CLEANING & CHANGING TECHNIQUES
Proper cleaning techniques will maintain skin integrity and prevent infections, just as prompt and proper disposal of soiled diapers will keep patient environment clean and odor free.
List of Necessary Items
- Sturdy Plastic Basin/Bowl/Bucket to be filled with warm water
- Toilet Paper
- Soft Wash Cloths/Disposable Wipes (See washcloths and wipes.)
- Soft Towel for drying
- Mild Soap/Hypoallergenic Body Wash
- Protective Cream (See perineal care.)
- Powder/ talc or cornstarch
- Incontinent Disposable briefs/pull-ups (See adult diapers and briefs.)
- Portable container for ready access to supplies
- Lined Trash Can
- Plastic Disposable Gloves
Steps for Changing a Bed Bound Patient
- Assemble supplies in a portable container
- Discuss the process with recipient before and during care
- Fill the Basin/Bowl/Bucket with warm water
- Bring a Lined Trash Can next to bed for easy access for disposal of soiled paper products
- Put on Gloves
- If incontinent briefs are being used, remove soiled brief, careful not to drop and contents.
- Initially wipe away as much stool or urine as possible with toilet paper or facial tissue and discard into lined trash can.
- Wet and wring wash cloth, and apply minimal amount of body wash to first cloth. Be careful not to splash water, especially after it is used.
- Wash front genital area first-discard disposable wipe into plastic bag or trash can, (wash cloths should be placed into separate bag or can). This single use method will keep the basin water clean and prevent contamination/infection.
- Wet and wring additional wash cloths or disposable cloths- remembering to wipe from front to back until all visible incontinence has been removed and area is clean.
- Rinse thoroughly.
- Dry area with soft towels.
- Apply protective cream to buttocks and groin folds.
- Apply powder to dry clean cloth and dust area around waist or between skin folds.
- Remove gloves.
- Apply incontinent brief/pullup.
- Remove liner from trash can and dispose of it.
- Follow washing instructions for washcloths and towels.
Repositioning may be necessary to complete this cleaning process
*If a hospital bed is in use, raise the bed to the caregiverís waist height to avoid back strain.
*To prevent leakage from incontinent briefs and prevent frequent full linen changes, ensure that a bed pad or disposable paper pad is positioned from under the waist to the mid thigh area
For individuals who change themselves, follow these steps.
Steps for Changing Oneself in the Lying Down Position
- Gather all of your supplies. (See list above.)
- Lie flat on a bed or in another comfortable area making sure all clothing and other fabric is out of the way.
- Undo the tapes of the diaper.
- (Keep the dirty diaper beneath you should have an accident.)
- Bend your knees putting your feet flat on the surface.
- Raise your bottom in the air off the surface on which you are lying.
- Begin wiping from front to back. (Put the dirty wipes in trash bag next to you.)
- Wipe until clean.
- Roll up the dirty diaper and throw it away.
- Unfold the clean diaper and put it beneath you with the tabs in the back.
- Apply any cream or powder you need.
- Pull the front of the diaper up between your legs and fasten the tabs.
- You're done.
Steps for Changing Oneself in the Standing Position
- Make sure all clothing is out of the way. (Pull your pants down to your ankles or tuck your dress under your chin.)
- Undo the tapes of your diaper and fold it up. (Place in plastic bag.)
- Clean yourself carefully over the toilet to catch accidents.
- Apply any necessary cream.
- Open the clean diaper.
- Put tabbed part around your waist in the back and pull the other end through your legs.
- Fasten the tabs on one side and then do the same on the other.
- Squeeze small amounts of powder down the front and back of the diaper.
- Fasten your clothes.
- You are done.