Disgusted - wipes for bathing

[beeker]

At my facility, on my floor, we are to use the bath wipes for bathing out patients. We are instructed that using a basin with water & soap creates an unnecessary infection risk. The patients are not getting clean with bath wipes. I am a firm believer in soap and water to wash up. One of the aides complained to our manager that I was asking her to actually clean our patients, rather than hand them the wipes and leave them. My issue with her is really irrelevant, it doesn't matter which method, she is not going to put forth the effort to assist anyone with anything. I wish I had a patient load that allowed me time to help bath the patients. Patients need help reaching places they can't get regardless of wipes or clothes. But I talked the to the manager about my dislike for the wipes, and she said they are fine because people are not expecting to be really clean while in the hospital. It will have to do.

What do you all think about the wipes? I think in a pinch they would be ok if you were helping someone with them, but if someone is in the hospital for days at a time, they need to actually wash up! Nothing worse than seeing "bedbath complete" when the patient is still stinky.

[Bringonthenight]

Im in Australia and we still perform real bed baths .

[DoGoodThenGo]

The bath basins are actually a HUGE infection risk. We've cultured bath basins where I work. All of them grew out pathogens, and a good deal of them grew out MDRO's, and alarmingly the patients that belonged to the basins did not have MDRO's. (though I was able to then trace the MRSA in the bath basin to a pts new MRSA status, talk about GROSS.)

It's not about the linens from an infection control standpoint, it's about the stupid plastic basins. If they were stored properly and DRIED, rather than being used as storage for a wide variety of things, we would have better success.

What we recommend at our facility is that if a pt has incontinence, we use a towel, wet or dry soap or not to clean the patient first, then we use the wipe. It's actually more expensive for us to have the wipes, but we decided it was good for infection control.

But we didn't get rid of washcloths, or towels. and use of them has not gone down. It's not the soap or water, it is the basin.

Funny thing is we also did a pilot study with patients, and about 98% of them preferred the warmed bath wipes to a basin bath. And our nurses really like using them as well, we haven't really had any of the issues described here. I wonder though, if they would have been if we had tried to lower the linen par or take away linen.

When you're right, you are right.

Insights on Infection Control : Wash Basins - Used for Cleaning - May Be Harborers of MDROs

Patients

[timmedico]

We wouldn't use wipes as an alternative to a bath...nor would we want someone bathing us with wipes. You're exactly in the right mindset! Patients should be treated how we'd like to be treated in the same situation. There is no alternative to a good, REAL bath. :)

[AnonRNC]

Those bath basins only cost about $1.50 each. Why can't we discard them after a bath and get a new one?

[VictoriaGayle]

When you're right, you are right.

Insights on Infection Control : Wash Basins - Used for Cleaning - May Be Harborers of MDROs

Patients

Is there not a way to fix the problem? sauconeyrunner seemed to be saying that the probem wouldn't be as bad if the basis were properly washed and dried.

[cantdoit]

I think the wipes are actually a lot more sanitary than the basin baths.

[BrandonLPN, LPN]

As long as you use a new, clean basin for each bath, I don't see how there's an infection risk....

[DoGoodThenGo]

As long as you use a new, clean basin for each bath, I don't see how there's an infection risk....

If one reads the AJCC study (see link posted by me upthread) it is not just the basins but contaminated bathing water, mechanical action of bathing, and so forth that are also part of the problem.

OTOH can see where they were going with this. I mean if one basin of soapy water is used for the entire bath it is going to be quickly contaminated. Each time the washcloth is immersed and wrung out of that water it not only adds more but things are picked up on the cloth and taken back to the patient. Sooner or later the bath water if left unchanged will become saturated with germs to the point one supposes more things are being spread than removed from patients.

Way around this would be frequent changes of water but probably also the basins and washcloths.

[BrandonLPN, LPN]

If one reads the AJCC study (see link posted by me upthread) it is not just the basins but contaminated bathing water, mechanical action of bathing, and so forth that are also part of the problem.OTOH can see where they were going with this. I mean if one basin of soapy water

is used for the entire bath it is going to be quickly contaminated. Each time the washcloth is immersed and wrungout of that water it not only adds more but things are picked up on the cloth and taken back to the patient.

Sooner or later the bath water if left unchanged will become saturated with germs to the point one supposes more things are being spread than removed from patients. Way around this would be frequent

changes of water but probably also the basins and washcloths.

I still don't really understand. What is the water contaminated with?

The water has only come in contact with the nurse's gloved hand. Once you use a washcloth you throw it in the linen bag. You don't put a soiled cloth back in the basin of soapy water. So the water should stay clean throughout, right? Just make sure you have a stack of washcloths ready to go, and you will never have to immerse a used cloth back in the water. Yeah, technically, your gloved hand may have some bacteria on it, but isn't that true with the wipes, too?

[jewelspassion]

i guess when it comes down to it, we have to weigh the risks of basin/washcloths vs wipes. I would think the patient would prefer to feel a little more stinky than to get MRSA or other HAIs. If i had to choose i would be like let me smell! lol but seriously yes as for myself yes i want to give the best care and yes nothing cleans like soap in warm water! I think what it comes down to, as someone mention earlier, it really is about what is done with those basins once used. I hate to say but i wonder how many nurses put huge importance on infection control, besides protecting self???? I think most do, but there are always those few God help that nurse.

[MsPiggy]

Exactly my response to this article:

After bathing the patient the basin should be washed with disinfectant soap, dried well and stored in a closed cupboard or drawer specifically for that. Basins shouldn't ever be used for storage and emesis basins/bedpans should not be kept nestled inside bathing basins-yes, I've actually seen it.

And handwashing people-please. Wash your hands before and after caring for a patient, or handling their linens. Don't just throw off those gloves and move on to the next. I'd bet if these bad habits ceased the infection rates would likely drop. Seems like common sense to me. Bathing the patient is a very important part of good nursing care.

I would like to see this study repeated with caregivers diligently using and maintaining clean basins, storing them properly and using good hand hygiene"

I think the wipes are nice to have on hand for quick clean ups, or peri care where a washcloth may be to rough on fragile skin. But not as a replacement for a bed bath.

Ms. P

[DoGoodThenGo]

I still don't really understand. What is the water contaminated with?

The water has only come in contact with the nurse's gloved hand. Once you use a washcloth you throw it in the linen bag. You don't put a soiled cloth back in the basin of soapy water. So the water should stay clean throughout, right? Just make sure you have a stack of washcloths ready to go, and you will never have to immerse a used cloth back in the water. Yeah, technically, your gloved hand may have some bacteria on it, but isn't that true with the wipes, too?

OIC, was stuck in an "old school" time warp. Your way makes sense but again according to how one read the above study the bath water becomes "contaminated" from contact with the patient/washcloth. Can only assume that the nurses/UAPs in the study were doing bed baths the "old" way as one mentioned rinsing/wringing out the wash cloth in the same soapy water between body parts.

Have to run out for some tea bags, then dowload the report for a late nite read.