease
ragged edges, a Too soft
laxative dose
Currentmobility
Advise on ways to improve Medication mushy stool
Difficulty in swallowing/chewing 2. There may be more than one tick in a table.
Aluminium antacids Needs assistance to eat Watery, no solid
Encourage patients to achieve at least minimum fluid intake TYPE 7 pieces ENTIRELY Too soft
Stop taking laxatives
Anticholinergics Daily Fluid Intake 3. LIQUID
ADD ALL THE TICKS TOGETHER.for a day or two
Improve nutrition according to nutritional intake score (see below for calculation table)

Antiparkinson drugs Reproduced by kind permission of Dr KW Heaton, Reader in Medicine at the University of Bristol.
In Antipsychotic from your continence advisor, doctor, clinical nurseMinimum
drugs
addition to advice specialist fluids not achieved 2000 Norgine Pharmaceuticals Ltd.4. Fill in the number of ticks in the box below.
or pharmacist,
Calcium
certain channel
associated blockers
risk factors may be addressed by referring a patient to a dietitian, speech and DAY 1 5. Date
2 and sign
3 4 5 6 7
language therapist,
Calcium supplementsoccupational therapist, dentist, podiatrist or physiotherapist.
Number of bowel
Diuretics about your local Continence Advisory Service can be found at the Fluid
Information Requirementmovements
Continence Calculation
today
Foundation web site: www.contfound.org.au 30mls fluid per 1kg of body weight 2.
Iron supplements D AT E T O TA L N O . S I G N AT U R E
Type of bowel OF TICKS
Non-steroidal anti-inflammatory drugs (NSAIDs) Patients minimum fluid intake should be: (see above)
movement
Opioids Weight in kg = x 30ml =
The Norgine
Tricyclic Risk Assessment Tool for Constipation was developed by Gayle Kyle, Senior Lecturer, Thames Valley University, (gayekyle@tiscali.co.uk), Terri Dunbar, Advanced Nurse Practitioner, Berkshire West
antidepressants
PCT and Phil Prynn, Continence Services Manager, Berkshire West PCTPatients actual
to encourage fluidcare
health intake is:
professionals to adopt a proactive approach to bowel care. If you wish to offer feedback and/or request more
Polypharmacy
copies of this risk(more than 5tool,
assessment drugs
please email rasst@norgine.com
including ones not on this list)
Supported by an educational grant from Norgine Pharmaceuticals Pty Limited. 2007 Norgine Pharmaceuticals Ltd. N-0301. Norgine is a registered trademark.
1. Australian NHMRC recommends adults consume 30g of fibre daily. 2. Ritz P(2001) Factors affecting energy amd macronutrient requirements in elderly people. Public Health Nutrition Vol 2. No.2B pp561-68
Action
Action to
to take
take when
when risk
risk of
of constipation
constipation isis identified
identified
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patients
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encourageproactive
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The Norgine Risk Assessment Tool for Constipation was developed to raise awareness increase
of increase
a laxatives
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4 4ticks,
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outlinedininthe
thecheck
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but
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steps to reduce the score over time e.g. by increasing fluids, increasing fibre in diet, improving
CHC HEECCKKLLI SI STT
mobility, reducing polypharmacy etc. For patients
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asausage
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recommended that the patient but
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fully with cracks
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assessed
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dose TYPE 2
ononitsitssurface
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andrecord
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usingthe
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and
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and
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andestablish
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minimumfluid
fluidintake
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TYPE7 7 including over the counter
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soft
Stop
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takinglaxatives
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forfora aday
dayorortwo
two TYPE 6
LIQUID
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nutritionaccording
accordingtotonutritional
nutritionalintake
intakescore
score Advise on ways to improve mobility
Reproduced
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permissionofofDrDrKW
KWHeaton,
Heaton,Reader
ReaderininMedicine
Medicineatatthe
theUniversity
UniversityofofBristol.
Bristol.
2000
2000Norgine
NorginePharmaceuticals
PharmaceuticalsLtd.
Ltd.
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The
TheNorgine
NorgineRisk RiskAssessment
AssessmentTool
ToolforforConstipation
Constipationwas
wasdeveloped
developedbybyGayle
GayleKyle,
Kyle,Senior
SeniorLecturer,
Lecturer,Thames
ThamesValley
ValleyUniversity,
University,(gayekyle@tiscali.co.uk),
(gayekyle@tiscali.co.uk),Terri
TerriDunbar,
Dunbar,Advanced
AdvancedNurseNursePractitioner,
Practitioner,Berkshire
BerkshireWest
West
Type of bowel
PCT
PCTandandPhil
PhilPrynn,
Prynn,Continence
ContinenceServices
ServicesManager,
Manager,Berkshire
BerkshireWest
WestPCT
PCTtotoencourage
encouragehealth
healthcare
careprofessionals
professionalstotoadopt
adopta aproactive
proactiveapproach
approachtotobowel
bowelcare.
care.If Ifyou
youwish
wishtotooffer
offerfeedback
feedbackand/or
and/orrequest
requestmore
more
movement (see
copies
copiesofofthis
thisrisk
riskassessment
assessmenttool,
tool,please emailrasst@norgine.com
pleaseemail rasst@norgine.com

Supported
Supportedbybyananeducational
educationalgrant
grantfrom
fromNorgine
NorginePharmaceuticals
PharmaceuticalsPty
PtyLimited.
Limited.2007
2007Norgine The Norgine
NorginePharmaceuticals
PharmaceuticalsLtd. Risk Assessment
Ltd.N-0301.
N-0301. NorgineisTool
Norgine for Constipation
isa aregistered
registered was developed by Gayle Kyle, Senior Lecturer, Thames Valley University
trademark.
trademark.
PCT and Phil Prynn, Continence Services Manager, Berkshire West PCT to encourage health care professionals to adopt a
copies of this risk assessment tool, please email rasst@norgine.com

Supported by an educational grant from Norgine Pharmaceuticals Pty Limited. 2007 Norgine Pharmaceuticals Ltd. N-0301. N