Meaning of hygiene care for patients as perceived by clinical nurses through an interactive care process: A grounded theory approach.

AIM: This study aimed to explore the meaning of hygiene care for patients from the perspective of nurses, who provide them with care through an interactive process. METHODS: Sixteen registered nurses working in general wards for over 5 years were selected through purposive and snowball sampling. Individual semi-structured interviews were conducted between May and August 2021. Data were analyzed using a grounded theory approach, and the Consolidated Criteria for Reporting Qualitative Research was used to ensure quality and transparency. RESULTS: The participants recognized the core category "realizing oneself alive here," where hygiene care energized patients and promoted their realization of "feeling alive." Hygiene care created "time of relief, temporarily forgetting the illness," and "restoring a sense of oneself." A situation of care also created an "opportunity to treat each other as unique individuals," "opportunity to face self," and "encouraging the recovery and disease-fighting process." CONCLUSIONS: This study highlights the value of hygiene care provided by nurses to patients. The meaning of hygiene care conceptualized in this study should help build a conceptual framework for understanding the patient's experience and reaffirming the value of hygiene care.

Minimum wiping pressure and number of wipes that can remove dirt during bed baths using disposable towels: a multi-study approach.

BACKGROUND: Friction irritation by wiping increases the risk of skin problems. In bed baths with cotton towels, wiping three times with weak pressure (10-20 mmHg ≈ 1333-2666 Pa) can remove dirt while maintaining skin barrier function. However, few studies have examined the appropriate frictional irritation with disposable towels. This study aimed to analyse the wiping pressure and number of wipes currently applied by nurses when using disposable towels during bed baths and propose the minimum values for removing dirt from the skin. METHODS: This multi-study approach consisted of cross-sectional and crossover design components. In Study 1, 101 nurses in two hospitals were observed by recording the wiping pressure and number of wipes when using both disposable (nonwoven) and cotton (woven) towels. Wiping pressure and number of wipes by towel materials were analysed using a linear mixed model. In Study 2, 50 adults received oily and aqueous dirt on their forearms, which were wiped six-times with disposable towels, applying randomly assigned pressure categories. We used colour image analysis and a linear mixed model to estimate the dirt removal rate for each combination of wiping pressure and number of wipes. RESULTS: Study 1 showed that although wiping pressure did not differ by towel material, the number of wipes was significantly higher for disposable wipes than cotton wipes. Approximately 5% of nurses applied strong wiping pressure or wiped too often. In Study 2, wiping three times with disposable towels at least 5-10 mmHg achieved dirt removal rates of ≥80%. CONCLUSIONS: Some nurses excessively wiped using disposable towels, which might cause skin problems. However, excessive wiping is not required to adequately remove dirt, regardless of the towel material used in various clinical situations. We recommend wiping at 10-20 mmHg of pressure (just like stroking gently) at least three times to improve the quality of bed baths. These findings highlight the need to develop skin-friendly bed bath educational programmes, particularly using appropriate frictional irritation to reduce the risk of skin problems.

Effectiveness of bed bath methods for skin integrity, skin cleanliness and comfort enhancement in adults: A systematic review.

AIM: To evaluate the effectiveness of bed bath methods for skin integrity, skin cleanliness and comfort enhancement in adults. DESIGN: A systematic review based on the PRISMA guidelines. METHODS: We searched for quantitative studies published between 2004-2020, using the PubMed, MEDLINE and CINAHL. The remaining 25 studies were appraised by the JBI tool. RESULTS: Only four of the included studies were of high quality. Studies of above moderate quality demonstrated that disposable towels were as effective as cotton towels for skin lesions and bacterial removal. Applying a hot towel maintained the skin barrier function and provided warmth; cotton towels were effective for cleaning even with weak pressure, and post-bed bath moisturizer treatment contributed to skin integrity. CONCLUSION: Although various methods have been examined, the available evidence is inadequate for establishing best practices. It is necessary to verify empirical research with rigorous methodology involving elderly inpatients and to develop instruments that measure patients' comfort.