BED BATH DESCRIPTION A complete bed bath cleans the skin, stimulates circulation, provides mild exercise, and

promotes comfort. Bathing also allows assessment of skin condition, joint mobility, and muscle strength. Depending on the patient's overall condition and duration of hospitalization, he may have a complete or partial bath daily. A partial bath — including hands, face, axillae, back, genitalia, and anal region — can replace the complete bath for the patient with dry, fragile skin or extreme weakness and can supplement the complete bath for the diaphoretic or incontinent patient. PURPOSES

ASSESSMENT PLANNING  Prepare the necessary equipment/ materials for the procedure: o Bath basin o Bath blanket o Skin cleanser o Towel o Washcloth o Skin lotion o Orangewood stick o Gloves o Deodorant o Hospital-grade disinfectant o Optional: chlorhexidine-impregnated cloth, bath oil, perineal pad, abdominal (ABD) pad, and linen-saver pad

IMPLEMENTATION KAR HEALTH EDUCATION COMMUNICATION ETHICO-MORAL RESPONSIBILITY LEGAL RESPONSIBILITY PROCEDURE 1. Explain procedure to client and ask client about bathing preferences. 2. Prepare room for comfort and draw privacy curtains or close the door. RATIONALE Promotes client’s cooperation. Ensures client’s privacy.

9. Position the bed at a comfortable working height. SAFE & QUALITY NURSING CARE Removal of top linens prevent them from becoming soiled or moist during the bath. 8. 10. SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE . If not. Use of gloves serves as barrier for secretions. Warm water used during the bath promotes comfort. Proper disposal prevents the transmission of microorganisms Provides full exposure of body parts during bathing. Pull side rail up. and prevents unnecessary chilling. Having the patient test water temperature prevents accidental burns. Offer client bedpan or urinal. Assist/move client toward side of bed closest to you. Loosen top covers beginning at foot of bed. Fold and remove top sheet from under blanket. 7. Apply disposable gloves as needed. most effective way for preventing the transmission of microorganisms and infectious diseases. Hand washing is the single. SAFE & QUALITY NURSING CARE 5. Raising side rails maintains client’s privacy as the nurse leaves bedside. This promotes proper body mechanics and thus reducing strain on the nurse’s back. SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE Perform Complete or Partial Bath 6. Perform hand hygiene. Putting on bath blanket provides warmth and privacy. Have client test temperature by placing fingers in water. Lower side rail closest to you. If top sheet is to be reused.SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE 3. Provide towel and washcloth. and assist client in assuming a comfortable position that maintains body alignment. relaxes muscles. fold it for later replacement. 4. Remove client’s gown or pajamas. Aids the nurse’s access to the client and maintains comfort throughout the procedure. place it in laundry bag. Fill washbasin two-thirds full with warm water. This promotes client comfort during the procedure. Place bath blanket over top sheet.

Immerse mitt in water and wring thoroughly. neck. Prevents soiling of bed. 16. Mitt retains water and heat better than loosely held washcloth. 14. Place second bath towel over client’s chest. nose. Wash client’s eyes with plain warm water. and ears. rinse. Apply deodorant or talcum powder. Place bath towel under client’s head by asking the client to lift his head while the nurse supports the neck. Soak any crusts on eyelid for 2 to 3 minutes with damp cloth before attempting removal. Using separate sections of the mitt reduces transmission of infection. firm strokes from distal to proximal areas. Alkaline residue of soap discourages the growth of normal skin bacteria while excess moisture can cause skin maceration or . Removal of pillow makes it easier to wash client’s ear and neck. firm strokes stimulates circulation. Bathing eye from inner to outer canthus prevents secretions from entering the nasolacrimal duct.SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE 11. Soap lowers surface tension and facilitates removal of debris and bacteria when friction is applied during washing. Bathe client’s arm with soap and water using long. Fold washcloth around fingers of your hand to form mitt. Rinse and dry arm and axilla thoroughly. Raise and support client’s arm above head (if possible) while washing axilla. cheeks. Remove bath blanket from client’s arm that is closest to you. 13. Move mitt from inner to outer canthus. Long. 15. 12. Place bath towel lengthwise under arm. Placement of towels prevents soiling of bed linen and bath blanket. Ask if client prefers to have soap used on face. Soap tends to dry face. Dry eye thoroughly but gently. Use different section of mitt for each eye. Wash. SAFE & QUALITY NURSING CARE 17. which is exposed to air more than any other body parts. Movement of arm exposes axilla and exercise joints normal range-of-motion. and dry well client’s forehead. Soap irritates the eyes. if used. Remove pillow if allowed and raise head of bed 30 to 45 degrees.

Place basin on towel. Allow hand to soak for 3 to 5 minutes before washing hand and fingernails. Fold blanket down to just above client’s pubic region. 20. Keep client’s chest covered between washing and rinsing. Stroke from side to side. Lift bath towel. 23. Lift edge of towel away from client’s chest. Cover client’s chest with bath towel. and enhances feeling of cleanliness. Draping prevents unnecessary exposure of body parts. 19. 22. Secretions and dirt collect easily in areas of tight skinfolds which are susceptible to excoriation if breasts are pendulous . Place bath towel(s) lengthwise over client’s chest and abdomen. Dry well. Wash skinfolds under female clients’ breasts. Assist client put on clean softening. Raise side rail and move to other side of bed. 25. Warm water maintains client comfort To keep the water warm and clean. Check temperature of bath water. Dry well. Maintains client’s warmth . Moisture and sediment that collect in skinfolds predispose the skin to maceration and irritation. Fold bath towel in half and lay it on bed beside client. Lower side rails and repeat steps 15 through 17 for other arm. 24. and fold bath blanket down to umbilicus. Towel maintains warmth and privacy. Change the water as often as necessary. Remove hand from basin and dry well. SAFE & QUALITY NURSING CARE SAFE & QUALITY Prevents chilling and unnecessary exposure of body parts. Bathe client’s chest using long. firm strokes with mitted hand. Thorough drying removes moisture in between fingers. Raising the side rails ensures client safety.SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE 18. Bathe client’s abdomen with mitted hand. loosens debris beneath nails. SAFE & QUALITY NURSING CARE Prevents chilling and unnecessary exposure of body parts. Keep client’s abdomen covered between washing and rinsing. Soaking softens cuticles and calluses of hand. 21. Immerse client’s hand in water. Deodorant controls body odor.

Raise side rail and move to other side of bed. Sudden movement by client could spill bath water. Place bath basin on towel on bed. Clean and clip nails as needed. SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE Decreased bath water temperature can cause chilling. Bend client’s leg at knee by positioning your arm under client’s leg. Soak the foot while washing the leg. Cover client’s chest and abdomen with top of bath blanket. firm strokes in washing from client’s ankle to knee and from knee to thigh. Use long. SAFE & QUALITY NURSING CARE Secretions and moisture may be present in between toes. and slide bath towel lengthwise under leg.NURSING CARE SAFE & QUALITY NURSING CARE gown or pajama top. unless contraindicated. Cleanse client’s foot. making sure to bathe between toes. Clean waster . Dry well. SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE Proper positioning of foot prevents pressure being applied from edge of basin against calf. 28. raise side rail for client’s safety. SAFE & QUALITY NURSING CARE The towel prevents soiling of bed linen. 29. Cover client with bath blanket. Promotes venous return. Ask client to hold foot still. 32. 26. Prevents unnecessary exposure of body parts. and secure its position next to the foot to be washed. Application of lotion helps retain moisture and softens skin. Lower side rail and repeat steps 26 through 29 for client’s other leg and foot. Support of joint and extremity during lifting prevents strain on musculoskeletal structures. and change and comfort. 31. Do not massage any reddened area on client’s skin. Raise he lower leg while supporting it with one hand and slide the basin under the lifted foot. 30. Apply lotion to dry skin. Drape client’s perineum and other leg. Soaking softens calluses and rough skin. Expose client’s nearer leg by folding blanket toward midline. Dry well. 27. Elevate leg from mattress slightly while grasping client’s heel.

Promotes client’s body image. and dry perineum. Remove soiled linen and Prevents transmission of place it in laundry bag. microorganisms in body secretions. chapped skin. 39. 37. 38. Replace call light client’s comfort. Wash. Give client a back rub. Wash. 40.bath water. and prevents unnecessary exposure. Pay special attention to folds of buttocks and anus. reduces transmission of microorganisms Exposes back and buttocks for bathing. rinse. Comb client’s hair. Keep client draped by sliding bath blanket over his or her shoulders and thighs. Skinfolds near buttocks and anus may contain fecal secretions that harbour microorganisms. Assist client in assuming a prone or sidelying position (as applicable). 36. Change bath water. Lower side rail. SAFE & QUALITY NURSING CARE 33. Place towel lengthwise along client’s side. Clean Clean and replace bathing environment promotes equipment. Apply disposable gloves if Prevents contact with not done previously. 35. side-lying or supine position. Clients who are capable of Cover client’s chest and performing partial bath upper extremities with towel usually prefer to wash their and lower extremities with own genitalia. Assist client in assuming a Maintains client’s privacy. Dispose of gloves in Prevents transmission of receptacle. SAFE & QUALITY NURSING CARE Maintains warmth. and dry back from neck to buttocks using long. Provides a clean environment and provides client comfort 41. Moisturizing lotion prevents dry. bath blanket. Apply additional body lotion or oil on client as desired. Keeping . Assist client in dressing. Make client’s bed. 34. SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE SAFE & QUALITY NURSING CARE Changing bath water prevents transfer of microorganisms from anal area to genitalia. Expose client’s genitalia only. firm strokes. infection. infection. rinse.

Record bath on flow sheet. If client becomes excessively fatigued and unable to cooperate or participate in bathing. Report evidence of alterations in client’s skin integrity. EVALUATION       Observe client’s skin. Leave room as clean and comfortable as possible. Perform hand hygiene. be sure to raise side rails up before obtaining fresh water or other supplies. reddened. Note level of assistance required. Observe client’s range of motion during the bath. call light and articles of care within reach promotes client’s safety. Remember side rails cannot be used as a restraint. or that showed early signs of breakdown. Do not massage any reddened area on client’s skin because massaging causes breaks in the skin surface capillaries and increased risk of skin breakdown. Clients with history of deep vein thrombosis (DVT) should not have their lower extremities washed with long firm strokes. paying particular attention to areas that were previously soiled. NURSING CONSIDERATIONS       Clients whose level of independence and mobility change frequently may require more or less assistance during bathing If available.SAFE & QUALITY NURSING CARE and client’s personal possessions. Reduces the transmission of microorganisms. reschedule bathing to a time when client is more rested . Ask client to rate level of comfort. be sure that clients with an IV or upper extremity injury have a gown with snap or tie sleeves. Thus there is easy access to upper extremities during hygiene If a client us at risk for falls. Record condition of client’s skin and any significant findings. 42.

. take a clean. Fold the top of the washcloth down and tuck it into the bottom of the mitt.MAKING A WASHCLOTH MITT To make a washcloth mitt. dry washcloth and fold it in thirds lengthwise around your hand.

.Cleaning the eyes from inner to outer cantus.

Performing foot care. .Washing of the arms from distal to proximal.

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