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  1. McGoldrick, Mary MS, RN, CRNI

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When a patient is unable to get out of bed, providing the patient with a bed bath using a basin full of water, soap, and cloth towels is an alternative way to provide personal hygiene. Bath basins are commonly used by home healthcare and hospice aides when performing bed baths, as well as incontinence care, gastrostomy-tube site care, and indwelling catheter care. Studies have shown that bath basins can serve as a reservoir for bacteria and as a potential source for the transmission of healthcare-associated infections (Danielson et al., 2013; Johnson et al., 2009; Marchaim et al., 2012). Sources of bath basin contamination may include the:

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* Patients' own skin flora that is removed during bathing and then transferred to the basin through the wet washcloth.


* Tap water used to fill and rinse the basin after use (when it is not adequately dried).


* Patient's supplies stored inside the bath basin in between patient use.



Many healthcare facilities have moved toward using prepackaged, premoistened, rinse-free disposable washcloths on a one-time basis. The washcloth contains an antiseptic that may reduce the amount of potentially pathogenic organisms on the patient's skin and because tap water is not used, it eliminates the risk of infection from waterborne microorganisms. This alternative product may reduce the patient's risk of infection, but it does not totally eliminate it. There is still the human factor to consider with regard to the risk of cross-contamination if each body area is not cleansed separately. For example, a home healthcare or hospice aide may contribute to a catheter-associated urinary tract infection if each body site is not bathed separately with a new wipe (i.e., a contaminated wipe is used to perform meatal care).


Although the patient's towels are routinely laundered, the patient's plastic bath basin is rarely replaced or disinfected. The Centers for Disease Control and Prevention (CDC) recommends that the bath basin be cleaned and disinfected on a regular basis by using an EPA-registered product (CDC, 2003). It would not be cost effective to eliminate the use of a bath basin when bathing a patient, especially in the home, but there are actions the home healthcare or hospice aide can take. After use:


1. Empty, rinse, wash, and dry the bath basin. Do not dry the bath basin with a "used" towel.


2. Disinfect the bath basin by:


A. Wiping the interior's surfaces with a disinfectant and keeping the surfaces wet for the manufacturer-stated contact time; or


B. Placing the basin on the top rack of a dishwasher, and using a standard dishwashing detergent and allowing the dishwasher to run on the full wash cycle.


3. Store the bath basin "empty." Instruct the caregiver(s) not to store items inside the basin in between patient use (McGoldrick, 2016).



It may be ironic that we are "cleaning" a patient with an object that may be contaminated, but these actions can help reduce the patient's risk for developing an infection.




Centers for Disease Control and Prevention.(2003). Guidelines for Environmental Infection Control in Health-Care Facilities, 52(RR10), 1-42. [Context Link]


Danielson B., Willamson S., Johnson N., Danielson B. (2013). Patients' bath basin: Friend or foe. American Journal of Infection Control, 41(6), S93. [Context Link]


Johnson D., Lineweaver L., Maze L. M. (2009). Patients' bath basins as potential sources of infection: A multicenter sampling study. American Journal of Critical Care, 18(1), 31-40. [Context Link]


Marchaim D., Taylor A. R., Hayakawa K., Bheemreddy S., Sunkara B., Moshos J., ..., Kaye K. S. (2012). Hospital bath basins are frequently contaminated with multidrug-resistant human pathogens. American Journal of Infection Control, 40(6), 562-564. [Context Link]


McGoldrick M. (2016). Cleaning and storage of bath basins. Cleaning and disinfection. Home Care Infection Prevention and Control Program. St. Simons Island, GA: Author. [Context Link]