Transcript Document

Any One of These Issues is a
Good Reason to Use Comfort Bath™
Add Them All Up for Your
Hospital. . .
And the Evidence is
Overwhelming!
+ Compromised Skin
+ Risk Management
+ Patient Satisfaction
+ Patient Safety
+ Employee Satisfaction
+ Water Conservation
+ Waterborne Infections
+ Nursing Shortage
+ Nursing Productivity
+ Linen Management
+ Basin Contamination
+ Patient Care Quality
Nursing and Patient Satisfaction
Traditional Basin Baths Consume Unnecessary
Nursing Hours and Yield Low Satisfaction Scores
The Proof:
 “In one survey of nurses describing their last shifts, 31% said their patients did not receive
necessary skin care, 20% said patients did not receive oral care and 28% were not able to
provide patients and their families with necessary education and instruction. 40% of nurses
were not able to comfort or talk with their patients on their last shift.”
- Joint Commission on Accreditation of Healthcare Organizations, “Healthcare at the Crossroads: Strategies for
Addressing the Evolving Nursing Crisis” August 2002 Report
 Traditional bathing can consume over 12,000 annual nursing (patient care) hours
at a
busy 250 bed hospital
- Total Delivered Cost Analysis Database from U.S. Hospitals 1997-2002.
 “…the odds of patient mortality increased by 7% for every additional patient in the average
nurse’s workload . . . an increase from four to eight patients per nurse would be
accompanied by 31% increases in mortality . . .”
- Aiken, L.H. et al, Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction. Journal of the American
Medical Association ( JAMA) Vol. 288 No. 16. October 23/30, 2002
 ”Grumpy clinicians at the bedside can translate into high turnover, unhappy patients, and
lower quality of care”
- Huff, Charlotte, “Job Satisfaction: Why your job isn’t a bowl of cherries” , Nurseweeek, October 1997
. . . throw the basin out WITH the bath water!
Nursing and Patient Satisfaction
Traditional Basin Baths Consume Unnecessary
Nursing Hours and Yield Low Satisfaction Scores
The Proof:

“Only 34% of nurses said they had enough RNs to provide quality care and still fewer than
33% had enough staff to get their work done.”
- Joint Commission on Accreditation of Healthcare Organizations, “Healthcare at the Crossroads: Strategies for Addressing
the Evolving Nursing Crisis” August 2002 report

“A traditional bed bath is always a mess. Water gets all over the sheets and blankets, the
patients are uncovered, and they get cold and uncomfortable.”
- Howe,L . “Bath in a Bag Gets High Marks From Patients, Staff” North Shore Health System Newsletter , New York
November 2002

Only 4% of patients preferred the traditional basin bath method for patient cleansing. The
majority did not feel clean or comfortable after the basin bath.
- Comfort Bath™ Cleansing System vs. the Basin Bath: Patient Preference Study, Barbara Skiba, RN, BSN. 200 bed acute care
hospital, Chicago, IL.

Only 3% of patients and 2% of nurses prefer basin baths over basinless bathing.
- Patient and Nursing Satisfaction Evaluation Surveys. U.S. Hospitals, 1997 – 2002
. . . throw the basin out WITH the bath water!
Comfort Bath™
Basinless Bathing
Annual Nursing Hours
Nursing Satisfaction
0% of Nurses
Prefer Basin Baths
Nursing Satisfaction
Strongly
Agree
1. The basinless bath is easy to administer.
87%
Agree
12,000Patient
Care Hours
Consumed
Disagree
Strongly
Disagree
13%
2. The basinless bath technique saves me time.
75%
25%
3. The patient is clean after the basinless bath.
68%
32%
4. The patients skin felt soft after the basinless bath.
87%
13%
5. The patient was satisfied with the basinless bath.
72%
28%
12,000
Hours
8,000 Patient
Care hours
Gained
6. The bathing technique I like best was: Basinless Bath 100% Traditional Bath 0%
4,000
Hours
100% of Nurses
Prefer Comfort Bath™
Kron-Chalupa J, RN, MSN, Benda T, RN, Williams B., RN
The Basinless Bath: A Study on Skin Dryness and
Patient/Nurse Satisfaction. VA Medical Center, Iowa City,
Iowa, 1998
Basin Baths
Comfort Bath™
Delivers High Nursing Productivity
. . . throw the basin out WITH the bath water!
Compromised Skin
Traditional Basin Baths May Be Doing More Harm Than Good
The Proof:

Traditional bathing techniques constitute one particular practice that may present
considerable potential harm.”
- Ruth Bryant, RN, MS, CWOCN; Bonnie Rolstad, RN, BA, CWOCN, Examining Threats to Skin Integrity ,Ostomy Wound
Management 2001:47(6), 18-27.

“Basin bathing based on scores from the Skin Condition Data Form (SCDF) proved to cause
significantly more dryness, scaling than a basinless bath product.”
- Kron-Chalupa J, et al, Iowa City, VAMC, Iowa, The Basinless Bath: A study on skin dryness and patient/nurse satisfaction, VAMC

“In addition, soaps decrease the natural skin lubricants, interfere with the water-holding
capacity of the skin, thin the layers of the stratum corneum, and increase the skin pH.
- Ruth Bryant, RN, MS, CWOCN; Bonnie Rolstad, RN, BA, CWOCN, Examining Threats to Skin Integrity, Ostomy Wound
Management 2001: 47(6), 18-27.

“Cleansing is the first step in skin protection. As mentioned earlier, bar soaps can harm skin
by changing the pH to alkaline, making the skin more permeable to water-soluble irritants.”
- Shannon ML, RN, Ed.D., and Lehman CA, RN, MSN, CRRN, “Protecting the Skin of the Elderly Patient in the ICU.”
Critical Care Nursing Clinics of North America, Vol. 8, No. 1, March 1996.

“Soap and a washcloth are fragile and/or damaged skin’s worst enemies.”
- Friers SA, RN, BSN, CETN, “Breaking the cycle: The etiology of incontinence dermatitis and evaluating and using skin care
products,” Ostomy/Wound Management, Vol. 42, No. 3, April 1996.
. . . throw the basin out WITH the bath water!
Comfort Bath™
Basinless Bathing
“ Under double-blind conditions, the Comfort Bath™
Cleansing System formula and sodium chloride 0.9%
solution (physiological saline) ranked as Class I
materials…essentially no evidence of cumulative irritation
under continuous reapplication and occlusion …”
Dennis P. West, PhD, FCCP and Andrew Scheman, MD
Northwestern University Department of Dermatology, Chicago,
Illinois, May – June 1998
. . . throw the basin out WITH the bath water!
Basin Contamination
The Basin is Both a Reservoir and a Vehicle
for Nosocomial Pathogens
The Proof:
 “High colony count found in bath water is similar to the number of bacteria found in urine from patients
with UTIs.”
- Shannon et al, Journal of HealthCare Safety, Compliance & Infection Control, April 1999; Vol. 3, No. 4, pg. 180-184.
 “Basins are used for multiple purposes such as emesis, incontinence clean-up, and bathing.”
- William Rutula, PhD, David Weber, MD, Infection Control and Hospital Epidemiology, Volume 18(9), September 1997 editorial.
 “Bath water could serve as a high magnitude microbial reservoir of potentially antibiotic resistant organisms.”
- Shannon et al, Journal of HealthCare Safety, Compliance & Infection Control, April 1999; Vol. 3, No. 4, pg. 180-184.

“A major question emerging from Dr. Reuter and colleagues’ study is how to limit the spread of pathogens
from contaminated sinks (faucets) to patients.”
- Bonton MJM, Weinstein RA, Transmission pathways of Pseudomonas aerugiuosa in intensive car units: Don’t go near the water.
Critical Care Medicine, Vol. 30, No. 10, pp. 2384-5
 “The patient’s skin may harbor more gram negative organisms once the basin bath is completed.”
- Susan M. Skewes, RN, ONC, Skin care rituals that do more harm than good, American Journal of Nursing, Vol. 96, No. 10.

“By the end of the bath, the water is a soup of soap and bacteria….Contaminated wash bowels (basins) have
been implicated in an outbreak of infection.”
- Ayliffe, GAJ “Nursing aspects of prevention of infection: aseptic and hygienic techniques” Hospital Acquired Infection: The
Principles and Prevention Second Edition pp 58-59
. . . throw the basin out WITH the bath water!
Comfort Bath™
Basinless Bathing
• Does not require basins
• 8 Individually dispensed washcloths
• Immediately discard washcloths in clear trash
• No contact with sinks and/or commodes
• No transport of contaminated basins & linens
. . . throw the basin out WITH the bath water!
Waterborne Infections
Hospital Tap Water
is a Major Source of Nosocomial Infections
The Proof:

“Although numerous hospital sources cause nosocomial outbreaks, perhaps the most overlooked,
important and controllable source of nosocomial pathogens is hospital water.”
- Anaissie, et al, Archives of Internal Medicine, July 8, 2002, Vol 162, No. 1, pp 1483-1492.

“Several investigators have suggested that gram-negative bacteria can pass to patients by employee’s
hands contaminated during hand washing, presumably by splashing water droplets from the sink basins to
hands.”
- William Rutula, PhD, David Weber, MD, Infection Control and Hospital Epidemiology, Vol. 18(9),
September 1997 editorial

“Dr. Reuter and co-workers report that in their intensive care unit, 35% of all cases of acquired colonization
with Pseudomonas aeruginosa originated from contaminated tap water…”
- Bonton MJM, Weinstein RA, Transmission pathways of Pseudomonas aerugiuosa in intensive car units:
Don’t go near the water. Critical Care Medicine, Vol. 30, No. 10, pp. 2384-5

“...Contaminated water was used to wash pre-term infants, leading to the colonization of four infants and
the death of a fifth from Stenotrophomas maltophilia. The outbreak was controlled by reinforcing hand
disinfection, limiting use of tap water for hand washing and using sterile water to wash the pre-term
babies.”
- Verwey PE, Meis JFGM, Christmann V, Van der Bar, Melchers WJG, Hilderink BGM, et al. Nosocomial outbreak of colonization
and infection with Strenotrophomas maltophilia in pre-term infants associated with contaminated tap-water. Epidemiology Infect
1998; 120: 251-6..
. . . throw the basin out WITH the bath water!
Waterborne Infections
Hospital Tap Water is a Major Source
of Nosocomial Infections
The Proof:

“The best advice is to eliminate water where possible. This will
greatly decrease the chances of contamination. Replace all watercontaining devices with those that do not require water to work, keep
potentially contaminated water away from the patient, and include
waterless hand products in your hand hygiene program. Prevent
infection from potentially contaminated water.”
- Burns SM, Water: Is it a breeding ground for bacteria in your facility?”
Infection Control Today, October 2002

“Nosocomial infections caused by waterborne bacteria have been
associated with serious morbidity and even mortality . . the annual
mortality rate from waterborne Pseudomas aeruginosa in the U.S. is
approximately 1400.”
- Anaissie, et al, Archives of Internal Medicine, July 8, 2002, Vol. 162, No. 1 pp 1483-1492.

“…contamination of faucets with P. aerugenosa is an important
source of endemic P. aeruginosa and that eradication of
contaminants from these sources is nearly impossible.”
- Bonton MJM, Weinstein, RA, Transmission pathways of Pseunomonas aerugiuosa in intensive care
units: Don’t go near the water. Critical Care Medicine, Vol. 30, No. 10, pp. 2384-5.
. . . throw the basin out WITH the bath water!
Comfort Bath™
Basinless Bathing
• Requires no hospital tap water
• Microwaved to an average temperature of 125o F
• Uses only 6.75 oz. of purified water
• Tested under USP XXIV microbial limits
• Helps close the gap on waterborne pathogens
. . . throw the basin out WITH the bath water!
The Unknown Costs
Basin bath costs are buried in multiple budgets and
consume significant hospital resources
The Proof:

In a statistically significant analysis of U.S. Hospitals, the average supply and laundry costs associated
with basin baths was $1.85 and the average nursing labor cost was $5.71.
- McNees, D., The McNees Report, Claymore Consulting, February 2003.

The traditional basin bath used a basin, bar soap, bath oil, 4 laundered washcloths and 2 towels, and
hot water. The non-labor cost of the bath alone was over $2.00.
- Kron-Chalupa J, et al, Iowa City, VAMC, Iowa, The Basinless Bath: A study on skin dryness and patient/nurse satisfaction, VAMC

“…the costs for the soap, lotion, two towels, three washcloths, and the laundry service, we arrived at a
total of $2.01 per bed bath, plus $5.04 in nursing salary. “
-Wright, KL “Considering a New Product? Put it to a Test” RN Journal, December 1996 pp 21-23
A 250 bed hospital can consume a million gallons of hot water, over 100,000 pounds of laundry,
thousands of dollars in disposable supplies and over 12,000 patient care hours just giving baths.
- Total Delivered Cost Analysis, U.S. hospitals greater than 200 acute care beds, 1997-2002
. . . throw the basin out WITH the bath water!
The Unknown Costs
Basin bath costs are buried in multiple budgets and
consume significant hospital resources
The Proof:

Comfort Bath™ enabled this 500+ bed facility to reduce medical supply costs by $15,216 and
eliminate four bathing related sku’s (lotion, soaps, and powders) in the process.
- Insights TDC Outcomes Analysis, St. John’s Medical Center, Tulsa, OK 2001

This specialty hospital was able to trim their supply cost of traditional bathing items by over 80% after
implementing Comfort Bath™.
- Select Specialty Hospital of Western Michigan, Muskegon, Michigan, 2000

Over a three year period of using Comfort bath™, this 1000 bed teaching facility created 104,133
nursing hours and reallocated them to new patient care hours. That’s the equivalent of 15 full-time
nurses/nursing technicians.
- Baylor University Medical Center, Dallas, Texas, January 1999 to April 2002
. . . throw the basin out WITH the bath water!
Comfort Bath™
Basinless Bathing
• Effectively competes with the cost of a traditional
basin bath
• Reduces the consumption of valuable hospital
resources
• Helps meet key organizational goals: nursing morale
and productivity, patient safety and patient
satisfaction
. . . throw the basin out WITH the bath water!
Comfort Bath™
Patient Bathing Costs
Patient Satisfaction
Only 4% prefer
traditional basin baths
$5.71
Nursing
Time
$1.83
$1.02
Nursing
Time
Laundry
&Linens
$.10
Water,Sewer,Energy
$1.75
96% of Patients
$.83
Materials
Basin Bath
Basinless Bath
Effectively Competes with Cost
Source: - McNees, D., The McNees Report, Claymore Consulting, February 2003.
Prefer Comfort Bath™
Skiba B, RN, BSN, Patient Satisfaction Preference
Study: Comfort Bath vs. The Basin Bath, 200 Bed
Acute Care Hospital, Chicago, IL, 1997
“A good clinical outcome is a patient’s expectation,
but it doesn’t necessarily affect their satisfaction…
…The satisfaction comes when they are delighted with
service they receive - the care and compassion, and
timeliness of the service”
Material Management in Health Care, January 2002
Comfort Bath™
Basinless Bathing

Improves patient satisfaction

Increases nursing satisfaction

Creates thousands of patient care hours

Improves overall skin care

Reduces the risk of basinborne contamination

Eliminates exposure to waterborne pathogens

Meets CDC, NPUAP and APIC guidelines

Delivers a consistent standard of patient care
Comfort
™
Bath
Basinless Bathing
…to the surface
It brings opportunities for your hospital…