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How often should patients get bed baths?

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Skippers1 Skippers1 (New) New

Specializes in Trauma ICU. Has 1 years experience.

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.

Virgo_RN, BSN, RN

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.

CathyLew

Specializes in MSP, Informatics. Has 17 years experience.

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!

Sue Damones

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:

lpnflorida

Specializes in psych. rehab nursing, float pool. Has 30 years experience.

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 .

kellykelly

Specializes in cardiac. Has 10 years experience.

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. :)

whipping girl in 07, RN

Specializes in ICU, nutrition. Has 7 years experience.

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!!

kellykelly

Specializes in cardiac. Has 10 years experience.

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.

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

jbluehorseh

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

Oz2

Specializes in rehab, long-term care, ortho. Has 2 years experience.

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.

Edited by Oz2

One Flew Over

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:

RN1982

Specializes in ICU/Critical Care.

I like using the bath wipes and most of my co-workers do. Yea, there is a white residue, not a lot but it drys and it keeps the patient's skin moist. In my ICU, if the patient gets bath on days, they get bathed on days. When I work and I know that my patient was bathed during day shift, I wash them up with the bath wipes and change the pads and drawsheet beneath them. Everyone has their preference, there is no wrong way. I think using soap/water all the time is very drying to the skin and we don't have bath oil or lotion so I think the wipes are great most of the time. Of course, if there's a big mess to clean, soap and water is better.

Virgo_RN, BSN, RN

Specializes in Cardiac Telemetry, ED.

Our patients get baths on day shift. We use soap and water and washcloths.

PICNICRN, BSN, RN

Specializes in PICU/NICU. Has 14 years experience.

Our pts get a bath every night shift- with the pink basin and washcloths. I just had a mother/infection control nurse insist on a new pink basin for EVERY bath because you "wash the butt and then rinse it out and wash the face the next day in the same basin".:uhoh21: Guess she never thought about the possibility that it could have been used for puking!:nono:

yousoldtheworld

Has 5 years experience.

At my LTC, the residents get two showers a week and a "bed bath" (usually done in the bathroom) each morning. Really it's supposed to be a full bath, but the staffing is so low right now that often all you have time to wash in the mornings are the face, back, stinky parts, and creases (basically, just a bit more than a partial).

When I worked at the hospital, the patients got a bed bath each morning and a partial each night, and showers upon request.

madwife2002, BSN, RN

Specializes in RN, BSN, CHDN. Has 26 years experience.

My pts ostomy burst the other day and the PCT grabbed the wash bowl and put it underneath the illeostomy. After we has cleaned him up with out the use of the wash bowl LOL, the offending wash bowl was placed in the garbage I was so afraid somebody would wash his face and body with it the next day. Yuck

CathyLew

Specializes in MSP, Informatics. Has 17 years experience.

does anyone use a C-tub anymore? I think it was called a century tub.... maybe that was just the one in our hospital, because it was a couple of centuries old! it had a mechanical lift and you dipped the patient into a swirling bath.

The thing was scary to me... I can't see how it would ever get really clean. the staff was responsible for cleaning it in between patients...and you know how many short cuts are taken with short staffing.

And some paitients used it as a whirlpool for wound debridement.

to me it was like a public hot-tub.... you take your chances at what is brewing in there!

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