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Bag bath

LTC Nursing Assistant Trainer, March 30, 2005

Bathing residents is an important, and sometimes challenging, part of CNAs' jobs. Residents need to be bathed frequently both for their well-being and the integrity of their skin. By keeping the skin clean and free of perspiration and other bodily waste, you can help residents avoid embarrassing and unpleasant odors and protect their skin from irritation and bacterial growth that can lead to or worsen skin ulcers.

The bag bath is one alternative to the traditional bed bath used in some nursing homes. The bath is performed with a series of 10 washcloths and a no-rinse liquid cleanser. To prepare:

• Moisten the washcloths with water and put in a plastic bag with the cleanser
• Warm the bag in the microwave for 60 to 90 seconds
• Test the temperature of the cloths before touching a resident with them and be careful when you open the bag, as steam can burn you
• Take the bag to the resident's bedside

If you are using a commercial bag bath, follow the directions on the package. Before you bathe a resident, ask for permission. Never force a resident to be bathed. Close door and windows to prevent cold drafts and wash your hands with warm water before you begin. Offer the bedpan or urinal, elevate the bed to a comfortable position, and ask the resident if there is anything you can do to make the experience more enjoyable. When you are not cleaning a body part, keep it covered. Only expose as much of the resident's body as necessary to adequately clean him or her. Be especially sensitive to exposing genitals, buttocks, and breasts. Bathing can be an extremely stressful experience for residents, so try to make it as easy as possible.

Once you have completed the preparations for the bath, follow your facility's procedure, which will be similar to the following:

• Use the first washcloth on your hand like a mitt to wash the resident's face, eyes, ears, and neck.

• Use the second washcloth to wash the arm, shoulder, and underarm farthest away from you.

• Repeat on arm closest to you with a fresh cloth.

• Pat underarm dry. Apply deodorant. Clean resident's nails.

• Use a fresh cloth to clean chest and breasts.

• Dry well under breasts and in any folds of the skin. Allow the rest of chest to air dry.

• Wash resident's abdomen with a fresh cloth.

• Dry any skin folds.

• Use a fresh cloth to cleanse leg farthest away from you.

• Repeat on leg closest to you with a fresh cloth.

• Oberve toenails for length and general condition of the foot. Gently dry between the toes.

• Wash perianal area with a fresh cloth. Remember to wash from front to back on females. Gently wash a male's penis, testicles, and foreskin if not circumcised. Dry perianal area well with towel.

• Turn resident on side and wash back with a fresh cloth.

• Wash buttocks and rectal area with the last fresh cloth.

• Permit buttocks to air dry, but towel dry rectal area.

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