Assessment:
Check the chart for any existing bath plan. Assess the patient to determine if there are other concerns of a higher priority than hygiene-like the need for toileting. Assess for current symptoms related to the medical diagnosis, for fatigue or pain, and for level of sedation. Assess also for hygiene preferences. Check to see whether needed special supplies or equipments are already in the room.
Planning:
Determine whether or not you will need any assistance. Determine what supplies and equipment are needed. Wash hands. Don gloves if necessary. Obtain the needed supplies.
Implementation:
Identify the patient. Explain to the patient what you plan to do and how he or she can participate. Prepare equipment supplies and materials and arrange them with paper lining conveniently for use on the bedside chair or over bed table. Raise the bed at a convenient working level. Ensure privacy throughout the procedure. Make sure that the room is free from drafts. Close windows and doors or put off electric fans if any. Get patients vital signs.
Oral Care:
Assist the client to a sitting position in bed, if health permits. If not, assist the client to aside-lying position with the head on a pillow so that the client can spit out the rinse water. Place a towel under the patient’s chin, tucking it behind the shoulders. Don gloves. Moisten the toothbrush with water from a glass and spread a small amount of toothpaste on it. If no cleansing agent is adequate. Baking soda and mouth wash which are substitutes that also freshen the breath.
Brush the teeth or hand the brush to the client as follows: Hold the brush at 45º angle; use a small, vibrating, and circular motion with the bristles at the junction of the teeth and gums. Use the same action on the front and the back of the teeth. Use a back-and-forth brushing motion over the biting surfaces of the teeth. Brush the tongue. Allow the patient to rinse the mouth with water, followed by a mouth wash and floss if desired. Wipe patient’s mouth then remove towel on chin afterwards. Rinse equipment and return to its appropriate place. Return bed to low position.
Hair Shampoo
Loosen linen at foot of bed. Place bath blanket over top sheet and unfold it so that the linens are fully covered. With the client holding the edge of the bath blanket, gently withdraw the top sheet toward the foot of the bed. If top sheet is to be reused, fold it for replacement later, and place in a clean surface. If not, dispose in laundry bag taking care that the linen does not come in contact with your uniform. Assist the client to move near you. Remove client’s gowns or pajamas, keeping the bath blanket over the client. If patient can tolerate, remove pillow. Bring patients head near the edge of the bed. Place waterproof pad under client’s shoulders, neck and head. Place plastic trough spout under head and wash basin at the end of trough, being sure that trough spot extends beyond edge of mattress and runs into wash basin. Place rolled towel under neck and bath towel across shoulders.
Brush and comb hair. Ask client to hold clamp wash cloth over eyes. Place cotton balls in the clients ears. With water pitcher slowly pour water over hair until it is completely wet. Apply diluted shampoo to the scalp. Make a good lather with the shampoo while massaging the scalp with the pads of your fingertips. Massage all areas of the scalp systematically. Rinse the hair thoroughly to remove all the shampoo. Reapply shampoo when needed. Squeeze as much water as possible out of the hair with your hands. Dry the hair thoroughly. Rub the client’s hair then wrap with bath towel. Comb hair to remove tangles. Assist client to comfortable position and complete combing of hair. Invite a parent or family member to participate if desired. Close the window and doors to make sure that the room provide privacy by drawing the curtains or closing the doors. Offer the client a bedpan or urinal or ask whether the client wishes to use the toilet or commode. During the bath, asses each area of the skin carefully. Prepare the bed, and position the client appropriately. Place the bed in the high position. Place an infant or small child on a changing table or elevated crib.
Remove the top bed linen, and replace it with the bath blanket. If the bed linen is to be reused, place it over the bedside chair. If it is to be changed place it in the linen hamper. Assist the client to move near you. Remove the gown. Make a bath mitt with the washcloth. Wash the face. Place one towel across the client’s chest. Wash the client eyes with water only and dry them well. Use a separate corner of the washcloth for each eye. Wipe from the inner to the outer canthus. Ask whether the client wants soap use on the face. Wash, rinse and dry the client’s face, neck and ears. Wash the arms and hands. Wash the legs and feet. Wash the back and then the perineum. Assist the client with the grooming aid such as powder, lotion or deodorant. Document data.
