Bed bath

Promote independence and participation by explaining the procedure to the client. If possible, involve
the family or significant other.

Check the chart for client’s diagnosis, activity orders, positioning or movement or any orders specific to
hygiene.

Determine whether or not you will need any assistance and also what client’s supplies and equipment
are present. Then wash hands.

Gather all the needed supplies and equipment then bring preparations to client’s room.

Bath blanket

Bath basin

2-4 wash cloths

2-4 bath towels

Soap in a soap dish

Clean clothes

Paper towels

2 pair of gloves

Lotion

deodorant

Brush or comb

Identify and explain the procedure to the client.

Adjust room temperature and ventilation. Close doors and windows or provide screen

Wash hands and wear gloves. Offer bedpan or urinal. Provide tissue paper if necessary. Client will feel
more comfortable after voiding and prevents interruption of bath

Bring client toward side closest to you. Having the bed in high position and having less effort in reaching
across bed prevents strain on the nurse’s back.

Loosen top cover at the foot of bed. Place bath blanket gently on the chest area . Ask the client to hold
the tip/hemline of the bath blanket if able, (if unable) tuck the blanket under the client’s shoulder. Grasp
the top sheet and bath blanket hemline and together bring it down to the foot part. Place the soiled top
sheet inside the hamper. (If the top sheet is to be

Remove the client’s gown or pajamas while maintaining privacy. If extremity is injured or has reduced
mobility due to presence of IV line, begin removal from unaffected side. Rehang IV container and check
the flow rate. Please be reminded that in changing gown of the client, placing a bath blanket is not
necessary.
Remove pillow. Place bath towel under client’s head and chest. Adjust bed position from fowler’s to
semi fowlers. Removal of pillow makes it easier to wash client’s ears and neck. Placement of towel
prevents soiling of bed linen.

Fold washcloth around fingers of your hand to form a mitt. Immerse mitt in water and wring thoroughly.

Mitt retains water and heat better than loosely held washcloth, keeps cold edges from brushing against
client and prevents splashing.

With wet wash cloth (no soap), wipe the farther eye from inner to outer canthus using different section
of mitt for each eye. Dry eye thoroughly but gently. Repeat with nearest client’s eye. Soap irritates eyes.
Use separate sections of mitt reduces infection transmission. Bathing the eye from inner to outer
canthus prevents secretions from entering nosocomial duct. Pressure can cause internal injury.

Wash, rinse and dry well forehead, cheeks, nose, neck and ears. Avoid soap on the face if the client
prefers. Soap tends to dry face more quickly and maybe avoided as a personal preference.

Expose the farthest arm to be cleansed then place the towel lengthwise under it. Using firm long
strokes, wet, soap, rinse and dry the arm. Strokes should be from distal to proximal. Towel prevents
soiling of bed. Washing the far side first eliminates contamination a clean area once it is washed. Gentle
friction stimulates circulation. Excess moisture causes skin maceration.

Place basin on the towel. Immerse client’s hand in water. Soap, rinse and dry the hand. If nails are dirty,
perform nail care. Soaking softens the cuticle and calluses of hand and loosens debris beneath nails.

Raise the arm and expose axilla. Gently support the arm while thoroughly washing the axilla. Rinse and
Dry. Place deodorant to control odor.

Replace water. Perform the last steps

Spread the towel across the client’s chest and abdomen. Lower the bath blanket down to the client’s
umbilicus/pubic area or as the bath towel can reach. Wash, soap, rinse, dry the chest and abdomen,
giving special attention to the skinfold under breasts. Keep the chest and abdomen covered with a towel
between the wash and rinse. Apply powder, if desired. Spreading the towel across the client’s chest will
avoid unnecessary exposure and chilling. Secretions and dirt collect easily in areas of tight skin folds.

To clean the lower extremities, cover the upper extremities with the bath blanket and expose the leg
farthest to you. Flex client’s leg by positioning your arm under leg while grasping client’s heel. Place the
bath towel under leg, covering also the perineal area. Prevent soiling of linen. Support of joint and
extremity during lifting prevents strain on musculoskeletal structure.

Wash, soap, rinse and dry from the ankle to the knee then the knee to the thigh. Place the foot into the
basin. Soap, rinse and dry. Soaking softens calluses and rough skin. Use the same bath towel for lining
and drying

Place water in the basin , soak the foot, clean, soap and rinse. Remove basin and cover with towel. Dry
properly and apply lotion, if desired. Cover with bath blanket after removing the basin.

Obtain fresh, warm water. Water may become dirty or cold.

Repeat the last three steps before.

Assist the client to side lying position facing away from you, and place the bath towel lengthwise, to
cover the back and lumbar area after washing. Wash the back and buttocks with long downwards
strokes paying particular attention to the gluteal folds. Avoid undue exposure of the client.

Assist the client to supine position, and determine whether the client can wash the genital area
independently. If able, the client can finish the bath or if unconscious you finish the bath.

Help the client to put on a clean gown. Replace bath blanket to top sheet and allow the client to comb
hair.

Perform after care and document

Oral care for independent client

Explain the procedure. It Fosters understanding and cooperation for care.

Gather all supplies needed. Be sure to place these in a tray with lining. Organization facilitates accurate
skill performance.

Close door and/or place screen. To Maintain privacy

Wash hands and wear clean disposable gloves. Prevent spread of infection.

Assist the client a comfortable sitting position (Fowler’s position).Promote comfort while brushing and
effectiveness of care.

Inspect oral cavity for cavities or any dental problems. Assessment is essential to determine individual
needs and care.

Place towel over the client’s chess. Prevent the clothing from wetting and not to give uncomfortable
condition.

Put kidney basin in hand and assist the client. To receive disposal surely.

Assist the client to brush teeth and tongue. Effective in dislodging debris and dental plague from teeth
and gingival margin.

Give to the client a glass of water and allow to rinse oral cavity. Ask the client to void contents into the
kidney basin you are now holding. To make comfort and not to remain any fluid and debris inside the
mouth thus reducing potential infection.

If desired, give an enough amount of mouthwash, gargle and void into the kidney basin.

Ask the client to wipe mouth and around it. For comfort

Confirm the condition of client’s teeth, gums and tongue. Apply lubricant to lips. To reduce from
cracking of lips

Rinse and dry toothbrush thoroughly. Return to its proper place for personal belongings. To Prevent the
growth of microorganisms.
Discard dirt properly. To prepare supplies for the next procedure.

Remove gloves and wash hands. Prevent spread of infection.

Document the care. Provides ongoing data collection and coordination of care

Report any findings. Provide continuity of care.

Eye care

Explain the procedure to the client and obtain consent.

Prepare the equipment and supplies

Sterile Cotton Balls Kidney basin

Thumb forceps Towel

Sterile gallipot or bowl Sterile 0.9 Saline solution

Wash hands.

Adjust the bed to the comfortable working position of the nurse.

Take two cotton balls dip in sterile saline solution and squeeze them. Clean the eye from inner canthus
to outer canthus in a straight single stroke. Ensure to use new CB each time. Dry. Repeat the procedure
until all the discharges has been removed.

Make the client comfortable. Discard used supplies and materials. Wash hands.

Record the procedure in the nurses record.

Hair shampoo

Obtain client’s consent about the nurse rendering hair shampoo

Review client history for allergies and confirm/obtain providers’ orders for medicated shampoo or scalp
treatment as needed.

Gather all equipment and supplies. Place all of these on the overbed table or bedside table.

Rubber sheet/disposable under pads Kelly Pad

Comb / hair brush wash cloth

Clean gloves Three bath Towels

Cotton balls Pitcher

Bath blanket

Wash hands and bring preparations to the client’s room or bedside.

Prepare room environment; provide privacy, close all windows, turn off fans/air conditioning unit.

Adjust bed to comfortable working height. Be sure side rails are up, especially on the opposite side of
the bed.

Assist the client to move his/her head towards the edge of the bed. For appropriate position,
considering body mechanics.

Place siderails up and go to the opposite side. Adjust lower extremities of the client. Go back to working
side. For comfort.

Remove pins and clips. Put plastic lining or rubber sheet, preferably down to the shoulder of the client.

Brush/comb hair observing scalp and hair for color, texture, distribution, scaling, infestations or
infection. To remove dandruff and fallen hairs and make washing easier.

Remove the pillow from the client’s head and push/slide it under the shoulder unless there is an
underlying conditions.

Comb and brush hair

Place bath towel around the neck & chest

Place bath towel around the client’s shoulder

Place the Kelly pad with a towel along the client’s head.

Cover the upper part of the client with a bath blanket. Fanfold the top beddings down to the waist

Place the pail and the Kelly pad spout over the receptacle. Line the pail with old newspaper for spilling.

Protect the client’s eye by placing a damped washcloth over the eyes. Place dry CB on both ears.

Wet the hair thoroughly with lukewarm water. Warm water eliminates surplus oil from scalp and hair.
This is beneficial for those who have greasy or oily hair. Warm water also opens up the cuticles on scalp
cleaning it thoroughly

Apply shampoo and massage the scalp well. Scalp massages can stimulate the hair's follicles and help
with removing dead skin cells on the scalp.

Rinse hair thoroughly and apply conditioner if requested. Rinse again.

For the final rinsing of hair, use plain cold water, unless contraindicated. Cold water for hair ensures
your scalp remains cleaner for longer as it closes the pores, making it less vulnerable to grease, oil and
dirt.

Wrap the hairs with the big towel used to cover the client’s neck and chest. Dry thoroughly. If the client
is able, ask client to continue drying his/her hairs.

Remove CB from ears then discard. Remove next the washcloth over the client’s eyes. Set aside. Remove
this time the cotton balls from the ears and discard.

Remove Kelly pad and towel then place it in the pail. Replace bath blanket and fix top sheet.
Assist the client to comb his/her hairs. Change gown. Tidy the surroundings and place the client in a
comfortable position.

Clean the equipment and replace them to each proper places. Discard dirty / used supplies.

Do aftercare. Remove gloves. Wash hands. Document and report abnormalities