Cost-consequence analysis of ‘‘washing without water’’ for nursing home residents: A cluster randomized trial
Cost-consequence analysis of ‘‘washing without water’’ for nursing home residents: A cluster randomized trial
Background: no-rinse disposable wash gloves are increasingly implemented in health care to replace traditional soap and water bed baths without proper evaluation of (cost) effectiveness.
Objectives: to compare bed baths for effects on skin integrity and resistance against bathing and costs.
Design: cluster randomized trial.
Setting: fifty six nursing home wards in the Netherlands.
Participants: five hundred adult care-dependent residents and 275 nurses from nursing home wards.
Methods: the experimental condition ‘washing without water’ consists of a bed bath with disposable wash gloves made of non-woven waffled fibers, saturated with a no-rinse, quickly vaporizing skin cleaning and caring lotion. The control condition is a traditional bed bath using soap, water, washcloths and towels. Both conditions were continued for 6 weeks. Outcome measures were prevalence of skin damage distinguished in two levels of severity: any skin abnormality/lesion and significant skin lesions. Additional outcomes: resistance during bed baths, costs.
Results: any skin abnormalities/lesions over time decreased slightly in the experimental group, and increased slightly in the control group, resulting in 72.7% vs 77.6% of residents having any skin abnormalities/lesions after 6 weeks, respectively (p = 0.04). There were no differences in significant skin lesions or resistance after 6 weeks. Mean costs for bed baths during 6 weeks per resident were estimated at €218.30 (95%CI 150.52–286.08) in the experimental group and €232.20 (95%CI: 203.80–260.60) in the control group (difference €13.90 (95%CI: ?25.61–53.42).
Conclusion: washing without water mildly protects from skin abnormalities/lesions, costs for preparing and performing bed baths do not differ from costs for traditional bed bathing. Thus, washing without water can be considered the more efficient alternative
bed bath, cost-effectiveness, nursing, skin damage
112-120
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
van Gaal, B.G.I.
066737a8-2dd7-41e4-bac8-badc4bca8771
Teerenstra, S.
90cea70d-3f89-49a3-b71d-addc511d3c09
Adang, E.
69d9d708-659e-49c2-9fdd-ca531912d4b6
van der Vleuten, C.
2e29738b-fbb8-4eff-a745-63a53e85ad0f
van Achterberg, T.
1b413585-49b3-4989-a1b6-7fb4d4bac453
January 2015
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
van Gaal, B.G.I.
066737a8-2dd7-41e4-bac8-badc4bca8771
Teerenstra, S.
90cea70d-3f89-49a3-b71d-addc511d3c09
Adang, E.
69d9d708-659e-49c2-9fdd-ca531912d4b6
van der Vleuten, C.
2e29738b-fbb8-4eff-a745-63a53e85ad0f
van Achterberg, T.
1b413585-49b3-4989-a1b6-7fb4d4bac453
Schoonhoven, Lisette, van Gaal, B.G.I., Teerenstra, S., Adang, E., van der Vleuten, C. and van Achterberg, T.
(2015)
Cost-consequence analysis of ‘‘washing without water’’ for nursing home residents: A cluster randomized trial.
International Journal of Nursing Studies, 52 (1), .
(doi:10.1016/j.ijnurstu.2014.08.001).
Abstract
Background: no-rinse disposable wash gloves are increasingly implemented in health care to replace traditional soap and water bed baths without proper evaluation of (cost) effectiveness.
Objectives: to compare bed baths for effects on skin integrity and resistance against bathing and costs.
Design: cluster randomized trial.
Setting: fifty six nursing home wards in the Netherlands.
Participants: five hundred adult care-dependent residents and 275 nurses from nursing home wards.
Methods: the experimental condition ‘washing without water’ consists of a bed bath with disposable wash gloves made of non-woven waffled fibers, saturated with a no-rinse, quickly vaporizing skin cleaning and caring lotion. The control condition is a traditional bed bath using soap, water, washcloths and towels. Both conditions were continued for 6 weeks. Outcome measures were prevalence of skin damage distinguished in two levels of severity: any skin abnormality/lesion and significant skin lesions. Additional outcomes: resistance during bed baths, costs.
Results: any skin abnormalities/lesions over time decreased slightly in the experimental group, and increased slightly in the control group, resulting in 72.7% vs 77.6% of residents having any skin abnormalities/lesions after 6 weeks, respectively (p = 0.04). There were no differences in significant skin lesions or resistance after 6 weeks. Mean costs for bed baths during 6 weeks per resident were estimated at €218.30 (95%CI 150.52–286.08) in the experimental group and €232.20 (95%CI: 203.80–260.60) in the control group (difference €13.90 (95%CI: ?25.61–53.42).
Conclusion: washing without water mildly protects from skin abnormalities/lesions, costs for preparing and performing bed baths do not differ from costs for traditional bed bathing. Thus, washing without water can be considered the more efficient alternative
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Accepted/In Press date: 1 August 2014
e-pub ahead of print date: 10 August 2014
Published date: January 2015
Keywords:
bed bath, cost-effectiveness, nursing, skin damage
Organisations:
Faculty of Health Sciences
Identifiers
Local EPrints ID: 380935
URI: http://eprints.soton.ac.uk/id/eprint/380935
ISSN: 0020-7489
PURE UUID: 3fda7cde-c2ca-4dc5-bfca-3f9a9f95eb18
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Date deposited: 21 Sep 2015 10:41
Last modified: 15 Mar 2024 03:41
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Contributors
Author:
B.G.I. van Gaal
Author:
S. Teerenstra
Author:
E. Adang
Author:
C. van der Vleuten
Author:
T. van Achterberg
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