Bed Pan
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A bedpan or bed pan is a device used as a receptacle for the
urine Urine is a liquid by-product of metabolism in humans and many other animals. In placental mammals, urine flows from the Kidney (vertebrates), kidneys through the ureters to the urinary bladder and exits the urethra through the penile meatus (mal ...
and/or
feces Feces (also known as faeces American and British English spelling differences#ae and oe, or fæces; : faex) are the solid or semi-solid remains of food that was not digested in the small intestine, and has been broken down by bacteria in the ...
of a person who is confined to a bed and therefore not able to use a
toilet A toilet is a piece of sanitary hardware that collects human waste (urine and feces) and sometimes toilet paper, usually for disposal. Flush toilets use water, while dry or non-flush toilets do not. They can be designed for a sitting p ...
or
chamber pot A chamber pot is a portable toilet, meant for nocturnal use in the bedroom. It was common in many cultures before the advent of indoor plumbing and flushing toilets. Names and etymology "Chamber" is an older term for bedroom. The 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 Recycling is the process of converting waste materials into new materials and objects. This concept often includes the recovery of energy from waste materials. The recyclability of a material depends on its ability to reacquire the propert ...
and/or
biodegradable Biodegradation is the breakdown of organic matter by microorganisms, such as bacteria and fungi. It is generally assumed to be a natural process, which differentiates it from composting. Composting is a human-driven process in which biodegrada ...
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 A toilet seat is a hinged unit consisting of a round or oval open seat, and usually a lid, which is bolted onto the bowl of a toilet used in a sitting position (as opposed to a squat toilet). The seat can be either for a flush toilet or a dry ...
and
toilet bowl A toilet is a piece of sanitary hardware that collects human waste (urine and Human feces, feces) and sometimes toilet paper, usually for disposal. Flush toilets use water, while dry toilet, dry or non-flush toilets do not. They can be desi ...
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 A pelvic fracture is a break of the bony structure of the pelvis. This includes any break of the sacrum, hip bones (ischium, pubis, ilium), or tailbone. Symptoms include pain, particularly with movement. Complications may include internal ble ...
or are recovering from a
hip replacement Hip replacement is a surgery, surgical procedure in which the hip joint is replaced by a prosthetic implant (medicine), implant, that is, a hip prosthesis. Hip replacement surgery can be performed as a total replacement or a hemi/semi(half) repl ...
. 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 Bariatrics is a discipline that deals with the causes, prevention, and treatment of obesity, encompassing both obesity medicine and bariatric surgery. Terminology The term ''bariatrics'' was coined around 1965,Dictionary.com, based on Random ...
bedpan can be used, which includes tapered edges for durability. Bedpans differ from
chamber pot A chamber pot is a portable toilet, meant for nocturnal use in the bedroom. It was common in many cultures before the advent of indoor plumbing and flushing toilets. Names and etymology "Chamber" is an older term for bedroom. The chamber pot ...
s 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 John Higgins (born 18 May 1975) is a Scottish professional snooker player from Wishaw in North Lanarkshire. Since turning professional in 1992, he has won 33 ranking titles, placing him in third position on the List of snooker players by num ...
in 1572, and one of the oldest known bedpans is on display in the Science Museum of London. It is a green, glazed
earthenware Earthenware is glazed or unglazed Vitrification#Ceramics, nonvitreous pottery that has normally been fired below . Basic earthenware, often called terracotta, absorbs liquids such as water. However, earthenware can be made impervious to liquids ...
bedpan that has been dated to the 16th or 17th century. At that time, bedpans were made from materials including
pewter Pewter () is a malleable metal alloy consisting of tin (85–99%), antimony (approximately 5–10%), copper (2%), bismuth, and sometimes silver. In the past, it was an alloy of tin and lead, but most modern pewter, in order to prevent lead poi ...
,
brass Brass is an alloy of copper and zinc, in proportions which can be varied to achieve different colours and mechanical, electrical, acoustic and chemical properties, but copper typically has the larger proportion, generally copper and zinc. I ...
,
pottery Pottery is the process and the products of forming vessels and other objects with clay and other raw materials, which are fired at high temperatures to give them a hard and durable form. The place where such wares are made by a ''potter'' is al ...
,
glass Glass is an amorphous (non-crystalline solid, non-crystalline) solid. Because it is often transparency and translucency, transparent and chemically inert, glass has found widespread practical, technological, and decorative use in window pane ...
, and
porcelain Porcelain (), also called china, is a ceramic material made by heating Industrial mineral, raw materials, generally including kaolinite, in a kiln to temperatures between . The greater strength and translucence of porcelain, relative to oth ...
. Bedpans were not a commonplace item in hospitals until the late 1800s.
Florence Nightingale Florence Nightingale (; 12 May 1820 – 13 August 1910) was an English Reform movement, social reformer, statistician and the founder of modern nursing. Nightingale came to prominence while serving as a manager and trainer of nurses during th ...
, 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 The Crimean War was fought between the Russian Empire and an alliance of the Ottoman Empire, the Second French Empire, the United Kingdom of Great Britain and Ireland, and the Kingdom of Sardinia (1720–1861), Kingdom of Sardinia-Piedmont fro ...
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 A ceramic is any of the various hard, brittle, heat-resistant, and corrosion-resistant materials made by shaping and then firing an inorganic, nonmetallic material, such as clay, at a high temperature. Common examples are earthenware, porcela ...
, enamel, or
stainless steel Stainless steel, also known as inox, corrosion-resistant steel (CRES), or rustless steel, is an iron-based alloy that contains chromium, making it resistant to rust and corrosion. Stainless steel's resistance to corrosion comes from its chromi ...
, 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 Plastics are a wide range of synthetic polymers, synthetic or Semisynthesis, semisynthetic materials composed primarily of Polymer, polymers. Their defining characteristic, Plasticity (physics), plasticity, allows them to be Injection moulding ...
, or
disposable A disposable (also called disposable product) is a product designed for a single use after which it is recycled or is disposed as solid waste. The term is also sometimes used for products that may last several months (e.g. disposable air filt ...
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 An autoclave is a machine used to carry out industrial and scientific processes requiring elevated temperature and pressure in relation to ambient pressure and/or temperature. Autoclaves are used before surgical procedures to perform steriliza ...
, 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 In health care, toileting is the act of assisting a dependent patient with their elimination needs. Methods of toileting Depending on a patient's condition, their toileting needs may need to be met differently. This could be by assisting the pa ...
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 Alzheimer's disease (AD) is a neurodegenerative disease and the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in remembering recent events. As the disease advances, symptoms can include problems wit ...
,
Parkinson's disease Parkinson's disease (PD), or simply Parkinson's, is a neurodegenerative disease primarily of the central nervous system, affecting both motor system, motor and non-motor systems. Symptoms typically develop gradually and non-motor issues become ...
,
stroke Stroke is a medical condition in which poor cerebral circulation, blood flow to a part of the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemor ...
, or
dementia Dementia is a syndrome associated with many neurodegenerative diseases, characterized by a general decline in cognitive abilities that affects a person's ability to perform activities of daily living, everyday activities. This typically invo ...
. Additionally, individuals may be confined to bed temporarily as a result of a short-term
illness A disease is a particular abnormal condition that adversely affects the structure or function (biology), function of all or part of an organism and is not immediately due to any external injury. Diseases are often known to be medical condi ...
,
injury Injury is physiological damage to the living tissue of any organism, whether in humans, in other animals, or in plants. Injuries can be caused in many ways, including mechanically with penetration by sharp objects such as teeth or with ...
or
surgery Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...
. Current nursing guidance suggests that bedpans are indicated for immobile patients with the following concerns:
fractures Fracture is the appearance of a crack or complete separation of an object or material into two or more pieces under the action of stress (mechanics), stress. The fracture of a solid usually occurs due to the development of certain displacemen ...
, such as hip or lower extremities, profound
fatigue Fatigue is a state of tiredness (which is not sleepiness), exhaustion or loss of energy. It is a signs and symptoms, symptom of any of various diseases; it is not a disease in itself. Fatigue (in the medical sense) is sometimes associated wit ...
, major surgeries, high fall risk, increased injury potential, and
obstetrical Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgic ...
. Some downsides to using bedpans include the risk of
pressure ulcer Pressure ulcers, also known as pressure sores, bed sores or pressure injuries, are localised ulcer (dermatology), damage to the skin and/or underlying tissue that usually occur over a Bone, bony prominence as a result of usually long-term pres ...
s, lack of privacy, and the potential to spread
infection An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...
. 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 Ergonomics, also known as human factors or human factors engineering (HFE), is the application of psychological and physiological principles to the engineering and design of products, processes, and systems. Primary goals of human factors engi ...
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 A sex organ, also known as a reproductive organ, is a part of an organism that is involved in sexual reproduction. Sex organs constitute the primary sex characteristics of an organism. Sex organs are responsible for producing and transporting ...
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
microorganism A microorganism, or microbe, is an organism of microscopic scale, microscopic size, which may exist in its unicellular organism, single-celled form or as a Colony (biology)#Microbial colonies, colony of cells. The possible existence of unseen ...
s; there have been improvements in cleaning and
sterilization Sterilization may refer to: * Sterilization (microbiology), killing or inactivation of micro-organisms * Soil steam sterilization, a farming technique that sterilizes soil with steam in open fields or greenhouses * Sterilization (medicine) render ...
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 (CDC), the Food and Drug Administration (FDA), and the European Centre for Disease Prevention and Control (ECDC). 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 A disinfectant is a chemical substance or compound used to inactivate or destroy microorganisms on inert surfaces. Disinfection does not necessarily kill all microorganisms, especially resistant bacterial spores; it is less effective than ...
. 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 Chemotherapy (often abbreviated chemo, sometimes CTX and CTx) is the type of cancer treatment that uses one or more anti-cancer drugs (list of chemotherapeutic agents, chemotherapeutic agents or alkylating agents) in a standard chemotherapy re ...
in order to avoid exposure to toxins. Using stainless steel or plastic reusable bedpans poses a risk of spreading
infection An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...
through
caregivers A caregiver, carer or support worker is a paid or unpaid person who helps an individual with activities of daily living. Caregivers who are members of a care recipient's family or social network, who may have specific professional training, are o ...
and the environment. Compared to other metals like
copper Copper is a chemical element; it has symbol Cu (from Latin ) and atomic number 29. It is a soft, malleable, and ductile metal with very high thermal and electrical conductivity. A freshly exposed surface of pure copper has a pinkish-orang ...
, steel does not have an inherent ability to disinfect. Copper has had some
antimicrobial An antimicrobial is an agent that kills microorganisms (microbicide) or stops their growth (bacteriostatic agent). Antimicrobial medicines can be grouped according to the microorganisms they are used to treat. For example, antibiotics are used aga ...
indications dating back to the 19th century, as some copper workers appeared immune to
cholera Cholera () is an infection of the small intestine by some Strain (biology), strains of the Bacteria, bacterium ''Vibrio cholerae''. Symptoms may range from none, to mild, to severe. The classic symptom is large amounts of watery diarrhea last ...
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 Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19, the respiratory illness responsible for the COVID-19 pandemic. The virus previously had the provisional name 2019 novel coro ...
or
Ebola Ebola, also known as Ebola virus disease (EVD) and Ebola hemorrhagic fever (EHF), is a viral hemorrhagic fever in humans and other primates, caused by ebolaviruses. Symptoms typically start anywhere between two days and three weeks after in ...
. 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.


Global usage of bedpans

Bedpan use varies significantly among countries based on social and
cultural norms A social norm is a shared standard of acceptable behavior by a group. Social norms can both be informal understandings that govern the behavior of members of a society, as well as be codified into rules and laws. Social normative influences or so ...
, resources available, and infection control priorities. A recent study estimated that 40 percent of the world's population lacks adequate sanitary toilet facilities. This lack of access to basic sanitation has far reaching effects, leading to the spread of diseases and reducing overall quality of life. This has a correlation with the amount of bedpan usage, whether multi-use or single-use, as well as how they are cleaned. As of 2014, countries such as Denmark, France, Germany, Hong Kong, Indonesia, Mongolia, Norway, Thailand, Tunisia, and Uruguay, had rates of 93%–100% for multiple use bedpans. In other countries, single-use bedpans are more prevalent, such as in Australia, Canada, China, the UK, and the US, with rates varying from 46%–89%. Plastic bedpans are used mostly in the US (93%), Netherlands (100%), France (94%), China (100%), and Tunisia (91%), whereas steel bedpans are mainly used in Germany (91%) and Indonesia (80%). Macerators for single-use bedpans are predominantly used in Australia (73%) and the UK (95%), but not in Canada (48%), the US (7%), China (14%), and Thailand (8%). Bedpan washers use chemical disinfectants mainly in the US, Uruguay, Tunisia, and India, whereas heat is commonly used in Australia, Denmark, the Netherlands, Germany, and Hong Kong. Only 13% of bedpans were fully sterilized worldwide. It was mentioned in Canada (14%), the US (31%), the Netherlands (20%), France (9%), China (20%), Egypt (19%) and Pakistan (18%) that water was used only for manual cleaning. This was the largest study to date on worldwide bedpan usage, with 93 countries participating and providing 1440 total responses.


Alternatives

For individuals who are bedridden or experience urinary
incontinence Incontinence or Incontinent may refer to: * Urinary incontinence, the most commonly occurring type of incontinence, the involuntary excretion of urine *Fecal incontinence Fecal incontinence (FI), or in some forms, encopresis, is a lack of con ...
, urinary
catheters In medicine, a catheter ( ) is a thin tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. Catheters are man ...
provide an additional option for getting rid of fluid waste; however, fecal matter may still require the use of a bedpan or other instruments. Indwelling urinary catheters are catheters that can be used for years and, akin to bedpans, come either as a one-time-use drainage bag or as a leg bag that can be cleaned or reused. While there are benefits to catheters, a common complication of long-term catheter use is asymptomatic
bacteriuria Bacteriuria is the presence of bacteria in urine. Bacteriuria accompanied by symptoms is a urinary tract infection while that without is known as asymptomatic bacteriuria. Diagnosis is by urinalysis or urine culture. ''Escherichia coli'' is the ...
. Portable
urinals A urinal (, ) is a sanitary plumbing fixture similar to a toilet, but for urination only. Urinals are often provided in men's public restrooms in Western countries (less so in Muslim countries). They are usually used in a standing position. U ...
, or urinal bottles, are common instruments used by not only those who are bedridden, but also those en route to get rid of liquid wast

````. The use of portable urinals has a long history, dating back to the
French Renaissance The French Renaissance was the cultural and artistic movement in France between the 15th and early 17th centuries. The period is associated with the pan-European Renaissance, a word first used by the French historian Jules Michelet to define ...
in the 16th century, when surgeons developed the urinals to manage male urinary incontinence. Female urinals do exist; however, they may be less easy to use compared to male urinals since they require a wider opening and this can lead to spillage, especially for bedridden individuals, for whom a bedpan may be better suited. Mobile shower commodes are types of sturdy portable toilets that can be used outside the bed by individuals. For those with spinal cord injuries, shower commodes are a common part of assistive technology to help with bowel movements and bathing routines. Some concerns with shower commodes include long and frequent usage being associated with skin breakdown and the development of pressure ulcers, but additional studies need to be conducted to further address safety concerns. Old age and multiple
comorbidities In medicine, comorbidity refers to the simultaneous presence of two or more medical conditions in a patient; often co-occurring (that is, concomitant or concurrent) with a primary condition. It originates from the Latin term (meaning "sickness" ...
increase the risk of adults developing urinary incontinence. Absorbent products are designed specifically to absorb or contain urine, and some are even reusable. There are various designs of absorbent products, and some may be better suited for individuals depending on their level of incontinence. Pantyliners, pads, and leakage guards for adults help to manage light to moderate incontinence, whereas undergarments, protective underwear, and
adult diapers An adult diaper (or adult nappy in Australian English, British English, and Hiberno-English) is a diaper made to be worn by a person with a body larger than that of an infant or toddler. Diapers can be necessary for adults with various conditions, ...
help to manage moderate to heavy incontinence. Choosing which product to use depends on a variety of different factors, such as gender, cost, and level of dependence on absorbent products, but all such products have an absorbent lining that prevents leakage and odor.


See also

*
Chamber pot A chamber pot is a portable toilet, meant for nocturnal use in the bedroom. It was common in many cultures before the advent of indoor plumbing and flushing toilets. Names and etymology "Chamber" is an older term for bedroom. The chamber pot ...
*
Urinal (health care) A urinal, urine bottle, or male urinal is a bottle for urination. It is most frequently used in health care for patients who find it impossible or difficult to get out of bed during sleep. Urinals allow the patient who has cognition and move ...
, used for male patients' urination


References

{{Toilets Toilets Medical equipment