Hygiene: Bed Bath procedures

• Chapter Four focuses on Hygiene.
• The topics covered are bathing a patient (complete bed bath), mouth care, hair shampooing, and back rub and massage.

Bathing a Patient (Complete Bed Bath)

• Bathing removes accumulated oil, perspiration, dead skin cells, and some bacteria.
• Two categories of baths include cleansing baths and therapeutic baths.
• Cleansing baths are for hygiene, includes complete bed bath, self-help bed bath and partial bath.
• Therapeutic baths are given for physical effects, such as to soothe irritated skin or to treat an area.
• The purposes of bathing are to cleanse the skin, stimulate circulation, improve patient self-image, reduce body odors, and promote exercise through joint range of motion (ROM).
• Assessment includes evaluating the patient's tolerance of activity, level of discomfort, cognitive ability, and musculoskeletal function.
• Assess patient bathing preferences, identify skin impairment risks like immobilization, reduced sensation, and nutritional alterations.
• Review orders and specific precautions for patient's movement or positioning.
• Equipment needed includes two bath towels, two washcloths, a washbasin, soap and soap dish, bath blanket, a clean gown or pajamas, hygienic aids, a bedpan or urinal, linen hamper or laundry bag and disposable gloves.
• Planning involves maintaining skin integrity, joint ROM, and comfort.
• Implementation requires safety precautions for the student.
• Adjust room temperature and ventilation, explain the procedure to the patient.
• Steps of the Procedure:
• Assess patient to detect the type of bathing equipment is needed.
• Wash hands to reduce transmission of microorganisms and prepare equipment.
• Gathe equipment to patient bed to facilitate procedure and reduce time
• Introduce yourself to decrease patients anxiety, and increase comfort level.
• Provide privacy to enhance patient comfort and reduce anxiety
• Explain procedure to reduce anxiety.
• Don gloves to prevent infection.
• Offer patient bedpan or urinal and provide towel and washcloth.
• Lower side rails and assist patient in assuming comfortable position maintaining body alignment.
• Bring patient toward side closest to you and raise hospital bed to high position, minimizing back strain for the nurse.
• Loosen top covers at foot bed and place bath blanket over top sheet.
• Fold and remove top sheet from under blanket, blanket provides warmth and privacy.
• If top sheet is to be reducted, fold it for replacement later.
• Dispose in laundry bag, taking care not to allow linen to contact your uniform, proper disposal prevents transmission of microorganisms.
• Remove patient's gown or pajamas, removing from unaffected side first if an extremity is injured or has reduced mobility, provides full exposure of body parts.
• Remove gown from arm without IV first, then lower IV container and slide gown covering affected arm.
• Re hang IV container and check flow rate, supports maintaining ROM.
• Pull side rail up fill washbasin two-thirds full with water between 43-46° and ask patient to place fingers in water to test temperature tolerance, raising side rail maintains patient's safety.
• Remove pillows if allowed and raise head of bed 30-45 degrees and place bath towel under patient's head, placement of towel prevent soiling
• Place bath towel over patient's chest to prevent soiling of bath blanket.
• Fold washcloth around fingers of your hand to from a mitt and immerse mitt in water and wring thoroughly.
• Mitt retains water and heat better than loosely held washclothpreventing splashing.
• Wash patient's eyes with plain warm using different section of mitt for each eye and moving mitt from inner to outer canthus.
• Soak any crustations on eyelid for 2-3 minutes with damp cloth before attempting removal, and keep eye closed.
• Ask patient uses soap,wash and dry forehead cheeks nose neck and ears.
• Remove bath blanker from over patient's arm that is farthest from you and place bath towel lengthwise under arm, move to other side to wash arm.
• Lower side rails, bathe arm with soap and water using long, firm strokes from distal to proximal areas, and thoroughly washing axilla.
• Rinse and dry arm and axilla thoroughly and if patient uses deodorant or talcum powder, apply it.
• Fold bath towel in half and lay it on bed beside patient and immerse patient's hand in water to soaking it.
• Allow hand soak for 3-5 minutes before washing hand and fingernails.
• Remove basin and dry hand well.
• Repeat steps for other arm.
• Check temperature of bath towel and fold bath blanket down to umbilicus maintain patient's comfort.
• Cover patient's chest with bath blanketto prevent exposure.
• Lift edge of towel away from chest, and with mitted hand, bathe chest using long, firm strokes and taking care wash skin folds.
• Keep patient's chest covered between washing and rinsing periods and dry well.
• Place bath towel lengthwise over chest and abdomen, and fold blanket down to just above pubic region.
• With one hand, lift bath towel and bathe abdomen and giving special attention to bathing umbilicus to side.
• Keep abdomen covered between washing and rinsing, dry well.
• Apply clean gown or pajama and always dress affected side first.
• Cover chest and abdomen with top of bath blanket and expose far leg by folding blanket over toward midline making sure perineum is draped to preventing exposure.
• Bend patient's leg at knee by positioning your arm under leg elevating leg from mattress slightly and secure its position next to the foot to be washed.
• Ask patient to hold foot still and place bath basin on towel on bed, placing next to foot to washed.
• Supporting lower leg, that raising it and slide basin under lifted foot, making sure foot is firmly placed on bottom of basin to soak.
• Use long, firm strokes in washing from ankle to knee and from to knee to thigh, and dry well to promote venous return.
• Cleanse and dry between toes.
• Clean and clip nails as needed and apply lotion if skin is dry.
• For other leg and foot,repeat step.
• Cover patient with bath blanket raise side rail.
• Lower side rail and changing new water with safetyand clean patient in assuming prone or side-lying,placing towel,apply gloves,and keep draped slilding back
• Wash, raise, and dry back from neck to buttocks using long, firm strokes paying special attention and Dry well.
• Make warm bath over.
• Return top supine and assit cover and keep warm bath body
• Back in order
• Document it

Mouth Care

• Mouth care is the scientific care of the teeth and mouth including mechanical brushing, flossing, and gum stimulation.
• The purposes of mouth care is to remove food particles and dental plaque, enhance well-being, and prevent sores and oral tissue infection.
• Assessment involves evaluating patient risk for oral hygiene problems, inspecting the oral cavity, and testing for the gag reflex.
• Equipment includes anti-infective solution, sponge toothiest or tongue blade, padded tongue blade, face towel, curved emesis basin, paper towel, water glass with cold water, petrolatum jelly, portable suction machine, small bulb syringe and disposable gloves.
• Contraindications include bleeding tendency, other oral problems like dehydration or surgery.
• Objectives are to maintain the oral mucosa, prevent injury from aspiration, maintain cleanliness of mouth.
• Precautions for patient and student, and schedule schedule
• Assess mouth and care -steps: Raise bed Lower and position the patient Wash hands Raise side rails Explain
  • Dont glove
• Step of mouth care
• Place equipment over table and bide
• Pull curtin around bed ot door
• Raise bed, lower side
• Positon patient to side
• place towel,ememis basin under face. figure the
• Retract patent teeth to insert if possible and comfortable
• Gentle cleanse after.
• Have second nurse to give solution

Performing Mouth Care for the Unconscious or Dependent Patient

• Wash hang to get. to test patients back.
• Document care in follow

Assisting the Independent Patient with Mouth Care

• Providing and cooperation with better understand when getting to the care.
• Close room is must important to protect patient privacy.
• Make comfortable better and have access
• Important to get comfort
• Document sing

Hair Shampooing

• Hair washing is a part of general care for clients who cannot do it themselves.
• The purpose is to improve the patient's well-being.
• Assessment includes checking for contraindications like recent head or neck surgery and assessing the patient's level of consciousness and ability to maintain position.
• Note patient’s need if have any scalp issues.
• Equipment involves large basin, two towels, rubber draw sheet, linen draw sheet, container with warm water, shampoo, cotton swab, safety pin, brush or comb, and an optional hair dryer.
• Recent head must take shampoo and take action.
• Wash it.
• The student should to maintain personal patient hygeine through the surgery.
• Steps:
• Explain the precerude and make sure you get you answer any question.
• Prepare, equip at the door.
• Provide a wash from the head.
• Do the towel and give the hair.
• Try is possisbel and wet.
• Add a lot

Back Rub and Massage

• Back care is defined as cleaning and massaging the back, paying special attention to pressure points for promoting comfort and relaxation.
• The purposes are to improve circulation, refresh the mood, relieve fatigue and promote rest and sleep.
• Assessment includes identifying positioning limitations and inspecting skin integrity, checking for signs of fatigue.
• Equipment: massage lubricant or lotion, skin application (lotion, alcohol, or powder), bath blanket and towel.
• Make sure the you ask if the need back ,patient and wound that is avoid lying prone
• Steps to perform;
  • Explain the process offer -wash hand
  • privacy
• position is comfortable -adjust some area within
• Assit the patient
• Dry the patient
• Assess, if you see any damage on area.