Personal Care and Support – Back RubSECTION: 18.01

Strength of Evidence Level: 3__RN__LPN/LVN__HHA

PURPOSE:

To refresh the patient, relax muscles, stimulate circulation and prevent pressure areas.

CONSIDERATIONS:

1.Patients who spend a great deal of time in bed need special attention because of pressure caused by bedding and lack of movement.

2.DO NOT rub persistent reddened areas, broken skin or wounds.

3.May be performed as part of bathing.

EQUIPMENT:

Towels

Lotion of patient's choice

Basin of warm water

PROCEDURE:

1.Adhere to Standard Precautions.

2.Explain procedure to patient.

3.Provide for privacy if appropriate.

4.Raise the bed to waist height or comfortable working position and lock the wheels (if applicable). Position the patient on side or abdomen so that you can easily reach his/her back. For warmth and privacy, cover the patient with a blanket.

5.For safety, keep the side rail up on the far side of the bed. Lower the side rail closest to you. If there are no side rails on the bed, assure the patient is safe from falling or harm.

6.Place the lotion bottle in a basin of warm water.

7.Expose the patient’s back. DO NOT overexpose the patient. Prevent chilling from drafts or exposure by using bath towels or bath blanket.

8.Pour a small amount of lotion into the palm of your hand; rub hands together, using friction to warm the lotion.

9.Apply lotion to the entire back with the palms of your hands. Use firm long strokes from the buttocks to the shoulders, then around the shoulder area, and back to the lower back.

10.Use proper body mechanics. Keep your knees slightly bent and your back straight.

11.Exert firm but gentle pressure as you stroke upward from the lower back towards the shoulders. Use gentle pressure as you move down the back. DO NOT lift your hands as you massage.

12.Use a circular motion on each bony area. This rhythmic rubbing motion should be continued for 1 to 3 minutes.

13.Dry the patient's back by patting it with a towel.

14.Assist the patient in putting on appropriate attire.

15.Straighten bed linen.

16.Return the patient to a position of comfort.

17.Return side rails to upright position and lower bed to a safe height.

18.Tidy area and put supplies away.

19.Discard soiled supplies in appropriate containers.

AFTER CARE:

1.Document in patient's record:

a.Skin condition.

b.Patient's response to procedure.

2.Report any changes in patient's condition to supervisor.

REFERENCES:

Leahy, W., Fuzy, J., & Graf, J.,(1999). Providing home care: A textbook for home care aides. (3rd ed.). Albuquerque, NM: Hartman Publishing, Inc