Transcript adminstering personal hygiene

ADMINSTERING PERSONAL
HYGIENE
NA LTC Unit 5 LP1
Personal Care For The Residents:
Objectives
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Identify activities that make up personal care
Identify points to consider when planning personal
care
Identify key points in helping residents maintain
general hygiene.
Identify appropriate clothing fore residents
Describe major areas of personal care
Identify points to remember when performing
personal care activities
Identify adaptive measures that may be necessary to
take when giving personal care to residents with
special conditions
Personal Hygiene
Personal Hygiene includes:
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Bath
Back care
Perineal care
Oral Hygiene
Hair Care
Nail Care
Shaving if necessary
Dressing
Sensitivity to patients needs, cultural and/or religious
beliefs
Respect patients right to privacy
Planning Personal Care
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Check care plan
Know residents capabilities
Encourage independence. Do not save time
et by doing personal care for the resident
Provide choices
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What do you want to wear?
How do you want to wear your hair?
Invading personal space
Do NOT treat resident like a child. Dignity et
Respect!!
Purpose of Good Personal
Hygiene
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Prevent infection
Eliminate odors
Promote relaxation
Stimulates circulation, provide mild exercise
Enhances self-esteem
Allows the healthcare worker to develop a good
and caring relationship with the patient
Observation
Personal Hygiene
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Elderly May Experience:
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Eyesight less sharp
Hands may tremble
Activities take effort et energy
Clothes may be soiled
Teeth not brushed
Food spilled on clothes
Shirts not properly buttoned
Types of Baths
The type of bath depends on the patients
condition et ability to help, Dr. Order
Elderly - thin, dry skin they may bathe 1 or
2x a week
Three Types of Baths
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Complete bed bath (CBB)
Partial Bed bath (PB)
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Tub bath, Whirlpool or Shower
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Complete Bed Bath (CBB)
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Health assistant bathes the entire body
Water temperature 115 F, cools quickly
Provides oral hygiene, back care, back rub,
hair et nail care, perineal care, and shaving if
necessary
Usually given to patient who is confined to
bed or is too weak or ill to bathe
Partial Bed Bath
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2 meanings
Partial bath- patient is too weak or ill,
only the face, arms,axilla, hands, back
and perineal area is bathed
Partial bath- patient is able to wash most
of body and assistant completes the bath,
usually washing the legs and back
assistant prepares supplies needed for
the patient
Tub Bath or Shower
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Some patients are allowed to take a tub bath,
whirlpool or shower
Bath water temperature 105 F
Assistant helps by providing towels et supplies,
preparing tub or shower area, et assisting
patient as situation indicates
General Guidelines for Assisting with
Bed Bath
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Care plan (ex Dr. order type of bath, special
information, patients ability to assist, adaptive
devices, patient needs and preferences
Bed raised to working height, patient moved to
the side of bed that is near you.
Privacy, room temperature warm
Offer the bedpan or urinal, warm water can
stimulate the urge to urinate or defecate
General Guidelines Related to Giving
a Bed Bath
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Gloves are worn for parts of bathing procedure
Wash Mitt
Keep body covered with bath blanket for
modesty et warmth, expose only body part you
are washing
Offer patients choices
Bed bath water temp is 115F, cools quickly
Wash cleanest to dirtiest
Change water if it cools becomes soapy or dirty
General Guidelines for Assisting with
Bed Bath
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Soap can be irritating and drying to skin,
rinse thoroughly
Keep soap in soap dish when not using
Warm lotion in bath water during bath
Washing farthest extremity first prevents
dripping water across part cleaned
General Guidelines for Tub and
Shower Bath
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Tub bath is for residents who can get out
of bed but may not like showers
Tub bath= greater relaxation, helps
resident feel cleaner
If transporting patient to tub or shower
room cover patient body
Use gait belt over clothing
Use safety belts and locks on tub lifts and
shower chairs
General Guidelines for Tub or
Shower Bath
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Tub room temperature 75-80 F, free from
drafts
Test temperature of bath water 105 degrees F.
Do NOT add oils to water, slippery
Assist pt in et out of tub or shower
Resident usually stays in tub for 10-15 minutes to
prevent chilling
Never leave resident unattended
Tub Bath
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If Resident becomes Faint during a Tub Bath
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Call for help
Drain water from tub
Lower head as much as possible
Cover resident with bath blanket
Note: Fainting is caused by warm water dilating
the blood vessels of the skin, increasing amt of
blood to skin, decreasing the blood flow to the
brain
Shower Bath
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Safety Measures
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Shower is frequently chose due to residents poor
mobility, difficulty getting in or out of tub
Shower chair locks
Shower room temp 75-80 F
Face resident to the door of the shower stall
Once a towel has been used below the waist do
NOT use it above the waist
Never leave resident unattended
Do NOT lock bathroom door
Shower Bath
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Resident Becomes Faint during Shower
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Call for help
Turn off water
If resident is standing, sit them down
Lower head as much as possible
Cover with bath blanket
Bed bath, Tub or Shower
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Dry skin very well, pay attention to folds
et creases
Apply deodorant after bath unless patient
objects
Upon completion of bathing dress patient
appropriately, cover the body
Patients preference under garments
Nonskid slippers or house shoes
General Infection Control Guide
General Infection Control Guidelines for
Personal Care Procedures
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b)
c)
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Wear gloves when in contact with blood, body
fluids, secretions, excretions, mucous
membranes or nonintact skin
Wear gloves when washing mucous membranes
eyes,nose, mouth et genital areas
Disinfect tub, shower chair, or whirlpool
according to policy
Follow facilities infection control policy when
handling clean et soiled linen
Oral Care
Oral Care includes cleaning of the..
a)
b)
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d)
Mouth
Teeth
Tongue
Gums
Purposes of Proper Oral Care
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Prevent tooth decay and dental disease/problems
Stimulate appetite, provide comfort
Prevent halitosis or bad breath
Stimulate circulation of gums
Create a feeling of well being
OBSERVATION
Oral Care Observation
Observe et report signs of :
 Tooth decay (blackened teeth)
 Irritation
 sores
 loose teeth
 pain
 swelling
 white patches
 or other abnormalities to your supervisor
Oral Care
Frequency
a)
b)
c)
At least 3 times a day. Before breakfast, after meals, at
bedtime
Frequent oral care based on pts condition may be every
two hours. Ex mouth breather, NPO, TF, oxygen
Inspect residents mouth et report
Routine Oral Hygiene
a)
b)
c)
Regular tooth brushing et flossing
Patient often independent, assistance needed to gather
supplies needed
Health care assistant may need to assist or completely
provide oral care to the patient
Oral Care
General Guidelines for Giving Oral Care
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Independence of pt
1st choice bathroom sink not in bed
Always wear gloves when assisting
Explain procedure to every pt even if confused or
unresponsive
Turn patients head to side
Moisten lips with lip balm If oxygen is in use use water
soluble lubricant
Mouth wash does not replace the need to brush teeth
Dilute Mouthwash should be 1oz to 1 oz water
Oral Care
Denture Care
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b)
c)
Pt has dentures or artificial teeth
Privacy, respect pts preferences
Extreme care to prevent damage to dentures
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b)
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Handle with washcloth or paper towel to prevent slipping
Keep in water when not in mouth
Soaking in solution does NOT eliminate need for brushing
Line sink with wash cloth or paper towel. Do NOT rinse in
standing water
Label denture cup
Oral Care
General Guidelines for Denture Care
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b)
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Always wear gloves
Handle dentures very carefully
Let pt remove dentures from their mouth, if able
Check dentures for cracks, chips, or loose teeth
Store dentures in marked denture container.
Some dentures you store dry others with cool
water. When in doubt store in cool water.
Oral Care
Special Oral Hygiene
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Care provided to unconscious or semiconscious
pts
Mouth breathers
Complete Oral care: mouth, teeth, gums, tongue
Special supplies: toothettes, lemon glycerin
swabs
Hair Care
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Purpose of Hair Care
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Clean hair of dirt particles et dead cells; prevent
matting
Stimulate scalp circulation
Improves ones appearance
Observation of hair et scalp
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Sores
Redness
Dry scalp, excessive dandruff
Swollen areas
Hair Care
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When Hair Care Should be Done
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Comb et brush in morning et prn
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Brushing, hold hair gently above tangle,
brush tangle from end to scalp
Bed ridden pt tangled and knots in hair
 Use alcohol to remove tangles from oily
hair
 Use petroleum jelly to remove tangles from
dry hair
Hair Care
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When Hair Care Should be Done
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Washed at least weekly.
Refer to care plan
Younger may prefer daily
Do NOT shampoo as part of shower or tub
bath. Salon Appts
Resident independently comb with assistive
devices
Hair Care Observation
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Sores
Redness
Dry scalp, excessive dandruff
Swollen Areas
Specific Measures Related to
Hair Care
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Label residents comb et brush
Brushing hair apply towel to residents
shoulders
Clean brush after every use
Hair dryers, keep your hand under air stream
to avoid burning
Shampoo- water temp 105 F
Coarse thick hair, use softening baby
shampoo
Hair Care
Shampooing
a)
b)
c)
d)
Dr. Order, refer to care plan
Various types of dry chemical or fluid shampoos
ex no rinse shampoo
Read instructions carefully before using
Special devices available to use ex shampoo tray
Nail Care
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Purpose of Nail care
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Decrease bacteria build up that could
cause infection
Neat appearance
Prevent cuts/scratches from long nails
Nail Care
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Observation
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Cuts
Calluses, corns
Change in skin color
C/O of tenderness
Swelling/edema
Elderly nails thick, brittle, difficult to trim
Change in nail color- Black fungal infection or
injury, blue cyanosis, decreased circulation
Specific Measures Related to
Nail Care
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Dr. Order
Good source of light
Soak nails in water to make them softer
Dry thoroughly between toes et fingers; excess
moisture can lead to skin break down
Residents incontinent, confused, or unconscious
should have short fingernails so feces do not collect
under nails
Specific Measures Related to
Nail Care
If you a permitted to cut finger nails
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Use nail clippers , not scissors
Clip the nails straight across
Clip slowly et carefully
File rough edges straight across
Never cut Toenails
Injuries to feet are prone to infection et slow
healing
File toenails straight across
Learn et follow agency policies on nail care
Shaving
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Pt may be independent, dependant or require
assistance
Gather supplies
Use electric or disposable razors, pt preference
Preference of shaving area (Male, or female)
Correct technique
Check orders, care plan
Shaving may be prohibited or special precautions
for pts on anticoagulant, or medications that
prevent blood from clotting.
Perform shaving in residents bedroom or bathroom
not in public area
Back Rub
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Part of daily bath unless contraindicated
Frequency pt confined to bed once every 8 hours
Time frame 4-7 minutes
Purpose
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Stimulates circulation
b)
Prevents pressure ulcers
c)
Relaxation et comfort
Back Rub/Skin Care
Observation
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Irritation/redness
Rashes
Bruises- size, color, location
Swelling
Excessive dryness
Sores, lumps, growth
Cuts, Abrasions, burns
Mottled skin that is cool to touch
Check condition of skin over bony
prominences
Specific Measures Related to
Backrub/Skin Care
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Lotions needed- elderly skin very dry
Powder used to absorb skin moisture at
skin folds. Do not shake powder- inhale
Perineal Care
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Terms and Definitions
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Anus- outlet of rectum
Male Reproductive
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Circumcision- surgical removal of the end of the
foreskin of the penis
Foreskin- loose skin at et covering the end of
the penis
Scrotum- encloses et protects the testes
Testis- primary reproductive organ of male;
sperm cell producing organ
Perineal Care
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Terms and Definitions
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Female Reproductive Tract
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Labia majora- 2 folds of hair covered skin that
lie external to the labia minora
Labia minora- flattened longitudinal folds forms
the margins of the vestibule
Vestibule- space between labia minora that
includes the vaginal and urethral openings
Vulva- includes the labia majora, minora,
clitoris, vestibular glands
Purpose of Peri Care
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Cleans the peri area for the resident
who is unable to or has difficulty with
adequately cleaning self
Prevents skin breakdown of peri area
Prevents itching, burning, odor
Prevents infection
When should Resident have
Peri Care
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Continent- daily with a.m. care
Incontinent- after each voiding or stool
Indwelling catheter- once a shift et
after every BM
Necessary if feces are noted under
fingernails
Perineal Observation
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Discharge or odors
Signs of skin breakdown- redness
irritation, rashes
Specific Measures Related to
Peri Care
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Peri care (refer to care plan)
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Soap et water
No rinse peri wash
Periwash that requires rinsing
Skin-barrier creams
Pre moistened wipes
Specific Measures Related to
Peri Care
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Wash from front to back. To prevent spreading fecal
matter from anal area to vagina or urethra (opening
to bladder)
Offer bedpan or urinal before starting peri care
Uncircumcised males- retract foreskin, cleanse
circular, return foreskin over tip of penis
Wear gloves
Perineal area more sensitive to temperature than the
rest of the body. Water needs to be slightly cooler
Bed protector or pad
Key Points to Dressing et
Undressing
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Day et night clothes. Identify time of day
Supervise appropriate dress upon weather et
occasion
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Remember elderly have poor circulation, little
body fat, less active therefore they may complain
of being cool
Encourage handicapped resident to wear
clothes that open down front
Do NOT put residents clothes on backward
Key Points to Dressing et
Undressing
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Family or facility laundry residents clothes
Name sewn or marked with ink on all
residents clothes
Resident nonfunctioning weak side, dress
weak side first
Dependant resident dressed in bed before
transferring to wheelchair
Residents shoes must be on prior to standing
Key Points to Dressing et
Undressing
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Monitor independent resident during
dressing, assist if needed
Assistive devices
If Rx Apply Elastic Stockings, TEDS, Antiembolism before getting out of bed
 Rationale- reduce incidence of inflammation of the veins
et edema
 Teds 24 hours remove 30 minutes with am care et 30
minutes with pm care.
 Check care plan to see if Rx night
 Wash with mild soap, hang up to dry