• Hour of Sleep or PM Care is provided to
clients before they retire for the night. It
Overview
Hygiene is a self-care by which people attend to
such functions as bathing, toileting, general body hygiene,
and grooming. Hygiene is highly personal matter
determined by individual values and practices. It involves
care of the skin, feet, nails, oral and nasal cavities, hair,
eyes, ears, and perineal-genital areas.
Taking a shower or bath is an important daily
routine to keep us clean and comfortable especially in a
humid environment. But for people who are bed-ridden,
they need to take their bath in bed with a help of a care
giver.
In this module, you will learn how to bathe your
patient in bed and attend to their hygiene needs. This may
seem a very simple procedure, but this can be
intimidating for first time patients, but either way, we
would like to maintain privacy and preserve dignity at all
times.
Learning Content
➢ It is important for nurses to know exactly how
much assistance client needs for hygienic care.
Clients may require help after urinating or
defecating, after vomiting, and whenever they
become soiled, or from wound drainage or from
profuse perspiration.
Hygienic
Nurses commonly use the following terms to describe
types of hygienic care:
• Early Morning Care is provided to clients as
they awaken in the morning. This care consists
of providing a urinal or bedpan to the client
confined to bed, washing the face and hands,
and giving oral care.
• Morning Care is often provided after clients
have breakfast, although it may be provided
before breakfast. It usually includes providing
for elimination needs, a bath or shower,
perineal care, back massages, and oral, nail,
and hair care. Making the client's bed is part of
morning care.
usually involves providing for elimination
needs, washing face and hands, giving oral
care, and giving a back
Bathing
• Bed Bath is the cleaning and providing hygienic
care to clients in bed.
• Bathing removes accumulated oil, perspiration,
dead skin cells, and some bacteria.
• In addition to cleaning the skin, bathing also
stimulates circulation.
• A warm or hot bath dilates superficial
arterioles, bringing more blood and
nourishment to the skin.
• Rubbing with long smooth strokes from the
distal to proximal parts of extremities
facilitates increased venous blood flow return.
• Bathing also produces a sense of well-being. It
is refreshing and relaxing and frequently
improves morale, appearance, and self-respect.
Purposes of Bath
• To remove transient microorganisms, body
secretions and excretions, and dead skin cells
• To stimulate circulation to the skin
Two categories of baths are given to clients:
1. CLEANSING BATHS are given chiefly for hygiene
purposes and include these types:
• COMPLETE BED BATH. The nurse washes the
entire body of a dependent client in bed.
• SELF-HELP BED BATH. Clients confined to bed are
able to bathe themselves with help from the
nurse for washing the back and perhaps the
feet.
• PARTIAL BATH (abbreviated bath). Only the
parts of the client's body that might cause
discomfort or odor, if neglected, are washed:
the face, hands, axillae, perineal area, and
back.
• BAG BATH. This bath is a commercially prepared
product that contains 10 to 12 presoaked
disposable washcloths that contain no rinse
 cleanser solution. The package is warmed in a temperature is generally included in
microwave. the order
• TOWEL BATH. This bath is similar to a bag bath
but uses regular towels. The client is covered Important Points to Consider
and kept warm throughout the bathing process
by a bath blanket. The nurse gradually replaces Making a Bath Mitt:
the bath blanket with a large towel that has
been soaked with warm water and no-rinse a. Triangular Method
soap. The client is then gently massaged with
the warm, wet, soapy towel. The wet towel is
replaced with a large dry towel for drying the
client's skin.
• TUB BATH. Tub baths are often preferred to bed
baths because it is easier to wash and rinse in
a tub. Tubs are also used for therapeutic baths.
The amount of assistance the nurse offers
depends on the abilities of the client.
o SPONGE BATHS are suggested for the
newborn. After the bath, the infant
should be immediately dried and
wrapped to prevent heat loss.
Parents need to be advised that the
infant's ability to regulate body
temperature has not yet fully
developed.
• SHOWER. Many ambulatory clients are able to
use shower facilities and require only minimal
assistance from the nurse. Clients in long-term
care settings are often given showers with the
aid of a shower chair. The wheels on the shower
chair allows clients to be transported from their
room to the shower. The shower chair also has
a commode seat to facilitate cleansing of the
client's perineal area during the shower
process.

2. THERAPEUTIC BATHS
• Therapeutic baths are given for
physical effects, such as to soothe
irritated skin or to treat an area (e.g.,
the perineum). Medications may be
placed in the water. A therapeutic
bath is generally taken in a tub one
third or one half full. The client
remains in the bath for a designated
time, often 20 to 30 minutes. If the
client's back, chest, and arms are to
be treated, these areas need to be
immersed in the solution. The bath
 b. Rectangular Method

Checking for Broken Skin

Check his skin especially over bony areas such as the ear,
back of the head, shoulder, elbow, hip, base of spin,
ankles and heels for redness or skin breakdown.

Cleaning the Eyes
After cleaning your loved one's face, proceed to clean the
eyes:
1. Wipe both eyes with cotton swab and discard
2. If necessary, gently retract the upper and/or
lower eyelid with the index finger to remove
dirt or discharge with a clean cotton wool. Wipe
from the inner to the outer eyelid.
Key Points
✓ DURING BATH, assess skin areas carefully for
any breakdown or Abnormality
✓ Caution is needed when bathing clients who are
receiving IV therapy
✓ The nurse should use universal precautions
when bathing a client, particularly when
performing perineal care. It is not necessary,
however, to wear gloves while providing a bath
and the nurse should use clinical judgment
when deciding to wear gloves and offer an
explanation to the client
✓ Air current facilitates heat loss by convection,
so close windows, fans, and aircon units to
prevent chills
✓ Maintain proper body mechanics when bathing
a patient
✓ Expose only the body part that is being wasjed;
avoid unnecessary exposure
✓ Ensure patient’s safety throughout the
procedure to prevent fall
✓ Long, firm strokes from distal to proximal area
facilitates increased venous return flow
✓ Wiping should always start from the cleanest
part
✓ Use separate wash cloth as you move on to a
different body area
✓ Encourage as much participation as possible on
patient’s part to promote independence