How does washing without water perform compared to the traditional bed bath: a systematic review

Fabian M V Groven, Sandra M G Zwakhalen, Gaby Odekerken-Schröder, Erik J T Joosten, Jan P H Hamers, Fabian M V Groven, Sandra M G Zwakhalen, Gaby Odekerken-Schröder, Erik J T Joosten, Jan P H Hamers

Abstract

Background: For immobile patients, a body wash in bed is sometimes the only bathing option. Traditionally, the bed bath is performed with water and soap. However, alternatives are increasingly used in health care. Washing without water is one such alternative that has been claimed to offer several advantages, such as improved hygiene and skin condition. This systematic review aims to provide a comprehensive overview of the evidence on outcomes of the washing without water concept compared to the traditional bed bath.

Methods: Controlled trials about washing without water outcomes published after 1994 were collected by means of a systematic literature search in CINAHL, Embase, MEDLINE, and PUBMED at the 25th of February, 2016. Additionally, references and citations were searched and experts contacted. Studies were eligible if (1) the study designs included outcomes of washing without water products developed for the full body wash compared to the traditional bed bath, and (2) they were controlled trials. Two researchers independently used a standardized quality checklist to assess the methodological quality of the eligible studies. Finally, outcomes were categorized in (1) physiological outcomes related to hygiene and skin condition, (2) stakeholder-related outcomes, and (3) organizational outcomes in the data synthesis.

Results: Out of 33 potentially relevant articles subjected to full text screening, six studies met the eligibility criteria. Only two studies (of the same research group) were considered of high quality. The results of these high quality studies show that washing without water performed better than the traditional bed bath regarding skin abnormalities and bathing completeness. No differences between washing without water and the traditional bed bath were found for outcomes related to significant skin lesions, resistance during bathing and costs in the studies of high quality.

Conclusions: There is limited moderate to high quality evidence that washing without water is not inferior to the traditional bed bath. Future research on washing without water is needed and should pay special attention to costs, hygiene, and to stakeholder-related outcomes, such as experiences and value perceptions of patients, nursing staff and family.

Keywords: Bathing; Baths; Bed bath; Hygiene; Patient experiences; Review; Washing without water.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram. Legend: A total of 6 studies were used to inform the findings for this manuscript. None of the studies labeled as “uncertain” based on title or abstract screening turned out to be eligible. Flow diagram adapted from Moher, Liberati, Tetzlaff, Altman, and THE PRISMA Group (2009) [37]

References

    1. Thoma-Lürken T, Bleijlevens MHC, Lexis MAS, Hamers JPH, de Witte LP. An overview of potential labor-saving and quality-improving innovations in long-term care for older people. J Am Med Dir Assoc. 2015;16:482–489. doi: 10.1016/j.jamda.2014.12.017.
    1. Schoonhoven L, van Gaal BGI, Teerenstra S, Adang E, van der Vleuten C, van Achterberg T. Cost-consequence analysis of “washing without water” for nursing home residents: a cluster randomized trial. Int J Nurs Stud. 2015;52:112–120. doi: 10.1016/j.ijnurstu.2014.08.001.
    1. Gozalo P, Prakash S, Qato DM, Sloane PD, Mor V. Effect of the bathing without a battle training intervention on bathing-associated physical and verbal outcomes in nursing home residents with dementia: A randomized crossover diffusion study. J Am Geriatr Soc. 2014;62(5):797–804. doi: 10.1111/jgs.12777.
    1. Barsevick A, Llewellyn J. A comparison of the anxiety-reducing potential of two techniques of bathing. Nurs Res. 1982;31(1):22–27. doi: 10.1097/00006199-198201000-00005.
    1. Downey L, Lloyd H. Bed bathing patients in hospital. Nurs Stand. 2008;22(34):35–40. doi: 10.7748/ns2008.04.22.34.35.c6531.
    1. Vollman K, Garcia R, Miller L. Interventional patient hygiene: proactive (hygiene) strategies to improve patients’ outcomes. AACN News. 2005;22:1–9.
    1. Cowdell F, Steventon K. Skin cleansing practices for older people: a systematic review. Int J Older People Nurs. 2015;10:3–13. doi: 10.1111/opn.12041.
    1. Lopes JL, Nogueira-Martins LA, de Barros ALBL. Bed and shower baths: comparing the perceptions of patients with acute myocardial infarction. J Clin Nurs. 2012;22:733–740.
    1. Hoeffer B, Talerico KA, Rasin J, Mitchell CM, Stewart BJ, McKenzie D, et al. Assisting cognitively impaired nursing home residents with bathing: effects of two bathing interventions on caregiving. Gerontologist. 2006;46(4):524–532. doi: 10.1093/geront/46.4.524.
    1. Sloane PD, Rader J, Barrick AL, Hoeffer B, Dwyer S, McKenzie D, et al. Bathing persons with dementia. Gerontologist. 1995;35(5):672–678. doi: 10.1093/geront/35.5.672.
    1. Voegeli D. The effect of washing and drying practices on skin barrier function. J Wound Ostomy Continence Nurs. 2008;35(1):84–90. doi: 10.1097/01.WON.0000308623.68582.d7.
    1. Marchaim D, Taylor AR, Hayakawa K, Bheemreddy S, Sunkara B, Moshos J, et al. Hospital bath basins are frequently contaminated with multidrug-resistant human pathogens. Am J Infect Control. 2012;40:562–564. doi: 10.1016/j.ajic.2011.07.014.
    1. Johnson D, Lineweaver L, Maze LM. Patients’ bath basins as potential sources of infection: a multicenter sampling study. Am J Crit Care. 2009;18(1):31–40. doi: 10.4037/ajcc2009968.
    1. Anaissie EJ, Penzak SR, Dignani MC. The hospital water supply as a source of nosocomial infections. Arch Intern Med. 2002;162(13):1483–1492. doi: 10.1001/archinte.162.13.1483.
    1. Skewes SM. Skin care rituals that do more harm than good. Am J Nurs. 1996;96(10):33–35. doi: 10.2307/3465053.
    1. Collins F, Hampton S. The cost-effective use of BagBath: a new concept in patient hygiene. Br J Nurs. 2003;12(16):984–990. doi: 10.12968/bjon.2003.12.16.11436.
    1. Knibbe JJ, Knibbe NE. Businesscase verzorgend wassen wassen-zonder-water. Stichting RegioPlus/Platform Zorginnovatie, Zoetermeer. 2006. . Accessed 13 Aug 2015.
    1. Carruth AK, Ricks D, Pullen P. Bag baths: an alternative to the bed bath. Nurs Manage. 1995;26(9):75–78. doi: 10.1097/00006247-199509000-00025.
    1. Eigsti JE. Innovative solutions: beds, baths, and bottoms: a quality improvement initiative to standardize use of beds, bathing techniques, and skin care in a general critical-care unit. Dimens Crit Care Nurs. 2011;30(3):169–176. doi: 10.1097/DCC.0b013e31820d25b1.
    1. Knibbe H, Geuze L, Knibbe N. Ergonomische aspecten van wassen-zonder-water voor zorgverleners. 2005. . Accessed 13 Aug 2015.
    1. Hodgkinson B, Nay R, Wilson J. A systematic review of topical skin care in aged care facilities. J Clin Nurs. 2007;16:129–136. doi: 10.1111/j.1365-2702.2006.01723.x.
    1. Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52(6):377–384. doi: 10.1136/jech.52.6.377.
    1. Cochrane Handbook for Systematic Reviews of Interventions [database on the Internet]. The Cochrane Collaboration. 2011. Available from: . Accessed 30 July 2015.
    1. West S, King V, Carey TS, Lohr KN, McKoy N, Sutton SF, et al. Systems to Rate the Strength of Scientific Evidence. Evidence Report/Technology Assessment No. 47 (Prepared by the Research Triangle Institute-University of North Carolina Evidence-based Practice Center under Contract No. 290-97-0011) Rockville: Agency for Healthcare Research and Quality; 2002.
    1. van Achterberg T, van Gaal BGI, Geense WW, Verbeke G, van der Vleuten C, Schoonhoven L. Completeness of assisted bathing in nursing homes related to dementia and bathing method: results from a secondary analysis of cluster-randomised trial data. Int J Older People Nurs. 2015
    1. Gillis K, Tency I, Roelant E, Laureys S, Devriendt H, Lips D. Skin hydration in nursing home residents using disposable bed baths. Geriatr Nurs. 2015:1-5. doi:10.1016/j.gerinurse.2015.11.003.
    1. Larson EL, Ciliberti T, Chantler C, Abraham J, Lazaro EM, Venturanza M, et al. Comparison of traditional and disposable bed baths in critically ill patients. Am J Crit Care. 2004;13(3):235–241.
    1. Nøddeskou LH, Hemmingsen LE, Hørdam B. Elderly patients‘ and nurses’ assessment of traditional bed bath compared to prepacked single units - randomised controlled trial. Scand J Caring Sci. 2015;29(2):347–352. doi: 10.1111/scs.12170.
    1. Sheppard CM, Brenner PS. The effects of bathing and skin care practices on skin quality and satisfaction with an innovative product. J Gerontol Nurs. 2000;26(10):36–45. doi: 10.3928/0098-9134-20001001-08.
    1. Crossing the Quality Chasm: A new health system for the 21st century. Institute of Medicine. 2001. . Accessed 26 Nov 2015.
    1. Wolf DM, Lehman L, Quinlin R, Zullo T, Hoffman L. Effect of patient-centered care on patient satisfaction and quality of care. J Nurs Care Qual. 2008;23(4):316–321. doi: 10.1097/01.NCQ.0000336672.02725.a5.
    1. Feo R, Kitson A. Promoting patient-centred fundamental care in acute healthcare systems. Int J Nurs Stud. 2016;57:1–11. doi: 10.1016/j.ijnurstu.2016.01.006.
    1. Powers J, Fortney S. Bed baths: much more than a basic nursing task. Nursing. 2014;44(10):67–68. doi: 10.1097/01.NURSE.0000453714.58446.98.
    1. Berwick DM. A user’s manual for the IOM’s ‘Quality Chasm’ report. Health Aff (Millwood) 2002;21(3):80–90. doi: 10.1377/hlthaff.21.3.80.
    1. Berry LL, Wall EA, Carbone LP. Service clues and customer assessment of the service experience: lessons from marketing. Acad Manag Perspect. 2006;20(2):43–57. doi: 10.5465/AMP.2006.20591004.
    1. Frow P, Payne A. A stakeholder perspective of the value proposition concept. Eur J Mark. 2011;45(1/2):223–240. doi: 10.1108/03090561111095676.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, Group TP. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 2009;6(7):e1000097. doi: 10.1371/journal.pmed.1000097.

Source: PubMed

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