Bed bath; Sponge bath

Some patients cannot safely leave their beds to bathe. For these people, daily bed baths can help keep their skin healthy, control odor, and increase comfort. If moving the patient causes pain, plan to give them a bed bath after they have received pain medicine and it has taken effect.

Encourage the patient to be as involved as possible in bathing themselves.

A bed bath is a good time to inspect a patient's skin for redness and sores. Pay special attention to skin folds and bony areas when checking.

You will need:

• Gloves
• Large bowl of warm water (around 106 degrees Fahrenheit)
• Soap (regular or non-rinse soap)
• Two washcloths or sponges or at least 7 no-rinse cloths
• Dry towel
• Lotion
• Shaving supplies, if you are planning to shave the patient
• Comb or other hair care products
• Deodorant

Bag Bath -- instead of soap and water. If available, you can use a bag bath package with 8 to 10 premoistened disposable cloths that contain a no-rinse surfactant instead of using soap and water. The bag bath needs to be warmed before use.

To prevent hospital-acquired infections, consider the use of chlorhexidine-impregnated disposable no-rinse cloths. Make sure the patient can tolerate and does not have allergies to chlorhexidine.

If you wash the patient's hair, use either a dry shampoo that combs out or a basin that is designed for washing hair in bed. This kind of basin has a tube in the bottom that allows you to keep the bed dry before you later drain the water.

The following steps should be followed when giving a bed bath:

• Bring all the supplies you will need to the patient's bedside. Raise the bed to a comfortable height to prevent straining your back.
• Explain to the patient that you are about to give them a bed bath. Make sure the room is warm enough and the doors and windows are closed to prevent a draft of cold air.
• Put on gloves.
• Make sure you uncover only the area of the body you are washing. This will keep the person from getting too cold. It also provides privacy.
• While the patient is lying on their back, begin by washing their face and move toward their feet. Then, roll your patient to one side and wash their back.
• To wash a patient's skin with soap and water, first wet the skin with a sponge, then gently apply a small amount of soap. Check with the patient to make sure the temperature is okay and you are not rubbing too hard.
• Make sure you rinse off all the soap and then pat the area dry, including the skin folds and creases. Apply lotion before covering the area up.
• Bring fresh, warm water to the patient's bedside with a clean washcloth to wash private areas. First wash the genitals, then move toward the buttocks, always washing from front to back.
• If you are using a bag bath or no-rinse cloth, you should let the skin air dry before you cover the skin. Most no-rinse cloths have moisturizers, so you do not need to rinse, dry, or put lotion on the skin afterwards. Start by cleaning the face, do not use chlorhexidine cloths on the face. You will need a fresh no-rinse cloth for each of these areas: face, neck to chest, armpit to hand, stomach to a private area, each leg to the foot, neck to back, and finally the buttocks.

American Red Cross. Assisting with personal cleanliness and grooming. In: American Red Cross. American Red Cross Nurse Assistant Training Textbook. 3rd ed. American National Red Cross; 2013:chap 13.

Konya I, Nishiya K, Yano R. Effectiveness of bed bath methods for skin integrity, skin cleanliness and comfort enhancement in adults: A systematic review. Nurs Open. 2021;8(5):2284-2300. PMID: 33724709 pubmed.ncbi.nlm.nih.gov/33724709/.

Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M. Personal hygiene. In: Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M, eds. Clinical Nursing Skills: Basic to Advanced Skills. 9th ed. New York, NY: Pearson; 2017:chap 9.