Offering the Bedpan

Written by Amanda R. McDaniel, MS, BSN, RN
Amanda is a BSN/RN with a MS in Physiology and a BA in English. She worked as a medical writer in the pharmaceutical industry for 11 years before pursuing a career in nursing. She now works as a nurse on a NeuroTelemetry unit and continues to write and edit on a freelance basis. Amanda’s LinkedIn

When a resident is bed-bound, they must use a bedpan to urinate and defecate. This can be embarrassing for the resident, so it should be done with sensitivity to the resident’s privacy and dignity.

There are two types of bedpans. A regular bedpan is the deeper and more rounded of the two. A fracture pan has a relatively flat upper end with a trough at the lower end. Fracture pans are used for residents who have difficulty, or restrictions against, moving their hips and/or backs.

  1. Gather your supplies.
    • Gloves
    • Appropriate bedpan
    • Toilet tissue or disposable wet wipes
    • Clean bedding (if needed)
  2. Provide the resident with privacy by closing the door or curtain.
  3. Don gloves.
  4. Raise the bed to a comfortable working height.
  5. The resident should be lying on their back (supine).
  6. Remove the top bedding to provide access.
  7. If the resident can help with the process:
    • Raise the bed to Semi-Fowler’s position.
    • Have the resident flex their knees and keep their feet flat on the bed.
    • The resident should then raise their hips.
    • Slide the bedpan under the resident’s bottom. The trough of the bedpan should be toward the foot of the bed. Do not force the bedpan into place.
    • Have the resident lower their bottom onto the pan.
  8. If the resident is immobile or cannot help with the process:
    • Help the resident roll to face away from you. This may require logrolling the resident.
    • Place the bedpan against the resident’s bottom and hold it in place as you help the resident back to a supine position. Again, the trough of the bedpan should be toward the foot of the bed.
  9. Raise the head of the bed to the degree the resident can tolerate.
  10. Lower the bed back to the lowest position and step away to give the resident privacy.
    • It is VERY important to keep the amount of time a resident is on a bedpan to the shortest time possible. The edges of the pan can quickly create pressure wounds.
  11. If you leave the room, remove gloves and perform hand hygiene.
  12. To remove the bedpan:
    • Raise the bed to a comfortable working height.
    • Help the resident clean themselves with toilet tissue or wet wipes. Female residents should always be wiped front to back.
    • If the resident can help, have them lift their bottom as they did when getting on the bedpan. Be sure to have at least one hand on the bedpan to prevent spilling. Slide the bedpan from under the resident.
    • If the resident cannot help, lower the head of the bed. Help the resident roll to face away from you. This may require logrolling the resident. Be sure to have at least one hand on the bedpan to prevent spilling. Slide the bedpan from under the resident.
    • Help the resident back to a comfortable position and perform hand hygiene.
  13. Change the resident’s linens if they have become soiled.
  14. Lower the bed back to lowest position.
  15. Note the type and quantity of waste in the bedpan. Dispose of the waste in the toilet and clean or dispose of the bedpan per institutional policy.
  16. Remove gloves and Perform hand hygiene.
  17. Document the procedure and waste per institutional policy. Report any difficulties or change in elimination pattern (ex. diarrhea or blood-tinged urine) to the nurse per unit policy.

References

Bowel elimination and gastric intubation. (2014). In A. G. Perry, P. A. Potter, and W. R. Ostendorf (Eds), Clinical nursing skills & techniques (8th ed., pp. 844-848). St. Louis, MO: Mosby Elsevier.

More Resources

Supine Position

Supine position is a natural and comfortable position for most people. For this reason, it is a highly utilized position for nursing procedures. Unfortunately, this position puts pressure on many bony prominences that can lead to discomfort and/or pressure ulcers if the pressure is not relieved every so often (typically every two hours or less).

Removing Personal Protective Equipment

It is important to follow the correct procedure while removing personal protective equipment to avoid contaminating your skin or clothing. The most common source of contamination in this process stems from improper removal of gloves. Gloves are often the most soiled piece of equipment. To avoid contaminating your skin or the other equipment worn, gloves should always be removed first. Then remove the goggles, gown, and mask, in that order.

Partial Bed Bath

Bathing is an important part of a patient’s health routine. A partial bed bath focuses on bathing sensitive areas that cause discomfort if not cleansed frequently, such as the face, hands, axillae, back, and perineum. Though patients receiving a bed bath are typically confined to the bed, some are able to wash themselves and should be encouraged to do so to promote independence.

Prone Position

Prone position is not used as commonly as other patient positions. This position allows for full extension of the hips and the knees and gives many bony prominences a break from continuous pressure. However, placing patients in prone position does not come without the risks of pressure ulcers.

Using a Gait / Transfer Belt to Assist the Resident to Ambulate

Walking (aka, ambulating) helps residents maintain mobility and independence, and prevents complications. However, ambulation must be done safely so that the resident does not have a fall or injury. A gait or transfer belt, when properly used, can increase resident safety. Gait belts can vary between facilities, so make sure you know how to use the one in your facility.

Handwashing for CNAs

Handwashing is considered the single most important practice to prevent the spread of infection. Even when hands look clean, they could potentially be crawling with dangerous microorganisms and pathogens. Using soap and friction during handwashing helps loosen the oils on the skin, allowing dirt and pathogens to be rinsed away.