Student ______________________________________________________ Instructor ____________________________________________________

Date _________________________ Date _________________________

PERFORMANCE CHECKLIST SKILL 17-1 BATHING AND PERSONAL HYGIENE

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ASSESSMENT

NP

Comments

1. Assessed patients preference and tolerance for bathing. 2. Assessed patients visual status, ability to sit without support, hand grasp, and ROM of extremities. 3. Assessed for presence of equipment (e.g., intravenous [IV] line or oxygen tubing). 4. Asked if patient has noticed any problems related to condition of skin and genitalia. 5. Assessed condition of patients skin. 6. Identified risks for skin impairment. 7. Assess patients knowledge of skin hygiene. 8. Checked physicians therapeutic bath order for type of solution, length of time for bath, and body part to be attended. 9. Reviewed orders for specific precautions concerning patients movement or positioning.
NURSING DIAGNOSIS

1. Developed appropriate nursing diagnoses based on assessment data.

PLANNING

1. Identified expected outcomes. 2. Explained procedure to patient and asked for patients suggestions. 3. Adjusted room temperature and ventilation for patients comfort and provided for patients privacy during bath. 4. Prepared necessary equipment and supplies.
IMPLEMENTATION

1. Complete or Partial Bed Bath a. Offered bedpan or urinal before bath. b. Gathered all supplies, performed hand hygiene, and applied gloves. c. Adjusted bed height, lowered side rail, and assisted patient to a comfortable position.
Mosby items and derived items 2010 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published.

S d. Used bath blanket properly while removing top linens of bed. Disposed of soiled linen correctly. e. Removed patients gown correctly. f. Checked temperature of bath water and patients tolerance. Warmed bath lotion, if desired. g. Removed pillow if allowed and raised head of bed; placed a towel under patients head and a towel over patients chest. h. Washed face: (1) Inquired if patient was wearing contact lenses. If so, performed eye care. (2) Formed mitt with washcloth. Immersed mitt in water and wrung thoroughly. (3) Washed patients eyes with plain warm water, using a clean area of cloth for each eye, bathing from inner to outer canthus. Soaked any crusts on eyelid for 2 to 3 minutes with damp cloth before attempting removal. Dried around eyes gently and thoroughly. (4) Asked if patient would prefer to use soap on face. Otherwise, washed, rinsed, and dried forehead, cheeks, nose, neck, and ears without using soap. Asked men if they would like to be shaved. i. Provided eye care for the unconscious patient: (1) Cleansed the eyelids with a washcloth from the inner to outer canthus using plain warm water. (2) Instilled prescribed eye drops or ointment per physicians order. (3) In absence of blink reflex, kept eyes closed. j. Washed trunk and upper extremities: (1) Removed bath blanket from patients arm. Placed bath towel lengthwise under arm. Bathed with minimal soap and water using long, firm strokes from distal to proximal (fingers to axilla). (2) Raised and supported arm above head (if possible) to wash, rinse, and dry axilla thoroughly. Applied deodorant or powder to underarms if desired or needed.

NP

Comments

Mosby items and derived items 2010 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published.

S (3) Moved to other side of bed and repeated steps a and b with other arm. (4) Covered patients chest with bath towel and folded bath blanket down to umbilicus. Bathed chest using long, firm strokes. Took special care with skin under female patients breasts. Rinsed and dried well. k. Washed hands and nails: (1) Folded bath towel in half and laid it on bed beside patient. Placed basin on towel. Immersed patients hand in water. Allowed hand to soak for 3 to 5 minutes (if needed) before cleansing fingernails. Removed basin and dried hand well. Repeated for other hand. l. Checked temperature of bath water and changed water if necessary; otherwise continued. m. Washed the abdomen: (1) Placed bath towel lengthwise over chest and abdomen. (Two towels may be needed.) Folded bath blanket down to just above pubic region. Bathed, rinsed, and dried abdomen with special attention to umbilicus and skinfolds of abdomen and groin. Kept abdomen covered between washing and rinsing. Dried well. (2) Applied clean gown or pajama top. n. Washed the lower extremities: (1) Covered chest and abdomen with top of bath blanket. Exposed near leg by folding blanket toward midline. Kept perineum draped. (2) Placed bath towel under leg, while supporting leg at knee and ankle. If appropriate, placed patients foot in a basin to soak while washing and rinsing. (3) Washed leg using long, firm strokes from ankle to knee, then knee to thigh. Did not rub or massage the back of the calf. Dried well. Washed between toes of foot. Cleansed foot, making sure to bathe between toes. Cleaned and clipped nails, adhering to agency policy as needed. Dried toes and feet completely. Removed and discarded towel.

NP

Comments

Mosby items and derived items 2010 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published.

S (4) Raised side rail, moved to opposite side of bed, lowered side rail, and repeated steps for other leg and foot. Applied moisturizing lotion to dry skin. When finished, covered patient with bath blanket. (5) Raised side rail and changed bath water. Removed contaminated gloves. o. Washed back: (1) Reapplied clean gloves. Assisted patient to a comfortable position Placed towel along side. (2) If fecal material was present, enclosed in toilet tissue and removed with disposable wipe. (3) Washed, rinsed, and dried back from neck to buttocks. Assessed skinfolds. Removed soiled linens. Made bed. Removed gloves. Performed hand hygiene. p. Gave back rub with lotion. Determined patients sensitivities or allergies to product. q. Repositioned grooming. patient and assisted in

NP

Comments

r. Cleaned and replaced bathing supplies. Placed bed in safe position with call light and personal belongings next to patient. s. Performed hand hygiene.
RECORDING AND REPORTING

1. Recorded procedure and amount of assistance and patient participation. 2. Recorded condition of skin, joints, and muscles. 3. Reported findings to charge nurse or health care provider.

Mosby items and derived items 2010 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published.