What do we know about skin‐hygiene care for patients with bariatric needs? Implications for nursing practice

Abstract

This article presents a discussion of the current state of knowledge about bariatric skin-hygiene care and whether this is sufficient to underpin evidence-based nursing practice. The challenges of providing bariatric skin-hygiene care are highlighted and include managing specific skin changes with associated risk of skin breakdown and practical management needs. The risk of skin breakdown is high and can have a devastating impact on well-being and increased treatment costs. A four-stage search strategy included: (i) literature search using electronic databases from inception-May 2013; (ii) hand search of selected journals; (iii) review of internet-based guidelines, policies or protocols and (iv) contact with clinical experts. There is a dearth of robust evidence on bariatric skin-hygiene care. Whilst a range of information and guidelines exist, these are generally based on expert opinion and often used only in a local context. Nurses are increasingly faced with the challenge of providing skin-hygiene care for patients with bariatric needs. At present, care is largely based on custom and practice or clinical opinion; this limits capacity to provide optimum evidence-based nursing care. As the prevalence of people needing bariatric skin-hygiene care continues to increase, there is a lack of evidence to inform interventions and hence a growing need for further research in this challenging clinical area to help nurses and patients select the best possible interventions that will meet individual personal-hygiene needs and preserve skin integrity.