Definition
A bed bath for an adult patient is a vital nursing procedure that promotes hygiene, comfort, skin integrity, and dignity—especially for patients who are bedridden or have limited mobility.
Purposes of Bed Bath
- To remove transient microorganisms, body secretions, and excretions, dead skin cells.
- To stimulate circulation.
- To produce a feeling of well-being.
- To promote relaxation and comfort.
- To improve self-esteem.
- To prevent or eliminate bad odor.
Articles for Bed Bath
- Bedpan/urinal.
- Basin.
- Jugs with hot water and cold water [water of 110 – 115°F (43 – 45 °C) for adults and 100 to 105°F for children].
- Table or trolley.
- Bath blanket/sheet.
- Clean gloves.
- Wash clothes (2 nos.).
- Soap.
- Towels (2 nos).
- Lotions, powders, deodorants (optional).
- Change of bed linen (1 set).
- Change of patient’s dress (1 set).
Procedure for Bed Bath
| NURSING ACTIONS | RATIONALE | |
| 1. | Before procedure Prepare patient and environment. Explain the bed bath procedure to patient and relative and encourage participation from patient or relative. | Reduces anxiety and encourages cooperation. Air currents increase loss of heat from the body. Reduces patient’s embarrassment. |
| Close windows and doors to make sure that the room is free from drafts and switch off fan/AC. | Enhances comfort of the patient. | |
| Provide privacy by drawing curtains and closing doors. | ||
| Offer bedpan or urinal if he/she requires before starting bed bath. | ||
| 2. | Prepare bed and position patient appropriately: Place bed in a high position. | Reduces strain to nurse’s back. |
| Position patient close to right side of the bed or close to nurse. | ||
| Raise side rails on both sides. | ||
| 3. | During procedure Wash hands and put on clean gloves. | Reduces transmission of microorganisms. |
| 4. | Lower side rails on the right side. | |
| 5. | Arrange articles within your reach. | |
| 6. | Make mittens with the washcloth. | Mitts conserve heat of water and prevents tip of wash cloth from trailing and dripping over patient’s body. |
| 7. | Check temperature of water mixed in the basin by pouring water on the inner aspect of the palm of the patient. | Prevents risk of burns. |
| 8. | Remove patient’s clothing and cover with a bath blanket or sheet. Expose only that part of the body which is to be washed. | Ensures privacy and prevents chills for the patient. |
| 9. | Wash face: Place one bath towel under patient’s head. | Prevents wetting pillows and bed linen. Bath mitt retains temperature of water. |
| Wet bath mitt, squeeze water from it, so that it is not dribbling. | ||
| Wash patient’s eyes using separate corners of the bath mitt for each eye and wipe from inner canthus to outer canthus. | Prevents transmission of organisms from one eye to another, wiping from inner to outer canthus prevents secretions from entering nasolacrimal duct. | |
| Ask patient if he prefers using soap for the face (in unconscious patients avoid soap). | Soap has a drying effect and face is more exposed to the air than any other body part and hence tends to be drier. | |
| If using soap, apply soap with the second mitt and then rinse with the first mitt, till the soap is completely removed. | Soap if remains on skin will cause irritation. | |
| Repeat entire procedure for other arm. | ||
| 10. | Wash arms and hands: Place bath towel lengthwise under arm farther to you. | Protects bed linen from becoming wet. |
| Wash, apply soap, rinse, and dry arms using long strokes from distal to proximal areas. | Firm strokes from distal to proximal areas will increase venous return. | |
| Pat dry using the second bath towel. Do not rub. | Rubbing may cause skin injuries. | |
| Wash axilla well. Exercise precaution, if there is an IV infusion on arm. | ||
| Place folded towel on bed under hands and place basin on it. Attend to interdigital spaces. Immerse hand in basin and assist patient in washing hand. | ||
| Repeat entire procedure for other arm. | ||
| 11. | Wash chest and abdomen: Fold bath blanket up to pubic area. Place towel over the chest and abdomen. | Prevents unnecessary exposure of patient. |
| Wash, rinse, and dry chest and abdomen giving special attention to skin folds under breasts. | ||
| Keep chest and abdomen covered all along and use long firm strokes to wash the area. In women, wash chest and abdomen separately. | ||
| 12. | Change water if cold, dirty, or soapy. | |
| 13. | Wash back of patient: Turn patient to side lying or prone position and expose back. | |
| Place towel lengthwise alongside back of patient. | ||
| Wash, rinse, and dry using long, firm strokes from neck to buttocks. | ||
| Give back massage. | ||
| 14. | Change bath water. | |
| 15. | Turn patient back to supine position. | |
| 16. | Wash legs: Place towel lengthwise under farther leg away from you. | |
| Bend leg at knee, supporting under leg and ask patient to hold position. If patient is unable to do it, ask another nurse/family member to support leg. | ||
| Use long, firm strokes to wash from distal to proximal/from ankle to knee and knee to thigh. Do not use such long strokes in patients having blood clots in lower extremities. For example, in deep vein thrombosis (DVT) as it may dislodge the clot. | Moving from distal to proximal improves venous circulation and removes dirt from skin pores. | |
| Wash, rinse, and dry the extremity. | ||
| Fold towel and place beneath foot of the patient. Place basin with water under the foot and clean with mitt. Take out the foot and dry the extremity. | ||
| Discard water. | ||
| Repeat the entire procedure for the other leg. | ||
| 17. | Encourage patient to clean perineal area with mitt. Discard it into a kidney tray. | Promotes patient’s independence. |
| 18. | Position patient in a comfortable manner. | Ensures patients wellbeing. |
| 19. | Apply moisturizer or body lotion if patient prefers or if skin is dry. | Lotions prevent drying and chapped skin. |
| 20. | Assist the patient in dressing. | |
| 21. | Comb hair. | Ensures that the patient is well groomed which promotes well-being. |
| 22. | Change bed linen. | |
| 23. | After procedure Wash hands. | |
| 24. | Record procedure: Record any specific observations made while bathing, e.g., pressure sores, skin integrity, etc. | |
| 25. | Replace all articles. |
Special Considerations
- Obtain assistance if required in case of helpless/unconscious patient.
- If patient is obese or cannot move in bed, nurse may move from one side of the bed to the other side to ensure good body mechanics.
- Assess patient’s general condition before giving bath.
- Bath should not be given immediately after food because it interferes with the process of digestion.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
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