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

• the primary outcome is prevalence of care associated skin damage [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]
  Skin damage is defined as intertrigo, dermatitis and/or other erythema on skin areas which were not exposed to pressure directly before observation.
  
  

• Patient and nurse satisfaction with bathing technique [ Time Frame: 6 weeks ] [ Designated as safety issue: No ]
  • patient perceived discomfort during bathing
  • nurse perceived work load
  • observed bathing quality
  
  
• Cost bathing [ Time Frame: 6 weeks ] [ Designated as safety issue: No ]
  Bathing and skin damage associated costs will be calculated from the costs of bathing and skin care associated staff time and the materials used.
  
  

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.