Code: Number:

Personal Hygiene: Bathing

Sage Comfort Personal Cleansing® Bath with Skin Check™ Guide -5-Pack

Approved: / Reviewed: / Revised:

POLICY:

The Sage Comfort Personal Cleansing bath will be used on all patients that require a bed bath unless the patient declines or has any know sensitivities to ingredients.

PURPOSE:

The purpose of a bath is to cleanse the skin, remove harmful bacteria, control odor, stimulate tissue and promote relaxation and comfort, while providing an opportunity for skin monitoring and/or assessment.

ARTICLES NEEDED:

Sage Comfort Personal Cleansing bath (1 package)

Towel (1, optional)

Clean gown

Pads for incontinence care (if necessary)

Cleansing agent for incontinence care (if necessary)

Comfort Personal Cleansing microwave and/or Warmer (14 or 28 count capacity)

PROCEDURE:

1. Warming the Comfort Personal Cleansing bath

  1. Warm according to directions on the package.
  2. Consult package for complete indications, ingredients and warnings.
  1. Bathing with Comfort Personal Cleansing bath
  2. Ensure a private environment.

KEY POINT: Use a towel or sheet to cover the patient appropriately to protect their privacy as you progress through the bath.

b.Remove the Skin Check™ Guide from the package label and place in an accessible location.

c. Peel back the package label and test the temperature of the washcloths. If temperature is acceptable to your touch you may proceed with the bathing process. If not, stop procedure. Repeat every 10 minutes until temperature is acceptable to patient.

KEY POINT: Remember, gloves diminish your sensitivity to heat. Obtain feedback from your patient on his or her comfort with the bath. Continue to monitor patient’s comfort level temperature as bath progresses.

  1. Remove the first washcloth. Clean the face, neck and upper torso with the #1 washcloth and discard. No rinsing or drying is required.

KEY POINT: Following the bathing procedure in a sequenced order reduces the chance of cross contamination by providing a clean washcloth for separate areas of the body while maximizing appropriate use of the product to prevent waste.

KEY POINT: In patients who have a potential for moisture entrapment in skin folds, it may be necessary to pat dry with clean soft towel. Use caution around dressings, intravascular lines, etc.

  1. Remove the #2 washcloth. Clean the right and left arms and armpits with the #2 washcloth and discard.
  1. Remove the #3 washcloth. Clean the perineal area with the #3 washcloth and discard. If patient is incontinent, clean perineal area according to the incontinence care policy and procedure
  1. Remove the #4 washcloth. Clean the right and left legs with the #4 washcloth and discard.
  1. Remove the #5 washcloth. Ask the patient to turn on their side, if able, or obtain assistance, as necessary.

Clean the upper back and buttocks with the #5 washcloth and discard.

  1. Once the bath is completed, apply clean gown, cover the patient as appropriate and return side rails to correct position.

DO NOT FLUSH WASHCLOTHS

  1. Complete additional personal hygiene activities as necessary (oral care, comb hair and clean nail beds; wash hair and shave facial hair as necessary).

3. Instruct the patient/family about importance of personal hygiene.

4. Clean the work environment and leave the patient in a safe, comfortable position. Return the head of bed to a 30-degree position if no contraindications or discomfort.

5. Documentation:

  1. Using the Skin Check Guide, mark areas of skin redness, irritation, bruising, blistering, discoloration, cuts/open areas, unusual moles, or any skin condition you are unsure of on the appropriate body diagram. Document patients name, location and who completed the skin monitoring check. If skin monitoring was completed by a nursing assistant, give the completed label to the RN assigned to the patient for follow up skin assessment. Otherwise, place the Skin Check Guide in a designated documentation location as applicable.
  1. Document completion of the procedure on your facility’s appropriate form.

REFERENCES:

Anaissie, E. et al (2002). The Hospital Water Supply as a Source of Nosocomial Infection. Arch Intern Med, 162:1483-1492.

Frantz, R.A. & Gardner, S. (1996). Clinical Concerns: Management of Dry Skin. Journal of Gerontological Nursing, 15-18.

Frantz, R.A. & Kinney, C.N. (1986). Variables Associated With Skin Dryness in the Elderly. Nursing Research, 35, 98-100.

Hess, C.T. (1997). Fundamental Strategies for Skin Care. Ostomy/Wound Management, 43(8), 32-41.

Larson, E. et al (2004). Comparison of Traditional and Disposable Bed Baths in Critically Ill Patients. AJCC, 13:235-241.

Mason, S.R. (1997). Type of Soap and the Incidence of Skin Tears Among Residents of a Long-Term Facility. Ostomy/Wound Management, 43(8), 26-30.

Shannon, R. et al (1999). Patient Bath Water as a Source of Nosocomial Microbiological Contamination: An Intervention Study Using Chlorhexidine. J of HC Safety, Compl & IC, 3(4)180-184.

Skewes, S.M. (1996). Skin Care Rituals That Do More Harm Than Good. AJN, 96(10), 33-35.

U.S. Dept. of Health and Human Services. (1992). U.S. Agency for Health Care Pressure Ulcers in Adults: Prediction and Prevention. (AHCPR Pub No. 92-0047). Rockville, MD: Author.

20614B

AUTHOR: Kathleen M. Vollman, MSN, RN, CCNS, CCRN, FCCM

Clinical Nurse Specialist/Educator/Consultant

ADVANCING NURSING 2004 1