1. Copyright © 2008 Delmar Learning. All rights reserved. Unit 24 Patient Bathing

2. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. Waterless Bath Waterless bathing –Some facilities are taking this new approach to bathing –It may also be called basinless bathing or bag bath

5. Copyright © 2008 Delmar Learning. All rights reserved. Whirlpool Bath The most stimulating form of bathing for patients –Therapeutic bath given in a whirlpool tub

6. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. Whirlpool Bath The whirlpool can act as a fomite and spread pathogens to many individuals

8. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. Cultural Beliefs Learn about accepted ways to show respect Work on building a relationship of trust with each patient

14. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. Perineal Care Perineum –Area between the legs –In females Area between vagina and anus –In males Area between scrotum and anus

17. Copyright © 2008 Delmar Learning. All rights reserved. Perineal Care Perineal care –To wash the area including genitals and anus

18. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. Towel Bath Used for patients with dementia who are distressed by a tub or shower bath

25. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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. Copyright © 2008 Delmar Learning. All rights reserved. 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