Self Care Deficit: Bathing

Self Care Deficit: Bathing

(_)Actual (_) Potential

Related To:
[Check those that apply]
(_) Neuromuscular impairment
(_) Visual disorders
(_) Trauma or surgical procedure
(_) External devices
(_) Aging process
(_) Musculoskeletal disorders
(_) Immobility
(_) Nonfuntioning or missing limbs
(_) Other:_____________________________
____________________________________
____________________________________

As evidenced by:
[Check those that apply]
Major:
(
Must be present)
(_) Unable or unwilling to wash body or body parts.
(_) Unable to obtain water.
(_) Unable to regulate temperature or water flow.

Date &
Sign.
Plan and Outcome
[Check those that apply]
Target
Date:
Nursing Interventions
[Check those that apply]
Date
Achieved:
The patient will:

(_) Perform bathing activity at expected optimal level.

(_) Demonstrate use of adaptive devices for bathing.

(_) Other:

(_) Assess for causative factors.

(_) Provide opportunities to relearn or adapt to activity.

(_) Teach patient to use affected extremity to accomplish tasks.

(_) Consistent bathing routing at ___ am/pm every day.

(_) Provide as much privacy as possible by pulling curtains and closing doors.

(_) Provide equipment within easy reach.

(_) Encourage independence.

(_) Reinforce success for task accomplished.

(_) OT consult for:

  • Adaptive devices
  • Safety measures for home
  • Other:

(_) Other:________________
________________________
________________________
________________________

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Patient/Significant other signature

__________________________
RN signature

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