Partial Bed Bath & Making an Occupied Bed

Step A

• Check MD orders

• Gather supplies: bath towel, 4 towels, gown, brief, bottom sheet, chux, pillow case, top sheet, green cover

• Hand Hygiene: wash hands and put on gloves

• Self Introduction: “Hello my name is Jhesslee and I’m a psych tech student. I am here today to give you a partial bath and change your linens.”

• Patient Identification: Full Name & DoB

• Explain Procedure: Partial bath means that I’ll be cleaning areas of the body that accumulate sweat and bacteria; hands, axilla, perineal area, or back. When you are clean, we will change your bed linens. Because you are not cleared to get out of bed, we will assist you when rolling back and forth while we move sheets under you.

• Privacy: “invisible curtain”

1)

• *Fills 2 basins about 2/3 full of water (100°-105°F), one with soapy water and one with plain water. Allows patient to test water temperature and places basins on the bedside table

2)

• *Adjust bed to comfortable working height

• Remove call bell

3)

• Removes the bedspread

• *Covers client with bath blanket or clean flat sheet then removes the dirty top sheet by sliding out

4)

• STUDENT A: Lowers the bed side rail on the near side, while keeping the other rail raised

• STUDENT A & B: Remove the client’s gown, while keeping the bath blanket in place, covering the client

• Places an open towel over chest and abdomen

5)

• STUDENT A

• Uses the washcloth to make a mitt or four corners

• *Moistens the mitt with plain water and washes the eyes. Cleanses from the inner canthus (near the nose) to the outer canthus of each eye. Uses a different section of the mitt to wash each eye.

• *Washes face, neck and ears. Uses soap on these areas if preferred by the client. Rinses with plain water if soap used. Dries these areas carefully.
  

6)

• STUDENT B

• *While leaving towel over chest/abdomen, lowers bath blanket to below chest. Washes, rinses, and dries under breasts in female and any skin folds observed. (May wash under the towel, without exposing the breasts, except to wash under them). Covers chest with bath blanket and removes towel.

• BOTH STUDENTS

• *Uncovers arm. Places a towel under the arm. Washes, rinses, and dries the hand

• *Washes the axilla; rinses the axilla and dries the towel

• Removes the towel that was under arm. Covers arm and hand with the bath sheet

7)

• BOTH STUDENTS: Opens brief tabs, checks for stool, tucks front of brief between patient’s legs

8)

• *Raises the side rail

• *Changes the water and places basins on the side table. Perform hand hygiene and changes gloves. (ok to verbalize)

9)

• STUDENT A

• *Lowers the side rail on the near side, while keeping the other rail raised

• *Assist the client to turn away from you onto their side (student B can assist & hold client). Uncover the back and buttocks. Remove brief. Place towel the long way on the bed, parallel to the back. Wash, rinse, and dry the back

• Wash, rinse, and dry the buttocks, then the rectal area. Change gloves as needed. Assess for reddened areas or skin breakdown. Pat dry. Remove towel. Return the client to their back

• Raises the side rail and changes the water. Performs hand hygiene, changes gloves (ok to verbalize)

10)

• STUDENT B

• *Raises the bath blanket to expose the perineal area. Asks or help to bend their knees and spread their legs. Puts a clean towel near/under the buttocks.

• Asks the client if they prefer to wash themselves. Places the necessary equipment within the client’s reach, provides privacy, and allows the client to complete perineal care, if they are able to do so. If they are not able to do themselves, then proceed as below

• Wash, rinse, and dry groin folds

• *Female perineal care:

  • *Holds a clean non-soapy washcloth in one hand and cleanses outer labia with downward strokes, using a different corner for each.

  • *Separates the outer labia and cleanses two inner labia with plain water downward from the pubic to the anal area (i.e., top to bottom/front to back)

  • *Washes from the outside and works toward the center

  • Pats dry

• *Male perineal care:

  • *Cleanses in a circular motion, moving from the tip of the penis downward toward the pubic area. Ensure soapy water does not enter the urethral meatus

  • *In an uncircumcised male, retracts the foreskin before washing the penis

  • *Rinses well and dries

  • *Returns the foreskin to its former position

  • *Washes, rinses, and dries the perineum and scrotum carefully

• *Removes and discards the used gloves and washes hands

11)

• BOTH STUDENTS: Apply clean brief by turning patient first on their side, then their back and fasten tabs

• Recover with bath blanket

• BOTH STUDENTS: Assist with dressing the client. (If we were not changing linens, at this point replace bed sheet and bedspread)

12)

• *Ensures the side rails are raised.

• *Lowers the bed & replaces call light on the bed

13) BED

• *Lowers the side rail on the near side, while keeping the other rail raised

• Loosens the top bed linens

• *Removes the bedspread

14)

• *Assist the client to turn towards the other side of the bed and asks the client to hold onto the side rail, if able

• *Adjusts the pillow and assure face is not pressed into side rail

15)

• STUDENT A: Loosens the bottom bed linens on the near side.

• *Rolls the used linens from the side of the bed towards the middle and wedges them close to the client’s back

• *Places the clean bottom sheet & bed pad on the bed, folded lengthwise and fold up on patient

• Rolls the top half of the sheet and bed pad under the client and under used linens

• *Pushes it under the used sheet and under the client’s back as far as possible

• *Smooths the bottom sheet and miters/tucks the upper corners of the sheet

• *Raises the side rail on the near side

16)

• BOTH STUDENTS *Assists the client to roll over the folded linen to the near side of the bed

• STUDENT B: asks the client to move as close as possible to near side and hold onto the side rail, if able

• *Adjusts the pillow

• Lowers the side rail on side of Student B

• *Carefully, eases the used bottom linens out of the bed, holds them away from the body, and places them into the appropriate receptable

• *Grasps the clean bottom linen and gently eases them (without dragging), out from under the client

• *Smooths the bottom sheet and miters/tucks the upper corners of the sheet

• *Raises side rail and assists the client back to the center of the bed
  

17)

• *STUDENT B: Replace pillowcase and places the pillow under head

• *BOTH STUDENTS: places the top clean sheet over the used top sheet or bath blanket

• Asks the client to hold onto the upper edge of the clean sheet as the used sheet or bath blanket is carefully removed

• *Places used sheets into linen basket (hamper)

18)

• *Unfolds and replaces the bedspread over the clean top sheet

• *Makes partial Miter to lower ends of top sheet and bedspread

• Makes a toe pleat over client’s feet

• Folds the top of bedspread down

• Turns the top edge of the sheet back over the bedspread

19)

• *Ensures the side rails are raised

• *Lowers the bed and adjusts the head of the bed to a comfortable position

• *Replaces the call light on the bed

• *Removes and discards the used gloves/PPE and washes hands