Personal Hygiene for Nurses

Personal Hygiene Basics

• Nurses must give patients the chance to maintain proper hygiene.
• While hygiene tasks can be delegated, that isn't always the case.

Scientific Knowledge

• Hygiene is essential for the patient's comfort, safety, and overall well-being.
• Ill patients often need help with personal hygiene.
• A patient's culture and age affect their hygiene habits.
• Hygiene methods should support the normal structure/function of tissues.
• Preventative hygiene care is enhanced by understanding pathophysiology.

Benefits of Bathing

• For patients, bathing cleanses the skin, boosts circulation, provides relaxation/comfort, and improves self-esteem.
• For nurses, bathing allows skin assessment and strengthens the nurse-patient relationship.

Nursing Knowledge

• It's important to understand the patient's perspective.
• Use communication to build a strong therapeutic relationship.
• When providing hygiene, assess emotional status, health promotion habits, and health education needs.
• Key areas to consider during hygiene include self-care ability, skin condition, and the state of feet and nails.
• Assess the patient's oral cavity including hair and haircare
• Cultural considerations must be taken into account such as hygiene routines.
• Hygiene problems do put patients at risk.

Factors That Affect Hygiene

• Social patterns, like ethnic or family customs, influence hygiene habits.
• Personal preferences dictate hygiene practices.
• A person's self-image impacts their hygiene.
• Socioeconomic status influences the hygiene products and practices used.
• Health beliefs and motivation are key to hygiene habits.
• The developmental stage affects the ability to perform hygiene.
• Cultural background dictates different hygiene rituals.
• Physical condition affects the energy and dexterity needed for self-care.

Critical Thinking

• Nursing knowledge should be used together.
• Consider cultural and developmental factors.
• Creative thinking is helpful.
• Be confident, but don't judge.
• Use your own experiences and professional standards to help your decision making.

Care Practices

• Use caring to reduce patient anxiety and promote comfort.
• Give medicine to help with symptoms before hygiene care.
• Watch out for patient anxiety or fear.
• Help patients do as much of their own hygiene as they can.
• Educate them on techniques and potential problems.
• Inform patients about community resources.

Implementation Strategies

• Keep regular grooming routines in mind when individualizing care.
• Bathing and skin care include therapeutic baths, complete bed baths/showers, and partial bed baths with bag baths/perineal care.
• Back rubs and foot/nail care are beneficial.

Categories of Personal Care

• Self-care: Patients can do ADLs without help.
• Assisted care: Patients need some help with ADLs.
• Total care: Patients can do very little for themselves.

Bathing Guidelines

• Always provide patient privacy.
• Focus on safety.
• Keep the patient warm.
• Encourage the patient to be independent.
• Predict what the patient needs.

Nurse Bathing Responsibilities

• Check the skin for rashes, bruises, and lesions.
• Finish bathing quickly.
• Watch for signs of patient fatigue.
• Conserve the patient's energy when doing the bath.

Assessing Oral Hygiene Needs

• Frequency of oral care depends on the patient's mouth condition.
  • Patients with dry mouths/lips may need care every 2 hours.
  • Oral care is typically done twice daily.
• The need for help is determined by patient's ability to perform oral care.
• Nurses can:
  • Educate patients on proper techniques.
  • Perform oral care for those who can't.

Guidelines for Oral Hygiene

• Oral hygiene includes:
  • Brushing to remove particles/bacteria, massage gums, and freshen breath.
  • Flossing to remove tartar at the gum line.
  • Rinsing to remove particles/excess toothpaste.
• Patients with diabetes, artificial airways, or undergoing chemotherapy along with those who are unconscious or NPO need special oral care.
• You must assess for:
  • Loose/missing teeth.
  • Swelling/bleeding gums.
  • Bad mouth odor.
  • Mouth pain.

Denture Care Tips

• To avoid dropping dentures, use gauze squares or a washcloth.
• To protect dentures, line the sink with a washcloth or paper towel.
• Dentures are personal property and are fragile.
• Remove dentures before sleep so gums can breathe and avoid germs.
• Store dentures in a labeled container with water or cleaner.

Unconscious Oral Hygiene Considerations

• Safety is vital with unconscious patients.
• To prevent aspiration:
  • Use a lateral or side-lying position with head turned.
  • Support the head with a pillow, face tipped forward so fluids flow out of the mouth
  • Keep bulb syringe/suction nearby.
• For proper access:
  • Open the mouth with a padded tongue blade separating upper/lower teeth.
  • Don't put fingers in the mouth.
  • Oral stimulation can trigger biting.
  • An oral airway can be used to keep the mouth open.
• Mucous membranes and teeth should be cleaned using a small brush or swab.
• Use suction to clear fluid/secretions.
• Use chapstick as needed.

Hair and Scalp Care

• Brushing and combing:
  • Distributes oil.
  • Prevents tangling like braiding does.
  • Get consent before braiding or cutting.
• Also provide shampooing, shaving, and mustache/beard care.
• Hair appearance is linked to well-being.

Brushing and Combing Benefits

• Brushing cleans hair/spreads oil evenly.
• Combing styles to hair and stops it from tangling.
• Assessment whilst brushing includes looking for:
  • Scalp issues: sores, scrapes.
  • Dandruff.
  • Parasites.
  • Hair quality.
  • Appearance.

Shampooing Guidelines

• Frequency hinges on personal preference and daily hygiene practices.
• Consider the hair's condition.
• Shampoo can be accomplished in multiple different forms:
  • Hand shower if the patient is upright.
  • Stretcher and shower area if the patient cannot get up.
  • Shampoo in bed, if patient is unmovable.
  • "Shampoo in a Bag" or dry shampoos can also be used.

Shaving

• Can greatly improve a patient's emotional needs and bolster self-esteem.
• Shaving is usually performed after a bath or shampoo.
• Start with an assessment of:
  • Skin condition, moles, warts, rashes, patchy skin, lesions, or pustules.
• Electric razors are a must for patients at risk of bleeding, confused patients or patients that are depressed.

Tips for Safe Shaving

• For safety, when using a razor:
  • Soften skin to avoid cuts.
  • Apply a warm washcloth, gel, foam or cream
  • Hold your razor at a 45 degree angle
  • Keep skin taut to prevent cuts.
  • Shave in the direction of hair growth.

Care of the Genitalia

• This can be a sensitive matter for both nurse and patient.
• It should not be overlooked because of embarrassment.
• Let patients do it themselves, if they can.
• If possible, offer assistance by handing over a washcloth and allowing them to finish on their own.

Perineal Care

• Patients who require nurses assistance:
  • Vaginal/Urethral discharge is present.
  • Skin irritation.
  • if they have a Catheter
  • Post surgical applications
  • Are incontinent (urine or feces)

Perineal Care For Women

• Wipe labia majora in downward motion (front to back) and wash. Switch to clean wipe for each swipe.
• Using a clean side each time, clean between the labia minor from front to back.
• Front to back swipe of the meatus. Ensure the site of catheter is cleaned with clean sweep of cloth for each wipe. Use circular fashion to carefully clean catheter.
• Use proximal to distal movements for inner thighs.

Perineal Care For Men

• Begin by retracting forskin of the penis if not circumcised.
• Clean around urinary meatus in circular motion using wash cloth for each stroke around head of penis. Switch to fresh portion of wash cloth each stoke.
• Changing the wash cloth frequently, wash down shaft of the penis toward thighs.
• Wipe down scrotum from font to back
• Wash inner thighs.

Foot and Nail Care

• It is generally part of the bath
• Serve to reduce oder and infection.
• During assessment observe:
  • Shape Length's colour of the nails
  • Conditions of cuticles around nails and skin between fingers and toes like lesions etc.

Caring For extremities

• Soak hands to soften the nail and cuticles.
• Dry and clean the extremities properly.
• With consent or given institution's permission, ONLY then, can you proceed to trim nails.
• Do not trim nails if most institutions do forbid it.

Nail and Foot Care Notes

• Emphasize cutting nails straight across.
• Consider referrals for nail care when needed.
• Elderly and patients with diabetes typically require extra attention.
• If patient has bad conditions for feet and nails, alert the doctor or podiatrist and consult them.

Ear Care Highlights

• Typically involves minimal care.
• Just clean the external auricle during bathing using a cloth.
• Do not insert objects into the inner ear.

Eye Care

• When conducting assessment, make not of the following:
  • Assess for any visual aids need.
  • Lesions, discharge or tearing
  • Pre-existing conditions or infection.

Giving Eye Care

• Use warm water and cloth the carefully clean outer canthus without using any soap.
• Special care should be given patients suffering from unconsciousness, patients like these are likely to require tape shut the eyelids due to inability to protect them.

Implementing Best Practices in Safety

• Have great communication with the care team
• Get priorities directly from patient
• Areas go from least dirty to most.
• Mucous, blood secretions all call for use of gloves.
• Patient handle should be safe with body mechanics in mind.
• Try to test how hot water is before contact.
• Being sensitive of privacy

Additional Notes

• A young girl with long hair is experiencing a problem with matting. The most appropriate action to take would be braiding the hair to reduce tangles.
• You are caring for a non-English-speaking male patient. When preparing to assist him with personal hygiene, you should, ensure that culture and ethnicity influence hygiene practices.