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.
  • During a tub bath, you wash the upper body. Carefully wash under the breasts and between skin folds. Also wash the perineal area. Pat dry the person with towels after the bath. A tub bath can make a person feel faint, weak, or tired—great risks for a person on bed rest. A tub bath lasts no longer than 20 minutes.
  • If a person can stand for a shower, he or she should use grab bars for support. A weak or unsteady person should not stand in the shower. Instead, he or she must use a shower chair or shower trolley (portable tub).

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.

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Disposable bath mat

Bath blanket

Two bath towels

Mirror

Gloves

Bath thermometer

Rubber bath mat if needed

Disinfectant

Soap

Lotion

At least two washcloths

Comb

Clothing or sleepwear

Robe and non-skid footwear

Shower chair

Wheelchair

Delegation

Follow delegation guidelines. Before assisting with a tub bath or shower, obtain this information from the nurse and care plan:

• If the person takes a tub bath or shower
• What water temperature to use—usually 105˚F (40.5˚C)
• What equipment is needed—shower chair, shower trolley, and so on
• How much help the person needs
• If the person can bathe himself or herself
• 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.
• Reserve the bathtub or shower.
• Practice hand hygiene.
• Identify the person. Check the ID bracelet against the assignment sheet. Also call the person by name.
• Collect the equipment.

Safety

• Some persons are very weak. At least two staff members are needed to safely assist them with tub baths and showers. If the person is heavy, three or more staff members may be needed.
• The person may use a tub with a side entry door, a shower chair, a shower trolley, or other device. Always follow the manufacturer’s instructions.
• Protect the person from falls, chilling, and burns. Follow all appropriate safety measures. Remember to measure water temperature.
• Clean, disinfect, and dry the tub or shower before and after use. This prevents the spread of microbes and infection.

Comfort

• Make sure the tub or shower room is warm.
• Provide for privacy. Close the room door, screen the person, and close window coverings.
• Make sure the water temperature is warm enough for the person.
• Have the person remove his or her clothing or robe and footwear just before getting into the tub or shower. Do not have the person exposed longer than necessary.
• Leave the room if the person can be left alone. Stay within hearing distance.

Follow-up Care

• Provide for comfort.
• Place the call light within reach.
• Raise or lower bed rails. Follow the care plan.
• Unscreen the person.
• Complete a safety check of the room.
• Clean, disinfect, and dry the tub or shower. Remove soiled linen. Wear gloves.
• Discard disposable items. Put the unoccupied sign on the door. Return supplies to their proper place.
• Follow agency policy for dirty linens.
• Remove and discard the gloves. Practice hand hygiene.

Reporting/Recording

Report and record your observations, including:

• Dizziness or light-headedness
• 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
• Tender 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