Bed Bath and the Infectious Risk

25/05/20

Bed bath can be a source of contamination for patients as well for caregivers.

During a traditional bed bath, the basin and water can be major sources of bacterial contamination and it is proved that 62% to 98% of bathing basins are contaminated (1).


It is thus a major risk especially for frail or immunosuppressed patients. In addition, the mechanical friction during a traditional bath deposits cutaneous flora in the basin, which may result in the presence of SMRSA, Acinetobacter, Pseudomonas, E. Coli and many other pathogens that 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)

Many studies have also demonstrated the risks of exposure to excreta during bedbath.

Risk analysis shows that exposure may occur through contamination of the hands or professional clothing (6), particularly when the task is interrupted.(7)

In 57.8% of cases during bathing and 50% of cases during the changing of protections, interruption of care was not accompanied by glove removal resulting in 23% to 65% of healthcare professionals who have been exposed to splashes.(8)

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

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 and sometimes results in the appearance of tears.(5)

No-rinse bathing with single-use gloves reduces the risk of contamination and is suitable to the frailest patients.

The pre-moistened wash glove allows quick and efficient bed bath without using traditional combination of basin and water.


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


An internal plastic liner is an additional protection, mainly to prevent the infectious risk due to interrupted tasks.


Following use, the pre-moistened wash glove must be disposed in the household waste or according to the current protocol.


Act for care

No-rinse bathing with single-use gloves has been proved to reduce infection.

A poster presented at APIC* 2010 showed that abolishing the use of basins and replacing the conventional bed bath with no-rinse bathing, resulted in a 78% drop in the rate of urinary infections associated with vesical catheters in 6 months. (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. *APIC : Association for Professionals in Infection Control and  Epidemiology ,USA).


 

In addition to the 1st objective, which is to reduce the risk of spreading infection, there is a certain appeal in using single-use gloves.

The patients and caregivers preference have been proven by a study (10).

No-rinse bathing, single use device Conventional bed bath (basin+water, etc.) No preference
Patient’s preferred bathing method (51 patients questioned) 24 (47%) 11 (22%) 16 (31%)
Caregiver’s preferred bathing method (54 caregivers questioned) 47 (87%) 6 (11%) 1 (2%)

No-rinse bathing with single-use gloves is also a mean to reduce by 20% the time dedicated for the bedbath and to cost control by 5% (11).

No-rinse bathing, single use device Conventional bed bath (basin+water, etc.)
Preparation 4 min. 5 min.
Patient bathing 21 min. 26 min.
Post-bath cleaning 4 min. 5 min.
Total 29 min. 36 min.
Result 20% time saved

Another study 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

As a conclusion, no-rinse bathing with single-use gloves  can be considered as the most efficient solution against risk of infection (11).

You can find more details on Dr.helewa pre-moistened gloves range here.

 

 

Sources:


  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 Ho Patient bath basins are a potential risk factor for HAIs in acute care

  3. Anaissie EJ, Penzak SR, DIgnani C, Arch Intern 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.

  7. 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

  8. 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

  9. 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.

  10. 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

  11. 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).