Bag baths may be more effective than traditional bed baths at reducing skin complications and hospital-acquired infections based on the following: 1) Bag baths use emollients that aid in skin integrity and reduce impairments, while soap in traditional baths causes dryness and vulnerability to infection. 2) Bath basins can harbor microorganisms posing an infection risk, while bag baths decrease bacterial counts and recontamination between body areas. 3) Studies found bag baths took less time, required fewer supplies, cleansed and moisturized skin effectively, and were preferred by patients and nurses.

1. Effectiveness of Bag Baths at Reducing Skin Integrity Complications and Decreasing Hospital
Acquired Infections
Kelsey Czajka, Karlie Dougherty, Diana Leas
NUR440
York College of Pennsylvania
METHODOLOGY
EVIDENCE SUMMARY TABLE
CONCLUSIONS
Are bag baths (as compared to traditional
bed baths) more effective at reducing
complications with skin integrity and other
hospital acquired infections?
Databases Used CINAHL, EBSCO, OVID, Google Scholar
Keywords bed bath, basinless bath, bag bath, chlorhexidine wipes, skin integrity, disposable
wipes, infection, microbial counts on skin, disposable washcloths, ICU bathing,
hospital-acquired infections
Inclusion Criteria Full text, References Included, Scholarly Journals, Johns Hopkins Levels 1-3, Adult
Patients, published from 2008- present
Level
Type
Number
of
Sources
Summary of Findings Overall
Quality
Rating
Level I 2 • The emollients in bag baths aid in the maintenance of skin integrity and decrease the
incidence of skin impairments.4
• The use of soap with the traditional basin baths causes skin dryness and makes the
skin vulnerable to skin impairments and infection.4
• Bath basins are hard to keep clean and were found to harbor microorganisms that
pose a risk for infection in patients.3
• Bag baths take significantly less time than traditional basin baths. The duration of
disposable bag baths (mean= 29 minutes) were significantly less (p < 0.001) than a
traditional basin bath (mean= 36 minutes).3
• More patients prefer the disposable bag bath (47%) over the traditional bath (22%).
Patients communicated feeling clean and that the time spent on bathing was
adequate.3
• A significant number of nurse (87%) preferred disposable bag baths over traditional
baths.3
A-B
Level II 4 • Bag baths are effective at decreasing bacterial counts while concurrently cleansing
and moisturizing the skin. 6
• In traditional basin baths, the basin and bath water was found to become
contaminated with skin microorganisms. 1
• A reduction in gram-negative microbial count on both the periumbilicus and groin
area after bathing patients with the disposable bag bath.1
• Bag baths containing Chlorhexidine gluconate (CHG) cleansing wipes decreased
gram-negative bacterial skin colonization and the incidence of hospital acquired
infections.2
• Bag bath decreased recontamination of bacteria from one area of the body to
another part. 2
• The Pampers Sensitive wipes, were used as bath wipes in the NICU. They increased
barrier function as well as maintained skin integrity.5
• Pampers Sensitive wipes were found to facilitate acid mantle development which
assisted in decreased bacterial colonization and infection control.5
• Nurses found bag bath to require significantly (P=<.001) less time and fewer
resources compared to a traditional bed bath. 1
• Patients prefer bag baths for their ease and comfort. 6
• Evidence found bag baths to convenient, easy to use, take less time, require fewer
supplies, warmed in warmer, clean and moisturize patient’s skin effectively, and
more comfortable for the patient. 6
• Most nurses (75.5%) prefer bag baths over traditional bed baths. 1
B
Level III 1 • Bag baths meet the cleansing needs for frail skin in the older population.7
• Bag baths are the best alternative to traditional basin baths due to no-soap, no-rinse,
and no-drying process which is easier on the skin.7
• Nurses found bag bath to require significantly less time and fewer resources
compared to a traditional bed bath.7
B
INTRODUCTION
IMPLICATIONS FOR NURSING
PICO QUESTION
There are currently no national guidelines for
patient bathing regimens to help maintain
skin integrity and to decrease hospital
acquired infections. Studies have shown that
the use of traditional bed baths actually
decreases the skin's resistance to microbial
invasion.4 Research findings suggest bag
baths being the method of choice for bed
baths to help improve overall skin integrity
and reduce risk for infection.6 The action
plan that can be put into place to initiate the
change in health care institutions would be
to create a change in policies and
procedures with the help of the joint
commission. Implementing change in
nursing practice through policies and
procedures to only bag bath bathing for pts
who meet criteria, can result in improved
skin integrity for patients in health care
facilities.
Hygiene care, including bathing and skin
maintenance, is an essential part of nursing
care. A bed bath is the standard of practice
used to provide hygiene care in patients that
are bed bound and too ill to meet their own
hygiene needs1. The traditional basin bath
and the disposable bag bath are the two
most common practices used in hospitals.
Research suggests that basin baths threaten
skin integrity and pose a risk for infection in
patients 2. Bathing and skin care should be
aimed at promoting hygiene and comfort
while reducing the risks of skin breakdown
and infection.
The implementation of bag baths in nursing
practice will help to:
• meet the hygiene needs of patients6,7
• maintain patient skin integrity4,5
• prevent dryness caused by basin bathing4
• prevent contamination of other parts of
the skin by basin bathing1
• decrease the colonization of bacteria on
patient’s skin1,2,3,4,5,6
• decrease hospital acquired infections4,2
• decrease the time spent bathing a
patient6,7
• more time efficient for nursing care1,7
Research findings and the literature
recommendations support a change in
current practice from traditional basin baths
to bag baths.
References
1. Larson, E., Ciliberti, T., Chantler, C., Abraham, J., Lazaro, E.,
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.
2. Cassir, N., Thomas, G., Hraiech, S., Brunet, J., Fournier, P., La
Scola, B., & Papazian, L. (2015). Chlorhexidine daily bathing: Impact
on health care–associated infections caused by gram-negative
bacteria. American Journal Of Infection Control, 43(6), 640-643.
doi:10.1016/j.ajic.2015.02.010
3. Nøddeskou, L. H., Hemmingsen, L. E., & Hørdam, B. (2014).
Elderly patients' and nurses' assessment of traditional bed bath
compared to prepacked single units - randomised controlled
trial. Scandinavian Journal Of Caring Sciences, 29(2), 347-352.
doi:10.1111/scs.12170
4. Schoonhoven, L., van Gaal, B. I., Teerenstra, S., Adang, E., van
der Vleuten, C., & vanAchterberg, T. (2015). Cost-consequence
analysis of ''washing without water'' for nursing home residents: A
cluster randomized trial. International Journal Of Nursing Studies
5. Visscher, M., Odio, M., Taylor, T., White, T., Sargent, S., Sluder, L.,
& ... Bondurant, P. (2009). Skin care in the NICU patient: effects of
wipes versus cloth and water on stratum corneum
integrity. Neonatology, 96(4), 226-234. doi:10.1159/000215593
6. Kron-Chalupa, J., Benda, T., & Williams, B. (2014). A Basinless
Bath: A Study on Skin Dryness and Patient Satisfaction. Nursing
World, 10(4). , 52(1), 112-120. doi:10.1016/j.ijnurstu.2014.08.001
7. Collins, F., & Hampton, S. (2003). Product focus. BAGBATH: the
value of simplistic care in the community. British Journal Of
Community Nursing, 8(10), 470.
Bag Baths. (2015). [Image of painting]. CWI Medical. Retrieved from
http://www.cwimedical.com/caregivers/personal-hygiene