1-4. ADMINISTERING A TOWEL BATH
When a patient, confined to bed, has casts and/or special dressing, the medical specialist may be required to give a towel bath. The towel bath prevents contamination of special dressing or cast. It also will comfort and encourage relaxation.
Important Points. Bathing the patient following the proper procedure will promote an effective towel bath, provide warmth, keep the bed dry, and avoid causing the patient to chill.
(1) Check the physician's orders. Confer with the nurse in charge to determine need for towel bath.
(2) Explain the procedure to the patient.
(3) Adjust the room temperature, and provide privacy.
(4) The following supplies and equipment should be assembled:
(a) Concentrate and/or solution Septi-Soft®.
(b) Measuring device, such as liter-calibrated device or plastic medication cup.
(c) Towel (3 ft x 7 1/2 ft).
(d) Large plastic bag.
(e) Bath towel.
(f) Washcloths (2).
(g) Bath blankets (2 or 3).
(h) Disposable gloves.
(i) Linens for bedmaking.
(j) Articles for personal hygiene (comb, toothbrush, lotion, toothpaste, mouthwash).
(5) Prepare the patient for a towel bath.
(a) Remove patient's clothing and excess bedding (top linens, bed spread). Place the patient on the bath blanket and cover the patient with the blanket.
(b) Cover the areas that should not be wet (surgical dressings, casts) with plastic.
(c) Fan fold the clean bath blanket at foot of the bed.
(d) Arrange the patient to the supine position.
(6) Prepare the towel for bathing the patient (figure 1-6).
Figure 1-6. Prepare a towel.
(a) Fold towel in half, top to bottom; fold in half again, top to bottom; now half again, side to side. Then roll towel with bath towel and washcloth inside, beginning with folded edge.
(b) Place rolled up towel (with bath towel and washcloths inside) in plastic bag with salvage edges toward open end of bag.
(c) Draw 2000 ml of water at 115º to 120ºF into plastic pitcher. Measure 30 ml of concentrate or 90 ml of solution. (If using dispenser with a pump, a single stroke measures 30 ml.) Mix 2000 ml of water and Septi-Soft®.
(d) Pour mixture over towel inside plastic bag.
(e) Knead the solution quickly into towel, position plastic bag with open end in sink, and squeeze out excess water, giving added wringing twists to salvage edges of towel.
(7) Bathe patient (figure 1-7).
Figure 1-7. Bathe the patient.
(a) Fold bath blanket down to waist. Remove warm, moist towel from plastic bag and place on patient's right or left chest with open edges up and outward. Unroll towel across chest.
(b) Open towel to cover entire body while removing top bath blanket. Tuck towel in and around body (leave bath towel and washcloths in plastic bag to keep warm).
(c) Begin bathing at feet, using gentle, massaging motion. Employ clean section of towel for each part of body as you move toward patient's head.
(d) Fold lower part of towel upward away from feet as bathing continues.
(e) Put clean bath blanket up over patient as you move upward. Leave 3 inches of exposed skin between towel and bath blanket. Skin will dry in 2 or 3 seconds.
(f) Wash face, neck, and ears with one of prepared washcloths.
(g) Turn patient onto side.
(h) Use bath towel for back care.
(i) Use second washcloth for perineal care (don disposable gloves).
(j) When bath is completed, remove towel and place with soiled linens in plastic laundry bag.
(k) If top bath blanket is not soiled, fold and use later.