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Informational/Educational Report
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Impact of a pre-packaged bath in medical surgical and oncology patients Kathy Schroeder, RN, BSN, Patrice Dillow RN,CWOCN,APN, Frances Willis, RN, Ninfa Bontes, RN, Sandy Beta, RN, Josephine Mezger, RN, Sue Wolf, Sharon Oliver, RN BACKGROUND.The bed bath, as administered by nursing personnel, has been used in hospitals as a means of improving hygiene and comfort of patients unable to bathe themselves.1 In addition; the bath process provides an opportunity to inspect the patient's skin condition.2 Guidelines for preventing pressure ulcers call for daily skin inspection and documentation of condition, interventions and outcomes.3-5 In our institution, bed baths are given by non-licensed Patient Care Technicians (PCTs) who do not document on the patient chart. Clear concise communication of skin condition is key to early identification of skin issues and intervention plus supports JCAHO's Patient Goal #2.6..OBJECTIVE.To assess the impact of a pre-packaged bath with a documentation tool (skin check guide) on communication between PCTs and nurses, early recognition of skin breakdown and staff/patient satisfaction. METHODS.Incidence studies were conducted pre-study and during the study period. RNs and PCTs completed pre-study questionnaires about beliefs and practices re: bathing. Following an inservice on their role in maintaining skin integrity and the prepackaged product, staff completed another questionnaire. Thirty patients on the oncology or medical surgical floors received both types of baths (basin versus pre-packaged) on different days. Patients and staff completed questionnaires about their satisfaction with the baths and their preference During the study, PCTs communicated patient skin condition to the RN using either the existing method (for basin baths) or the documentation tool (pre-packaged baths) RESULTS.PCTs consistently used the skin check guide to communicate patients' skin condition findings to the RN. Patients and staff rated the pre-packaged bath better than the basin bath CONCLUSION.Patients and staff prefer the pre-packaged bath. The use of the skin check guide facilitates clear communication about, and documentation of, the patient's skin condition and contributes to early identification of skin issues. Larsen Eet al. Comparison of traditional and disposable bed baths in critically ill patients. Am J Crit Care. 2004;13(3):235Ð241 Bryant RA, Rolstad BS. Examining threats to skin integrity. Ostomy Wound Manage. 2001;47(6):18Ð27 Guideline for prevention and management of pressure ulcers. Clin Practice Guideline No. 2. Glenview, IL: WOCN, 2003. Pressure ulcers in adults, prediction and preventionÑClinical Practice Guideline No. 3. Agency for Healthcare Research and Quality. Rockville, MD: US Dept Health & Human Svcs (AHCPR), 1992. Pressure Ulcer Prevention Points. Reston, VA: National Pressure Ulcer Advisory Panel (NPUAP), 1993 Critical Access Hospital and Hospital National Patient Safety Goals. Available at: http://www.jcaho.org. |
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