UNIT IV PERSONAL HYGIENE BED BATH Definition: Is an art of cleaning entire body of the dependent patient (s) in hospitalized bed. Purposes: 1 ween wus 10, To provide feelings of wellbeing and refreshing. To improve self-esteem, respect and morale To promote relaxation and comfort. To prevent or eliminate bad odor. To remove transient microbes, secretions and excretions, dirt and debris interfering with the normal flora on the body (skin) To ensure total cleanliness of the client's body Toreduce high temperature and keep the body temperature at optimal state To stimulate blood circulation and muscular tone of the body To assess and observe the skin conditions, muscular tone, joint movement and extremities of the body. To induce sleep/rest and conserve patient energy, Requirement: Trolley procedure 1 Top Shelf’ 2 basins/buckets — | for mixing water and other for the provided water to use in mixing, changing and/or rinsing 2. 2jugs forhotand cold water. 3. Cleangloves 4. 2-4 wash clothes /sponge cloth for either discharges/menstrual and perineal cleaning respectively while the one for the body could be rinse and re-use in the course of activity. i.e. one to clean and the 2nd to rinse before sanitary material is applied. 6. Soapina 7. Antiseptic solution ifrequired 7. Bath thermometer | 8. Facetowel 9. Apack of sanitary care material if required Bottom shelf Bed pan/ urinal 21——— ——————— 1 torcovering mackintosh Sy Bath Manket2) } Rereovering pationt body ifrequired i.e. in cold re; s Yoarh towel ie, Lon the bath blanket for} protectior dating Patient clothing (gown orpyjamas) gion/season mn and the other to cover client body at 4 S —_ Badlinen(! set) itrequired & Bucket forused water, & _ Diryylinendin, > Waterproofapron for the nurse(s) PROCEDURE: Nurse Action Rationale [Grass check the patient case note to identify his/her | condition, contraindication, and hypersensitivity, Please, never tr to confirm any doctor's order, except is ‘contraindicated. Rather inform other health team abou ¢ in, is you that will identify needs of patient not doctor stating it for you. For special consideration, ‘To ascertain if patient conditions require or negate bathing at that period 7 Seek consent, informed and explain the purpose and activities of the procedure to client. To respect human, ensure ethos of care and establish interpersonal relationship. 3. Assemble all items/equipment to use and wheel down to patient bedside. To ensure organizing and facilitate efficiency of work, 4. Close the curtain or the door. To provide privacy, respect human and provide warmth, 6. Put the sereen or curtain, To protect the client's privacy. 7-lnform the elient that you need to prepare the bed, i.e lay the bath mackintosh and towel on the foundation bedding or mattress and ask the client to assume a comfortable position for the bath if aided but preferably supine positioning but if not assisted. To promote and complement hygiene and induce sleep. 8. Wash hands & put on clean gloves. “To protect oneself and_avoid risk of ansmitting and introducing probable microbes. 9, Arrange Ttems/equipment to use within reach and open up the covers of trays, dish ete. if covered. ‘Ask the choice of water to use if he/she could response but if not inform the kind of wate r you will use and bearing in mind the condition/ weather. For easy reach TO, Pour the hot and ordinary water into a basin and mix, add cold water if necessary or other way round Ti, Check the temperature of the water mixed in the i ‘basin and ensure it is suitable to use and add few drops 2of antiseptic solution into water i necessary ‘Inform the clientpatient to fee it. ie. state of the water 100, 12. Ask the cient to move toward the side IFheThe could tur if nt assist when necessary Keep the li ent near you to limit reaching across the bed. 13. Remove patient clothing and cover with a baih towel, Expose only the part to wash and rinse politely and continuing systematically, Ensures privacy & prevent chills for the patient. 4, Face, neck, ears: 4) Pall the protective clothing (bath mackintosh and {owel) to cover the bed head, Place the face towel under the chin and around the neck, 2) Make a mitt with plain water, 2) Nash the client’ eyes. Cleanse from inner to outer Gomer. Use a different section ofthe mit to wash each eye, 4) Wash the client's face, neck, and ears, Use soap on these areas only ifthe cen prefers Rinse and dry carefully, the sponge towel and moisten with To protect bedding linens form getting wet, moist, damp and soiled To promote cleaning ofthe face and removing of debris if any, ‘Mashing from inner to outer comer prevents Sweeping debris imo the client's eyes, Using a {R2EE'E Portion ofthe mit foreach eye prevents the spread of infection, 1S. Upper extremities: 1) Ensure the bath mack ‘cover the bed, ‘intosh and towel underneath 2) Politely expose the clint distal arm 2) Wash the arm by using soap and rinse, thoroughly ‘lean the folds a the armpit and others 4) ash he far arm with soap an rns, Use long peas Rts'9 bow, how to should as ag Preferably 5) Dry the part using fa Provided, and cover wi O)Move the mackintosh and big ove! o under the near 4m and uncover i 1€ towel or small towel ith the long large towel 7) Repeat the same forthe proximal hand Soap is particularly drying tothe face, | To protect beddings ‘ashing the far side first prevents dripping bath Water onto a clean area ‘To promote blood circulation and warmth 6. Chest and abdomen 1) Ensure the protective 2) Politely and duly expose the wank 3) Fold the sponge towel and moisten 4) Wash and rinse th Using the small wel or ‘coverings are in place Ne upper part of trunk, and dry by flannels 5 Do the same for the tow. ‘ part of the trunk To protect beddings and give warmth : Bath towel provides warmth and priva[towel from the abdomen. 7) Change the mixed water by pouring away the used ‘water into the waste and re-mix another to continue with 'To provide a fresh, clean water and refreshment 17. Lower extremities: 1) Ensure the bath mackintosh and towel protect the bedding well, then put pillow under the leg ie. bend knee 2) Fold the sponge cloth and moisten 3) Wash with soap, rinse and dry. From the hi > joint/groin to the knee, knee to the ankle then wash the fect in a bowl of water 4) Repeat the same procedure as on the near side, '5) Cover the lower extremities with top sheet 6) Remove the cushion, mackintosh and big towel. 7) Inform the client to turn to other side if aided but if not assist in turing patientclient with your assistance, ‘To support and comfort leg for nurse's action “To provide access to other part ofthe body 0 clean, ‘To prevent risk of pressure ulcer, and stimulate and circulate systemic blood. TS, Back and buttocks: 1) Move the mackintosh and big towel under the trunk. 2) Cover the back with big towel 3) Fold the towel and moisten, Uncover the back 4) Wash with soap and rinse, Dry with big towel 5) Back rub if needed 16) Remove the mackintosh and big towel Skin breakdown usually occurs over bony prominences. Carefully observe the sacral area and back for any indications. 79. Politely and genily assist in tuming the client to supine posi "To provide comfortable — positioning to access perineal part to clean 20, Ask patient to wash and rinse his/her hands in a bow! 21. Encourage the client to clean the perineal area if sided with mitt but if not assist to do so, meanwhile make use of the new sponge cloth and anot her one (0 tinse it before applying sanitary care if required. 5 Inform patient to assume a convenience and Comfortable positioning if he/she could but i not assist to a comfort positioning. "To engage and involve in hisher eare and giving sense, ‘To stimulate and promote self esteem of responsibility To promote rest and sleep, ensure wellbeing a satisfactory ig body eream or body Totion 7. Apply @ moisturizin ed cline or cream and powder to the provided, antiseptic vas face and other necessary arca. Ta Return the client to the supine position 35 Humorously seek permission to groom her/his baie by applying hair eream and comb. 26, Give mirror to client i he/she is responsive to have & Took and comment or observe: "To promote skin wellbeing and freshness To make sustainable postion for perineal care "To promote good wellbeing appearance and healthy look “To promote self esteem and involvement in eare j | } } |27:After bed bath: 1) Tidy up the bed, keep client’s in a comfortable positioning. 2)IFIV line isin place, reconnect it, check the iv line for thrombi and emboli. If not maintains atthe required rate. To ensure proper environmental care and sanitation. To promote continuity of management and enhance health care delivery. 28. Pack the items/equip ment used, tidy up the client environment, wheel down to sluice room discard and clean items/equipment appropriately or send to advance care (CSSD). Wash hand thoroughly after procedure and dispose waste appropriately. Go back to check on the client and ensure is fine and everything is going on well with hinvher. And ask for any question, complaints etc. To promote hygiene and provide items for ‘subsequent use To ensure and maintain hygiene practices 29. Document details of the procedure such as the t ime, kind of water used, and solution added etc., participation of client ete. into all the necessary records and report To promote accountability and continuity of care, ensure ethos of medical practices note, 30 Return the clean items/equipment back to shelf, drawer or cupboard i.e. original place NOTE: Mitt means folding of wash cloth / sponge cloth around hand.