How to help a patient use a bedpan: A complete caregiving guide

According to the National Institutes of Health, over half of older adults in nursing homes require assistance with toileting, making bedpan usage a common caregiving task. Mastering how to help a patient use a bedpan is a vital skill for ensuring comfort, dignity, and proper hygiene for those with limited mobility.

Quick Summary

Assisting a patient with a bedpan requires proper preparation, careful positioning techniques, maintaining patient dignity, and following strict hygiene protocols to prevent complications like infection or skin breakdown.

Key Points

• Prioritize Privacy and Dignity: Always explain the procedure to the patient and ensure their privacy by closing doors and curtains.

• Gather Supplies First: Have all necessary items, including gloves, bedpan, and wipes, within easy reach before beginning.

• Use the Correct Positioning Technique: Roll a patient who cannot assist, or have them lift their hips if they are able, to prevent injury and spillage.

• Elevate the Head of the Bed: Raising the patient's head to a semi-sitting position helps facilitate easier elimination.

• Remove Carefully to Prevent Spills: Lower the head of the bed before removing the bedpan and hold it firmly to avoid accidental spills.

• Perform Meticulous Hygiene: Clean the patient and the bedpan thoroughly after each use to prevent infection and skin irritation.

Essential Preparations: Before You Begin

Before approaching the patient, ensuring you have all necessary supplies and a clear plan is crucial for a smooth and dignified process. The right preparation minimizes discomfort and reduces the risk of accidents.

Gather Your Supplies

Having everything you need within arm's reach prevents unnecessary delays and helps maintain the patient's privacy and comfort. You will need:

• Bedpan: Either a standard or fracture bedpan, depending on the patient's condition.
• Disposable gloves: Essential for infection control.
• Protective pad: A waterproof incontinence pad to place under the patient and protect the bed linen.
• Toilet paper or wet wipes: For cleaning the perineal area.
• Warm water and basin: For a comfortable hand wash after use.
• Towel or blanket: To provide privacy and warmth.
• Optional: Disposable bedpan liners for easier cleanup and absorbent pads for fluids.

Preparing the Patient and the Environment

• Explain the procedure: Always inform the patient of what you are about to do. Explaining each step helps them feel more in control and less anxious.
• Ensure privacy: Close the door, pull the curtain, and cover the patient with a sheet or blanket. Maintaining dignity is paramount.
• Adjust the bed: Raise the bed to a comfortable working height for you, the caregiver, to prevent back strain. Ensure the bed rails are up on the opposite side for safety.

Step-by-Step Guide: Placing the Bedpan

The method for placing a bedpan varies depending on the patient's ability to assist. Always prioritize their comfort and safety.

For Patients Who Can Lift Their Hips

This is often the simpler method and causes less strain for both the patient and caregiver.

1. Bend the patient's knees: Ask the patient to bend their knees with their feet flat on the mattress.
2. Slide the bedpan: Support the patient's lower back with one hand while asking them to lift their hips. With your other hand, slide the bedpan under their buttocks.
3. Position correctly: Ensure the bedpan is positioned correctly under the patient, with the wider, rounded end under their buttocks and the narrower end toward their feet.
4. Raise the head of the bed: Gently raise the head of the bed to a semi-Fowler's position (30 to 45 degrees) to mimic a natural sitting position. This facilitates easier elimination.

For Patients Who Cannot Lift Their Hips

For those who are immobile or too weak to assist, the log-roll technique is necessary.

1. Turn the patient: Gently roll the patient onto their side, facing away from you. Bend their top leg for stability.
2. Position the bedpan: Place the bedpan firmly against their buttocks.
3. Roll back: Holding the bedpan in place, gently roll the patient back onto their back and onto the bedpan. Ensure they are centered and comfortable.
4. Raise the head of the bed: Elevate the head of the bed to a sitting position, as tolerated by the patient.

Ensuring Comfort and Privacy During Use

Once the bedpan is in place, your role shifts to supporting the patient and respecting their privacy.

• Provide supplies: Ensure toilet paper or wet wipes are within the patient's easy reach.
• Give space: Provide privacy by leaving the room, if safe to do so. If the patient is weak or at risk of falling, remain in the room but turn away or provide a curtain for modesty.
• Respond promptly: Place the call light within reach and instruct the patient to use it when finished. Respond to their call as quickly as possible.

A Comparison of Bedpan Types

Feature	Standard Bedpan	Fracture Bedpan
Design	Resembles a traditional toilet seat, deep bowl.	Tapered, low-profile, and wedge-shaped front.
Patient Mobility	Best for patients who can lift hips and sit up easily.	Designed for patients with limited hip mobility, fractures, or extreme weakness.
Ease of Placement	Can be more difficult to position correctly if the patient cannot lift.	Easier to slide under the patient without requiring them to lift significantly.
Comfort	Can cause pressure points on the sacrum if not positioned properly or if used for extended periods.	Generally more comfortable for patients with limited movement due to its tapered design.
Risk of Spills	Higher risk if not handled carefully, especially with movement.	Tapered design can help reduce spillage during placement and removal.

The Bedpan Removal Process

Removing the bedpan is a delicate procedure that requires care and attention to hygiene.

1. Lower the head of the bed: Return the bed to a flat or near-flat position. This prevents spillage during removal.
2. Wear gloves: If you haven't already, put on a new pair of disposable gloves.
3. Roll the patient: Ask the patient to bend their knees and push up, or gently roll them onto their side, holding the bedpan firmly to prevent spills.
4. Remove the bedpan: Slide the bedpan out from under the patient and cover it to transport it discreetly. Place the bedpan on a flat, stable surface like a chair or a bedside table, never on the floor.

Post-Procedure Care and Hygiene

Proper cleaning is essential for patient comfort and preventing infection.

• Clean the patient: Use toilet paper or wet wipes to clean the patient's perineal area. For females, always wipe from front to back to prevent bacteria from entering the urinary tract.
• Dry the area: Ensure the area is completely dry to prevent skin irritation and breakdown, which can lead to bedsores.
• Ensure hand hygiene: Provide a wet washcloth or hand sanitizer so the patient can clean their hands.
• Dispose and clean: Empty the bedpan contents into the toilet, and rinse the bedpan thoroughly with water before cleaning it with a hospital-grade disinfectant or according to the manufacturer's instructions. If using disposable liners, seal and dispose of them properly.

Troubleshooting Common Bedpan Challenges

• Patient cannot go: Lack of privacy, discomfort, or the horizontal position can inhibit urination or defecation. Try raising the head of the bed further (if possible), ensuring the environment is quiet, and providing reassurance.
• Spillage: Spills often happen when the bedpan is not properly positioned or removed. Ensure the bed is flat before removal and consider placing extra absorbent pads underneath.
• Skin irritation: Prolonged contact with moisture can cause skin breakdown. Ensure thorough cleaning and drying after each use. Consider using barrier creams as a preventative measure.

Conclusion

Assisting a patient with a bedpan is a fundamental aspect of compassionate care. By approaching the task with preparation, patience, and respect, caregivers can ensure the patient's comfort and dignity throughout the process. Following a step-by-step approach and prioritizing safety and hygiene will make the experience as smooth as possible for everyone involved. For additional guidance on providing safe and effective patient care, resources like those from the Agency for Healthcare Research and Quality are invaluable. https://www.ahrq.gov/patient-safety/index.html

Frequently Asked Questions

How do you position a fracture bedpan versus a regular bedpan?

A fracture bedpan is flatter and has a tapered end. The tapered end is placed toward the front of the patient, making it easier to slide under someone with limited hip mobility. A regular bedpan is deeper and typically requires the patient to lift their hips higher.

How long should a patient be left on a bedpan?

A patient should not be left on a bedpan for more than a few minutes. Prolonged contact with the bedpan, especially a hard one, increases the risk of skin breakdown and pressure ulcers. Respond promptly to their call.

What if the patient is unable to use the bedpan?

First, ensure privacy and comfort to reduce anxiety. Check if the head of the bed is sufficiently elevated. If the issue persists, communicate with the patient and potentially inform a healthcare professional, as constipation or other issues may be a factor.

How can I make the bedpan more comfortable for the patient?

Warm the bedpan with warm water (and dry it) before placing it. Using a powder on the rim can help it slide easier. Ensure the patient is in a semi-sitting position, and consider padding the pan with a soft, protective liner.

What is the best way to clean a bedpan after use?

After emptying the contents into the toilet, rinse the bedpan with cold water to remove residue. Then, wash it with warm water and a hospital-grade disinfectant. Allow it to air dry or use a disposable towel. Many facilities have dedicated bedpan cleaning stations.

How do I prevent spills during bedpan use?

Lowering the head of the bed before removing the bedpan is critical. Always hold the bedpan level and steady during transport. Consider using disposable bedpan liners with absorbent pads, which contain spills and odors.

Is it safe to use powder on the bedpan rim?

Yes, using a light dusting of talc-free powder can help the bedpan slide under the patient more easily and reduce skin adherence. However, always check for any contraindications or policies against its use.