1. Hygiene needs Jana Heřmanová

2. Personal hygiene needs Satisfaction important for –Person’s sense of self and dignity –Functioning of the body – line of defence against infection We all have different habits and needs, these can be altered by disease or other conditions In the case of critically ill patients hygiene care can be challenging

3. Who needs assistance with hygiene needs Patients with limited mobility or restricted movement Patients with debilitating pain (fatigue, dyspnea) Unconscious patients Confused patients, patients with other cognitive problems

4. The procedures Complete bed bath Bath or shower in the bathroom Perineal care Oral hygiene Personal dressing and grooming

5. Complete bed bath Ensure patient’s privacy Keep the patient warm Use unperfumed and moisturized soap, emollients, creams Preferably two carers fro ergonomic reasons wash the face first, change water after washing perineum and genitalia, use separate washcloths

6. What to watch for Any skin abnormalities (rashes, bruises, skin tears, ulcers, other lesions) Fingernails and toenails – the cleanliness beneath, the length Know the policies of trimming nails, especially of diabetic patients

7. Do not forget toiletries Anti-perspirants, deodorants, talcum powder, cologne, aftershave, perfumes Be careful with powders and sprays – protect patient’s face, use with caution

8. No rinse products Shampoo, shampoo cap

9. Bath or shower in the bathroom Provide privacy Warm environment Special equipment – bathtubs, hoists, shower chairs, shower trolley, non-slip mats Proper water temperature, appr. 43ºC no more than 48ºC For independent patients call button within reach

10. Good drying is important To prevent chilling To prevent skin impairment Vulnerable patients: obese, patients with deformities Vulnerable areas: groin, under breasts, umbilicus, between buttocks, skin folds

11. Special equipment Dolphin bed

12. …equipment Bath and shower chairs

13. …equipment Shower - commode

14. …equipment Special bathtub, lifts - hoists

15. Shaving Relates to both male and female patients Use the patient’s own or disposable razor Use electric razor for patients with possible bleeding problems

16. Perineal care Important after each voiding or bowel movement Cotton or disposable wipes, warm water, mild soap Diaper wipes Dry thoroughly Patients with an indwelling catheter also require perineal care

17. Oral hygiene Who needs assistance: –Patients with eating or drinking difficulties – loss of natural cleansing action of saliva –Patients with SOB – loss of fluid from respiratory tract –Patients with compromised immune system –Patients with radiotherapy treatments to the head and neck –Patients on oxygen therapy

18. Importance of mouth care Prevents infection, distress, discomfort Maintains person’s dignity Dentures should fit, patients should be able to wear them (if they are conscious)

19. Assessment Pink, moist tongue, oral mucosa and gums teeth/dentures clean and free of debris Well fitting dentures Adequate salivation Smooth and moist lips No difficulties with eating or drinking

20. Equipment Cup Small torch, flash light Mouthwash Small bowl Protective towel Tissues Foam sticks Wooden spatula Small-headed soft toothbrush Toothpaste Disposable gloves Denture cleaning agent and brush

21. Equipment Toothettes, foam brushes

22. The procedure Wash hands, put on gloves Inspect patient’s mouth Remove dentures Brush teeth with small brush or foam Rinse away toothpaste If patient unable to rinse, use rinsed brush and foam stick When cleaning unconscious patient’s teeth, use suctioning device to remove water

23. Personal dressing and grooming Have patient’s own toiletries available Select those with light and fresh scent Apply make-up Comb hair in preferred style Family can bring clothes that are preferred by the patient, easy to put on Well-fitting shoes or slippers, with non-slip soles