Nursing Care: Bed Baths

Bed Bath

• Limited assistance is usually provided for washing difficult-to-reach body areas such as the feet and back.

Partial Bed Bath

• Involves cleaning only areas that would cause discomfort or odor if not washed, including face, axilla, hands, and perineal area.
• May be performed with the client lying in bed or standing at the sink.
• The nurse or client may perform a partial bath depending on the client's self-care ability.

Complete Bed Bath

• Provided to dependent clients confined to bed.
• The nurse washes the client's entire body during a complete bed bath.

Procedure for Complete Bed Bath

• Preliminary assessment involves:
  • Identifying the patient and assessing their need.
  • Checking doctors' orders for any specific precautions.
  • Assessing the general condition of the patient.
  • Assessing the patient's ability for self-help.
  • Assessing the patient's mental status to follow directions.
  • Checking the patient's preference for soap, powder, etc.
  • Checking whether the patient has taken a meal in the previous one hour.
  • Finding out the available articles in the unit.
  • Providing privacy, avoiding draught, and maintaining proper light.
  • Teaching the patient and relatives about personal hygiene.
• Preliminary assessment also involves:
  • Assessing physical or emotional factors (fatigue, sensitivity to cold, need for control, anxiety or fear).
  • Assessing the condition of the skin (color, texture, and turgor, presence of pigmented spots, temperature, lesions, excoriations, abrasions, and bruises).
  • Assessing the presence of pain and need for adjunctive measures (analgesic) before bath.
  • Assessing the range of motion of the joints.

Equipment Needed

• Basin with warm water.
• Soap and soap dish.
• Linens: bath blanket, towels, washcloth, clean gown.
• Clean Gloves, if appropriate.
• Personal hygiene items: deodorant, lotions.
• Shaving equipment.
• Table for bathing equipment.
• Laundry bag.

Procedure Steps

• Introduce self and verify the client's identity.
• Explain to the client what you are going to do, why it is necessary, and how they can participate.
• Discuss with the client their preferences for bathing and explain any unfamiliar procedures.
• Perform hand hygiene and observe other appropriate infection prevention procedures.
• Provide for client privacy.
• Prepare the client and environment.
• Prepare the bed and position the client appropriately.
• Make a bath mitt with the washcloth.
• Wash the face, arms, hands, chest, abdomen, legs, feet, back, and perineal area, following specific steps for each area.

Patient Positioning

• Patient positioning is a practice that involves maintaining a patient's body in a neutral alignment to prevent immobility and injury.
• Learning the rules for patient positioning in nursing is an important practice and a responsibility of the Registered Nurse.
• Goals of patient positioning:
  • Provide patient comfort and safety.
  • Maintain patient dignity and privacy.
  • Allow maximum visibility and access.

Guidelines for Patient Positioning

• Explain the procedure to the client.
• Encourage the client to assist as much as possible.
• Get adequate help when planning to move or reposition the client.
• Use mechanical aids such as bed boards, slide boards, pillows, patient lifts, and slings.
• Raise the client's bed to the nurse's center of gravity level.
• Make frequent position changes to prevent skin breakdown.
• Avoid friction and shearing when moving patients.

Trendelenburg Position

• Involves lowering the head of the bed and raising the foot of the bed of the patient.
• Promotes venous return and is beneficial for hypotensive patients.
• Used for postural drainage of the basal lung lobes.

Sims Position

• Used for perineal area visualization and treatment.
• Also used for paralyzed clients to reduce pressure over the sacrum and greater trochanter of the hip.
• Pregnant women may find the Sims position comfortable for sleeping.