The "sharing" of bedpans, portable urinals and vomit bowls among National University Hospital (NUH) patients will soon be scrapped for a more hygienic system.
Earlier this month, the hospital started replacing such items with disposable versions, which can be easily shredded and flushed away after a single use.
By March, all 38 wards and seven other sections, including the emergency department and operating theatres, will be fully converted to the disposable system. This means no more bad smells and higher hygiene standards for patients, said Mrs Lee Siu Yin, NUH's director of nursing.
The move, a first for a Singapore hospital, follows a successful 2012 trial by NUH in which patients used containers made of wood pulp. These were then thrown into a machine, called the macerator, to be flushed away like toilet paper.
Forty-seven macerators have now been bought by the hospital for about $500,000. The supply of pulp containers will cost up to $2,500 a month for each of the 45 sections. That works out to $112,500 a month or $1.35 million a year.
But the costs will not be passed on to patients, said Mrs Lee.
Currently, nurses have to empty soiled bedpans down a sluice and place the items, one by one, into a sanitiser machine for sterilisation, so that other patients can use them. Urinals and vomit bowls are cleaned using similar methods.
But bacteria such as the clostridium difficile, which can cause diarrhoea and is a growing problem at health-care facilities, are often shed in faeces.
"We don't want our patients to catch these bugs," said Mrs Lee, explaining that the disposable system can help with infection control, especially among the elderly and more seriously ill patients.
And then there is the smell after the items are used.
Although staff will try to remove them from the patient's bedside as quickly as possible, in C-class wards which do not have air-conditioning, for instance, the smell is "not very nice", she said.
The hot water which staff use to clean bedpans produces steam, which can worsen the stink.
"I am all for it because it is more hygienic - just use and throw. It's convenient," said 72-year-old retired engineer John Chee, who used a disposable urinal during his four-day hospital stay two weeks ago.
But the appearance of the containers could be improved, for instance, with a coat of paint or lacquer, suggested Mr Chee, who was warded after complaining of dizzy spells. "It looks like cardboard, so people may have the impression that it will leak."
Generally, the containers do not leak but they may get soggy if liquids are left inside for hours.
For nurses, the disposable system means the end of having to wash bedpans, which sometimes remain stained and have to cleaned again. Also, sanitiser machines can hold only one to four bedpans at a time, with each wash cycle lasting 12 minutes.
This means nurses often have to keep checking on the cleaning's progress. Said senior staff nurse Moe Oo Khin: "As nurses, we want to to spend more time with the patients, not on cleaning."
Removing patients' waste and vomit can take up to four hours of a nurse's time each day. The disposable system greatly cuts down the time spent on this, she added.