Elimination Assistance

Assisting with a Bedpan

Procedure Guidelines 1. Provide privacy by closing the bedside curtain or the door to the room. 2. If the bedpan is cold, place it under warm, running water for a few seconds. Dry it and cover it with a bedpan cover or towel. 3. With the side rail in the raised position on the opposite side of the bed, raise the bed to a comfortable working height. 4. If the patient is mobile in bed and can assist: A. Help the patient into a supine position, and raise the head of the bed 30 to 60 degrees. B. Lower the top linens so they are out of the way, but do not expose the patient more than needed. Then remove the bedpan cover and place it nearby. C. After powdering the rim of the bedpan to prevent sticking, instruct the patient to flex the knees and lift the hips. If necessary, place one hand (palm up) under patients sacrum to help lift. With your other hand, slip the bedpan under the patient with its rim facing the foot of the bed. If using a fracture pan, slip it under the patient (with the narrow end under the sacrum) as the hips are raised. 5. If the patient is immobile or has restricted mobility on the bedpan: A. Lower the head of the bed flat (if medically appropriate), raise the bed to a comfortable working height, and remove the top linens so you can turn the patient while minimizing exposure. B. Help the patient roll onto one side with the patients back toward you.

Mosby items and derived items 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Procedure Guidelines C. With the open rim of the bedpan facing the foot of the bed, place the pan firmly against the patients buttocks and push it down toward the mattress. D. Keeping the bedpan centered under the patient with one hand, place your other hand around the hip and help the patient roll flat on his back onto the bedpan. Do not force the pan under the patient. E. Raise the head of the bed 30 degrees and raise the knee gatch (or have the patient bend the knees), unless contraindicated. 6. Cover the patient for warmth. 7. Ensure that the patient can easily reach the call light and toilet tissue.

8. Instruct the patient to wipe from front to back to prevent the transmission of anal bacterial to the urinary tract. 9. Remove gloves. Ensure that the bed is in the lowest position with the side rails up. 10. Give the patient privacy, but monitor regularly and respond promptly to the call light. 11. When the patient signals, apply clean gloves and position the bedside chair near the working side of the bed. 12. Move the top linens aside and, if the patient is able to wipe own perineal area, ask if it has been done. 13. If the patient is mobile in bed: A. Have patient flex knees and lift buttocks by shifting weight onto feet and upper torso. B. If necessary, lift patients sacrum with one hand and hold the side of the bedpan with the other. C. Remove the pan, cover it, and place it on the chair. D. Assist patient in performing hand hygiene. 14. If the patient is immobile:

Mosby items and derived items 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Procedure Guidelines A. Lower the head of the bed, hold the bedpan steady, and help the patient roll onto side and off the bedpan. B. Remove the pan, cover it, and place it on the chair. C. If patient cannot wipe own perineal area, clean this area from front to back, using toilet tissue or a perineal wipe, noting the skin integrity in the perineal area. D. Place used tissue in the bedpan (or trash if intake and output are being measured). E. If needed, perform perineal hygiene.

15. If necessary, changed soiled linens. Make the patient comfortable. Ensure that the bottom linens are wrinkle-free and that the call light is within patients reach. 16. As part of follow-up care, note characteristics of patients stool and urine. If needed, obtain specimens for testing. 17. Empty bedpan contents into toilet. Rinse or disinfect the pan according to facility policy. 18. Discard gloves and perform hand hygiene.

Mosby items and derived items 2009 by Mosby, Inc., an affiliate of Elsevier Inc.