A disposable female urinal bottle (the EasyWee tm pending) improves patient experience for immobilised females with lower limb fractures

Female patients with lower limb fractures often experience pain and loss of dignity when manoeuvred onto a bedpan. Poor bladder management, including urinary catheterisation for convenience, can lead to longer hospital stays and eventual loss of independence. Disposable pulp male urinal bottles have been modified into a shape that accommodates the female perineum but they have not been used consistently, the design has varied depending on the fabricator and no formal evidence supported their use. Using the Model for Improvement process with sequential Plan, Do, Study, Act (PDSA) cycles we formalised the design and spread the use of the urinal to other hospitals and an ambulance service. This project was inspired by a patient advocate of the female urinal. A local feasibility study focussed on female patients with hip fracture in an emergency department and was followed by a second cycle in both emergency and trauma departments. The final cycle was a multi-institutional study*. The final study cohort was immobilised female patients (n=103) and healthcare professionals supporting them (n= 118). Utility was assessed by feedback on the advantages of the urinal. Healthcare professionals were also asked about impact on their working practices. Acceptability was addressed by asking patients and healthcare professional participants whether they would recommend the urinal. Most patients and healthcare professionals in this trial would recommend the urinal to another patient. Patients felt they suffered less pain from movement and that it was a more dignified way to micturate. Healthcare professionals felt the advantages were potential to reduce the need for urinary catheters, for lifting and log rolling patients. A disposable urinal that accommodates female anatomy and supplies the same advantages as the male urinal bottle (ability to micturate without the need for movement) would have value in many clinical settings.