Republic of the Philippines

CAMARINES SUR POLYTECHNIC COLLEGES

Nabua, Camarines Sur

COLLEGE OF HEALTH SCIENCES

Name: ______________________________________ Grade: _________

Year & Section: _______________________________ Date: __________
Group No: ___________________________________

PROCEDURE CHECKLIST
ASSISTING SITZ BATH
Instruction: Below is the grading scale which will be used in rating your performance.

5 Excellent 95 - 100
4 Very Satisfactory 88 - 94
3 Satisfactory 82 – 87
2 Fair 76 – 81
1 Need Practice 70 – 75

A. Purposes:
 To aid healing a wound in the area by cleaning on discharges and slough
 To induce voiding in urinary retention
 To relieve pain, congestion and inflammation in cases of: hemorroids, tenesmus, rectal
surgery, anal fissures, after proctoscopic or cycloscopic exams., sciatica, uterine and
renal colic.
 To induce menstruation.

B. Important Considerations
 Warm water should not be used if considerable congestion is already present.
 The patient should be observed closely for signs of weakness and faintness.
 After the patient is in the tub or the chair, check to see whether or not there is pressure
against the patient’s thighs or legs.
 Support patient’s back in the lumbar region.

C. PROCEDURES 5 4 3 2 1
1. Adhere to Standard Precautions.
2. Explain procedure to patient.
3. Allow for privacy.
4. Review and follow nurse's instructions.
5. Clean portable sitz bath. Follow the manufacturer's instructions
for operating and cleaning the equipment.
6. Fill the portable sitz bath with warm water to approximately 2/3
(two-thirds) full of warm water. Water temperature should be
approximately 100- 104 degrees Fahrenheit for cleansing the
perineal area. Water temperature should be approximately 105-
110 degrees Fahrenheit for pain and circulation stimulation.
Check the water temperature and have the patient test to
comfort level.
7. Remove any dressings patient may have in place, unless
otherwise indicated.
8. Assist patient onto the portable sitz bath and unclamp the valve.
9. Remain with the patient during the procedure if they are weak or
unsteady. Check with patient every 5 minutes for feelings of
dizziness or weakness. The sitz bath should take approximately
20 minutes.
10. A valve on the tubing connected to the bag will allow more hot
water to be placed in the bag.
11. Dry the patient.
12. Reapply any dressings as ordered by the nurse.
13. Assist the patient to dress and return to a position of comfort.
14. Clean tub or portable sitz bath according to the manufacturer’s
directions and straighten bathroom.
15 Discard soiled supplies in appropriate containers.
 Republic of the Philippines
CAMARINES SUR POLYTECHNIC COLLEGES
Nabua, Camarines Sur

COLLEGE OF HEALTH SCIENCES

16. Perform hand hygiene.

D. Evaluation
1. Document in patient's record:
a. Procedure, time, duration and water temperature.
b. Skin condition.
c. Assistance required.
d. Patient's response to procedure.
2. Report any changes in patient's condition to supervisor.

REMARKS:
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________

Date & Time: _______________

Clinical Instructor: ________________