GIVING A BED BATH

Goal: The patient will be clean and fresh.

 STEPS
1. Review chart for any limitations in physical activity.
• Identify the patient.
• Discuss procedure with patient and assess patient’s
ability to assist in the bathing process, as well as
personal hygiene preferences.
 STEPS
2. Bring necessary equipment to the bedside stand or
overbed table.

• Remove sequential compression devices and

antiembolism stockings from lower extremities according
to agency protocol.
 STEPS
3. Close curtains around bed and close door to room if
possible. Adjust the room temperature if necessary.
4. Offer patient bedpan or urinal.
5. Perform hand hygiene.
6. Raise bed to a comfortable working height.
 STEPS
7. Lower side rail nearer to you and assist patient to side
of bed where you will work. Have patient lie on his or
her back.

8. Loosen top covers and remove all except the top

sheet.
• Place bath blanket over patient and then remove top
sheet while patient holds bath blanket in place.
• If linen is to be reused, fold it over a chair.
• Place soiled linen in laundry bag.
• Take care to prevent linen from coming in contact with
your clothing.
 STEPS
9. Remove patient’s gown and keep bath blanket in place.
• If patient has an IV line and is not wearing a gown with
snap sleeves, remove gown from other arm first.
• Lower the IV container and pass gown over the tubing
and the container.
• Rehang the container and check the drip rate.
 STEPS
10. Raise side rail.
• Fill basin with a sufficient amount of comfortably
warm water (110º–115ºF).
• Change as necessary throughout the bath.
• Lower side rail closer to you when you return to
the bedside to begin the bath.
11. Put on gloves, if necessary. Fold the washcloth
like a mitt on your hand so that there are no loose
ends.
 STEPS
12. Lay a towel across patient’s chest and on top
of bath blanket.

13. With no soap on the washcloth, wipe one eye

from the inner part of the eye, near the nose, to
the outer part. Rinse or turn the cloth before
washing the other eye.

14. Bathe patient’s face, neck, and ears, avoiding

soap on the face if the patient prefers. Apply
appropriate emollient.
 STEPS
15. Expose patient’s far arm and place towel lengthwise
under it.
• Using firm strokes, wash arm and axilla, lifting the arm as
necessary to access axillary region.
• Rinse, if necessary, and dry.
• Apply appropriate emollient.
 STEPS
16. Place a folded towel on the bed next to patient’s hand
and put basin on it.

• Soak patient’s hand in basin.

• Wash, rinse, if necessary, and dry hand.
• Apply appropriate emollient.
 STEPS
17. Repeat Actions 15 and 16 for the arm nearer you.
• An option for the shorter nurse or one prone to back strain
might be to bathe one side of the patient and move to the
other side of the bed to complete the bath.
 STEPS
18. Spread a towel across patient’s chest.
• Lower bath blanket to patient’s umbilical area.
• Wash, rinse, if necessary, and dry chest.
• Keep chest covered with towel between the wash and
rinse.
• Pay special attention to skin folds under the breasts.
 STEPS
19. Lower bath blanket to perineal area. Place a towel over
patient’s chest.

20. Wash, rinse, if necessary, and dry abdomen. Carefully

inspect and clean umbilical area and any abdominal folds
or creases.
 STEPS
21. Return bath blanket to original position and expose far
leg.
• Place towel under far leg.
• Using firm strokes, wash, rinse, if necessary, and dry leg
from ankle to knee and knee to groin.
• Apply appropriate emollient.
 STEPS
22. Fold a towel near patient’s foot area and place
basin on it.
• Place foot in basin while supporting the ankle and
heel in your hand and the leg on your arm.
• Wash, rinse, if necessary, and dry, paying
particular attention to area between toes.
• Apply appropriate emollient.

23. Repeat Actions 21 and 22 for the other leg and

foot.
 STEPS
24. Make sure patient is covered with bath blanket. Change
water and washcloth at this point or earlier if necessary.

25. Assist patient to prone or side-lying position. Put on

gloves, if not applied earlier. Position bath blanket and
towel to expose only the back and buttocks.
 STEPS
26. Wash, rinse, if necessary, and dry back and buttocks
area.

• Pay particular attention to cleansing between gluteal

folds, and observe for any redness or skin breakdown
in the sacral area.
 STEPS
27. If not contraindicated, give patient a backrub. Back
massage may be given also after perineal care. Apply
appropriate emollient and/or skin-barrier product.
28. Raise the side rail. Refill basin with clean water.
Discard washcloth and towel. Remove gloves and put on
clean gloves.
 STEPS
29. Clean perineal area or set up patient so that he
or she can complete perineal self-care. If the
patient is unable, lower the side rail and complete
perineal care. Raise side rail, remove gloves, and
perform hand hygiene.
30. Help patient put on a clean gown and assist
with the use of other personal toiletries, such as
deodorant or cosmetics.
 STEPS
31. Protect pillow with towel and groom patient’s hair.

32. Change bed linens, as described in Skills 7-9 and 7-10.

Remove gloves and perform hand hygiene. Dispose of
soiled linens according to agency policy.
SHAMPOOING A
PATIENT’S HAIR IN BED
Goal: The patient’s hair will be clean.
 STEPS
1. Identify the patient. Explain procedure to patient.
2. Assemble equipment on overbed table within reach.
3. Close the room door or curtain.
4. Perform hand hygiene. If you suspect there are any
cuts of the scalp or blood in the hair, put on
disposable gloves. Lower head of bed.
 STEPS
5. Remove pillow and place protective pad under
patient’s head and shoulders.

6. Fill the pitcher with warm water (43º–46ºC

[110º–115ºF]). Position the patient at the top of
the bed, in a supine position. Have the patient lift
his head and place shampoo board underneath
patient’s head. If necessary, pad the edge of the
board with a small towel.
 STEPS
7. Place bucket on floor underneath the drain of the
shampoo board.
8. If the patient is able, have him or her hold a folded
washcloth at the forehead. Pour pitcher of warm water
slowly over patient’s head, making sure that all hair is
saturated. Refill pitcher if needed.
 STEPS
9. Apply a small amount of shampoo to patient’s hair.
Massage deep into the scalp, avoiding any cuts,
lesions, or sore spots.

10. Rinse with warm water (43º–46ºC [110º–115ºF]) until all

shampoo is out of hair. Repeat shampoo if necessary.

11. If patient has thick hair or requests it, apply a small

amount of conditioner to hair and massage throughout.
Avoid any cuts, lesions, or sore spots.
 STEPS
12. If bucket is small, empty before rinsing hair.
Rinse with warm water (43º–46ºC [110º–115ºF])
until all conditioner is out of hair.

13. Remove shampoo board. Place towel around

patient’s hair.

14. Pat hair dry, avoiding any cuts, lesions, or sore

spots. Remove protective padding but keep one
dry protective pad under patient’s hair.
 STEPS
15. Gently brush hair, removing tangles as needed.
16. Blow-dry hair on a cool setting if allowed and if patient
wishes.
17. Change patient’s gown and remove protective pad.
Replace pillow.
18. Remove gloves. Perform hand hygiene.
Giving a back massage
 Massage
• a systematic manual or mechanical
manipulations of soft tissues of the body
movements such as rubbing, kneading,
pressing, rolling, slapping, and tapping for
therapeutic purposes.
 Importance: Back Massage
1. To bring about any of the physiologic,
mechanical or psychological effect attributed to
massage.
2. To relieve pain
3. Prepares the injured or involved muscle for
exercise to their fullest capacity
4. Encourage the confidence of the patient
5. Prepare healthy muscle for strenuous sports
activity
Benefits:
1. Stress and tension are relieved.
2. Mental and physical fatigue is relieved leading to
renew energy and ambition
3. Pain in the shoulders, neck and back is relieved.
4. Muscles and joints become more supple. Soreness
and stiffness are relieved.
5. Muscle soreness from overextension can be
reduced or prevented.
6. Circulation is improved, thus improving skin tone.
7. Facial massage tones the skin, help prevent
blemished skin, and softens fine lines.
9. Muscular spasms are relieved.
10.Deep relaxation is induced and insomnia
relieved.
11.Mental strain is reduced, resulting in better
productivity.
12.Mildly high blood pressure is temporarily
reduced.
13.Ease anxiety
14.Joint mobility can be increased.
Assessment:
1. Behaviors indicating potential need for a back
massage, such as a complaint of stiffness,
muscle tension in the back or shoulders, or
difficulty sleeping related to tenseness or
anxiety.
2. Whether the client is willing to have a massage,
because some individuals may not enjoy a
massage.
3. Contraindicated for back massage:
- impaired skin integrity (acne, boils, burns)
- back surgery
- vertebral or rib fracture
Massage Techniques
 Effleurage
– means a long, soothing, stroking movements
which are performed using the flat of the hand or
fingers.
 Petrissage
• the movements
which involves
various way of
kneading, rolling
and picking up the
skin and muscles.
 Tapotement
• fast and stimulating movements of massage,
they include cupping, hacking and pounding
(also called pummeling)
 Friction
• using the thumb, fingertips or knuckles, one can
apply deep direct pressure to one particular site of
muscular tension.
• This type of massage is also called “connective tissue
massage”. It is very useful for focusing on specific of
tightness and muscles spasms in the back.
 Hand over Hand

• massage the back

with short quick
strokes,
alternating hands.
 Kneading
• squeeze the shoulder muscle with each hand
as you slide the hands together.
• Massage 5-20 minutes in accordance with
client’s tolerance.

• use oil, lotion or powder.

THE END