HYGIENE PROCEDURE – CARE OF SKIN-BATH,
EYE CARE, EAR CARE AND CARE OF NOSE.
A SIMPLE NURSING PROCEDURE
CARE OF SKIN – BATH
Definition :
Sponge bath is the procedure of cleaning the body of the patient, who is in the bed i.e unable to take bath himself/herself.
Purpose :
To prevent bacteria spreading on skin.
To clean the patient’s body.
To stimulate general muscular tone and joint.
To make patient comfort and help to induce sleep.
To observe skin condition and objective symptoms.
Equipment :
A pair of gloves, apron, emollinet, soap with soap dish, jug, basin, bucket, sponge cloth, face towel, gauze piece: 2-3, mackintosh, bottom sheet, top sheet, draw sheets, nail cutter, bath towel.
Procedure :
1. explain the purpose and procedure to the patient; if he/she is alert or oriented, question the patient about personal hygiene preference and ability to assist with the bath.
2. Gather all required equipments near the patient bed side.
3. Assess and plan care in action with patient and family/friend if needed.
4. Check the room temperature; switch off air conditioner (AC)/fan if not needed.
5. Wash your hands and put on gloves.
6. Provide urinals, bedpan or commode to the patient.
7. Remove the gloves and wash hands, use disposable gloves and apron.
8. Provide proper privacy to the patient.
9. Assist to remove clothing without exposing the patient.
10. Remove the patient’s clothes and cover the patient body with top sheet, if an intravenous (IV) tubing is present on the patient’s upper extremity, thread the IV tubing and bag through the sleeve of the soiled cloth and rehang the IV solution; check the IV flow rate.
11. Fill two basins about two third full with warm water (43 to 46 degree).
12. Assist the patient to move toward the right side of the cot.
13. Lift the patient’s head and shoulder and put mackintosh and big towel under the patient’s body from the head to shoulder’s place face towel under the chin, which has also covered the top sheet. Make a mitt with the sponge towel and moisten it with plain water. Wash the patients eyes, clean from inner to outer corner, use a different section of the mitt to wash each eye wash the patient face, neck and ears, use soap on those areas only if the patient prefers rinse and dry carefully.
14. Wash, rinse and dry upper half of the body, starting with the side farthest away from your side, care needs to be taken not to wet drains/dressings and IV devices.
15. Wash, rinse and dry legs starting with the side farthest away from your side, roll patient, wash back, then using disposable pads, wash sacral area, check pressure points and cover areas that are not being washed return patient on to their back, ensuring they are covered, apply napkin as required.
16. Clear areas of any obstacles, ensure the environment warm and draw curtains, close doors to guarantee privacy and dignity.
17. Change the water and wash the genital area with patients verbal consent, (if patient is willing to wash this area themselves, provide enough water to wipe).
18. If patient is on urinary catheter, wear the gloves and wash the tubing away from the genital area; avoid using soap in genital area.
19. Turn the patient one side and remove the soiled sheet and advance the new bottom sheet and draw sheet, if they are to remain in bed, ensure that a minimum of two nurses are present during this procedure.
20. Dry and comb patients hair as defined.
21. Cover the patient with top sheet, position the patient comfortably.
22. Take away all used articles and linen from the patient side.
23. Remove the apron and gloves and dispose it according to hospital policy and wash the hand thoroughly.
EYE CARE
Definition :
Eye care is the procedure of assessing, cleaning or irrigating the eye and/or instillation of prescribed ocular preparation.
Purpose:
To relieve pain and discomfort.
To prevent or treat infection.
To prevent or treat injury to the eye.
To detect disease at an early stage.
To detect drug-inducted toxicity at an early stage.
To prevent damage to the cornea in sedated or unconscious patients.
Equipment :
Sterile tray containing::
Cotton balls.
Thumb forceps
Bowl
Kidney tray.
Towel.
Sterile 0.9% sodium chloride.
Preparation of The Client and Unit:
1. explain the procedure to the client. Explain how the client can help you.
2. Adjust the bed to the comfortable working of the nurse.
3. Arrange the article conveniently on the bed side table.
4. Keep the client flat if the condition permits. Remove all pillows leaving one pillow under the head.
5. Protect the pillow and the bed with a mackintosh and towel placed under the head.
Procedure :
1. explain the procedure to the patient.
2. Place the patient head well supported with tilted back.
3. Wash hands thoroughly using bactericidal soap.
4. Make sure enough light source is available.
5. For all time, treat infected or uninflamed eye first.
6. Take two cotton balls dip in sterile 0.9% normal saline and squeeze them nicely. Start to clean the eye from inner can thus to outer canthus in a straight single stroke.
7. Ensure to use new swab each time, repeat the procedure until all the discharge has been removed.
8. Once both eyelids have been cleaned and dried out, make the patient comfortable.
9. Discard the waste according to the hospital policy.
10. Replace the equipment.
11. Wash hand.
12. Record the procedure in the nurses record.
After Care of the Client and Articles :
1. instill any medications that is ordered.
2. Remove the mackintosh and towel from under the client’s head.
3. Adjust the position of the client in bed.
4. Tidy up the bed and make the client comfortable.
5. Take all the articles to the utility room. Clean them. Boil the bowl. Send the towels to laundry. Replace the articles to proper places.
6. Wash hands.
7. Record the treatment with date and time. Record the observations made on the nurse’s record.
EAR CARE
Introduction :
Normal ear require minimal hygiene. Client who have excessive cerumen (ear wax) and dependent client who have hearing aid may require assistance from the nurse.
Purpose :
To maintain proper hearing aid function.
Client uses proper technique for cleansing the ears.
Client follows preventive guidelines for hearing loss.
Client with hearing loss communicates effectively.
Equipment :
Cotton ball
Warm liquid paraffin or vegetable oil.
Client hearing aid.
Soap, water, towel.
Damp cloth.
Pipe cleaner or tooth prick ( if needed)
Preparation of Clients :
Instruct client in the proper way to clean the outer ear, avoiding use of cotton – tipped applicators and sharp objects such as hairpins, which cause impact of cerumen deep in the ear canal or cause trauma.
Tell client to avoid inserting pointed objects into the ear canal.
Encourage clients over age 65 to the regular hearing checks.
Instruct family members of clients with hearing losses to avoid shouting and instead speak in low tones, and to the sure the client is able to see the speaker’s face.
Procedure :
1. verbally confirm the identify of the patient by asking for their full name and date of birth.
2. ensure verbal consent for the presence of any other third party is obtained.
3. Explain procedure to patient including risk and benefits and gain valid consent.
4. Before careful examination of the ear, listen to the patient, elicit symptoms and take a history.
5. Establish patient has no known allergies, check in patients record.
CARE OF NOSE :
Definition :
The external midline projection from the face. The purpose of the nose is to warm, clean and humidity the air that a person breathes. In addition, it helps a person to smell and taste. The nose is divided into two passage ways by a partition called the septum. Opening to these passage ways are the nostrils. Bony projections, called turbinates, protrude into each breathing passage; they help to increase the surface area of the inside the nose.
Purpose :
To prevent bacteria.
To clean the patient nose.
To prevent or treat injury to the nose.
To prevent damage to the nose.
Equipment :
Cotton
Saline or Water
Towel.
Preparation of the Client :
Explain the procedure to the client. Explain how the client can help you.
Adjust the bed to the comfortable working of the nurse.
Arrange the articles conveniently on bedside table. Remove all pillow leaving one pillow under the head.
Procedure :
1. explain the procedure to the patient.
2. place the patient head well supported with tilted back.
3. Wash hand thoroughly using bactericidal soap.
4. Make sure enough light source is available.
5. Remove the nasal secretion of the client by using cotton balls and water.
6. Ensure the new cotton ball is used each time, repeat the procedure until all the secretion has been removed.
7. Once the nose have been cleaned and dried out, make the patient comfortable.
8. Discard the waste according to the hospital policy.
9. Replace the equipment.
10. Wash hands.
11. Record the procedure in the nurses record.
