Bedpan
A bedpan or bed pan is a device used as a receptacle for the urine and/or feces of a person who is confined to a bed and therefore not able to use a toilet or chamber pot.
Bedpans can be either reusable or disposable, and include several different types. Reusable bedpans must be emptied, cleaned, and sanitized after each use and allow for urination or defecation while either sitting or lying in bed, as they are placed beneath the buttocks for use. Disposable bedpans are made of recycled and/or biodegradable materials, and are disposed of after a single use. Disposable bedpans or liners rest inside a reusable bedpan, which is needed to support the user's weight during use.
Regular bedpans look similar to a toilet seat and toilet bowl combined, and have the largest capacity. Fracture or slipper bedpans are smaller than standard-size bedpans and have one flat end. These bedpans are designed specifically for people who have had a pelvic fracture or are recovering from a 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. Bedpans have a weight limit, which is different depending on the material and style of the bedpan. For people who are over those weight limits, a bariatric bedpan can be used, which includes tapered edges for durability.
Bedpans differ from chamber pots in both size and function. Chamber pots are larger and usually have handles and a lid. A bedpan is smaller, since it is placed in the bed and positioned under the person for use. Bedpans can have lids, but most do not, as they are immediately emptied or disposed of after use. Bedpans have a long single handle that can double as a spout, either for urine entry or for emptying after use.
History
The word bedpan was first seen in the literature of John Higgins in 1572, and one of the oldest known bedpans is on display in the Science Museum of London. It is a green, glazed earthenware bedpan that has been dated to the 16th or 17th century. At that time, bedpans were made from materials including pewter, brass, pottery, glass, and porcelain. Bedpans were not a commonplace item in hospitals until the late 1800s. Florence Nightingale, who worked as a nurse in the United Kingdom from the mid to late 1800s, diagramed death rates and causes for soldiers in military hospitals during the Crimean War and then correlated them to corresponding sanitization procedures. As a result, Nightingale proposed several methods to improve the sanitary conditions in both military and civilian hospitals, including the addition of bedpans in order to reduce infection exposure from urine or feces.In the 20th century, bedpans were made of ceramic, enamel, or stainless steel, and after the 1960s, bedpan materials expanded to include plastics and disposable substances. The initial bedpan patent was created in the United States in the 1940s. Today, most bedpans are made of stainless steel, plastic, or disposable materials. Stainless steel is durable and easy to clean, but it may be cold, hard, and/or uncomfortable to use. Since the 1960s, disposable bedpans or single-use bedpan liners, made from either recycled wood pulp or biodegradable plastics, have become more popular. The first patent for disposable bedpan liners was patented in the United States in June 1976 and relied mainly on wood pulp products as the primary material.
In particular, after the introduction and implementation of the Health Technical Memorandum in the United Kingdom in 2007, now renamed Health Technical Memorandum 2030, it became mandatory to sterilize hospital equipment using an autoclave, also known as a steam sterilizer or macerator. This jumpstarted the switch from stainless steel bedpans to pulp-made bedpans within the United Kingdom, mainly because the overall cost of using a macerator outweighed the cost of disposing of pulp materials. Furthermore, in the European Union, pulp products have recently been reclassified as medical devices, beginning in 2021. This means that these products must meet certain requirements and regulations to ensure their safety and efficacy for medical use. By categorizing pulp products as medical devices, the European Union recognizes their importance in healthcare settings due to their crucial role in maintaining hygiene and preventing infection spread. Utilizing disposable bedpans can prevent the spread of infectious diseases by lowering the risk of contamination during handling and disposal of the excretions.
Use and indication
Bedpans are used for toileting for those confined to beds and may be used in a hospital, nursing facility, or at home. There are many reasons someone may be confined to bed, necessitating the use of bedpans. These include permanent or long-term disease states with limited mobility such as Alzheimer's disease, Parkinson's disease, stroke, or dementia. Additionally, individuals may be confined to bed temporarily as a result of a short-term illness, injury or surgery.Current nursing guidance suggests that bedpans are indicated for immobile patients with the following concerns: fractures, such as hip or lower extremities, profound fatigue, major surgeries, high fall risk, increased injury potential, and obstetrical.
Some downsides to using bedpans include the risk of pressure ulcers, lack of privacy, and the potential to spread infection. Pressure ulcers can be caused by prolonged use and the supporting areas of the bedpan being too small. In order to reduce this risk, ergonomic bedpans have been developed, which support the person with a larger area of less-conductive plastic. There are also designs that completely cover the genitalia during use, offering protection and providing an extra measure of privacy. Some of these ergonomic designs require material that is more difficult to sterilize, and may become a reservoir for microorganisms; there have been improvements in cleaning and sterilization to combat this.
Cleaning, sterilization, and infection control
Managing proper hygiene and the cleaning of bedpans for bedridden individuals is important to reduce the risk of infection. Used bedpans contain bodily fluids and waste 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 three categories of medical device types, which are generally agreed upon by international governing bodies, including the Center for Disease Control and Prevention, the Food and Drug Administration, and the European Centre for Disease Prevention and Control. 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. For shared equipment, the CDC recommends cleaning and disinfecting before and after each use, and when compatible disinfectants are not available, guidance is to use a washer-disinfector or boiling water. Dedicated equipment cleaning and disinfectant are similar, but with an additional note to accommodate sanitization based on the risk level of the patient. For example, caregivers should wear gloves when emptying bedpans for those on chemotherapy in order to avoid exposure to toxins. Image:Image-Oval-steel.jpg|Oval stainless steel pan|thumbUsing stainless steel or plastic reusable bedpans poses a risk of spreading infection through caregivers and the environment. 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 used copper to treat infections or infectious complications. There are a variety of alternative disposal methods to ensure that infection spread is under control, such as bedpan washer disinfector machines and disposable bedpans.
Washer disinfectors have been utilized more recently for the cleaning of reusable bedpans rather than disinfectants, especially due to the risk of cross-contamination with viruses such as SARS-CoV2 or Ebola. Washer disinfectors are instruments used to disinfect used bedpans at high temperatures of at least 80 °C to 85 °C.
Disinfector machines have been shown to be efficacious against common bacterial infections such as C. difficile spores and E. coli when following instructions, which is an alternative to disposable bedpan waste management. This was proven by a trial where commercially available washer disinfectors were evaluated for efficacy and thermal disinfections against C. difficile spores and colonies of E. coli. After one cycle of the washer the bedpan devices were observed for their efficacy in disinfection against C. diff and E. coli by using swabs of the devices shortly after the cycle, microorganisms were eluted and log-kill was calculated. This process showed evidence that the washer disinfector was highly efficacious in against both C. diff spores and E. coli colonies. However, it is important to note that not all countries have this technology and may use other methods of disinfecting for reusable bedpans or opt in for disposable bedpans. Reusable bedpans used multiple times after a disinfecting procedure carried out by hospital staff, whereas disposable bedpans are used once and then discarded right after use.