Marianne Martinez
Toilet needs are a challenge for people who are immobile due to illness or injury. Solutions include physically transferring the person to the bathroom, using a hoist or commode chair, providing a bedpan or hand-held urinal, or using incontinence protection. This article will focus on how to toilet someone in bed using a bedpan, covering preparation, placement, and clean-up.
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What You'll Learn
Explain the procedure to the patient and be emotionally sensitive
When explaining the procedure to the patient, it is important to be emotionally sensitive and physically gentle. This can be an uncomfortable and embarrassing situation for the patient, so show patience and compassion. Greet the patient and explain that you are going to help them use the bedpan. Reassure the patient that you know what you are doing and that you will make the experience as pleasant as possible. Explain everything to the patient beforehand to calm them and reduce their fear and uncertainty.
Provide as much privacy as possible throughout the procedure. Close the door and cover the windows with curtains. If the patient shares a room, draw the curtain for privacy. Keep the patient's legs covered with a blanket or sheet until you are ready to position the bedpan.
Explain to the patient that you will be placing a barrier, such as a towel or pad, under their buttocks. Tell them that you will then position them on the bedpan correctly. The deeper portion of the bedpan should be directed toward their toes, and they should be centred on the bedpan. If using a fracture bedpan, explain that the handle should be directed toward their toes.
Inform the patient that you will then raise the head of the bed to a comfortable level, bringing their body up into a more natural toileting position. Ask the patient to spread their legs slightly so that you can verify the proper placement of the bedpan. Make sure the bedpan is positioned securely beneath the entire area of the buttocks.
Let the patient know that you will place toilet paper and sanitary wipes for their hands within their reach. Tell them that they can ring a signal cord or bell when they have finished. Explain that you will then help them perform hand hygiene and move them away from the bedpan. If they got onto the bedpan on their own, they should also get off on their own. If you need to turn them onto the bedpan, you will also need to turn them off of it.
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Position the bedpan securely and protect the bed
To position the bedpan securely, first, ensure the bed is low and locked, and check the brakes. If the patient has no bedsores or cuts on their buttocks, you can apply a thin coating of talcum powder to the rim of the bedpan to make it easier to slide the device underneath them. If the patient has open wounds, do not use talcum powder. Instead, you can fill the bedpan with enough water to cover the bottom, which will make emptying and cleanup easier.
Next, place the bedpan against the patient's hips and roll them onto it, towards you. If you are working from a hospital bed, raise the head of the bed so the patient is in a semi-upright position. If the patient is not in a hospital bed, place pillows under their back and shoulders to raise them up as much as possible. If the patient is able, they can bend their knees and lift their hips as you slide the bedpan under their buttocks. If the patient is unable to lift their hips, roll them to the side facing away from you, and slide the bedpan under their buttocks. Make sure the deeper portion of the bedpan is directed toward their toes, and the resident is centred on the bedpan. For fracture bedpans, the handle should be directed toward their toes.
Once the bedpan is in position, cover the patient's legs with a sheet or blanket and give them privacy. Leave toilet tissue, hand wipes, and hand sanitiser within reach of the patient. Wait nearby, allowing for resident privacy. When the resident signals, return and assist the resident to perform hand hygiene.
After the patient has finished, remove the bedpan carefully, as it can stick and pull on sensitive skin. Set the pan aside and help the patient clean up. Empty the bedpan contents into the toilet carefully. Rinse the bedpan thoroughly each time you empty it and clean it regularly with soap and water.
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Help the patient get into position
Helping a patient use a bedpan can be an uncomfortable and embarrassing situation for them, so it's important to remain emotionally sensitive, physically gentle, and calm throughout the process. Explain the procedure to the patient beforehand to reduce their fear and uncertainty.
To help the patient get into position, start by raising the head of the bed to bring the patient's body into a more natural toileting position. If the patient is not in a hospital bed, place pillows behind their back and shoulders to raise them up as much as possible. Ask the patient to sit up or lift their hips slightly, then slide the bedpan under them. If the patient can't lift their hips, gently roll them onto their side, being careful not to roll them too far, and slide the bedpan under their buttocks. Alternatively, if you have a helper, one of you can lift the patient's hips while the other slides the bedpan into place.
Once the bedpan is in position, ask the patient to spread their legs slightly so you can verify that the bedpan is securely positioned beneath their buttocks. Place a bed pad under the bedpan to catch any spills, and cover the bedpan with a towel. Provide the patient with toilet paper and wipes within reach, and let them know there is a signal cord or bell they can use to call for help.
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Provide privacy and check on the patient
It is important to respect the patient's privacy during this process. Pull the privacy curtain around the patient's bed or close the door to the room. If the patient is a woman, ask a female nurse or aide to assist if possible.
Explain each step of the process to the patient as you go, so they know what to expect and can be as comfortable as possible. Make sure the patient understands what is happening and why.
If the patient is conscious, offer them the opportunity to change into their own nightclothes after the procedure. If they are unconscious, respect their privacy by covering them with a sheet or blanket.
Throughout the process, maintain the patient's dignity by keeping them covered as much as possible. Only expose the parts of the body that are necessary for the task.
Once the patient has finished using the bedpan, dispose of the contents properly and clean the bedpan with soap and warm water, or as directed by the patient's healthcare guidelines. Dry it thoroughly before replacing it in its usual spot.
Wash your hands thoroughly after the procedure, and assist the patient in washing their hands and perineal area if needed. Make sure to offer the patient a washcloth or wipe to clean themselves if they are able to do so.
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Clean the patient, the bedpan and the area
Once the patient has finished using the bedpan, it is important to clean both them and the surrounding area to maintain good hygiene and prevent infections. Start by putting on personal protective equipment (PPE), such as gowns, disposable gloves, masks, and eye protection.
First, empty the contents of the bedpan into the appropriate toilet or disposal system. Then, use warm water to rinse the bedpan, removing any remaining waste. Next, apply a hospital-grade disinfectant to all surfaces of the bedpan. Use a cleaning brush or sponge to scrub all surfaces, paying extra attention to corners and crevices to ensure all biofilm and residues are removed.
After scrubbing, thoroughly rinse the bedpan again with warm water to remove any remaining disinfectant and loosened debris. This step is important to prevent skin and mucous membrane irritation from chemical residues. Once rinsed, use disposable towels or cloths to dry the bedpan completely. Proper drying prevents the growth of microorganisms, as residual fluid can serve as a reservoir.
After drying, inspect the bedpan for any remaining stains or residues. If necessary, repeat the cleaning process until the bedpan meets acceptable cleanliness standards. Finally, properly dispose of any waste and PPE to maintain a clean environment. Wash your hands thoroughly with liquid soap and warm water, dry them with a paper towel, and dispose of the towel appropriately.
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Frequently asked questions
First, explain the procedure to the patient and show patience and compassion. Then, help the patient get into position by raising the head of the bed or placing pillows under their back and shoulders. Give them toilet paper and wipes, and step away to allow for privacy. After the patient is finished, help them move off the bedpan, clean them, and return them to a comfortable position.
If you are working from a hospital bed, carefully raise the head of the bed to bring the patient's body into a more natural toileting position. If the patient is not in a hospital bed, place pillows under their back and shoulders to raise them up as much as possible. Ask the patient to bend their knees and place their feet flat on the mattress, then slide the bedpan under their buttocks.
If the patient can lift their hips, ask them to do so and remove the bedpan. Clean the patient with wet wipes or a wet washcloth, then clean the area. Return the patient to a comfortable position. If there is a spill, change the bed linens and the patient's clothing, then spray an air freshener.
Rinse and wash the bedpan using a disinfectant diluted with water. Dry the bedpan or let it air dry.
