Comparison of two washing methods for bed baths: Soap and water or disposable wet wipes – A mixed methods study

Background: Bed baths are offered to bedridden patients during hospital admissions. The use of soap and water (SAW) has gradually been replaced by a more widespread use of disposable wet wipes (DWW). Knowledge and evidence about SAW and DWW are important elements in nursing staff’s clinical decision-making regarding choice of washing method for a bed bath. The study investigates the implications of SAW and DWW for bed baths.
Methods: A convergent fixed mixed methods design was used including three studies. In study I, a block-randomized cross-over design was used to compare the efficacy of SAW and DWW to remove microorganisms on the skin. Skin swabs were compared before and after washing with SAW and DWW. In study II, qualitative interviews were conducted to explore the patients’ preferences for and perspectives of the use of SAW and DWW for bed baths. Study III was a scoping review, which aimed to identify operating and capital costs included in cost analyses for bed bath washing methods. The mixed methods findings and results were integrated through narrative weaving.
Results: The themes of the integrated findings across the three studies were: “Shared clinical decision-making regarding choice of washing method for bed bath”, “Freshening up or feeling really clean” and “Cleanliness in social relations”
Conclusion: Overall, the patients’ preferences depended on the context, but they would like to have the opportunity to be involved in the clinical decision-making, regarding choice of washing method for bed baths. However, the most important for them, was to be washed.