Bed Bath & Bed Shampoo.pptx

GIVING A BED BATH Goal: The patient will be clean and fresh.

STEPS 1. • •

Review chart for any limitations in physical activity. Identify the patient. Discuss procedure with patient and assess patient’s ability to assist in the bathing process, as well as personal hygiene preferences.

STEPS 2. Bring necessary equipment to the bedside stand or overbed table. • Remove sequential compression devices and

antiembolism stockings from lower extremities according to agency protocol.

STEPS 3. Close curtains around bed and close door to room if possible. Adjust the room temperature if necessary. 4. Offer patient bedpan or urinal. 5. Perform hand hygiene. 6. Raise bed to a comfortable working height.

STEPS 7. Lower side rail nearer to you and assist patient to side of bed where you will work. Have patient lie on his or her back. 8. Loosen top covers and remove all except the top sheet. • Place bath blanket over patient and then remove top sheet while patient holds bath blanket in place. • If linen is to be reused, fold it over a chair. • Place soiled linen in laundry bag. • Take care to prevent linen from coming in contact with your clothing.

STEPS 9. Remove patient’s gown and keep bath blanket in place. • If patient has an IV line and is not wearing a gown with snap sleeves, remove gown from other arm first. • Lower the IV container and pass gown over the tubing and the container. • Rehang the container and check the drip rate.

STEPS 10. Raise side rail. • Fill basin with a sufficient amount of comfortably warm water (110º–115ºF). • Change as necessary throughout the bath. • Lower side rail closer to you when you return to the bedside to begin the bath. 11. Put on gloves, if necessary. Fold the washcloth like a mitt on your hand so that there are no loose ends.

STEPS 12. Lay a towel across patient’s chest and on top of bath blanket. 13. With no soap on the washcloth, wipe one eye from the inner part of the eye, near the nose, to the outer part. Rinse or turn the cloth before washing the other eye. 14. Bathe patient’s face, neck, and ears, avoiding soap on the face if the patient prefers. Apply appropriate emollient.

STEPS 15. Expose patient’s far arm and place towel lengthwise under it. • Using firm strokes, wash arm and axilla, lifting the arm as necessary to access axillary region. • Rinse, if necessary, and dry. • Apply appropriate emollient.

STEPS 16. Place a folded towel on the bed next to patient’s hand and put basin on it. • Soak patient’s hand in basin.

• Wash, rinse, if necessary, and dry hand. • Apply appropriate emollient.

STEPS 17. Repeat Actions 15 and 16 for the arm nearer you. • An option for the shorter nurse or one prone to back strain might be to bathe one side of the patient and move to the other side of the bed to complete the bath.

STEPS 18. Spread a towel across patient’s chest. • Lower bath blanket to patient’s umbilical area. • Wash, rinse, if necessary, and dry chest. • Keep chest covered with towel between the wash and rinse. • Pay special attention to skin folds under the breasts.

STEPS 19. Lower bath blanket to perineal area. Place a towel over patient’s chest. 20. Wash, rinse, if necessary, and dry abdomen. Carefully inspect and clean umbilical area and any abdominal folds or creases.

STEPS 21. Return bath blanket to original position and expose far leg. • Place towel under far leg. • Using firm strokes, wash, rinse, if necessary, and dry leg from ankle to knee and knee to groin. • Apply appropriate emollient.

STEPS 22. Fold a towel near patient’s foot area and place basin on it. • Place foot in basin while supporting the ankle and heel in your hand and the leg on your arm. • Wash, rinse, if necessary, and dry, paying particular attention to area between toes. • Apply appropriate emollient. 23. Repeat Actions 21 and 22 for the other leg and foot.

STEPS 24. Make sure patient is covered with bath blanket. Change water and washcloth at this point or earlier if necessary. 25. Assist patient to prone or side-lying position. Put on gloves, if not applied earlier. Position bath blanket and towel to expose only the back and buttocks.

STEPS 26. Wash, rinse, if necessary, and dry back and buttocks area. • Pay particular attention to cleansing between gluteal

folds, and observe for any redness or skin breakdown in the sacral area.

STEPS 27. If not contraindicated, give patient a backrub. Back massage may be given also after perineal care. Apply appropriate emollient and/or skin-barrier product. 28. Raise the side rail. Refill basin with clean water. Discard washcloth and towel. Remove gloves and put on clean gloves.

STEPS 29. Clean perineal area or set up patient so that he or she can complete perineal self-care. If the patient is unable, lower the side rail and complete perineal care. Raise side rail, remove gloves, and perform hand hygiene. 30. Help patient put on a clean gown and assist with the use of other personal toiletries, such as deodorant or cosmetics.

STEPS 31. Protect pillow with towel and groom patient’s hair. 32. Change bed linens, as described in Skills 7-9 and 7-10. Remove gloves and perform hand hygiene. Dispose of soiled linens according to agency policy.

SHAMPOOING A PATIENT’S HAIR IN BED Goal: The patient’s hair will be clean.

STEPS 1. Identify the patient. Explain procedure to patient. 2. Assemble equipment on overbed table within reach. 3. Close the room door or curtain. 4. Perform hand hygiene. If you suspect there are any cuts of the scalp or blood in the hair, put on disposable gloves. Lower head of bed.

STEPS 5. Remove pillow and place protective pad under patient’s head and shoulders. 6. Fill the pitcher with warm water (43º–46ºC [110º–115ºF]). Position the patient at the top of the bed, in a supine position. Have the patient lift his head and place shampoo board underneath patient’s head. If necessary, pad the edge of the board with a small towel.

STEPS 7. Place bucket on floor underneath the drain of the shampoo board. 8. If the patient is able, have him or her hold a folded washcloth at the forehead. Pour pitcher of warm water slowly over patient’s head, making sure that all hair is saturated. Refill pitcher if needed.

STEPS 9. Apply a small amount of shampoo to patient’s hair. Massage deep into the scalp, avoiding any cuts, lesions, or sore spots. 10. Rinse with warm water (43º–46ºC [110º–115ºF]) until all shampoo is out of hair. Repeat shampoo if necessary. 11. If patient has thick hair or requests it, apply a small amount of conditioner to hair and massage throughout. Avoid any cuts, lesions, or sore spots.

STEPS 12. If bucket is small, empty before rinsing hair. Rinse with warm water (43º–46ºC [110º–115ºF]) until all conditioner is out of hair. 13. Remove shampoo board. Place towel around patient’s hair. 14. Pat hair dry, avoiding any cuts, lesions, or sore spots. Remove protective padding but keep one dry protective pad under patient’s hair.

STEPS 15. Gently brush hair, removing tangles as needed. 16. Blow-dry hair on a cool setting if allowed and if patient wishes. 17. Change patient’s gown and remove protective pad. Replace pillow. 18. Remove gloves. Perform hand hygiene.

Giving a back massage

Massage • a systematic manual or mechanical manipulations of soft tissues of the body movements such as rubbing, kneading, pressing, rolling, slapping, and tapping for therapeutic purposes.

Importance: Back Massage 1. To bring about any of the physiologic, mechanical or psychological effect attributed to massage. 2. To relieve pain 3. Prepares the injured or involved muscle for exercise to their fullest capacity 4. Encourage the confidence of the patient 5. Prepare healthy muscle for strenuous sports activity

Benefits: 1. Stress and tension are relieved. 2. Mental and physical fatigue is relieved leading to renew energy and ambition 3. Pain in the shoulders, neck and back is relieved. 4. Muscles and joints become more supple. Soreness and stiffness are relieved. 5. Muscle soreness from overextension can be reduced or prevented. 6. Circulation is improved, thus improving skin tone. 7. Facial massage tones the skin, help prevent blemished skin, and softens fine lines.

9. Muscular spasms are relieved. 10.Deep relaxation is induced and insomnia relieved. 11.Mental strain is reduced, resulting in better productivity. 12.Mildly high blood pressure is temporarily reduced. 13.Ease anxiety 14.Joint mobility can be increased.

Assessment: 1. Behaviors indicating potential need for a back massage, such as a complaint of stiffness, muscle tension in the back or shoulders, or difficulty sleeping related to tenseness or anxiety. 2. Whether the client is willing to have a massage, because some individuals may not enjoy a massage. 3. Contraindicated for back massage: - impaired skin integrity (acne, boils, burns) - back surgery - vertebral or rib fracture

Massage Techniques

Effleurage – means a long, soothing, stroking movements which are performed using the flat of the hand or fingers.

Petrissage • the movements which involves various way of kneading, rolling and picking up the skin and muscles.

Tapotement • fast and stimulating movements of massage, they include cupping, hacking and pounding (also called pummeling)

Friction • using the thumb, fingertips or knuckles, one can apply deep direct pressure to one particular site of muscular tension. • This type of massage is also called “connective tissue massage”. It is very useful for focusing on specific of tightness and muscles spasms in the back.

Hand over Hand • massage the back with short quick strokes, alternating hands.

Kneading • squeeze the shoulder muscle with each hand as you slide the hands together.

• Massage 5-20 minutes in accordance with client’s tolerance. • use oil, lotion or powder.

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