Abstract
Background: Despite data supporting the reduction of interactions with patients during nighttime, bed bathing is sometimes performed within this period in sedated patients unable to manage their own hygiene care.
Objectives: To compare patient physiologic variables and adverse effect incidence between night and day bed baths.
Methods: This was a single-center prospective observational study in a 12-bed intensive care unit during 2 months. Night period was defined to run from 10 PM to 6 AM. Night bed baths were provided to sedated ventilated patients whatever their sedation, if their Richmond Agitation Sedation Scale score was -2 or deeper. Bed bath-induced changes in physiological variables, treatments, and related unscheduled events were registered during both night and day bed baths.
Results: Twenty-one patients (aged 62.9 [52.5-73.2] years, 14 male patients) were included. We registered 97 night bed baths and 95 day bed baths. Heart rate increased only after day bed baths (85 beats/min [bpm] [69-97 bpm] vs 88 bpm [73-98 bpm], P = .02). Increase in Richmond Agitation Sedation Scale score occurred, respectively, during 13 (13.4%) and 8 (8.4%) night and day bed baths, without significant differences. Body temperature significantly decreased during both night and day bed baths (respectively, 37[degrees]C [36.6[degrees]C-37.4[degrees]C] vs 36.6[degrees]C [36.2[degrees]C-37.2[degrees]C], P < .0001; and 36.9[degrees]C [36.5[degrees]C-37.2[degrees]C] vs 36.7[degrees]C [36.2[degrees]C-37.2[degrees]C], P = .0006). Overall, unscheduled events, whether physiologic changes, pain, or calling a physician in rescue occurred in 97 procedures (50.5%), irrespective of their timing (night vs day, respectively 53% [54.6%] vs 44% [46.3%], P = .31).
Discussion: Although unscheduled events occurred in half of bed baths, differences evidenced between nighttime and daytime bed baths were scarce. The appropriateness of nighttime bed bathing remains questionable.