Bathing hospitalized dependent patients with prepackaged disposable washcloths instead of traditional bath basins: A case-crossover study

Am J Infect Control. 2017 Sep 1;45(9):990-994. doi: 10.1016/j.ajic.2017.03.023. Epub 2017 May 11.

Abstract

Background: Basins used for patient bathing have been shown to be contaminated with multidrug-resistant organisms (MDROs) and have prompted the evaluation of alternatives to soap and water bathing methods.

Methods: We conducted a prospective, randomized, open-label interventional crossover study to assess the impact of replacing traditional bath basins with prepackaged washcloths on the incidence of hospital-associated infections (HAIs), MDROs, and secondarily, rates of skin deterioration. Unit-wide use of disposable washcloths over an 8-month period was compared with an 8-month period of standard care using basins.

Results: A total of 2,637 patients were included from 2 medical-surgical units at a single tertiary medical center, contributing 16,034 patient days. During the study period, there were a total of 33 unit-acquired infections, the rates of which were not statistically different between study phases (incidence rate ratio, 1.05; 95% confidence interval [CI], 0.50-2.23; P = .88). However, occurrence of skin integrity deterioration was significantly less in the intervention group (odds ratio, 0.44; 95% CI, 0.22-0.88; P = .02).

Conclusions: Although we were unable to demonstrate a significant reduction in HAI or MDRO acquisition, we found a decrease in skin deterioration with the use of disposable washcloths and confirmed earlier findings of MDRO contamination of wash basins.

Keywords: Bathing; Hospital-associated infections; Skin integrity; Washcloths.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anti-Infective Agents, Local / pharmacology
  • Baths / methods*
  • Bedding and Linens*
  • Cross Infection / microbiology
  • Cross Infection / prevention & control*
  • Cross Infection / transmission
  • Cross-Over Studies
  • Disinfectants / pharmacology
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Methicillin-Resistant Staphylococcus aureus / drug effects
  • Methicillin-Resistant Staphylococcus aureus / pathogenicity
  • Methicillin-Resistant Staphylococcus aureus / physiology
  • Middle Aged
  • Prospective Studies
  • Staphylococcal Skin Infections / drug therapy
  • Staphylococcal Skin Infections / microbiology
  • Staphylococcal Skin Infections / prevention & control*
  • Staphylococcal Skin Infections / transmission

Substances

  • Anti-Infective Agents, Local
  • Disinfectants