Bed Bath Procedure - Definition, Purpose, Procedure and Key Points (2025)

Updated 2024

Bed bath means bathing a patient who is confined to bed and cannot have the physical and mental capability of self-bathing. This procedure is often used for bedridden or immobile patients.

BED BATH DEFINITION

Bath is the act of cleaning the body. Baths are given for therapeutic purposes

Purposes

• To cleanse body of dirt, debris andperspiration
• To refresh
• To stimulate circulation
• To provide comfort and relaxation
• To enhance self-concept
• To provide tactile stimulation
• To facilitate head to be assessment
• To regulate body temperature
• To induce sleep
• To prevent pressure sore
• To remove toxic substances from bodysurface
• To maintain an effectivenurse-patient relationship
• To give health instruction to patient
• To remove unpleasant odors due toperspiration
• To relieve fatigue
• To prevent contractures by givingexercises
• To minimize the skin irritation

Types of Patients Needing Bed Bath

• Unconscious or semiconscious patients
• Postoperative patients
• Patients with strict bed rest
• Paraplegic patients
• Orthopedic patients in plaster – castand traction
• Seriously ill patients

Types of Cleansing Bath

Bed bath: it is the bathing of a patient who is confined to bed

Therapeutic bath: doctor specifies the temperature of the water, medications to be added and the body part to be treated

Partial bath: it is the act of cleaning particular areas in the body part. They are face, axilla, and genitalia, upper and lower-limbs

Self-administered bath: this is same as in bed bath except the patient is assisting in taking bath

Tub bath or bath room bath: this bath is allowed to the patient only if he has enough confidence for self-help and to withstand procedure

Scientific Principles

• Heat is conveyed to the body byconvection
• The tolerance of heat is different indifferent persons
• The skin is sometimes irritated bythe chemical composition of certain soaps
• Moving the joints through their fullrange of movement helps prevent loss of muscle tone and improves circulation
• Long smooth strokes on the arms andlegs that are directed from the distal end to proximal increases the rate ofvenous flow
• Healthy unbroken skin is a defenseagainst harmful agents and assures resistance to injuries to a certain extent
• Hygiene practices vary in societyaccording to the socioeconomic standard and culture of the individual
• Practice of food technique save time,energy material and adds to the comfort of the patient
• Sensory receptors in the skin aresensitive to heat, pains, touch and pressure

Factors Affecting the Skin

• Impaired self-care
• Immobilization
• Exposure to pressure and moisture
• Vascular insufficiency
• Reduced sensation
• Nutritional alternation
• Constrictive external devices

General Instructions

• Explain the procedure to the patient
• Maintain privacy of the patient
• Put off the fans and close thewindows and doors to avoid chill
• Do not give bath immediately afterthe lunch
• Cleaning is to be done from thecleanest area to the less clean area
• The temperature of the water shouldbe 110 – 115 degree F
• A thorough inspection of the skin andback is necessary to find out early signs of pressure sore
• Use soap which contains less alkali
• Special attention must be given tothe creases and folds and bony prominences between fingers and toes and pubicregion
• Remove the soap completely to avoidthe drying effect of the soap on the skin
• Do not touch the body with wet handsit is unpleasant to the patient
• Creams or oils used to prevent dryingor excoriation of the skin
• The nurse should maintain goodposture and balances of the body during bed bath

Preliminary Assessment

• Identify the patient and assess theneed
• Check doctors order for any specificprecautions
• Assess the general condition of thepatient
• Assess the patient’s ability ofself-help
• Assess the patient’s mental status tofollow directions
• Check the patient’s preference forsoap, powder, etc
• Check whether the patient has takenthe meal in the previous one hour
• Find out the available articles inthe unit
• Provide privacy avoid draught andmaintain proper light
• Teach the patient and relatives aboutpersonal hygiene

Preparation of the Patient and Environment

• Explain the sequence of the procedureto the patient
• Close the windows and doors toprevent draughts put off the skin
• Arrange the necessary articles at thebedside
• Maintain the room temperature whichwill be must comfortable for patient
• Adjust the height of the bed to thecomfortable work of the nurse
• Bring the patient to the edge of thebed and towards the nurse to prevent overreaching
• Provide privacy by means of curtains
• Offer bed pan or urinals if necessary
• Keep the patient flat if thecondition permits remove extra pillows and back rest
• Remove the personal clothing andcover the patient with the bath blankets

Equipment

• Basins – 2 (big land small 1)
• Soap and soap dish
• Wash cloth – 2
• Bath touch – 2
• Face towel – 1
• Bath blanket of sheet – 1
• Surgical spirit and powder
• Nail cutter
• Comb and oil
• Kidney tray or paper bag
• Jugs – 2
• Bucket – 1
• Clean bed linen
• Clean dress to patient
• Bucket or a laundry bag
• Bath thermometer – 1

Procedure

• Explain the procedure
• Remove the patients dress, cover withbath sheet while removing top sheet and dress
• Mix hot and cold water in basin halffull and check the temperature on the back of your hand
• Spread face towel around neck
• Wet sponge towel and form mittenaround gingers after removing excess water
• Clean body in following

Face

• Wet and apply soap to forehead, face,over and behind ear and neck
• Clean eyes from inner to outercanthus
• Rinses sponge towel and allow patientto wipe face
• Dry with face towel, replace at headend of bed

Arms

• Place towel lengthwise under thefarthest arm if there is IV do not disturb it
• Take soapy bath mitt and soap the armand axilla
• Massage the pressure areas
• Place the hand in basin of water towash
• Rinse and dry well, paying attentionto skin under breast
• Recover with towel

Chest

• Avoid unnecessary exposure
• Cover chest with towel and turn bathsheet down to abdomen
• Wet chest and apply soap in rotatory movement, paying attention to skin creases
• Remove soap thoroughly by wiping fromneck to check
• Dry with bath towel

Abdomen

• Fold top sheet up to suprapubic regioncover the chest with bath towel
• Wet and clean abdomen with soap
• Clean umbilicus and dry with bathtowel
• Cover the patient with top water andremove towels

Back

• Turn the patient on side or leftlateral position. Close to edge of bed, with back towards nurse
• Expose back including buttocks,spread bath towel on bed, close the patients back
• Wet the area and apply soap withrotatory movements clean and remove soap and dry the area
• Give massage by applying firmpressure with palms and fingers from sacrum to shoulder in sequence, coveringwhole back
• Help the patient to return to supineposition

Legs

• Uncover the farthest leg and placetowel under leg
• Apply soap to the leg and givespecial attention to the groin
• Massage the pressure points
• Place foots in basin of water to wash
• Rinse and dry well, paying specialattention in between the toes
• Repeat the procedures on the near leg

Pubic Region

• Clean pubic region with wet large ragpiece (for helpless patient)
• Permit patient to clean if so desired
• Discard rag pieces into large K-basin
• Give perineal care for helpfulpatient

After Care

• Provide clean gown and pajama
• Replace articles after cleaning
• Discard dirty water in sluice room
• Clean the bed linen if needed
• Offer a hot drink (coffee or tea) if permitted
• Position the patient for comfortable and proper alignment
• Cut short the finger nails and toe nails
• Comb the hair and arrange the hair
• Hand wash
• Record the procedure in the nurse’s record with time, date, type and abnormalities noticed

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NURSE FUNDAMENTAL PROCEDURES

MEDICAL SURGICAL NURSING

KEY POINTS IN BED BATH PROCEDURE

Here are key points to keep in mind when conducting a bed bath:

1. Patient Dignity and Privacy:
   • Always prioritize the patient’s dignity and privacy. Use curtains or doors to create a private space, and communicate with the patient throughout the process.
2. Hand Hygiene:
   • Wash your hands thoroughly before starting the bed bath, and wear disposable gloves throughout the procedure to prevent the spread of infection.
3. Gather Supplies:
   • Collect all necessary supplies before beginning the bed bath, including soap, washcloths, towels, gloves, moisturizer, and any specialized cleansing products.
4. Maintain a Comfortable Environment:
   • Ensure the room is warm and comfortable to prevent the patient from getting chilled during the bed bath.
5. Explain the Procedure:
   • Communicate with the patient, explaining each step of the bed bath to ensure their understanding and cooperation. Obtain verbal consent before proceeding.
6. Adapt to Patient’s Abilities:
   • If the patient is able, encourage them to participate in the bed bath as much as possible. Adapt the procedure based on the patient’s level of mobility and comfort.
7. Use Warm Water:
   • Use warm water for the bed bath to enhance the patient’s comfort. Check the water temperature to prevent burns.
8. Address Specific Areas:
   • Cleanse the patient’s face, upper body, lower body, and perineal area systematically. Pay attention to skin folds, underarms, and areas prone to moisture.
9. Be Gentle and Thorough:
   • Be gentle when washing the patient’s skin, especially if they have fragile or sensitive skin. Thoroughly clean and dry all areas to prevent skin issues.
10. Perineal Care:
    • If performing perineal care, use a separate washcloth and follow proper hygiene practices. Always maintain the patient’s dignity during this part of the bed bath.
11. Moisturize Dry Skin:
    • Apply a mild lotion or moisturizer to dry skin, especially in areas prone to dryness. Be mindful of the patient’s preferences and any existing skin conditions.
12. Document Observations:
    • Document any observations, changes in skin condition, or concerns during the bed bath in the patient’s medical chart.
13. Adapt to Cultural Sensitivities:
    • Respect and consider the patient’s cultural background and personal preferences during the bed bath. Adapt the procedure as needed to accommodate individual beliefs and practices.
14. Ensure Safety:
    • Be aware of the patient’s safety throughout the procedure. Use bed rails or assistive devices as necessary to prevent falls or injuries.
15. Maintain Professionalism:
    • Approach the bed bath with professionalism, empathy, and a caring attitude. Respond to the patient’s needs and concerns with compassion.