How to Use a Bedpan as a CNA: A Complete Step-by-Step Guide

Proper hygiene and compassionate care are essential in a clinical setting. Studies show that maintaining a patient's dignity and privacy during sensitive tasks, such as assisting with a bedpan, can significantly improve their comfort and emotional well-being. This guide will walk you through the correct procedure for how to use a bedpan as a CNA, focusing on best practices for patient safety and respect.

Quick Summary

Assisting a patient with a bedpan involves gathering supplies, ensuring privacy, proper positioning, assisting with use, careful removal, and thorough cleaning, all while prioritizing patient comfort and dignity.

Key Points

• Pre-procedure Preparation: Gather all supplies, including gloves, bedpan, and protective pads, before entering the patient's room to ensure a smooth process.

• Patient Dignity: Prioritize the patient's privacy and comfort by communicating clearly, providing a bath blanket for cover, and giving them time alone if appropriate.

• Proper Positioning: Use the appropriate technique based on the patient's mobility, either by having them lift their hips or assisting them in rolling onto their side for placement.

• Infection Control: Always use new gloves for removal and cleaning, and thoroughly clean the bedpan according to facility policy to prevent the spread of germs.

• Assessing Output: Observe and document the characteristics of the patient's urine or stool, and measure output if required by their care plan.

• Post-Procedure Comfort: After removing the bedpan, provide perineal care, ensure the patient is in a comfortable position, and place the call light within reach.

Preparing for the Bedpan Procedure

Before entering the patient's room, gather all necessary supplies to ensure the process is efficient and respects the patient's privacy. A well-prepared CNA can make a significant difference in the patient's experience.

Supplies Needed

• Bedpan: Choose between a standard bedpan and a fracture pan, depending on the patient's mobility. A fracture pan has a lower, thinner rim and is ideal for patients with hip fractures or mobility issues.
• Protective underpad (chux): This disposable pad protects the bed linens from spills or accidents.
• Disposable gloves: You will need at least two pairs: one for the initial placement and a fresh pair for cleaning.
• Toilet paper or wet wipes: Have these ready for post-procedure cleaning.
• Warm water and basin: Used for perineal cleaning.
• Towel or washcloth: For drying the patient after cleaning.
• Bath blanket or top sheet: To maintain the patient's privacy and dignity.
• Call light: Place it within the patient's reach so they can signal when finished.
• Privacy screen or curtain: Ensure the patient has complete privacy.

Communicating with the Patient

Clear communication is key. Before starting, explain the procedure to the patient in simple, reassuring terms. Address them by their preferred name and maintain a calm, professional demeanor.

Step-by-Step Guide for Bedpan Placement

A. Assisting a Patient Who Can Lift Their Hips

1. Introduce and prepare: Enter the room, greet the patient, and explain the procedure. Ensure privacy by closing the door or pulling the curtain. Perform hand hygiene and put on your first pair of gloves.
2. Position the patient: Lower the head of the bed until the patient is lying flat. Assist the patient in bending their knees with their feet flat on the mattress.
3. Place the underpad and bedpan: Ask the patient to lift their hips. If they need assistance, support their lower back with one hand while sliding the protective pad and the bedpan underneath them with your other hand. Ensure the bedpan is centered.
4. Raise the head of the bed: Once the bedpan is securely in place, raise the head of the bed to a semi-Fowler's position (30-45 degrees) to mimic a normal sitting position. This promotes comfort and makes urination or a bowel movement easier.

B. Assisting a Patient Who Cannot Lift Their Hips

1. Introduce and prepare: Follow the same initial steps as above: introduce yourself, ensure privacy, wash hands, and put on gloves.
2. Turn the patient: Carefully and gently roll the patient onto their side, positioning them away from you.
3. Place the underpad and bedpan: Tuck the protective underpad under the patient's hip area. With the patient on their side, place the bedpan firmly against their buttocks, ensuring the rim is positioned correctly. For a standard bedpan, the wider, rounded end should be under the patient's hips.
4. Roll the patient back: While holding the bedpan in place with one hand, use your other hand to assist the patient in rolling back onto their back, securely positioning them on the bedpan.
5. Raise the head of the bed: Raise the head of the bed to a semi-Fowler's position, providing support with pillows if needed for comfort.

Providing Privacy and Assistance

After positioning the bedpan, give the patient privacy.

Promoting Independence

• Offer the patient toilet paper and wet wipes and ask if they are able to wipe themselves. This promotes independence and maintains dignity.
• Place the call light within their easy reach and explain that they should use it when they are finished.
• Leave the room to give them privacy, but stay nearby and check on them after a set time, or when they call.

Completing the Procedure: Removal and Cleaning

1. Removing the Bedpan

• Re-enter the room after the patient signals. Perform hand hygiene and put on a fresh pair of gloves.
• Lower the head of the bed to a flat position.
• Ask the patient to roll to their side, away from you. Hold the bedpan securely with one hand to prevent spills while they roll off.
• Carefully slide the bedpan and the underpad out from under the patient simultaneously to avoid spillage.
• Cover the bedpan to minimize odors and prevent exposure.

2. Perineal Care

• Assist the patient with cleaning the perineal area. Always wipe from front to back to prevent infection.
• Use fresh wet wipes or a damp washcloth, followed by a dry towel, to ensure the area is clean and dry. Check the skin for any redness or breakdown.
• Roll the patient onto their back, remove the underpad, and dispose of it.

3. Cleaning the Bedpan

• Take the bedpan to the designated hopper or toilet. If intake and output (I&O) is being measured, document the volume before disposing of the contents.
• Empty the contents into the toilet, rinse the bedpan with water, and empty the rinse water.
• Clean and sanitize the bedpan according to facility protocol and store it properly.

Comparing Bedpan Types

Feature	Standard Bedpan	Fracture Bedpan
Shape	Rounded, with a wide, high rim	Flat, with a lower, thinner rim and a handle
Best for	Patients with good mobility and strength in the hips who can lift themselves	Patients with limited mobility, hip injuries, or those who find lifting difficult
Patient Position	Requires lifting the hips or rolling to position	Can be slid under the patient with less effort
Comfort	Can feel more secure and stable for mobile patients	Reduced pressure on the lower back and hips, increasing comfort for less mobile patients
Ease of Use	May be easier for some patients to manage independently	Requires less patient effort for placement, ideal for CNA assistance

Conclusion

Mastering the skill of using a bedpan is a core competency for any CNA. By following a clear, systematic procedure, you can provide necessary care while upholding a patient's dignity and promoting a safe, comfortable environment. Communication, empathy, and attention to detail are paramount to a positive outcome for both the caregiver and the patient. Remember to always prioritize infection control and patient comfort throughout the process. For more information on professional caregiving best practices, visit the National Institute on Aging website.

Tips for Success

• Always maintain privacy: Even with a call light, check on the patient discreetly. Announce your presence by knocking before entering.
• Prioritize comfort: Ensure the bedpan is warm (by running it under warm water and drying) and that the patient is positioned correctly.
• Promote independence: Whenever possible, let the patient assist with tasks like wiping. This preserves their autonomy and self-esteem.
• Use proper body mechanics: Raise the bed to a comfortable working height to prevent back strain during placement and removal of the bedpan.
• Stay observant: Note any changes in stool or urine color, odor, or consistency, and report them to the charge nurse.
• Communicate effectively: Throughout the process, check in with the patient to ensure they are comfortable and understand each step.

Frequently Asked Questions

What is the correct positioning for placing a bedpan under a patient?

The correct positioning depends on the patient's mobility. For a patient who can assist, have them bend their knees and lift their hips. For a dependent patient, have them roll onto their side while you slide the bedpan under them. The wide, rounded end of a standard bedpan should be under the buttocks, toward the head.

How do I ensure patient privacy and dignity when using a bedpan?

Always close the door or pull the curtains before beginning the procedure. Explain each step to the patient, provide a bath blanket for covering, and give them privacy by leaving the room and placing the call light within reach once the bedpan is in place.

What is the difference between a standard bedpan and a fracture bedpan?

A standard bedpan is a deep, rounded pan best for patients with good mobility. A fracture bedpan is flatter and smaller, designed for patients with limited mobility or hip injuries who cannot lift their hips high enough for a standard bedpan.

How do I prevent spills when removing the bedpan?

To prevent spills, lower the head of the bed completely before removing the pan. When the patient rolls to their side, hold the bedpan securely with one hand while gently sliding it out from under them with the other, coordinating with the patient's movement.

How should I clean the bedpan after use?

After emptying the contents into the toilet or hopper, rinse the bedpan with water and dispose of the rinse water. Follow facility protocol for sanitization, which usually involves cleaning with a disinfectant. Be sure to perform hand hygiene and use gloves throughout the process.

What is the proper way to provide perineal care after bedpan use?

After removing the bedpan, assist the patient with perineal hygiene by wiping from front to back to prevent bacterial transfer. Use clean toilet paper first, then wet wipes or a damp washcloth, and finish by patting the area dry with a clean towel.

When should I report concerns about a patient's output?

You should report any unusual findings to the charge nurse. This includes abnormal color, consistency, or odor of stool or urine, as well as the presence of blood. If you are monitoring intake and output, ensure the measurements are accurate and documented correctly.