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Procedure guideline 6.1 Slipper bedpan use: assisting a patient

Essential equipment

Disposable apron and gloves

Slipper bedpan and paper cover

Toilet paper

Manual handling equipment as appropriate

Additional nurse if required

Wash bowl, warm water, disposable wipes and a towel

Preprocedure

Action Rationale

1 Take the equipment to the bedside and explain the procedure to the patient. To ensure that the patient understands the procedure and gives their valid consent (NMC 2008a, C).

2 Carry out appropriate manual handling assessment prior to commencing procedure and establish whether an additional nurse or equipment such as a hoist is necessary. To maintain a safe environment. E

Procedure

3 Take the equipment to the bedside and explain the procedure to the patient. To ensure that the patient understands the procedure and gives their valid consent (NMC 2008a, C).

4 Wash hands, put on gloves and apron. To ensure the procedure is as clean as possible (Fraise and Bradley 2009, E).

5 Close door/draw curtains around the patient’s bed area. To maintain privacy and dignity and avoid any unnecessary embarrassment for the patient (NMC 2008b, C).

6 Remove the bedclothes and, providing there are no contraindications (e.g. if patient is on flat bed rest), assist the patient into an upright sitting position. An upright, ‘crouch-like’ posture is considered anatomically correct for defaecation. Poor posture adopted while using a bedpan has been shown to cause extreme straining during defaecation. Patients should therefore be supported with pillows in order to achieve an upright position on the bedpan (Taylor 1997, E).

7 Ask the patient to raise their hips/buttocks and insert the bedpan beneath the patient’s pelvis, ensuring that the wide end of the bedpan is between the legs, and the narrow end is beneath the buttocks. A slipper bedpan provides more comfort for a patient who is unable to sit upright on a conventional bedpan (Nicol 2008, E).

8 Offer patients the use of pillows and encourage them to lean forward slightly. To provide support and optimize positioning for defaecation (Taylor 1997, E).

9 If the patient is unable to adopt a sitting/upright position, then roll them onto one side, using appropriate manual handling equipment, and insert a slipper bedpan with the narrow/flat end underneath their buttocks and wide end between their legs. Then roll the patient onto their back and so onto the bedpan. To ensure that the patient is in optimum position for eliminating. E

10 Once the patient is on the bedpan, encourage them to move their legs slightly apart and check to ensure that their positioning is correct. To avoid any spillage onto the bedclothes and reduce risk of contamination and cross-infection. E

11 Cover the patient’s legs with a sheet. To maintain privacy and dignity (NMC 2008b, C).

12 Ensure that toilet paper and call bell are within patient’s reach and leave the patient, but remain nearby. To maintain privacy and dignity (NMC 2008b, C).

13 When the patient has finished using the bedpan, bring washing equipment to the bedside, remove the bedpan, and replace paper cover. Assist patient with cleaning perianal area using warm water and soap. Apply a small amount of barrier cream to the perineal/buttock area if appropriate. Talcum powder should not be used and barrier creams should be applied sparingly, gently layered on in the direction of the hair growth rather than rubbed into the skin (Le Lievre 2002, E).

14 Offer a bowl of water for the patient to wash their hands. For infection prevention and control and patient’s comfort (Fraise and Bradley 2009, E).

15 Ensure bedclothes are clean, straighten sheets and rearrange pillows, assisting patient to a comfortable position. Ensure call bell is within reach of the patient. For patient comfort. P

16 Take bedpan to the dirty utility (sluice) room and, where necessary, measure urine output and note characteristics (see Figure 6.2) and amount of faeces. To monitor and evaluate patient’s elimination