BED BATH

Purpose:
a. To clean the skin
b. To promote circulation
c. To provide comfort and relaxation
d. To provide physical, emotional and mental well-being
e. To provide an opportunity for patient assessment

Requisites:
a. Bath basin e. clean bed linen
b. Soap/ soap dish f. bedpan or urinal
c. Wash clothes g. personal supplies like lotion,
deodorant and toothbrush
d. Bath towels
Procedure RATIONALE
1. Assemble all the equipment To ensure all
equipment is ready to
use
2. Explain the bath to the client To gain informed
consent and client’s
co-operation and
participation in the
activity
3. Provide privacy for the client, Prepare the
and offer bedpan or urinal environment so that it
is warm. Close
windows and ensure
privacy to avoid
chilling the patient
4. Raise the bed to work level. For the clients comfort
Raise the side rail on the far and safety
 side of the bed.
5. Wash hands. To reduce transmission
of microorganism.
6. Remove the top linen and To maintain client’s
replace with a bath blanket. privacy and dignity
7. Provide or assist the client with To promote good oral
oral hygiene. hygiene
8. Fill the bath basin two-thirds Water at proper
full with warm water, change temperature relaxes
the water as necessary during him/her and provides
bath warmth. Water will
cool during the
procedure
9. Place the client in a supine or For the client co-
semi-fowler’s position and operation and easier
remove his gown access for the nurse
10. Maintain privacy by To maintain client’s
covering the client with a bath privacy and dignity
blanket and lay a bath towel
over his chest
11. Fold a wash cloth on your A bath mitt retains
hand like a mitt, with no loose water and heat better
ends than a cloth loosely
held.
12. Wash the client’s eyes with Washing from inner to
warm water and wiping from outer corner prevents
inner to outer canthus; dry eyes sweeping debris into
gently but thoroughly the client’s eyes. Using
a separate portion of
the mitt for each eye
prevents the spread of
infection
13. Wash and rinse the face, To prevent
neck and ears and dry unnecessary cooling
thoroughly
14. Place a bath towel Firm strokes from
lengthwise under the client’s distal to proximal
arm, wash the arm using long areas increase venous
firm strokes from fingers to blood return.
axilla; rinse and dry well and
repeat for the other arm.
Always work from the distal
portion towards the proximal
area of the client
15. Apply deodorant or talcum NONE
powder that the client prefers
16. Place the wash basin on a NONE
towel on the bed and immerse
client’s hands
17. Help the client wash, rinse NONE
and dry both hands
18. Place a towel over the For privacy
client’s chest and abdomen and
fold the bath blanket down to
the pubic area
19. Wash, rinse and dry the Skin under breast is
chest and abdomen, taking vulnerable to
special care to wash the skin excoriation if will not
folds of a breast kept clean and dry.
20. Cover the chest, abdomen, This provides warmth
opposite leg and perineum with and privacy
a blanket then slide a towel
under the leg to be washed first
21. Place the wash basin on
the bed next to the client foot;foot prevents pressure
bend the leg at the knee and
immerse the foot in the basin
and allow the foot to soak whileagainst calf. Soaking
washing the leg
22. Wash the leg from ankle to NONE
knee and from knee to thigh,
using long firm, smooth
strokes; rinse and dry well
23. Wash, rinse and dry the
foot thoroughly and wash the
other leg and foot in the same
manner
24. Cover the client with bath
blanket, change the water and
place the client in a prone or
side-lying position
25. Place a towel lengthwise
along the client’s back and
buttocks; wash, rinse and dry
the back from neck to buttocks,
paying special attention to the
folds of the anus and buttocks
Proper positioning of
from being applied
from edge of basin
softens calluses and
rough skin. NOTE: If
client is unable to hold
leg in basin, do not
immerse, simply wash
it with washcloth. firm
strokes in Promotes
venous return
NONE
NONE
Observe for redness or
other indications of
skin breakdown in the
sacral area. Prevents
contact with
microorganism in body
secretions. The
 direction moves from
clean to contaminated
area.
26. Give the client a back rub To relax the back of
the patient and to get
warm.
27. Place the client in a supine NONE
position and cover him with a
bath blanket over the chest
down to the legs
28. Put on gloves To prevent the spread
of infection
29. Change water and use a Changing to clean
clean wash clothes, rinse and supplies decreases the
dry perineum from front to spread of
back, paying special attention microorganisms from
to skin folds the anal area to the
genital.
Maintains clients
privacy. Skinfolds are
sites for accumulation
of secretions and
moisture
30. Discard gloves and help This prevents
client put on clean gown; comb transmission of
the client’s hair and allow a microorganism. A
female client to put on make-up clean gown promotes
the warmth and
comfort of the client.
Combing hair and
applying make-up
maintains clients body
 image
31. Make the client’s bed. Provides clean
Placed soiled linen in a laundry environment and
bag. comfort to the patient.
Prevents transmission
of infection. Clean
environment promotes
comfort. Keeping call
light, articles of care
within reach and
always raise the side
rails promotes safety.
32. Wash hands To reduce transmission
of microorganism.

BACK MASSAGE
PURPOSE:
 To promote relaxation
 To increase circulation
 To assess the skin circulation
REQUISITES:
a. Body lotion
b. Towel

PROCEDURE RATIONALE
To ensure all equipment is
1. Assemble all the
ready to use
 equipment.
2. Identify the client.
3. Explain the client
that you will be
massaging his back.
4. Wash hands.
5. Assist the client to a This position exposes
prone or side lying an adequate area for
position. massage with privacy
and warmth maintained
6. Place a small pillow This is to increase the
under the client’s patients comfort
abdomen to
maintain correct
body alignment. Because cold lotion
7. Pour a small amount causes chilling and
of lotion onto the uncomfortable
palm of your hand;
rub your palms
together to warm the
lotion.
8. Follow the sequence
for back massage
with your palms and
finger rather than
fingertips, using
long firm connecting
strokes. Use
 additional lotion as
needed.

9. Hand-over-hand.
Massage the back with
short quick strokes,
alternating hands.

Kneading helps reduce

muscle tightness by
10. Kneading. increasing temperature
Squeeze the of soft tissues,
shoulder muscle increasing blood
with each hand as circulation, breaking
you slide the hands down adhesions and
together. decreasing tone
This is to maintain the
mobility within the soft
tissue structures of
ligament, tendon, and
11. Friction. muscle and prevent
Massage the back adherent scars from
with your thumbs, in forming.
a circular motion
and an upward
direction along the
spine from the
sacrum to the
shoulders. Move
 outward each time Effleurage relaxes the
until the entire back patient and lessens
is covered. tension.

12. Effleurage.
Massage the back
with both hands,
using long strokes
upward from the
This helps by
sacrum to the
increasing blood
shoulder and down
circulation, increasing
again. Use firmer
tissue elasticity and
pressure with the
removing waste
upward motion to
products from the
aid in venous
muscles. Petrissage
returns.
helps by increase fresh
13. Petrissage. blood to the muscles
Stroke the back and soft tissues.
horizontally, move
hands in opposite
directions using a
kneading motion.

14. Brush-Stroking.
Lightly stroke the
back with your
 fingertips to
complete the
massage.
15. Assist the client
to a comfortable
position.
16. Return
equipment to its
appropriate
location. 
17. Wash hands.
18. Record the
procedure.