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Nursing Diagnosis: Bathing/hygiene Self-care deficit

Linda S. Williams


Impaired physical mobility-functional level classification:

0 Completely independent
1 Requires use of equipment or device
2 Requires help from another person for assistance, supervision, or teaching
3 Requires help from another person and equipment or device
4 Dependentdoes not participate in activity

impairment; musculoskeletal impairment; environmental barriers

NOC Outcomes (Nursing Outcomes Classification)

Suggested NOC Labels

Self-Care: Activities of Daily Living (ADLs)

Self-Care: Bathing

Self-Care: Hygiene

Client Outcomes

Remains free of body odor and maintains intact skin

States satisfaction with ability to use adaptive devices to bathe

Bathes with assistance of caregiver as needed without anxiety

Explains and uses methods to bathe safely and with minimal difficulty

NIC Interventions (Nursing Interventions Classification)

Suggested NIC Labels


Self-Care Assistance: Bathing/Hygiene

Nursing Interventions and Rationales

observation of function and report of function provide complementary assessment data for
goal and intervention planning (Reuben et al, 1992).
to provide more accurate ability data (Guralnik, 1994).

prevents learned helplessness, and preserves self-esteem (Miller, 1997). Cultural
preferences are respected (Freeman, 1997).

be a comforting experience for the client that enhances health. (Rader, Hoeffer, McKenzie,

Individualize bathing by identifying function of bath (e.g., odor or urine removal),

frequency required to achieve function, and best bathing form (e.g., towel bathing, tub, or
shower) to meet client preferences, preserve client dignity, make bathing a soothing
(especially) and tub bathing. Towel bathing increases privacy and eliminates need to move
showering or tub bathing (Rader, Hoeffer, McKenzie 1996; Hoeffer et al, 1997; Miller,

Request referrals for occupational and physical therapy. Collaboration and correlation
tasks (Schemm, Gitlin, 1998).

Energy conservation increases activity tolerance and promotes self-care.

participation in self-care.

Function can be improved based on engineering principles that adapt environmental
factors to the meet the client's capabilities (Rogers et al, 1998).

Use any necessary adaptive bathing equipment (e.g., long-handled brushes, soap-on-
a-rope, washcloth mitt, wall bars, tub bench, shower chair, commode chair without pan in
shower). Adaptive devices extend the client's reach, increase speed and safety, and
decrease exertion.

traffic location that allows staff to enter freely during care (Miller, 1994).
hypothermia may experience evaporative cooling during and after bathing, which produces
an unpleasant cold sensation (Miller, 1994).

response (Maxfield et al, 1996).


of touch offers reassurance and comfort.

signaling device promotes safety and provides reassurance for the client.

may help foster understanding of bathing and self-care (Danner et al, 1993).

can inhibit relearning of self-care.

discomfort, especially in clients with visual changes or cataracts (Miller, 1994).

alone to obtain forgotten items (Sloane et al, 1995).

clients sleep better (Kanda, Tochihara, Ohnaka, 1999).

Bathe cognitively impaired clients before bedtime. Bathing a cognitively impaired

client in the evening helps improve symptoms of dementia (Deguchi et al, 1999).

bathing promotes skin dryness. Reducing frequency of bathing decreases aggressive
behavior in cognitively impaired clients (Hoeffer et al, 1997).

self-care deficit require more time to complete a task.
decreased oil and perspiration production in the elderly (Skewes, 1997).

promotes skin dryness and may burn a client with decreased sensation.


before client's skin is moistened with water (Skewes, 1997).

Home Care Interventions

energy of the client and provides respite for caregivers.

enhance their self-esteem.


and provide care when client and family will most benefit (e.g., before visitors, at bedtime,
in the early morning). When desired, improved hygiene greatly boosts the morale of
terminally ill clients.



Client/Family Teaching

techniques that promote safety (e.g., getting into tub before filling it with water, emptying
water before getting out, using an antislip mat, wall-grab bars, tub bench). Adaptive
devices can provide independence, safety, and speed (Schemm, Gitlin, 1998).

client's needs increases the client's satisfaction with the bathing experience.

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