A bedpan is a specialized, portable receptacle used for patients who cannot safely get out of bed to use a standard toilet due to illness, injury, or recovery. It is designed to collect urine or feces while the individual is lying down or partially seated. The correct technique minimizes physical strain for both the patient and the caregiver while ensuring hygienic and efficient use.
Essential Preparation and Supplies
Preparation begins by gathering all necessary items: a clean bedpan, disposable gloves, toilet paper or cleansing wipes, and a protective pad (chux) to shield the bed linens. To increase patient comfort, warm the bedpan under running water and dry it before use, as cold plastic can be startling against the skin.
Bedpans come in two main types: the standard bedpan and the fracture pan. The standard bedpan is contoured and deeper, resembling a toilet seat, and is best for patients who can lift their hips. The fracture pan has a lower, flatter rim and is designed for individuals with limited mobility, such as those with hip fractures or recent hip replacements. This pan is typically slid under the patient from the front.
Before touching the patient, the caregiver must perform hand hygiene and put on disposable gloves. Patient privacy is paramount, so close the door, draw the curtain, and cover the patient, exposing only what is necessary. Adjust the bed height to a comfortable working level to protect the caregiver’s back, and ensure the bed brakes are locked to prevent movement. Explain the procedure calmly to the patient, confirming their ability to assist.
Step-by-Step Placement and Positioning
Correct placement depends on the patient’s physical ability to assist with movement. For a patient who can bend their knees and lift their hips slightly, this is the least invasive method. Ask them to bend their knees with their feet flat on the mattress, and instruct them to raise their hips off the bed. The caregiver can place one hand under the patient’s lower back for support while sliding the bedpan into place with the other hand.
If the patient is unable to lift their hips due to injury, pain, or weakness, the rolling technique is necessary. First, roll the patient onto their side, turning them away from the caregiver. Place the protective pad underneath them, then firmly press the bedpan against the patient’s buttocks. The standard bedpan’s wider end should align with the buttocks, while the flatter end of a fracture pan slides under the hips, with the handle facing the foot of the bed.
Once the bedpan is against the patient, gently help them roll back onto their back, ensuring they are centered directly over the pan. The buttocks must rest on the rounded shelf of the regular pan or the shallow rim of the fracture pan. This proper placement prevents the patient from missing the pan and soiling the linens. After positioning, raise the head of the bed to a near-sitting position (30 to 45 degrees), which promotes a more natural posture for elimination.
Cover the patient for warmth and privacy, and place the call light and toilet paper within easy reach. If the patient is safe to be left alone, the caregiver should step away to provide privacy. Return promptly when the patient signals they are finished, as leaving the room preserves the patient’s dignity.
Safe Removal and Hygiene Procedures
When the patient is finished, return the bed to a flat or near-flat position before removal. If the patient can lift their hips, ask them to do so while the caregiver firmly grasps the bedpan and slides it out. If the patient cannot lift, they must be gently rolled off the bedpan, turning away from the caregiver. Hold the bedpan flat and steady against the patient’s body during the roll to prevent spillage of the contents onto the bed or floor.
After removing the bedpan, the patient requires assistance with perineal care (cleaning the genital and anal areas). Wiping must always be done from front to back, especially for female patients, to prevent the transfer of bacteria that could cause a urinary tract infection. Use toilet tissue, pre-moistened wipes, or a warm washcloth until the area is clean, and then ensure the skin is thoroughly dried.
The soiled bedpan should be covered immediately with a paper towel or cover and moved to the bathroom. Empty the contents into the toilet, and rinse the bedpan with water, pouring the rinse water into the toilet as well. The equipment should then be cleaned and stored according to sanitation protocols. Finally, remove and discard the soiled gloves, ensure the patient is comfortable, and assist the patient in washing their hands.