BEDBATH

Bed bath
Is a type of bath given to a client who cannot perform his / her own personal hygiene or who
can but in a very limited way. The client is required to remain in bed as part of the therapeutic
regimen.

RATIONALE

 To promote cleanliness; prevent or eliminate body odor.

 To provide comfort and relaxation.
 To improve the client’s self - image.
 To assess client’s skin and body parts.
 To stimulate the peripheral circulation of the client.
 To provide an opportunity to strengthen a helping nurse – client relationship, to observe
the client’s physiological and emotional status and to teach the client, as needed.

EQUIPMENT
 Bath Towels (2)
 Washcloths or Face towels (2)
 Soap in a Soap Dish
 Basin with warm water (between 43°C and 46°C / 110°F and 115°F)
 Hygienic Supplies such as lotion, powder, and deodorant
 Bath Blanket

PLANNING AND IMPLEMENTATION

 Special Consideration: Apply the principles of asepsis and body mechanics in
bedmaking.
 Remember to:
 Knock before entering the person’s room
 Address the person by name
 Introduce yourself by name and title
 Clean Gown or Pajamas
 Clean Bed Linens
 Bedpan or Urinal
 Hamper for Soiled Linens
 Gloves (optional)

Pre-procedure
1. Prepare the client and the environment.
1.1. Explain the procedure to the client.
1.2. Before beginning the bath, determine
(a) Other care the client is receiving such as x-ray or physiotherapy so that the bath can be
coordinated with those activities; and
(b) Aspects of the client’s health that affect the bathing process such as limited ROM,
muscle pain, or cast or IV therapy.
1.3. Close the windows and doors.
1.4. Close the door or draw curtains or place a screen.
RATIONALE
 To minimize loss of heat from the body by convection.
 To provide client’s privacy.
1.5. Offer the client a bedpan or a urinal or ask whether the client wants to use the toilet
or commode.
RATIONALE
 To promote comfort. Voiding is also advisable before cleaning the perineum.
Procedure
2. Prepare the bed and position the client appropriately.
RATIONALE
 To avoid undue strain on the nurse’s back.
 To prevent unnecessary exposure of the client.
 To prevent the spread of microorganisms.
 2.1. Place the bed in high position.
2.2. Place a fan-folded bath blanket over the client’s chest and ask the client to
hold the top edge of the bath blanket. Grasp the bottom of the bath blanket and the top edge
of the top sheet and pull the top sheet and bath blanket together to the foot of the bed. If the
bed linens is to be reused, place it over the bedside chair. If it is to be changed, place it in the
linen hamper.
2.3. Assist the client to move near you.
2.4. Remove the client’s gown.
2.5. During the bath, assess each area of the skin.
RATIONALE
 To prevent undue reaching and straining.
 To detect any skin irritation, a break in the skin or reddened area.
3. Give oral care if not done yet. (refer to specific procedure)
4. Make a bath mitt with the washcloth.
RATIONALE
 To allow the water and heat to be retained better.
4.1. Triangular Method
(a) Lay your hand on the washcloth;
(b) fold the top corner over your hand;
(c) fold the side corners over your hand;
(d) tuck the second corner under the cloth on the palmar side to secure the mitt.
4.2. Rectangular Method:
(a) Lay your hand on the washcloth, and fold one side over your hand;
(b) fold the second side over your hand;
(c) fold the top of the cloth down, and tuck it under the folded side
against your palm to secure the mitt.
5. Wash the face.
5.1. Place one towel across the client’s chest.
5.2. Wash the client’s eyes with water only, and dry them well. Use a separate
corner of the washcloth for each eye. Wipe from the inner to the outer canthus.
5.3. Ask whether the client wants soap used on the face.
RATIONALE
 To prevent eye irritation.
 To prevent the transmission of microorganisms from one eye to the other.
 To prevent the secretions from entering the nasolacrimal ducts.
 To determine the client’s preference because soap has a drying effect especially on
the face.
5.4. Wash, rinse, and dry the client’s face, neck, and ears. You may use soap when
washing the neck and ears.
6. Wash the arms and hands.
6.1 Place the bath towel lengthwise under the arm.
6.2. Wash, rinse, and dry the arm using long, firm strokes from distal to pro-
ximal areas. Wash the axilla well. Repeat for the other arm. Do the far arm first.
6.3. Exercise caution if an intravenous infusion is present, and check its flow after moving
the arm.
6.4. Place a towel directly on the bed and put the basin on it. Place the client’s hands in the
basin. Wash, rinse, and dry the hands paying particular attention to the spaces between the
fingers, and around and under the nails.
6.5. Discard the water from the basin and replace it with a clean one.
7. Wash the chest and abdomen.
7.1. Fold the bath blanket down to the client’s pubic area and place the towel along-
side the chest and abdomen.
7.2. Wash, rinse, and dry the chest, giving special attention to the skinfold
under the breasts. Wash the abdomen with long, firm strokes giving special attention to the
umbilicus. Rinse and dry. Keep the chest and abdomen covered with the towel between the
wash and the rinse.
7.3. Replace the bath blanket when the areas have been dried.
8. Wash the legs and feet
8.1 Wrap one of the client’s legs and feet with the bath blanket, ensuring that the pubic area is
well covered. Place the bath towel lengthwise under the leg and wash that leg. Use
long, smooth, firm strokes, washing from the ankle to the knee to the thigh.
 8.2. Rinse and dry that leg, reverse the covering and repeat for the other leg. Do the far leg
first.
8.3. Place the basin near the feet with the towel under it. Flex the leg at the knee and
while supporting the heel with the cup of your hand, wash one foot at a time in
the basin. Pay particular attention to the spaces between the toes. Rinse, place on the towel, and
dry.
8.4. Remove the basin. Discard the water and obtain fresh, warm bath water.
9. Wash the back and perineum.
9.1. Assist the client to turn to a prone position or side-lying position facing away from
you, and place the bath towel lengthwise alongside the back and buttocks.
9.2. Expose the back and the buttocks. Wash and dry the back, buttocks, and upper
thighs, paying particular attention to the gluteal folds. Give A back rub (refer to
specific procedure for backrub). Avoid undue exposure of the client.
9.3. Assist the client to the supine position and determine whether the client can wash
the genital – perineal area independently. If the client can do so, place the basin
(with newly replaced water), washcloth and towel within easy reach so the client can
wash the genital area or assist the client as necessary. If the client cannot do so, drape the
client and wash the genital area (refer to specific procedure).
9.4. Discard the used washcloth, towel, and water.
10. Assist the client with grooming aids such as powder, lotion, or deodorant.
10.1. Use powder sparingly.
10.2. Help the client to put on a clean gown or pajama.
10.3. Assist the client with hair, mouth, and nail care. Some people prefer or need mouth
care prior to the bath.

Post Procedure
11. Make an Occupied Bed (refer to specific Procedure).
12. Do after-care of equipment and supplies.
13. Lower the bed to its lowest position.
14. Unscreen the person.
15. Decontaminate your hands.
Evaluation and Documentation
1. Evaluation is done in terms of fatigue manifested by the client, feelings about comfort
and cleanliness, and objective signs of cleanliness.
Document pertinent data: Assessment findings such as excoriation in the folds beneath the
breasts or reddened areas over bony prominences and progress in relief of previous problems;
Type of bath given; Client’s preferences or ability to participate