SPONGE BATH: WHAT IT IS FOR, BASICS, MATERIALS, PROCEDURE - MEDICINE - 2024

The sponge bath is a technique that allows the general hygiene or hygiene of a patient confined to bed, immobilized or who, due to his condition, is not allowed to wash in a bath or shower. It can be used in a hospital setting, in nursing homes, or in the patient's home.

In hospitalization areas, it is frequently used in patients confined in intensive care units, in neonatal care rooms, in patients in post-surgical periods who must remain immobilized or in patients who are unable to maintain their personal hygiene.

Sponge bath with massages (Source: Internet Archive Book Images Via Wikimedia Commons)

Sponge bathing in these areas should be carried out by properly trained personnel who handle the technique and who maintain a respectful attitude towards the patient. Supervised nursing assistants are usually responsible for these tasks, but in large hospitals where there is a shortage of staff, this responsibility is usually passed on to the patient's relatives.

Grooming and grooming improve the appearance of the person and make them feel better. In addition, they help prevent ulcers and bedsores, improve blood circulation and the integrity of the skin.

Some studies have reported hemodynamic changes as a consequence of the sponge bath in critically ill patients due to cardiovascular conditions. However, these do not represent a significant clinical alteration.

In critically ill "preterm" newborns, important changes have been reported as a consequence of sponge bathing. This must be done quickly and may require additional attention to that of the child before the bath, especially in relation to the temperature at which the incubator is and the fraction of inspired oxygen.

What is the sponge bath for?

Personal hygiene with the sponge bath is used to clean the body, in order to eliminate bad odors, some microorganisms, eliminate body secretions, eliminate sweat, dust, stimulate skin circulation and generate a sensation of wellness and relaxation.

The sponge bath helps maintain the integrity of the skin, removes dead skin and improves the appearance of the patient. At the same time, the bed linen is changed and clean clothes are placed. This gives a feeling of freshness and well-being to the patient and their environment.

Fundamentals and materials

Frequently, the sponge bath is carried out with a sponge or a towel provided for this purpose, water and soap. Currently some hospitals use disposable wet towels soaked in a quick-drying solution that contain a cleaning and disinfectant product.

Other methods use towels that are dampened in a quick-drying cleaning and disinfecting solution. These last procedures do not require rinsing or drying, therefore they are faster and less uncomfortable for the patient.

There are many commercial disposable forms for the sponge bath, some are preheated and are free of alcohol and soap, contain several pieces of polyester moistened in a solution with a pH similar to that of the skin and are enriched with vitamin E.

These pieces are designed for certain areas of the body, which prevents cross infections on the body segments. There are similar kits for dry hair washing, eliminating bad odors and leaving hair clean and fresh.

These methods of dry cleaning or with quick-drying solutions (40 to 45 seconds) are very useful in patients who have contraindicated mobilization or who, due to their pathology, are connected to different devices that should not be disconnected during the bath.

Materials for the sponge bath

Photograph of bath towel (Image by jacqueline macou at www.pixabay.com)

- A sponge or hand towel.

- A container with cold water.

- A container with hot water.

- A bucket or container for dirty water.

- A bath towel.

- A towel for the face.

- A soap with soap dish.

- Cotton.

- Scissors or nail clippers (optional).

- Linens.

- Hospital pajamas or loose and comfortable clothing.

- Lotion or cream to moisturize the skin (optional).

- Talc (optional).

- Bag for waste.

Process

The sponge bath consists of washing the patient in order, from the cleanest to the least clean areas. For this, a sponge impregnated with soap and water is used. At the same time, the bed is made and the position changes are made.

Many hospitals have standards and procedures manuals for nursing functions within which they specify the procedure to be followed for sponge bathing. Here is a summary of the general procedure for a sponge bath.

1- Wash your hands.

2- Prepare the materials and take them to the unit or room where the patient is.

3- Identify with the patient and greet him. If the patient is conscious, explain the procedure to be performed and request their cooperation or that of the family members who accompany them.

4- Close all the windows and curtains; if you have one and if it is a shared room, place a screen to give the patient privacy.

5- Detach the sides of the bedding.

6- Remove the blankets or blankets, disposing of them in a different place to prevent them from getting wet or dirty.

7- Keep at least one of the sheets to cover the patient during the procedure.

8- Start the bath.

Bath process

8.1- Clean the eyes from the nose towards the cheek (ear), using a different portion of the cloth or sponge to wash each eyelid (without soap), directing the movements from the nose outwards.

8.2- Rinse the sponge, squeeze it and lather it.

8.3- Wash the face in a downward direction, that is, start from the forehead and continue towards the cheeks, ears and neck.

8.4- Rinse and dry, using the bath towel.

8.5- Wash, rinse and dry both arms starting with the hands up to the shoulders and ending with the armpits.

8.6- Wash, rinse and dry the anterior thorax and abdomen. Use gauze or cotton and clean the navel.

8.7- If it is a patient (woman), it is important to pay attention to cleaning the chest and breasts.

8.8- Place the patient in a lateral or prone position, and proceed to wash, rinse and dry the area from the nape to the gluteal region.

8.9- Take advantage of each change in position to provide massages using lotion (optional).

8.10- Put on the clean nightgown and gather it around the waist.

8.11- Proceed to wash, rinse and dry both lower limbs

8.12- Finish the bath with the pubic and rectal area.

8.13- Arrange the patient's pajamas or clothing.

8.14- Provide the implements for hair care. Brush and, if necessary, shampoo in bed, previously obtaining the consent of the patient.

8.15- Fix the bed, changing sheets and blankets.

8.16- Properly dispose of dirty clothes and used instruments.

8.17- Wash, dry and store the equipment.

recommendations

- During the bath it is recommended to thoroughly rinse the bath towel or sponge and change the water as many times as it gets cold or dirty.

- When cleaning the genital area, it is convenient to change the water constantly.

- When the back and lower limbs are washed, greater pressure should be applied during ascending movements than during descending ones, in order to favor venous return (improve venous circulation in the area).

- At the end of the bath, if necessary, they clean themselves and cut their fingernails and toenails.

- If it is an elderly patient, it is advisable to carefully clean the wrinkles, rinsing and drying them properly.

- Optionally, bony prominences can be massaged, that is, the sites where the bones protrude throughout the body, particularly those in contact with the bed.

- Avoid drafts.

- Ensure that the patient is always covered with the sheet during the different stages of the bath.

- Pay attention to the skin of the whole body in order to discover lesions, irritations, abrasions or reddened areas that need to be treated.

- If the patient is a man, he must also be shaved.

- It is not necessary to perform a complete bath daily, unless it is patients who present excessive sweating; however, this will depend on the assessment of the personnel in charge of the nursing service.

References

1. Barken, R. (2019). 'Independence'among older people receiving support at home: the meaning of daily care practices. Aging & Society, 39 (3), 518-540.
2. Córdova Leiva, BI (2009). Sponge bath technique of bedridden geriatric patient (bachelor's thesis).
3. Diana Angélica, MC, Brenda Violeta, HM, Sarai, VN, & Yoana Noemi, SM (2019, June). Effect of the sponge bath on the comfort level of hospitalized patients with limited movement. In XVIII Congress of the Cuban Society of Nursing.
4. González Meneses, A. (2009). Evaluation of the technical quality of the sponge bath (Doctoral dissertation).
5. Quiroz Madrid, S., Castro López, C., Felipe Tirado Otálvaro, A., & Rodríguez Padilla, LM (2012). Hemodynamic alterations of the critical cardiovascular patient during the daily bath. UPB Medicine, 31 (1). C línica, 64 (4), 344-353.
6. Rombo, CAT, Cortés, UM, Carrasco, HU, García, LS, Reyes, DT, & Casillas, ECL (2012). Variations in vital signs and peripheral oxygen saturation in the critically ill preterm newborn after sponge bathing. Research journal
7. Scholes, B. (2005). Explaining about… bathing safely. Working with Older People, 9 (2), 8-10.