¶ Introduction
Sponge bathing, or bed bathing refers to being bathed by an assistant while lying in bed or on a similar surface, typically by using wet washcloths.
Sponge bathing is an alternative to more conventional bathing methods, when safe and appropriate access to a shower or bathtub is limited or nonexistent.
This article provides information about sponge bathing to a general audience. Some patients may have different personal or cultural wishes related to keeping clean. In such cases, those wishes should be honoured instead of what is described here.
¶ Supplies
The following supplies are recommended for a sponge bath:
- two small pails, each filled partway with warm water
- two or more washcloths
- soap
- optionally: special wipes, and no-rinse soap
- large towels for draping, and for drying
A "cleaning" pail, typically used by janitors, is ideal for a sponge bathing as the handle makes it easy to carry, and the narrow width allows for a high depth of water with minimal volume.
Sponge bath equipment for washing. Drying towels will also be required.
¶ Technique
A well-executed sponge bath should leave the patient both feeling and being clean. If this is not the case, improvements should be made.
¶ Steps
- Place a towel on the bed under the patient's body. If it is not long enough, their lower legs and feet can extend beyond it.
- With the patient lying flat on the towel, place another towel or sheet on top of them to keep them warm.
- Select one of the pails and a washcloth. Wet the washcloth in the pail along with soap.
- Gently clean a small area of the patient's body.
- Using the other pail and another washcloth, clean the same area of the patient's body, but without soap.
- Use a drying towel to dry this area of the patient's body.
- Cover this area of the patient's body, and move on to another area.
- Repeat this process until the entire body (except for the perineum) has been washed and dried.
- Clean the perineum using the single-use wipes and no-rinse lotion. The genitalia should be cleaned before the anus. Discard the wipes when complete.
In some cases, it may be prudent to replace the water in both pails partway through the sponge bath.
¶ Sequence
- The face should be cleaned first.
- The majority of the body except for the perineum should be cleaned next. Rollovers and other types of repositioning should be kept to a minimum.
- The perineum should be cleaned last.
¶ Cleaning the face
The face, especially the eyes, should be cleaned first and rinsed thoroughly. Soap which is allowed to remain on the skin near the eyes may enter the eyes if the patient were to sweat, even many hours after the sponge bath.
Patients that must wear a ventilator mask during the sponge bath may instead have their face cleaned after transferring to an upright position, such as in a wheelchair.
¶ Cleaning the perineum
Cleaning the perineum can be uncomfortable for both the patient and the assistant. Such discomfort can be reduced by doing the following:
- engaging in light conversation during the process
- avoiding light touch, especially with the hands themselves
The genitalia should be cleaned before cleaning the anus.
Wiping the genitalia should always be in a direction such that no germs from elsewhere are brought toward it. Instead, start at the genitalia and wipe outward.
The genitalia can be rinsed by holding the washcloth without soap over top of the genitalia and squeezing it out.
Male patients that are not circumcised should have their foreskin carefully pulled back, and their glans carefully cleaned and dried. No soap should remain, as it can cause significant irritation.
Wiping the anus should always be in a direction such that any amount of stool that may be present is not spread around to other parts of the buttocks, or the genitalia. Instead, start at a distance from the anus and wipe toward it. Finally, wipe the anus itself.
¶ Applying deodorant
The end of a sponge bath is an ideal time to apply deodorant. The deodorant should be prominent from the dispenser, otherwise scratching the patient's armpit can occur.
The deodorant should be standing prominently from the dispenser, as seen on the right.
¶ Common Mistakes
Common mistakes when giving a sponge bath include:
- not scrubbing off soap from the skin
- missing certain areas of skin, especially on the limbs, and sides of the body
- forgetting to wash a part of the body altogether
- wiping the genitalia and anus in a pattern that spreads germs inappropriately to and from these areas
- washing too large of an area at one time, causing the patient to get cold
- not drying off the patient in a timely manner, causing the patient to get cold
- leaving the patient in an indecent level of dress when leaving the room temporarily