CLEANSING BED BATH

DEFINITION: Bathing client while on bed.

GENERAL OBJECTIVES:
1. To stimulate circulation in order to: c. To relieve muscular fatigue.
a. Increase functioning of the skin. 2. To clean skin and refresh the patient.
b. Promote muscular relaxation. 3. To observe unusual signs and symptoms.
EQUIPMENTS AND SUPPLIES:
 Two bath towels  Pitchers with warm water
 Two washcloths  Bed pan or urinal and toilet paper
 2 washbasin (for complete or partial bed bath)  Linen hamper or laundry bag
 Soap and soap dish  Disposable gloves
 Bath blanket or top spread  Bed linen (optional)
 Clean gown or pajamas  Table protector
 Hygenic acids, such as skin lotion, deodorant or powder  Comb

STEPS RATIONALE

1. Assemble all equipments at bed side.

2. Assess the client’s preferences for bathng practices, frequency of Promotes participation and sense of comfort.
bathing, preferred time and day, type of hygenic products used.

3. Consider client’s condition and review order of precautions Prevents accidental injury to client during bathing
concerning client’s movement on positioning. activities.

4. Explain procedure to client. If partial bath is to be performed, ask Promotes client cooperation and participation.
how much bath client wishes to complete.

5. Adjust room temperature and ventilation, and close room doors Prevents rapid loss of heat during bathing. Ensure
and windows. Close curtains around bed. privacy.

6. Offer client bedpan or urinal. Provide towel and wash cloth for Client will feel more comfortable after voiding, prevents
client. interruption of bath.

7. Wash hands. (Optional) Apply gloves according to institutional Reduces transmission of microorganisms.
policy.

8. Pull side rails up. Fill wash basin two thirds full, with water 43-46 Raising side ails maintain safety as you leave the
C (110-115 F) Dip client’s fingers in water to test temperature bedside. Warm water promotes and revents chilling.
tolerance. Testing temperature prevents accidental burning of
client’s skin.

9. Bring client toward side closer to you. This facilitates access without undue reaching and
straining.

10. Remove pillow if allowed and raise head of bed 3-45 degrees. Removal of pillow make it easier to wash client’s ears
Place bath towel under client’s head. and necks. Placement of towel prevents soiling of bed
linen.

11. Loosen top covers at foot of bed. Place bath blanket over top Removal of top linens prevents them from becoming
sheet. Fold and remove top sheet from under blanket. If possible, soiled or moist during bath. Blanket provides warmth
have client hold bath blanket while you withdraw the sheet. and privacy.

12. If top sheet is to be reused, fold it and place on the back of the Proper disposal prevents transmission of
chair. If not, dispose in laundry bag; don’t allow linen to come in microorganism.
contact with your uniform.

13. Remove client’s gown or pajamas while maintaining privacy. If Provides full exposure of body parts during bathing.
extremity is injured or has reduced mobility, removal starts from Undressing unaffected side first allow easier
unaffected side. If client has intravenous (IV) tube, remove gown manipulation of gown over body part with reduced
from arm without IV first. ROM.

14. Place the bath towel over client’s chest under the chin. Prevents soiling of bath blanket.

15. Immerse washcloth in water and wring thoroughly. Fold Mitt retains water and heat better than loosely held
washcloth around fingers of your hand to mitt. washcloth, keeps cold edges from brushing against
client, and prevents splashing.

16. Wash the client’s eyes with plain warm water. Use different Soap irritates eyes. Use of different section of mitts
section of mitt for each eye. Move mitt from inner to outer canthus. reduces infection transmission. Bathing eye from inner
Soak encrustation on eyelids for 2-3 minutes with damp cloth to outer canthus prevents secretion from entering
before attempting removal. Fry thoroughly but gently nasolacrimal duct. Pressure can cause internal injury.

17. Ask client about reference for using soap on face. Wash rinse Soap tends to dry face more quickly because it is
forehead, cheeks, nose, neck and ears. Dry well. exposed to air more than any other body parts.

18. Remove bath blanket over client’s arm that is farthest from you. Bathing far side first prevents reaching over clean area.
Place bath towel lengthwise under arm.

19. Lower side rails if moved to opposite side. Bath arm with soap Soap lowers surface tension and facilitates removal
and water using long, firm strokes from distal to proximal (finger to debris and bacteria when friction is applied during
axilla). raise and support arm above (if possible) while thoroughly washing. Long firm strokes stimulate circulation.
washing axilla. Movement of arm exposes axilla and exercise joint
normal ROM distal to proximal to increase venous
return to the heart.

20. Rinse and dry arm and axilla thoroughly. If client prefers, Excess moisture causes skin maceration or softening.
deodorant or talcum powder. Deodorant controls body odor.

21. Fold bath towel in half and lay it on bed beside client. Place Soaking soften cuticles and calluses of hand and loosens
basin on towel. Immerse client’s hand in water. Option: allow hand debris beneath nails. Soaking also enhances feeling of
to soak for 3-5 minutes before washing hand and fingernails. cleanliness. Thorough drying removes moisture from
Remove basin and dry hand well. between fingers.

22. Repeat 18-21 for the other arm.

23. Check temperature of bath water change if necessary. Use of warm water maintains client’s comfort.

24. Cover client’s chest with bath towel and fold blanket down to Prevents unnecessary exposure of body parts.
umbilicus.

25. With one hand, lift edge of towel away from the chest. With Maintains warmth and privacy. Secretions and dirt
mitted hand, bathe chest using long firm strokes. Take special care collect easily in areas of tight skinfolds.
to wash skinfolds under female client’s breast, lifting breasts if
necessary. Keep chest, covered between wash and rinse periods.
Dry well.

26. Place bath towel lengthwise over chest and abdomen. (tow Prevent chilling and exposure of body parts.
towels may be needed) Fold blanket down to just above pubic
region.

27. With one hand, lift bath towel. With mitted hand, bathe Moisture and sediments that collect in skinfolds
abdomen, giving special attention to umbilicus and abdominal folds. predispose client to skin maceration and irritation.
Stroke from side to side. Keep abdomen covered between washing
and rinsing. Dry well.

28. Cover chest and abdomen with top bath blanket. Prevents unnecessary exposure.

29. Expose far leg by folding blanket over toward midline. Be sure
perineum is draped.

30. Bend knee by positioning your arm under leg. While grasping Prevents soiling of bed linen. Support of joint and
client heel, elevate leg from mattress slightly and side bath towel extremity during lifting prevents strain on
lengthwise under leg. musculoskeletal structures.

31. Ask client to hold still. Place bath basin on towel on bed and Sudden movement by client could cause spillage of
secure its position next to foot to be washed. bathwater. (this step is omitted if client is unable to hold
leg in basin).
32. Unless contraindicated, use long, firm, strokes in washing from Promotes venous return. Long, firm strokes should not
ankle to knee, knee to thigh. Dry well. be used for clients with blood clots.

33. Do the same with leg near you.

34. With one hand supporting lower leg, raise it and slide basin Proper positioning of foot prevents pressure from the
under lifted foot. Immerse one foot at a time. Make sure foot is edge of basin against the calf. (Note: if client is unable
firmly places on bottom basin. to hold leg in basin, do not immerse; simply wash with
washcloth).

35. Soap foot, making sure to clean between toes. Rinse and dry Secretions and moisture may be present between toes.
well. If skin is dry, apply lotion according to patient’s choice. Lotion helps to retain moisture.

36. Cover the client bath blanket, raise side rail for client’s safety, Drop in water temperature during bathing can cause
and change bathwater. chilling. Clean water reduces microorganism
transmission.

37. Lower side rail. Assist client in prone or side-lying position (as Exposes back and buttocks for bathing.
applicable). Place towel lengthwise along client’s side.

38. Slide bath blanket over shoulders and thighs. Maintain warmth and unnecessary exposure.

39. Apply disposable gloves (if not done yet) Prevents contact with microorganisms in body
secretions.

40. Wash, rinse, and dry back from neck to buttocks using long, firm Skinfolds near buttocks and anus may contain fecal
strokes. Pay special attention to folds of buttocks and anus. Give secretions that harbor microorganisms.
back rub.

41. Change bath water and washcloth. Prevents transfer of microorganisms from anal area to
genitalia.

42. Assist client in side lying or supine position. Cover sheet and Maintains client’s privacy, clients capable of performing
upper extremities with towel and lower extremities with bath partial bath usually prefer to wash their own genitalia.
blanket. Expose only genitalia. Wash, rinse, and dry perineum. Give Skinfolds are site for accumulation of secretions and
special attention to skinfolds. If client is able to do perineal care, moisture.
leave wash cloth, basin and soap with in easy reach and leave area.

43. Dispose gloves in receptacle. Prevents transmission of microorganisms.

44. Apply additional body lotion or oil as desired. Moisturizing lotion prevents dry and chapped skin.

45. Help the client to put on a clean gown. If one extremity is Dressing affected side first, allows easier manipulations
injured or immobilized always dress affected side first. of gown over body part with reduce ROM.

46. Comb client’s hair. Women may want to apply make-up. Maintain client’s body image.

NOTE: Mouth care, nail care, ear care, hair care will be
demonstrated separately.

47. Straighten client’s bed. Provide clean environment.

48. Discard soiled linen in dirty linen bag. Replace call light and Prevents transmission of infection. Clean environment
personal possessions. Leave room as clean and comfortable as promotes comfort. Keeping call light and articles of care
possible. within reach promotes safety.

49. Note skin areas that were previously soiled reddened or showed Techniques used during bathing should leave skin clean
early signs of breakdown. and clear.

50. Record type of bath and client’s tolerance to bathing. Note Timely documentation maintains accuracy of client’s
significant findings, joint or muscle pain. Record level of assistance record. Record condition of akin and document
required by client. response to therapy such as turning and positioning.