What is the best position for the bed when a client uses a bedpan?

Proper patient positioning is clinically proven to reduce discomfort and promote natural bodily functions. When caring for a bedridden individual, knowing what is the best position for the bed when a client uses a bedpan is a vital skill that ensures both dignity and efficiency.

Quick Summary

The most effective and comfortable position for a client on a bedpan is a semi-sitting position with the head of the bed raised to 30-45 degrees, simulating a normal seated posture for easier elimination. This modified Fowler's position is ideal unless medically contraindicated.

Key Points

• Modified Fowler's Position: The ideal position for bedpan use is a 30-45 degree elevation of the head, known as modified Fowler's.

• Pre-Use Preparation: Raise the bed to a safe working height for the caregiver and ensure privacy and all necessary supplies are ready before starting.

• Placement Varies by Mobility: The bedpan is placed differently depending on whether the client can lift their hips or must be rolled to their side.

• Fracture Pans: For clients with hip or spinal issues, a flatter fracture pan with the handle toward the feet is the correct choice.

• Gentle Removal: After use, lower the head of the bed to a flat position before gently removing the bedpan to prevent spills and discomfort.

• Prioritize Dignity: Always prioritize the client's privacy, comfort, and independence throughout the entire procedure.

The Importance of Proper Positioning

Proper positioning is more than just a matter of comfort; it's a critical component of dignified and effective care. For a client using a bedpan, achieving the correct angle reduces physical strain on the body and utilizes gravity to aid the elimination process. A flat position is unnatural and can lead to difficulties, spills, and discomfort. The correct semi-sitting or modified Fowler's position mimics the natural posture used on a toilet, which is why it is the standard recommendation.

The Step-by-Step Bedpan Procedure

Preparation and Privacy

Before beginning, gather all necessary supplies: gloves, a bedpan (standard or fracture), a protective pad, toilet tissue, and a washcloth and soap. Explain the procedure to the client to gain their cooperation and trust. Ensure their privacy by closing the door or drawing the curtains.

Placing the Bedpan: Technique Depends on Mobility

The method for placing the bedpan depends on the client's ability to assist. Ensure the bed is raised to a comfortable working height for the caregiver and that the bed's wheels are locked.

Technique for clients who can lift their hips

1. With the bed flat, ask the client to bend their knees and place their feet flat on the mattress.
2. Instruct them to lift their hips up on the count of three.
3. Gently slide the protective pad and the bedpan underneath their buttocks, making sure it is centered.
4. Once in place, assist the client in lowering their hips back down onto the bedpan.

Technique for clients who cannot lift their hips

1. Help the client roll onto their side, facing away from you. A side rail can provide a secure handhold.
2. Place the protective pad and then the bedpan firmly against their buttocks, pushing it slightly into the mattress.
3. Hold the bedpan securely in place as you assist the client in rolling back onto their back, centered over the pan.

The Best Position for Use: Modified Fowler's

Once the bedpan is correctly positioned, raise the head of the bed to a 30-45 degree angle. This modified Fowler's position allows the client to assume a more natural sitting posture, using gravity to help with elimination. Ensure the client is comfortable and provide them with the call bell and toilet tissue, allowing for privacy.

Comparison of Bedpan Techniques

Feature	Client Lifts Hips	Client Cannot Lift Hips
Best For	Mobile or moderately mobile clients	Frail, immobile, or post-surgical clients
Caregiver Effort	Minimal lifting required	More physical assistance needed
Patient Involvement	Actively assists in the process	Primarily passive, guided by caregiver
Positioning	Places bedpan while client lifts	Places bedpan while client is on side

Fracture Pan vs. Standard Bedpan

Fracture pan positioning

A fracture bedpan is flatter and has a tapered, smooth front edge, making it suitable for clients with hip injuries, spinal problems, or other conditions that prevent them from lifting their hips. When positioning, the flat, shallow end of the fracture pan should be placed under the client's buttocks, with the handle pointing towards the foot of the bed.

Standard bedpan positioning

The standard bedpan is larger with a higher rim. It is more suitable for clients who have better mobility and can assist with lifting their hips. The wider, rounded end of the bedpan should be positioned under the client's buttocks, with the flatter portion towards their head.

After the Bedpan is Used

When the client has finished, return to the room and provide a damp cloth or wipe for hand hygiene. Before removing the bedpan, lower the head of the bed slowly back to a flat position. This prevents spills and makes removal easier and safer. When removing, follow the same method used for placement (either lifting or rolling). Cover the bedpan and empty it promptly.

Ensuring Dignity and Comfort

Always prioritize the client's privacy and dignity throughout the process. Offer a washcloth and towel for the client to clean their perineal area if they are able, or provide assistance as needed. Ensure the bed linens are clean and dry before leaving the client comfortable. Providing gentle reassurance and maintaining a respectful tone can help ease any potential embarrassment.

Training and Resources

For caregivers seeking more in-depth training on patient care techniques, there are numerous reliable resources available. For comprehensive training videos and best practice guidelines, consult authoritative medical sites. The National Institute on Aging is one such resource offering robust information for caregivers.

Conclusion

Understanding what is the best position for the bed when a client uses a bedpan is fundamental to providing safe and compassionate care. By using the modified Fowler's position after initial placement, caregivers can facilitate the most natural and comfortable experience for the client. Combining the right technique with a respectful, patient approach ensures the process is as smooth and dignified as possible for everyone involved.

Frequently Asked Questions

What is the best bed position for a client using a bedpan?

The best position is the modified Fowler's, which involves raising the head of the bed to a 30-45 degree angle. This semi-seated position uses gravity to assist with elimination, making the process easier and more comfortable for the client.

Why can't a client use a bedpan while lying completely flat?

Using a bedpan while flat is awkward and can be painful. It forces the body into an unnatural posture, which is not conducive to proper elimination and can increase the risk of spills. The modified Fowler's position is far more natural and effective.

Should I position the client before or after placing the bedpan?

You should place the bedpan before raising the head of the bed. After the bedpan is securely positioned under the client, then raise the head of the bed to the modified Fowler's position. This technique prevents spills and unnecessary movement.

How do you place a bedpan under a client who cannot lift their hips?

For clients who cannot lift their hips, have them roll gently onto their side. Place the bedpan firmly against their buttocks and tuck it into the mattress. While holding the bedpan in place, help them roll back onto their back and onto the pan.

What is a fracture bedpan and when should it be used?

A fracture bedpan is flatter and has a tapered edge, designed for individuals with hip fractures, back injuries, or other conditions that prevent them from lifting their hips. Its low profile makes it easier and less painful to position.

How do you ensure proper bedpan placement?

To ensure proper placement, first identify the correct type of bedpan for the client's needs. Whether lifting or rolling, center the bedpan correctly under the buttocks. For a standard pan, the wider end goes under the hips. For a fracture pan, the flatter end goes under the hips.

What is the most important step after the client is finished using the bedpan?

The most important steps after use are lowering the head of the bed to a flat position before removing the bedpan, ensuring the client's perineal area is clean, and allowing them to wash their hands. This promotes both safety and good hygiene.