This document provides instructions for performing a bed bath. It begins by describing a bed bath and its benefits. It then outlines the necessary equipment and supplies. The main body of the document details each step of performing a complete or partial bed bath, including draping, washing different body parts, and providing comfort measures. It emphasizes maintaining patient privacy, safety, and proper body mechanics. The document concludes with considerations for special patient situations and making a washcloth mitt.

1. BED BATH
DESCRIPTION
A complete bed bath cleans the skin, stimulates circulation, provides mild exercise, and
promotes comfort. Bathing also allows assessment of skin condition, joint mobility, and muscle
strength. Depending on the patient's overall condition and duration of hospitalization, he may
have a complete or partial bath daily. A partial bath — including hands, face, axillae, back,
genitalia, and anal region — can replace the complete bath for the patient with dry, fragile skin
or extreme weakness and can supplement the complete bath for the diaphoretic or incontinent
patient.
ASSESSMENT
PLANNING
• Prepare the necessary equipment/ materials for the procedure:
o Bath basin
o Bath blanket
o Skin cleanser
o Towel
o Washcloth
o Skin lotion
o Orangewood stick
o Gloves
o Deodorant
o Hospital-grade disinfectant
o Optional: chlorhexidine-impregnated cloth, bath oil, perineal pad, abdominal (ABD)
pad, and linen-saver pad
IMPLEMENTATION
KAR PROCEDURE RATIONALE
HEALTH
EDUCATION
COMMUNICATION
1. Explain procedure to client and
ask client about bathing
preferences.
Promotes client’s cooperation.
ETHICO-MORAL
RESPONSIBILITY
LEGAL
RESPONSIBILITY
2. Prepare room for comfort and
draw privacy curtains or close
the door.
Ensures client’s privacy.
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3. Offer client bedpan or urinal.
Provide towel and washcloth.
This promotes client comfort
during the procedure.
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NURSING CARE
4. Perform hand hygiene. Apply
disposable gloves as needed.
Hand washing is the single,
most effective way for
preventing the transmission of
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2. microorganisms and infectious
diseases. Use of gloves serves
as barrier for secretions.
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5. Position the bed at a comfortable
working height.
This promotes proper body
mechanics and thus reducing
strain on the nurse’s back.
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Perform Complete or Partial Bath
6. Lower side rail closest to you,
and assist client in assuming a
comfortable position that
maintains body alignment.
Assist/move client toward side of
bed closest to you.
Aids the nurse’s access to the
client and maintains comfort
throughout the procedure.
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7. Loosen top covers beginning at
foot of bed. Place bath blanket
over top sheet. Fold and remove
top sheet from under blanket.
Removal of top linens prevent
them from becoming soiled or
moist during the bath. Putting
on bath blanket provides
warmth and privacy.
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8. If top sheet is to be reused, fold it
for later replacement. If not,
place it in laundry bag.
Proper disposal prevents the
transmission of
microorganisms
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9. Remove client’s gown or
pajamas.
Provides full exposure of body
parts during bathing.
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10. Pull side rail up. Fill washbasin
two-thirds full with warm water.
Have client test temperature by
placing fingers in water.
Raising side rails maintains
client’s privacy as the nurse
leaves bedside. Warm water
used during the bath promotes
comfort, relaxes muscles, and
prevents unnecessary chilling.
Having the patient test water
temperature prevents accidental
burns.
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11. Remove pillow if allowed and
raise head of bed 30 to 45
degrees. Place bath towel under
client’s head by asking the client
to lift his head while the nurse
supports the neck. Place second
bath towel over client’s chest.
Removal of pillow makes it
easier to wash client’s ear and
neck. Placement of towels
prevents soiling of bed linen
and bath blanket.
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12. Fold washcloth around fingers of
your hand to form mitt. Immerse
mitt in water and wring
thoroughly.
Mitt retains water and heat
better than loosely held
washcloth.
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13. Wash client’s eyes with plain
warm water. Use different
section of mitt for each eye.
Move mitt from inner to outer
canthus. Soak any crusts on
Soap irritates the eyes. Using
separate sections of the mitt
reduces transmission of
infection. Bathing eye from
inner to outer canthus prevents
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3. eyelid for 2 to 3 minutes with
damp cloth before attempting
removal. Dry eye thoroughly but
gently.
secretions from entering the
nasolacrimal duct.
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14. Ask if client prefers to have soap
used on face. Wash, rinse, and
dry well client’s forehead,
cheeks, nose, neck, and ears.
Soap tends to dry face, which
is exposed to air more than any
other body parts.
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15. Remove bath blanket from
client’s arm that is closest to you.
Place bath towel lengthwise
under arm.
Prevents soiling of bed.
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16. Bathe client’s arm with soap and
water using long, firm strokes
from distal to proximal areas.
Raise and support client’s arm
above head (if possible) while
washing axilla.
Soap lowers surface tension
and facilitates removal of
debris and bacteria when
friction is applied during
washing. Long, firm strokes
stimulates circulation.
Movement of arm exposes
axilla and exercise joints
normal range-of-motion.
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17. Rinse and dry arm and axilla
thoroughly. Apply deodorant or
talcum powder, if used.
Alkaline residue of soap
discourages the growth of
normal skin bacteria while
excess moisture can cause skin
maceration or softening.
Deodorant controls body odor.
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18. Fold bath towel in half and lay it
on bed beside client. Place basin
on towel. Immerse client’s hand
in water. Allow hand to soak for
3 to 5 minutes before washing
hand and fingernails. Remove
hand from basin and dry well.
Soaking softens cuticles and
calluses of hand, loosens debris
beneath nails, and enhances
feeling of cleanliness.
Thorough drying removes
moisture in between fingers.
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19. Raise side rail and move to other
side of bed. Lower side rails and
repeat steps 15 through 17 for
other arm.
Raising the side rails ensures
client safety.
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20. Check temperature of bath water. Warm water maintains client
comfort
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21. Change the water as often as
necessary.
To keep the water warm and
clean.
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22. Cover client’s chest with bath
towel, and fold bath blanket
down to umbilicus. Lift edge of
towel away from client’s chest.
Bathe client’s chest using long,
Draping prevents unnecessary
exposure of body parts. Towel
maintains warmth and privacy.
Secretions and dirt collect
easily in areas of tight
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4. firm strokes with mitted hand.
Wash skinfolds under female
clients’ breasts. Keep client’s
chest covered between washing
and rinsing. Dry well.
skinfolds which are susceptible
to excoriation if breasts are
pendulous .
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23. Place bath towel(s) lengthwise
over client’s chest and abdomen.
Fold blanket down to just above
client’s pubic region.
Prevents chilling and
unnecessary exposure of body
parts.
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24. Lift bath towel. Bathe client’s
abdomen with mitted hand.
Stroke from side to side. Keep
client’s abdomen covered
between washing and rinsing.
Dry well.
Prevents chilling and
unnecessary exposure of body
parts. Moisture and sediment
that collect in skinfolds
predispose the skin to
maceration and irritation.
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25. Assist client put on clean gown
or pajama top.
Maintains client’s warmth and
comfort.
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26. Cover client’s chest and
abdomen with top of bath
blanket. Expose client’s nearer
leg by folding blanket toward
midline. Drape client’s perineum
and other leg.
Prevents unnecessary exposure
of body parts.
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27. Bend client’s leg at knee by
positioning your arm under
client’s leg. Elevate leg from
mattress slightly while grasping
client’s heel, and slide bath towel
lengthwise under leg. Ask client
to hold foot still. Place bath basin
on towel on bed, and secure its
position next to the foot to be
washed.
The towel prevents soiling of
bed linen. Support of joint and
extremity during lifting
prevents strain on
musculoskeletal structures.
Sudden movement by client
could spill bath water.
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28. Raise he lower leg while
supporting it with one hand and
slide the basin under the lifted
foot. Soak the foot while
washing the leg.
Proper positioning of foot
prevents pressure being applied
from edge of basin against calf.
Soaking softens calluses and
rough skin.
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29. Use long, firm strokes in
washing from client’s ankle to
knee and from knee to thigh,
unless contraindicated. Dry
well.
Promotes venous return.
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30. Cleanse client’s foot, making
sure to bathe between toes. Clean
and clip nails as needed. Dry
well. Apply lotion to dry skin.
Do not massage any reddened
Secretions and moisture may
be present in between toes.
Application of lotion helps
retain moisture and softens
skin.
4

5. area on client’s skin.
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31. Raise side rail and move to other
side of bed. Lower side rail and
repeat steps 26 through 29 for
client’s other leg and foot.
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32. Cover client with bath blanket,
raise side rail for client’s safety,
and change bath water.
Decreased bath water
temperature can cause chilling.
Clean waster reduces
transmission of
microorganisms
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33. Lower side rail. Assist client in
assuming a prone or side-lying
position (as applicable). Place
towel lengthwise along client’s
side.
Exposes back and buttocks for
bathing.
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34. Keep client draped by sliding
bath blanket over his or her
shoulders and thighs. Wash,
rinse, and dry back from neck to
buttocks using long, firm strokes.
Pay special attention to folds of
buttocks and anus. Give client a
back rub. Change bath water.
Maintains warmth, and
prevents unnecessary exposure.
Skinfolds near buttocks and
anus may contain fecal
secretions that harbour
microorganisms.
Changing bath water prevents
transfer of microorganisms
from anal area to genitalia.
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35. Apply disposable gloves if not
done previously.
Prevents contact with
microorganisms in body
secretions.
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36. Assist client in assuming a side-
lying or supine position. Cover
client’s chest and upper
extremities with towel and lower
extremities with bath blanket.
Expose client’s genitalia only.
Wash, rinse, and dry perineum.
Maintains client’s privacy.
Clients who are capable of
performing partial bath usually
prefer to wash their own
genitalia.
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37. Dispose of gloves in receptacle. Prevents transmission of
infection.
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38. Apply additional body lotion or
oil on client as desired.
Moisturizing lotion prevents
dry, chapped skin.
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39. Assist client in dressing. Comb
client’s hair.
Promotes client’s body image.
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40. Make client’s bed. Provides a clean environment
and provides client comfort
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41. Remove soiled linen and place it
in laundry bag. Clean and
Prevents transmission of
infection. Clean environment
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6. replace bathing equipment.
Replace call light and client’s
personal possessions. Leave
room as clean and comfortable as
possible.
promotes client’s comfort.
Keeping call light and articles
of care within reach promotes
client’s safety.
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42. Perform hand hygiene. Reduces the transmission of
microorganisms.
EVALUATION
• Observe client’s skin, paying particular attention to areas that were previously soiled,
reddened, or that showed early signs of breakdown.
• Observe client’s range of motion during the bath.
• Ask client to rate level of comfort.
• Record bath on flow sheet. Note level of assistance required.
• Record condition of client’s skin and any significant findings.
• Report evidence of alterations in client’s skin integrity.
NURSING CONSIDERATIONS
• Clients whose level of independence and mobility change frequently may require more or
less assistance during bathing
• If available, be sure that clients with an IV or upper extremity injury have a gown with
snap or tie sleeves. Thus there is easy access to upper extremities during hygiene
• If a client us at risk for falls, be sure to raise side rails up before obtaining fresh water or
other supplies. Remember side rails cannot be used as a restraint.
• Clients with history of deep vein thrombosis (DVT) should not have their lower
extremities washed with long firm strokes.
• Do not massage any reddened area on client’s skin because massaging causes breaks in
the skin surface capillaries and increased risk of skin breakdown.
• If client becomes excessively fatigued and unable to cooperate or participate in bathing,
reschedule bathing to a time when client is more rested
MAKING A WASHCLOTH MITT
To make a washcloth mitt, take a clean, dry washcloth and fold it in thirds lengthwise
around your hand. Fold the top of the washcloth down and tuck it into the bottom of the
mitt.
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7. 7

8. 8
Cleaning the eyes from inner to outer cantus.

9. BED SHAMPOO
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Washing of the arms from distal to proximal.
Performing foot care.

10. DESCRIPTION
Shampooing removes dirt and old oils and helps prevent skin irritation. Frequency of hair
care depends on the length and texture of the patient's hair, the duration of hospitalization, and
the patient's condition. Usually, hair should be shampooed according to the patient's normal
routine. Typically, no more than 1 or 2 weeks should elapse between washings. Shampooing is
contraindicated in patients with a recent craniotomy, depressed skull fracture, conditions
necessitating intracranial pressure monitoring, or other cranial involvement.
PURPOSES
• To stimulate the blood circulation to the scalp through massage.
• To clean the hair and increase the client’s sense of well being
ASSESSMENT
• Signs and symptoms of alterations in respiration as well as factors that influence the rate
of respiration
• Determine any previous activity that would interfere with accuracy of respiratory rate
• Determine the normal values for age groups as it varies
PLANNING
• Prepare the necessary equipment/ materials to be used and checking their functionality
o Comb and brush
o Hand towel
o Liquid shampoo (or mild soap, such as castile)
o Shampoo tray with tubing
o Washcloth
o Three bath towels
o Two bath blankets
o Cotton
o Pail or plastic wastebasket
o Container for water
o One small pitcher or beaker
o Basin
o Linen-saver pads
o Gloves
o Optional: hair conditioner or rinse
• Gather the equipment on the patient's bedside stand.
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11. • Before shampooing the patient's hair, adjust the room temperature and eliminate drafts to
prevent chilling the patient. Next, obtain a shampoo tray or devise a trough if necessary.
IMPLEMENTATION
KAR PROCEDURE RATIONALE
1. Perform hand hygiene and put on
gloves, as necessary
Hand washing is the single,
most effective way for
preventing the transmission of
microorganisms and infectious
diseases.
2. Confirm the patient's identity
using two patient identifiers
according to your facility's policy
3. Explain the procedure to the
patient
4. Cover the patient with a bath
blanket. Then fanfold the linens to
the foot of the bed, or remove
them if they're scheduled to be
changed.
5. Place a wastebasket on a linen-
saver pad on the floor or on a
footstool near the head of the
bed.
The pail or container catches
wastewater from the shampoo
tray.
6. Fill large pitchers or containers
with comfortably warm water and
place them on the overbed table.
7. Lower the head of the bed until
it's horizontal, and remove the
patient's pillow, if allowed.
8. Fold the second bath blanket and
tuck it under the patient's
shoulders
to improve water drainage.
9. Cover the bath blanket and the
head of the bed with a linen-saver
pad
to protect them from moisture.
10. Place a bath towel and linen-saver
pad together, and position them
around the patient's neck and over
his shoulders.
Doing so protects the patient
from moisture and pads his
neck against the pressure of
the shampoo tray.
11. Place the shampoo tray under the
patient's head with his neck in the
U-shaped opening. Arrange the
bath blanket and towel so the
11

12. patient is comfortable.
12. Adjust the shampoo tray to carry
wastewater away from the
patient's head, and place the
drainage tubing in the pail. Tuck a
folded towel or drawsheet under
the opposite side of the shampoo
tray, if necessary.
to promote drainage
13. Put on gloves if necessary.
14. Place cotton in the patient's ears to prevent moisture from
collecting in them.
15. Hand the patient a washcloth to
place over his eyes.
16. Carefully pour water over the
patient's hair. Don't overfill the
shampoo tray.
To avoid spills,
17. Using your fingertips, rub
shampoo into the patient's hair.
Massage his scalp well to
emulsify hair oils.
Vigorous rubbing stimulates
the scalp and also helps the
patient relax.
18. Pour water over the patient's hair
until it's free from shampoo. Then
reapply shampoo and rinse again.
Apply conditioner or a rinse, if
desired.
19. Remove the shampoo tray, and
wrap the patient's hair in a towel.
Remove the linen-saver pad from
the bed, and return the bed to its
original position.
20. Dry the patient's hair by gently
rubbing it with a towel. Then
comb, brush, and style it.
21. Remake the bed or change the
linens, if needed, and remove the
bath blanket.
22. Reposition the patient
comfortably.
23. Remove and discard your gloves,
if worn, and perform hand
hygiene.
24. Remove and empty the pail.
Clean and disinfect the shampoo
tray, and return it to
storage. Remove the pitchers
from the bedside, and return the
shampoo to the bedside stand.
25. Perform hand hygiene.
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13. 26. Document the procedure.
EVALUATION
• Conduct ongoing assessments such as any scalp problems or intolerance to the procedure.
Report any problems noted to the nurse in charge.
NURSING CONSIDERATIONS
• If you don't have a shampoo tray and can't devise a trough, place pillows under the
patient's shoulders to elevate his head, and use a basin. Because a standard basin doesn't
have a drainage spout, empty it frequently to prevent overflow.
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