Effectiveness of bed bath methods for skin integrity, skin cleanliness and comfort enhancement in adults: A systematic review.
Issei Konya, Kotone Nishiya, Rika Yano
PMID 33724709WHAT IT FOUND
No single bed bath method was clearly best, but disposable towels cleaned as well as cotton, hot towel before wiping helped skin barrier and warmth, gentle wiping removed dirt, and moisturizer after bathing helped dry skin.
Key findings
01Disposable towels were not clearly better than traditional bed baths for reducing skin bacteria or significant skin lesions.
02Applying a hot towel for 10 seconds before wiping avoided an increase in measured water loss from the skin and provided warmth and comfort.
03Wiping three times at 10 mmHg or more removed oily and aqueous dirt without impairing the skin barrier in healthy adults.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only four of the 25 included studies were high quality, and most were moderate, low or very low, so the review cannot provide firm best-practice recommendations. The authors did not perform a meta-analysis because study designs, participants, interventions and outcomes varied too much. Many wiping and thermal findings came from healthy adults, not older inpatients or residents with vulnerable skin. The search was limited to English articles published between January 2004 and May 2020, and the protocol was not registered in advance. The review excluded qualitative studies, case studies and single expert opinion, so patient experiences and preferences were not synthesized. Comfort outcomes were measured with many different, mostly non-validated scales, and the review could not assess reporting bias or contact authors about unclear items.
Declared interests
The supplied publication types indicate non-U.S. government research support. No author conflict-of-interest or funding declaration is included in the article text.
The easy way to misread this
Do not conclude that any bed bath method is proven best for all adult patients. The review found only limited evidence, mostly from healthy adults or small studies, and only four of 25 included studies were high quality.