Patient bathing

[texasrn71]

Hey fellow RNs...what are you doing in your hospitals to bathe your patients? I know patients that can bathe themselves can take a shower on their own....but what about bed-ridden patients that need a bed bath...do they get a soap and water bath or do they get wiped down with a CHG wipe? I've tried to talk to our managers about this but I haven't gotten anywhere. If you read the back of the package of the Sage wipe, it says that it is not intended for daily patient bathing. Is anybody else using these? My patients are left sticky and gross...how is that good for preventing infection?

[Okami_CCRN, BSN, RN]

JAMA Network | JAMA | Chlorhexidine Bathing and Health Care–Associated Infections:Â*Â*A Randomized Clinical Trial

A few years ago there was a growing body of evidence that CHG daily bathing was decreasing HAI in critical care settings. However the above journal article contradicts that idea.

We did a study to determine if CHG bathing in our ICU would decrease infection rates and we discovered that the results were not statistically significant so instead we use soap and water with a new basin every time. CHG is reserved for patients who will be going to surgery or will have a central line/swan ganz cath inserted just to add an extra layer of protection prior to procedure.

It is important to note that MANY skin care creams/ointments deactivate CHG. I would contact Sage for that information

*CHG bathing does show a decrease in post operative infections, which is why it was adopted in critical care settings

[momof3lv]

We are in the process of a study using the CHG wipes. I hate them. I think their gross and I don't even like touching them with my bare hands let alone wipe down a pt with them, but it's what we have to do.

[momof3lv]

JAMA Network | JAMA | Chlorhexidine Bathing and Health Care–Associated Infections:Â*Â*A Randomized Clinical Trial

It is important to note that MANY skin care creams/ointments deactivate CHG. I would contact Sage for that information

Yeah we have to use the approved creams with the wipes.

[texasrn71]

Thanks, Okami! Interesting article...I did notice thought that the CHG product that they used was the Sage wipe though which is 2% CHG. Other products are 4% CHG like Hibiclens. Also, with the Sage wipe, you're not rinsing anything away, all the gunk remains on the skin. It's no wonder the wipe didn't perform better than soap and water!

[texasrn71]

Our patients deserve better :/

Whatever happened to old-school nursing? We need to bathe our patients not just wipe them down with glorified hand sanitizer

[calivianya, BSN, RN]

My job has gotten rid of bath basins altogether. My hospital sees it as unacceptably expensive to get a new bath basin every time, apparently, and they are seen as an infection risk. All we have are wipes - CHG and regular "soap" bath wipes. Some people still find creative ways to use soap and water, like setting a towel down and putting wet washclothes with soap on them on top of it, and then just wiping up the water that goes everywhere as a result, but I think that's too much work. Most of us just use the wipes.

[MunoRN, RN]

The reason pre-packaged wipes have become more commonly used is that there's been evidence that the tub-of-soapy-water and washcloth method is actually pretty disgusting, far worse in terms of just spreading around bacteria than the disposable wipes.

[flyersfan88]

My job has gotten rid of bath basins altogether. My hospital sees it as unacceptably expensive to get a new bath basin every time, apparently, and they are seen as an infection risk. All we have are wipes - CHG and regular "soap" bath wipes. Some people still find creative ways to use soap and water, like setting a towel down and putting wet washclothes with soap on them on top of it, and then just wiping up the water that goes everywhere as a result, but I think that's too much work. Most of us just use the wipes.

Why not invest in plastic basin liners instead of getting rid of basins all together? Liners literally cost less than 5 cents each. Oi....administration.

We are only required to do CHG baths daily if the patient has a central line, or the wipes the morning before surgery. Not gonna lie....looove the way hibiclens smells. Also....if a patient is particularly uh, smelly, we'll dilute some of the pink stuff in some hot water as part of their bed bath. Does a great job of cutting the odor.

[MunoRN, RN]

Why not invest in plastic basin liners instead of getting rid of basins all together? Liners literally cost less than 5 cents each. Oi....administration.

We are only required to do CHG baths daily if the patient has a central line, or the wipes the morning before surgery. Not gonna lie....looove the way hibiclens smells. Also....if a patient is particularly uh, smelly, we'll dilute some of the pink stuff in some hot water as part of their bed bath. Does a great job of cutting the odor.

While re-using basins make it far more disgusting, even using a brand new basin for each patient still results in just redistributing whatever you're trying to clean off to various other parts of their body.

[texasrn71]

Right? I thought there had to be basin liners out there! If not, why not just use a small trash can liner? The only reason basins become contaminated is because the user is not using proper clean to contaminated technique. If you get enough washcloths in a basin and don't put a used washcloth back into the basin, the basin will not get contaminated. I think the real reason the wipes have gained popularity is because of their convenience! Have we gotten that lazy as clinicians? But if the manufacturer states not to be used as a daily skin cleanser - aren't we all in the wrong for using them that way?

[loriangel14, RN]

We use a basin with hot soapy water. Sage wipes are for the peri area only.