Assisting with Bedpan Use (Nursing)

00:01 Hi, I'm Samantha Ray, and today we're going to talk about bedpan assistance.

00:06 So there are bedpans in museums made of pottery, glass and even porcelain.

00:11 If you can believe it, the versions now you are likely more to see and use are made of plastic and come in a variety of shapes like you might see here.

00:20 Patients use these when they're confined to bed, and your role assisting them depends a lot on their level of mobility and strength.

00:29 Now, in some cases, patients may have had pelvic injuries or surgeries that really limit their ability to roll or move in a certain way, meaning that the bedpan has to be inserted from underneath their hips rather than the side.

00:44 And some patients in the home setting use lifts and bed pans and other adapted ways.

00:50 Now let's take a look at what the different bedpans might look like for these situations.

00:55 This, as you see here depicted, is a traditional bedpan for someone who has no turning restrictions, but they may be weak or limited to the bed after delivering, for example, like a baby while an epidural wears off.

01:09 Now this next picture is a fracture bed pan.

01:12 Notice the difference in the size and the shape here.

01:16 You can see here that the back is flat and designed to designed to slide under the hips.

01:21 Much easier for someone who can't truly lift their hips very high.

01:26 This is standard for after a hip replacement or for someone who's had a pelvic fracture or displacement. Now, these bariatric bed pans are wider, made of heavier duty materials, and have tapered edges for greater durability.

01:40 They're also very useful for patients who require a bedpan for a longer period of time, and the device will need repeated disinfection and sterilization.

01:50 Ideally, bed pans are meant to be used for a short term period, as they can contribute to the development of pressure ulcers and the spread of infection even when they're routinely disinfected.

02:01 Today we're going to show you how to use a bedpan in combination with the log rolling technique and with a patient who can assist with turning.

02:10 I'm also going to verbally explain how it would work with a patient who could not help you, and with different kinds of bedpans in different situations.

02:19 Now let's talk about the skill of using a bedpan.

02:22 So first we want to make sure we consider the context of why the patient needs the bedpan. Is it a hip replacement or a pelvic surgery.

02:29 And what can the patient do for themselves? For example, can they log roll? Can they not? We want to make sure we select the appropriate bedpan for the situation, and make sure we also identify our client.

02:41 Want to wash your hands, put on our gloves and provide privacy.

02:46 This is a great time to educate the patient and discuss the steps of the bedpan.

02:50 Use with the patient before we start.

02:53 Now we want to raise the bed to a comfortable working height and lower the top rail on your side.

02:59 At this point, we want to have the patient turn away from you and assist the patient to remove any articles of clothing to expose the buttocks.

03:06 We're going to now place the bedpan with the curved plate at the pelvic ridge.

03:11 We want to assist the client to roll back towards us, ending up on top of the bedpan with their legs at a comfortable angle and a comfortable position for them.

03:21 Now offer or suggest to raise the head of the bed.

03:24 If the patient needs this, and raise the rail back up on your side.

03:28 Now we want to offer privacy and make sure we leave the call light where the patient can reach you when they're finished.

03:34 We're going to remove our gloves and wash our hands.

03:37 Now we're going to go ahead and return when the patient's ready.

03:41 We're going to wash our hands and re gloves and bring any sort of sanitizing wipe or cleansing cloth with us.

03:48 Return our patients back to a comfortable working height, but also lower the head of the bed. Now we want to lower our rail on our side and ask the patient to slowly turn away from you. And you want to make sure you stabilize and hold down the bedpan flat towards the mattress.

04:05 So we're going to go ahead and use wipes or cleansing cloths to clean our patient's anal area. Now once these are soiled, we can just place those wipes in the bedpan or the receptacle and put this bedpan aside.

04:16 You want to remove the gloves and help the patient redress and resume them back to a comfortable position.

04:22 Make sure to raise the rail on your side, back up, and then lower the bed back to a safety position.

04:28 We want to provide the call light and make sure that's within reach, and provide hand hygiene to the patient.

04:34 At this point, we also want to wash our hands and re glove because we're going to take the soil bed materials.

04:41 Now this is a great point to wear if needed.

04:44 We need to collect our stool sample and noting quality and amount.

04:48 This is the time we want to make sure we disinfect.

04:51 So we're going to use a hospital grade disinfectant when possible and store your bedpan for policy.

04:58 Now we're going to demo on how to assist a patient to use a bedpan.

05:03 So this is a really important time to consider the context of why the patient will need to use a bedpan.

05:09 That could mean they have had hip surgery, a replacement pelvic surgeries, and what can the patient do for themselves? What I mean by this in particular is can the patient log roll for you and grab the side rail, or do they need to completely have their hips lifted up for them? This is something that you want to check before you get started.

05:29 You also want to go ahead and select the appropriate bedpan for the situation.

05:34 So what we're going to use today is a traditional bedpan.

05:37 But if the patient had pelvic surgery or a hip fracture, for example, we would use the fracture pan. So now I'm going to go ahead and wash my hands, use my hand hygiene and put on my gloves.

05:52 So at this point you also want to make sure you provide complete privacy for your patient. And of course, before we get started, it's a good thing to go ahead and let the patient know what the steps of the bedpan used are going to be.

06:05 So I may say, Miss Smith, what we're going to do today so that you can help me log roll, I'm going to raise the bed up, and I'm going to have you turn away from me and grab the side rail. Once you do that, I'm going to slide the bedpan underneath your hips, and then I'm going to have you roll back over.

06:20 So that will be the steps today.

06:22 Now it's really important with this is you watch your body mechanics.

06:26 So we're going to raise the bed to a comfortable working height.

06:32 And because of this and just due to height you want to be careful also to make sure you're not leaning over the rail.

06:39 So we're going to lower this.

06:43 Now if you have the ability to or the patient cannot basically grab the side rail by themselves, you may want to grab another team member here to help you turn the patient. But if your patient can help you turn, allow them to do so.

06:58 So at this point, Miss Smith, I'm just going to go ahead and lower this.

07:01 I'm going to assist you in rolling to the other side of the bed and turning away from me. So at this point, once we've done that, we're going to assist the patient to remove any articles of clothing out of the way to expose the buttocks.

07:19 Now we also want to place the bedpan with the curved plate here at the pelvic ridge, which is at the backside of the patient.

07:28 So now that we've done this, we want to assist the client to roll back.

07:32 Okay. So, Miss Smith, I'm going to have you roll back over here.

07:36 Now, once we do this, this can always be quite uncomfortable.

07:40 So you kind of want to help the patient and have them position their legs where it's at a comfortable height.

07:46 So once this happens, as you can see, the patient could be pretty flat.

07:50 So you want to raise the head of bed for comfort.

07:53 So at this point I'm going to go ahead and raise the rail on my side for safety.

07:57 Raise the head of the bed to where the patient tells you to stop.

08:03 And once we get it at a comfortable height, make sure we lower the bed back down.

08:08 We're going to offer privacy to our patient and make sure we leave the coal light within reach. Okay, so, Miss Smith, I'm going to give you a few moments.

08:16 Once you're done, if you would make sure to hit the coal light.

08:19 So once we've done that we're going to go ahead and remove our gloves.

08:22 We're going to practice our hand hygiene and return when the patient's ready.

08:27 Okay. So Miss Smith is just call me with her coal light and let me know that she's ready to get off the bedpan.

08:33 So, of course, once we reenter into the room, we're going to wash our hands again.

08:36 And of course, we're going to re glove.

08:39 Make sure you go ahead and bring your supplies, like your sanitizing wipes for you.

08:44 And then we're going to return the patient back to a working height.

08:49 Okay. Miss Smith.

08:50 Hello. I'm back.

08:52 Are you finished with your bedpan? Okay, great.

08:55 So now that I'm going to do that, I'm going to go ahead and raise your bed to where I can get to you a little bit easier and lower the head of the bed.

09:06 All right, Miss Smith, I'm also going to lower this side rail, and I'm going to have you slowly go back towards the other direction.

09:14 Okay. So this is the key part here.

09:17 Once we assist your patient back.

09:20 All right. So now I'm just going to show you again when we help the patient roll it's very important to stabilize the bedpan.

09:28 The reason why this is important is you don't want this to spill.

09:31 So now, once we've stabilized this, this is a great time to go ahead and grab your tissues or your wipes to help assist cleaning the patient's anal area.

09:42 Now, once these are soiled, we can go ahead and place the wipes in the bedpan receptacle.

09:47 We're going to go ahead and set the bedpan aside.

09:51 All right. At this point we want to go ahead and remove our gloves.

09:57 And assist our patient to redress and resume back to the bed position somewhere comfortable for your client.

10:05 Let me go ahead and cover them back up.

10:09 And for safety, we want to make sure to raise our rail on our side and put the bed in the lowest position.

10:21 And of course, before you leave the room, make sure to provide the coal light for the patient. One more step is not to forget is to make sure we provide hand hygiene to the patient. Oftentimes we forget to do this.

10:33 Now for us we want to go ahead and re wash our hands and re glove again because at this point we would remove the soil bed pan materials.

10:42 We would want to make sure we collect our stool sample at this time if needed.

10:46 We want to note the quality and the amount and make sure you go ahead and use a hospital grade disinfectant when possible, and store the bedpan per agency policy.

10:57 Now you can see that there were several steps in the sequence where you might have to adjust the steps depending on what happens and what your patient needs.

11:05 For example, if the patient is unable to turn completely to the side and you can't get the bedpan under them, well, you may have to stop and then get assistance from another team member. It is also possible that a bedpan overflows.

11:20 In this situation.

11:21 You would need to change the linens and provide a complete bed bath when removing the bedpan. And in other situations, patients may be constipated and the prescribing providers need them involved.

11:32 Because at this point, you may need an order for an enema or a laxative, and this may need to be considered when using different styles of bedpans and lift devices, trapeze bars, or other pieces of mobility equipment.

11:46 The principles of positioning and gravity are similar.

11:49 The goal is to position the bedpan so that the patient is comfortable to pass stool into the cavity of the bedpan.

11:56 Then, when you're ready to remove the device, it's important that you remove it gently. So, number one, you don't accidentally spill it onto the linens or harm the patient. It's important that every time you use a bedpan, you take the opportunity to look at your patient's skin for signs of breakdown.

12:15 Is there any redness, any tearing, irritation? Because this is significant.

12:20 There are many things that can be done, but it's important that this is done earlier rather than later.

12:26 It can get busy taking care of multiple people, but try not to leave a patient sitting on a bedpan for more than 10 to 15 minutes at most.

12:35 Even if they ask to.

12:37 It's more effective to remove it and try again later before you leave.

12:42 A few things to note.

12:43 Remember that having someone help you with tasks that are traditionally private can feel violating, and many patients have trauma in their backgrounds that you may not know about. When providing bedpan assistance, take additional time to explain the steps, provide privacy, and make sure you look for signs that your patient is uncomfortable.

13:04 Thanks for watching today.