Equipment
■ Water basin.
■ Bath blanket.
■ 2 bath towels.
■ Washcloths.
■ Soap or liquid rinse-free soap.
■ Orangewood stick.
■ Deodorant, lotion, and/or powder as needed.
■ Clean gown (with shoulder snaps if the patient has an IV line) and bed linen.
■ Procedure gloves.
■ Bedpan or urinal.
■ Laundry bag.
■ Be Smart!You may need special soaps and lotions for older adults or patients with skin conditions, or skin breakdown; and additional washcloths and towels for patients with incontinence or drainage.
Assessment
■ Assess:
■ Mobility.
■ Activity tolerance.
■ Type of bath needed.
■ Ability to perform bathing self-care.
■ Personal and cultural issues regarding the bath.
■ Specific patient needs and preferences (e.g., special soaps
or lotions).
■ Check for positioning or activity restrictions.
■ Determine how many people you need to safely bathe and reposition
the patient.
■ Be Smart! Save time. While bathing the patient, assess level of consciousness, short- and long-term memory, ability to follow instructions, ROM, skin condition, activity tolerance, and self-care ability.
Key Points
■ Provide privacy, and offer patient a bedpan before beginning.
■ Use warm, not hot, water (105 F, or 41 C).
■ Protect bed linen with towels unless you will be changing them.
■ Wear procedure gloves if exposure to body fluids (e.g., draining wounds) is likely or if you have breaks in your skin.
■ Prevent chilling or tiring the patient (e.g., cover with bath blanket, expose only the body part you are washing).
■ Be Safe! Lower the siderail on the side where you are working; raise it when moving to the other side of the bed.
■ Be Safe! Do not disconnect an IV to remove the patient’s gown. Remove the gown first from the arm without the IV.
■ Follow the principles, “head to toe” and “clean to dirty” (bathe face, neck, arms and chest, abdomen, legs, feet, back, buttocks, perineum).
■ Change the water and don procedure gloves before cleansing the perineum; change the water whenever it becomes dirty or cool.
■ For extremities, wash and dry from distal to proximal.
■ Pat the skin dry; do not rub.
■ Perform hand hygiene when moving from a contaminated body part to bathe a clean body part.
Documentation
■ You will usually document hygiene care on checklists and flowsheets.
■ For nursing notes, chart:
■ The type of bath given.
■ Extent to which patient was able to help.
■ Tolerance of the procedure.
■ Mobility.
■ Any abnormal findings.
 |
| Wipe outward from the inner canthus |
 |
| Wash rectal area from front to back |
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