Back Care
Regular bathing and massage of the neck, back, buttocks, and upper arms promotes patient relaxation and allows assessment of the patient’s skin condition. Particularly important for the bedridden patient, massage causes cutaneous vasodilation, helping to prevent pressure ulcers from prolonged pressure on bony prominences or perspiration. Gentle back massage can be performed after myocardial infarction but may be contraindicated in patients with rib fractures, surgical incisions, or other recent traumatic injury to the back.
Equipment
Basin ▪ skin cleaner ▪ bath blanket ▪ bath towel ▪ washcloth ▪ back lotion with lanolin base ▪ gloves, if the patient has open lesions or has been incontinent.
Preparation of Equipment
Fill the basin two-thirds full with warm water.
Implementation
Gather the equipment at the patient’s bedside.
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.4
Explain the procedure to the patient and provide privacy.5 Ask him to tell you if you’re applying too much or too little pressure.
Adjust the bed to a comfortable working height and lower the head of the bed, if allowed.
Place the patient in the prone position, if possible, or on his side. Position him along the edge of the bed nearest you to prevent back strain.
Untie the patient’s gown, and expose his back, shoulders, and buttocks. Then drape the patient with a bath blanket to prevent chills and minimize exposure. Place a bath towel next to or under the patient’s side to protect bed linens from moisture.
Fold the washcloth around your hand to form a mitt to prevent the loose ends of the cloth from dripping water onto the patient and to keep the cloth warm longer. (See Making a washcloth mitt.) Then apply skin cleaner.
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