1. FACILITATING HYGIENE
FALL, 2010

2. What is Hygiene? Why is it Important?
Science of the establishment and maintenance of health
Contributes to psychological and physiological well-being
Promotes comfort, improves self-image and decreases infection and disease

3. ASSESSMENT FACTORS INFLUENCING HYGIENE PRACTICE
Personal preferences-normal routine-assistive devices needed
Culture and religion or spirituality
Economic status or living environment
Developmental level
Knowledge level
Allergies

4. ASSESSMENT OF SELF-CARE ABILITIES
Bathing/Hygiene
Dressing/Grooming
Toileting
Pain?
Limited mobility?
Sensory deficits?
Cognitive impairment?
Emotional disturbances?

5. CLASSIFICATION OF SELF-CARE ABILITIES
Completely independent
Requires use of assistive device
Requires help from 1 person
Requires help from 1 person and
equipment
Totally dependent

6. NURSING DIAGNOSIS SELF-CARE DEFICITS
Bathing/Hygiene Self-Care Deficit
Dressing/Grooming Self-Care Deficit
Toileting Self-Care Deficit
Total Self-Care Deficit
RELATED TO: (Examples)
Decreased or lack of motivation
Weakness and/or fatigue
Impaired transfer ability
Perceptual or cognitive ability

7. DELEGATION Instruct UAP regarding:
Patient’s limitations and restrictions
Use of assistive devices
Specific safety precautions to follow
Maintenance of tubes and bandages
Required observations during bathing
Need to collect a specimen?

8. ABOUT SKIN Protective Barrier Regulates Body Temperature
Secretes Sebum
Excretes Sweat
Transmits sensations
Facilitates absorption of Vitamin D

9. FACTORS AFFECTING THE SKIN
Health Status
Dampness
Dehydration
Insufficient circulation
Nutritional status
Skin diseases
Jaundice (itchy and dry skin)
Immobility
Nursing Diagnosis: Risk for impaired skin integrity

10. FACTORS AFFECTING THE SKIN
Developmental Stage
Infants
Fragile, easily injured
Children
Need adults to provide or supervise
Adolescents
Oily skin/acne
Older adult
Thinner, more fragile skin
Drier, scaly, itchy skin
Impaired temperature regulation
Hair and nails grow more slowly

11. IMPORTANT SKIN TERMINOLOGY
Pallor
Erythema
Jaundice
Cyanosis
Pruritis
Dry skin
Maceration
Excoriation
Abrasion
Pressure Ulcers
Acne

12. HYGIENE INTERVENTIONS
BATHING
Removes perspiration and bacteria, increases circulation, stimulates depth of respirations, provides sensory input, strengthens nurse-patient relationship, promotes relaxation and comfort, provides opportunity for assessment

13. HYGIENE INTERVENTIONS
Cleaning Baths OPPORTUNIY FOR
Shower
Tub
Self/Help
Partial Bed Bath
Assisted Bed Bath
Complete Bed Bath
Therapeutic Baths
Sitz
Soaks
Cool or tepid water baths

14. HYGIENE INTERVENTIONS
Oral Care-Halitosis, Dental caries, Gingivitis, Periodontal disease, Stomatitis, Glossitis, Cheilosis, Oral Malignancies
Hair Care-Dandruff, Pediculosis, Alopecia
Eye, Ear and Nose Care
Perineal Care
Unconscious clients
Dementia clients
**See page Wilkinson and Van Leuven text for more details

15. HYGIENE INTERVENTIONS
Foot and Nail Care OPPORTUNITY FOR
Corns
Calluses
Tinea pedis
Ingrown toenail
Foot odor
Plantar wart
Pressure ulcers
Color, drainage, edema, cracks, capillary refill?

16. WHAT ABOUT A BACKRUB?

17. BEFORE YOU LEAVE Room temperature comfortable?
Siderails up as indicated? Bed position?
Bed wheels locked?
Bed linens clean and free of wrinkles?
Patient’s call device within reach?
Overbed table clean and uncluttered?
Uncluttered walking space?
Unpleasant odors?
What else may I do for you?

18. A PICTURE’S WORTH A THOUSAND WORDS