Bed baths: CLINICAL

 

Bed baths, a source of contaminationand risk factor for the most frail patients

Several studies have shown:

 

During a traditional bed bath, the basin and water can be major sources of bacterial contamination, a risk factor especially for frail or immunosuppressed patients.


62% to 98% of bathing basins are contaminated: the patient risks being contaminated.1

The mechanical friction during a traditional
bath deposits cutaneous flora in the basin.
2

SMRSA, Acinetobacter, Pseudomonas, E. Coli
and many other pathogens have been detected
in the bathwater and in the environment
(nurses’ gloved hands, objects handled, towels, etc).
1

Tap water may also be a potential source of waterborne nosocomial infections.3

With age, the skin tends to atrophy and dry out; it is less supple and less firm (parchment effect).


The traditional bath may then be too aggressive,
particularly in certain areas of the body.


The friction involved in cleaning a patient with soap and water during a bed bath may present a number of risks for skin integrity.4

 

The appearance of tears in the skin may be due to a trigger factor such as a bed bath.5

Caregivers use protective gloves to bathe the patient and change any soiled protection.
 

Nevertheless, many studies have demonstrated the risks of exposure to excreta.


A risk analysis shows that exposure may happen through contamination of the hands or professional clothing.6

Sources (extracts and adaptations):
Photos : Giving a Patient a Bed Bath, Hawknurse - https://www.youtube.com/watch?v=hYXYcOHT6aE 1- American Journal of Infection Control xxx (2011) 1-3 Hospital bath basins are frequently contaminated with
multidrug-resistant human pathogens 2- O’Flynn J, Kosair Children’s Hospital. Patient bath basins are a potential risk factor for HAIs in acute care 3-Anaissie EJ, Penzak SR, DIgnani C, Arch Intern Med. 8 Jul 2002; 162(13): 1483-92. 4- Bryant RA, Rolstad BS, OstWound Mgmt. June 2001;47(6):18-27 5- Best Practice Recommendations for the Prevention and Treatment of Skin Tears By Kimberly LeBlanc, Dawn Christensen, Heather L. Orsted, David H. Keast, WoundCare Canada Volume 6, Number 1, 2008 6- extrait de ACTUALISATION DES PRÉCAUTIONS STANDARD - HYGIÈNES - VOLUME XXV - N° HORS SÉRIE - JUIN 2017.

 

Bed baths: RECOMMENDED USE

 

Single-use glove, no-rinse bathing:
Recommended use

Urinary infections: proven decrease1

Urinary tract infections are the most common bacterial infections in hospitals (36% of all infections), 80% of these infections are associated with the placement of a vesical catheter2 (the most common of all nosocomial infections, more than 1 million cases per year in the US, 200,000 in France).

Cost control: proven savings3

Another study4 showed that:
The average cost of bed baths over 6 weeks, per resident, was estimated at €218 in the experimental group (single-use glove no-rinse bathing) and at €232 in the control group (traditional bed bath with basin and water, etc.).
Results: 5% savings / costs

Patients and caregivers: proven preference3

WASHING WITHOUT WATER IS GENERALLY

THE MOST EFFICIENT ALTERNATIVE 4

Sources (extracts and adaptations):
1- Stone S, et al., Removal of bath basins to reduce catheter-associated urinary tract infections. Poster presented at APIC 2010, New Orleans, LA, July 2010 2- Infections urinaires nosocomiales Martine
BUTREAU-LEMAIRE, Henry BOTTO - Service d’Urologie, CMC Foch, Suresnes, France - Progrès en Urologie (1997) 3- Scand J Caring Sci; 2014 - Elderly patients’ and nurses’ assessment of traditional
bedbath compared to prepacked single units, Lis Horstmann Nøddeskou, Lars E. Hemmingsen, Britta Hørdam 4- International Journal of Nursing Studies, Volume 52, Issue 1, January 2015, Pages 112-120 ,
Cost-consequence analysis of “washing without water” for nursing home residents (Schoonhoven L, van Gaal BG, Teerenstra S, Adang E, van der Vleuten C, van Achterberg T).

Bed baths: MATERIAL CHOICE

 

No-rinse bathing with single-use gloves

With no risk of contamination, suitable for the frailest patients

Scientific recommendations and product features

Caregivers use protective gloves to bathe the patient and change any soiled protections. Nevertheless, many studies have demonstrated the risk of exposure to excreta,1 particularly when the task is interrupted.2 “Because of consequences that are sometimes
underestimated, excreta management requires increased vigilance by health professionals. Risk analysis shows that exposure may occur through contamination of the hands or professional clothing. A study has shown that 23% to 65% of healthcare professionals
have been exposed to splashes.”
3
“Out of 230 baths and changing of soiled protections, there were 45 interrupted tasks during bathing, 8 during changing, in bath audits. In 57.8% (26/45) of cases during bathing and 50% (4/8) of cases during the changing of protections, interruption of care was not accompanied by glove removal.” 2

Modalities of glove use when changing a patient’s soiled protection2

* The entire set of tasks includes resettling the patient.

Modalities of glove use when bathing a patient2

Moreover, a study focusing on 199 bathing sessions assessed “the use of single-use gloves for bathing bedridden patients” 4 and concluded that: “The average duration of bathing is 16.77 minutes. 43 patients experienced a sensation of freshness, 31 patients a sensation of dampness, 11 patients a sticky sensation and there were 4 cases of irritation. In addition to the primary goal of the method, which is to reduce the risk of spreading infection, there is thus a certain appeal in using single-use gloves. Optimizing glove material and improving the formula of the cleanser on the glove is likely to result in favorable opinions from caregivers and patients...”

 

The glove material should meet the most stringent demands(thick, non-woven and ultra soft; pleasant hypoallergenic lotion)

INTERNAL
LINER

ULTRA-SOFT


MOISTURIZING, PROTECTIVE
BATHING OR SHAMPOO
NO RINSE LOTION

SHAMPOOING

BATHING

Technical specifications

Non-woven glove:

Non-woven with high viscose content (40%), ultra-soft, thick (90g/m2) and waffled for good, non-aggressive cleansing of the skin, lined with a protective PE 25mic. film that is impermeable to prevent any soiling of the caregiver’s hands.


Hypoallergenic, no-rinse cleansing lotion – pH neutral, without soap, alcohol, triclosan, silicone, latex, paraben-free - 3 dermatological tests conducted and available upon request:
HET CAM, hypoallergenicity test, patch test

 

Can be heated in a microwave for more comfort
Open the package a little beforehand.

Maxi. 40°C / 100°F

No-rinse bathing with single-use gloves

With no risk of contamination, suitable for the frailest patients

Sources (extracts and adaptations):
1- Extrait de ACTUALISATION DES PRÉCAUTIONS STANDARD - HYGIÈNES - VOLUME XXV - N° HORS SÉRIE - JUIN 20174 2- Synthèse de Évaluation des pratiques d’utilisation des gants de soins au cours d’actes de nursing - L. Thiriet, K. Jeunesse, A. Gizzi, B. Ibarissène Unité d’hygiène hospitalière – Centre hospitalier – Sedan - HYGIÈNES - 2011 - Volume XIX - n° 5 3- Davanzo E, Frasson C, Morandin M, Trevisan A. Occupational blood and body fluid exposure of university health care workers. Am J Infect Control 2008; 10: 753-756 4- Extrait de Delpech, Laura ; Dubaele, JM ; Dupuis, C ; Guyot, F ; Evrard, MP ; Ducrocq, MA ; Dubois, C ; Belmekki, M Hygiènes. 2012/09; XX (4) : 237-240.