Maintaining personal hygiene is an essential component of care provision and directly impacts on skin health and a person’s comfort and wellbeing. Personal hygiene includes care of the skin, hair, nails, mouth, eyes, ears and nose, perineal region, and facial shaving.
Many factors can have a negative impact on skin health including (Coyer et al., 2011; Konya et al., 2021; Lawton & Shepherd, 2019):
- Excessive washing and the use of harsh cleansing products
- Lack of hygiene resulting in a build-up of potential pathogens and increasing the risk of infection
- Poor nutrition and hydration
- Older age
- Urinary and/or faecal incontinence
- Chronic health conditions
- Poor skin integrity or wounds
- Poor mobility
- Dependence on others for assistance with activities of daily living
The opportunity to assist with personal hygiene is the ideal time to identify factors impacting on skin health and to implement timely strategies to reduce the risk of avoidable complications.
When correctly performed, bed bathing supports skin integrity (Groven et al., 2017), skin hygiene (Groven et al., 2017), and the overall health and well-being of the person (Konya et al., 2021). It is important to offer the person having the bed bath with the opportunity to participate in their care to maintain their independence, self-esteem, and dignity (Veje et al., 2019).
Plastic bowls, soap and water, and reusable washcloths should be avoided in favour of pre-packaged products for bed bathing (also referred to as bag baths) (Groven et al., 2017; Lawton & Shepherd, 2019). These do not require water, are pH neutral, include emollients and some even include barrier preparations to protect the skin from moisture-associated skin damage. They are designed for single-use only and reduce the risk of infection.
Despite bed bathing being a common practice, there is a paucity of research supporting its practice (Barakat-Johnson et al., 2020; Groven et al., 2017; Konya et al., 2021). However, there is widespread agreement in the literature that bed bathing is safe and effective (Groven et al., 2017; Konya et al., 2021), improves skin cleanliness, and enhances patient comfort (Barakat-Johnson et al., 2020). Furthermore, bed bathing may be a more efficient and cost-effective alternative when compared to traditional soap and water (Schoonhoven et al., 2015).
Written by Dr Michelle Gibb, Nurse Practitioner Wound Management, Founder & Director of Wound Specialist Services.
References:
Barakat-Johnson, M., Basjarahhil, S., Campbel, J., Cunich, M., Disher, G., Geering, S., Ko, N., Lai, M., Leahy, C., Leong, T., McClure, E., O'Grady, M., Walsh, J., White, K., & Coyer, F. (2020). Implementing best available evidence into practice for incontinence-associated dermatitis in Australia: a multisite multimethod study protocol. Journal Of Tissue Viability, 30(2021), 67-77.
Coyer, F. M., O'Sullivan, J., & Cadman, N. (2011, Aug). The provision of patient personal hygiene in the intensive care unit: a descriptive exploratory study of bed-bathing practice. Aust Crit Care, 24(3), 198-209. https://doi.org/10.1016/j.aucc.2010.08.001
Groven, F. M., Zwakhalen, S. M., Odekerken-Schröder, G., Joosten, E. J., & Hamers, J. P. (2017, Jan 25). How does washing without water perform compared to the traditional bed bath: a systematic review. BMC Geriatr, 17(1), 31. https://doi.org/10.1186/s12877-017-0425-4
Konya, I., Nishiya, K., & Yano, R. (2021, Sep). Effectiveness of bed bath methods for skin integrity, skin cleanliness and comfort enhancement in adults: A systematic review. Nurs Open, 8(5), 2284-2300. https://doi.org/10.1002/nop2.836
Lawton, S., & Shepherd, E. (2019). The underlying principles and procedure for bed bathing patients. Nursing Times [online], 115(5), 45-47. https://cdn.ps.emap.com/wp-content/uploads/sites/3/2019/04/190424-The-underlying-principles-and-procedure-for-bed-bathing-patients.pdf
Schoonhoven, L., van Gaal, B. G., Teerenstra, S., Adang, E., van der Vleuten, C., & van Achterberg, T. (2015, Jan). Cost-consequence analysis of "washing without water" for nursing home residents: a cluster randomized trial. Int J Nurs Stud, 52(1), 112-120. https://doi.org/10.1016/j.ijnurstu.2014.08.001
Veje, P. L., Chen, M., Jensen, C. S., Sørensen, J., & Primdahl, J. (2019, Jun). Bed bath with soap and water or disposable wet wipes: Patients' experiences and preferences. J Clin Nurs, 28(11-12), 2235-2244. https://doi.org/10.1111/jocn.14825
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