Cost-consequence analysis of "washing without water" for nursing home residents: A cluster randomized trial
Publication year
2015Source
International Journal of Nursing Studies, 52, 1, (2015), pp. 112-120ISSN
Publication type
Article / Letter to editor

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Organization
IQ Healthcare
Health Evidence
Primary and Community Care
Dermatology
Journal title
International Journal of Nursing Studies
Volume
vol. 52
Issue
iss. 1
Page start
p. 112
Page end
p. 120
Subject
Radboudumc 0: Other Research RIHS: Radboud Institute for Health Sciences; Radboudumc 18: Healthcare improvement science RIHS: Radboud Institute for Health SciencesAbstract
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 euro218.30 (95%CI 150.52-286.08) in the experimental group and euro232.20 (95%CI: 203.80-260.60) in the control group (difference euro13.90 (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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- Faculty of Medical Sciences [80320]
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