Bathing and cleansing
BATHING
Body washes and shampoos should have a pH between 4 and 7. pH is a measure of the acidity or alkalinity of a liquid. The pH is especially important for elderly patients whose skin is dry, more likely to crack, and slower to recover from the effects of cleansing with a product that causes the skin to become alkaline. Additionally, the right skin cleanser can rinse away unwanted microorganisms and preserve the skin’s ability to act as a natural barrier.1
When bathing the patient, avoid hot water and use a mild cleansing agent that does not cause irritation and dryness of the skin.
CLEANSING
During the cleansing process, the skin should be treated gently.2 Cleansers used to remove soils should be pH balanced to the skin.1,3 pH is a measure of the acidity or alkalinity of a liquid. You can help preserve the skin by using a no-rinse cleanser and a moisture barrier that helps keep moisture out. Furthermore, no-rinse cleansers provide cost-effective cleansing care for those patients who are incontinent.3
Bowel (fecal) incontinence irritates the surrounding skin (perineum) more than urinary incontinence does. That’s because feces contain bacteria and digestive enzymes that can seriously damage the skin. The combined effects of urinary and fecal incontinence are more damaging to the skin than either one alone.4 When soiling does occur, the skin should be gently cleansed to remove the irritating material left by the urine or feces.5
NO-RINSE BATHING GUIDELINES
Greet patient and explain procedure.
- Wash hands and apply gloves.
- Fill a basin with half a gallon of water. Check water temperature with a thermometer (38°C - 40°C; warm, not hot), or with the back of caregiver’s hand or elbow.
- Place towel over patient’s chest and wash eyes with water only. Dry carefully. Now add Aloe Vesta® Body Wash & Shampoo to water. (Dilute according to label usage instructions.)
- Wash and dry face and ears. Remove patient’s clothing. Cover patient with a sheet or bath blanket.
- Place towel under one arm. Wash and dry both arms, hands, and underarms.
- Fold sheet or bath blanket down to pubic area. Wash and dry chest and abdomen. Move sheet or bath blanket up to cover abdomen and chest. Change bath water as needed.
- Place towel under one leg. Wash and dry both legs and feet. Inspect feet and contracted areas for excessive dryness, moisture, or pressure points.
- Assist patient to side-lying position, placing towel near back. Wash and dry neck and back.
- Remove towel and position patient on his/her back (supine position). Wash and dry perineal area. Inspect perineal skin for excessive moisture, excoriation, redness, or irritation. Apply Aloe Vesta® Protective Ointment
if necessary. Always change bath water after perineal care.
- Cleanse hair with a moist washcloth (with diluted cleansing solution). Gently rub hair/scalp to loosen and remove dirt and oils. Towel dry and comb.
- Remove and discard gloves. Dress patient. Change bed linen.
- Wash hands. Document findings and update nursing care plan. Report any skin changes to the supervising nurse.
Refer to product labeling for complete Directions for Use.
CLEANSING GUIDELINES
Greet patient and explain procedure.
- Wash hands and apply gloves.
- With a damp washcloth (no cleansing solution), wash eyes, face, and ears.
- A basin filled with warm water (38°C - 40°C) may be convenient.
- Remove patient’s clothing and cover patient with a sheet or bath blanket.
- Apply Aloe Vesta® Cleansing Foam
directly to skin or onto a damp washcloth.
- Wash and dry arm, hand, and underarm areas. Repeat with other arm, hand, and underarm areas.
- Wash and dry upper body (arm, hand, underarm areas, chest, and abdomen). Change bath water as needed.
- Wash and dry both legs and feet.
- Inspect feet, limbs, and contracted areas for excessive dryness, moisture, or pressure points.
- Place patient in supine position. Wash and dry perineal area.
- Inspect perineal skin for excessive moisture, excoriation, redness, or irritation.
- Apply Aloe Vesta® Protective Ointment
, if necessary.
- Apply skin conditioner over slightly moist skin to maximize skin hydration.
- Remove and discard gloves. Dress patient. Change bed linen.
- Discard disposable items in a plastic trash bag and secure. Empty and rinse basin. Dry thoroughly.
- Wash hands. Document findings and update nursing care plan. Report any skin changes to the supervising nurse.
Refer to product labeling for complete Directions for Use.
Greet patient and explain procedure.
- Dampen hair with a washcloth to remove excess soils and debris.
- Apply Aloe Vesta® Cleansing Foam
directly onto dampened hair and work into a lather.
- With a washcloth, gently massage the hair and scalp to remove loosened dirt and oils.
- Repeat as needed. Towel dry and comb. No rinsing necessary.
Refer to product labeling for complete Directions for Use.
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References [+]
- Nix DH. Factors to consider when selecting skin cleansing products. J WOCN. 2000 Sep;27:260-268.
- Clinical Practice Guideline Number 3: Pressure Ulcers in Adults: Prediction and Prevention. Rockville, Md: US Dept of Health and Human Services, Agency for Health Care Policy and Research; 1992. AHCPR publication 92-0047.
- Byers PH, Ryan PA, Regan MB, Shields A, Carta SG. Effects of incontinence care cleansing regimens on skin integrity. J WOCN. 1995 Jul;22[4]:187-192.
- Gray M, Ratliff C, Donovan A. Perineal skin care for the incontinent patient. Adv Skin Wound Care. 2002 Jul/Aug;15[4]:170-178.
- Ratliff CR, Bryant DE. Guideline for Prevention and Management of Pressure Ulcers: WOCN Clinical Practice Guideline Series, No. 2. Flagstaff, Ariz: Best Publishing Co; 20043