INFORMATION SHEET 5.3-1F

INFORMATION SHEET #5.3-1F
CLEANSING BED BATH

Cleansing Bed Bath and Backrub
Definition: Bathing client while on bed

Objectives:
1. Stimulate the circulation in order to:

a. Increase functioning of the skin
b. Promote muscular relaxation
c. To relieve muscular fatigue
d. To clean the skin and refresh the patient
e. To observe unusual signs and symptoms
Equipment:
a. Two bath towels
b. Two washcloths
c. bed linen (optional)
d. Soap and soap dish
e. Bath blanket or top spread ( for complete or partial bath )
f. Clean gown or pajamas
g. Hygienic aids, such as skin lotion, deodorant, powder
h. Bedpan, urinal & toilet paper
i. Linen hamper or laundry bag

j. Disposable gloves
k. 2 washbasin ( for complete or partial bath )
l. l. Table protector
m. Comb
n. Pitchers with warm water
a. Backrub
Definition: Massage of the back while generally follows with the client's bath.
Objectives:
1. It acts as a general body conditioner and promotes peripheral circulation.
2. It relieves tension and may also relieve headache due to tension in the

back and the shoulders
3. It has psychological benefits. It gives an opportunity for the health worker

and the client to establish rapport.
4. It also provides an opportunity for the health worker to observe the skin

for signs of breakdown.

Techniques Used:
a. Effleurage – are smooth, long rhythmical

movements that are used in moving the hands
up the spine and then lightly down the sides.
This technique is also called deep stroking. The
health worker must place her entire hand on
the client's skin.

b. Petrissage – this is also kneading. Large
pinches of about three inches of skin and
muscles are taken ( picking up the skin between
the fingers ) and the fingers move up the sides
of the vertebral column and then over the entire
back.

c. Tapotement – uses the edges of the
hand in a hacking motion over the surface of
the back ( striking the back lightly with the
sides of the hand )

Solution Used:
1. Emollient lotions or creams are preferred because of their smoothness and
therapeutic benefits to the skin.

2. Alcohol should be used with caution because it dries and hardens the skin
and makes it more prone to cracking.

Cleansing Bed Bath

STEPS RATIONALE

1.Assess client for bathing practices, Promotes participation and
frequency of bathing, time of day sense of comfort
preferred,type of hygienic products
used. Prevent accidental injury to
client during bathing
2. Consider client’s condition and activities
review orders for precautions
concerning client’s movement for Promote s client cooperation
positioning. and participation

3. Explain procedure and ask client for
suggestions or ways to prepare
supplies. If partial bath is to be
performed, ask how much bath client
wishes to complete.

4.Adjust room temperature and Prevents rapid loss of heat
ventilation, and close room doors and during bathing. Ensures
windows. Close curtain around bed privacy

5. Offer client bed pan or urinal. Client will feel comfortable
Provide towel and wash cloth for client. after voiding, prevents

interruption of bath.

6. Wash hands. Optional. Apply gloves Reduces transmission of
if required by institution’s policy or microorganism
procedure.

7. Pull side rail up. Fill wash basin two Raising side rail maintain
thirds full, with water at 43o – 46o C safety as you leave bedside.
(110 – 115oF). Have client place fingers
in water to test temperature tolerance. Warm water promotes and
Option. Place plastic container of bath prevents chilling. Testing the

lotion in bath water. temperature prevents

accidental burning of client's
skin. Keeps lotion warm for

application to skin.

8. Bring client toward side closer to This facilitates access
you. without undue reaching and
straining.
9. Remove pillow if allowed and raise
head of the bed 30 – 40 degrees. Place Removal of pillow makes it
bath towel under clients head. easier to wash client's ears
and neck. Placement of towel
10. Loosen top covers at foot of the prevents soiling of bed linen.
bed. Place bath blanket over top sheet.
Fold and remove top sheet from under Removal of top linens
blanket. If possible, have client hold prevents them from becoming
soiled or moist during bath.

bath blanket while you withdraw Blanket provides warmth and

sheet. privacy.

11. If top sheet is to be reused, fold it Proper disposal prevents
and place on the back of the chair. If transmission of
not, dispose in laundry bag, taking microorganism.
care not to allow linen to contact to

your uniform.

12. Remove client's gown or pajamas Provides full exposure of body
while maintaining privacy. If extremity
is injured or has reduced mobility, parts during bathing.
begin removal from unaffected side. If
client has intravenous (IV) tube, Undressing unaffected side
remove gown from arm without IV first,
and then lower IV container and slide first allows easier
gown covering affected arm tubing and manipulation of gown over

container. Rehang IV. body part with reduced ROM.

13. Place the bath towel over client's Prevents soiling of bath
blanket
chest under the chin.

14. Fold washcloth around fingers of Mitt retains water and heat
your hand to form mitt. Immerse mitt better than loosely hold
in water and wring thoroughly. washcloth, keeps cold edges
from brushing against client,

prevent splashing.

15. Wash client's eyes with plain warm Soap irritates eyes. Use of
water. Use different section of mitt for
each eye. Move mitt from inner to outer separate section of mitt
canthus. Soak encrustation on eyelids reduces infection
for 2 – 3 minutes with damp cloth
before attempting removal. Dry eye transmission. Bathing eye
thoroughly but gently. from inner to outer canthus

prevents secretions from

entering nasolacrimal duct.

Pressure can cause internal
injury.

16. Ask client about preference for Soap tends to dry face
using soap for face. Wash, rinse and quickly because it is exposed
dry well forehead, cheeks, nose, neck to air more than other body
parts.
and ears.

17. Remove bath blanket from over Bathing far side first prevents
client's arm that is farthest from you. reaching over clean area.
Place bath towel lengthwise under
arm.

18. Lower side rails if removed to Soap lowers surface tension
opposite side. Bath arm with soap an & facilitates removal of debris
water using long firm strokes from and bacteria when friction is
distal to proximal areas (finger to
axilla). Raise and support arm above (if applied during washing.
possible) while thoroughly washing Long, firm strokes stimulate

axilla. circulation. Movement of arm
exposes axilla and exercises

joints normal ROM distal to
proximal to increase venous

return to the heart.

19. Rinse and dry arm and axilla Excess moisture causes skin
thoroughly. If client's prefers, apply maceration or softening.
deodorant or talcum powder. Deodorant controls body

odor.

20. Fold bath towel in half and lay it on Soaking softens cuticles and
bed beside client. Place basin on towel. calluses of hand and loosens

Immerse client's hand in water. debris beneath the nails.
Option. Allow hand to soak 3 – 5 Soaking also enhances
feeling of cleanliness.
minutes before washing hand and

fingernails. Remove basin and dry Thorough drying removes

hand well. moisture between fingers.

21. Repeat steps 17 – 20 for other arm.

22. Change temperature of bath water Use of warm water maintains

and change if necessary clients comfort.

23. Cover client's chest with bath towel Prevents unnecessary
and fold bath blanket down to the
exposure of body parts
umbilicus.
Maintains warmth and
privacy.

24. With one hand, lift edge of towel Prevent chilling and exposure
of body parts.
away from chest. With mitted hand,
bathe chest using long firm strokes. Moisture and sediments that
Take special care to wash skin folds collect in skin folds
predispose client to skin
under female client's breast, lifting maceration and irritation.
breast in unnecessary. Keep chest

covered between wash and rinse

periods. Dry well.

25. Place bath towel lengthwise over Prevents unnecessary
chest and abdomen. exposure.

(two towels may be needed). Fold
bath blanket down to just above pubic
region.

26. With one hand, lift bath towel. With Prevents soiling of bed linen.
emitted hand bath abdomen, giving Support of joint & extremity
special attention to bathing umbilicus during lifting prevents strain
and abdominal folds. Stroke from side on musculoskeletal
to side. Keep abdomen covered structures.

between washing and rinsing. Dry well.

27. Cover chest and abdomen with top
bath blanket.

28. Expose far leg by folding blanket Sudden movement by client
over toward midline. Be sure perineum could cause spillage of
is draped. bathwater. ( This step is
omitted if client is unable to
hold leg in basin ).

29. Bend client's leg at knee by Promotes venous return.
positioning your arm under the leg. Long, firm strokes should not
While grasping client heel, elevate leg be used for clients with blood
from mattress slightly and slide bath clots

towel lengthwise under leg.

30. Ask client to hold still. Place bath Proper positioning of foot
basin on towel on bed and secure its prevents pressure from being
position next to foot to be washed. applied from edge of basin
against calf.(Note: if client is
unable to hold leg in basin,
do not immerse, simply wash
with wash cloth).

31. Unless contraindicated, use long, Secretion and moisture may
firm strokes in washing fro ankle to be present between toes.
knee, knee to thigh. Dry well. Lotion helps to retain
moisture.

32. Do the same with leg near you. Drop in water temperature
during bathing can cause
chilling. Clean water reduces
microorganism transmission.

33. With one hand supporting lower Expose back and buttocks for
leg, raise it and slide basin under lifted bathing
foot. Immerse one foot at a time. Make
sure foot is firmly placed on bottom of Maintain warmth and
basin. unnecessary exposure
Prevents contact with
34. Soap foot, making sure to bathe microorganism in the body
between toes. Rinse and dry well. If secretions.
skin is dry. Apply lotion.

35. Cover client with bath blanket, Skin folds near buttocks and
raise side rail for client's safety, and anus may contain fecal
change bathwater. secretions that harbor
microorganisms. Prevents
transfer of microorganism

from anal area to genitalia.

36. Lower side rail. Assist client in Maintains client's privacy,
assuming prone or side lying position client's capable of performing
(as applicable). Place towel lengthwise partial bath usually prefer to

along client's side. wash their own genitalia.

37. Keep client draped by sliding bath
blanket over shoulders and thigh.

38. Apply disposable gloves ( if not
done yet )

39. Wash, rinse and dry back from Skin folds are site for
neck to buttocks using long, firm accumulation of secretion
strokes. Pay special attention to folds
and moisture.
of buttocks and anus. Give back rub.

40. Change bath towel and washcloth.

41. Assist client in assuming side-lying Prevents transmission of
or supine position. Cover chest and microorganism
upper extremities with towel and lower
extremities with bath blanket. Expose
only genitalia. (if the client can help,
covering the entire body with bath
blanket may be preferable. ) Wash,
rinse and dry the perineum. Gave
special attention to skin folds. If client
is able to do the perineal care, leave
wash cloth basin and soap within easy
reach and leave are.

42. Dispose gloves in a receptacle

Moisturizing lotion prevents
43. Apply any additional body lotion or dry, chapped skin.
oil as desired.

44. Help the client to put on a clean Dressing affected side first
gown. If one extremity is injured or allows easier manipulations
immobilized always dress affected side of gown over body part with
first. reduce ROM

45. Comb client's hair.
Woman may want to apply make-up. Maintain client's body image

NOTE: Mouth care, nail care, ear care,
hair care will demonstrated separately.

46. Straighten client's bed.

Provide clean environment

47. Remove soiled linen and place and Prevents transmission of
place in dirty linen bag. Cleanse and infection. Clean environment
replace bathing equipment. Replace promotes comfort. Keeping
call light and personal possessions. call light and articles of care
Leave room as clean and comfortable within reach promotes safety

as possible.

48. Wash hands Reduce transmission of
microorganism

49. Observe client's behavior and ask Determine tolerance to
if fatigue or discomfort is felt. bathing activities

50. Note areas on skin that were Technique used during
previously soiled or reddened or bathing should leave skin

showed early signs of breakdown. clean and clear

51. Record type of bath and client's Timely documentation
tolerance of bathing. Also note
condition of skin and any significant maintains accuracy of client's
findings such as reddened skin areas record. Condition of skin
or joint or muscle pain. Record level of
assistance required by the client. documents response to
therapy such as turning and

positioning.