Placement and removal of a device (wedge) so that the patient can carry out both urinary (women) and fecal elimination, when the patient cannot make use of the toilet by herself due to limitations in mobility, neurological, psychiatric diseases, etc.
Objectives:
– Facilitate fecal and urinary elimination of the bedridden patient. – Educate the patient and family in wedge management.
Equipment:
– Graduated container. – Wedge. – See genital hygiene procedure kit.
Material:
– See material for genital hygiene procedure. – Non-sterile gloves. – Toilet paper. – Detergent. – Bleach. – Soaker. – Nursing records.
Procedure:
– Perform hand washing. – Prepare the material. – Preserve the patient’s privacy. – Inform the patient. – Request the collaboration of the patient and family. – Offer the bottle if male.
PATIENT WITH MOBILITY:
Place the patient in the supine position with the head of the bed elevated. Remove clothes from the bed. Ask the patient to bend the knees and raise the hips. Insert the wedge under the buttocks and make sure it is well centered.
POSITION THE PATIENT’S BED IN A NON-MOBILE POSITION:
Place the patient’s bed in a horizontal position. Remove the bedclothes. Place the patient in lateral decubitus. Place the wedge under the buttocks. Turn the patient on his back with the wedge placed on the buttocks. Check that the wedge is centered under the patient. Elevate the bedside for comfort if not contraindicated. – Cover the patient with the top sheet.
– Provide toilet paper. – Allow the necessary time and inform the patient to inform us at the end of the procedure. – Remove gloves. – Wash hands. – Put on non-sterile disposable gloves. – Remove the wedge and transfer it to the cleaning area. – Assist in genital hygiene. – Change underpads if necessary and leave bed linen neatly in place. – Provide material for hand hygiene. – Leave the patient in a comfortable position. – Pour urine into a graduated container and measure, if necessary. – Dispose in the toilet. – Clean and disinfect the bedpan. – Collect the material. – Remove gloves. – Perform hand washing. – Record in the nursing documentation the procedure, date and time, incidences, and patient response.
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