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Personal Hygiene and Oral Care

DPS S12

Learning Outcomes
To explore issues relating to personal hygiene and oral care in the context of practice To review the principles of infection control (last weeks session) in relation to personal hygiene and oral care To list the equipment necessary to carry out these skills To carry out personal hygiene and oral care effectively

What do we mean by personal hygiene? Why is it important to maintain personal hygiene?

What is personal hygiene?


Essence of Care (DH, 2009) the physical act of cleansing the body to ensure that the hair, nails, ears, nose and skin are in optimal condition. It also includes mouth hygiene which is the effective removal of plaque and debris to ensure the structures and tissues of the mouth are kept in a healthy condition

Personal hygiene
A basic right for all people, not a luxury. When a person is unable to maintain their own personal hygiene, intervention is required this is a basic nursing duty. All nursing models e.g Roper et al; Orem, make reference to the patients hygiene needs. Relies on initial and continuous assessment of the patients needs and ability to self-care.

Why is personal hygiene important?


She was left in lie in her excrement and urine and the staff informed us she was doubly incontinent. We informed them that she would be if no-one came to see if she needed to go to the toilet and she couldnt see anyone, being flat on her back on a large busy ward. She was confused and frail, but before she went into hospital she was not incontinent.she deteriorated so rapidlythe ward was a disgrace, dirty sheets (Gilchrist, 1999 in Smith and Field, 2011)

Nurses were laughing and chatting at the nurses station while my mother was dying in squalor (Daily Telegraph, 2003) ..she was left on a bedpan for hours without a bowl of water to wash her hands. The family often found traces of faeces under her fingernails and on her hands and she was not given a bath or shower whilst at hospital (DH, 2010)

How do these statements make you feel: a) About the patients and their families? b) About the Nursing profession? Why is this happening? How is this avoided? .all to often lack of resources is used as an excuse for poor nursing care

Essence of Care Benchmarking Standards


All patients are assessed to identify the advice and/or assistance required in maintaining and promoting their individual personal hygiene Planned care is negotiated with patients and/or their carers and is based on assessment of their individual needs Patients have access to an environment that is safe and acceptable to the individual Patients are expected to supply their own toiletries but singleuse toiletries are provided until they can supply their own Patients have access to the level of assistance that they require to meet their individual needs

DH (2009)

Preparation
Patient assessment to identify the advice and/or care needed to maintain and promote their personal hygiene How do we gain this information? From whom? Involves consideration of the environment what would the ideal environment be? http://www.cetl.org/learning/tutorials.html Dignity in Care

Infection Control
What infection control measures should be implemented during the maintenance of personal hygiene and oral care?

Cultural and Religious factors


Cultural and religious factors must be respected at all times. The wishes of individuals must be sought and not assumed. For example: The Islamic and Hindu religions require individuals to wash before prayer. Sikhs place great importance on not shaving and cutting hair.

Bed Bathing - Equipment


Soap/pre-packed cloths Other toiletries, as preferred by the patient Brush/Comb 2 flannels (may be disposable) one for the face and one for the body 2 towels one for the face and one for the body Towel, sheet or small blanket to cover the patient Washing bowl of hand-hot water (always check the patient is happy with the temperature of the water)

Bed Bathing - Equipment


Disposable apron Non-sterile gloves Incontinence pads Clean bed linen (last weeks session) Laundry skips (soiled/non-soiled, see last weeks session) Clean clothes Yellow bag for clinical waste (optional such as razor, nail clippers, emery boards, manual handling equipment if necessary)

Giving a Bed Bath


The Procedure: ClinicalSkills.net (Giving a bed bath; Facial Shave; Washing a patients hair in bed) http://www.clinicalskills.net/clientarea/catalogue/category/2 Video (YouTube) Giving a Bed Bath

Equipment Oral Care


Disposable non-sterile gloves Yellow bag for clinical waste Towel Pen torch and spatula to examine the patient mouth Toothpaste Patients own toothbrush Receiver (kidney dish) Plastic cups Denture pot and solution Mouth wash tablets Yellow paraffin (optional)

Oral Care
The procedure: ClinicalSkills.net (mouth care) http://www.clinicalskills.net/clientarea/catalogue/category/2

Video (YouTube) http://www.youtube.com/watch?v=AVsMmppY XrI