bed bath

Patient care

All necessary equipment is assembled, the room temperature is adjusted to a comfortable level, and the room is checked for drafts. While shielding the patient, the health care provider removes the top covers and replaces them with a bath blanket for the patient's physical warmth. The patient's ability to bathe independently is assessed, and the patient is encouraged to do so to the extent possible and permitted. Bathing may be accomplished using prepackaged disposable cloths impregnated with a no-rinse cleansing agent (heated in the microwave), various sized towels wet in warm water and wrung well prior to application or a basin of water which should be comfortably warm, 110° to 120°F (43.3° to 48.1°C), and changed as often as necessary to maintain the desired temperature and to permit thorough rinsing. The entire body, including the perineal area and genitalia, is washed, rinsed (if soap used), and dried thoroughly, one area at a time. Although traditional bathing has been done from the head downward toward the toes, with genitalia bathed last, use of prepared disposable cloths or towels for separate areas allows the care provider to bathe the patient in any order desired: for instance, demented patients may become upset by having their faces washed but accept bathing that begins with upper or lower extremities. Whatever method is employed, the patient should remain covered except for the area being bathed. After the bath, lotion may be applied to the skin (if not contraindicated), a clean gown is applied, and the patient's hair is combed or brushed. Oral hygiene is performed in conjunction with bathing. The bed is usually remade with clean linens at this time or following removal of the patient from bed to chair. The health care provider assists as needed with any part of this care. When bathing obese patients, drying of skin folds may be facilitated by using a handheld hair dryer on warm, taking care not to injure the skin in any way. Researchers have shown that bathing patients in ICU settings with disposable clothes saturated with 2% chlorhexidine gluconate reduces contamination rates from vancomycin-resistant enterococci (VRE), a common nosocomial infection, for both patients’ skin and the ICU environment (object surfaces, health care providers’ hands, et al), leading to less frequent infection. Additional hair care (shampoo, wet and dry shampoo products, styling) is provided as necessary, following protocols.