Clinical considerations:
CLINICAL JUDGMENT: Use slow movements when setting up sterile drapes. Fast movements can stir up
dust, lint, and infectious microorganisms, which can contaminate the sterile field.
BOX 40.4
Hygiene Care Schedule in Acute and Long-Term Care Settings
Early morning care
Nursing personnel on the night shift may provide basic hygiene to patients getting ready for
breakfast, scheduled tests, or early morning surgery. “am care” includes offering a bedpan or
urinal if the patient is not ambulatory, washing the patient’s hands and face, and helping with oral
care.
Routine morning care
After breakfast help by offering a bedpan or urinal to patients confined to bed; provide a full or
partial bath or a shower, including perineal care and oral, foot, nail, and hair care; give a back
rub; change a patient’s gown or pajamas; change the bed linens; and straighten a patient’s
bedside unit and room. This is often referred to as “complete am care.”
Afternoon care
Hospitalized patients often undergo many exhausting diagnostic tests or procedures in the
morning. In rehabilitation centers patients participate in physical therapy in the morning.
Afternoon hygiene care includes washing the hands and face, helping with oral care, offering a
bedpan or urinal, and straightening bed linen.
Evening, or hour-before-sleep, care
Before bedtime offer personal hygiene care that helps patients relax and promotes sleep. “pm
care” often includes changing soiled bed linens, gowns, or pajamas; helping patients wash the
face and hands; providing oral hygiene; giving a back massage; and offering the bedpan or urinal
to non-ambulatory patients. Some patients enjoy a beverage such as juice; check diet to
determine which beverages are allowed.
Types of Baths
Complete bed bath: Bath administered to totally dependent patient in bed.
Partial bed bath: Bed bath that consists of bathing only body parts that would cause discomfort if
left unbathed, such as the hands, face, axilla, and perineal area. Partial bath also includes
washing back and providing back rub. Dependent patients in need of partial hygiene or self-
sufficient bedridden patients who are unable to reach all body parts receive a partial bed bath.
Sponge bath at the sink: Involves bathing from a bath basin or sink with patient sitting in a chair.
Patients can perform part of the bath independently. Nurse helps with hard-to-reach areas.
Tub bath: Involves immersion in a tub of water that allows more thorough washing and rinsing
than a bed bath. Patients may require nurse’s help. Some agencies have tubs equipped with
lifting devices that facilitate positioning dependent patients in the tub.
Shower: Patient sits or stands under a continuous stream of water. The shower provides more
thorough cleaning than a bed bath but can be tiring.
