How to clean up a patient who has pooped? A Guide for Dignified and Hygienic Care

According to MedlinePlus, proper skin care is crucial for individuals with incontinence to prevent infection and irritation. Understanding how to clean up a patient who has pooped? is an essential skill for any caregiver, ensuring comfort, dignity, and optimal hygiene for the person in your care.

Quick Summary

A successful cleanup involves gathering all necessary supplies beforehand, communicating with the patient to preserve their dignity, using proper rolling techniques to protect your back and their skin, and ensuring thorough cleansing and skin protection. Prioritizing hygiene and comfort is key to providing excellent care.

Key Points

• Prepare Fully: Gather all necessary supplies—gloves, wipes, pads, clean linens—before starting to ensure a smooth, quick process.

• Prioritize Dignity: Communicate with the patient throughout, explain your actions, and maintain their privacy to foster trust and respect.

• Use Safe Techniques: Employ proper rolling methods to safely position the patient, prevent injury to yourself, and protect the patient's skin.

• Cleanse Thoroughly and Gently: Always wipe from front to back using unscented products. Ensure the area is completely dry before applying protective cream.

• Protect the Skin: Apply a moisture-barrier cream to prevent skin breakdown, a common complication of incontinence, ensuring the skin is dry first.

• Maintain Environmental Hygiene: Promptly dispose of soiled materials and clean the surrounding area to manage odors and prevent infection.

Preparation is Key: Gather Your Supplies

Before you begin the cleanup process, a proper setup will make the task smoother, faster, and more dignified for the patient. Gather all items and place them within arm's reach. Rushing to find supplies mid-procedure can lead to unnecessary discomfort and anxiety.

Essential Cleanup Checklist

• Disposable gloves: Have multiple pairs readily available. Consider doubling up for extra protection during heavy soiling.
• Absorbent bed pads: At least two waterproof pads (e.g., Chux pads) to protect the bed linens. A soiled pad can be rolled up and removed easily.
• Incontinence wipes or washcloths: Unscented, alcohol-free wipes are best for sensitive skin. You can also use a washbasin with warm water and a few designated washcloths.
• Barrier cream: A moisture-barrier cream protects the patient's skin from breakdown caused by continued exposure to moisture.
• Soiled linen bag: A large plastic trash bag or designated hamper for soiled pads and clothes. Having it open and nearby minimizes mess.
• Clean linens and clothing: Fresh underwear, pads, bed sheets, and a clean gown for the patient.
• Deodorizer: A simple room spray can help neutralize odors, which can be a source of embarrassment for the patient.

The Step-by-Step Patient Cleanup Process

Step 1: Communication and Dignity

Always start by calmly explaining the process to the patient, even if they are non-verbal. Reassure them that you are there to help and that their privacy and dignity will be respected throughout the process. Close the door or pull the curtain to provide privacy.

Step 2: Position the Patient Safely

With the bed at a comfortable height to protect your back, put on your first pair of gloves. If the patient is on their back, roll them carefully to one side. You can have them hold onto a side rail for stability if they are able. Place a clean, disposable pad under them, tucking one side firmly beneath their back.

Step 3: Initial Bulk Cleaning

Using the soiled brief or a disposable cloth, gently scrape and remove as much of the stool as possible. For very loose or wet stool, use a dry wipe or disposable cloth first to gather the bulk before introducing moisture. This prevents smearing and makes the cleaning process more efficient. Dispose of all soiled items in your prepared trash bag.

Step 4: Thorough Cleansing

Use warm, wet wipes or a soapy washcloth to clean the area thoroughly. Always wipe from front to back to prevent the spread of bacteria and reduce the risk of urinary tract infections (UTIs). Clean all skin folds, creases, and around the genital area. Rinse with a clean, wet washcloth if using soap. Use a dry cloth to gently pat the skin completely dry, paying close attention to prevent friction.

Step 5: Apply Barrier Cream

Once the skin is clean and dry, apply a thin layer of barrier cream to any areas prone to irritation, such as the buttocks and perineum. This protective layer is crucial for preventing skin breakdown.

Step 6: Reposition and Repeat

Roll the patient gently onto their clean side, over the new pad. Reach under and pull the soiled pad and any dirty linens out from beneath them. Dispose of them immediately. Complete the cleaning process on the other side of the patient, ensuring all areas are addressed. Put on a new pair of gloves for this step.

Step 7: Final Adjustments

Help the patient roll onto their back. Position them comfortably and ensure all linens are smooth and secure. Change their gown if necessary. Adjust the bed's height and side rails as needed, and ensure the call light is within reach. Clean and disinfect all equipment and surfaces.

Comparison of Cleaning Methods

Feature	Disposable Wipes	Washbasin & Washcloths
Convenience	High. Ready to use, quick disposal.	Low. Requires preparing water, washing and sanitizing cloths.
Cost	Can be higher over time.	Lower initial cost, but involves time for laundry.
Skin Sensitivity	Good for sensitive skin if unscented and alcohol-free.	Excellent. Allows for control over soap and water temperature.
Environmental Impact	Creates more waste.	Less waste with reusable washcloths.
Effectiveness	Highly effective for standard cleaning.	Highly effective, especially for stubborn soiling.

Tips for Maintaining Dignity and Hygiene

• Be Mindful of Temperature: Use warm water and warm wipes. A cold wipe can be a shock and adds to the discomfort of the situation.
• Work with a Partner: When possible, have a second person help. This can make the process faster and safer for both you and the patient.
• Talk Through It: Continuing to talk to the patient, reassuring them and letting them know what you are doing, can help ease their anxiety.
• Address Skin Health Proactively: Regularly check for any signs of skin irritation or bedsores. Incontinence can significantly increase the risk of skin breakdown.
• Prioritize Skin Protection: Ensure the skin is completely dry before applying barrier cream. The combination of moisture and occlusive cream can worsen skin issues.
• Use Proper Lifting Techniques: When rolling the patient, bend your knees and use proper ergonomics to avoid straining your back.

By following this careful and compassionate process, caregivers can provide excellent hygiene while preserving the patient's dignity. For more information on managing fecal incontinence and maintaining skin health, consult the Mayo Clinic's guide on the topic.

Frequently Asked Questions

What supplies are essential for cleaning up a patient who has pooped?

Essential supplies include multiple pairs of disposable gloves, absorbent bed pads, unscented incontinence wipes or a washbasin with cloths, barrier cream, and a receptacle for soiled items.

How do I maintain a patient's dignity during cleanup?

Maintain dignity by communicating your actions, ensuring privacy with a closed door or curtain, and being calm and respectful throughout the process. Treating the individual with care and respect is paramount.

What is the correct technique for wiping to prevent infection?

Always wipe from the front toward the back. This prevents bacteria from the anal area from entering the urinary tract, which can cause urinary tract infections (UTIs).

Why is barrier cream important after cleaning a patient?

Barrier cream creates a protective layer on the skin, shielding it from moisture and irritants found in urine and feces. This prevents skin breakdown, rashes, and pressure sores.

How do you roll a bedridden patient safely for cleanup?

With the bed at a comfortable height, put on gloves. Bend the patient's knee and cross their arms over their chest. Gently roll them onto their side away from you, using a sheet to assist if necessary. Ensure they are stable before proceeding.

What if the patient's stool is very loose or watery?

Use a dry, disposable cloth or diaper to soak up the bulk of the moisture before introducing wet wipes. This prevents smearing and makes the area easier to clean thoroughly and effectively.

Is it better to use disposable or reusable cleaning cloths?

Both can be effective. Disposable wipes are more convenient and reduce laundry. Reusable washcloths are more cost-effective over time and allow for control over temperature and soap, which can be gentler on very sensitive skin.