Robust, functional and easy to clean, the Design Bugs Out commode minimises the risk of infection without compromising the patient’s dignity.
Designer: PearsonLloyd
Manufacturer: Kirton Healthcare
The problem
Existing commodes tend to be made up of multiple parts, with complex junctions between different materials. This makes them difficult and time-consuming to take apart for thorough cleaning.
The solution
A simplified construction makes cleaning the commode quicker and easier, reducing the risk of HCAIs. Aesthetic and functional changes also improve patient comfort and dignity.
How it works
A detachable plastic shell and robust stainless steel frame make the commode easy to clean and easy to store.
Using a top-loading system for the pan instead of mounting it on the underside of the seat eliminates gaps and openings, preventing waste from contaminating any hard-to-reach parts of the commode. And fewer touch-points between patient and commode reduce the chance of cross-infection through contact with contaminated surfaces.
The Commode has adjustable arm rests so patients can slide directly onto it from a bed or chair. Adjustable footrests also make it easier for patients to get into and out of the Commode. Research also found that making a commode look like a piece of furniture can be off-putting for patients. The new design actually looks like a toilet instead of a chair, which helps put patients at ease when using it at the bedside.
The designers' insights
In this short film, PearsonLloyd discuss their work on the Design Bugs Out project.
Evaluation
The new commode was well received by staff. It was seen as easier to clean and able to be cleaned more thoroughly than existing commodes. It was also seen as easy to operate, stable and safe. It was considered easy to transfer patients on and off it. The pulp pan was also well received, as was the overall appearance of the commode. Overall, 78% of staff thought that it was an improvement on the old commode.
Patients were almost unanimous in praising the cleanliness of the commode, and also found it robust, functional and easy to get onto and off. Some 90% of them liked it, as did 84% of visitors.
One issue for some hospitals was that the commode did not fit well with their toilets, and this is something that trusts considering adopting the commode would need to bear in mind.
The work carried out by a human factors expert confirmed that the commode performed well across all the criteria developed by stakeholders: 92% of staff and 87% of patients and visitors considered it an improvement on the old commode.
One issue that arose was that commodes were not cleaned consistently. This did not arise from the design of the commode – indeed, it was seen as being easier to clean than the old commode – but rather is a matter of staff training. As such, it is something that all hospitals may wish to check.
Another issue was storage, a point that also arose from the staff survey, with a significant minority of staff having concerns about this. Observation of a new stacking storage system suggests that this may well help to alleviate these concerns.
There were few other issues arising during the introduction of the commode. A design flaw in the pulp pan was quickly corrected and, as noted above, the new design was very favourably received. One point that trusts considering introducing the new commode will need to bear in mind, however, is that the pan does not fit some toilet units, so other pulp pans may be needed if stool samples are collected from patients by giving them a pulp pan to take into the bathroom to use with the toilet.
The laboratory-based cleaning assessments confirmed that the new commode was easier to clean than the old one.
To sum up, the evaluation strongly suggests that the new commode is a significant improvement on existing designs, which is well received by staff, patients and visitors alike.