An evaluation of two bathing products in a chronic care setting
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Geriatric Nursing 2001 • Volume 22 • Number 2 91 An Evaluation of Two Bathing Products in a Chronic Care Setting Margaret Dawson, BScN,Ana Pilgrim, RN, Cleary Moonsawmy, BSN, and Julie Moreland, Msc T he purpose of this study was to compare a no- rinse skin cleanser with a detergent for bathing residents. Our primary research question was whether the no-rinse cleanser more effectively decreased the number of skin-related prescrip- tions and nonprescription preparations than the detergent. Secondary comparisons included skin condition (erythema, rashes, open areas), odor control, cleansing efficacy, patient comfort during the bath, time taken to bathe, ease of use, and product cost. Participants were recruited from two units of the Complex Continuing Care Program and randomized to receive the detergent cleanser or the no-rinse cleanser for 10 weeks in period 1 and the other cleanser for 10 weeks in period 2. Data were collected on demographic and clinical charac- teristics. A blinded observer counted the number of medica- tions and preparations given for skin conditions for each patient on the last day of each 10-week period. Areas of ery- thema, rashes, and open wounds also were counted. Redness, blisters, or pustules on the perineum were evaluated on a visual analogue scale. During the last week of each 10-week period, nurses used data collection sheets to record the time taken to give the bath, the cleanser’s ease of use, cleansing effectiveness, odor control, patient comfort during the bath, scratching, and restlessness.These scores were averaged over three baths. RESULTS Thirty-two patients were recruited, and 24 completed the study (those who did not complete the project died from con- ditions unrelated to the study). The primary diagnoses among participants were cerebrovascular accident (10), dementia (10), other neurologic conditions (7), musculoskeletal diag- noses (3), and other psychiatric diagnoses (2). Prescriptions for skin conditions included hydrocortisone, fucidin, trichlosan, bactroban, sebutone shampoo, canestin, selsun shampoo, ure- mol, cilistoderm cream, and arabane. A and D ointment was used as a barrier cream for all incontinent patients. The mean differences between the no-rinse and detergent periods were not clinically significant. The largest effect was noted in the product ease of use; however, the mean difference was small and not likely to be clinical important. The times taken to give the baths with the two types of cleansers were similar. The cost per mL of the detergent and cleanser was quoted at 0.46 and 1.03 cents, respectively.The average amount of de- tergent used during the 10-week period was 996 mL, and, on av- erage, 1271 mL of the no-rinse cleanser were used per patient. Therefore, the cost per patient was $4.58 for the detergent and $13.09 for the no-rinse cleanser. DISCUSSION Cost was the only major difference between the two products—in fact, the no-rinse product was more than twice as expensive as the detergent. This result suggests that the no- rinse cleanser should be used for select cases based on clinical problem-solving. For example, patients with pruritus may re- spond favorably to the no-rinse product. Otherwise our eval- uation led us to recommend staying with our current detergent for patients with uncomplicated skin conditions. Acknowledgment: this work should be attributed to the Complex Continuing Care Program and Research Department of St. Peter’s Hospital in Hamilton, Ontario, Canada. This research was funded by the St. Peter’s Hospital Foundation and St. Peter’s Hospital. MARGARET DAWSON, BScN, and ANA PILGRIM, RN, are case managers at St. Peter’s Hospital in Hamilton, Ontario, Canada. CLEARY MOONSAWMY, BSN, is the clinical leader of nursing at St. Peter’s. JULIE MORELAND, MSc, was the research coordinator at St. Peter’s and assistant professor at McMaster University in Hamilton. Copyright © 2001 by Mosby, Inc. 0197-4572/2001/$35.00 + 0 34/1/107133 doi:10.1067/mgn.2001.107133 GN Management
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Transcript of An evaluation of two bathing products in a chronic care setting
Geriatric Nursing 2001 • Volume 22 • Number 2 91
An Evaluation of Two Bathing Products in a Chronic Care Setting
Margaret Dawson, BScN, Ana Pilgrim, RN, Cleary Moonsawmy, BSN, and Julie Moreland, Msc
The purpose of this study was to compare a no-rinse skin cleanser with a detergent for bathingresidents. Our primary research question waswhether the no-rinse cleanser more effectivelydecreased the number of skin-related prescrip-
tions and nonprescription preparations than the detergent.Secondary comparisons included skin condition (erythema,rashes, open areas), odor control, cleansing efficacy, patientcomfort during the bath, time taken to bathe, ease of use, andproduct cost.
Participants were recruited from two units of theComplex Continuing Care Program and randomized to receivethe detergent cleanser or the no-rinse cleanser for 10 weeks inperiod 1 and the other cleanser for 10 weeks in period 2.
Data were collected on demographic and clinical charac-teristics. A blinded observer counted the number of medica-tions and preparations given for skin conditions for eachpatient on the last day of each 10-week period. Areas of ery-thema, rashes, and open wounds also were counted. Redness,blisters, or pustules on the perineum were evaluated on a visualanalogue scale. During the last week of each 10-week period,nurses used data collection sheets to record the time taken togive the bath, the cleanser’s ease of use, cleansing effectiveness,odor control, patient comfort during the bath, scratching, andrestlessness. These scores were averaged over three baths.
RESULTSThirty-two patients were recruited, and 24 completed the
study (those who did not complete the project died from con-ditions unrelated to the study). The primary diagnoses amongparticipants were cerebrovascular accident (10), dementia(10), other neurologic conditions (7), musculoskeletal diag-noses (3), and other psychiatric diagnoses (2). Prescriptions forskin conditions included hydrocortisone, fucidin, trichlosan,bactroban, sebutone shampoo, canestin, selsun shampoo, ure-mol, cilistoderm cream, and arabane. A and D ointment was
used as a barrier cream for all incontinent patients.The mean differences between the no-rinse and detergent
periods were not clinically significant. The largest effect wasnoted in the product ease of use; however, the mean differencewas small and not likely to be clinical important.The times takento give the baths with the two types of cleansers were similar.
The cost per mL of the detergent and cleanser was quotedat 0.46 and 1.03 cents, respectively. The average amount of de-tergent used during the 10-week period was 996 mL, and, on av-erage, 1271 mL of the no-rinse cleanser were used per patient.Therefore, the cost per patient was $4.58 for the detergent and$13.09 for the no-rinse cleanser.
DISCUSSIONCost was the only major difference between the two
products—in fact, the no-rinse product was more than twiceas expensive as the detergent. This result suggests that the no-rinse cleanser should be used for select cases based on clinicalproblem-solving. For example, patients with pruritus may re-spond favorably to the no-rinse product. Otherwise our eval-uation led us to recommend staying with our currentdetergent for patients with uncomplicated skin conditions.
Acknowledgment: this work should be attributed to the ComplexContinuing Care Program and Research Department of St. Peter’sHospital in Hamilton, Ontario, Canada. This research was fundedby the St. Peter’s Hospital Foundation and St. Peter’s Hospital.
MARGARET DAWSON, BScN, and ANA PILGRIM, RN, are casemanagers at St. Peter’s Hospital in Hamilton, Ontario, Canada.CLEARY MOONSAWMY, BSN, is the clinical leader of nursing at St.Peter’s. JULIE MORELAND, MSc, was the research coordinator atSt. Peter’s and assistant professor at McMaster University inHamilton.
Copyright © 2001 by Mosby, Inc.0197-4572/2001/$35.00 + 0 34/1/107133doi:10.1067/mgn.2001.107133
GN Management
