Hygiene and emollient interventions for maintaining skin integrity in older people in hospital and residential care settings

Cowdell, Fiona; Jadotte, Yuri T.; Ersser, Steven J.; Danby, Simon; Lawton, Sandra; Roberts, Amanda; Dyson, Judith

doi:10.1002/14651858.cd011377.pub2

Cited by 30 publications

(50 citation statements)

References 89 publications

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“…One possible explanation for this issue is the lack of evidence of wiping pressure in previous studies or textbooks. Even though wiping pressure and number of wipings are the factors directly affecting friction irritation to the skin, the only suggestions reported in the literature are as vague as “minimize force and friction” and “avoid vigorously rubbing the skin.” The results of this study provide new evidence that, even without exerting strong wiping pressure, increasing the number of wipings can sufficiently remove skin dirt.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, bed baths must effectively remove dirt from the skin and mucous membranes and must ensure good hygiene while simultaneously maintaining skin integrity and its barrier function . Regarding wiping pressure and number of wipings, it has been recommended to “minimize force and friction” and to “avoid vigorously rubbing the skin.” However, the wiping pressure and number of wipings that satisfy the dual requirement of removing dirt without damaging the patient's skin have not been determined quantitatively.…”

Section: Introductionmentioning

confidence: 99%

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Combination of minimum wiping pressure and number of wipings that can remove pseudo‐skin dirt: A digital image color analysis

Konya

Shishido

Ito

et al. 2020

Skin Research and Technology

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Maintaining and improving skin health and integrity by skin care are major goals in acute and long-term care. 1 Skin integrity is regarded as a quality indicator, 2 and maintaining skin integrity is widely accepted as being more cost-effective than wound treatment. 3-5 Therefore, thousands of patients receive daily routine skin care, including washing, showering, and bathing; these personal hygiene and skin care activities are integral parts of the nursing practice. 1 Bed baths are a type of skin care performed to maintain the cleanliness and

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Combination of minimum wiping pressure and number of wipings that can remove pseudo‐skin dirt: A digital image color analysis

Konya

Shishido

Ito

et al. 2020

Skin Research and Technology

View full text Add to dashboard Cite

show abstract

“…Evidence based treatments for neonatal EOL skin care are lacking; however, pediatric studies show topical emollients may aid in reduction of cutaneous dryness (58). If incomplete eyelid closure is noted, artificial tear ointments have shown to be helpful in multiple intensive care settings (59).…”

Section: Skin Eye and Mouth Carementioning

confidence: 99%

End-of-Life Care for Neonates: Assessing and Addressing Pain and Distressing Symptoms

2020

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One of the most essential components of end-of-life (EOL) care for neonates is assessing and addressing distressing symptoms. There is limited evidence to guide neonatal EOL symptom management and therefore significant variety in treatment (1-4). EOL neonatal palliative care should include identifying and relieving distressing symptoms. Symptoms to manage at neonatal EOL may include pain using both non-pharmacologic and pharmacologic comfort measures, respiratory distress, secretions, agitation and neurologic symptoms, nutrition and gastrointestinal distress, and skin care. Also of equal importance is communication surrounding familial existential distress and psychosocial care (1, 5-7). Institutions should implement a guideline for neonatal EOL care as guidelines have been shown to decrease variability of interventions and increase use of pharmacologic symptom management (4). Providers should consult with palliative care teams if available for added multidisciplinary support for family and staff, which has been shown to enhance EOL care in neonates (8, 9).

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“…Skin health and integrity are essential in many ways for maintaining health [1]. Personal hygiene assistance, including bed baths, is one of many elements that contribute to maintaining skin integrity [2]. Therefore, bed bath is key nursing activity to maintain hygiene and to provide comfort for bedridden patients who are unable to perform self-care due to chronic or acute illness [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…Suiting patients' needs and preferences is patient-centered care, which is argued to contribute to patient satisfaction [15]. Therefore, Cowdell et al [2] reported that future studies should include patient-reported outcomes, such as comfort and acceptability.…”

Section: Introductionmentioning

confidence: 99%

Effect on autonomic nervous activity of applying hot towels for 10 s to the back during bed baths

Shishido

Konya

Yano

2020

J Physiol Anthropol

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Background Bed baths are a daily nursing activity to maintain patients’ hygiene. Those may provide not only comfort but also relaxation. Notably, applying a hot towel to the skin for 10 s (AHT10s) during bed baths helped to reduce the risk of skin tears and provided comfort and warmth in previous studies. However, it is still unclear whether autonomic nervous system is affected by bed baths. Thus, this study investigated the effect on the autonomic nervous activity of applying hot towels for 10 s to the back during bed baths. Methods This crossover study had 50 participants (25 men and women each; average age 22.2 ± 1.6 years; average body mass index 21.4 ± 2.2 kg/m2) who took bed baths with and without (control condition: CON) AHT10s on their back. Skin temperature, heart rate variability (HRV), and blood pressure (BP) were measured. Subjective evaluations and the State-Trait Anxiety Inventory in Japanese were also performed. Results A significant interaction of time and bed bath type on skin surface temperature was observed (p < .001). Regarding the means of skin surface temperature at each measurement time point, those for AHT10s were significantly higher than those for CON. Although the total state-anxiety score significantly decreased in both the bed bath types after intervention, the mean values of comfort and warmth were higher for bed baths with AHT10s than for CON (p < .05) during bed baths; AHT10s was significantly higher in warmth than CON after 15 min (p = .032). The interaction and main effects of time on HRV and BP and that of bed bath type were not significant. Conclusion Bed baths that involved AHT10s caused participants to maintain a higher skin temperature and warmer feeling than under the wiping-only condition; they also provided comfort during the interventions. However, the bed baths with AHT10s did not allow participants to reach a relaxed state; moreover, there was no change in autonomic nerve activity. This may be due to participants’ increased anxiety from skin exposure and the intervention being limited to one part of the body.

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Hygiene and emollient interventions for maintaining skin integrity in older people in hospital and residential care settings

Abstract: Hygiene and emollient interventions for maintaining skin integrity in older people in hospital and residential care settings (Review)

Cited by 30 publications

References 89 publications

Combination of minimum wiping pressure and number of wipings that can remove pseudo‐skin dirt: A digital image color analysis

Combination of minimum wiping pressure and number of wipings that can remove pseudo‐skin dirt: A digital image color analysis

End-of-Life Care for Neonates: Assessing and Addressing Pain and Distressing Symptoms

Effect on autonomic nervous activity of applying hot towels for 10 s to the back during bed baths

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