Bed Bathing: Skill (Nursing)

by Samantha Rhea, MSN, RN

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    00:04 Welcome to the skill of performing a bed bath with a client.

    00:07 Now before we get started, of course, you want to perform your hand hygiene and provide as much privacy as possible, that is going to be key during the skill.

    00:16 Then you want to explain thoroughly to your client the procedure, and it's a great idea to get all of your equipment and your bed linens ready.

    00:24 And then, we've got our basins here and we want to fill those with warm water.

    00:28 Just a little tip for you, I like to do a basin with my soap for cleansing and then I'd like to have another basin for rinsing my patient.

    00:37 Now once we get all of our equipment such as all of our linen that we need, we can go ahead now and apply our gloves.

    00:43 So when we do this we want it then, raise the bed to appropriate working height.

    00:49 Now this can be a little bit difficult because you see, me and Dean here are quite two different heights, but make sure it's appropriate for both of you.

    00:56 So I'm going to go ahead and raise this up a little bit.

    01:04 Alright, how's that for you Dean? Good, thank you. Okay, perfect.

    01:07 So, you just want to compromise where everybody is going to have good body mechanics.

    01:11 And one thing to keep in mind as you can see here, now there are side brails on each side of the patient.

    01:17 Now this is very important for patient safety.

    01:19 However, you've got to keep good mechanics in mind.

    01:23 The other thing to know is that if I drop a siderail, when you turn the patient, some patient's ability allows them to grab on to the siderail, so just make sure you assess and see what's best for you and the client.

    01:36 Now for me, because I'm a little bit shorter, this would be difficult for me to work over the siderail and I'm on the side of the bed, I'm going to go ahead and drop this for working.

    01:49 And, of course, I'm going to stay here at the bedside.

    01:51 Now it's great to position your client on their back for performing a bed bath.

    01:56 Some clients, however, need their head of bed up just a little bit to help their work of breathing.

    02:01 Now we can go ahead and remove those top linens and also expose the client, but providing privacy is so important and chilling in comfort, so we're going to use a bath blanket here.

    02:15 So this is a typical bath blanket, usually they're white.

    02:18 Many facilities have them, but this great just to provide privacy and chilling, and we're going to go ahead and put this on the client.

    02:32 Perfect. Thank you, Dean.

    02:34 So this is just my preference.

    02:36 I like to put the bath blanket on first and then we can roll down the old linens because we're going to change those later, and again, as you can see, this helps provide privacy to your client.

    02:51 And, now, we're going to move down the gown, okay.

    03:00 So now that we've done this, and you see we're keeping the client nice and covered.

    03:05 Now when we started doing our bed bath, it's a great idea just to kind of think about like you would do an assessment, so go from head, all the way down.

    03:13 So we're going to start by the face and the head and the neck of our client.

    03:17 Now, here's one thing to remember any time you're performing a bed bath.

    03:21 If your client can do as much as they can as possible, this is great because it helps promote independence and just gives them ownership of their own care.

    03:30 So now just to get stared, I'm going to take my rinse cloth, because this has no soap on it and here's just a thought, something that I like to do is that I have two basins here.

    03:42 I've got a basin with my washcloth with soap, then I got my basin here with my warm water with no soap for rinsing.

    03:50 So because I'm going to start with the client's eyes, I'm going to get my rinse rag, then I'm going to help clean the patients eyes, so I'm going to go and start with one and clean one side of the patient eye and their face, and here's a really important point to note.

    04:06 When you go to the other eye, please make sure you use a clean section of the washcloth.

    04:12 Clean the other side, okay, there you go.

    04:15 Now that we've done this, I can go ahead and get my washcloth with my mild soap.

    04:21 It's a good idea to wring our any extra moisture just so it doesn't get all over your patient.

    04:26 Then, I'm going to assist my client, if they need me to, to clean their face, head, and neck, and just be conscious about being gentle any time you're giving a bed bath as well.

    04:46 Okay, so now that I've done this, because I've got mild soap on the patient's face that can be a little bit irritating, so I'm going to use my rinse cloth and also rinse this off.

    05:05 Thank you, Dean.

    05:08 And any time that we wash a client, to prevent chilling and chafing, you want to pat dry as well.

    05:23 Okay. So now that we've done the face, head and neck, we can move to the patient's anterior body, of their chest, their arms, and their axillae.

    05:34 So just make sure here that you're really conscious about either a male or a female client, or the patient's preference for privacy.

    05:42 Now it's okay for our client, for our discussion, that we're going to go ahead and expose the chest.

    05:50 Now it's really helpful when you've got two people, you can have someone working on each side.

    05:55 So we're going to start with our washcloth with mild soap, then we're going to start on the patient's chest so we're just going to clean thoroughly here on each side and kinda split the body if you will.

    06:12 Alright. Get the patient's arms.

    06:24 Make sure we clean well in the axilla area as well.

    06:29 Okay, perfect, thank you, Dean.

    06:31 Now we can get our rinse cloth and get all that soap off.

    06:43 Now it's important here when you were bathing client anytime, to try to prevent from scrubbing too hard and irritating or tearing the skin.

    06:55 Perfect, thank you, Dean.

    06:57 Now, again, don't forget to go ahead and dry thoroughly your client.

    07:03 Alright.

    07:18 Okay, perfect.

    07:22 So now that we've thoroughly dried our client, we're going to go ahead and cover them back up to prevent chilling and provide privacy.

    07:31 Now, we're going to go ahead and clean the patient's abdomen.

    07:34 So we're going to take our bath blanket and expose this particular area.

    07:38 So we're going to clean the abdomen and their groin, perfect.

    07:42 So as you've noticed here we've left the old dirty gown, this just helps provide some more privacy and prevent chilling and of course, we're going to change this later, so for now, this just helps us with privacy.

    07:54 So now I'm going to get my washcloth with our soap.

    07:59 We're going to clean the patient's abdomen and then anywhere in their groin area, too.

    08:10 Okay. Now we're going to make sure we rinse thoroughly.

    08:23 Okay. And then we're going to pat dry as well.

    08:30 Now, if you're client's alert, it's a great time just having conversion, talk them through that and explain the procedure as you're going.

    08:40 Okay, so now that we've done this, we can go ahead and re-cover up our client, and now we can take out that old gown, thank you, Dean.

    08:53 Now, we're going to clean the patient's legs, their thighs, and down to their feet.

    09:00 So we're going to take our washcloth with mild soap again, and then we're going to start the anterior part of their thighs all the way the top, down through their ankle and their feet.

    09:14 Now this is an important point to know and this is a great time to do a skin assessment with your client and don't forget to wash in between their toes.

    09:25 Alright, perfect, thank you.

    09:27 And, of course, we're going to rinse thoroughly and make sure here to dry well.

    09:39 Sometimes extra moisture in between the client's toes can definitely promote break down.

    09:46 Now, after we rinse, don't forget to dry.

    10:04 Alright, perfect.

    10:06 Now we've washed the anterior part of the body and then we can cover them here as well.

    10:14 Okay. Now we've covered our client to provide privacy and warmth, and now we're going to start bathing our posterior side of our patient's body.

    10:23 Now, since we're going to the posterior side, it's a great time now that you can change your basin of water and make sure it's nice and warm and you get fresh soap and also fresh washcloth.

    10:33 So now we can go ahead and remove our gloves.

    10:36 We can perform our hand hygiene and then we would put on new gloves at this time.

    10:47 So, again, if we are dealing with a real patient, we can perform our hand hygiene and then make sure you've done new gloves at this point.

    10:57 Now, this is the point to where, you see, Dean's siderail is up.

    11:01 This is really helpful if your patient can, because when I roll the client to the side of Dean, if they're able to they can grab on to that siderail and help steady themselves.

    11:12 But that's also why Dean's there because he can support the client in that position.

    11:19 And sometimes, during a bed bath, your hands get a little bit moist and totally get on those gloves.

    11:26 Okay, so now that we're ready, we can go ahead and help him roll the client to the side.

    11:31 Now we're going to be exposing the posterior side of the client and log rolling them is a great method to do so. Thank you, Dean.

    11:38 So as for supporting the client here.

    11:41 Now, if you can, this is a great time to put a towel underneath the patient's - client or any extra linens just to help absorbed any extra moisture.

    11:50 But, later, make sure after bed bath, it's a great time to change out the bed linens as well.

    11:55 Now that we've rolled the client to their side, we're exposing the posterior part of the patient's body.

    12:01 And, again, great idea to leave the side rail up and Dean's there supporting them.

    12:05 So, I'm going to get my washcloth with mild soap and this is a great time to catch maybe the back of the head or the neck that you may have missed on the anterior side and thoroughly cleanse the patient's posterior back.

    12:21 Now, I'm going from the back, all the way down to the legs on the posterior side because it's a good practice to get a new washcloth for the patient's buttocks and not reuse that on the rest of the body, okay.

    12:44 Okay. Now once we've washed thoroughly, of course, we want to make sure we rinse and this is a great time to perform a skin assessment on your patient.

    13:10 And, now, make sure to pat dry.

    13:25 Okay, thank you, Dean.

    13:27 And we're going to go ahead and roll the patient on their back at this point. Thank you, Dean.

    13:35 Okay, so now that we've got our patient in the supine position, this is a great time to talk about peri-care during a bed bath our client.

    13:43 Now, when we're talking about a male versus a female client, there's a little variation that you want to consider.

    13:50 And, also, don't forget that when we're starting to talk about cleansing for peri area, this is a great time to change out the basin of water as well and put on new gloves.

    14:00 So, let's talk about the difference between a male and a female client when we're cleaning.

    14:05 So just to kinda walk you through this, we're going to go ahead and expose the client.

    14:16 Okay, so when we're talking about cleansing the client, it's important that I go ahead and if you remember, I've got my basin with mild soap and then I got my rinse.

    14:26 So we want to go ahead and wring out our washcloth.

    14:30 Now when we're talking about cleansing a male client, it's important to make sure we clean down the shaft of our patient, all the way around our patient. It's also really important to make sure, especially at the meatus, that we are cleansing and using a different part of the washcloth each time, to prevent contamination.

    14:51 The other thing I want you to consider, when we are talking about a male client and we're providing pericare here, it's really important that if the patient has not been circumcised, that we want to make sure that we retract the foreskin, we cleanse thoroughly around it, then after we do that, we'd make sure we get our rinse cloth and make sure we rinse thoroughly.

    15:17 Then after we did that, we, of course, want to make sure also that we're going to dry thoroughly.

    15:23 Now, anytime, that you have an uncircumcised client and you cleanse here, it's really important that we clean this area, we rinse and dry thoroughly, and please make sure that we put the foreskin back.

    15:37 So that's really important to promote circulation and comfort for your client.

    15:41 Now that's talking about a male client.

    15:44 Now if we're going to talk about a female client, there's some other considerations we want to talk about.

    15:51 So we talk about a female client, it's really important that when we get our washcloth, this is with our soap, that we want to wipe front to back. It's also important that with each swipe, I'm using a clean part or a new washcloth, so that way we prevent contamination.

    16:11 Now, once we've done this of course, we want to make sure we rinse as well, and of course, it's really important to pat dry.

    16:29 Now that's some considerations with the female client. Don't forget front to back.

    16:35 Now just a key point to remember, anytime that you're talking about peri-care with a female or a male client, it's really important that drying step because excess moisture here can contribute to excoriation and a lot of chafing for your client.

    16:52 So now we can go ahead and complete our procedure.

    16:56 So once we've performed our peri-care, it's a great time to remove your gloves and perform hand hygiene.

    17:01 Now, anytime, if the patient wants moisturizer or a particular lotion, it's a great idea to switch out your gloves and put on new once.

    17:09 So once we've completed this step, now here's where we want to go ahead and change out our linens for our patient.

    17:16 Now, as you can imagine, there's some water and soap that got on there and just to help them feeling a little bit better and get clean linen on, we're going to dress the patient our gown.

    17:32 Okay, now while dressing the client, we can just use that bed bath blanket as well for privacy.

    17:45 Okay, thank you, Dean.

    17:50 Now once we've changed out the gown, this is a great time to help with making a clean new occupied bed for your patient, and change out all those linens.

    18:08 Thank you. Perfect. Thank you.

    18:17 Now, if the patient has a preference, we can help them brush and comb their hair and perform any extra hygiene practices for them that they prefer.

    18:26 Then, of course, make sure, that you position the client for comfort, and then before we leave, make sure your side rail's up and ensure that this is on the lowest position for safety.

    18:41 Now, don't forget for future use, you've got your basins here that we used for cleansing and for rinsing.

    18:46 Make sure you empty, clean these, and disinfect as well.

    18:50 Now here's a key point that a lot of times when we perform a bed bath, these are dirty linens, there could be incontinent episodes or blood and body fluids on these linens, so it's really important that you follow your agency's infection control measures.

    19:04 Now many times there's a specific linen bag that we'll use and a specific place in the facility we place all dirty linens.

    19:12 Now we can remove our gloves, perform our hand hygiene, and document the procedure.

    19:17 Thank you for watching.

    About the Lecture

    The lecture Bed Bathing: Skill (Nursing) by Samantha Rhea, MSN, RN is from the course Bed Bathing and Making an Occupied Bed (Nursing).

    Included Quiz Questions

    1. Obtaining items for the bath
    2. Cleansing the patient with soap
    3. Rinsing the patient with water
    4. Washing the patient’s face
    1. Provide the patient with a washcloth to assist
    2. Wash the patient from head to toe
    3. Obtain more assistance from another co-worker
    4. Pat dry the patient
    1. Head, face, neck
    2. Chest, axilla, arms
    3. Genitals
    4. Back, legs, and feet
    1. Retract foreskin, cleanse, rinse, dry, and return the foreskin forward
    2. Pull the foreskin back, rinse, and dry
    3. Cleanse, rinse, dry, and pull the foreskin back
    4. Retract the foreskin, pat dry, and pull the foreskin back
    1. Wipe front to back
    2. Wipe back to front
    3. Wipe side to side
    4. Swipe with the same washcloth and side the entire time

    Author of lecture Bed Bathing: Skill (Nursing)

     Samantha Rhea, MSN, RN

    Samantha Rhea, MSN, RN

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