Bedside Commode: Definition and Clinical Use
A bedside commode is a portable toilet chair placed at the patient's bedside to provide safe toileting access when bathroom facilities are unsafe, inaccessible, or when patient mobility is restricted.
Primary Clinical Indications
Bedside commodes should be provided when bathroom access poses safety risks or is physically impossible for the patient. The key scenarios include:
- Patients in seclusion or isolation settings where bathroom facilities are considered unsafe 1
- Patients with impaired mobility who cannot safely ambulate to the bathroom 2
- Patients requiring continuous monitoring or restrictive equipment that prevents bathroom access 3
- Fall prevention in patients at high risk during transfers to distant bathroom facilities 4
Safety and Injury Prevention Context
Keeping a bedside commode is fundamentally a safety intervention to prevent falls and injuries during toileting. Research demonstrates that 45.2% of all inpatient falls are toileting-related, with the most common scenario being falls occurring during transfer from bed to bathroom 4.
- The commode eliminates the need for high-risk ambulation to distant bathrooms, particularly during urgent toileting needs 3, 4
- In psychiatric settings, portable commodes are specifically recommended when bathroom facilities pose self-harm or assault risks 1
- For patients with REM sleep behavior disorder or sleep terrors, bedside commodes reduce nighttime fall risk by minimizing ambulation 1, 5
Practical Implementation
The bedside commode should be positioned within immediate reach of the patient, typically adjacent to the bed. Key considerations include:
- Ensure the commode has proper safety features including lockable brakes, stable armrests for transfers, and adequate padding for patients requiring prolonged use 6
- For patients confined to one room, consider alternatives like chemical toilets to address odor and privacy concerns 2
- Disposable commode pails reduce cross-contamination risk and eliminate the need for staff to transport human waste through clinical areas 3
Infection Control Requirements
Proper handling and disposal of commode contents is essential to prevent pathogen transmission. Emergency departments have 5 times higher fecal pathogen exposure rates with traditional reusable equipment 3.
- Soiled commode contents should be disposed of in closed receptacles designated for this purpose 1, 7
- Hand hygiene must be performed after assisting with commode use, using either soap and water or alcohol-based sanitizers 7
- Reusable commode equipment requires thorough cleaning with detergent followed by EPA-approved disinfectant or 1:100 bleach solution 1
- Disposable commode systems reduce at-risk sanitization shortcuts and cross-contamination between patients 3
Patient Privacy and Dignity Considerations
Privacy concerns are paramount—120 patients in one study reported embarrassment about commode use, and 96 would not use it if someone was present 2.
- Position the commode in a location that maximizes privacy while maintaining safety 2
- 101 users reported unfavorable appearance of standard commodes; consider models with more discreet design 2
- Regular follow-up is needed to identify problems with comfort, safety, or positioning—only 15 users in one study knew who to contact for issues 2
Special Populations
For spinal cord injury patients, specialized commode-shower chairs with enhanced safety features prevent falls during transfers and reduce pressure ulcer risk during lengthy bowel care regimens 6.
In pediatric settings, provide diaper-changing areas with closed receptacles as an alternative to commodes for non-toilet-trained patients 1, 7.