Bed bath.pptx

bed bath

1. Bed bath

2. definition Bed bath refers to the procedure of giving bath to the patients who is confined to bed or is not ambulatory or is not physically or mentally capable of self care.

3. Types of therapeutic baths Hot water tub bath Immersion in hot water helps to relive muscle soreness and spasm. Water temperature should be 45ºC TO 46ºC

4. WARM WATER TUB BATH Bathing in warm water relieves muscle tension. Water temperature should be 43ºC

5. COOL WATER BATH Bathing in tepid water helps to lower body temperature is over 40ºC. Water temperature should be 37ºC.

6. Sitz bath

7. SITZ BATH HOT SITZ BATH Cleanses and reduces inflammation of the perineal and anal areas of a patient who has undergone rectal or perineal surgery or in hemorroids or fissures. Water temperature should be 43ºC TO 45ºC.

8. COLD SITZ BATH Cold sitz bath is more effective in releiving pain in the post partum period.

9. BACK RUB OR BACK MASSAGE It promotes relaxation, relieves muscular tension and stimulates skin circulation. An effective back rub takes 3-5 minutes.

10. PURPOSES Removal of bacteria from the skin Confinement in bed increases perspiration and bacterial growth, stimulated by moisture. Skin irritation from hospital bed linens may results in skin breakdown and subsequent infection.

11. Stimulation of blood circulation to the skin, respirations and eliminations Maintenance of joint mobility Relaxation effect on the patient

12. Improvement of the patient’s self image and emotional and mental wellbeing Providing the nurse with an opportunity for health teaching and assessment Providing the nurse with an opportunity to give the patient psychological support The bath aids in the development of therapeutic nurse patient relationship as the patient has the nurse’s undivided attention The nurse can orient the scientific method of providing skin care to the patient relatives

13. TIMING OF PROVIDING BED BATH A patient’s bath may be given at any time, according to the patient’s needs, but certain routines are generally followed on a ward Morning care The procedure followed in the morning affects the patients comfort throughout the day Each morning before breakfast, the patient should be assissted to the bathroom or a bedpan or urinal The patient is then given the opportunity to wash his/her teeth. The bed linen is straightened and the overbed table is cleaned in preparation for the breakfast tray After breakfast, the patient has a complete bath

14. Bed linens are changed and the unit is cleaned and straightened to provide a comfortable and safe environment Evening care Care provided to patient at the end of the day greatly influences the patient's level of relaxation and ability to sleep Bed linens are straightened, the patient’s unit is straightened, to ensure comfort and safety.

15. GENERAL INSTRUCTIONS Maintain privacy of the patient by using screens, drapes etc. The patient’s unit should be warm and free odf droughts. Bed bath should not be given immediately after meals, because it will affect the normal process of digestion Avoid unnecessary exertion of the patient Avoid over exposure of the patient

16. Give special attention to pressure points, skin creases and folds Maintain proper body mechanism during the procedure Cleaning is done from cleanest to less clean area Temperature of the water should be according to the patient’s comfort For sponge bath 100-115ºf For tub bath/bathroom bath 90-100ºf

17. procedure Preliminary assessment Assess the patient’s need for bathing Check the patient’s ability for self care Check whether the patient has taken meals not less than before one hour Check the articles available with the patient and keep in his unit

18. articles Bath basin -1 Sponge clothes – 2 Small bowl – 1 Soap with soap dish Bath towel – 1 Face towel – 1 Bath blanket/sheet-1 Spirit and powder

19. Nail cutter or scissors Comb and oil A kidney tray and a paper bag Jugs – 2 Bucket -1 A set of the patient’s clothes Screen/curtain A laundry bag Bath thermometer

20. Preparation of the patient Explain the patient regarding the sequence of the procedure Bring the patient to the edge of the bed nearer to the nurse Provide privacy by means of screens/curtains Remove extra pillows and backrest, keep one pillow under the patient’s head, if condition permits Offer a bed pan or urinal, if necessary Remove the top linen, patient’s clothes Replace the top linen with bath blanket/sheet

21. procedure Steps Wash hands Pair of gloves Mix hot and cold water in the basin and check for the temperature for tolerance by placing elbow in water(preferably to be checked with bath thermometer) rationale To prevent cross-infection To prevent cross-infection Excess of heat can give rise to burns

22. steps Place the bath towel over the patient’s chest under the chin Wash, rinse and dry forehead, cheeks, nose, neck and ears Dry the face with a face towel Place the bath towel length wise under the farthest arm. Wrap your right hand with a sponge towel. Bath arm with soap and water with long firm strokes from distal to proximal. rationale To prevent soiling of the bath blanket/sheet Cleansing is done from cleanest to less cleanest to less clean areas. To avoid uneasiness Soap removes dirt and cleans the skin. Long firm strokes stimulate circulation

23. Rinse and support arms above the head while washing axillae thoroughly. Rinse and dry arm and axillae. Apply talcum powder, if needed. Fold the bath towel in half and place basin on the towel. Immerse the patient’s hand in water. Rinse and dry thoroughly, giving special attention to the skin between fingers and nails. Movement of arms expose axillae. Skin folds to be kept dry Soaking softens cuticles and calluses of hand and loosens debris beneath nails. Soaking gives a feeling of cleanliness. Through drying removes moisture in between fingers

24. Repeat the same for the other arm. Cover the patient’s chest with a bath towel and fold the bath blanket down to umbilicus Soaking softens cuticles and calluses of hand and loosens debris beneath nails. Soaking gives a feeling of cleanliness. Through drying removes moisture in between fingers Prevents unnecessary exposure of the body parts.

25. With one hand, lift the edge of the towel away from the chest. With mitted hand, clean the chest using long firm strokes. Give special care to wash skin folds under breasts in a female patient, keep the chest covered between wash and rinse periods. Dry well. Maintain privacy and warmth. Secretions and dirt usually get collected in areas of tight skin folds.

26. With the towel remaining on the chest, fold back the blanket down to the pubic region, clean the abdomen by giving special attention to the umbilicus and abdominal folds. Keep the abdomen covered between washing and rinsing. Dry well. Remove the towel and put back the bath blanket and cover the patient. Change water. The waste water is discarded into the bucket. Moisten the sediments that collect in skin folds, predispose the client to skin maceration and irritation. To avoid over exposure and chills in the patient

27. Turn the patient to the prone or side lying position. Place a towel length wise along the client’s side. Keep the patient draped by sliding a bath blanket over shoulders and thighs. Wash, rinse and dry back from the neck to buttocks, using long firm strokes. After drying the back give a through back rub with powder longitudinally in circular motion. Pay special attention to all pressure points. Expose back and buttocks for bathing. Maintains warmth and prevents unnecessary exposure. A thorough cleaning, back rub and application of spirit and powder prevents bed sores.

28. Put on the upper garments and cover him/her with a bath blanket Expose farthest leg by folding the bath blanket towards midline. Flex the knees. Place the bath towel length-wise under the leg. Place the basin on the towel and keep the foot in the basin. Prevent exposure of the body for a longer period. Patient feels safe and comfortable Promotes thorough cleaning.

29. Use long, firm strokes in washing from ankle to knee and from knee to thigh. Dry well. At the end clean the foot in water, paying particular attention to the toes and nails. Promotes venous return. Water softens the nailbeds and makes it easier to clean. Secretions and moisture may be present between toes

30. By exposing only genitalia, clean the perineum thoroughly and dry. Give special attention to skin folds. The patient can do it himself if he is able to do so. Put on the lower garments. Remove the bath blanket. Cover the patient with top linen. Maintains the patient’s privacy. Patients, who are capable, usually prefer doing it by themselves. Skin folds are a site for accumulation of secretions and moisture. To prevent exposure

31. After care of the patient Cut short finger nails and toe nails. Put oil and comb the hair. Offer hot/cold drinks as permitted. Remove the bath blanket and cover the patient with the top linen of the bed. Take the opportunity to educate the patient on health during bath time. Later educate his relatives about the importance of maintaining personal hygiene. Wash hands. Record the procedure in the nurses record regarding all observations made during bath.

32. After care of the articles Take all the articles to the utility room, clean them with soap and water. Dry them and replace at their respective places. Disinfect the linen and other articles in case the patient is suffering from any communicable disease.