The fracture pan is a specialized toileting device for individuals confined to bed with severe limitations in hip mobility, such as those recovering from hip replacement surgery or pelvic fractures. Unlike a standard bedpan, the fracture pan is distinctly flatter and wedge-shaped. This low-profile design allows it to be slid easily beneath the patient’s sacrum and buttocks without requiring them to lift their hips significantly, thereby minimizing painful movement. This ensures patients can maintain hygiene during recovery.
Preparing the Patient and Supplies
Before placement, the caregiver must gather all necessary equipment for a smooth and sanitary procedure. Supplies include the fracture pan, at least two pairs of clean gloves, disposable wipes, a protective pad (chux) to safeguard linens, and toilet paper. Ensure patient privacy by closing curtains or doors, and explain the procedure fully to the patient beforehand to encourage cooperation.
The patient should be positioned supine, meaning the head of the bed must be lowered completely before placement begins. If the patient can manage it without pain, gently flexing their knees with feet flat on the mattress helps ready the lower body for the slight movement required. Place the protective pad beneath the patient’s lower back to maintain comfort and safety during the placement technique.
Step-by-Step Placement Techniques
The correct positioning requires the pan’s orientation to be precise: the shallow, tapered end must be placed directly under the patient’s sacrum. The higher rim and handle must point toward the foot of the bed. This alignment ensures the pan slides easily and the reservoir is correctly positioned to collect waste. Two primary techniques are used, based on the patient’s ability to move.
For patients with a minimal ability to lift their hips, the caregiver uses the lift method. Ask the patient to push down with their heels and raise their hips slightly. As the patient lifts, the caregiver slides the flat end of the pan beneath the buttocks, supporting the lower back while guiding the pan. For severely restricted patients, the roll method is more common. This involves the caregiver raising the opposite side rail and gently rolling the patient onto their side, away from the caregiver.
Once the patient is turned, the caregiver places the pan firmly against the patient’s buttocks, ensuring the shallow end is aligned with the sacrum and the pan is centered. While holding the pan securely, the caregiver assists the patient in slowly rolling back onto their back, directly onto the pan. Confirm that the patient is centered and the perineal area is correctly positioned over the central collection area to prevent spillage.
Ensuring Patient Safety and Comfort
Once the fracture pan is in position, check the patient’s comfort and adjust the bed to facilitate elimination. Raising the head of the bed to a Semi-Fowler’s position (30 to 45 degrees) simulates a sitting posture. This elevation anatomically aids voiding and defecation by utilizing gravity and abdominal pressure.
Visually check that the edges of the pan are not pressing into the patient’s skin, which could cause pressure points or skin breakdown, especially over the sacrum. Provide the patient with toilet paper and a readily accessible call bell before leaving the immediate area. The patient should not be left unattended for an extended period; communicate a clear timeframe for return to minimize feelings of vulnerability.
Removal and Post-Care Procedures
Removal of the pan requires reversing the placement process to prevent spillage and patient injury. Before any movement, the head of the bed must be lowered flat to reduce strain on the patient’s back and hips. Ask the patient to roll gently to the side, away from the caregiver, using the same direction as the roll method placement.
As the patient rolls, the caregiver must firmly stabilize and hold the pan flat against the bed surface to break any suction that may have formed and to prevent the contents from sloshing out. Once the pan is removed, gently roll the patient back to the supine position.
The caregiver assists with perineal care, wiping from front to back to mitigate the risk of transferring bacteria and causing infection. After the patient is clean and dry, remove the soiled protective pad and linens. Secure the pan contents for disposal or measurement, and then perform hand hygiene.