Set of hygienic measures performed by the nurse when the patient presents limitation to perform his/her own hygiene and requires being bedridden.
Objectives:
– To keep the skin and its appendages clean and in good condition.
– Prevent skin alterations and infections. – Contribute to the physical and psychological well-being of the patient. – To provide the patient with the necessary cleanliness to satisfy hygiene and comfort needs. – Educate the patient and family in hygiene care.
Equipment:
– Clean sheets. – Towels. – Basin or bedpan. – Personal hygiene items: comb, brush, cologne, deodorant, etc. – Laundry cart.
Material:
– Non-sterile gloves. – Disposable sponge with and without soap. – Neutral soap. – Moisturizing cream. – Clean pajamas or nightgown. – Nursing records.
Procedure:
– Perform hand washing. – Prepare the material. – Preserve the patient’s privacy. – Inform the patient. – Ask the patient and family to cooperate. – Maintain water temperature 35-36ºC (room temperature 24-25ºC). – Avoid drafts in the room. – Protect the patient from falling. – Put on gloves. – Place the patient in the supine position. – Undress the patient and cover the genitals with a sheet. – Put the dirty clothes in laundry bags (do not throw them on the floor). – Wash in order from the cleanest to the least clean areas. – Start washing the patient’s face, with water and without soap. Dry. – Wash the neck, ears, arms and armpits with soap and water. Rinse and dry. Lather the soap by rubbing gently with circular movements. – Bring the basin close to the patient’s hands, incorporate the patient and allow the patient to insert his hands and wash them. Dry the hands.
– Change the water, soap and sponge. – Continue washing the thorax. In women, focus on the submammary area and continue with the abdomen. Rinse and dry. – Wash lower extremities, paying more attention to the interdigital folds. Rinse and dry. – Change water, soap and sponge. – Wash genitals and anal area. Rinse. – Dry skin thoroughly. – Moisturize the skin with moisturizing cream with gentle massage. – Perform respiratory physiotherapy (clapping, vibration, etc.) and place pressure ulcer prevention devices, if necessary. – Dress the patient in clean pajamas. – Comb the patient’s hair and provide him/her with personal hygiene items such as cologne, deodorant, etc. – Observe the condition of the nails, clean and cut if necessary. – Leave the patient in a comfortable and appropriate position. – Pick up the material. – Remove gloves. – Wash hands. – Record in the nursing documentation, the procedure, date and time, incidents and patient’s response.
Observations:
– Perform daily cleaning as many times as the patient needs. – In patients with immobilized upper limbs or patients with a venous line, the patient should undress starting with the free arm. To dress the patient, start with the arm carrying the IV. – If the patient is carrying an intravenous infusion to remove the hospital gown will proceed as follows: 1. Completely remove the sleeve from the arm without the infusion and bring it to the tubing connected to the arm with the infusion. 2. Hold the container above the patient’s arm, pull the sleeve up over the container to remove the used gown. 3. Place the clean gown sleeve of the infused arm over the container as if it were an extension of the patient’s arm and pull the container through the cuff of the sleeve. 4. Replace the container. Carefully slide the gown over the tubing and the patient’s hand. 5. Slide the arm and the tube through the sleeve, taking care not to pull on the tube. 6. Help the patient put on the other sleeve. 7. Check that the infusion drip rate is adequate.
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