Bath (Bathing and Skin Care)

It is a bath or wash given to a patient in the bed who is unable to care for himself/herself.

1. Cleansing bath: Is given chiefly for cleansing or hygiene purposes and includes:
• Complete bed bath: the nurse washes the entire body of a dependent patient in bed
• Self-help bed bath: clients confined to bed are able to bath themselves with help from the nurse for washing the back and perhaps the face
• 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, axilla, perineum
and back (the nurse can assist by washing the back) omitted are the arms, chest, and abdomen.
• Tub bath: preferred to bed baths because it is easier to wash and rinse in a tub. Also used for therapeutic baths
• Shower: many ambulatory clients are able to use shower
• The water should feel comfortably warm for the client
• People vary in their sensitivity to heat generally it should be 43-46 oc (110-115of)
• The water for a bed bath should be changed at least once

Before bathing a patient, determine
a. The type of bath the client needs
b. What assistance the client needs
c. Other care the client is receiving – to prevent undue fatigue
d. The bed linen required

Note: when bathing a client with infection, the caregiver should wear gloves in the presence of body fluids or open lesion.

Principles
• Close doors and windows: air current increases loss of heat from the body by convection
• Provide privacy – hygiene is a personal matter & the patient will be more comfortable
• The client will be more comfortable after voiding and voiding before cleansing the perineum is advisable
• Place the bed in the high position: avoids undue strain on the nurses back
• Assist the client to move near you – facilitates access which avoids undue reaching and straining
• Make a bath mitt with the washcloth. It retains water and heat better than a cloth loosely held
• Clean the eye from the inner canthus to the outer using separate corners of the wash cloth – prevents transmitting micro organisms, prevents secretions from entering the nasolacrmal duct
• Firm strokes from distal to proximal parts of the extremities increases venous blood return

Purpose:
◘ To remove transient moist, body secretions and excretions, and dead skin cell
◘ To stimulate circulation
◘ To produce a sense of well being
◘ To promote relaxation, comfort and cleanliness
◘ To prevent or eliminate unpleasant body odors
◘ To give an opportunity for the nurse to assess ill clients
◘ To prevent pressure sores Two categories of baths given to clients
◘ Cleansing
◘ Therapeutic