Bedpan
A bedpan or bed pan is a tool used for the toileting of a patient confined to a bed, primarily for the collection of human urine and/or feces. Many diseases can confine a person to bed, necessitating the use of bedpans, including Alzheimer's disease, Parkinson's disease, stroke, and dementia. Additionally, many individuals may be confined to a bed temporarily as a result of a temporary illness, injury, or surgery.[1]
Bedpans are usually made of metal, glass, ceramic, or plastic, but are usually constructed of stainless steel. Stainless steel is durable and easy to clean, but may be cold, hard, and uncomfortable to use. Also, the supporting area of some products is very small, and prolonged use can cause pressure ulcers. To solve these problems, ergonomic bedpans have been developed, which support the individual with a larger area of less-conductive plastic. Some designs completely cover the genitalia during use, offering protection and an extra measure of privacy. On the other hand, the material is more difficult to sterilize, and may become a reservoir for microorganisms.
Fracture bedpans are smaller than standard size bedpans, and have one flat end. These bedpans are designed specifically for people who have had a hip fracture or are recovering from hip replacement. This type of bedpan may be used for those who cannot raise their hips high enough or roll over onto a regular size bedpan.[2]
Cleaning and sterilization
Managing proper hygiene and cleaning of bedpans for bedridden individuals is important to reduce the risk of infection. Used bedpans contain bodily fluids and wastes and can either be reused through disinfection or disposed of.
Sterilization and disinfection procedures for medical devices are established based on the device category. There are 3 categories of medical device types which are generally agreed upon by international governing bodies, including the Center for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the European Centre for Disease Prevention and Control (ECDC). These categories are Critical Use, Semi-Critical Use and Non-Critical Use. Bedpans are considered Non-Critical use, meaning the recommendation for cleaning is a low or intermediate level disinfectant.[3]
Washer disinfectors have been used more recently for re-usable bedpans rather than disinfectants due to risk of the cross-contamination of SARS-CoV2. Washer disinfectors are instruments used to disinfect used bedpans with high temperatures of at least 80°C.[4]
As mentioned previously, bedpans commonly come in stainless steel because of its durability and ease of cleaning. Compared to other metals like copper, steel does not have an inherent ability to disinfect. Copper has had some antimicrobial indications dating back to the 19th century as some copper workers appeared immune to cholera outbreaks, or using copper to treat infections/infectious complications.[5]
Bedpan management
Bedpan management is important to ensure sanitation for patients who are bedridden as well as infection control. There are specific standard of procedures and training that is developed for bedpan care. [6] The ward manager is responsible for making sure that all staff who handle bedpans are properly educated.
Steps for bedpan management:
1. Perform hand hygiene.
2. Put disposable gloves on and follow any isolation practices, by wearing personal proactive equipment (PPE).
3. Ensure patient is pulled as high as they can on their bed, body positioning has a major impact on gastric flow.
4. Place bedpan under patient by assisting the patient to roll on their side with their buttocks towards the healthcare provider.
5. Powder may be used to ensure patient skin from sticking to the pan.
6. Ensure that buttocks are firm against bedpan and push in a downward motion.
7. Hold bedpan with one hand and the hip with the other to roll patient on the bedpan.
8. Raise head of bed to 30 degrees and add pillow to facilitate adequate bowel movement.
9. Ask patient to bend knees, if possible, to motion squatting motion.
10. Place toilet paper near patient for ease of use.
11. Lower head of bed to help remove bedpan.
12. Ensure perineal area is cleaned from front to back.
13. Offer washcloth for their hands if needed.
14. Dispose of bedpan.
Disposable bedpans
In recent years,[when?] single-use bedpan liners made of recycled wood pulp (molded pulp) have become more widely used in UK hospitals; they decrease the risk of cross-contamination. Another alternative is the plastic bedpan liner. Some liners are made of biodegradable plastic and contain absorbent powder to eliminate splashing and spills. Liners are used in hospitals to decrease infection, and are also used for home health care. Disposable bedpans are single-use, which allows for more sanitation and lowers the risk of contamination and infection. After use, they can be disposed of which removes the need to clean and sanitize for another use. Furthermore, disposable bedpans allow for better infection control practices, for example they can prevent the spread of infectious diseases by lowering the risk of contamination during the handling and disposal of the excretions.[7]
Bedpans and infection control
Using the steel or plastic reusable bedpans poses a risk of spreading infection via caregivers and environment.[8] There are alternative methods of disposal to ensure that infection spread is under control, such as bedpan washer disinfector machines and disposable bedpans.
Disinfector machines have shown to be efficacious against common infections such as C. difficile spores and E. coli when followed instructions which is an alternative to the disposable bedpan waste management.[9]
See also
- Chamber pot
- Urinal (health care), used for male patients' urination
References
- ^ Toney-Butler, Tammy J.; Gaston, Gwendolyn (2023), "Nursing Bedpan Management", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 29763153, retrieved 2023-07-24
- ^ Bunker Rosdahl, Caroline; Kowalski, Mary T. (2008). Textbook of basic nursing (9th ed.). Philadelphia: Lippincott Williams & Wilkins. p. 648. ISBN 978-0781765213. Retrieved March 29, 2012.
- ^ Rowan NJ, Kremer T, McDonnell G (June 2023). "A review of Spaulding's classification system for effective cleaning, disinfection and sterilization of reusable medical devices: Viewed through a modern-day lens that will inform and enable future sustainability". The Science of the Total Environment. 878: 162976. doi:10.1016/j.scitotenv.2023.162976. PMID 36963674.
- ^ Hallam C, Denton A, Thirkell G (December 2020). "COVID-19: considerations for the safe management and disposal of human excreta". Infection Prevention in Practice. 2 (4): 100085. doi:10.1016/j.infpip.2020.100085. PMC 7443054. PMID 34316567.
- ^ Grass G, Rensing C, Solioz M (March 2011). "Metallic copper as an antimicrobial surface". Applied and Environmental Microbiology. 77 (5): 1541–1547. doi:10.1128/AEM.02766-10. PMC 3067274. PMID 21193661.
- ^ Toney-Butler, Tammy J.; Gaston, Gwendolyn (2023), "Nursing Bedpan Management", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 29763153, retrieved 2023-07-26
- ^ Gibson GL (December 1973). "A disposable bedpan system using an improved disposal unit and self-supporting bedpans". Journal of Clinical Pathology. 26 (12): 925–928. doi:10.1136/jcp.26.12.925. PMC 477932. PMID 4784500.
- ^ Apple, Michael (July 2016). "Toward a Safer and Cleaner Way: Dealing With Human Waste in Healthcare". HERD: Health Environments Research & Design Journal. 9 (4): 26–34. doi:10.1177/1937586715619739. ISSN 1937-5867.
- ^ Hatt, Savannah; Schindler, Bryan; Bach, Diana; Greene, Christine (2020-07-01). "Washer disinfector and alkaline detergent efficacy against C. difficile on plastic bedpans". American Journal of Infection Control. 48 (7): 761–764. doi:10.1016/j.ajic.2019.11.028. ISSN 0196-6553.
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