Wash and wean: bathing patients undergoing weaning trials during prolonged mechanical ventilation.
BACKGROUND
Bathing is a fundamental nursing care activity performed for or with the self-assistance of critically ill patients. Few studies address caregiver or patient-family perspectives about bathing activity during weaning from prolonged mechanical ventilation (PMV).


OBJECTIVE
To describe practices and beliefs about bathing patients during weaning from PMV.


METHODS
Secondary analysis of qualitative data (observational field notes, interviews, and clinical record review) from a larger ethnographic study involving 30 patients weaning from PMV and the clinicians who cared for them using basic qualitative description.


RESULTS
Bathing, hygiene, and personal care were highly valued and equated with "good" nursing care by families and nurses. Nurses and respiratory therapists reported "working around" bath time and promoted conducting weaning trials before or after bathing. Patients were nevertheless bathed during weaning trials despite clinicians' expressed concerns for energy conservation. Clinicians recognized individual patient response to bathing during PMV weaning trials.


CONCLUSIONS
Bathing is a central care activity for patients on PMV and a component of daily work processes in the intensive care unit. Bathing requires assessment of patient condition and activity tolerance and nurse-respiratory therapist negotiation and accommodation with respect to the initiation or continuation of PMV weaning trials during bathing. Further study is needed to validate the impact (or lack of impact) of various timing strategies for bathing patients who are on PMV.
Happ
Mary Beth
MB
University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania 15261, USA. mhapp@pitt.edu
Tate
Judith A
JA
Swigart
Valerie A
VA
DiVirgilio-Thomas
Dana
D
Hoffman
Leslie A
LA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001494:Baths / Q000451:nursing*; D017028:Caregivers / Q000941:ethics / Q000523:psychology; D016638:Critical Illness / Q000451:nursing / Q000523:psychology; D036262:Empirical Research; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D006920:Hygiene; D007206:Individuality; D007362:Intensive Care Units / Q000458:organization & administration / Q000592:standards; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009732:Nursing Care / Q000941:ethics / Q000458:organization & administration; D013997:Time Factors; D015300:Ventilator Weaning / Q000451:nursing / Q000523:psychology