BATHING

Assisting patients with personal hygiene is a fundamental part of nursing care and provides an
opportunity for nurses to carry out a holistic assessment of their patient. Some patients cannot safely
leave their beds to bathe. For these people, daily bed baths can help keep their skin healthy, control
odor, and increase comfort. If moving the patient causes pain, plan to give the patient a bed bath after
the person has received pain medicine and it has taken affect. If a bed bath is required, it is important to
offer patients the opportunity to participate in their own care, which helps to maintain their
independence, self-esteem and dignity but bed bath is not as effective as showering. Bathing cleans the
skin and helps keep the skin free of infection. It helps to relax the person being bathed and help him feel
better. Moreover, it also allows time to address any concerns patients have and provides a valuable
opportunity to assess the condition of their skin. It provides the nurse with an opportunity to assess the
patient's activities of living. Valuable insight can be gained regarding the independence or dependence
of the patient, including mobility, hygiene, dressing and continence needs.

For the patients especially senior patients or patients with dementia, it is important to be sensitive,
tactful, and respect their dignity. Establish respect right away by using formal language and use a calm,
soothing normal voice tone voice and if they refuses drop the subject and move on to something
pleasant. This avoids a fight that will create negative feelings that often linger. Wait and try again in a
little while. And if they still refuse Document the refusal yourself, pass it on in report to the next CNA
and report it to the nurse working with you.

For the procedure, Assess: • Condition of the skin • Fatigue • Presence of pain and need for adjunctive
measures before the bath • Range of motion of the joints • Any other aspect of health that may affect
the client’s bathing process.

Assemble equipment and supplies: this includes • Basin or sink with warm water • Soap and soap dish •
Linens: bath blanket, two bath towels, wash cloth, clean gown, or pajamas or clothes as needed,
additional bed linen and towels, if required • Gloves, if appropriate • Personal hygiene articles • Shaving
equipment for male clients • Table for bathing equipment • Laundry hamper

Determine: • The purpose and type of bath the client needs • Self-care ability of the client • Any
movement or positioning precautions specific to the client • Client’s comfort level with being bathed by
someone else

Procedure Explain to the client what you are going to do, why it is necessary, and how he/she can
cooperate. Wash hands and observe other appropriate infection control procedures. Provide for client
privacy. Prepare the client and the environment. Invite a family member or significant other to
participate, if desired. Close windows and doors to ensure the room is in a comfortable temperature.
Offer the client a bedpan or urinal, or ask whether the client wishes to use the toilet or commode.
Encourage the client to perform as much personal self-care as possible. During the bath, assess each
area of the skin carefully

For a bed bath, Prepare the bed and position the client appropriately. Position the bed at a comfortable
working height. Lower side rail on the side close to you. Keep the other side rail up. Assist the client to
move near you. Place a bath blanket over the top sheet. Remove the top sheet from under the bath
blanket by starting at the client’s shoulders and moving linen down towards client’s feet. Ask the client
to grasp and hold the top of the bath blanket while pulling linen to the foot of the bed. Note: If the bed
linen is to be reused, place it over the bedside chair. If it is to be changed, place it in the linen hamper.
Make a bath mitt with the washcloth.

To wash the face, Place towel under the client’s head. Wash the client’s eyes with water only, and dry
them well. Use separate corner of the washcloth for each eye. Wipe from inner to the outer canthus.
Ask whether the client wants soap to be used on her/his face. Wash, rinse and dry the client’s face, ears
and neck. Remove the towel from under the client’s head.

To wash the arms and hands, Place a towel lengthwise under the arm away from you. Wash, rinse and
dry the arm by elevating the client’s arm and supporting the client’s wrist and elbow. Apply deodorant
or powder if desired. Optional: Place a towel on the bed and put wash basin on it. Place the client’s
hands in the basin. Assist the client as needed to wash, rinse and dry her/his hands, paying particular
attention to the space between her fingers. Repeat for arm and hand nearest you.

To wash the chest and abdomen, Place bath towel lengthwise over chest. Fold bath blanket down the
client’s pubic area. Lift the bath towel off her chest, and bathe her/his chest and abdomen with your
mitted hand, using long, firm strokes. Rinse and dry well. Replace the bath blanket when the areas have
been dried.

To wash the legs and feet, Expose the leg farthest from you by folding the bath blanket towards the
other leg, being careful to keep the perineum covered. Lift leg and place the bath towel lengthwise
under the leg. Wash, rinse and dry the leg, using long, smooth and firm strokes from the ankle to the
knee to the thigh. Reverse the coverings and repeat for the other leg. Wash the feet by placing them in
the basin of water. Dry each foot. Obtain fresh, warm bathwater now or when necessary.

To wash the back and the perineum, Assist the client into a prone or side-lying position facing away from
you. Place the bath towel lengthwise alongside the back and buttocks while keeping the client covered
with the bath blanket as much as possible. Wash and dry the client’s back, moving from the shoulders to
the buttocks, and upper thighs, paying attention to the gluteal folds. Perform a back massage now or
after completion of the bath

Assist the client to the supine position and determine whether the client can wash the perineal area
independently. If she/he cannot do so, drape the client and wash the area. Assist the client with
grooming aids such as powder, lotion or deodorant. Use powder sparingly. Release as little as possible
into the atmosphere. Help the client put on a clean gown or pajamas. Assist the client to care for hair,
mouth and nails.