UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE
TITLE: Bowel Preparation/Instructions
Effective Date: February, 2005 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education
Reviewed Nov., 2007 May 2009 November 2011
PURPOSE: To provide guidelines for patients undergoing a bowel-prep at UWMF Clinics.
DEFINITION: A bowel-prep is used for the evacuation of the large colon prior to a diagnostic procedure or surgery.
POLICY: The clinical staff will utilize the following guidelines to instruct patients on the necessary steps for preparation
for a bowel-prep.
SUPPLIES: Provider’s order, Patient’s record, bowel prep medication/prescription,
Bowel-prep handout- either GoLytely Preparation for Surgery or Magnesium Citrate Preparation for Surgery
1. Check provider’s order for type of bowel prep and clarify any inconsistencies.
2. Check surgeon’s order for bowel prep on Preoperative Checklist.
3. Introduce yourself and identify the patient. Include date of birth. Verify allergies.
4. Review “Bowel Prep” handout with the patient.
5. Send the patient home with signed prescription and bowel prep handout.
6. Documentation (in Progress Notes section of HealthLink)
type of “bowel prep” instructions given
follow-up appointment (if any)
WRITTEN BY: Sarah C Schaefer, R.N., General Surgery Clinic
REVISED BY: Carol Decker, RN, MSN, Clinical Staff Education
REVIEWED BY: Kelly Meyer R.N., Department of General Surgery
Department of Surgery Date
Medical Director Date