How often should patients get bed baths?

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Specializes in Trauma ICU.

In my unit (trauma ICU) patients get bed baths twice a day - once by day shift and again by night shift. The nurses do this as an opportunity to check the patients for pressure sores and because they say it is comforting to the patient. I have no problem doing this assuming time permits, but wouldn't excessive bathing make patients prone to skin breakdown, dry out their skin, and reduce the skin's normal flora? I would always bath a patient if they are really dirty and when they are incontinent, but how often should they get a full bath? Can anyone help by recommending research articles on this topic? I want to use evidence-based practice to determine the correct thing to do.

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Specializes in Cardiac Telemetry, ED.

I'm interested to read the responses. I, too, would think too much bathing would increase the risks of skin breakdown, but I have no real knowledge of whether that is the case.

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Specializes in MSP, Informatics.

Its great that you guys can sqeeze in 2 full baths a day. And I agree, for skin assessment, you can't beat it.

Depending on the patient, 2 baths may be too much or too few. If a patient is bed bound, and has a high temp, sweating, incontinent, etc.... they can easily take 5 full baths (or more) a day. If the patient is older, frail skin...depending on what kind of soap you use, the soap, friction, etc, may be too much for their skin.

Our hospital is looking into the variouse bath in a bag type options. Skin friendly sanitary wipes that you use for the entire bath. Since some studies have shown that the actual bath basin is a harbor for bacteria. Our hospital's infection control person just swabbed all our ICU basins that were in the patient rooms, and is cooking up the cultures this week!

I have personally seen people use the basen for the whole bath, rinsing nasty washcloths in it, soaking the pts feet in it, and all it gets is a quick rince and wipe out with a paper towel....if that!

I have even seen bath basens that have been used as puke buckets, then the next morning, filled with luke warm water for the morning bath! Yikes!

You try not to do that kind of thing, but who knows what was in it the shift before...or how it was (or wasn't) washed out!

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Specializes in ICU.

I have even seen bath basens that have been used as puke buckets, then the next morning, filled with luke warm water for the morning bath! Yikes! quote]

:barf02:

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Specializes in psych. rehab nursing, float pool.

A few of our patients who have very dry skin, we put body lotion in the water with no soap, that way they are freshened up but it won't add to drying out their skin. Our patients get showers every two days the opposite days they have either bed baths or they wash up at the sink. Everyone gets lotion to their feet and legs after bathing .

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Specializes in cardiac.

Those bed in a bag things are great. You pop them in the microwave for however many seconds it says on the bag and they are warm and really convenient for those patients not allowed to shower. We don't have them where I work but had them at another job and that was one of the few things I really liked about that place. That, and mucomyst in pill form instead of having to mix with Sierra Mist, and vending machines you could swipe your badge through for credit. Otherwise it sucked. :)

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Specializes in ICU, nutrition.

I worked ICU for several years, and minimally, the patient got a full bath every day, and more if they needed it (sweaty, fever, incontinent, etc). I usually hit the stinky spots on my shift even if their bath was on the other shift. I've used those bath bag things, they are pretty good, although nothing beats antibacterial soap, shaving cream and water for really stinky feet/pits...you know, those patients you have to bath twice a day for a week before they smell like they've had a bath because who knows when they last had a shower before they hit your doors?!

Yeah, I don't miss that part...

The bath basin thing doesn't surprise me...that's what I always grabbed for pukers...come on, those kidney basins aren't good for much more than brushing your teeth!!! But I always threw it away after it was puked in. I was glad we got away from them, and I never put a cloth back in the clean water once it had touched the patient. And if I saw someone else do it...(maybe once or twice in 7 years, newbies) I'd say something and toss the water.

I personally liked the sink bath...stack of washcloths, wet down a few with hot water and soap, tossed a couple to my bath partner on the far side of the bed. They'd do one side, I'd do one side. Dirty clothes. Back to the sink, few more each to rinse. Dirty clothes. Towel each to dry, clean gown. Dirty clothes. Lotion and deodorant, dressing changes and skin cares. Bath partner turned, one to wash, one to rinse, towel to dry. Lotion and skin cares to bottom. Lower extremity skin cares and dressing changes. Bedroll on the bed, roll to me. If the patient is big, the partner washed what I couldn't get to. It was quick but good, the patient didn't get cold or get exposed to an icky basin. The team I used to work with had it down to a science!!

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Specializes in cardiac.

Amen to the soap and water for the stinky bits! I always throw the used cloths in the dirty linen bag instead of back in the water. I get grossed out seeing butt cloths thrown back in the basin.

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I have even seen bath basens that have been used as puke buckets, then the next morning, filled with luke warm water for the morning bath! Yikes!

when my younger sister was 13, she shared w/me that she wanted to know what getting drunk was like.

so being the worldly 16 yo that i was, i insisted in being the one to initiate her and i was with her the night she chugged down some cheap wine.

she ended up feeling ill, and cried out, "I'M GOING TO GET SICK"...

i ran to the kitchen and grabbed the teak salad bowl, ran back and held it while she leaned over and puked her guts out.

after all was done, i escorted her to bed, then washed the salad bowl.

every time mom would make a salad, lisa and i would share a 'look' at the dinner table.

only she and i knew what happened.

it wasn't until 30 yrs later that we spilled the beans to our sister and brother.

heh.

you just never know, i'm telling you...

leslie

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Specializes in Chemo.

those baths in a bag are not that great they tent to leave a white residue on the patient, they are great cleaning up a patient when they soil themselves

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Specializes in rehab, long-term care, ortho.

I just read a study they did on bed bath buckets and how many organisms are in there, with evidence pointing to bath-in-a-bag being a better choice. Here's the link... http://www.medscape.com/viewarticle/586213?src=mp&spon=24&uac=124177MN

I could have sworn I read an EBP article a while back saying that excessive bedbaths was not beneficial as it removes normal, beneficial flora and contributes to excessive drying of the skin.

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Specializes in CV Surgical, ICU.

I have even seen bath basens that have been used as puke buckets, then the next morning, filled with luke warm water for the morning bath! Yikes!

I've grabbed a basin and had my patient use it when I'm in a time of desperation, (you know when they're giving you the look)but it's supposed to go right in the trash after! :eek:

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