Registered Nurse

Topics: Hygiene, Nursing, Patient Pages: 10 (3806 words) Published: August 18, 2013
Partial Literature Review:
Scope and Significance of the Problem
Hygiene and cleanliness are important parts of nursing care provided to hospitalized patients. Patients who are unable to bathe themselves are dependent on nursing staff for their hygienic needs. This population includes patients who are unable to care for themselves due to physical limitations such as age, bowel or bladder incontinence, injury and illness. The traditional bathing technique of soap and water provides good hygiene but dries out the skin. The use of wash clothes produces friction, is abrasive and leaves the patient at risk for skin breakdown and infection. This is a concern especially for the immobile, comatose, confused, and elderly patient populations. The use of water basins, wash cloths and towels increase the risk of cross contamination if proper bathing technique is not used. Water basins not properly cleaned harbor bacteria and when re-used can introduce bacteria on susceptible areas of skin. This is important to realize when providing hygiene to patients who are incontinent or have reddened areas on boney prominences that are at risk for breakdown. Significance to Nursing

Traditional bed bathing allows nurses to spend time with their patients, provide adequate skin care with lotions and good hygiene making patients feel better and clean. This type of bath is time- consuming for nurses. The increase in patient acuity and nurse- patient ratio has put many time constraints on nurses today. The place of the traditional soap and water bath in routine patient care is changing; and the use of anti-bacterial wipes provides effective hygiene when used together with emollients for skin care. Anti-bacterial wipes are being used in hospitals, long -term care facilities, and in some instances home care. Positive results in patient care are being validated in areas of skin care, infection reduction, and patient and nurse satisfaction. Personal Connection to the Issue

As an Intensive Care Unit nurse for over twenty-eight years I have considered the traditional bed bath to be an important part of care for my patients. This bathing technique provides good hygiene, is a valued way to assess my patients, and provides quality time for my patients and me to talk and develop a relationship. The change to anti-bacterial wipes for cleansing patients has not been easily accepted. I feel it takes away the personal relationship and reduces the quality of bathing. This is why I choose to do a study and partial literature review on my PICO question; In hospitalized patients dependent upon nursing staff for hygiene, how does the traditional use of soap and water compare to anti-bacterial wipes, affect in terms of cleanliness, skin integrity and patient satisfaction. This review has provided new insights with regards to patient hygiene, skin care, infection risk, time management, and cost containment. Moreover, it has provided useful information about the products evaluated and which products and techniques provide evidence based practice for safe quality patient care. Search History

I performed a comprehensive computerized search of MEDLINE/, PubMed, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). I used the following keywords: Intensive care patients; and skin care AND infection. I revised the search by adding hygiene AND “nurse’s role,” “nursing care” baths, soaps, incontinence, and/or chlorhexidine use. The search was limited to works in English published from 1994 through 2013. I limited the age to adults and the elderly. This search retrieved four hundred and fifty six articles. The search was limited to scholarly articles (peer reviewed, and research articles). The reference lists (or bibliographies) of identified articles were also searched for additional relevant references and journal articles. These search parameters provided the ten articles obtained to review my PICO question. Within the ten articles reviewed...

References: Byers P H Ryan P Regan M B Shields A Carta S G 1995 Effects of Incontinence Care Cleansing Regimens on Skin Integrity.Byers, P. H., Ryan, P., Regan, M. B., Shields, A., & Carta, S. G. (1995). Effects of Incontinence Care Cleansing Regimens on Skin Integrity. Journal of Wound, Ostomy an Continence Nurses Society, 22(4), 187-191. 201304141219431707878590
Cooper P Gray D 2001 Comparison of two skin care regimes for incontinence.Cooper, P., & Gray, D. (2001). Comparison of two skin care regimes for incontinence. British Journal of Nursing, 10(6), S6-S20. 20130414122248224623561
Coyer F O 'Sullivan J Cadman N 2011 provision of patient personal hygiene in the intensive care unit: a descriptive exploratory study of bed-bathing.Coyer, F., O 'Sullivan, J., & Cadman, N. (2011). The provision of patient personal hygiene in the intensive care unit: a descriptive exploratory study of bed-bathing. Austrailian Critical Care Nurses, 24(3), 198-209. 201304141250061311469674
Eigisti J 2011 Innovative Solutions Beds,Baths,and Bottoms: A Quality Improvement Initiative to Standardize Use of beds, bathing techniques, and skin Care in a General Critical-Care Unit.Eigisti, J. (2011). Innovative Solutions Beds, Baths, and Bottoms: A Quality Improvement Initiative to Standardize Use of beds, bathing techniques, and skin Care in a General Critical-Care Unit. Dimensions of Critical care Nursing, 30(3), 169-176. 20130414122646762553930
Hancock I Bowman A Prater D 2000 'The day of the soft towel? ': Comparison of the current bed-bathing ethod with the Soft Towel bed-bathing method.Hancock, I., Bowman, A., & Prater, D. (2000). 'The day of the soft towel? ': Comparison of the current bed-bathing method with the Soft Towel bed-bathing method. International Journal of Nursing Practice, 6, 207-213. 20130414120005455367326
Larson E L Ciliberti T Chantler C Abraham J Lazaro E M Venturanza M Preeti P 2004 Comparison of Traditional And Disposable bed baths in Critically Ill Patients.Larson, E. L., Ciliberti, T., Chantler, C., Abraham, J., Lazaro, E. M., Venturanza, M., & Preeti, P. (2004). Comparison of Traditional And Disposable bed baths in Critically Ill Patients. American Journal of Critical Care, 13(3), 235-240. 201304141238321222222328
Massa J 2010 Improving efficiency, reducing infection, and enhancing experience.Massa, J. (2010). Improving efficiency, reducing infection, and enhancing experience. British Journal of Nursing, 19(22), 1408-1414. 20130414124706614486933
Popovich K Lyles R Hayes R Hota B Trick W Weinstein R Hayden M 2012 Relationship between Chlorhexidine Glucnate Skin Concentration and Microbial Density on the Skin of Critically Ill Patients Bathed daily with Chlorhexidine Gluconate.Popovich, K., Lyles, R., Hayes, R., Hota, B., Trick, W., Weinstein, R., & Hayden, M. (2012). Relationship between Chlorhexidine Glucnate Skin Concentration and Microbial Density on the Skin of Critically Ill Patients Bathed daily with Chlorhexidine Gluconate. Infection Control and Hospital Epidemiology, 33(9), 799-896. 20130414120625108042359
Skewes S 1994 No More bed Baths!...bag bath... a technique that lessons the risk of skin impairment.Skewes, S. (1994). No More bed Baths!...bag bath... a technique that lessons the risk of skin impairment. RN, 57(1), 34-35. 20130414124503308728575
Whittingham K May S 1998 Cleansing regimens for continence care.Whittingham, K., & May, S. (1998). Cleansing regimens for continence care. Professional Nurse, 14(3), 167-172. 201304141233511062184453
Continue Reading

Please join StudyMode to read the full document

You May Also Find These Documents Helpful

  • Adn Nurses vs Bsn Nurses Essay
  • The American Nurses Association (ANA) Essay
  • Essay on Nurse Practioner
  • Nursing and Nurse Practitioner Essay
  • Essay about My Role as a Nurse in Canada
  • MALPRACTICE BY NURSES AND THE ETHICAL D Essay
  • Differences Between Adn and Bsn Nurses Essay
  • Nurse Practitioner Research Paper

Become a StudyMode Member

Sign Up - It's Free