Cost-consequence analysis of "washing without water" for nursing home residents: A cluster randomized trial. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Schoonhoven, Lisette; van Gaal, Betsie G.I.; Teerenstra, Steven; Adang, Eddy; van der Vleuten, Carine; van Achterberg, Theo
• Is Part Of: International journal of nursing studies. Volume 52:Issue 1(2015:Jan.)
• Page Start: 112
• Page End: 120
• Publication Date: 2015-01
• Subjects: Nursing -- Periodicals; Nursing -- Periodicals; Soins infirmiers -- Périodiques; Nursing; Periodicals; 610.73
• DOI: 10.1016/j.ijnurstu.2014.08.001
• Languages: English
• ISSNs: 0020-7489

Abstract

<abstract abstract-type="author" id="abs0005"> <title id="sect0005">Abstract</title> <sec> <title id="sect0010">Background</title> <p id="spar0005">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.</p> </sec> <sec> <title id="sect0015">Objectives</title> <p id="spar0010">To compare bed baths for effects on skin integrity and resistance against bathing and costs.</p> </sec> <sec> <title id="sect0020">Design</title> <p id="spar0015">Cluster randomized trial.</p> </sec> <sec> <title id="sect0025">Setting</title> <p id="spar0020">Fifty six nursing home wards in the Netherlands.</p> <p id="spar0025">Participants: Five hundred adult care-dependent residents and 275 nurses from nursing home wards.</p> </sec> <sec> <title id="sect0030">Methods</title> <p id="spar0030">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.</p> <p id="spar0035">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.</p> </sec> <sec> <title id="sect0035">Results</title> <p id="spar0040">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 (<italic>p</italic> = 0.04). There were no differences in significant skin lesions or resistance after 6 weeks.</p> <p id="spar0045">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).</p> </sec> <sec> <title id="sect0040">Conclusion</title> <p id="spar0050">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.</p> </sec> </abstract>