PEOPLE & OPINIONS
Nosocomial infections acquired from a bath are not from the type of cleanser being used. They are a result of re-infecting the patients with their own germs through incorrect bathing processes. Decreas- ing the nurse’s time with the pa- tient by giving a quick wipe down with pre-moistened cloths isn’t exactly providing personal nurs- ing care. Nurses want to spend time with their patients; they just aren’t given the opportunity in their busy day. Taking the time to give the patient a full, proper bed- bath allows the nurse to perform a head-to-toe assessment, talk to the patient, explain their plan of care, and collect the social and emotional information that is so important but easily overlooked. Communication happens during this time and that is what is mea- sured on the HCAHPS survey — not the type of bath you received. There are even more potential downsides to this bath-in-a-bag, as well. Patients that would oth- erwise have gotten out of bed to bathe can now stay in bed and wipe themselves down instead. Sounds great, right? Except am- bulation and independence are important factors necessary for discharge. The patient walks less and his muscles weaken. He takes fewer deep breaths causing the lower airways to close and increasing his risk for pneumonia. All of a sudden you have a patient who can no longer ambulate as well, and has a potential for hospital-acquired pneumonia — affecting two other quality measures you would not necessarily relate to the bath-in-a-bag. I left my bedside nursing career three
years ago, opting for a change in scenery and perspective, and found myself on the supply chain and value analysis side of healthcare. From this viewpoint, I see what hospitals are purchasing in the name of boosting patient satisfaction, and more importantly, the value or lack thereof, of these purchases. I see hospitals spending $100,000 annually on these bath-in-a-bag products, but I am sorry to say patient satisfaction cannot be purchased on a purchase order. What a PO could do is replace that bath-in-a-bag with a lower-cost bathing product that can be used multiple times by the same patient and provide the waterless functionality for half the cost. Take the extra $50,000 and add a full-time eqiuivalent. Provide the nurse
for? And I “lost” my water pitcher at least twice. Those bath-in-a- bag products provide so much convenience that when a patient needs their hands washed after dinner, guess what is being used — an eight-pack of pre-moistened washcloths. The overall theme be- ing that you are not only paying a few dollars and cents more for the bath-in-a-bag, a name-brand dia- per, or a fancy lotion, you will also be using more of them unnecessar- ily because the patients inherently want more of them, and the nurses are striving for better satisfaction scores, throwing anything they can at the issue. Not only have line-item costs increased, but the overall utilization of the product has skyrocketed as well, all the while providing little-to-no value to the patient or your HCAHPS scores.
In contrast, hourly rounding has
become a standard of practice in hospitals today, requiring every patient to be checked on by staff at least once per hour. Research shows that hourly rounding leads to 52 percent reduction in falls, 37 percent decrease in call light use, and a 12 percent increase in patient satisfaction scores.2
Hourly
with increased personnel to assist him or assign him one less patient so he can provide “personal caregiving.” Let’s use our supply chain powers to find the functionality in the newest products and see what else is out there offering the same function — without the bells and whistles and extra cost.
Beware the freebie geebies We should also remember the hidden costs of some of these new products. Admit it, we all like fancy freebies, and we want as many of them as we can get, whether we need them or not. I experienced this impulse first-hand when giving birth to my children. Per the advice of my nurse, I emptied the drawer full of the brand-name diapers daily so it would be continuously refilled. By the end of my two day post-partum stay I had an entire case of free diapers at my house waiting for me. Turns out, my nine-pound baby boy only fit into the newborn diapers for two weeks, so I didn’t even use all of the diapers I hoarded. Would I have hoarded the generic brand? Probably not. How many bottles of the nice-smelling brand-name lotion do you think I asked
rounding substantially increased patient satisfaction in all of the Press Ganey and HCAHPS subscales.
Changing the personal impact of caregiv-
ing has nothing to do with products, but has proven value. I challenge hospitals that are looking for “products to boost patient satisfaction” to stop and consider that the biggest factor in patient satisfaction is the “impact of personal caregiving.” Let’s look for ways to foster practices that provide the personal touch and instead of relying on products, find processes to boost patient satisfaction. HPN
1. “Healthgrades Announces 2014 Outstanding Patient Experience Award Recipients.” Healthgrades Announces 2014 Outstand- ing Patient Experience Award Recipients. Business Wire, 8 Apr. 2014. Web. 08 Sept. 2015. <
http://www.businesswire.com/ news/home/20140408005590/en/Healthgrades-Announces- 2014-Outstanding-Patient-Experience-Award%E2%84%A2#. VhaonE2FMdX>.
2. Meade, Christine M. et al. “Effects on Nursing Rounds on Patients’ Call Light Use, Satisfaction, and Safety.” American Journal of Nursing, September 2006. 106 (9): 60.
Elizabeth Morgan, R.N., serves as Director of Clinical Utiliza- tion at Blue.Point.LLC.
hpnonline.com • HEALTHCARE PURCHASING NEWS • January 2016 37
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