Complete Bed Bath Performance Checklist

Complete Bed Bath Including Perineal Care and Back Massage

Check care plan for direction and client needs. Perform hand hygiene. Assess the client’s status before undertaking the activity. Explain the procedure to the client. Provide for privacy.

Prepare equipment and supplies:

•  Basin
•  Gloves
•  Washcloths
•  Towels
• Waterproof pad
•  Soap
• Paper towels
• Medicated, non-medicated lotions/creams
• Other equipment as preferred by client.
• Offer client bedpan or urinal.

Cleaning

• Perform hand hygiene. Raise bed to a comfortable working height. Lower side rail and position client supine toward side closest to you.
• Drape client with bath blanket and remove top covers. Remove gown without exposing client.
• Place towel across shoulders. Wash client’s eyes from inner to outer canthus with plain warm water. Dry gently using a separate washcloth for each eye. Repeat washing as needed.
• Wash, rinse, and dry forehead, cheeks, nose, neck and ears.
• Remove bath blanket from client’s arm. Place towel lengthwise under arm. Support arm at the elbow; wash arm, shoulder, and axilla.
• Place basin on folded bath towel beside client. Immerse client’s hand in water for 3 – 5 minutes (optional). Wash hand making sure to wash well between fingers, dry well.
• Repeat for the other arm.
• Cover client’s chest with bath towel. Wash, rinse, dry well, paying special attention to skin folds under breasts. Change bath water, as necessary.
• Position bath towel to cover chest & abdomen. Wash, rinse, dry abdomen well giving special attention to umbilicus & abdominal folds.
• Expose far leg and place bath towel under leg. Wash, rinse & dry well. Then, place the towel under the client’s feet. Wash the client’s feet. Repeat for the other leg and foot. Change bath water as necessary.
• Cover client with blanket, raise side rail & change bath water.
• Position client in a side lying position.
• Lower side rail & place bath towel lengthwise along client’s bath. Wash, rinse, & dry back from neck to buttocks.

Provide back massage.

• Expose back, shoulders, upper arms and buttocks only.
• Warm lotion.
• Stroke up from buttocks to the shoulders using long strokes.
• Knead skin by grasping skin between your thumb and fingers. Start at buttocks and move up to shoulder and then down from shoulder to buttocks. Repeat on other half of the back.
• Repeat steps for 3 – 5 minutes.
• Position client in a supine position. Rotate bath blanket to diamond shape to expose only genitalia. Change wash cloth and bath water.

Perform Perineal Care:

• For females: Position client in a supine position. Assist client to flex knees & spread legs. Place bath towel under buttocks. Separate labia majora and in the first stroke, wash the labia on the side farthest from you. Clean downward from top to bottom with one stroke. The second stroke should then wipe the labia closest to you. Use a separate section of the cloth for each stroke and stroke in only one direction, from top to bottom. Using a clean section of the cloth, perform the third stroke, wiping down the centre of the perineum, cleaning from the pubic area toward the rectal area in one stroke. Cleanse thoroughly around the clitoris and vaginal orifice.
• For males: Place bath towel under penis. Retract foreskin if uncircumcised. Wash tip of penis using circular motion from urinary meatus outward toward base of penis. Rinse & dry well. Inspect skin. Return foreskin to natural position. Gently bathe scrotum, rinse & dry well. Dispose of soiled washcloth & gloves.
• Assist client to lateral position. Wash anal area from front to back. Rinse & dry well.
• Cover client with bath blanket & raise side rail. Dispose of soiled gloves, washcloth & towel. Perform hand hygiene.
• Apply deodorant, lotion and non-medicated lotions, creams, or ointments as directed by care plan.
• Report and record actions and observations according to agency policy.