Patient Hygiene

1. Patient Hygiene NEO111M. Jorgenson, RN BSN

2. 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

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

4. Folding the Washcloth for a Bed Bath

5. 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.

6. 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

7. 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!!

8. 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

9. 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

10. 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.

11. 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.

12. Cleaning Dentures at the Sink

13. 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.

14. Contact Storage Case Marked L and R

15. 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

16. 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.

17. 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.

18. Fan-Folding Bottom Sheet When Making a Bed

19. 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.

20. 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.

21. Questions?