Assisting individuals with bathing in nursing
Maintaining personal hygiene is essential for the preservation of health and the prevention of infection, and removal of body odour. Individuals, whenever possible, should be encouraged to perform their own personal hygiene so that their independence is promoted. Bathing may involve assisted washes in or out of bed, bed bathing, showering or immersion in a general bath. Care must be taken throughout to keep wounds or dressings dry, and such considerations may influence the mode of choice.
Equipment
The equipment required will vary according to individual client needs but may include soap, face cloth, two towels (one face and one bath), disposable wipes, clinical waste disposable bags, toiletries (for example, deodorant, perfume, aftershave), client’s comb/brush, bowl of hot water (35–40ºC), gloves and apron, lotion thermometer, suitable bath/shower, chair/shower stool, disposable floor mat, appropriate aids if bathing/ shaving, clean nightdress/pyjamas or clothing as required, clean bed linen/linen skip and a trolley/adequate surface.
Bathing/showering in the bathroom
The client’s preference may be for a general bath (sometimes referred to as an ‘up bath’ or shower. An assessment of the individual client’s preference along with an assessment of their strength, mobility and mental capacity is essential prior to the carrying out of this activity. The nurse must ensure the client’s safety at all times.
Assisted wash
Assessment of the client’s abilities is crucial prior to facilitating them to independently undertake any aspect of their personal cleansing. This assessment must be undertaken by a health care professional who is knowledgeable about the person’s medical condition, as the person may at first glance appear independent and indeed believe they are capable of self-care when they are at rest. However, for some clients, the slightest exertion can radically alter their ability to perform even the simplest task such as washing their face.
Assistance may be anything from merely providing them with the appropriate equipment and ensuring a safe environment, to washing the parts that they are unable to reach without causing undue distress, for example back, legs and hair.
Bathing a baby or child
In addition to the preservation of health and the prevention of infection, bath time for a small child offers an ideal opportunity for activities other than for their hygiene needs. The removal of drains, catheters, and dressings, or the passing of urine after surgery, are examples of activities that can be more easily undertaken during a bath. However, as with adults, care must be taken not to wet wounds or dressings that should be kept dry.
Bath time is also an opportunity to play with and get to know the small or older child in a non-threatening environment. It also can have a calming effect on babies who are distressed by their unfamiliar environment. The procedure for bathing a child is the same as for an adult but is usually undertaken with the use of bath toys. Toys that are used must be left to drain and thoroughly dried afterwards to prevent the growth of bacteria. The following procedure should be undertaken with newborn babies and babies up to the age of about six months. It can be modified to simply wash the baby’s face and bottom, more commonly referred to as ‘topping and tailing’.
Equipment
The equipment needed consists of mild baby soap or baby bath solution; clean towel; non-sterile eye swabs (not cotton wool); disposable wipes; clean nappy and disposal bag for the soiled one; change of clothing if required; container of sterile water; and a baby bath.
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