A bedpan is a medical device designed to assist individuals who are temporarily or permanently unable to leave their bed for toileting needs. Its primary purpose is to provide a sanitary and dignified means for elimination when a toilet is inaccessible. Proper use of a bedpan is foundational to patient comfort, preventing complications like skin breakdown and pressure ulcers, and maintaining essential hygiene. Understanding the correct orientation and placement technique is paramount for both the caregiver and the patient.
Identifying Standard Versus Fracture Bedpans
Bedpans are generally categorized into two main types based on their design and intended use: the standard bedpan and the fracture pan. The standard bedpan, sometimes called a regular bedpan, is deeper and rounder, resembling a traditional toilet seat and bowl. This type has the largest capacity and is typically used for patients who retain a reasonable amount of mobility and can lift their hips significantly.
The fracture pan, or slipper pan, has a distinctly different, low-profile design. It is smaller and much flatter on one side, tapering down towards the other end. This specialized shape makes it easier to slide beneath a patient who cannot raise their hips or must keep a lower extremity still, such as those with a hip fracture or a leg cast. The low side of the fracture pan often has a handle, which assists in placement and removal.
The Critical Orientation Rule
The most common question regarding bedpan use, “Which way does the bedpan go?” has a straightforward answer rooted in anatomy and design. Regardless of the type used, the wider, flatter, or more contoured end must be placed beneath the patient’s hips. This broad end is engineered to provide stable support across the sacrum and gluteal region, mimicking a seat.
This supportive end must face toward the head of the bed, where the patient’s buttocks will rest. Conversely, the narrower, tapered end—which sometimes includes a handle or a pouring spout—must face toward the foot of the bed. Correct orientation maximizes the collection area and prevents spillage. Improper placement, such as positioning the narrow end under the buttocks, can cause the pan to dig into the skin and lead to leaks.
Step-by-Step Placement and Positioning
Before placing the bedpan, the caregiver should raise the bed to a comfortable working height to ensure proper ergonomics and prevent back injury. An incontinence pad should always be placed under the patient to protect the linens from any potential soiling. The technique for placement depends entirely on the patient’s ability to assist with the process.
For patients who can partially assist, they should bend their knees and push up with their feet while the caregiver slides the bedpan underneath their hips. The caregiver uses one hand to provide gentle support under the lower back while the patient elevates their body. Once the pan is centered under the buttocks, the head of the bed should be raised to at least a 30-degree angle (semi-Fowler’s position) to facilitate natural elimination.
For patients who cannot lift their hips due to injury or immobility, the rolling technique is used. The caregiver should roll the patient onto their side, away from the side where the caregiver is standing. The bedpan is then placed firmly against the patient’s buttocks and held in place as the patient is gently rolled back onto their back and over the pan. It is important to confirm the patient is centered over the receptacle to ensure adequate positioning and prevent accidents.
Ensuring Patient Comfort and Post-Use Hygiene
Maintaining the patient’s dignity is a primary concern; privacy should be ensured by closing the door and curtains before the procedure begins. To enhance comfort, some caregivers use a thin layer of powder or place a warm cloth on the pan’s rim to prevent the patient’s skin from sticking to the surface. After the bedpan is correctly positioned, the patient should be given the call light and provided with privacy.
Once the patient is finished, the bed is lowered, and the bedpan is carefully removed by having the patient either lift their hips or roll away from the caregiver. It is paramount to hold the bedpan level during removal to avoid spills. After removal, the patient’s perineal area must be cleaned thoroughly from front to back to prevent urinary tract infections and skin irritation. The bedpan should then be immediately covered, emptied, and disinfected according to standard hygiene protocols.