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4 Complete Bed Bath & Making an Occupied Bed

Assessment

  • Assessed client’s tolerance for activity, comfort level, cognitive ability, musculoskeletal function and presence of equipment.
  • Assessed client’s bathing preferences (partial bed bath, bath at the sink or bath in a bag) and self- care ability. Acknowledged awareness of client’s cultural preferences.
  • Assessed condition of skin.
  • Assessed any special needs specific to client and assessed for any allergies.
  • Assessed client’s knowledge of skin hygiene.
  • Assessed potential for client incontinence or excess drainage on linen.
  • Assessed physician’s orders such as therapeutic bath and specific precautions concerning movement and positioning.
  • Assessed institution’s policy on changing linen.

Nursing Diagnosis

  • Identified purpose and risks associated with complete bed bath and making an occupied bed.

Planning

  • Explained procedure.
  • Provided privacy.
  • Prepared equipment and supplies.

Evaluation

  • Observed skin and assessed client’s range of motion (ROM) during bath.
  • Assessed client level of comfort.
  • Assessed client’s level of fatigue.
  • Recorded bath on flow sheet, noted level of assistance required.
  • Recorded condition of skin and significant findings.
  • Reported and recorded evidence of alterations in skin integrity.

Complete Bed Bath & Making an Occupied Bed – Implementation

  1. Performed hand hygiene. Offered client bedpan or urinal.
  2. Washed hands.
  3. Raised bed to a comfortable working height, removed call light, lowered side rail and positioned client supine toward side closest.
  4. Draped client with bath blanket, loosened bottom linens and removed top bed covers.
  5. Removed gown without exposing client.
  6. Placed towel under or around head, wash client’s eyes from inner to outer canthus with plain water. Dried gently.
  7. Washed, rinsed and dried forehead, cheeks, nose, neck and ears.
  8. Removed bath blanket from client’s arm. Placed towel lengthwise under arm. Bathed arm with soap & water using long, firm strokes from distal to proximal areas. Raised arm & bathed axilla. Inspected skin. Rinsed & dried arm, applied deodorant according to client preference.
  9. Repeated for the other arm and axilla.
  10. Changed bath water as necessary.
  11. Covered client’s chest with bath towel and folded bath blanket down to umbilicus. Bathed chest using long, firm strokes, paying special attention to skin folds under breasts. Inspected skin, rinsed and dried well.
  12. Placed basin on folded bath towel beside client. Immersed client’s hand in water for 3-5 minutes (optional). Washed hand making sure to wash well between fingers, dried well.
  13. Positioned bath towel to cover chest & abdomen. Folded bath blanket down to just above pubic region. Bathed abdomen giving special attention to umbilicus and abdominal folds. Inspected skin. Rinsed and dried well.
  14. Covered chest and abdomen with bath blanket. Exposed leg and placed bath towel under leg. Unless contraindicated, bathed leg using long, firm strokes from ankle to knee, and knee to thigh. Rinsed and dried well.
  15. Repeated for other leg.
  16. Bathed foot, made sure to wash well between toes. Foot soaks optional unless contraindicated. Rinsed & dried well. Changed water.
  17. Covered client with blanket, raised side rail and changed bath water.
  18. Have client in side lying position, washed back. Applied gloves. Bathed buttocks and anus, washed from front to back. Rinsed and dried well. Inspected skin.
  19. Disposed of soiled gloves, washcloth and towel. Covered client with bath blanket and raised side rail. Changed bath water as necessary.
  20. Positioned client supine. Rotated bath blanket to diamond shape to expose only genitalia. Applied gloves.
    1. For females: Positioned client in dorsal recumbent position. Assisted client to flex knees and spread legs. Placed bath towel under buttocks. Washed labia majora from front to back. Separated labia majora and washed labia minora downward from pubic area toward rectum in one smooth stroke. Used a separate section of washcloth for each stroke. Rinsed and dried perineum well. Inspected skin.
    2. For males: Placed bath towel under penis. Retracted foreskin if uncircumcised. Washed tip of penis using circular motion from urinary meatus outward toward base of penis. Rinsed and dried well. Inspected skin. Returned foreskin to natural position. Gently bathed scrotum rinsed and dried well. Disposed of soiled washcloth and gloves.
  21. Assisted client to dress.
  22. Assisted client with hair care, shaving and oral hygiene. Raised side rail.
    1. Assisted client to a side lying position on the far side of the bed. Rolled loosened bottom linens close to the client. Wiped off any moisture on exposed mattress.
    2. Applied clean linen to expose half of the bed. Unfolded bottom sheet lengthwise so that center crease is situated lengthwise along center of bed alongside client. Lower hem of bottom sheet placed seam down and even with bottom edge of mattress (flat sheet)
    3. Mitered bottom sheet at head of bed. Tucked remaining portion of sheet under mattress moving toward foot of bed. Kept linen smooth.
    4. Opened draw sheet (if used) so that it unfolds in half. Place centerfold along middle of bed lengthwise. Fan folded top layer toward client. Smoothed bottom layer over mattress and tucked excess edge under mattress.
    5. Placed waterproof pad (if used) over draw sheet, with centerfold against client’s side. Fan folded top layer toward client.
    6. Assisted client to roll slowly over layers of linen. Raised side rail and moved to other side of bed.
    7. Lowered side rail. Positioned client if needed. Removed soiled linen by folding it into a bundle with soiled side turned in. Discarded linen in laundry bag while holding away from the body.
    8. Pulled sheet while tucking clean fan folded linen smoothly over edge of mattress from head to toe. Mitered top corner of bottom sheet.
    9. Smoothed fan folded draw sheet over bottom sheet. Pulled and tucked draw sheet from middle to top and then to bottom.
    10. Placed top sheet over client with centerfold lengthwise down middle of bed & seam facing up. Removed soiled bath blanket and discarded in linen bag.
    11. Placed top spread/blanket over top sheet unfolding it so that crease runs lengthwise along middle of bed and top of spread is approximately 4-6” from top edge of sheet.
    12. Made cuff by turning edge of top sheet down over top edge of spread.
    13. Lifted mattress corner at one side of foot of bed and tucked top linens under mattress. Made a modified mitered corner then raised side rail.
    14. Moved to other side of bed, lowered rail and made other side of bed.
    15. Changed pillowcase.
  23. Returned each client to comfortable position, raised side rail, lowered bed and placed call bell within reach.
  24. Disposed of soiled linen. Cleaned and replaced bathing equipment and suppliers. Tidied bedside unit.
  25. Washed hands.

Faculty Comments
Assessment Nursing Diagnosis Planning Implementation Evaluation
Attempt Number &
Outcome Number
Student Signature  
 

 Faculty Signature
 
 		 Date
 
 
The student was unable to perform the skill competently and will be retested.
 
 

 Faculty Signature
 
 		 Date
 
 

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Practical Nursing Program Skills Checklist Copyright © 2023 by Nova Scotia Community College. All Rights Reserved.

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