Bathing and Showering

Bathing is one of the most fundamental personal care skills a CNA performs. Proper bathing maintains skin integrity, promotes comfort, provides an opportunity to observe the patient's skin condition, and supports the resident's dignity and self-esteem.

Types of Baths

Bed Bath Procedure

The bed bath follows a specific order to maintain cleanliness and patient dignity:

Standard Order for Bed Bath:

1. Face - Wash first with plain water (no soap near eyes)
2. Neck and ears - Include behind ears
3. Arms and hands - Far arm first, then near arm
4. Chest and abdomen - Cover areas not being washed
5. Legs and feet - Far leg first, then near leg
6. Back - Turn patient on side
7. Buttocks and perineal area - Wash last (most soiled area)

Key Principles for All Bathing

Safety First:

• Check water temperature (100-105°F / 37.8-40.6°C)
• Test water on your inner wrist before patient contact
• Ensure non-slip surfaces in tub/shower
• Never leave patient unattended in tub or shower
• Have all supplies ready before starting

Maintaining Dignity:

• Close doors and pull privacy curtains
• Expose only the area being washed
• Cover patient with bath blanket
• Allow patient to do as much as possible independently
• Respect cultural and personal preferences

Infection Control:

• Use clean water and washcloth for each body area
• Change water when it becomes cool or soapy
• Wash from cleanest to dirtiest areas
• Never wash perineum before other body parts
• Perform hand hygiene before and after

Water Temperature Guidelines

Skin Observations During Bathing

Bathing provides an excellent opportunity to observe the patient's skin. Report any of the following to the nurse:

• Redness - Especially over bony prominences
• Bruising - New or unexplained marks
• Rashes - Any skin irritation or breakdown
• Pressure injuries - Redness that doesn't blanch, open areas
• Edema - Swelling in extremities
• Skin tears - Common in elderly with fragile skin
• Changes in moles or lesions - Size, color, or shape changes