What position should the resident be in when you are placing removing the bed pan?

According to the Centers for Disease Control and Prevention (CDC), falls among older adults are common and often result from improper transfers or repositioning, underscoring the critical need for correct technique. This guide explains exactly what position should the resident be in when you are placing removing the bed pan, ensuring both safety and dignity throughout the process.

Quick Summary

The safest position for placing or removing a bedpan typically involves the resident lying on their side to roll them onto or off the pan, followed by a semi-upright (semi-Fowler) position for use, if possible. This method minimizes strain for both the caregiver and the individual, prioritizing safety and comfort.

Key Points

• Side-Lying for Placement: For maximum safety and minimal strain, position the resident on their side before placing the bedpan underneath them, not by lifting them directly.

• Semi-Upright for Use: Once the bedpan is in place, raise the head of the bed to a semi-Fowler's position (30-45 degrees) to facilitate natural elimination.

• Controlled Removal: To remove the bedpan, lower the bed flat and turn the resident to their side again, holding the pan securely to prevent spills.

• Prioritize Privacy and Dignity: Always explain the process, ensure privacy, and handle the procedure with respect to minimize the resident's potential embarrassment or discomfort.

• Ergonomics for Caregiver Safety: Adjust the bed height to a comfortable level to avoid back strain during the transfer process, protecting your own health.

Preparing for Bedpan Placement

Before you begin the process of placing or removing a bedpan, proper preparation is key to a smooth and respectful experience. The primary goals are to ensure the resident's privacy, prevent spills, and work ergonomically to protect yourself from injury. Always begin by gathering all necessary supplies: a clean bedpan, protective chux pads or absorbent linen protector, toilet paper or wipes, clean gloves, and a washcloth and towel for hygiene. Place the bedpan on the side of the bed where you will be working, ensuring it's within easy reach. The resident should be in a supine (on their back) position with the bed flat. If the resident is using a hospital bed, raising the bed to a comfortable working height will save you from bending over and straining your back.

The Importance of Explaining the Process

Communication is a fundamental aspect of caregiving that should never be overlooked. Explain each step to the resident clearly and calmly, even if they are nonverbal or seem unresponsive. This helps to maintain their dignity and allows them to feel involved in their own care. Reassure them that you will provide privacy and work as quickly and respectfully as possible. Pulling the curtain or closing the door is a simple yet vital step to protect their privacy and build trust. This empathetic approach fosters a positive care environment and reduces potential anxiety for the resident.

Step-by-Step Guide to Placing the Bedpan

Placing the bedpan involves a specific sequence of actions to ensure the resident's safety and comfort. Always prioritize gentle, supportive movements rather than force.

1. Lower the head of the bed so the resident is lying as flat as possible. This makes rolling easier and safer.
2. Turn the resident to their side. Ask the resident to bend their knees and cross their arms over their chest. Place one hand on their shoulder and the other on their hip. Gently and slowly roll them towards you. Use a gait belt if necessary to assist with the turn safely.
3. Position the protective pad and bedpan. With the resident on their side, place the absorbent pad under their hips and buttocks. Then, position the bedpan firmly against their buttocks, ensuring the wider, curved end faces towards their head.
4. Roll the resident back onto the bedpan. Support the resident's hips and gently roll them back onto their back, centering them over the bedpan. Ensure they are positioned securely with their buttocks resting firmly on the pan. Never force the pan under them.
5. Raise the head of the bed. Once the resident is securely on the bedpan, raise the head of the bed to a semi-Fowler's position (30 to 45 degrees). This position mimics a natural sitting posture and aids in elimination. Place a pillow under the knees for added support if needed.
6. Ensure comfort and privacy. Place the call light within easy reach and provide privacy. Leave the room to give the resident space, and return promptly when they signal they are finished.

Removing the Bedpan Safely and Hygienically

Removing the bedpan requires the same care and attention to detail as placing it. The goal is to avoid spills and ensure the resident is clean and comfortable afterward.

1. Lower the head of the bed. Gently lower the bed to a flat position. This reduces the risk of spillage and prepares the resident for rolling.
2. Have the resident turn to their side. Ask the resident to bend their knees and, while holding the bedpan in place firmly to prevent spillage, assist them in rolling onto their side and away from you.
3. Carefully remove the bedpan. Once the resident is safely on their side, you can gently slide the bedpan out from underneath them. Cover it immediately to prevent odors and contain contents. Place it on a designated chair or side table, on top of a barrier, and out of sight.
4. Perform perineal care. With the resident still on their side, use toilet paper or pre-moistened wipes to clean the perineal area from front to back. Place used materials into a plastic bag or a designated waste receptacle. Use a clean washcloth to dry the area thoroughly.
5. Reposition the resident. Assist the resident in rolling back to a comfortable position. Adjust pillows and bedding as needed.
6. Complete hygiene and documentation. Empty the bedpan contents, clean and sanitize the bedpan, and dispose of gloves and waste. Remember to perform hand hygiene and document the resident's output if required by facility protocol.

Proper Bedpan Technique Comparison

Aspect	Assisted Rolling Technique (Recommended)	Hip Lift Technique (If Resident Can Assist)
Resident's Position	Starts supine, turns to side for placement/removal.	Starts supine, lifts hips while caregiver slides pan.
Caregiver Strain	Minimal; utilizes resident's body mechanics and caregiver's strength.	Moderate; requires resident to have significant upper body and core strength.
Resident's Involvement	Passive; caregiver performs most of the work.	Active; resident must actively participate by lifting hips.
Risk of Spillage	Low; bedpan is held stable during the rolling process.	Higher; stability depends on resident's ability to hold position.
Dignity & Privacy	High; resident's backside is covered during placement and removal.	Moderate; can be more exposing for the resident.
Use Case	Ideal for residents with limited mobility or those who need full assistance.	Suitable for more mobile residents who can follow commands and aid in the process.

Advanced Considerations for Caregivers

Beyond the basic procedure, a few advanced considerations can improve the bedpan experience for residents and caregivers alike. First, be aware of skin integrity. Prolonged time on a hard bedpan can lead to pressure sores, especially in frail or immobile individuals. Ensure you are not leaving the resident on the pan for an excessive amount of time. If they are prone to skin breakdown, consider a padded or inflatable bedpan for added comfort.

Second, always check the bedpan's temperature before use, particularly if it has been stored in a cold area. A quick rinse with warm water can make the process much more comfortable for the resident. Lastly, encourage fluid intake and a high-fiber diet where appropriate. Regular bowel movements can reduce the frequency of needing a bedpan for defecation, improving the resident's quality of life.

For additional training and resources on best practices in patient care, the American Geriatrics Society offers excellent guidelines and information American Geriatrics Society.

Conclusion

Mastering the correct techniques for placing and removing a bedpan is an essential skill for any caregiver. By using the proper positioning—turning the resident onto their side for placement and removal—you can protect both the resident's safety and your own physical health. Prioritizing communication, privacy, and hygiene ensures the process is conducted with the utmost dignity and respect for the resident. By following these guidelines, you can transform a potentially uncomfortable task into a routine act of compassionate care.

Frequently Asked Questions

What is the best initial position for a resident before placing a bedpan?

The resident should be lying flat on their back (supine position) with the bed flat. This is the optimal starting point for safely turning them onto their side to place the bedpan.

Why is it important to use the side-lying position for placing and removing a bedpan?

The side-lying technique is crucial for several reasons: it's safer for the resident, requires less strenuous lifting for the caregiver, and significantly reduces the risk of spills. It also protects the caregiver's back from injury.

How do you position a bedpan for a resident who cannot lift their hips?

For residents who cannot lift their hips, the side-lying technique is the standard procedure. You roll the resident onto their side, place the bedpan, and then roll them back over onto it. This is the safest method when the resident cannot assist.

What is the semi-Fowler's position, and why is it used with a bedpan?

The semi-Fowler's position is when the head of the bed is elevated to a 30 to 45-degree angle. This position is used with a bedpan to create a more natural, seated posture, which facilitates more complete elimination.

What should I do if a resident is uncomfortable or anxious about using a bedpan?

Communicate openly and empathetically with the resident. Explain each step clearly and provide maximum privacy. You can also warm the bedpan with a little warm water beforehand to make the process less startling.

How can I prevent spills when removing the bedpan?

To prevent spills, hold the bedpan firmly in place with one hand while gently rolling the resident onto their side with the other. Ensure the bed is flat during this process to maintain a level surface.

What happens if I place the bedpan incorrectly?

Incorrect placement can cause discomfort or skin irritation for the resident. It can also increase the risk of spillage and make elimination difficult. Always ensure the resident is centered over the pan with the correct end facing their head.