Personal Hygiene for Nurses

Personal Hygiene

• Nurses are responsible for providing hygienic opportunities for patients.
• Delegation of hygiene tasks is possible, but depends on facility policy.

Purpose of Bathing

• Cleansing the skin removes perspiration and bacteria, minimizing irritation and infection risk.
• Stimulating circulation with warm water and gentle strokes improves venous return.
• Bathing improves self-image and promotes feelings of freshness and relaxation.
• Bathing reduces body odors, especially in the armpits and groin.
• Bathing promotes range of motion by moving extremities.

Nurse's Advantage

• Providing hygiene opportunities fosters meaningful nurse-patient relationships.
• Assessments of patients' conditions, psychosocial needs, and learning needs are facilitated.

Before Bathing

• Nurses should assess patients before bathing.

Factors Affecting Personal Hygiene

• Social practices
• Personal preferences
• Body image
• Socioeconomic status
• Health beliefs and motivation
• Cultural factors

Types of Baths

• Complete Bed Bath: The nurse performs a full body bath for dependent patients.
• Self-Help Bath: Patients confined to bed may assist in their own hygiene with support.
• Partial Bath: A portion of the body is washed by the patient, and the rest by the nurse.

Back Rub

• Performed after drying during the bath.
• Patient position: prone or lying sideways.
• Expose the back, shoulders, and upper arms.
• Use a towel alongside the back.
• Use warm lotion (may be cool and wet).

Guidelines for Bathing

• Ensure patient privacy.
• Maintain patient safety.
• Maintain a warm environment.
• Support patient independence as much as possible.

Perineal Care

• Perineal care can be embarrassing; ensure dignity and respect for the patient.
• Allow patients to perform perineal care if possible.
• If needed, assist with cleaning using a washcloth.
• Considerations for assistance include: vaginal/urethral discharge, skin irritation, catheters, surgical dressings, and incontinence.

Perineal Care - Procedure (Women)

• Wipe labia majora (outer) from front to back.
• Wipe labia minora (inner) from front to back.
• Clean the urinary meatus from front to back.
• Clean around (if applicable) urinary catheters in circular motion.
• Wash inner thighs from proximal to distal.

Female Perineal Care

• Rinse with warm water from a peri-bottle (if available).
• Pat dry using a clean towel.
• Remove bedpan (if used).

Female Perineal Care - Body Parts

• Prepuce
• Clitoris
• Labium majus
• Urethral orifice
• Labium minus
• Vaginal orifice
• Perineal raphe
• Anus
• Vulva
• Vestibule

Perineal Care - Procedure (Men)

• Retract foreskin (if uncircumcised).
• Wash around the urinary meatus in a circular motion.
• Wash the shaft of the penis towards the thighs, changing washcloths with each stroke.
• Wash the scrotum from front to back.
• Wash the inner thighs.

Perineal Care - Male (additional steps)

• Rinse with clean water or peri-bottle, using warm water.
• Dry with clean towel in same sequence as washing.
• Replace foreskin as appropriate.
• Turn patient on side to wash anal area from front to back and dry.
• (Reference: Potter and Perry, p. 801)

Oral Hygiene

• Maintains a healthy mouth.
• Removes food particles, plaque, and bacteria from teeth and gums.
• Relieves discomfort from unpleasant odors and tastes and refreshes the mouth, stimulating appetite.

Oral Hygiene Assessment

• Frequency: Depends on the patient's condition. Some patients need care every 2 hours. Usually twice daily or after meals.
• Assistance: Assess if patient needs assistance; nurses can teach techniques or perform oral care for weakened/disabled patients.
• Abnormalities: Look for loose or missing teeth, swollen/bleeding gums, unusual odors, or pain/stinging in the mouth.

Brushing (Conscious Patients)

• Main concerns: thoroughness in cleansing and maintaining oral mucosa health.
• Procedure: upright position.

Brushing (Unconscious Patients)

• Safety is crucial.
• Prevent aspiration: lateral position, head turned to side, pillow for head support.
• Use a bulb syringe or suction to clear mouth secretions.

Oral Hygiene - Unconscious Patients

• Keeping the mouth open: Use a padded tongue blade.
• Avoid placing hands in the mouth to prevent reflex reactions.

Denture Care

• Clean dentures regularly, like natural teeth.
• Handle dentures carefully due to their fragility.
• Remove dentures before bed to give gums rest and prevent bacteria buildup.
• Store dentures in a labeled container with water or denture cleaner. (if available).

Denture Care - Procedures

• Use gauze squares or washcloths to grasp dentures to prevent slipping.
• Place washcloths or paper towels in the sink to prevent damage.
• Ensure you clean closely to the sink to avoid drops.
• Use tepid water for cleaning.

Hair Care

• A person's appearance and sense of well-being are frequently influenced by their hair's state.
• Goals for hair care include stimulating circulation and preventing matting.

Brushing and Combing Hair

• Keeps hair clean and distributes oil evenly.
• Comb styles hair and prevents tangling.
• Assessment during brushing/combing includes scalp lesions, abrasions, dandruff, parasitic infestations, quality/appearance of hair.

Shampooing

• Shampoo frequency depends on the patient's preference and condition.
• Provide a way for self-shampooing if feasible (shower/sink).
• If not self-sufficient, place the patient on a stretcher to access the shower area.
• Offer shampoo options such as shampoo in a bag or dry shampoos.

Shaving

• Improves patient self-esteem and emotional well-being.
• Usually done after a bath or shampoo.
• Assessment should focus on skin for moles, warts, rashes, patchy lesions, or pustules.

Shaving - Safety Precautions

• Soften skin with warm washcloths, and apply shaving gel/cream/foam before shaving with a razor.
• Hold razor at a 45° angle.
• Pull skin taut.
• Shave in the direction of hair growth.

Shaving - Additional Safety Precautions

• Use electric razors with patients at risk of bleeding, confusion, or depression.

Foot and Nail Care

• A routine part of the bath.
• Purpose: Eliminate infection sources and reduce odors.
• Assessment: Color, shape, texture of nails, condition of skin around nails and toes, swelling, inflammation, calluses, lesions, temperature.

Foot and Nail Care - Procedures

• Soak hands/feet to soften cuticles.
• Clean thoroughly and dry.
• Trim nails ONLY with permission (permission may vary by facility).
• If feet and nails are not in good condition, notify doctor for podiatrist consult.

Ear Care

• Usually requires minimal intervention.
• Clean the external ear (auricle) with a washcloth during bathing.
• Avoid inserting objects into the ear.

Hearing Aids

• Check device functionality; clean of cerumen/body oil.
• Ensure volume is off and volume is down before insertion.
• Insert hearing aid: pull earlobe down, press inward.
• Turn on and adjust volume.
• Ensure patient comfort and hearing outcomes.

Eye Care

• Assessment: Abnormal eye lesions, discharge, tearing, and eye infections.
• Assessment should also include use of visual aids (contacts/glasses) and when/if needed.
• Wash eyes with warm water (NO SOAP) from inner canthus to outer canthus; special attention to the inner canthus (corner of the eye).
• Provide eye care to unconscious patients; eye care may include taping eyelids shut.

This quiz explores the vital role nurses play in promoting personal hygiene for patients. It covers the purpose of bathing, advantages for both nurses and patients, and factors influencing personal hygiene. Assess your understanding of how hygiene practices can improve patient care and well-being.