Unit 24

1. Unit 24 Patient Bathing

2. Objectives • Spell and define terms. • Describe the safety precautions for patient bathing. • List the purposes of bathing patients. • State the value of whirlpool baths.

3. Introduction • A daily bath is as important for the patient as it is for you • Following a bath, a patient feels relaxed, clean, and refreshed

4. Waterless Bath • Waterless bathing • Some facilities are taking this new approach to bathing • It may also be called basinless bathingor bag bath

5. Whirlpool Bath • The most stimulating form of bathing for patients • Therapeutic bath given in a whirlpool tub

6. Whirlpool Bath • The whirlpool • Has a specific procedure for disinfecting the tub • This ensures the disinfectant circulates through the internal jets • Know and follow your facility procedures carefully

7. Whirlpool Bath • The whirlpool can act as a fomite and spread pathogens to many individuals

8. Patient Bathing • Nursing assistants are frequently assigned to bathe patients • It is important to follow the guidelines and procedures for bathing carefully to ensure patient comfort and safety

9. Patient Bathing • In most facilities • The patient should not be left alone in the bathtub • Know and follow your facility policies for tub baths

10. Dignity and Modesty • Keep the patient warm during bathing • Drape the patient with a bath blanket • As appropriate before, during, and after bathing procedure

11. Dignity and Modesty • This is an important dignity issue that should not be forgotten • When a shower chair is used: • Cover the patient’s perineum with a towel during the tub bath, whirlpool bath, and shower

12. Cultural Beliefs • Affect patients’ bathing preferences • Always show respect for patients’: • Cultural beliefs • Privacy concerns regarding touching the body • Gender difference • Personal hygiene and peri care after toileting • Keeping the body covered • Wearing clothing with religious significance

13. Cultural Beliefs • Learn about accepted ways to show respect • Work on building a relationship of trust with each patient

14. Safety Measures for Special Treatments • Patients receiving special treatments can be bathed • Patient receiving an IV • Patient who has drainage tubes • Patient who is receiving oxygen

15. Safety Measures for Special Treatments • Patients with casts may shower if the cast is covered with a plastic bag • These patients, however, need special care • Follow the care plan and nurse’s instructions

16. Perineal Care • Perineum • Area between the legs • In females • Area between vagina and anus • In males • Area between scrotum and anus

17. Perineal Care • Perineal care • To wash the area including genitals and anus

18. Infection Control Issues • When using liquid soap from a wall dispenser: • Dispense soap into a small cup and carry it to the bedside • Pour the liquid soap onto the washcloth as needed

19. Infection Control Issues • If refillable liquid soap bottles are used: • Each patient should have a bottle labeled with his or her name • Soap is used for that patient only • Once a towel has been used below the waist: • Avoid using it above the waist

20. Infection Control Issues • Hang the hand held shower spray on the hook when not in use • Do not let it hang down or touch the floor • Which is always considered dirty

21. Bathing Patients with Alzheimer’s Disease • Bathing is often upsetting for patients with Alzheimer’s disease and other dementias • Signs of distress are: • Increased motor activity • Change in tone of voice • Screaming or fighting

22. Bathing Patients with Alzheimer’s Disease • Patient may perceive being disrobed and having the body handled as a form of sexual assault • Patient's behavior • Reveals no tolerance for methods being used for bathing and/or hygiene

23. Bathing Patients with Alzheimer’s Disease • He or she is using the only means available to ask you to find another, less traumatic way of doing it. • Consider a bag bath, towel bath, or partial bath • Bathing should never be traumatic • Be flexible and considerate

24. Towel Bath • Used for patients with dementia who are distressed by a tub or shower bath

25. Towel Bath • Bathing environment should be considered: • Darkening the room slightly may be helpful • Play soothing music • Use products with a pleasant aroma on the patient and in the environment

26. Towel Bath • Goal for this bath is to keep the patient clean and odor free • While avoiding a situation that is potentially upsetting to the patient • Respect the patient’s autonomy

27. Towel Bath • Use a variety of techniques to personalize the bath to make it as pleasant as possible • Type of bath is more creative than other baths • But is not more work, and does not take more time

28. Towel Bath • Bathe patient with a kit prepared for this purpose, using: • No-rinse skin cleanser • 2 washcloths • 2 hand towels • 1 large towel • 2 bath blankets

29. Towel Bath • Cover the patient with a warm bath blanket • Gradually undress him or her under the blanket • Cleanse the body by placing warm, moist towels with no-rinse cleanser under the blanket

30. Towel Bath • Use whatever bathing sequence that is comfortable for the patient • Avoid rushing • Speak in a calm, soothing manner • Replace the blankets and towels as needed to keep the patient warm

31. Patients with Alzheimer’s Disease • Washing a cognitively impaired patient’s hair under running water can also be very upsetting • Try washing the hair with a/an: • Bed shampoo tray • Inflatable shampoo basin • Shampoo cap • Dry shampoo product

32. Dressing a Patient • Patients in hospitals generally wear hospital gowns because they are in bed most of the time • Some patients prefer to wear their own nightgowns or pajamas • They will need assistance in dressing