Healthcare facilities must consider a range of factors when deciding between pulp and reusable plastic bedpans, most importantly:

• Infection control
• Cost
• Staff and patient preferences
• Space limitations
• Environmental responsibility

Pulp bedpans

Pulp bedpans are widely available and are disposed of after use in a macerator or an offensive waste bin.

Reusable bedpans

Reusable bedpans are washed either by hand or by a washer-disinfector after use and are made of plastic or stainless steel.

Further Reading

Delaney, Molly Bridget. “Kick the Bucket: One Hospital System’s Journey to Reduce Clostridium Difficile.” Journal of Emergency Nursing 43, no. 6 (2017): 519–25. https://doi.org/10.1016/j.jen.2017.02.003.

Bryce, Elizabeth, Allison Lamsdale, Leslie Forrester, Linda Dempster, Sydney Scharf, Michael Mcauley, Ian Clearie, Sharon Stapleton, and Sheila Browning. “Bedpan Washer Disinfectors: An in-Use Evaluation of Cleaning and Disinfection.” American Journal of Infection Control 39, no. 7 (2011): 566–70. https://doi.org/10.1016/j.jmii.2015.02.055.

Both disposable and reusable bedpans are available to both private and commercial purchasers. Disposable bedpans are available in pulp (recycled, moulded paper) and plastic. Reusable bedpans are generally made from plastic or stainless steel. When purchasing bedpans, you should ensure they meet the relevant standards of fluid retention, including:

• ISO9001:2008
• PAS29:1999
• EU Directive 2007/47/EC

Disposables: pulp bedpans

Pulp bedpans are cheap, easy to source and environmentally friendly. They are generally produced from recycled paper products (e.g. newspapers) and, in line with regulations, will hold fluids for over 4 hours. In some cases, a plastic bedpan support may be necessary to avoid crushing when using in difficult-to-reach areas. These are widely available. When using bedpans as part of a one-way system with a macerator, you should ensure that your machine is compliant with the chosen bedpan provider. Macerator manufacturers should provide evidence of pulp testing on demand.

Disposables: plastic bedpans

Plastic disposable bedpans tend to be more expensive than pulp and are not usually made from recycled plastic. As plastic bedpans are disposed of into landfill, this cases problems with unsustainable waste. Some healthcare providers have criticised disposable plastics as being too thin and leaks occur. Their availability depends on geographic location – disposable plastic bedpans are much more widely used in North America then Europe, for example.

Reusables: plastic bedpans

Reusable plastic bedpans are much more robust than their disposable alternatives and generally made from polyethylene. They are suitable for washing by hand or in a bedpan washer and are a cheap option for reusables. With time, plastic bedpans develop scratches which become recesses for bacteria to collect and posing an infection control risk. It is therefore recommended to replace plastic bedpans every 6-12 months.

Reusables: metal bedpans

Metal bedpans are normally made from stainless steel which can offer more resistance to bacteria than plastic alternatives. They can also be handwashed or cleaned in a bedpan washer, however patients and staff often complain that this can be very noisy and disruptive. Stainless steel bedpans are much more expensive than their plastic counterparts.  They may be less pleasant for patients as they can be uncomfortable and cold.

Using pulp bedpans is a great way to start your transition to a one-way process. Here are some hints and tips on what you should think about when switching to pulp for the first time.

Supplier

Which supplier will you use? It is generally best to compare quotes from multiple suppliers to ensure you get the best price and quality. This will depend on your geographic location. For personalised advice on suppliers in your area, contact us on This email address is being protected from spambots. You need JavaScript enabled to view it..

Quantity

How many will pulp items will you need? Consumption depends on many factors such as facility type (home or healthcare provider), ward and patient mobility. A gastrointestinal ward will likely need considerably more pulp bedpans than a paediatric ward, for example. A simple audit of normal usage of reusable bedpans is one way to forecast needs. It is a good idea to order 10-20% more devices than estimated need to ensure a smooth transition to pulp. In a busy ward for twenty people, we generally estimate need of 2 pans per patient per day (assuming mobility amongst some patients so not all will need them).

Supports

Plastic bedpan supports are necessary to prevent crushing. They are easily available.

Storage

Most pulp bedpan items are stackable (with the exception of male urinal bottles). Wall mounted racks are therefore good storage solutions for easy access. If storing in the sluice room, ensure they are kept well away from slop hoppers or any other areas which could risk contamination from aerosols.

Disposal

Think about how you will dispose of used bedpans. If disposing in the trash, do local regulations require you to use certain disposal types (e.g. offensive waste)? You will need to arrange more frequent waste collection from wards to prevent overfilling. Alternatively, you could trial using a bedpan macerator so waste is immediately disposed of.

What are bedpan washers

Bedpan washers are machines which automatically clean used bedpans for reuse. Much in the same way as a dishwasher, pans are manually loaded into the device which uses hot water and detergent to wash the pans.

How do bedpan washers work?

Manufacturers offer different bedpan washer systems, however the process is usually as follows:

• Dispose of any papers in an offensive waste bin and the contents of the pan into the slop hopper (dirty sink)
• Load the bedpan(s) into the machine and start the cycle
• Machine cleaning cycles will generally include the following stages:
  1. Rinse cycle (cold water)
  2. Hot water steam cycle with detergent (minimum 1 minute at 80’C for compliance with ISO 15883)
  3. Cooling and drying cycle
• Empty and store cleaned bedpans.

Cycle duration

To be compliant with ISO standards, bedpan washer-disinfectors cycles must clean at a minimum temperature of 80’C for one minute (ISO 15883-3:2006). Cycles will usually include rinsing and cooling stages, so total cycle times vary between 3-15 minutes (depending on model and capacity).

How do I ensure bedpan washers are effective?

Bedpan washers are regulated medical devices and as such must be compliant to ISO 15883. However, studies have suggested that these standards are insufficient to eliminate spores associated with human waste, such as Clostridium difficile. Even when machines are functioning in line with ISO standards, disinfection failure rates of up to 33% have been identified (Bryce 2011, 566-570). To increase reliability, healthcare providers ensure the following:

• Comprehensive training for all staff (including agency workers)
• Regular machine testing
• Regular auditing
• Clear, uncomplicated processes

For more information on infection control, click here.

Do I have space to install a bedpan washer?

Machine dimensions vary depending on brand and specification. Most machines use standard electrical and water connections, but check with your provider at the planning stage.

What are the benefits of washers?

• Washers are a much safer way of cleaning bedpans than traditional handwashing systems
• Using a washer is less labour intensive than hand-washing
• There is a significant range of washers on the market, so you can find an option which suits your needs
• Washers are easy to install

What issues should I consider?

• Infection control– studies have reported disinfection failures in bedpan washers. We advise you to read relevant scientific papers on machine effectiveness.
• Utilities – washers can be electricity and water-intensive as they require high levels of electricity to heat water and long washing cycles. This can be expensive over the machine’s life-cycle
• Complex processes – reprocessing used bedpans requires a multi-stage, cyclical process which can be demanding on health-care workers and have increased risk factors.
• Maintenance – washers require regular maintenance and testing, costs for which should be budgeted. Consider what guidelines would need to be in place during machine downtime.

How can I guarantee complete disinfection when using a washer?

Regular surface bacteria testing of pans after washing is advised to ensure complete disinfection. ISO 15883 stipulates that washers must be tested annually as a minimum standard. Many healthcare providers schedule 6-monthly tests, particularly in high use areas, to ensure they are following safe practice.

What are the hidden costs of using bedpan washers?

Below are some hidden costs of using bedpan washers. Click here for further information.

• Utilities: washers have high water and energy consumption
• Detergent: to eliminate bacteria, high levels of expensive detergents are needed
• Maintenance: regular maintenance can be expensive, and due to the complex components in washers, breakdowns tend to be more common
• Nursing hours: time spent loading, operating and unloading bedpans into a washer, a process which takes up to four times longer than alternatives.
• Longevity: machines typically have a life cycle of 3-7 years
• Replacement plastic pans: reusable bedpans should be replaced every 6-12 months as they develop tiny scratches, in which bacteria accumulates
• Infection: if bacteria is spread through inadequately cleaned pans, the cost of HCAI treatment is expensive. Contracting a Clostridium difficile infection, for example, can increase hospital costs by 40% (Delaney 2017, 519-525).

Recommended articles

Bryce, Elizabeth, Allison Lamsdale, Leslie Forrester, Linda Dempster, Sydney Scharf, Michael Mcauley, Ian Clearie, Sharon Stapleton, and Sheila Browning. “Bedpan Washer Disinfectors: An in-Use Evaluation of Cleaning and Disinfection.” American Journal of Infection Control 39, no. 7 (2011): 566–70. https://doi.org/10.1016/j.ajic.2010.10.028.

Delaney, Molly Bridget. “Kick the Bucket: One Hospital System’s Journey to Reduce Clostridium Difficile.” Journal of Emergency Nursing 43, no. 6 (2017): 519–25. https://doi.org/10.1016/j.jen.2017.02.003.

Tresman, Rebecca, and Simon D Goldenberg. “Healthcare Resource Use and Attributable Cost of Clostridium Difficile Infection: a Micro-Costing Analysis Comparing First and Recurrent Episodes.” Journal of Antimicrobial Chemotherapy 73, no. 10 (February 2018): 2851–55. https://doi.org/10.1093/jac/dky250

Wilcox, Mark H., Harblas Ahir, John E. Coia, Andrew Dodgson, Susan Hopkins, Martin J. Llewelyn, Chris Settle, Susan Mclain-Smith, and Stephen W. Marcella. “Impact of Recurrent Clostridium Difficile Infection: Hospitalization and Patient Quality of Life.” Journal of Antimicrobial Chemotherapy 72, no. 9 (2017): 2647–56. https://doi.org/10.1093/jac/dkx174.