Disposable female urinal bottle (the UniWee) improves patient experience for immobile women with lower limb fractures

BACKGROUND: Female patients with lower limb fractures experience pain and loss of dignity when manoeuvered onto a bedpan. Poor bladder management, including urinary catheterisation for convenience, can lead to longer hospital stays and eventual loss of independence. Staff at Great Western Hospital Emergency Department modify disposable male urinal bottles to accommodate the female perineum without need to reposition the patient. These have not been used consistently and no formal evidence supported their use. METHODS: This project was inspired by a patient who advocated widespread use of the 'female' urinal. We formalised the design of the urinal and spread use to other hospitals and an ambulance service in the South West of England over three improvement cycles. Feedback on utility and acceptability of this urinal was sought from the study group of female immobile patients (primarily hip fracture) and healthcare staff supporting them to use the urinal. Local feasibility studies were initiated in an emergency department and then extended to the emergency and trauma departments. The final cycle was a study in four hospital sites. Evaluation was conducted from January 2021 to February 2023. RESULTS: The final study cohort included 103 immobile female patients and 118 healthcare professionals. 74% of patients (n=103) and 78% of healthcare professionals (n=118) in this trial would recommend the urinal. Patients felt they avoided pain because the urinal minimised movement and that it was a more dignified way to void their bladder. Healthcare professionals felt that the potential advantages were reducing the need for urinary catheters, and reducing lifting and log rolling patients. CONCLUSION: A disposable urinal that accommodates female anatomy and supplies the same advantage as the male urinal bottle in allowing the patient to void the bladder without repositioning, appears to be acceptable to patients and staff and would have value in many clinical settings.