Toileting for bedbound patients is a topic that is not widely discussed, but is an everyday procedure that can cause distress and embarrassment to many patients who may already be suffering and in discomfort.


Toileting for bedbound patients is a topic that is not widely discussed, but is an everyday procedure that can cause distress and embarrassment to many patients who may already be suffering and in discomfort.


That is why the dignity and comfort of all patients is at the heart of what we do every day at Vernacare.


From a very personal perspective, my own sister, a highly competent and talented clinician, was diagnosed with terminal cancer in her twenties and found being reliant on others for her toileting to be deeply humiliating and one of the hardest parts of coping with the latter stages of her illness. It is that experience that drives me personally to strive to develop the best possible solutions for patient toileting and personal care.


Single-use male urinals have been around for more than fifty years, enabling male patients to urinate independently, but that option wasn’t available for bedbound female patients. Whilst traditional bedpans and slipperpans ‘worked’ as a toileting method, it didn’t give female patients the ease of use, independence and dignity they deserved. It was a problem that urgently needed addressing.


In collaboration with clinical experts, we brought an innovation to female toileting that healthcare markets needed, delivering a disposable independent toileting solution for women, reducing the need to be catheterised and preserving patient dignity. The ‘VernaFem’, is a wide-opening female urinal with curved edges, ergonomic design and enough capacity to minimise the risk of spillages (1200ml when flat, and 525 ml at a 20 degree angle).


The VernaFem was a bold and challenging project, and we were particularly pleased to hear of a study carried out by Richardson, Farrington, Hill and Fader at the University Hospital Southampton NHSFT entitled ‘Supporting women with toileting in palliative care: use of the female urinal for bladder management’ (International Journal of Palliative Nursing 2016, 2016 Nov 2;22(11): 524-533). They considered that urinary incontinence and toileting for terminally-ill female patients in acute healthcare settings had been neglected. Whilst bedpans were available, many patients found them to be uncomfortable and embarrassing. Female catheters also increased the risk of urinary infections. The VernaFem empowered women to toilet themselves.


The researchers recognised the need to compare findings amongst healthy women, and those who were on an oncology ward receiving palliative care as well as asking healthcare professionals for their perspectives. Between February 2015 and March 2016, all participants used the VernaFem at least once, and were the interviewed about their experience with specific reference to positioning, spillage, ease of independent use, comfort, and impact of dignity.


Positioning: whether the VernaFem can be used if the patient is horizontal, and how it compares to using the product whilst standing or seated;


All participants were given basic instructions on how to position themselves, most opting to sit half-up in bed or choose their own position. One participant spoke of how ‘you can very comfortably get it in the correct position without having to sort of get yourself in an awkward position’, whilst another patient spoke of the bedpan being more difficult to use than the VernaFem.


Spillage: whether the urinal can be used without spillage;


One member of staff said they had been told to expect spillages with a bedpan as a non-preventable incident, but the shape of the VernaFem made a spillage a lot less likely.


Ease of independent use: whether a nurse or healthcare assist is needed to assist the patient;


Of the healthy participants, all were able to use the VernaFem with no help. The patients who were interviewed were assisted to position the VernaFem, and were largely able to use the product alone. Healthcare staff remarked that the VernaFem only needed one member of staff to help a patient which would be of great benefit to nursing staff and patients alike.


Comfort: how comfortable the VernaFem was to use compared to other products;


Described by participants ‘perfect’, ‘magic’, ‘robust’ and ‘secure’, the majority of users preferred the VernaFem to the bedpan, with others referring to the product as ‘safer’ and ‘more secure’ than the bedpan.


Impact on dignity and privacy: whether the VernaFem allows them to maintain their dignity compared to other toileting means including bedpans and catheters.


The VernaFem was referred to as ‘discreet’, with one participant talked about there being ‘something better about doing it yourself and having a bit of control over your own body’, with other nursing staff stating that the lesser likelihood of spillages meant less bed changes which was naturally more dignifying for patients.


What can we learn from the study?


With the patients who took part in the study receiving end of life care, the VernaFem allowed them to toilet themselves with less discomfort, especially at night with the difficulties in being able to get out of bed alone. The VernaFem was better than the bedpan, but patients and staff alike needed to become more familiar with the female urinal after always using bedpans. Some patients didn’t need to use continence pads or catheters anymore because they had the option of the VernaFem.


What do clinicians think about the VernaFem?


We think we’ve created a revolutionary product, but when we spoke to clinicians, they told us that the VernaFem with its aesthetic and ergonomic design solved many female toileting issues, “like a toilet being pushed under you”. They commented on how it could assist patients who had poor mobility, were recovering from operations or needed assistance in using the toilet. They also commented on the fact that it could be easily gripped for patients who might have difficulty in using their hands, such as arthritic patients. They valued the fact that the VernaFem gave them a viable alternative to a female catheter and exposing themselves to a heightened risk of acquiring Catheter Associated Urinary Tract Infections (CAUTIs).


The VernaFem is a real winner


In October 2017, we were delighted and very proud to win the Patient Experience Award for our VernaFem female urinal at The NHS in the North West Excellence in Supply Awards. Chair of NHS North West Procurement Development and Chief Executive of event sponsors the Innovation Agency, Dr Liz Mear said: “The collaboration of Vernacare with Lancashire Teaching Hospitals in developing VernaFem is a great example of using innovation in procurement to improve care.”


When we developed the VernaFem with support from the Lancashire Teaching Hospitals NHS Foundation Trust and other Trusts across the North West and UK, it’s because we know that collaborative working is the key to clinical success. VernaFem is helping the NHS and global healthcare providers to prevent potentially deadly and costly Catheter Associated Urinary Tract Infections (CAUTIs) and Healthcare Associated Infections (HCAIs).

The VernaFem’s latest iteration hasn’t even celebrated its 2nd birthday yet. We were the first to introduce a truly patient focussed disposable female urinal back in 2013, and that’s because we listen to what healthcare professionals and patients tell us. We know there’s always more to learn to ensure we’re designing and delivering the best products we can. The VernaFem is just the beginning.


You can watch our video all about the VernaFem here


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