07.09 Hygiene

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Overview

  1. Hygiene
    1. Hygiene considerations
    2. Systems
    3. Nursing care

Nursing Points

General

  1. Hygiene considerations
    1. Beliefs
      1. Culture
    2. Personal preferences
      1. Does preference create a conflict with care?
    3. Fragrance and allergies
    4. Body image
  2. Systems
    1. Skin, hair and nails
      1. Bathing
        1. Chlorhex/Wipes
        2. Bed bath
      2. Shaving
        1. Preference vs need for care
      3. Foot care
        1. Nail considerations
        2. Skin integrity
    2. Oral
      1. Regular oral care
        1. Prevents infection
        2. Pneumonia avoidance
    3. Pericare
        1. Dignity
        2. Safety
          1. Skin integrity
          2. Reduction in irritation
        3. Use of appropriate products
  3. Nursing care
      1. Encourage autonomy
        1. Encourages independence
      2. Provide education
        1. Fill knowledge gaps and clarify information
      3. Encourage family participation
        1. Identify caregiver role
        2. Educate family

Nursing Concepts

  1. Tissue/Skin Integrity
  2. Safety
  3. Professionalism
  4. Health Promotion

Patient Education

  1. Educate patient on hygiene goals
    1. Provide evidence to dispel myths or misinformation

Reference Links

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Video Transcript

In this lesson we’re going to talk about hygiene.

So before we get started, the one thing I want you to think about it as we go to this lesson is to do a little bit of self-reflection.

When we talk about hygiene for our patients, consider the things that we would do for ourselves. We brush our teeth and take a bath every day, stuff like that. So what we need to focus on when we are taking care of our patients and their hygiene is reflect what you would do for yourself for them.

So as we go into this, be mindful of our culture or belief systems of patients. Some patients don’t like using certain fragrances, or certain products, or they want their hair kept at a certain length or in a certain style.

The other thing that you want to think about when you’re dealing with your patients hygiene is what are their personal preferences. Do they like long beards or short hair? Try to honor that, but make sure that their preferences aren’t keeping you from providing care. An example of this would be like if a patient wants to keep their beard, but they have a new tracheostomy. For the time being, we may have to keep that area nice and trimmed up, so that it doesn’t cause any problems with the healing of the new tracheostomy site.

Also think about really strong fragrances or that your patient might have an allergy to a certain product to a certain smell. We don’t want our patients having aversions to things we’re trying to make positive. So ask about any fragrances or products they don’t want to use.

Also consider body image and promote positivity for your patient. So flat out ask them, how do you like your hair done? By giving the sense of positivity, it helps them to gain a greater sense of self esteem.

When we’re talking about hygiene, we were really want to focus on things like skin, hair, and nails. We want to make sure that your patient skin is always clean, so make sure that you bathe your patients on a regular basis. There’s a couple of different ways to do this. In the past I’ve always used either chlorhexidine wipes, or I’ve done a bed bathroom I patients using non-abrasive, gentle soaps. Also find out what your unit or facility policy is.

Consider offering to shave your patient. Sometimes they can’t do it, but make sure that you are offering that to them.

Also make sure that you’re taking care of their feet because they may not be able to. Again you’re going to want to ask them how they like their nails done, if they would like lotion applied to their feet. The reason we ask these things is because we keep skin breakdown from happening by keeping the skin on the feet clean, and from drying and cracking, which could potentially lead to an infection. So you have the opportunity to really promote positive but care for your patient while you are taking care of them.

Also make sure that you’re always taking a look at your patient’s skin. Look under devices and look in between the hard-to-reach places, because we want to make sure that your patient is not getting skin breakdown. Also check for rashes or skin irritation, or anything that could cause an infection.

Another thing we want to focus on is oral care. I can’t tell you how many times in the unit I’ve seen a patient Oral Care get totally missed because it’s low on the priority list. But make your patient oral care part of your priority especially for your patients like in the ICU. Poor oral care contributes to different types of infection, especially pneumonia in your ventilated patients. So make sure that you’re always offering good oral hygiene to your patient. Make sure you’re using the appropriate toothbrushes for those patients and the appropriate toothpaste or cleaning product.

Peri care is a big issue and I really want to drive some things home. Just like in our bowel and urinary elimination lessons, we really want to focus on providing a patient dignity and safety. Taking care of their private parts is really awkward for everybody, so as long as you provide them privacy and you are professional, you’re really going to help promote those ideas of dignity. And when I talk about safety, I’m talking about reducing the likelihood of infection. Be sure if your patient has some sort of tube like a Foley catheter, make sure that you’re doing your catheter care and your peri care for your patient daily to twice a day, because that really reduces the opportunity for infection. The last thing you want is your patient getting urinary tract infection because nobody’s being proactive about their peri care.

Also make sure that if your patient’s tube is leaking or they have higher likelihood of having stool or urine on them that you really focus on keeping that skin intact and you work on keeping them clean. Make sure that again that you’re using the appropriate products to keep them from having any sort of adverse reaction, or being irritated.

As the nurse, you should really focus on autonomy and Independence for your patient. And make sure that you’re encouraging your patient to participate if they can, so that they have a better sense of self while they heal. Also look at your patient’s understanding of hygiene and assess their knowledge. If you realize that they have gaps in their knowledge or if there is misinformation, work to provide the correct information so that you can really promote good hygiene and care for them.

Another thing you want to do is encourage your family to participate. By finding out who that primary caregiver is, then you can help to instruct them and educate them on how to properly take care of your patient when they get home. You want to focus on promoting some sense of normalcy for your patient, so involve them and their family in their hygiene care.

Today we’ve really focused on tissue and Skin Integrity for our nursing Concepts along with safety and professionalism.
Okay so let’s recap.

Pay attention to your patients beliefs and preferences and consider what your patient thinks about hygiene.

Always make sure that you’re using the appropriate products and patience and that you’re paying attention to if they have any allergies or aversions to any fragrances.

By practicing good Oral Care with your patient really helps to reduce and prevent infections, especially in your ventilated patients.

Encourage your patient to participate in their care and encourage autonomy and Independence.

Educate educate educate! Focus on finding gas in your patients knowledge and fill them in with the correct information about hygiene.

Well that’s our lesson on hygiene, make sure you check out all the resources attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing!!

Read more

  • Question 1 of 5

A public health nurse is teaching a seminar about hygiene promotion. Which best describes the difference between health education and health promotion?

  • Question 2 of 5

A nurse is getting ready to perform oral hygiene for an unconscious client. Which of the following principles would the nurse follow that are associated with oral hygiene in an unconscious client? Select all that apply.

  • Question 3 of 5

While caring for a client in a rehabilitation center who has self-care deficit related to bathing and hygiene, the nurse assists the client by finding loose clothing to wear that snaps easily in the front. Which of the following best describes the rationale for this?

  • Question 4 of 5

A nurse is helping a client with his oral hygiene after eating breakfast in the morning. The nurse assesses the client’s ability to brush teeth and knows that lack of oral hygiene affects the client’s health. Which of the following situations is a risk for a client with poor oral hygiene?

  • Question 5 of 5

A nurse overhears two employees talking about a client’s poor hygiene in a derogatory way. Which of the following actions should the nurse take first?

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