Bed Baths Washing Post Op Heart Patients

[AllisonMcTigue]

Hello All

I was wondering what your practice is for washing patients from theatre. Do you wash them before extubation? The next day? Is there a particular shift that washes these patients?

Thank you in advance.

[sugarmagnoliaRN]

Night shift did all the baths where I worked. We were expected to give everyone a chlorhexidine bath every day, so if I got a patient from OR on my shift I'd usually end up bathing around 2 or 3am when things (hopefully) settled down a bit.

[AllisonMcTigue]

Yes - that is what happens where I work but only for the patients operated on that day. However, we have had patient feedback saying that they are being disturbed at night and we are taking steps to try to resolve this. Leaving the bed bath for the night shift seems ritualistic - it disturbs not only them but also the other patients. I know though that there can be more time on the night shift and washing from theatre may delay extubation. Thanks for your reply. It's interesting to see what other units do.

[tcvnurse, BSN, RN]

In my unit if the patient is stable we will give them a chlorhexidine bed bath before extubation. That's when we turn and change the sheets and admin an asa suppository. It is our protocol to get bathed with chlorhexidine daily, although foley care is done q shift. The trend now is to try and limit the stuff we do to patients at night with the caveat that if you're sick you're getting the full We-Put-The-Intense-In-Intensive-Care treatment.

[AllisonMcTigue]

That seems more logical to me. The practice presently on the unit where I work is to roll, change the linen when stable but leave the actual bed bath to the night shift. Again many thanks for your comment.

[MYSTICOOKIEBEAR]

CHG bed bath during night shift is the standard protocol in my Cardiac/Transplant ICU. Whether it is given before or after extubation is up to the patient's nurse.

[sjalv]

On my unit, intubated patients/continuous bipap are bathed at night, everyone else is bathed in the day. By bathe, I mean 'chg bath'. This is irrespective of their surgical status. If they are so hemodynamically unstable that they cannot be turned to bathe, it will be put off until they are stable.

[MunoRN, RN]

My usual routine is to extubate the patient with their front washed, leads changed to the front, and a gown on. We dangle/stand within a few hours of extubation and that's when we wash the back half. In general we no longer bathe any ICU patients at night.

[jamst149]

When they were still intubated/sedated so within 4 hours was generally the protocol. Essentially the sooner the better if possible. They were protocoled to be OOB within 4 hours of extubation again if the pt condition warranted it.