Purpose

• Bathing cleans the skin and the mucous membranes of the genital and anal areas. It removes microbes, dead skin, perspiration, and excess oils. A bath is refreshing and relaxing. It stimulates circulation and exercises body parts. It gives you a chance to observe and talk with the patient.
• You may give a complete or partial bath, tub bath, or shower. The method depends on the person’s condition, self-care abilities, and personal choice.
  • For a complete bed bath, you wash the person’s entire body in bed. Such baths are for persons who cannot bathe themselves. They usually are unconscious, paralyzed, in casts or traction, or weak from illness or surgery.
  • A partial bath involves bathing the face, hands, axillae (underarms), back, buttocks, and perineal area. You assist as needed. You give partial baths to persons who cannot bathe themselves.
• In hospitals, bathing is common after breakfast. In nursing centers, it usually occurs after breakfast or dinner. Respect the person’s choice of bath time, when possible.
• Bathing frequency is a personal matter. Some people bathe daily. Others bathe once or twice a week. Personal choice, weather, activity, illness, and skin dryness affect bathing.

Equipment

Roll cursor over items to see labels. For the purposes of clearly depicting the equipment, a barrier is not shown in this photo. When providing care, a barrier should always be placed on the surface before placing the equipment.

Sleepwear

Two bath towels

Soap

Deodorant

Powder

Lotion

Gloves

Two hand towels

Bath thermometer

Orangewood stick or nail file

Wash basin

Paper towels

Washcloth

Bath blanket

Brush and comb

Delegation

Follow delegation guidelines. Before giving a complete or partial bed bath, obtain this information from the nurse and care plan:

• What bath to give—complete bed bath, partial bed bath, tub bath, or shower
• How much help the person needs
• The person’s activity or position limits
• What water temperature to use—usually 110˚F to 115˚F (43.3˚C to 46.1˚C) for adults (lower for older persons)
• What skin care products to use and what the person prefers
• What observations to report and record
• When to report observations
• What patient or resident concerns to report at once

Preparation

• Observe quality-of-life measures.
• Review the information under Delegation and Safety and Comfort.
• Practice hand hygiene.
• Identify the person. Check the ID bracelet against the assignment sheet. Also call the person by name.
• Collect clean linens. Place it on a clean surface.
• Collect the equipment.
• Cover the over-bed table with paper towels. Arrange items on the over-bed table. Adjust the height as needed.
• Provide for privacy.
• Raise the bed for body mechanics. Bed rails are up if used.

Safety

• To avoid burns, measure water temperature according to agency policy. If unsure, ask the nurse to check it.
• Protect the person from falls and other injuries. Practice appropriate safety measures. Protect the person from drafts.
• Apply powder with caution. Do not use it near persons with respiratory disorders. Before using it, check with the nurse and the care plan. To safely apply powder:
  • Turn away from the person.
  • Sprinkle a small amount onto your hand or a cloth.
  • Apply powder in a thin layer on the person.
  • Make sure powder does not get on the floor. It can cause falls.
• You make beds after baths. After making the bed, lower it to the low position. For an occupied bed, raise or lower bed rails based on the care plan. Lock the bed wheels.
• Follow Standard Precautions and the Bloodborne Pathogen Standard.

Comfort

• Before bathing, let the person meet elimination needs.
• Oral hygiene is common before or after bathing. Allow personal choice and follow the person’s care plan.
• Provide for warmth. Cover the person with a bath blanket. Make sure the water is warm enough for the person.
• If preferred, remove sleepwear after washing the eyes, face, ears, and neck.
• If the person is able, let him or her wash the genital area.

Follow-up Care

• Provide for comfort.
• Place the call light within reach.
• Lower the bed to the low position. Raise or lower bed rails. Follow the care plan.
• Put on clean gloves.
• Empty, clean, rinse, and dry the wash basin. Return all supplies to their proper place.
• Wipe off the over-bed table with paper towels. Discard the paper towels.
• Unscreen the person.
• Complete a safety check of the room.
• Follow agency policy for dirty linen.
• Remove and discard the gloves. Practice hand hygiene.

Reporting/Recording

Report and record your observations, including:

• The color of the skin, lips, nail bed, and sclera (whites of the eyes)
• If the skin appears pale, grayish, yellow (jaundiced), or bluish (cyanotic)
• The location and description of rashes
• Skin texture—smooth, rough, scaly, flaky, dry, moist
• Diaphoresis—profuse (excessive) sweating
• Bruises or open skin areas
• Pale or reddened areas, particularly over bony parts
• Drainage or bleeding from wounds or body openings
• Swelling of the feet and legs
• Corns or calluses on the feet
• Skin temperature (cold, cool, warm, hot)
• Complaints of pain or discomfort