BED BATH

BED BATH

Bed bath means bathing a patient who is confined to bed and cannot have the physical and mental capability of self-bathing

Bath is the act of cleaning the body. Baths are given for therapeutic purposes

Purposes

  • To cleanse body of dirt, debris and perspiration
  • To refresh
  • To stimulate circulation
  • To provide comfort and relaxation
  • To enhance self-concept
  • To provide tactile stimulation
  • To facilitate head to be assessment
  • To regulate body temperature
  • To induce sleep
  • To prevent pressure sore
  • To remove toxic substances from body surface
  • To maintain an effective nurse-patient relationship
  • To give health instruction to patient
  • To remove unpleasant odors due to perspiration
  • To relieve fatigue
  • To prevent contractures by giving exercises
  • To minimize the skin irritation

Types of Patients Needing Bed Bath

  • Unconscious or semiconscious patients
  • Postoperative patients
  • Patients with strict bed rest
  • Paraplegic patients
  • Orthopedic patients in plaster – cast and traction
  • Seriously ill patients

Types of Cleansing Bath

Bed bath: it is the bathing of a patient who is confined to bed

Therapeutic bath: doctor specifies the temperature of the water, medications to be added and the body part to be treated

Partial bath: it is the act of cleaning particular areas in the body part. They are face, axilla, and genitalia, upper and lower-limbs

Self-administered bath: this is same as in bed bath except the patient is assisting in taking bath

Tub bath or bath room bath: this bath is allowed to the patient only if he has enough confidence for self-help and to withstand procedure

Scientific Principles

  • Heat is conveyed to the body by convection
  • The tolerance of heat is different in different persons
  • The skin is sometimes irritated by the chemical composition of certain soaps
  • Moving the joints through their full range of movement helps prevent loss of muscle tone and improves circulation
  • Long smooth strokes on the arms and legs that are directed from the distal end to proximal increases the rate of venous flow
  • Healthy unbroken skin is a defense against harmful agents and assures resistance to injuries to a certain extent
  • Hygiene practices vary in society according to the socioeconomic standard and culture of the individual
  • Practice of food technique save time, energy material and adds to the comfort of the patient
  • Sensory receptors in the skin are sensitive to heat, pains, touch and pressure

Factors Affecting the Skin

  • Impaired self-care
  • Immobilization
  • Exposure to pressure and moisture
  • Vascular insufficiency
  • Reduced sensation
  • Nutritional alternation
  • Constrictive external devices

General Instructions

  • Explain the procedure to the patient
  • Maintain privacy of the patient
  • Put off the fans and close the windows and doors to avoid chill
  • Do not give bath immediately after the lunch
  • Cleaning is to be done from the cleanest area to the less  clean area
  • The temperature of the water should be 110 – 115 degree F
  • A thorough inspection of the skin and back is necessary to find out early signs of pressure sore
  • Use soap which contains less alkali
  • Special attention must be given to the creases and folds and bony prominences between fingers and toes and pubic region
  • Remove the soap completely to avoid the drying effect of the soap on the skin
  • Do not touch the body with wet hands it is unpleasant to the patient
  • Creams or oils used to prevent drying or excoriation of the skin
  • The nurse should maintain good posture and balances of the body during bed bath

Preliminary Assessment

  • Identify the patient and assess the need
  • Check doctors order for any specific precautions
  • Assess the general condition of the patient
  • Assess the patient’s ability of self-help
  • Assess the patient’s mental status to follow directions
  • Check the patient’s preference for soap, powder, etc
  • Check whether the patient has taken the meal in the previous one hour
  • Find out the available articles in the unit
  • Provide privacy avoid draught and maintain proper light
  • Teach the patient and relatives about personal hygiene

Preparation of the Patient and Environment

  • Explain the sequence of the procedure to the patient
  • Close the windows and doors to prevent draughts put off the skin
  • Arrange the necessary articles at the bedside
  • Maintain the room temperature which will be must comfortable for patient
  • Adjust the height of the bed to the comfortable work of the nurse
  • Bring the patient to the edge of the bed and towards the nurse to prevent overreaching
  • Provide privacy by means of curtains
  • Offer bed pan or urinals if necessary
  • Keep the patient flat if the condition permits remove extra pillows and back rest
  • Remove the personal clothing and cover the patient with the bath blankets

Equipment

  • Basins – 2 (big land small 1)
  • Soap and soap dish
  • Wash cloth – 2
  • Bath touch – 2
  • Face towel – 1
  • Bath blanket of sheet – 1
  • Surgical spirit and powder
  • Nail cutter
  • Comb and oil
  • Kidney tray or paper bag
  • Jugs – 2
  • Bucket – 1
  • Clean bed linen
  • Clean dress to patient
  • Bucket or a laundry bag
  • Bath thermometer – 1

Procedure

  • Explain the procedure
  • Remove the patients dress, cover with bath sheet while removing top sheet and dress
  • Mix hot and cold water in basin half full and check the temperature on the back of your hand
  • Spread face towel around neck
  • Wet sponge towel and form mitten around gingers after removing excess water
  • Clean body in following

Face

  • Wet and apply soap to forehead, face, over and behind ear and neck
  • Clean eyes from inner to outer canthus
  • Rinses sponge towel and allow patient to wipe face
  • Dry with face towel, replace at head end of bed

Arms

  • Place towel lengthwise under the farthest arm if there is IV do not disturb it
  • Take soapy bath mitt and soap the arm and axilla
  • Massage the pressure areas
  • Place the hand in basin of water to wash
  • Rinse and dry well, paying attention to skin under breast
  • Recover with towel

Chest

  • Avoid unnecessary exposure
  • Cover chest with towel and turn bath sheet down to abdomen
  • Wet chest and apply soap in rotatory movment, paying attention to skin creases
  • Remove soap thoroughly by wiping from neck to check
  • Dry with bath towel

Abdomen

  • Fold top sheet up to suprapubic region cover the chest with bath towel
  • Wet and clean abdomen with soap
  • Clean umbilicus and dry with bath towel
  • Cover the patient with top water and remove towels

Back

  • Turn the patient on side or left lateral position. Close to edge of bed, with back towards nurse
  • Expose back including buttocks, spread bath towel on bed, close the patients back
  • Wet the area and apply soap with rotatory movements clean and remove soap and dry the area
  • Give massage by applying firm pressure with palms and fingers from sacrum to shoulder in sequence, covering whole back
  • Help the patient to return to supine position

Legs

  • Uncover the farthest leg and place towel under leg
  • Apply soap to the leg and give special attention to the groin
  • Massage the pressure points
  • Place foots in basin of water to wash
  • Rinse and dry well, paying special attention in between the toes
  • Repeat the procedures on the near leg

Pubic Region

  • Clean pubic region with wet large rag piece (for helpless patient)
  • Permit patient to clean if so desired
  • Discard rag pieces into large K-basin
  • Give perineal care for helpful patient

After Care

  • Provide clean gown and pajama
  • Replace articles after cleaning
  • Discard dirty water in sluice room
  • Clean the bed linen if needed
  • Offer a hot drink (coffee or tea) if permitted
  • Position the patient for comfortable and proper alignment
  • Cut short the finger nails and toe nails
  • Comb the hair and arrange the hair
  • Hand wash
  • Record the procedure in the nurse’s record with time, date, type and abnormalities noticed
BED BATH - Definition, Purpose. Equipment , Procedure, After care
BED BATH – Definition, Purpose. Equipment , Procedure, After care BED BATH – Definition, Purpose. Equipment , Procedure, After care

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