CLEANSING BED BATH

Objectives:

After 4 hours of varied learning activities, the level I students will be able to:

1. Define the following terms:

1.1. Cleansing bed bath 1.9. Medical bath
1.2. Personal hygiene 1.10. Whirl pool bath
1.3. Sebaceous gland 1.11. Friction stroke
1.4. Epidermis 1.12. Apocrine glands
1.5. Dermis 1.13. Effleurage
1.6. Massage 1.14. Tapotement
1.7. Therapeutic bath 1.15. Three handed effleurage
1.8. Tepid sponge bath

2. Explain the importance of cleansing bed bath

3. Discuss the scientific principles involved in cleansing bed bath
4. Enumerate the different kinds of bath
5. Differentiate cleansing bed bath from tepid sponge bath
6. Identify the types of massage
6.1. Indications
6.2. Contraindication
6.3. Factors
7. Discuss the responsibilities and guidelines of a nurse before, during and after bed bath.
8. List down the materials/equipment used in cleansing bed bath.
9. Demonstrate beginning skills in cleansing bed bath.
1.Define the following terms:

1.1 Cleansing Bed Bath

Cleansing bed baths are routine client care for personal hygiene.

1.2 Personal Hygiene

It involves those practices performed by an individual to care for one's bodily health and well
being, through cleanliness.

1.3 Sebaceous Gland

It is a small gland in the skin which secretes a lubricating

oily matter

1.4 Epidermis

The upper or outer layer of the two main layers of cells that make up the skin.

1.5 Dermis

The thick layer of living tissue below the epidermis that forms the true skin

1.6 Massage

It is the manual manipulation of soft body tissues to

enhance a person's health and well-being
1.7 Therapeutic Bath

Bathing the skin in a variety of preparations

1.8 Tepid Sponge Bath

A bath in which the individual is immersed up to the

neck in water that is slightly cooler than the
body’s normal temperature

1.9 Medical Bath

A therapeutic immersion of a part of the body (as an extremity) alternately in hot and cold water.
1.10 Whirl Pool Bath

It is a therapeutic bath in which all or part of the body is exposed to forceful whirling currents of
hot water.

1.11 Friction Stroke

A deep circular transverse movements with thumbs or fingers. It is the best stroke to break up
adhesions.
1.12 Apocrine Gland

are a subtype of exocrine secretory glands.

1.13 Effleurage

It is the most frequently used massage technique and is one of the most versatile
techniques. Long and sweeping strokes are typically used to cover more than just one area of the
body.

1.14 Tapotement

Rapid and repeated striking of the body as a technique in massage.

1.15 Three Handed Effleurage

Used at the beginning of a session and used at the end of treatment as a gentle 'wind-down'

10. Explain the importance of cleansing bed bath

 Promotes circulation through the body
 Decrease the possibility of infection by removing dirt and debris, secretions and
perspiration
 Provides range of motion exercise during the procedure

11. Discuss the scientific principles involved in cleansing bed bath

Anatomy and Physiology
It is important to understand and have knowledge regarding the structures of the body from head
to toe because it serves as a guide in performing the bed bath properly and efficiently

Microbiology
Bed bath involves removing all microorganisms that are present in all surface of the body and
helps prevent the spread of organisms.
Physics
Firm rubbing and circular motion causes friction that helps lift dirt grease and microbes from the
skin

Chemistry
Bed bath uses soap which is a surfactant or a surface active agent that helps reduce the surface
tension of the water and creates a good lather to speed up the cleaning process
Psychology
Bed bath or cleansing influences clients psychological view as one that can make a difference in
the way they look, smell, and feel thus improves their appearance and well-being.

Sociology
The nurse should have a good interaction with the client to help them demonstrate in performing
bed bath procedure properly

Body mechanics
Ensures clinician and patients safety. Patient and anyone assisting invests movements. So
instructions regarding their responsibilities should be given to avoid body strain and injury.

12. Enumerate the different kinds of bath

Complete Bed Bath
 A complete bed bath involves washing the entire body.
 It indicates that someone must totally wash a patient, as is done with an unconscious patient.
Self Help Bed Bath
 Patients who are confined to bed are able to bathe themselves with some help

Partial Bath
 Parts of the body are washed by the patients and some by the nurse
 The nurse will assists with cleansing only those body areas that would cause discomfort
or odor.
Tub Bath
 Is considered as therapeutic.
 Clients with physical limitations will be assisted by the nursse when entering and exiting the
tub.
Shower Bath
 Patients are capable of taking a shower.
 Clients with physical limitations can use a waterproof chair in the shower.
 The nurse may provide some assistance with the shower
13. Differentiate cleansing bed bath from tepid sponge bath

Cleansing Bed Bath Tepid Sponge Bed Bath

Strokes used Circular Tap

Stroke

Purpose Complete bed bath is To lower a high

a bath provided for the temperature
weak, clients who are
dependent and are
confined to bed
14. Identify the types of massage

Effleurage

- It is a very soothing movement and may be superficial or deep.

- Generally it is used at the beginning and the end of the massage.
- This stroke 'accustoms the patient to the touch of the operator and allows sensitive fingers
to search for areas of spasm and soreness.

- Effleurage is a stroke used a lot with palliative patients and is very calming. It is often
interspersed with other techniques and for best effects it needs to be rhythmical.

Petrissage

- consists of kneading manipulations that press and roll the muscles under the hands.
- It is a type of compression movement where one picks up as much of the muscle and lifts
it away from the bone attachment. Your hands should work alternatively in rapid
succession.
Tapotement

- The fast and stimulating movements of massage are termed as Tapotement, or percussion
movements.
- They include cupping, hacking, pounding (also called pummeling). Tapotement should
not be used on a particularly bony area or on broken or varicose veins. The key to
perfection is to keep the hands and wrists relaxed.
- These movements stimulate the blood circulation, tone and help strengthen sagging skin
and muscles, especially the soft tissue areas, such as thighs and buttocks, which are prone
to cellulite.
Friction Stroke

Friction is the best stroke to break up adhesions since it sinks deep into the muscle tissue and
works to break apart and realign muscle fibers. Therefore, this technique is often used to treat
tendinitis such as lateral epicondylitis (tennis elbow) and medial epicondylitis (golfer’s elbow) .
On most occasions, friction is done with the thumbs. It is also performed without lubricant, so
that therapist’s fingers do not glide over the client’s skin. The tissues should be warmed and
stretched before the technique is applied. Since friction raises local temperature, it should be
followed by effleurage and icing.

Vibration

Static vibrations involve using therapist’s whole hand or part the hand to apply continuous
contact with the client’s body without sliding over the client’s skin. Running vibrations involves
the therapist’s whole hand or part of the hand to apply continuous contact with the client’s body
with a slight glide over the client’s skin.
 14.1. & 6.2 Indications & Contraindications of Cleansing Bed Bath

Indications: Contraindicators:

Bedridden patients Patients with new surgical dressing

For comatose patient Patients with burns

To post- operative patients Patients who just undergo surgeries

6.3 Factors
Culture
• Cultures and cultural practices relating to hygiene vary around the globe. In North
America, there is a high cultural value on cleanliness, daily bathing, an odor free body and
the absence of leg hair on females. Other cultures, however, may only bathe once a week or
less and they are not offended with bodily odors or the presence of underarm and leg hair
among females.
Personal preference
• The client's personal preferences in terms of their personal hygiene habits and routines
also vary. Some clients has many preferences in what time they want. Some male clients
prefer to shave everyday but some prefer twice a week. Females preferably choose to shave
their legs but some are not.
Socio-economic Status
• Economics and economic constraints may alter hygiene processes when, for example,
when the client lacks the funds for basic hygiene needs like soap, shampoo, lotions, and even
hot water.
 Physical Condition
• The client's overall level of health are also factors that can both positively and negatively
impact on the client's hygiene practices and routines. Clients are wholly compensatory in
terms of their self care activities. These clients need the nurse and other members of the
nursing team to provide this care to them; other clients are partly compensatory and they can
perform their activities of daily living with the help and assistance of another.

Cultural Variables
• Some of the religions practices and beliefs that may impact on our clients include those
relating to religious ceremonious bathings and washings
15. Discuss the responsibilities and guidelines of a nurse before, during and after bed bath.

Responsibilities of a Nurse Before Cleansing Bed Bath:

1. Assess the client’s need for bathing
2. Check the client’s preference for soap, powder etc
3.Check whether the client has taken the meal in the previous one hour
4.Prepare necessary equipment and supplies before starting the procedure
5.Adjust room temperature
6. Provide privacy to the patient and ventilation
7. Offer bed pans or urinals to the patient

Responsibilities of a Nurse During Cleansing Bed Bath:

1. Warmth should be maintained throughout the procedure
2. Side rails should be raised to keep the client safe
3.Make sure that you have properly done the procedure

Responsibilities of a Nurse After Cleansing Bed Bath:

1. Replace the client’s personal clothing
2. Straighten the bed linen
3. Remove the bath blanket and put it for washing
4. Change the bed linen if needed
5. Offer a hot drink if permitted
6. Cut short the finger nails and the toe nails. The nail cuttings should be received in the kidney
tray
7. Comb the hair and arrange the hair
8. Position the client for comfort and proper alignment
9. Take all articles to the utility room. Disinfect the bath basin and the wash clothes.
10. Send the soiled linen to the laundry. Put back all the articles in the proper places after
cleaning. Personal articles are replaced into the bedside table.
11. Wash hands. Record the procedure in the nurse’s record with time and date and the type of
bath. Record any abnormalities observed.
12. Take the opportunity to reach the client or his relatives about the personal hygiene.

Guidelines
1. Secure private place
2. Explain the procedure
3. Provide proper atmosphere
4. Prepare all materials to use
5. Promote independence

16. List down the materials/equipment used in cleansing bed bath.

One big basin, 2 small basin
Two bath towels
Three wash cloths
Toilet articles (comb, powder, soap in a soap dish)
70% Alcohol
Camisa or gown
Bath blanket
Two pitchers
Bath thermometer
Old news paper
Clean gloves
17. Demonstrate beginning skills in cleansing bed bath.