Objective: The objective of this review was to critically analyze and systematically review the best evidence related to the effectiveness of the Sitz bath in managing adult patients with anorectal disorders. Methods: The text terms were established and searched systematically from the relevant databases from 1990 to November 2009 in the English language. The eligible studies that were congruent with the review's inclusion criteria were selected. The selected studies were critically appraised for their methodological validity by two independent reviews and the data were extracted from the studies by using the Joanna Briggs Institute Systems Meta Analysis of Statistical Assessment and Review Instrument. The results were presented in narrative form because statistical pooling was not possible due to clinical heterogeneity. Results: A total of four randomized controlled trials was included in the review. The use of the Sitz bath had no significant impact on reducing the overall intensity of pain and postoperative pain. Conflicting findings for postdefecation pain were reported. The Sitz bath had no impact on accelerating fissure or wound healing. However, the patients were satisfied with using the Sitz bath and no severe complication was reported. Conclusion: There was no strong evidence to support the use of the Sitz bath for pain relief and to accelerate fissure or wound healing among adult patients with anorectal disorders. However, the Sitz bath may be prescribed for patients' satisfaction.
Bed bathing cleanses the skin, removes odor, and enhances personal hygiene, leading to higher self-esteem. Therefore, it is essential to perform bed bathing based on the best available evidence, so that hospitalized patients are receiving high quality care. The aims of this project were to ensure bed bathing is performed according to the best available evidence, provide a pleasant bed bathing experience for patients, and promote evidence-based practice within clinical culture. The project was implemented in three phases using a system of audit and feedback. JBI PACES (Practical Application of Clinical Evidence System) was utilized to set up a team, data collection, data analysis, GRIP process (Getting Research into Practice) and report writing. GRIP was used for barriers identification, formulation of strategies, and resource identification. There was 100% and 90% improvement of criteria 1 and 2 respectively. There were 21 sub criteria in criteria 1. The 21 sub criteria were detailed steps to follow when performing a bed bath. Criterion 2 referred to evidence of bed bathing and documentation in the patient's file. This project has successfully introduced evidence-based practice in relation to bed bathing among the assistant nurses. They have increased levels of confidence in performing high quality care, and are better prepared to be ambassadors for evidence-based practice among their colleagues.
Five key wordsAcute care, bed bathing, evidence-based practice, GRIP, JBI PACES
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