News

Disposable Eco-Friendly Bedpans Increase Nurse Morale

Vernacare Pulp Products

Bedpan Bliss - Increases Nurse Morale

No one enjoys cleaning bedpans, emesis basins and other plastic containers used to collect human excrement and body fluids, but it's been part of a nurse's job for as long as we can remember.

The plastic containers used in recent years have also added thousands of pounds of trash to the country's landfills. However, a number of American hospitals have begun joining their European counterparts, switching to environmentally friendly, single-use, paper products for waste disposal.

The reaction? Some might call it bedpan bliss.

"It's been successful, especially for nurse satisfaction," said Amy Tyler, RN, BSN, CEN, a staff development specialist for emergency services and the clinical decision unit at Christiana Care Health System in Wilmington, Delaware, which implemented the disposable system in the emergency department in 2008. "They are not having to clean out used patient-care items."

Vernacare of Toronto, Canada, produces the molded pulp-paper product, which resembles an egg carton, from recycled newspapers and telephone books, without using dyes or bleaches. It adds a natural resin to keep the utensils leak-proof. Bedpans require a plastic base, since the pulp-paper device cannot support a patient's weight.

Once a patient uses the item, the nurse disposes of it in a machine called a macerator, which adds water and grinds the vessel into fine paper fragments and sends them and the human waste out through the sewer system. The dishwasher-sized device is quiet and can handle multiple bedpans or urinals at one time.

"It's a time saver," Tyler said. "You can drop a used item into it, hit the start button and continue with what you were doing."

Thomas added that Vernacare decreases unpleasant odors on the unit, and the macerator requires no internal cleaning.

There are some procedural adjustments that have to be made, however, as nurses and technicians learn to properly use Vernacare products. For instance, urinals must be weighed to determine output, rather than read with a gauge while looking through the container. It is also critical that staff remembers not throw gloves, gauze or other items in the macerator, or it will clog.

"It's important to never put in anything that wouldn't go into a toilet," Tyler said.

European hospitals have used Vernacare products for more than 50 years. As some European nurses came to work in Canada and the United States, they introduced the system to North American hospitals. But the products did not take off until facilities started becoming more environmentally conscious. Today there are approximately 1,000 units in use throughout North America.

"It feels really good to be going green," said Wendi Thomas, RN, CEN, emergency department nurse manager at Petaluma Valley Hospital in Petaluma, California, which has used the single-use products from Vernacare for about 10 years. "And from the infection control perspective, it feels good."

No data exists to show whether Vernacare products might also reduce the risk of transmitting infections. A 2006 article in Healthcare Quarterly, however, attributed washing bedpans with a toilet wand with contributing to an increase in Clostridium difficile-associated diarrhea cases at a Toronto hospital. The facility converted to disposable bedpans and a macerator as one of many interventions, which succeeded in cutting the rate of C. difficile cases in half.

Bedpans are not the only vessels that present infection control challenges. A recent study in the American Journal of Critical Care reported that bath basins are a reservoir for bacteria and a source of transmission of hospital-acquired infections, especially for high-risk patients. The nurse researchers found some form of bacteria grew on 98 percent of the sterile sponges used to obtain basin samples for culturing. Thirteen percent of the samples grew vancomycin-resistant enterococci and 8 percent methicillin-resistant Staphylococcus aureus.

Tim Emo, vice president of Vernacare, added that the disposable system is safer for nurses as well as patients, because they avoid any splashes or aerosolization when cleaning a bedpan or commode bucket.

"It's a small tool to make bedside nursing more tolerable," Emo said.

Emergency departments, such as those at Petaluma and Christiana, tend to be the first departments to convert to Vernacare, Emo said. Tyler expects that is because the items are only used a couple of times in the emergency department, compared to multiple uses on an inpatient unit. Christiana has eliminated using more than 7,000 emesis basins, 17,000 urinals and 25,000 wash basins annually in its emergency department.

"In places where there is short duration of use, that's where you really accumulate a lot of plastic items going out," Tyler said.

Thomas indicated that the paper products cost about the same as plastic urinals, bedpans and emesis basins. The macerator, however, represents an additional investment.

Because hospitals save the costs associated with disposing of the plastic bedpans, basins and urinals, Emo estimates a facility can recoup the macerator's cost within 18 to 24 months.

Christiana Care eliminated the need to haul 4,000 pounds of plastic to a landfill during the first nine months after implementing Vernacare, Tyler reported.

"Just think of how long it would take to break that down," Tyler said. "Consider what this is doing for the landfill."