Personal Hygiene

1. Personal Hygiene Patient Care Skills

2. Personal Hygiene • A. Teeth, Gums, Oral • Keeping mouth clean, preventing odor and infection, increasing comfort, making food taste better, and reducing cavity risk • Terms include: • Plaque- thin film that sticks to teeth containing saliva, microbes, causes tooth decay • Tartar- when plaque hardens, builds up at gum line near the neck of the tooth

3. Personal Hygiene • Supplies for mouth care: • Infants- gauze pads, soft brushing • Brush, toothpaste, floss, swabs • What to Report: • Dry, cracked, swollen gums, lips, or membranes • Blisters, sores • Odor • Redness • Swelling, irritation • Bleeding • White patches on tongue • Loose or broken teeth or dentures

4. Personal Hygiene • Mouth care issues for the unconscious person: • May have oxygen or breathe with their mouth open- dries mucous membranes • Can have crusting on lips and tongue • Usually can not swallow • Should position on side and use only small amounts water, with suction • Keep mouth open with a padded tongue blade (not your fingers) and explain procedure to them • Do care at least every two hours

5. Personal Hygiene • Special Considerations with Dentures: • Need care as often as normal teeth • Slippery when wet!! • Can break or chip easily • Hold firmly and line basin with a towel • Warm, not hot water to wash • If stored, keep in cool water or soaking solution (not dry) • Do not wrap in tissues or napkins- can be thrown away easily this way • Label cup with patient name- loss or damage is considered negligence

6. Personal Hygiene • 2. Bathing • Cleanses skin, mucous membranes of genital and anal areas • Removes microbes, perspiration, dead skin, oils • Types: complete bed bath, partial bath, tub or shower bath • Need to know how much help patient needs, activity or position limits, what water temp, and what products to use

7. Personal Hygiene • What to report when bathing a patient: • Color changes to skin, lips, nails • Location and description of rashes • Dry skin • Bruises or open areas • Pale or red areas, especially over bony prominences • Drainage or bleeding • Swelling of feet or legs • Corns or calluses on feet • Skin temp changes • Pain or discomfort

8. Personal Hygiene • General Rules for bathing: • Follow orders on care plan • Allow personal choices whenever possible • Use standard precautions • Collect all items before starting • Provide for privacy • Assist with elimination before bathing • Cover for warmth and privacy • Reduce drafts by closing doors and windows • Protect from falls • Use good body mechanics • Use safe water temp (elbow test)

9. Personal Hygiene • Rules cont. • Wash from cleanest to dirtiest areas • Encourage the person’s help • Rinse skin thoroughly to remove all soap • Pat dry to avoid breaking skin, do not rub! • Dry well under breasts, between skin folds, periarea, and between toes • Bathe skin whenever urine or feces is present • Use caution with powders (esp. resp) • Make bed after bath completed

10. Personal Hygiene • Older Adults: • Due to dry skin and decreased levels of activity, may need less frequent bathing- 2 full baths per week and partial in between • When confused- get all items ready before beginning, do not rush the person, use a calm and pleasant voice, divert the person’s attention (chit chat), be gentle, try later if resistant

11. Personal Hygiene • Products for bathing: • Soaps- cleansing- not always needed (drying) • Bath oils- softening- can be mixed with soap • Creams and lotions- protect skin from drying-leave an oily film, most are scented • Powders- absorb moisture and prevent friction- under breasts, arms, groin, toes- applying thinly can still cause caking and crusting and can irritate, so use with caution • Deodorants- mask and control odor- never to irritated skin • Antiperspirants- decrease perspiration- never to irritated skin

12. Personal Hygiene • Types of Baths: • 1. Complete Bed Bath- • Washing a person’s entire body in bed, explain actions and focus on privacy • 2. Towel Bath- • Oversized towel used, covering body from neck to feet • It is saturated with a cleansing solution along with softening agents • Is quick, soothing, and relaxing (especially when patient has dementia)

13. Personal Hygiene • 3. Bag Bath • Commercially prepared with 8-10 wash cloths in a plastic bag, warm in microwave and use each cloth with a part of the body • Skin air dries • 4. Partial Bath- • Face, hands, axilla, back, buttocks, periarea 5. Tub and Shower- Tub is relaxing but can cause fainting, no longer than 20 minutes In shower, use shower chairs and hand held sprayers

14. Personal Hygiene • Safety for Tubs and Showers: • 1. Check water temp • 2. Clean tub or shower before and after use • 3. Dry tub or shower room floors • 4. Check handrails, grab bars • 5. Place nonskid mats on floors • 6. Cover person for warmth and privacy • 7. Place toiletries within reach

15. Personal Hygiene • 8. Place signal light within reach • 9. Instruct patient on how to use call light • 10. Remind them to always use grab bars, never towel bars • 11. Turn on cold water first, then add hot • 12. Fill tub before person gets in • 13. Adjust water first in shower, directing it away from patient

16. Patient Hygiene • 14. Avoid bath oils (slippery) • 15. Do not leave weak or unsteady patients unattended • 16. Stay within hearing distance with any patient • 17. Drain water from tubs before the patient gets out • 18. Cover them immediately to prevent chill

17. Patient Hygiene • Back Massage • Relaxed muscles, stimulates circulation • Works well after bath or at hs care • Should be about 2-5 min, not professional massage • Observe skin first for breakdown or discolored areas • Use lotion to reduce friction, warm in hands first (or hold bottle under warm water) • Prone or side position • Use firm strokes, always keeping in contact with person’s skin • Do not massage reddened areas over bones

18. Patient Hygiene • Periarea • Genital and anal areas, “privates” or “between legs” • Allow pt to was this area if at all able • Always clean from front to back • Report: • Unusual odors • Swelling or discharge • Pain or burning • incontinence