AHRQ Safety Program for Long-Term Care: HAIs/CAUTI
Disclaimer: FAQ answers are based on a combination of scientific evidence and clinical experience and expertise of a multidisciplinary national team.
Historically, bathing residents in long-term care (LTC) facilities has been via the use of a bath basin with water and personal hygiene supplies, or rinse-free disposable bath wipes. A multidisciplinary team reviewed the literature to determine the optimal evidence-based bathing practices to prevent bath basin contamination. Due to the lack of evidence-based literature1, an optimal bathing method for resident hygiene and comfort could not be determined. Instead, the team recommends LTC facilities make decisions based on national recommendations, evidence-based practices and their own risk assessment.
1. Should bath basin use be discontinued?
No, there is no compelling evidence to recommend stopping the use of bath basins for bathing residents. To reduce the possibility of bath basin contamination, ensure that it is properly cleaned and disinfected after each bathing procedure.
2. After use, how should the bath basin be cleaned and disinfected?
After use, bath basins should be cleaned/disinfected with a germicidal wipe, per manufacturer's instructions. Facilities may first want to conduct a risk assessment to determine ideal placement of the germicidal wipes within the resident care areas. Please refer to HICPAC/CDC Guideline on Disinfection and Sterilization for additional guidance. No recommendation can be made regarding the use of soap and water for cleaning/disinfecting the bath basin due to the various soap products (e.g., antibacterial vs. regular, liquid vs. bar) and their intended use on the skin, and not on bath basins.
3. How often should the bath basin be changed?
Bath basins, from a cleanliness perspective, should be changed per facility policy or when damaged. A resident identifier (i.e., name, room number and basin date) should be clearly displayed. The bath basin should be discarded if it is heavily soiled and cannot be cleaned/disinfected, or is damaged.
4. How and where should the bath basin be stored?
After cleaning/disinfecting, bath basins should be air dried and then be stored upside-down, in the resident's room, to prevent airborne contamination. Alternatively, due to space constraints, it's acceptable to store the dry basin right-side up and allow for storage of clean personal hygiene items within the container. Do not use the bath basin as a storage container for other items (e.g., shoes, hair brushes, combs, soap).
1The literature primarily addresses resident bathing in acute care, with very few studies focused on the LTC environment. While some studies found gram-positive and gram-negative organisms on bath basins after resident use, no direct, infection causation link was identified. The multidisciplinary team recommends additional bathing studies be conducted in the LTC environment.