Factors Influencing Hygiene

Social patterns Personal preferences

Ethnic, social, and family Dictate hygiene practices
influences on hygiene patterns

Body image Socio-economic status

A person’s subjective concept Influences the type and extent
of their body appearance of hygiene practices used

Health beliefs and Cultural variables

motivation People from diverse cultures
Motivation is the key factor to practice different hygiene
hygiene rituals
Bathing Guidelines
Provide privacy
Maintain safety
Maintain warmth
Promote independence
Anticipate needs
Bed baths: A necessary
(and embarrassing) evil
Case Study
 Mr. Singh is 75 and has just had a stroke that has left
him with left-sided hemiparesis. He is also diabetic.
You need to plan his morning care. What will you do
as the nurse? What are the priorities?
Foot and Nail Care Guidelines
Careful inspection
Lukewarm water temperature
Soaking generally not recommended
Asses need for cutting of nails
If cutting nails, cut straight across to prevent
damage to tissues and impede development of
ingrown toenails

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Grooming Assistance
Hair Care Shaving
Oral Hygiene
 Proper oral care decreases risk of aspiration and
hospital-acquired infections in ventilated clients
 Alert client’s should be assisted with oral care 4 times
per day
 Clients with special needs may need more frequent oral
care
 Presence of stomatitis
 Use of oxygen therapy
 Unconscious state
 Client’s on chemotherapy


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Denture care
Oral Care in Unconscious Client
Basic Eye/Artificial Eye Care
Diabetes
 At risk for foot and nail problems
 Decreased sensation to the feet
 Especially at risk for developing chronic foot ulcers
 Very slow to heal and difficult to treat
CDA Guidelines for Foot and Nail
Care
 Inspect feet daily
 Have a foot exam at least once a year
 Wash feet daily, do not soak feet
 Do not cut corns or calluses or use commercial
removers
 Do not apply lotion between toes (excessive moisture
can result in infection)
 File toenails, do not use scissors or clippers
CDA Guidelines for Foot and Nail
Care
 Do not use over-the-counter preparations to treat athlete’s
foot or ingrown toenails
 Avoid constricting foot wear (knee highs, elastic stockings,
etc)
 Do not walk barefoot
 Wear properly fitting shoes
 Do not wear high-heeled, open-toes or pointed-toe shoes
 Do not apply hot water bottles or heating pads to the feet
 Wash minor cuts immediately and dry thoroughly
 Newborn Bath
 Tub bathing preferred  What to think about!

 Safety
 Warmth
 Clean to dirty
 Frequency
 Cord Care
Cradle Cap

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Pressure Ulcer Risk Assessment Tool
 Braden Scale (6 subscales)
 Mobility
 Nutrition
 Sensory perception
 Moisture
 Activity
 Friction & Shear
 Scoring for Braden Scale
 Mild risk (15-16)
 Moderate risk (13-14)
 High risk (10-12)
 Very high risk (<9)
 Braden Q Scale: Tissue perfusion and oxygenation
 Pediatric tool
Causes of Pressure Ulcers
 Pressure

 Friction

 Shearing

 Moisture
Pressure Ulcer Sites
 Sacrum
 Heels
 Elbows
 Lateral malleoli
 Greater trochanter
 Ischial tuberosities
RNAO Best Practice Guideline for Prevention
of Pressure Ulcers in At-Risk Clients

 # 1 intervention: Assess for risk

 Hygiene and skin care
 Clean and dry, do not massage
 Equipment & Positioning
 Therapeutic bed – reduce or disperse pressure
 Nutrition
 Mobility