Posted: July 6th, 2015

Topic: NURS 6052- week 10- application, Project part 3

Course Project: Part 3—Translating Evidence Into Practice

In Part 3 of the Course Project, you consider how the evidence you gathered during Part 2 can be translated into nursing practice.

Now that you have located available research on your PICOT question, you will examine what the research indicates about nursing practices. Connecting research evidence and findings to actual decisions and tasks that nurses complete in their daily practice is essentially what evidence-based practice is all about. This final component of the Course Project asks you to translate the evidence and data from your literature review into authentic practices that can be adopted to improve health care outcomes. In addition, you will also consider possible methods and strategies for disseminating evidence-based practices to your colleagues and to the broader health care field.

To prepare:

• Consider Parts 1 and 2 of your Course Project (dear writer, I have past and copied the parts 1 and 2 at the end of this paper, please review and use them). How does the research address your PICOT question?
• With your PICOT question in mind, identify at least one nursing practice that is supported by the evidence in two or more of the articles from your literature review. Consider what the evidence indicates about how this practice contributes to better outcomes.
• Explore possible consequences of failing to adopt the evidence-based practice that you identified.
• Consider how you would disseminate information about this evidence-based practice throughout your organization or practice setting. How would you communicate the importance of the practice?

To complete:

In a 3- to 4-page paper:

• Restate your PICOT question and its significance to nursing practice.
• Summarize the findings from the articles you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles.
• Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice.
• Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?

This part of the Course Project is due by Day 7 of Week 10. It should be combined with the other two components of the Course Project and turned in as your Portfolio Assignment for this course.

Note:  In addition, include a 1-page summary of your project.

For this final iteration, you will need to:

• Submit your paper to Grammarly and Turnitin through the Writing Center. Based on the Grammarly and Turnitin reports, revise your paper as necessary.
• Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting.

References

Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice (Laureate Education, Inc., custom ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Please use 4 more references

 

* Use the following format. Please also include titles for each paragraph so the paper is easier to follow and understand

• Introduction paragraph.

• The last phrase of the paragraph should say: “the purpose of this paper is to examine…”
• Body
• Summary
  • It should start with “the purpose of this paper was to analyze …”
• References

 

 

PART 1

 

The Effects of the New Bathing Protocols in Bedridden Patients

NURS 6052

June 13, 2015

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The Effects of the New Bathing Protocols in Bedridden Patients

In the health care setting, there are numerous circumstances that hinder an individual’s ability to maintain an adequate level of personal hygiene. These circumstances include bedridden status, age, illness or the type of surgeries that can render a hospitalized patient immobile for a short or long period of time. One of the ways that nurses can meet the hygienic needs of bedridden patients is to provide bed baths. The purpose of this paper is to examine the effectiveness of the new bed baths protocols, which involve the use of emollients, chlorhexidine Gluconate (CHG), filtered tap water, disposable basins and cloths versus the traditional bed baths in reducing the risks for infections in bed-bound hospitalized patients.

The Area of Interest

Hospital-acquired infections endanger a patient’s safety by prolonging his/her hospital stay and increase the need for additional treatment and care, which financially, can put a burden on patients, their families, and the facility. Undoubtedly, maintaining an adequate level of personal hygiene by receiving frequent baths can significantly reduce the risks of contracting nosocomial infections and improve patient outcomes. Therefore, the primary purpose of bed baths is to provide the patient with an adequate level of personal hygiene, as well as reducing the risk for infections by removing sweat, dirt, oil and other microorganisms on the skin (Veje & Larsen, 2014). Also, bathing reduces pyrexia and creates an opportunity for assessing skin integrity by the nurse.

Identifying the Problem

Across the nation, the process of bed baths has been significantly improved over the past decade. It is now separated into two categorize, the traditional and the new method of bathing. The problem arises from the fact that numerous facilities continue to use the traditional method of bathing despite research, which has shown to increase the risk of infections among bedridden patients.

Traditional Bed Bath

Traditional bed bath procedures use a basin of warm water, bath towels, washcloth, and soap. Undeniably, the traditional bed bath assists a patient in maintaining his or her personal hygiene needs. However, it is not considered the most effective way of washing patients because the procedure itself could be the cause of transmission of infection. A systematic review conducted by Veje and Larsen (2014), has shown that traditional bed bathing procedures increase the risk of infection and transmission among immobile patients regardless of their gender and ethnicity. Furthermore, in another study, traditional bed baths using soap, cloths, basin and water was contributed to an increase in urinary tract infections from 50% to 95% among bedridden patients (Downy & Lloyd, 2008).

New Bed Bath

The new bathing protocols emphasis on the importance of frequent bed baths, where disposable basins and clothes, emollients, CHG and filtered tap water is used (Downy & Lloyd, 2008). The use of emollients, CHG, and filtered tap water is a significant factor in reducing the risk for infections. Emollients in bed bathing are important in restoring and improving the part of the skin that is left supple and soft. Most importantly, emollients moisturize the body and prevent skin peeling and dryness, and deter the possibility of developing an infection. Intact skin plays a vital role in underlining the body’s first line of defense from microbial invasion. Moreover, it appears beneficial in reducing the transmission and shedding of microorganisms (Veje & Larsen, 2014).

The use of CHG is also reported to have significant reductions in specific bacteria colonization and in organisms that are multi-resistant. Reductions in bacterial colonization and prevention of their transmission are an important key in reducing the risk of infection among patients (Larson et al., 2004).

 

The Importance in Nursing Practice

Mission

Nurses are morally and legally responsible for patient safety and comfort. Despite the vast research that have shown the use of traditional methods of bed baths to be ineffective in maintaining patient hygiene and preventing infections, their continuous use is a direct contradiction of the nursing mission.

Effectiveness

The new bathing protocols are less time consuming and more effective in reducing the microbial counts on the patient’s skin. Furthermore, the new methods are more cost effective and have shown to increase nurses’ satisfaction with the task of bathing patients (Downy & Lloyd, 2008).

Patient Satisfaction

Also, research has shown that patients prefer the new methods of bathing over traditional ones. A randomized controlled trial conducted by Noddeskou, Hemmingsen and Hordam (2014), has shown that 86% of patients prefer the new methods of bathing.

Importance

Therefore, the effectiveness of the new bathing methods and patient’s preference of their use have rendered the issue of bad baths significant to the nursing practice.

Five Questions

Based on the importance of bed baths, the following five questions have been generated:

1. What are the traditional and new protocols for bed bath procedures?
2. Is there a significant difference in traditional bed bath procedures and new

protocols for bed baths?

3. What are the effects of the two procedures in reducing the risk for infection?
4. How does the use of more frequent baths, use of disposable basins and cloths,

use of emollients, CHG and filtered tap water reduce the risk for infections?

5. What are the implications of the study in nursing procedures?

Feasibility

As presented in this paper, there are significant differences between traditional and new methods of bed baths and their likelihood of reducing infections among patients. At the same time, the nursing mission is in line with the goals of the new bathing methods, which is to reduce infection and promote patient satisfaction.

PICOT Question

The PICOT question formulated based on the above evidence is: in bed-bound hospitalized patients (P), what effects do the new bathing procedures of using disposable basins, cloths, emollients, CHG and filtered tap water (I) have when compared to traditional bed baths (C) in reducing the risks for infection in patients (O)?

Variables

This variable refers to the subgroup of hospitalized patients who are immobile because of surgery, illness or advanced age.

I.

This variable refers to the effectiveness of using disposable basins, cloths, emollients, CHG and filtered tap water when bathing a bedridden patient.

C.

This variable emphasizes on the results of the comparison between the traditional and new methods of bathing

O.

This variable examines the patient outcomes and the risks for infection.

T.

This variable refers to time spent in collecting data.

Keywords

The following keywords were used in conducting the search within the databases: bed bath, traditional bath, use of disposable basin and cloths, emollients, CHG and filtered tap water in bed baths, promoting personal hygiene, reducing risk for infections, nursing management. The rationale for choosing these words were to collect relevant and current data that were peer-reviewed.

Summary

The purpose of this paper was to examine the effectiveness of the new bed bath protocols involving the use of emollients, CHG, filtered tap water, disposable basins and cloths versus the traditional bed bath in reducing the risks for infections in bed-bound hospitalized patients. Research has shown that the new bed bathing methods reduce infection and increase patient and staff satisfaction. At the same time, the new methods are more cost effective and less time consuming when compared to the traditional methods of patient bathing.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Downy L. & Lloyd, H. (2008). Bed bathing patients in hospital. Nursing Standard, 22(34), 35-40.

Larson, E. L., Ciliberti, T., Chantler, C., Abraham, J., Lazaro, E. M., Venturanza, M. & Pancholi P. (2004). Comparison of traditional and disposable bed baths in critically ill patients. American Journal of Critical Care, 13(3), 235-241

Noddeskou, L. H., Hemmingsen, L. E. & Hordam, B. (2014). Elderly Patient’s and Nurses’ assessment of traditional bed bath compared to prepacked single units- randomized controlled trials. Nordic College of Caring Science. Retrieved from http://www.readcube.com/articles/10.1111%2Fscs.12170?r3_referer=wol&tracking_action=preview_click&show_checkout=1&purchase_referrer=onlinelibrary.wiley.com&purchase_site_license=LICENSE_DENIED

Veje, P. & Larsen, P. (2014). The effectiveness of bed bathing practices on skin integrity and hospital-acquired infections among adult patients: a systematic review protocol. JBI Library, 12(2), 71-81.

 

 

 

 

 

 

 

 

 

 

 

 

PART 2

 

The new Methods of Bathing

NURS 6052

July 05, 2015

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The new Methods of Bathing

In many ways, review of literature is an essential aspect of every research paper; it can elicit information related to the research questions. At the same time, it can describe the current state of knowledge to guide the practice and provide a comprehensive background for the reader on a topic. Furthermore, it can satisfy the intellectual curiosity of a reader and justify the need for more new research. The purpose of this paper is to examine five studies related to the previously developed PICOT question by analyzing the information provided by each study, and discuss any inconsistencies or contradictions within the studies.

The Traditional Bed Bath

In many studies, the bed bath is regarded as an important procedure in promoting hygiene, reducing infections and encouraging relaxation among patients. The traditional method of bathing promotes the use of non-disposable basins and cloths. However, some studies have shown that traditional bathing methods contribute to an increase in infections among patients. According to Veje and Larsen (2014), traditional bed bath methods have increased urinary tract infections from 50% to 95% among bedridden patients because of reusing the basins and cloths.

At the same time, cross-infection has also been linked to traditional bed bathing methods. These types of infections occur when the caregiver uses contaminated bathing equipment on another patient. Simply put, the equipment serves as a reservoir of bacteria. As evidence by a study conducted by Veje & Larsen (2014) concluded that 98% of reused equipment in traditional bed bath procedures have several different species of bacteria on their surfaces (Veje & Larsen, 2014).

New Bathing Protocols

Over the last decade, bed bath procedures have improved noticeably. These improvements have led to the development of new bathing protocols. The new bathing procedures include more frequent baths, use of disposable basins, cloths, emollients and CHG.

Study 1

The use of disposable basins and cloths are supported with multitudes of literature. A study conducted by Larson et al. (2004) has compared traditional bed bathing methods to those of new bathing procedures using disposable basins in terms of four outcomes which included:

1. Microbial counts on the skin
2. Time and quality of bathing
3. Costs
4. Nurses’ satisfaction with the provided care

The result of this study showed that the new bathing methods are preferred by many nurses, since the use of disposable basins reduces the time required to complete the task. At the same time, Larson et al.’s study showed by using the new protocols, there is less recontamination of the skin among the bathed patients.

Study 2

Another study conducted to evaluate the use of basins as the probable reservoir for colonization of bacteria, revealed that their use is linked to an increase of risk in the number of hospital-acquired infections (Johnson, Lineweaver & Maze, 2012).

Study 3

As for emollients, the study by Veje & Larsen (2014) highlighted the noteworthiness of emollients in bed bathing procedures. This study showed that emollients are important in restoring and improving the part of the skin that is left supple and soft. Moreover, emollients moisturize the body, prevent skin peeling, dryness and deter the possibility of developing an infection (Veje & Larsen, 2014).

Study 4

Many works of literature support the use of chlorhexidine gluconate (CHG) in bed bathing procedure. A study done by Coyer, Fiona, O’Sullivan and Cadman (2011) revealed that the use of CHG reduces the vancomycin-resistant Enterococcus (VRE) by 50% and methicillin-resistant Staphylococcus aureus (MRSA) incidence by 32% among critically bedridden patients.

Study 5

The last study was conducted by Powers, Peed, Burns and Davis (2012). This study compared the infection caused by the use of basins, water, and soap, against those caused by CHG. The result showed a significant decrease in the rate of hospital-acquired infections among patients bathed using the new protocols versus those of the traditional methods.

Inconsistencies in Literature

In the same systematic review by Veje and Larson (2014), the two researchers stated that there were no definite pieces of evidence that the use of CHG preoperatively in bedridden patients reduced the risk of infection at the surgical site compared to those of the old methods, such as traditional bed baths. To explain this inconsistency, the authors claimed that use of CHG can still reduce bacterial colonization and prevent their transmission if the CHG is applied to the skin in adequate quantities. Furthermore, the study reinforced the idea of using CHG on bedridden patients since it found no contradiction for their use.

Preliminary Conclusion of the Studies

Based on the above five studies, the use of new bathing methods can significantly reduce the risk of infection among bedridden patients. Additionally, the reuse of basins and cloths are linked to an increase in the rate of urinary tract infections, which are costly to treat and extend the patient’s stay in a hospital. At the same time, the new disposable basins and cloths do not require rewashing or restocking, which shortens the length of bed baths, thus, allowing the nurses more time to meet patients’ medical needs.

Summary

The purpose of this paper was to examine five studies related to the developed PICOT question by analyzing information provided by each study. At the same time, this paper discussed an inconsistency with one of the studies. Undoubtedly, the new bathing methods have been proven to reduce the rate of infection among bedridden patients. Therefore, there needs to be a national push to implement this method as the only acceptable way of meeting a bedridden patient’s hygienic needs.

 

 

 

 

 

 

 

 

 

 

 

 

References

Coyer, Fiona M., O’Sullivan, Judy, & Cadman, N. (2011). The provision of patient personal hygiene in the intensive care unit : a descriptive exploratory study of bed-bathing practice. Australian Critical Care, 24(3): 198-209.

Larson, E. L., Ciliberti, T., Chantler, C., Abraham, J., Lazaro, E. M., Venturanza, M. & Pancholi P. (2004). Comparison of traditional and disposable bed baths in critically ill patients. American Journal of Critical Care, 13(3), 235-241

Johnson, D., Lineweaver, L.,&. Maze, L. M. (2012). Patients’ Bath Basins As Potential Sources Of Infection: A Multicenter Sampling Study. American Journal of Critical Care, 18(1), 31-40.

Powers, J. Peed, J., Burns, L., & Davis, M. Z. (2012). Chlorhexidine Bathing and Microbial Contamination in Patients’ Bath Basins. American Journal of Critical Care, 21(5), 338-342.

Veje, P. & Larsen, P. (2014). The effectiveness of bed bathing practices on skin integrity and hospital-acquired infections among adult patients: a systematic review protocol. JBI Library, 12(2), 71-81.