In nursing homes, bath time isn’t just a necessity. It can be one of the most enjoyable and relaxing times of the day for many residents. However, potential risks exist seemingly everywhere. If a facility’s bathing environment isn’t regularly monitored for potential dangers or staff are not properly trained in lifting, transferring and more, trouble can ensue. Here, skilled nursing experts focus on how to keep the bathing experience safe and enjoyable at the same time.
1. Be constantly vigilant of the top bath safety hotspots.
Dangers can lurk in plain sight in even the cleanest and neatest bathing areas. There are core issues that guide safety-mindedness.
“Many safety concerns exist when environments are not built with optimal ergonomics and accessibility in mind,” states Jaime Stoffer, PT, DPT, director of clinical programs for rehab and fall prevention for Medline.
Supporting proper body mechanics is key.
“Slips and falls increase when a facility is not equipped with bathroom modifications for stability and safety,” adds Stoffer.
Inadequate bathing spaces are another concern, according to Karen Lerner, RN, MSN, ATP, CWS, the clinical vice president of Drive DeVilbiss Healthcare. Such lapses can increase risks of slips and falls, poor hygiene and infection control.
A patient-centric approach is needed, adds Patricia Howell, RN, BSN, WCC, CFCS, clinical support manager, clinical resource team for McKesson Medical-Surgical Extended Care.
“The first step in patient safety and better experience in bathing is to know your patient,” says Howell.
She urges caregivers to be mindful of residents’ individual impairments, such as partial blindness, deafness or left- or right-sided weakness.
2. Don’t take safety issues for granted.
Even seemingly minor issues can quickly escalate in the bathing environment.
Stoffer warns against treating actions independently and prefers taking a broad view, focusing on the frequency of bathing routines and bathing facilities.
“One instance of lifting may not be extremely risky,” she says. “When you look at the big picture, lifting weight several times a day in a wet, cramped environment creates a whole new set of risks and challenges.”
The same principle applies when evaluating bathing implements and facility cleanliness. Caregivers are also advised to not ignore small areas where mold appears.
“Healthcare-associated infections remain one of the leading causes of increased morbidity and mortality among health care consumers,” Lerner says. “Even visibly clean surfaces may be microbiologically contaminated and constitute a reservoir of infectious agents.”
The simplest hazards can be easily overlooked.
Howell warns caregivers to ensure adequate lighting, easy-to-reach fixtures and grab bars, non-slip surfaces and that water is at a safe temperature before allowing elderly residents, especially those who are prone to falling, to dip their toes.
3. Take steps quickly to mitigate problems and prevent small issues from getting out of hand.
“It’s important that a facility does not wait until after a fall happens to implement safety standards,” according to
Stoffer. “Consider every potential safety issue, then evaluate the equipment that is being used and consider whether it fits the space appropriately and whether it aligns with your patients’ physical abilities.”
Howell reminds all caregivers to be as mindful entering and leaving a resident room as they are when touching residents.
“Hand washing continues to be the best way to stop the spread of infection,” she notes.
4. Be mindful of best practices when it comes to addressing safety lapses in bathing areas.
“Some of the immediate fixes that can make a big difference are small,” says Stoffer. Examples include removing tripping hazards such as rugs, properly directing water flow to prevent slipping, and providing ample-sized sitting surfaces, transfer benches and shower chairs. “If the space allows, transfer aids such as lifts can be useful,” she adds.
For more independent residents, Lerner encourages walk-in tubs, while cautioning facilities to “consider the whole suite, and discuss dignified bathroom management instead of just products and a price.
“Rehab-style commode chairs can permit a dignified and safe transfer in the resident’s room,” she adds. “These chairs back up over toilets and can be wheeled right into zero threshold showers. Not only are these much safer for residents, but they are also easier for staff, too.” n
From the September 2023 Issue of McKnight's Long-Term Care News
