OLEH : NINA GARTIKA, M.

KEP
Personal Hygiene

 It is the nurses
responsibility to provide
the patient with the
opportunity for hygiene
 The skill may be delegated
but not always, depends on
facility policy.
 Purpose of Bathing
 Cleansing the skin
 Removes perspiration, bacteria, which
minimizes skin irritation and reduces
chance of infection
 Stimulation of circulation
 Warm water and gentle strokes from
distal to proximal increase circulation
and promote venous return
 Improve self-image
 Promotes feeling of being refreshed,
relaxed
Purpose of Bathing

 Reduction of body odors

Especially in axillae and pubic

areas
 Promotion of Range of Motion

Movement of extremities
while bathing
Nurse’s Advantage

 Provides opportunity to develop a

meaningful nurse-patient relationship

 Provides opportunity for assessment of

the patient including condition of patient,
psychosocial and learning needs.
Before You Begin Bathing

It is the Nurses Role to:

Assess Your Patient

Factors Affecting Personal Hygiene
1. Social Practices

2. Personal Preferences

3. Body Image

4. Socioeconomic Status

5. Health Beliefs and Motivation

6. Cultural Variables
p 770
 Complete Bed Bath
 Nurse baths entire body of dependent patient in bed

 Self-Help Bath
 Patients confined to bed are able to bathe themselves with some help

 Partial Bath
 Parts of the body are washed by the patient and some by the nurse
 Back Rub
 May be performed after drying off
the back during the bath.

 Position of Patient: Prone or side-lying

 Expose only the back, shoulders, upper arms.

Cover remainder of body
 Lay towel alongside back

 Warm lotion in your hands—still explain that

it may be cool and wet.
Guidelines for Bathing
1. Provide Privacy

2. Maintain Safety

3. Maintain warmth

4. Promote the patient’s independence as much as possible

Procedure for Bathing

 Bed Bath

See the movie

 Perineal Care
 Can be embarrassing for the nurse and the patient.
 Should not be overlooked because of embarrassment.

 If the patient can do it themselves—let them.

Hand them the washcloth and ask if

they would like to “finish their bath.”
 Perineal Care

 Those patients who may need the nurses assistance:

Vaginal or urethral discharge

Skin irritation
Catheter
Surgical dressings
Incontinent of urine or feces
 Perineal Care Procedure
Normal conditions, Discharge, Menses

Women
• Wipe labia majora (outer) from front to back in downward motion
using clean surface of wash cloth for each swipe.
• Wipe labia minora (inner) from front to back in downward motion
using clean surface of wash cloth for each swipe
• Wipe down the center of the meatus from front to back. If
catheter in place, clean around catheter in circular fashion, using
clean surface of wash cloth for each swipe.
• Wash inner thighs from proximal to distal
Cont. Female Perineal Care

• Rinse with warm to tepid water using pour from

peri-bottle if available.

• Pat dry using clean towel in same order as wash

• Remove bedpan if one is used

• Verbalize turning patient on side to wash anal area

from front to back and dry
Perineal Care - Male
 Retract foreskin of penis if uncircumcised

 Wash around the urinary meatus in a circular

motion, using clean surface of washcloth for each
stroke and around the head of penis in circular
motion

 Wash down shaft of penis toward the thighs

changing washcloth position with each stroke

 Wash scrotum – front to back

 Wash inner thighs

continued
Cont. Perineal Care - Male

 Rinse with clean wash cloth or peri-bottle

using warm water in same sequence as the
wash

 Dry with clean towel in the same sequence

 Replace foreskin, as appropriate

 Turn patient on side to wash anus from front

to back and dry

 Potter and Perry, p. 801

 Perineal Care with
Catheter
 Follow similar
procedure in the male
patient.

 Start at the urethra

opening and clean
outward.
 Oral Hygiene

 Maintains the healthy state of the mouth

 Cleanses teeth of food particles, plaque, and bacteria
 Massages the gums
 Relieves discomfort from unpleasant odors and tastes.

 Refreshes the mouth and gives a sense of

well-being and thus can stimulate appetite.
 Assessment: Oral Hygiene
a. Frequency
 Depends on the condition of the patient’s
mouth.
 Some patient’s with dry mouth or lips need care
every 2 hours.
 Usually done twice a day or after each meal
b. Assistance Needed
 Does the patient need assistance to do oral
care

*The nurse can help patients maintain good oral

hygiene by:
1. Teaching them correct techniques
2. Actually performing for weakened or
disabled patients.
Oral Hygiene Assessment

c. Abnormalities
 Loose or missing teeth
 Swelling and bleeding of gums
 Unusual mouth odor
 Pain or stinging in mouth structures
Brushing

 Major concerns are:

 Thoroughness in cleansing
 Maintaining the condition of the oral mucosa.

 Procedure for Conscious Patient:

 Upright position
 Potter and Perry, p. 808
 Brushing: Unconscious Patient
See performance checklist in syllabus
Safety is of utmost importance
 Prevent aspiration
1. Positioning—lateral position with head turned
to the side or side-lying. Position back of
head on a pillow so that the face tips forward
and fluid/ secretions will flow out of the
mouth, not back into the throat.

2. Place a bulb syringe or suction machine with

suction equipment nearby. Yankuer end on
suction device.
 Oral Hygiene: Unconscious Patient

 Keeping the mouth open

1. Use a padded tongue blade to open the patients mouth and
separate the upper and lower teeth

2. Never place your hand in the patient’s mouth or open with your
fingers. Oral stimulation often causes the biting –down reflex and
serious injuries can occur.

Potter and Perry p. 811

 Denture Care
 Clean dentures as frequently as natural teeth

 Dentures are the patient’s personal property

and should be handled with care because they
can be easily broken.

 Care:
 Remove before going to bed – allows gums to rest and prevents
buildup of bacteria.
 Store in a labeled container covered with water or denture cleaner
if available
Denture Care
• Procedure: Potter and Perry p.
787
• Tips to remember:
– Use gauze squares or washcloth to grasp
front of dentures to prevent from slipping
– Place wash cloth or paper towel in sink to line
it while you are cleaning the dentures
– Work close to the bottom of the sink in case
you drop them.
– Use tepid water
Part D: Hair Care

A person’s appearance and

feeling of well-being often
depends on the way their
hair looks and feels
Major Goals in Hair Care

Stimulate Circulation

Prevents Matting
 Brushing and Combing
 Keeps hair clean and distributes oil evenly
along the hair shaft
 Combing styles hair and prevents from
tangling
 Assessment while brushing
 Scalp lesions, abrasions
 Dandruff
 Parasitic infestations
 Quality of hair
 Appearance
Hair Care: Shampooing
 Depends on:
 Personal preference of the patient, does not
have to occur every day with hygiene
 Condition of the hair

 Ways to Shampoo
 If patient can get up and into a shower or sink,
use a hand held nozzle
 If patient can not get up, place on stretcher
and roll to a shower area
 If patient is unable to be moved, may shampoo
in the bed – see procedure in Potter and Perry
p. 789.
 “Shampoo in a Bag” or dry shampoos are
available
 Part E: Shaving

• Improves self-esteem and emotional needs of the

patient

• Usually done after the bath or shampoo

• Assessment:

– Skin for elevated moles,

warts, Rashes, patchy skin
lesions, or pustules
 Shaving
 Provide Safety
 When using a razor blade, the skin
must be softened to prevent pulling,
scraping, or cutting
 Place a warm wash cloth over area
and then apply some gel, cream,
foam.
 Hold the razor at a 450 angle
 Pull the skin taut
 Shave in the direction of hair growth
Shaving

Safety Precautions

Electric razors must be

used in patients who are
at risk for bleeding,
confused, or depressed
 Part F: Foot and Nail Care
 Usually part of the bath

 Purpose:
 Eliminate sources of infection and decrease odors

 Assessment:
 Color, shape length, texture of nails
 Condition of skin around nails and between toes and fingers –
swollen, inflamed, callused, lesions, temperature
 Foot and Nail Care
 Soak the hand or foot to
soften the cuticles

 Thoroughly cleanse and dry

 Trim the nails ONLY if you

have permission or it is
allowed at that institution.
Most institutions do not
allow nurses to trim the
nails.
 Foot and Nail Care

 Teach patient and family that nails

should be cut – straight across. May
need to get a referral if no one
available to cut nails.

 Show close attention to the feet and

nails of the diabetic patient and the
elderly

** If feet and nails are in bad

condition– notify doctor so a consult
can be ordered with a podiatrist
 Part G: Ear Care

 Usually requires minimal care

 Cleanse the external auricle with washcloth when bathing

 Avoid insertion of objects into the ear

 Hearing Aids

a. Check that the device is functioning correctly and

clean any body oils or cerumen from the hearing aid

b. Make sure the hearing aid is off and volume is down

before insertion

c. Insert hearing aid in ear by pulling earlobe downward

while pressing the hearing aid inward

d. Turn on and adjust volume

e. Ask the patient if comfortable and can they hear!

Part G: Eye Care

 Assessment:
 Abnormal lesions
 Discharge
 Tearing
 Presence of any infection
 Use of Visual Aids (contacts, glasses)

Ask when patient needs to use

these devices
 Eye Care
 Wash around the eyes with a warm moist
washcloth with warm water—NO SOAP!

 Clean from the inner canthus to the outer

canthus of the eye. Pay special attention to
the inner canthus.

 Provide special care for the eyes of

unconscious patients.
 May need to tape the eye lids shut if unable to blink and protect
own eyes