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Abstract
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Excretion
Small amounts of urea and salts are excreted through
perspiration.
Figure 2a. Equipment required for a soap and water bed bath
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product focus
The risk of cross-infection
Reusable washbowls, washcloths and water can all pose a
serious risk of cross-infection to patients.
Washbowls
In 2009, Johnson et al reported the presence of both
meticillinresistant Staphylococcus aureus (MRSA) and
vancomycin-resistant enterococcus (VRE) in sampled
washbowls. This study supported earlier work by Joynson
(1978), which specifically identified wash bowls as the source
of an outbreak of Klebsiella.
Both Greaves (1985) and Johnson et al (2009) highlight
that inadequate cleaning, drying and incorrect storage
of reusable washbowls can contribute to the presence of
microbial biofilms and place patients at risk of crossinfection.
Washcloths
It is not unusual for the same wash cloth to be used
on a number of occasions to clean all areas of the body
(Greaves, 1985). This presents clear infection risks to the
patient by facilitating the movement of bacteria from
one area of the patients body to another. Ayliffe (1990)
recommends that bathing should be carried out with care
and that it is better to clean towards the naturally heavily
contaminated areas such as the rectum so that gram-negative
bacteria are not distributed over the rest of the body surface.
The work by Greaves (1985) identified that all washcloths
tested prior to patient bathing and irrespective of whether
they were tested wet or dry, all grew gramnegative bacilli.
Ayliffe (1990) states that it is always preferable to use
a fresh disposable wipe (washcloth) for each bath, and
that the same washcloth should never be used on more
than one patient without being properly washed and
dried. Ayliffe (1990) goes on to say that unless a fresh
disposable wash cloth is used each time, the patient may
be microbiologically dirtier at the end of the bath than at
the beginning.
Water
The water used during a bed bath becomes increasingly
contaminated with microorganisms. Greaves (1985) reported
that, by the end of the bed bath, the water is a soup of soap
and bacteria. The work by Greaves (1985) also reported
finding significant numbers of gram-negative bacilli and
S.aureus redistributed over the patients body as a result of a
soap and water bed bath.
Efficiency savings
Figure 4. The Oasis Bed Bath wipes and Shampoo cap
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product focus
Table 2. Benefits offered by Oasis Bed Bath wipes over soap and water
Benefit
Patient benefit
Nurse benefit
Facility benefit
Product evaluation
Clinical procurement wanted to streamline the bed bath
process for dependent patients. The intention was to improve
efficiency and provide a greater number of patients with their
bed bath at the appropriate time of day. The Oasis Bed Bath
wipes and shampoo caps offered the clinical procurement
directive a number of benefits over soap and water (Table 2).
It was paramount to ensure that any new products adopted
by the hospital:
Table 3. Potential return on Investment when adopting Oasis Bed Bath wipes
COSTS
Per bath
Weekly cost*
Per bath
Weekly cost
Per bath
Weekly cost
DIRECT COST
0.84
(equipment only) cost
of bed bath
70.56
(89.16)**
0.86
72.24
1.17
98.28
25mins
35 hours
12 mins
17.5 hours
12 mins
17.5 hours
249.20
124.6
124.6
338.36
196.84
222.88
17594.72
10235.68
11589.76
EFFICIENCY SAVINGS /
YEAR COMPARED TO
SOAP AND WATER
7359.04***
6004.96***
INDIRECT
COST
Nursing time
Cost based
on HCA
band 2 at
7.12 / hour
*Weekly costs are based on bathing 12 patients per day for 7 days
**A soap and water bed bath using disposable (pulp) wash bowls incurs two additional costs
(1) Laundry costsdue to water spillages on bed linencosted by the site at 14.40/week
(2) Doubling up the pulp wash bowls in 50% of cases costs an additional 4.20/week
*** Efficiency savings will depend upon number of patients receiving a bath and the staff banding of the person performing the bath
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Key Points
n The
n A
carefully undertaken bed bath can have a number of health, social and
physical benefits for the patient
n The
traditional soap and water bed bath is labour-intensive and can pose
some significant threats to the patient in terms of skin integrity and
crossinfection
n Alternative
Conclusions
Specialist bed bath wipes that overcome many of the
problems associated with the traditional soap and water bed
bath are now available. One such product, the Oasis Bed
Bath system from Synergy Health, is skin-friendly, eliminates
the crossinfection risk posed by soap, water, washbowls
and washcloths, and in product evaluations offers efficiency
savings of up to 50% per patient bed bath.
Improving efficiency, quality of care and patient safety
ensures that the Oasis wipes meet the needs of the Productive
Ward Initiative. Such products should be given careful
consideration by any facility that cares for the needs of the
dependent patient and wishes to improve the patient
experience while maximizing available nursing time to care
BJN
for patients.
n Specialist
n A
Summary
Not only were the Oasis wipes well liked by both patients and
nursing staff, they also significantly improved the efficiency of
the bed bath process. Based on bathing 12 dependent patients
per day, a yearly efficiency saving of between 6000 and
7300 can be made by adopting the Oasis wipes (Table 3).
The time saved when using the wipes can be used to provide
additional patient care, or for other clinical tasks.
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