PROCEDURE FOR BED BATH

Definition
 Bed bath – is provided to dependent clients confined to bed. The nurse washes
the client’s entire body during a bed bath.
Objectives
1. To remove transient microorganism, body secretion and excretions, and
dead skin cells
2. To stimulate circulation to the skin
3. To produce a sense of well being
4. To promote relaxation and comfort
5. To prevent or eliminate unpleasant body odors.
Equipment
a. Basin and water
b. Soap and dish
c. Laundry hamper and bag
d. Bath blanket, towels and washcloths as needed
e. clean gown or pajamas
f. Necessary toiletries, such as toothbrush deodorant, comb, shaving
equipment
g. Clean gloves for pperineal care
h. Clean linen if you plan to make the bed.

ACTION RATIONALE
ASSESSMENT
1. Review the patient’s record and plan To determine the amount of assistance
of care regarding the patient’s ability the patient may need with hygiene
to participate; include medical
diagnoses activity or orders specific
to hygiene and type of bath.
 2. Assess the patient to determine if
there are concerns of higher priority
than hygiene. These might be related
to other basic needs, such as
toileting, fatigue, pain and level; of
sedation. Assess skin care and other
hygienic practices and any specific
concern that might affect hygiene
needs such as the presence of a
catheter, excessive perspiration from
fever or dry skin.
3. Check to see whether special
supplies or equipment are in the
patient’s room.
ANALYSIS
4. Critically think through your data,
carefully evaluating each aspect and
its relation to other data.
5. Identify specific problems and
modification of the procedure needed
for this individual.
PLANNING
6. Determine the following individualized
patient outcomes in relation to
hygiene.
7. Plan the bathing procedure, and
determine the supplies that will be
needed for bed bath.
IMPLEMENTATION
8. Wash or disinfect your hands
9. Identify the patients using two
identifiers
10. Explain the procedure you are about
to perform
Hygiene may be a lower priority than the
rest for the patient who is short of breath
or experiencing pain. Higher priority
problems need to be addressed before
hygiene is planned to meet identified
needs.
Having equipment and supplies available
and ready saves time. It is not cost
effective to obtain unneeded supply.
This enables you to determine specific
problems for this indiviual in relation to
hygiene practices.
Planning for the individual must take into
consideration the individual’s problem.
Identifying outcomes facilitates
evaluation.
a. Skin and nails clean
b. Absence of offensive odor
c. Skin and mucus membranes intact
d. Patient expresses comfort
Hand washing decreases the transfer of
microorganism that cause infection
Verifying the patient identity ensures that
you are performing the right skill for the
right patient.
Explaining the procedure helps relieve
anxiety or misperceptions that the patient
may have about a procedure or activity

11. Close the door and close the curtains
around the bed
12. Raise the bed to appropriate working
position based on your height
13. Carry out bed as follows:
a. Cover the patient with bath blanket
placed over the top linen. If the
bath blanket is not available, use
the top sheet for a cover during the
bath. Remove the top sheet and
bedspread, leaving only the bath
blanket covering the patient. Have
the patient hold the top edge of the
blanket while you pull the sheet
down toward the patient’s feet.
b. Offer to assist the patient with oral
hygiene. Some patients may prefer
oral care after the bath.
c. Fill the basin with comfortably
warm water for the bath.
d. Position the patient for the bath.
Usually the supine (face-up)
position is used unless the patient
cannot tolerate it. In some cases, it
may be necessary to use a semi-
Fowler's position. Lower the side
rail and move your patient to your
side of the bed.
e. Remove the patient’s gown. Keep
the patient covered with bath
blanket.
f. Continue with the bath procedures
as follows:
f.1. Spread a towel across the patient’s
chest on top of the bath blanket.
f.2. Make a mitt with the washcloth.
f.3. Without using soap, wipe one eye
from the inner canthus to the outer
canthus. Rinse or use another part of the
wash cloth to wash the other eye.
and sets the stage for patient
participation.
To provide privacy.
Allows to use correct body mechanics
and protect yourself from back injury.
The flannel blanket helps to prevent
chilling and does not adhere to the patient
should it become wet during the bath.
Maintains teeth and gums in good
condition and eliminates unpleasant
tastes and odors in the mouth.
Warm water is comfortable and relaxing
to the patients and provides for more
effective cleansing.
The position used must first
accommodate the comfort and well-being
of the patient and second, make it easy to
carry out the bath. The fowler’s position
facilitates respiratory function. The supine
position facilitates access to most of the
body for bathing. Lowering the side rail
helps to decrease the need for the nurse
to reach across the bed.
To facilitate access to the areas to be
bathed and respect the privacy and
comfort of the patient.
This keeps the bath blanket dry and
prevents chilling.
Using a mitt prevent loose, cool ends of
the cloth from dragging across that
patient and causing discomfort.
Rinsing or changing portions of the
washcloth prevents spreading organisms
from one eye to the other. The movement
of cleansing from the inner canthus to the
 outer canthus prevents secretion from
entering the nasolacrimal duct.
f.4. Wash the patient’s face. Ask the Soap can be drying to the skin.
patient about using the soap on the face.
Many people do not. Use gentle strokes
to wash the face. Use soap to wash
behind the ears and the neck. Rinse well.
Note: Many patients can do this portion of
the bath themselves.
f.5. Expose the far arm of the patient, and Washing the farmer arm prevents
place a towel lengthwise under the arm. contaminating a clean part by the leaning
Using long, firm strokes towards the over it once it is washed. Long strokes
center of the body, wash the hand, arm toward the center of the body promote
and axilla while providing support to the venous return. Covering the arm before
patient’s wrist and elbow. Cover the arm rinsing prevents chilling when water
with half of the towel while rinsing out the evaporates from the skin.
wash cloth. Rinse and dry the arm
thoroughly.
f.6. Optional: Place a folded towel on the Soaking can loosen dirt under the nails.
bed next to the patient’s hand, place the
basin on the towel and soak the hand.
Wash the hand, rinse and dry.
f.7. Place the towel under the near arm, Bathing the closer arm last prevent
and wash the hand, arm and axilla in the contamination from leaning over the clean
same way. Rinse and dry. arm to bathe the opposite arm.
f.8. Place a towel over the patient’s chest. Exposing the one area at a time for
Fold the bath blanket down to the waist. cleansing prevents chilling of the patient
Wash, rinse and dry the patient’s chest, and promotes privacy. Areas under the
keeping the patient covered with the breasts may be prone to skin breakdown
towel between washing and rinsing. Pay if not cleansed and dried thoroughly.
particular attention areas under the
female breasts.
f.9. Fold the blanket down to the pubic Keeping the towel in place prevents
bone, leaving the towel over the chest. chilling and respects privacy.
Wash, rinse and dry the lower abdomen,
paring particular attention to the
umbilicus.
f.10. Remove the bath blanket from the Washing from the distal to proximal areas
far leg only. Place the towel lengthwise promotes venous blood return and
under the leg. Bending the leg at the knee stimulates circulation.
and supporting the knee joint, wash the
leg using long, firm strokes towards the
center of the body. Rinse and dry the leg.
f.11. Place a towel near the patient’s foot Placing the patient’s foot in the basin is
and place the basin on it. Put the patient’s relaxing, and it promotes a more-
foot in the basin, and support the ankle thorough cleaning of the foot and the
and heel in your hand while supporting
the leg on your arm. Wash, rinse, and dry
the foot, paying attention to the toes and
between the toes.
Be sure to dry the toes thoroughly.
f.12. Wash the near leg and foot in the
same way.
f.13. Change the bathwater at this point
or sooner if needed. Make sure the bed’s
side rails are up while you change the
bathwater.
f.14. Assist the patient to a side lying
position, facing away from you. Some
patients will turn to a prone position, but
for many patients, this position is not
comfortable or maybe difficult to obtain.
Place the towel lengthwise along the back
and buttocks, keeping the patient covered
with bath blanket exposing the back.
f.15. Put on clean gloves, and wash the
buttocks and perianal area. Pay attention
to the sacral area by checking for redness
and the gluteal folds. Remove gloves and
discard.
f.16. give a back rub at this point, or wait
until after all care is completed
f.17. Change the bath water
f.18. Assist the patients to supine position
to wash the perineal area. If patient
cannot wash their ow genitalia, you must
do so for them. Put clean gloves. Wash
moving gently from front to back (clean to
dry) Making certain to wash and dry
carefully. Discard water and gloves.In
many cases, the patient can wash the
perineal area. I f so make sure is
everything within reach of the patient.
Provide privacy but stay within the
hearing distance, or instruct the patient to
call light.
f.19. Assist the patient in applying
deodorant if used and apply clean
pajamas or gown
g. Comb or brush arrange the
patients hair.
areas between the toes. Cleaning and
drying between the toes prevents skin
irritation and injury.
Washing the closer leg last prevents
contamination.
Changing the bath water keeps it warm
and clean. Side rails promote safety
Draping prevents unnecessary exposure
of the patient, and the towel protects the
bedding from dripping water. Long firm
strokes promote circulation.
Gloves protect you from potential contact
with fecal material and microorganisms.
Any fecal material near the anus is
irritating to the skin and source of
microorganism
Back rubs improve circulation to the area
and are relaxing
To prevent the spread of fecal organism
elsewhere in the body
Gloves protect you from potential contact
with microorganisms. Perineal care
decreases odor and contamination from
the rectal area.
Deodorant decreases body odor, and
clean pajamas or gown promotes warmth
and general comfort for the patient.
This enhances the self-image
h. Attend to any other personal
hygiene needs. Assist the male
patient with shaving at this point.
You may have his assemble his
shaving equipment, which will
vary, depending on the type of
razor he prefers. If he unable to
shave himself, this task is also
your responsibility. Some facilities
have an electric razor you can use
and infection control procedures
related to using razor.