Washing Without Water: Cost-effectiveness of a Rapidly Spreading Nursing Intervention in Bedridden Patients'

Study Overview
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Brief Summary
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The purpose of this study is to compare the traditional bed bath with 'washing without water' on 1) effects on skin integrity 2) patient and nurse satisfaction and 3) costs. In a cluster randomized trial we will randomize 50 nursing home wards (576 patients) to 'washing without water' or traditional bed baths. Bathing regimens are continued for six weeks. Whereas effects on skin damage are not likely to be specific for setting, these results can be generalized to other patient groups.

Detailed Description
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RAPID IMPLEMENTATION of new interventions while cost-effectiveness and acceptability for patients and care providers are unclear, is never desirable. 'Washing without water' is such an intervention. The traditional bed bath is executed by using tap water, towels, washcloths and soap. As an alternative, 'WASHING WITHOUT WATER' was recently introduced in the Netherlands. This concept consists of disposable washcloths made of a mix of soft synthetic fibers, saturated with a no rinse, quickly vaporizing skin cleaning and caring lotion. 'WASHING WITHOUT WATER' can be used with all patients who need bathing assistance, especially when taking a shower or sitting in a hot tub is not possible. However, while several claims are made about the positive effects of 'washing without water' as compared to traditional bathing, EVIDENCE IS LACKING. Also, 'washing without water' is CONTROVERSIAL. While some are eager to adopt the new concept, others see it as 'efficiency gone loose' and denying patients one of the most basic elements of care: a proper bath. This study therefore addresses the cost effectiveness of 'washing without water' in bedridden patients.

Official Title
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WASHING WITHOUT WATER Cost-effectiveness of a Rapidly Spreading Nursing Intervention om Bedridden Patients'

Conditions
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Skin Disease

Intervention / Treatment
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* Device: Washing without water


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: long stay psychogeriatric nursing home residents long stay somatic nursing home residents 100 randomly selected nurses from the participating nursing home wards Exclusion Criteria: -

Ages Eligible for Study
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Minimum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Washing without water<br>The experimental intervention is 'washing without water' and consists of disposable washing cloths made of a mix of soft synthetic fibers, saturated with a no rinse, quickly vaporizing skin cleaning and caring lotion. | Device: Washing without water<br>* The experimental intervention is 'washing without water' and consists of disposable washing cloths made of a mix of soft synthetic fibers, saturated with a no rinse, quickly vaporizing skin cleaning and caring lotion.<br>* Other names: disposable washing cloths;|
| Active Comparator: Traditional soap and water bath<br>The control intervention is the traditional bathing assistance as performed in care dependent patients by using tap water, a bowl, towels, washcloths and soap. | Device: Washing without water<br>* The experimental intervention is 'washing without water' and consists of disposable washing cloths made of a mix of soft synthetic fibers, saturated with a no rinse, quickly vaporizing skin cleaning and caring lotion.<br>* Other names: disposable washing cloths;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the primary outcome is prevalence of care associated skin damage | Skin damage is defined as intertrigo, dermatitis and/or other erythema on skin areas which were not exposed to pressure directly before observation. | 6 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient and nurse satisfaction with bathing technique | patient perceived discomfort during bathing nurse perceived work load observed bathing quality | 6 weeks | 
| Cost bathing | Bathing and skin damage associated costs will be calculated from the costs of bathing and skin care associated staff time and the materials used. | 6 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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skin damage, intertrigo, dermatitis, erythema, aggression, body Wipes, soaps, no rinse, cost effectiveness, nursing home residents, nurse