Patient Hygiene NEO111 M. Jorgenson, RN BSN

Personal Hygiene Measures for personal cleanliness and grooming Promotes physical and psychological well-being Care must be carried out conveniently and frequently enough to promote personal hygiene and wellness Practices vary widely among people; nurses should respect individual patient preferences Nurses should give only the care that patients cannot or should not provide for themselves

Bedside Cleansing and Skin Care Products Bathing cloths Bathing wipes No-rinse body wash and shampoo Body foam

Folding the Washcloth for a Bed Bath

Meeting Bathing Needs of Patients With Dementia Focus on comfort, safety, autonomy, and self-esteem, in addition to cleanliness. Individualize patient care. Consider what can be learned about the needs and preferences of the patient. Consider other methods for bathing. Maintain a relaxed demeanor; use calming language.

Assessments Made When Giving a Bed Bath Patient’s knowledge of hygiene practices and bathing preferences Frequency, time of day, type of hygiene products used Any physical activity limitations Patient’s ability to bathe himself or herself Patient’s skin for dryness, redness, or areas of breakdown

Bathing (cont.) Order of Bathing Eyes/Face (rinsing wash cloth between eyes) neck & ears Arms chest/abdomen Legs Back buttocks perineal area If using a water basin to bath a patient, water should be changed: After washing the front of the person and prior to cleaning the back and buttocks. Change the water again prior to perineal care!!

Assessments Made When Providing Oral Care for a Patient Patient’s oral hygiene preferences Frequency, time of day, type of hygiene products Patient’s oral cavity and dentition Patient’s lips for dryness or cracking Patient’s ability to perform own care Any physical activity limitations

Oral Care (Dependent Patient) Correct head position On its side and tilted forward Raised 30-45 degrees Rinsing the mouth of a dependent person Carefully squirt a small amount of water using an irrigating syringe being sure to avoid the back of the throat Immediately suction water out with a yankaur suction device Use of a toothette or suction toothette

Expected Outcomes When Performing Oral Care The patient’s mouth and teeth will be clean. The patient will not experience impaired oral mucous membranes. The patient will participate as much as possible with oral care. The patient will demonstrate improvement in body image. The patient will verbalize an understanding about the importance of oral care.

Oral Hygiene for Patients With Cognitive Impairments Choose a time of day when the patient is most calm. Enlist the aid of a family member or significant other. Break the task into small steps. Provide distraction. Allow the patient to participate. If the patient strongly refuses care, withdraw. Document effective and ineffective intervention.

Cleaning Dentures at the Sink

Assessments Made When Providing Eye Care for a Patient With Contacts Assess both eyes for contact lenses. Assess eyes for any redness or drainage. Assess for any eye injury. If an injury is present, notify the physician about the presence of the contact lens. Do not try to remove the contact lens in this situation due to the risk for additional eye injury.

Contact Storage Case Marked L and R

Assisting with Shaving Male facial hair—shave in the direction of hair growth (with the grain) Female leg hair—shave against the direction of hair growth (against the grain) When should shaving a patient with a straight edge razor be avoided and an electric razor used instead? Significant immunocompromised (low WBC) Anticoagulation therapy (blood thinners) Bleeding disorders Low platelet count

Unexpected Situations and Associated Interventions when Shaving a Patient Patient is cut and bleeding during shave: Apply pressure with gauze or towel to injured area for 3 - 3 minutes. Resume shaving after bleeding has stopped. Patient has large amount of hair to be shaved: It may need to be trimmed with scissors first.

Assessments Made When Making an Occupied Bed Assess the patient’s preferences regarding linen changes. Assess for precautions or activity restrictions for the patient. Check for evidence of body secretions or fluids on the linens. Check the bed for patient belongings. Note the presence and position of any tubes or drains.

Fan-Folding Bottom Sheet When Making a Bed

Providing Perineal Care for a Female Patient Spread the labia and move the washcloth from the pubic area toward the anal area. Always proceed from the least contaminated area to the most contaminated area. Use a clean portion of the washcloth for each stroke. Rinse the washed areas well with plain water.

Providing Perineal Care for a Male Patient Clean the tip of the penis first, moving the washcloth in a circular motion from the meatus outward. Wash the shaft of the penis using downward strokes toward the pubic area. Always proceed from the least contaminated area to the most contaminated area. Rinse the washed areas well with plain water.

Questions?