TY - JOUR
T1 - Completeness of assisted bathing in nursing homes related to dementia and bathing method: results from a secondary analysis of cluster-randomised trial data
AU - van Achterberg, Theo
AU - van Gaal, Betsie G.I.
AU - Geense, Wytske W.
AU - Verbeke, Geert
AU - van der Vleuten, Carine
AU - Schoonhoven, Lisette
PY - 2015/12/10
Y1 - 2015/12/10
N2 - BACKGROUND: Bathing assistance is a core element of essential care in nursing homes, yet little is known for quality of assisted bathing or its determinants.AIM:To explore differences in completeness of assisted bathing in relation to bathing method and resident characteristics.METHODS: Secondary analysis of a cluster randomised trial including 500 nursing home residents designed to compare traditional bathing methods for skin effects and cost-consequences; GlinicalTrials.gov ID [NCT01187732]. Logistic mixed modelling was used to relate resident characteristics and bathing method to bathing completeness.RESULTS: Bathing completeness was highly variable over wards. Apart from a large effect for ward, logistic mixed modelling indicated bathing was more often complete in case of washing without water (using disposable skin cleaning and caring materials; estimate 2.55, SE 0.17, P <0.0001) and less often complete in residents with dementia (estimate -0.22, SE 0.08, P = 0.0040).CONCLUSIONS: Introduction of washing without water is likely to lead to more bathing completeness in nursing homes. However, inequity in care was also identified with a view to highly variable bathing completeness over wards and more incomplete bathing by care staff in residents with dementia.IMPLICATIONS FOR PRACTICE: Monitoring the performance of assisted bathing in nursing homes is indicated for the identification of undesirable variation in essential care and poorly performing teams. The introduction of washing without water could serve the promotion of bathing completeness in nursing homes overall, but will not solve inequity issues for residents.
AB - BACKGROUND: Bathing assistance is a core element of essential care in nursing homes, yet little is known for quality of assisted bathing or its determinants.AIM:To explore differences in completeness of assisted bathing in relation to bathing method and resident characteristics.METHODS: Secondary analysis of a cluster randomised trial including 500 nursing home residents designed to compare traditional bathing methods for skin effects and cost-consequences; GlinicalTrials.gov ID [NCT01187732]. Logistic mixed modelling was used to relate resident characteristics and bathing method to bathing completeness.RESULTS: Bathing completeness was highly variable over wards. Apart from a large effect for ward, logistic mixed modelling indicated bathing was more often complete in case of washing without water (using disposable skin cleaning and caring materials; estimate 2.55, SE 0.17, P <0.0001) and less often complete in residents with dementia (estimate -0.22, SE 0.08, P = 0.0040).CONCLUSIONS: Introduction of washing without water is likely to lead to more bathing completeness in nursing homes. However, inequity in care was also identified with a view to highly variable bathing completeness over wards and more incomplete bathing by care staff in residents with dementia.IMPLICATIONS FOR PRACTICE: Monitoring the performance of assisted bathing in nursing homes is indicated for the identification of undesirable variation in essential care and poorly performing teams. The introduction of washing without water could serve the promotion of bathing completeness in nursing homes overall, but will not solve inequity issues for residents.
KW - aged
KW - baths
KW - nursing
KW - quality improvement
KW - residential facilities
U2 - 10.1111/opn.12104
DO - 10.1111/opn.12104
M3 - Article
SN - 1748-3735
SP - 1
EP - 9
JO - International Journal of Older People Nursing
JF - International Journal of Older People Nursing
ER -