Component Task: Bathing a Hypoactive Patient in Bed

This is the act of washing/cleansing the body of a patient who does not have the physical and mental capability of self-bathing and is confined to bed. Hypoactive patients are usually less active, withdrawn and retarded.

Aims

·         Keep patient clean and enhance self-concept

·         Stimulate blood circulation

·         Regulate body temperature

·         Provide comfort, relaxation and induce sleep

·         Prevent/minimize skin irritation/infection

·         Aid in physical assessment of the patient

Requirements

A trolley containing:

a.      Top shelf

·         Bowl/basin for the bath water

·         Face towel/sponge

·         Soap in a dish

·         Comb and hair brush

·         Talcum powder

·         Tooth brush and tooth paste/chewing sponge/stick

·         Bath thermometer

·         Nail cutter

·         Kidney dish

b.      Bottom shelf:

·         Bowl /bucket to receive used water

·         Two jugs for hot and cold water

·         Bath towels

·         Draw sheet/cloth, bed sheets

·         Mackintosh

·         Gown

·         Bin for soiled linen

·         Mirror

·         Patient clothes

·         Preferred body cream/lotion

·         Covered bedpan/urinal

·         Tissue paper

·         Examination gloves

c.      Screen

d.      Assisting nurse(s)

e.      Chairs

Steps

1.        Establish rapport (refer procedure)

2.      Explain the procedure to the patient

3.      Prepare the trolley and send it to the patient’s bedside

4.      Call for an assistant

5.      Provide privacy and offer bedpan/urinal if required

6.      Remove bedpan/urinal if used and empty them

7.       Place chairs in position

8.      Perform hand hygiene and don gloves

9.      Remove top bed clothes and put them on chairs and cover patient with a sheet

10.    Protect bottom sheet and pillow(s) with protective material

11.      Mix bath water in a basin to a desired temperature (30 - 400C) using a bath thermometer/the back of your hand/elbow

12.    Talk to the patient throughout the procedure

13.    Remove the patient’s clothes being careful not to cause any pain/discomfort to him/her

14.    Wash, rinse and dry patient’s face, neck and ears, using face towels (use soap if desired)

15.    Wash, rinse and dry the arms, first instruct the assisting nurse to wash hands farthest away from you(nurse) and then the arm nearest to you (nurse)

16.    Pay special attention to the hand, in between the fingers and the nails

17.    Wash, rinse and dry the chest and abdomen, (giving special care to the area under the breast if a female) the umbilicus and the folds of the skin in the groin

18.    Wash, rinse and dry the legs and feet in the same way as in step 14 paying special attention to toes

19.    Change water when necessary

20.  Clean the genitals (vulva into a bed pan if a female)

21.    Turn patient on his/her side and wash the back, rinse and dry thoroughly

22.  Examine and treat pressure areas

23.  Change the bottom linen if necessary

24.  Groom and put patient in a desired position and express appreciation to him/her

25.  Express appreciation to patient and direct him/her to the next activity

26.  Remove screen, clear trolley, disinfect used items and perform hand hygiene

27.  Document procedure and report any abnormalities in nurses’ notes/patient’s folder


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