COLLEGE OF NURSING

ALL INDIA INSTITUTE OF MEDICAL SCIENCES,

JODHPUR

BED BATH

SUBMITTED BY:

MINAKSHI SHAYAR

NURSING TUTOR

AIIMS, JODHPUR

DATE OF SUBMISSION: - 14-07-2016

BED BATH
DEFINITION:-
“Bed bath refers to the procedure of giving bath to a patient who is confined to bed and is not
physically or mentally capable of self care.”
PURPOSES:

1. To clean the body off dirt and bacteria.

2. To increase elimination through the skin.
3. To prevent bed sores.
4. To stimulate circulation.
5. To induce sleep.
6. To provide comfort to the client.
7. To give the client a sense of well being.
8. To relieve fatigue.
9. To provide active and passive exercises.
10. To regulate and maintain body temperature.
11. To establish an effective nurse-patient relationship.

INDICATIONS:-
The client who need bath on bed are those-

1. Client with plaster cast and Traction.

2. Strict bed rest.
3. Paralyzed patient.
4. Unconscious patient.
5. Handicapped.
6. Surgical client.

CONTRAINDICATIONS:-

1. Extensive burn.
2. Infectious skin conditions.
3. Spinal cord injury.
4. CNS injury.
5. Immediate after surgery.
ARTICLES:-

S. No. Name of Article Quantity

1. Bath Basin 3

2. Bucket 2

3. Jug 2

4. Soap with soap dish 1

5. Sponge cloth 2

6. Face towel 1

7. Bath towel 2

8. Small bowl 1

9. Bath blanket / sheet 1

10. Spirit and powder As required

11. Clean Gloves 1 pair

12. Nail cutter or scissor and nail filer 1

13. Comb and oil 1

14. Kidney tray 1

15. Bed pan or urinal 1

16. Change of bed linen 1 set

17. Change of patient’s dress 1 set

18. Screen 1

19. Table or trolley 1

20. Cotton balls 2

21. Mackintosh 1

22. Laundry bag 1

PROCEDURE:-

A) Preliminary Steps:-

S. No Step Rationales

1. Assess the client’s need for bathing. Ensures that the right
procedure is done on the right
patient.

2. Check the physician’s order. To see the specific precaution

if any, regarding the position
and movement of the client.

3. Check the client’s ability for self care. To involve the client in self
care.

4. Assess the client’s mental status. To follow directions.

5. Check whether the client has taken meal not less Bathing a client immediately
than before one hour. after a meal depletes the blood
supply to the digestive organs
and interfere with the
digestion.

6. Assess the cardio-respiratory functioning ,check To check that all the

T.P.R. and B.P. parameters are in normal
range.

7. Gather all required equipment. To avoid leaving the client

 unnecessarily until the entire
procedure has been
completed.
8. Offer bed pan and urinal if the client requires. Enhances comfort of the client
and preventing interruption of
bath.

B) Steps of Procedure:-

S .No. Step Rationales

1. Confirm Doctor’s order, check client’s To avoid any complications.

identification and condition. Ensures that the right
procedure is done on the right
patient.

2. Explain the purpose and procedure to the client. Providing information and get
co-operation of client.
3. Wash hands and put on clean gloves. To prevent cross infection.

4. Bring all the equipments to the bed side. To avoid leaving the client
unnecessarily until the entire
procedure has been completed.
5. Put the screen or curtain. To protect the client’s privacy.
6. Close the door and windows, and put off the fan. To ensure that the room is
warm and free of draught.
7. Prepare hot water Water will cool during the
procedure.
8. Remove the top bed linen or fanfold them to foot Removal of top linen
end of the bed. prevents their becoming soiled
or moist during bath.

9. Cover the client with bath blanket or sheet, remove Ensure privacy and prevent
the client’s clothing and expose only that part of chills for client.
 the body which is to be washed.
 If the client has I.V, remove the gown from Be sure that I.V delivery is not
the arm without I.V first then lower the I.V interrupted.
bottle, slide gown up the I.V tubing and
over the I.V container.

10. Pull the side rail up of the farther side. Raising side rail maintain
client’s safety as nurse leaves
bed side.

Mix hot and cold water in the basin and check the Water at proper temp. Relaxes
temp. for tolerance by placing elbow in water or client and provides warmth.
outer aspect of palm.
Fill the bath basin about 2/3 rd full with warm water
(110-115 degree F).
11. Assist the client to move toward the side of the To prevent over-reaching.
bed where the nurse will be working.
12. Remove pillow if allowed and raise head of bed Removal of pillow makes it
30-45 degree. easier to wash client’s ears and
neck.
13. Place bath towel and mackintosh under client’s To prevent soiling of bed linen
head, and one bath towel over the patient’s chest and bath blanket.
under the chin.
Put cotton balls on both ears. To prevent entry of water to
ears.
14. Fold wash cloth around fingers of your hand to Mitt retains water and heat
form a mitt. Immerse mitt in water and squeeze better than loosely held wash
thoroughly. cloth.
15. Wash face:-
a) Wash patient’s eyes using separate corners Prevent transmission of
of the bath mitt for each eye and wipe from infection from one eye to
inner canthus to outer canthus. Clean the another.
 farther side first. Pressure can cause internal
b) Soak any crustations on eyelid for 2-3 min. injury.
with damp cloth before attempting
removal.
c) Dry eye thoroughly. To avoid uneasiness.
d) Ask client about preference for using soap
on the face (In unconscious patient avoid
soap).

e) If using soap, apply soap with second mitt,

and clean the face, ears and neck. And then Soap if remaining on the skin
rinse with the first mitt, till soap is will cause irritation.
removed fully.( Put back the wash cloth in
the basin )
f) Dry the face with a face towel.
g) Remove ear plugs and towel.
To avoid uneasiness.
16. Wash Arm and Hand:-
a) Remove bath blanket from over client’s Protect the bed linen from
arm that is farthest to you. Place bath towel becoming wet.
lengthwise under arm.
b) Wash, apply soap, rinse and dry arms using Firm strokes from distal to
long firm strokes from distal to proximal proximal areas will increase
areas. venous return.
c) Pat dry using second bath towel. Do not Rubbing may cause skin
rub. injuries.
d) Pay special attention to axilla raise and Axilla is moist with
support arm above head, if possible. perspiration. If not properly
cleaned dirt will remain in
axilla and harbor
microorganisms.
-Arms are supported to prevent
 fatigue.
Deodorant control body odor.

e) Rinse and dry axilla thoroughly. If client

uses deodorant or telecom powders apply
Soaking softens cuticles of
it.
hand and loosens debris
f) Fold bath towel in half and lay out on bed.
beneath nails.
Place basin on towel. Immerse client’s
hand in water. Allow hand to soak for 3-5
min. before washing hand and fingernails.
Attend to inter digital spaces.
Thorough drying removes
moisture between fingers.
g) Remove basin and dry hand well.

h) Repeat entire procedure for other arm.

17. Check temperature of bath water and change water Use of warm water maintains
if needed. client’s comfort.
18. Wash Chest and Abdomen:-
a) Place bath towel over chest and abdomen, It prevents unnecessary
fold bath blanket up to pubic area. exposure of the patient.
b) With one hand lift edge of towel away Observe the chest and breast
from chest. With mitted hand, bath chest for any abnormalities.
using long, firm strokes .Giving special Secretions and dirt collect
attention to skin folds under breast. easily in areas of skin folds.
c) Keep client’s chest covered between Prevent chilling and exposure
washes and rinse periods. While the towel of body parts.
remaining on the chest, fold back the bath
blanket down to the pubic region.
d) With one hand lift bath towel, with mitted Moisture and sediment that
hand, bath abdomen, giving special collect in skin folds predispose
attention to bathing umbilicus and client to skin maceration and
abdominal folds. Stroke from side to side irritation.
 to keep abdomen covered between washing
and rinsing. Dry well.
e) Put back the bath blanket, remove the Maintain client’s warmth and
towel and cover the client completely. comfort.
19. Wash Back of client:-
a) Turn the client to side lying or prone Allows the visualization of the
position and expose back. back.
b) Fold back the bath blanket from shoulder Entire back is exposed from
to the thighs and tuck the edges securely the shoulder to the buttocks for
around the thighs. the thorough cleaning of the
back.
c) Place towel lengthwise alongside back of
the client.
d) Wash, rinse, and dry the back from the A thorough cleaning, back rub
shoulder to the buttocks by using long, and application of spirit and
firm, stroke. Pay special attention to folds powder prevent bed sores.
of the buttocks and all pressure points.
After drying the back give a thorough back
rub with spirit and powder longitudinally
in circular movements.
20. Turn client back to supine position.
21. Put on the upper garments and cover the client Prevent exposure of the body
with a bath blanket. for a longer period and client
feels safe and comfortable.
If one extremity is injured or immobilized, always Dressing affected side first
dress affected side first. allows easier manipulation of
gown over body part with
reduced ROM.

22. Change bath water and wash cloth. Prevent transfer of micro-
organism from anal area to
genitalia.
23. Wash Legs:-
 a) Expose farther leg by folding blanket over Prevent unnecessary exposure.
toward midline. Be sure perineum is
draped.
b) Place towel lengthwise under the leg. Flex Towel prevents soiling of bed
the knee so that the sole of the foot is linen.
supporting on the mattress.
c) Ask the client to hold the foot still. Place Observe the leg.
bath basin on towel on bed and secure its
position next to the foot to be washed.
With one hand supporting lower leg, raise Legs are supported to prevent
it and slide basin under lifted foot. Make fatigue.
sure foot is firmly placed on bottom of Soaking softens calluses and
basin. Allow foot to soak while you wash rough skin.
leg.
d) Use long firm strokes in washing from Moving from distal to
distal to proximal from ankle to knee and proximal improves venous
knee to thigh, (wash, rinse the thigh and return.
legs with the wash cloth). Dry well.
e) Cleanse foot, make sure to bath between Secretions and moisture may
toes. Clean and clip nails as needed. Dry present between toes. Lotion
well. If skin is dry apply lotion. helps to retain moisture and
soften skin.

f) Remove the basin and repeat the entire

procedure for other leg.
24. Change water. The waste water is discarded into To get clean water.
the bucket.
25. Assist the client in assuming supine position cover Maintain client’s privacy.
lower extremities with bath blanket.
Expose only genitalia (If client can help cover
entire body with bath blanket).wash, rinse and dry
perineum thoroughly.
 Give special care to skin folds. Skin folds are a site for
accumulation of secretion and
moisture.
The client can do it himself if he is able to do so. Client who are capable, usually
prefer doing it by themselves.
26. Discard mitt into a kidney tray and dispose of To prevent microbes
gloves. transmission.
27. Apply any additional body lotion or oil as desired. Moistening lotion prevents dry
and chapped skin.
28. Put on the lower garments. Remove the bath To prevent exposure.
blanket. Cover the client with top linen.
29. Comb client’s hair. Maintains client’s body image.
30. Lower the side rail and Make client’s bed. Provide clean surrounding
environment.
31. Remove soiled linen and place in dirty linen bag. Prevent transmission of
infection.
32. Wash hands. Reduces transmission of
microbes.

C) After Care of the Client and Articles:-

1. Replace the client’s personal clothing.
2. Offer a hot drink if permitted.
3. Position the client for comfort and proper alignment.
4. Take all articles to the utility room. Disinfect the bath basin and wash cloths. Send the
soiled linen to the laundry. Put back all the articles in the proper places after cleaning.
Personal articles are replaced into the bedside table.
5. Wash hands.
6. Record the procedure in the nurse’s record with date and time and record any
abnormalities observed during procedure.
7. Take the opportunity to teach the client and his relatives about the personal hygiene.

SPECIAL CONSIDERATIONS:-

1. Obtain assistance if required in case of helpless or unconscious client.

 2. If patient is obese and cannot move in bed, nurse may move from one side of the bed to
the other side to ensure good body mechanics.
3. Assess client’s general condition before giving bath. If unstable refrain from giving bath.
4. Conserve the energy of the client by avoiding unnecessary exertions.
5. Each stroke should be smooth and long rather than short and jerky.
6. Provide active and passive exercise whenever possible unless it is contraindicated.
7. Do not touch the body with hands. It is unpleasant to the client.
8. Bath should not be given immediately after food because it interferes with the process of
digestion.

BIBLIOGRAPHY
1. Prakash R. Manipal Manual of Nursing Procedures: Vol-1 Part-A. New Delhi : CBS
Publisher; 2012. 66-73.
2. Jacob A, R Rekha, Tarachand Jadhav Sonali. Clinical Nursing Procedures: The Art of
Nursing Practice. 2nd edition: . New Delhi Jaypee Brothers Medical Publishers;
2011. 84-86.
3. TNAI. Fundamental of Nursing: A procedure Manual. 1 st edition: New Delhi TNAI;
2012. 171-176.
4. Potter PA, Perry AG, Stockert P A, Hall A. Basic Nursing. 7 th edition: Philadelphia;
2010. 776-786.
5. Taylor CR, Lillis C, Le Mone P, Lynn P. Fundamentals of Nursing: The Art and
Science of Nursing Care. 7th edition: New Delhi Wolters Kluwer/ Lippincott
Williams&Wilkins; 2011. 879-880.
6. Berman A, Snyder S, Kozier&Erb’s. Fundamentals of Nursing: Concept, Process and
Practices. 9th edition: Chennai: Pearson; 2013. 755-762.
 PROCEDURE CHECK – LIST
Name of performer: Name of observer:
Date of observation: Area of observation:

S.NO. STEPS YES NO

1. Washed hands and put on gloves.
2. Identified the client and explained the procedure to
the client.
3. Select and assemble all needed materials before
beginning of bed bath.
4. Maintained privacy.
4. Raised the bed to working height.
5. Offered the bed pan or urinal to the client.
6. Applied the bath blanket.
7. Made mitts with the wash cloth.
8. Checked the temperature of water.
9. Exposed only that part of body which is to be
washed.
10. Washed, rinsed and dried face.
11. Washed, rinsed and dried the arms.
12. Washed, rinsed and dried the chest and abdomen.
13. Washed, rinsed and dried the back.
14. Washed, rinsed and dried the legs.
15. Perineal area cleaned
16. Nails checked and cleaned.
17. Changed the water as required.
18. Soiled linens replaced.
19. Equipments cleaned and replaced.
20. Documented the procedure.
Remark: Signature of observer