Father Saturnino Urios University

NURSING PROGRAM
Butuan City

Name of student: Samantha Loi Therese S. Medroso Section: N-12

Date of lecture: ___________________________Date of return demonstration: _________________________

THE CLEANSING BED BATH

DEFINITION: The act of washing the body with soap and water while the patient is in bed.
OBJECTIVES:
1. To cleanse the skin as bathing removes perspiration, some bacteria, sebum and dead skin cells.
2. To stimulate circulation.
3. To promote a positive self image
4. To reduce body odors.
5. To promote range of motion (ROM).
ASSESSMENT:
1. Vital signs
2. degree of assistance needed
3. patient’s preference for bathing procedure
4. availability of bathing supplies and equipment
5. need as to what bed linen is to be changed
6. patient’s activity order
7. environmental and procedural modification needed
PLANNING:
1. Recall relevant principles to be threaded through.
2. complete materials and equipments to be used:
a. wash cloth
b. face towel (optional)
c. bath towel
d. bath blanket
e. soap in a soap dish
f. comb (patient’s own)
g. talcum powder (patient’s own)
h. deodorant (patient’s own)
i. nail cutter
j. newspaper
k. clean linen (as needed)
l. clean gown
m. bath basin ½ full of warm water ( approximately 43-46 C or 110-115 F) tested by pouring on wrist)
n. screen as needed
o. bedpan or urinal (at bedside)
p. pail, basin (2), pitcher(2)
3. Conserve steps in doing the procedure
4. plan for modification if indicated

PROCEDURE:
STEPS KEY POINTS
1. Before beginning the bath, determine:
a. vital signs
b. other care the patient is receiving as
roentgenography, physiotherapy
c. aspects of the patient’s health status that affects the
bathing process.
2. explain the procedure to the patient
3. Inspect linens and determine which linen, needs to be
changed.
4. Clear bedside table. Table cover should be removed after
clearing table. Line the table top with newspaper before
placing bath basin on it.
5. Close the windows and door to make sure the room is free
from drafts.
6. Screen patient especially if he is in a semi-private room or
ward.
7. Offer the patient a bedpan or urinal or ask whether he or
she wishes to use the toilet or commode.
8. Wash hands
9. Prepare and bring all the necessary articles to the bedside.
10. Arrange linen in order of use on a chair
11. Adjust bed to appropriate height
12. Loosen top bedding at foot bed. Place bath blanket over
the top sheet is being removed. Fold top sheet and place on
chair.
13. Assist patient to move to side of bed nearest you
14. Remove clothing keeping patient covered with bath
blanket. Avoid exposing the patient unnecessarily. If
patient’s arm or shoulder is injured, begin removal of
clothing from uninjured side.
15. place bath towel under head and face towel under chin
16. make a bath mitt with the wash cloth
a. Triangular method
- lay your hand over one corner of the wash cloth
- fold the top corner over your hand
- fold the side corners over the hand
- tuck the second corner under the cloth on the
palmar side to secure the mitt
b. Rectangular method:
- lay your hand over the wash cloth, and fold one side
over your hand;
- fold the second side over your hand
- fold the top of the cloth down, and tuck it under the
folded side against your palm to secure the mitt.
17. Wash region around the eyes with clear water. Wipe from
inner canthus outward and use a separate position of the
wash cloth for each eye.
18. Wash face, neck and ears thoroughly with soap and
water. Rinse well then dry.
a. consult patient first as to his preference before applying
soap to the area.
b. use firm, gentle motion on face using upward strokes.
Clean ears well.
c. rinse off soap thoroughly and dry area well
19. Remove face towel and place over rack
20. Remove bath towel under head
21. Uncover farther arm and place bath towel lengthwise
under it. Wash the arm with soap and water using firm long
strokes from distal to proximal areas.
22. Soap are paying particular attention to the axilla. Rinse
well and dry.
23. Do the same procedure for the nearer arm.
24. Place a towel directly on the bed and put basin on it.
Place patient’s hands in the basin. Assist him/her to wash,
rinse and dry them paying particular attention to spaces
between the fingers.
25. Change the water
26. Cover chest and abdomen with bath towel and fold bath
blanket down to the pubic area
27. Soap chest and abdomen working under towel. Rinse
well and dry. Cover area with bath blanket. Pay particular
attention to the navel and to area under breasts of female
patients.
28. Turn patient on his side. Have patient’s back towards the
nurse with body slightly diagonal to bed.
29. Place bath towel lengthwise on bed alongside back and
soap area (including back of neck) rinse thoroughly and dry.
Do back rub after.
a. rub in circular motion over sacral area
b. move your hands up the center of the back and then
over both scapulae
c. massage in circular motion over the scapulae
d. move hands down the sides of the back
e. massage areas over right and left iliac crests
f. repeat steps as needed
g. massage pressure areas gently and only if there is no
evidence of underlying tissue damage
h. pat dry any excess solution with a towel
30. Put on patient’s gown or pajama top if any
31. Change water
32. Bathe thighs and legs in the same manner and order as
the arms paying particular attention to the inguinal areas.
Drape bath blanket around groin.
33. Flex patient’s knees and wrap blanket around legs. Have
edge of blanket come just below knees and be sure patient is
unnecessarily exposed.
34. Place bath towel under feet
35. Place basin on towel
36. Put feet flat into basin (feet may be placed in basin one at
a time) Avoid pressure on patient’s calves and ankles.
37. Wash feet thoroughly with soap and water using
washcloth. Particular attention should be given to areas
between toes and heels
38. Remove feet from basin by placing one hand under
patient’s legs while the other hand draws basin out. When
washing one foot at a time, place cleaned foot on bath towel
before proceeding with other foot. Lotion may be applied to
rough and calloused areas.
39. Dry feet paying close attention to areas between toes.
40. Bring basin and washcloth to utility room
41. Clean washcloth and basin well with soap and water.
Refill basin with water.
42. Bring wash cloth and basin back to patient’s unit
43. Place needed articles within reach of patient and instructs
him or her to finish bath or crotch care.
a. “finishing the bath” is the term used to wash the genital
area. This is done by the patient
b. the nurse may leave the unit placing a call bell within
easy reach while patient is finishing the bath unless his/her
condition requires the nurse’s presence.

c. If the patient is unable to finish the bath, the female

nurse does this for female patients while a male nurse or
orderly may do it for male patients. Careful cleansing of the
hands must be done by nurse or orderly afterwards.
44. Have patient wash his hands (while patient is finishing
his bath, the nurse brings in a small pitcher of water to wash
patient’s hands with)
45. Put on rest of clothing, if any
46. Make patient’s bed (occupied bed)
47. Do hair and nail care
48. make patient comfortable in bed
49. Do after care of unit
50. Clean equipment used and return to their proper places
51. Wash hands
52. Chart the following:
a. time bed bath was given
b. signs and symptoms observed
c. complains made
d. condition of the patient
 Father Saturnino Urios University
NURSING PROGRAM
Butuan City

Name of student: _________________________________________ Section: ___________________________

Date of lecture: ___________________________Date of return demonstration: _________________________

HAIR SHAMPOO

CONCEPT: Cleansing the hair to keep it free from dirt and make the patient feel fresh and comfortable.
OBJECTIVES:
1. To cleanse the patient’s hair and head
2. to promote the physical and mental comfort
3. to complete a treatment for pediculi
ASSESSMENT:
1. Assess the condition of hair and scalp
2. degree of assistance and modification needed
3. availability of supplies and equipment
PLANNING:
1. Check doctor’s needed
2. confer with the patient as to the best time of the day for the shampoo
3. provide privacy
4. Prepare all equipment needed
a. Hair brush and comb
b. Shampoo of patient’s choice
c. Jar of cotton balls
d. Pitcher of water with desired temperature 43-44 C (110 F)
e. Pail
f. Kelly pad (inflated) or rubber sheet
g. Bath towel
h. Plastic sheet
i. Wash cloth or pad
j. Hair dryer (optional)
5. Recall relevant principles
6. plan for modification, if indicated

PROCEDURE:
STEPS KEY POINTS
1. Wash hands
2. Offer bedpan or encourage patient to use toilet
(if ambulatory or with bathroom privileges)
3. Position the patient diagonally in bed with the head near
the side of the bed in which you will work
4. Remove pins and ribbons from the hair; brush and comb
it.
5. Place the plastic sheet or pad on the bed under the head
over the pillow
6. Remove pillow from under the client’s head, and place it
under the client’s head, and place it under the shoulders
7. Tuck a bath towel around the patient’s shoulders
8. Line the floor with newspaper
9. Place inflated Kelly pad under the head, with the tail into
the pail. Place a folded washcloth or pad where the patient
neck rests on the edge of the Kelly pad
10. Place a damp washcloth over the patient’s eyes
11. Stuff the patient’s ears with dry cotton balls
12. Wet hair thoroughly with water of the desired
temperature
13. Apply shampoo to the scalp. Make a good lather with
the shampoo while massaging the scalp using the pads of
the finger tips. Massage all areas of the scalp systematically
e.g. starting at the front and working to the back f the head.
14. Rinse well. Apply shampoo again. Make a good lather
and massage scalp as before.
15. Repeat step 14 until hair is sufficiently clean
16. Rinse hair thoroughly to remove all the shampoo
17. Squeeze as much water as possible out of the hair with
your hands. Do not pull hair
18. Remove wash cloth and dry face
19. Remove cotton balls and drop into coil
20. Remove Kelly pad under the head and drop into the pail
21. Wrap the patient’s hair with towel.
22. dry hair and assist the patient in combing
23. Tidy the bed and make the patient comfortable
24. Do after care of the unit and equipment used
25. wash hands
26. Chart:
a. assessment finding of hair and scalp
b. date and time shampoo was given
c. name of shampoo used
d. reaction of the patient
 Father Saturnino Urios University
NURSING PROGRAM
Butuan City

Name of student: _________________________________________ Section: ___________________________

Date of lecture: ___________________________Date of return demonstration: _________________________

OCCUPIED BED MAKING

CONCEPT: Making a bed safely for a bedridden patient

OBJECTIVES:
1. To change the linens of the bed without unnecessarily exposing the patient's body
2. To free the bed from wrinkles by having a good foundation of the bed thus preventing skin irritation to the patient
3. To provide patient's comfort and safety
ASSESSMENT:
1. Assess the linens to be changed
2. Check the general condition of the patient including the vital signs
3. Determine positions that maybe contraindicated to the patient
4. Degree of assistance needed
5. Type of linen/s needed
6. Availability of linens
7. Safety and special precautions to be observed in moving the patient
- locking the wheels of the bed
- adjusting the height of the bed to its working level
- side rails
- facing the direction of movement
PLANNING:
1. Greeting, introduction, asking, explain
2. Prepare needed supplies and equipment
- linens arranged in order of use
- linen hamper
- chair
- bath blanket
- screen if necessary

PROCEDURE:
STEPS KEY POINTS
1. Wash hands. Gather all equipment and bring to bedside.
place linens on chair and hamper at bedside.
2. Provide privacy by putting up the screen of closing the
door
3. Adjust the bed to a comfortable working height. Put up
side rails at the opposite the worker.
4. Remove any equipment attached to bed and any patient's
belonging on the bed
5. Loosen all top linens at the foot of the bed
6. Remove bed spread and blanket carefully. If to be re-
used fold each in a manner that readily reapplied to bed
later and place on the back of the chair. If soiled , discard
into the hamper.
7. Leave top sheet over the patient if it is to be changed it
replaced with bath blanket as follows:
a.spread the bath towel over the top sheet
b. ask the client to hold the top edge of the towel
c. holding the bottom edge of the towel over the top sheet
to the head part. Grasp together bottom edge of bath towel
and top edge of top sheet and pull down until patient is
adequately covered by bath towel
d. remove the sheet from the bed, fold and place at the back
of the chair
e. reaching under the blanket from the side, grasp the top
edge of the sheet and draw it down to the feet of the bed,
leaving the blanket in place
8. Loosen drawsheet, rubber sheet and bottom sheet
9. Move patient nearer to the worker
10. Assist patient to assume the Sim's lateral position facing
away from the worker. Move the pillow with the patient
11. Roll the draw sheet, rubber sheet and bottom sheet
piece by piece, towards the back of the patient and tuck
under patient's back and buttocks
12. proceed to the basic bed making, fan folding vertically
the clean bottom sheet at the center of the bed. Tuck in at
top, miter corner and finish tucking the side
13. Apply rubber sheet and cotton draw sheet and tuck in
well under the mattress
14. Help the patient to roll over the folded linen and on to
the clean linen and let lie in supine position. Adjust the
pillow under patient's head
15. Raise the side rail, if necessary, before leaving the side
of the bed
16. Move to the other side of the bed and lower the side rail
17. Assist the patient to Sim's lateral position away from
the worker
18. loosen the side foundation linens from the bed
19. Unfold each piece of clean linen towards you and
proceed to the basic bed making until bottom sheet, rubber
sheet and draw sheet are well tucked under the mattress
20. Reposition pillow at the center of the bed and assist
patient to the center of the bed in a position preferred or
requires
21. Return to first side and lower side rail
22. Place top sheet over the patient so that centerfold is in
the center of the bed and the top edge is at the client
shoulder
23. Ask the patient to hold the top edge of the sheet as you
pull the bath blanket from top to bottom
24. Fold the bath blanket if to be reused
25. Add the blanket and the bed spread and proceed by
tucking the top sheet, blanket and bed spread at the foot
part and make a modified miter at both corners
26. Instead of a toe pleat, you may have the patient point
his or her toes up, which allows room for the toes after the
bed has been made
27. Change pillowcase and slip under the patient's head
28. re-attach signal cord and other equipment removed
earlier
29. Tidy the unit or remove screen
30. Return hamper with soiled linens to laundry room
31. wash hands
Name of student: _________________________________________ Section: ___________________________
Date of lecture: ___________________________Date of return demonstration: _________________________

PERFORMANCE CHECKLIST

1 2 3 4 5
Cleansing Bed Bath
ASSESSMENT:
Vital signs
degree of assistance needed
patient’s preference for bathing procedure
availability of bathing supplies and equipment
need as to what bed linen is to be changed
patient’s activity order
environmental and procedural modification needed
PLANNING
Recalled relevant principles to be threaded through.
Materials and equipment to be used is complete
Conserved steps in doing the procedure
Planned for modification if indicated
PROCEDURE
Introduced self and verified client’s identity
Before beginning the bath, determined:
a. vital signs
b. other care the patient is receiving as roentgenography, physiotherapy
c. aspects of the patient’s health status that affects the bathing process.
Explained the procedure to the patient
Inspected linens and determined which linen, needs to be changed.
Lined the table and floor with newspaper
Closed the windows and door to make sure the room is free from drafts.
Screened patient especially if he is in a semi-private room or ward.
Offered the patient a bedpan or urinal or ask whether he or she wishes to use the toilet
Washed hands
Prepared and bring all the necessary articles to the bedside.
Arranged linen in order of use on a chair
Adjusted bed to appropriate height
Loosened top bedding at foot bed. Place bath blanket over the top sheet is being
removed. Fold top sheet and place on chair.
Assisted patient to move to side of bed nearest you
Removed clothing keeping patient covered with bath blanket. Avoid exposing the patient
unnecessarily. If patient’s arm or shoulder is injured, begin removal of clothing from
uninjured side.
Placed bath towel under head and face towel under chin

Made a bath mitt with the wash cloth: Triangular or Rectangular

Washed region around the eyes with clear water. Wipe from inner canthus outward and
use a separate position of the wash cloth for each eye.
Washed face, neck and ears thoroughly with soap and water. Rinse well then dry.
Removed face towel and place over rack
Removed bath towel under head
Uncovered farther arm and place bath towel lengthwise under it. Wash the arm with soap
and water using firm long strokes from distal to proximal areas.
Soap paying particular attention to the axilla. Rinse well and dry.
Did the same procedure for the nearer arm.
Placed a towel directly on the bed and put basin on it. Place patient’s hands in the basin.
Assist him/her to wash, rinse and dry them paying particular attention to spaces between
the fingers.
Changed the water
Covered chest and abdomen with bath towel and fold bath blanket down to the pubic
area
Applied soap on chest and abdomen working under towel. Rinse well and dry. Cover
area with bath blanket. Pay particular attention to the navel and to area under breasts of
female patients.
Turned patient on his side. Have patient’s back towards the nurse with body slightly
diagonal to bed.
Placed bath towel lengthwise on bed alongside back and soap area (including back of
neck) rinse thoroughly and dry.
Done with back rub
Put on patient’s gown or pajama top if any
Changed water
Bathed thighs and legs in the same manner and order as the arms paying particular
attention to the inguinal areas. Drape bath blanket around groin.
Flexed patient’s knees and wrap blanket around legs. Have edge of blanket come just
below knees and be sure patient is unnecessarily exposed.
Placed bath towel under feet
Placed basin on towel
Placed feet flat into basin. Avoid pressure on patient’s calves and ankles.
Washed feet thoroughly with soap and water using washcloth. Particular attention should
be given to areas between toes and heels
Removed feet from basin by placing one hand under patient’s legs while the other hand
draws basin out. When washing one foot at a time, place cleaned foot on bath towel
before proceeding with other foot. Lotion may be applied to rough and calloused areas.
Dried feet paying close attention to areas between toes.
Brought basin and washcloth to utility room
Cleansed washcloth and basin well with soap and water. Refill basin with water.
Brought wash cloth and basin back to patient’s unit
Placed needed articles within reach of patient and instructs him or her to finish bath or
crotch care.
Have patient wash his hands
Put on rest of clothing, if any
Do hair and nail care
Hair Shampoo
ASSESSMENT
Assessed the condition of hair and scalp
Assessed degree of assistance and modification needed
Availability of supplies and equipment
PLANNING:
Checked doctor’s order as needed
Conferred with the patient as to the best time of the day for the shampoo
Provided privacy
Prepared all equipment needed
Recalled relevant principles
Planned for modification, if indicated
PROCEDURE
Position the patient diagonally in bed with the head near the side of the bed in which you
will work
Removed pins and ribbons from the hair; brush and comb it.
Placed the plastic sheet or pad on the bed under the head over the pillow
Removed pillow from under the client’s head, and place it under the client’s head, and
place it under the shoulders
Tucked a bath towel around the patient’s shoulders
Placed inflated Kelly pad under the head, with the tail into the pail. Place a folded
washcloth or pad where the patient neck rests on the edge of the Kelly pad
Placed a damp washcloth over the patient’s eyes
Stuffed the patient’s ears with dry cotton balls
Wet hair thoroughly with water of the desired temperature
Applied shampoo to the scalp. Make a good lather with the shampoo while massaging
the scalp using the pads of the finger tips. Massage all areas of the scalp systematically
e.g. starting at the front and working to the back f the head.
Rinsed well. Apply shampoo again. Make a good lather and massage scalp as before.
Squeezed as much water as possible out of the hair with your hands. Do not pull hair
Removed wash cloth and dry face
Removed cotton balls and drop into coil
Removed Kelly pad under the head and drop into the pail
Wrapped the patient’s hair with towel.
Dried hair and assist the patient in combing
Occupied Bed Making
ASSESSMENT:
Assessed the linens to be changed
Checked the general condition of the patient including the vital signs
Determined positions that maybe contraindicated to the patient
Degree of assistance needed
Type of linen/s needed
Availability of linens
Safety and special precautions to be observed in moving the patient
PLANNING:
Prepare needed supplies and equipment
PROCEDURE:
Loosened drawsheet, rubber sheet and bottom sheet
Moved patient nearer to the worker
Assisted patient to assume the Sim's lateral position facing away from the worker. Move
the pillow with the patient
Rolled the draw sheet, rubber sheet and bottom sheet piece by piece, towards the back of
the patient and tuck under patient's back and buttocks
Proceed to the basic bed making, fan folding vertically the clean bottom sheet at the
center of the bed. Tuck in at top, miter corner and finish tucking the side
Applied rubber sheet and cotton draw sheet and tuck in well under the mattress
Helped the patient to roll over the folded linen and on to the clean linen and let lie in
supine position. Adjust the pillow under patient's head
Raised the side rail, if necessary, before leaving the side of the bed
Moved to the other side of the bed and lower the side rail
Assisted the patient to Sim's lateral position away from the worker
Loosened the side foundation linens from the bed
Unfolded each piece of clean linen towards you and proceed to the basic bed making
until bottom sheet, rubber sheet and draw sheet are well tucked under the mattress
Repositioned pillow at the center of the bed and assist patient to the center of the bed in
a position preferred or requires
Returned to first side and lower side rail
Placed top sheet over the patient so that centerfold is in the center of the bed and the top
edge is at the client shoulder
Asked the patient to hold the top edge of the sheet as you pull the bath blanket from top
to bottom
Folded the bath blanket if to be reused
Added the blanket and the bed spread and proceed by tucking the top sheet, blanket and
bed spread at the foot part and make a modified miter at both corners
Instead of a toe pleat, you may have the patient point his or her toes up, which allows
room for the toes after the bed has been made
Change pillowcase and slip under the patient's head
Tidy the bed and make the patient comfortable
Do after care of the unit and equipment used
Washed hands
Chart the following:
Date and time bed bath and hair shampoo was given
Assessment findings of the patient’s skin, hair and scalp
Name of Soap, lotion/oil, shampoo/conditioner used

Comments and Suggestions:

Rating: ____________________

____________________________________ ____________________________________
Name and Signature of Student Clinical Instructor