1. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Patient Bathing Unit 24

2. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Objectives Spell and define terms. Describe the safety precautions for patient bathing. List the purposes of bathing patients. State the value of whirlpool baths. 2

3. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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 3

4. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Waterless Bath Waterless bathing –Some facilities are taking this new approach to bathing –It may also be called basinless bathing or bag bath 4

5. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Whirlpool Bath The most stimulating form of bathing for patients –Therapeutic bath given in a whirlpool tub 5

6. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Whirlpool Bath The whirlpool –Has a specific procedure for disinfecting the tub –This ensures that the disinfectant circulates through the internal jets Know and follow your facility procedures carefully 6

7. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Whirlpool Bath The whirlpool can act as a fomite and spread pathogens to many individuals 7

8. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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 8

9. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Patient Bathing In most facilities –The patient should not be left alone in the bathtub –Know and follow your facility policies for tub baths 9

10. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Dignity and Modesty Keep the patient warm during bathing Drape the patient with a bath blanket –As appropriate before, during, and after the bathing procedure 10

11. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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 11

12. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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 12

13. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Cultural Beliefs Learn about accepted ways to show respect. Work on building a relationship of trust with each patient. 13

14. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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 14

15. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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. 15 Safety Measures for Special Treatments

16. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Perineal Care Perineum –Area between the legs –In females Area between vagina and anus –In males Area between scrotum and anus 16

17. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Perineal Care Perineal care –To wash the area, including genitals and anus 17

18. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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 18

19. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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 19

20. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Infection Control Issues Hang the handheld shower spray on the hook when not in use Do not let it hang down or touch the floor –Which is always considered dirty 20

21. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Bathing Patients Who Have Alzheimer’s Disease Bathing is often upsetting for patients who have Alzheimer’s disease and other dementias Signs of distress are: –Increased motor activity –Change in tone of voice –Screaming or fighting 21

22. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Patient may perceive being disrobed and having the body handled as a form of sexual assault. Patient's behavior will reveal tolerance for methods being used for bathing and/or hygiene. 22 Bathing Patients Who Have Alzheimer’s Disease

23. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The distressed patient 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. 23 Bathing Patients Who Have Alzheimer’s Disease

24. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Towel Bath Used for patients with dementia who are distressed by a tub or shower bath 24

25. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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 25

26. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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 26

27. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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 27

28. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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 28

29. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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 29

30. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Towel Bath Use whatever bathing sequence 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 30

31. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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 31

32. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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 32