LTACH bed bath

[Gibs112]

I work in a LTACH and we give our pts bed baths every night. Some pts have MRSA and CDIFF. I was wondering if it's necessary To give them full bed baths every night

[meanmaryjean, DNP, RN]

Would you want to go a day without a bath if you were sick and bedridden? What does their having MRSA or CDIFF have to do with it?

[elkpark]

If that is your facility's policy, then it's "necessary."

[Here.I.Stand, BSN, RN]

If you had C. diff, would you want to go more than a day without a bath? MRSA/MDRO might not be accompanied by the same nasty diarrhea, but those pts still get as sweaty as pts who don't require contact precautions.

I have worked in LTACH myself, and I get it... it's insanely busy. I have had days where my entire 4-5 pt assignment was on contact precautions. At the hospital where I work now, EVERY pt on the Burn unit is on contact precautions to protect THEM.

So a nurse who has floor status pts -- plus the CNAs -- have multiple pts on contact precautions.

BUT. The inconvenience of gown&gloves are not a justification for compromising care.

What I will say though is: what do you mean by "night?" When I worked in LTACH, it was drilled into us that 2300-0700 is "sacred sleep time," and we were only to wake pts when necessary. Repositioning, incontinence care, q 6 hr antibiotics: necessary. Routine daily hygiene, stool softeners and vitamins, lab draws, routine wound care: not overnight.

This was because LTACH pts are at such high risk for delirium, being sick/injured and hospitalized for so long. We don't want to add to that risk by keeping them awake at night.

Scheduling some baths for evening/HS is appropriate, but most of the baths should be done on the day shift. I know, day shift is nutty with new orders, therapies, visitors, 3 meals etc.... but it's also 12 hours of awake time, vs night shift's 4 hours. It's about what's best for the patients.