Hygiene


Hygiene



in this video our subject is cleanliness and hygiene we will discuss getting ready how to provide oral care how to give a shower or tub bath how to give a complete bed bath how to provide perennial care and finishing up the practices associated with personal hygiene are critical for maintaining one's physical health the body skin and the mucous membranes including those found in the mouth are the first line of defense against infection so good hygiene of the skin and mouth not only eliminates a portal of entry for microbes it also reduces the number of microbes minimizing the risk of infection good personal hygiene also contributes to a person's emotional health by helping the person feel relaxed loved and well cared for being clean and refreshed also helps people meet their need for self esteem by preventing body and breath odors and by helping them feel attractive to others most people take for granted the ability to keep their bodies clean but many of the people we care for those who are sick injured or otherwise disabled depend on us for help with their personal hygiene as in so many other areas of care when it comes to hygiene our patients and residents rely upon the professional skills and caring attitudes of nursing assistants to maintain their quality of life before providing assistance however remember you should allow the person to be as independent as possible and only assist each person is necessary according to his or her abilities preparation that is getting ready to manage your work in a manner that is safe healthful and efficient is key to successful healthcare no matter what tasks you'll be performing during your shift whether those tasks are planned or unanticipated you will benefit from a routine of careful preparation begin each interaction with patients or residents by performing these steps wash your hands gather all needed supplies not before entering the person's room introduce yourself using your name and title and greet the person by name remembering that a friendly greeting helps establish rapport carefully identify the person adhering to your facility's approved method explain to the person the procedure you're about to perform and make sure the person understands before you begin if necessary show visitors where they can wait outside the room provide privacy by closing the door and curtains as appropriate drape the person for modesty and then throughout the procedure see to safety using proper body mechanics and following all safety precautions for equipment use and infection control oral hygiene means care of the mouth and teeth be sure to employ standard precautions when you assist with brushing and flossing a person's teeth or when assisting with dentures because during routine care the gums may bleed potentially exposing you to blood-borne pathogens before providing oral care be sure to follow the standard getting ready steps begin by washing your hands taking any necessary standard precautions and gathering your supplies gloves paper towels paper cups a straw and a mises basin a toothbrush toothpaste dental floss and a towel you may also wish to gather mouthwash and lip lubricant cover the over bed table with paper towels then put your supplies on the paper towels fill a paper cup with water I'll be right back mr. Smith can begin by positioning the bed at a comfortable working height to promote good body mechanics make sure the wheels are locked you might need to lower the side rail on the working side of the bed raise the head of the bed as high as the patient or resident can tolerate next put on your gloves place the towel under the person's chin wet the toothbrush apply a small amount of toothpaste then brush the person's teeth position the toothbrush at a 45-degree angle to the gums against the outer surface of the top teeth start at the back of the mouth and brush the outer surface of each tooth using a circular motion as shown here repeat for the lower teeth remember you may need to allow the person to spit toothpaste into the emesis basin periodically during the tooth brushing procedure next brush the inner surfaces of the teeth position the toothbrush at a 45-degree angle to the gums start at the back of the mouth and brush the inner surface of each tooth again in a circular motion then brush the chewing surfaces of both the upper and lower teeth again using a circular motion finally brush the person's tongue off of the person the cup of water and a straw is desired so he can rinse completely and spit into the basin place the basin on the / bed table and dry the person's mouth and chin next cut a piece of dental floss about 18 inches wrap it around each of your middle fingers hold the floss in each hand between your thumb and index fingers and stretch it tight insert a segment of the floss between the upper back teeth move the floss up and down and then gently remove it advance the floss by releasing some floss from one middle finger and winding it onto the other then move forward to the next two teeth floss between all of the person's teeth offer him the opportunity to rinse as needed ask the person to rinse his mouth completely if the person requests mouthwash pour about a quarter cup into a clean paper cup and help them to rinse again swish it around just like some lip balm yes please okay to complete this procedure gather any soiled linens and place them in the soiled linen hamper clean and store the equipment and supplies dispose of disposable items remove your gloves wash your hands then complete your finishing up steps as described in the final section of this video many of the patients or residents in your care will have dentures or partial dentures these help people who are a dentist that is missing their natural teeth to chew their food properly as you assist with denture care be mindful that dentures are both fragile and expensive to replace or repair they are also very slippery when they are wet and you are wearing gloves when you clean dentures make sure you line the sink with a washcloth to provide a cushion should you accidentally drop the dentures to provide oral care for a person with dentures begin by washing your hands taking any necessary standard precautions and gathering your supplies gloves paper towels paper cups a straw and a mises basin a denture cup 4×4 gauze squares a denture brush or toothbrush denture cleaner or toothpaste a washcloth and a towel you might also need foam tipped applicators denture solution mouthwash and lip lubricant cover the over bed table with paper towels then put your supplies on the paper towels I'll be right back mrs. cloth fill a paper cup with water position the bed at a comfortable working height to promote good body mechanics check to make sure the wheels are locked raise the head of the bed as high as the patient or resident can tolerate next put on your gloves place a towel under the person's chin ask the person to remove her dentures and put them in the emesis basin or remove your dentures now could you do it for me if the person needs assistance ask her to open her mouth holding a gauze Square between your thumb and index finger grasp with the upper denture moving it gently back and forth to break the seal ease it down forward and out of the mouth place it in the mes Basin repeat for the lower denture you might need to turn the denture slightly to lift it from the mouth take the dentures and basin the washcloth the denture cup the denture brush or toothbrush the denture cleaner or toothpaste and the denture solution if you are using it to the sink line the sink with a washcloth fill it partially with lukewarm water with the dentures still in the basin wet the brush you'll use apply a small amount of cleaner or toothpaste work with one denture at a time in the palm of your hand and brush all surfaces when the denture is clean rinse it under running lukewarm water and place it in the denture Cup repeat with the other denture if you'll be storing the dentures fill the denture cup to cover the dentures with either lukewarm water a mixture of mouthwash and water or a denture solution place the lid on the denture tub making sure it is secure I'm going to set your dentures right here okay then return the denture cup to the person's bedside table so it is within easy reach if the person will be wearing the dentures after they are cleaned return the emesis basin the dentures in the cup and the toothbrush to the over bed table if the side rails are in use lower the side rail on the working side of the bed offer the person the cup of water and a straw if desired so that the person can rinse the person may wish to use mouthwash instead of water hold the mises basin under the person's chin so that she can spit into it return the amita's basin to the over bed table and dry the person's mouth and chin with a towel with a toothbrush or foam tip applicator moistened with water or mouthwash clean the person's gums tongue and the inside of the person's cheeks ask the person to insert the dentures shall we put your dentures in now would you help me certain if the person needs assistance ask the person to open her mouth lift her upper lip with a gauze Square between your thumb and index finger grasp the upper denture and insert it then be sure the denture is seated properly then pull down the person's lower lip grasp the lower denture and insert it into the person's mouth finished by drying the person's mouth and chin with the towel and applying lip lubricant if requested return the empty denture cup to the person's bedside table making sure it is within easy reach to complete this procedure gather any soiled linens and place them in the soiled linen hamper clean and store the equipment and supplies dispose of disposable items remove your gloves wash your hands then complete your finishing up steps as described in the final section of this video patience our residents in your care who are unconscious will need frequent mouth care an unconscious person usually breathes with his mouth open drying the lips and mouth drying and cracking of the lips and tongue creates a portal of entry from microbes and is also very uncomfortable for the patient or resident so providing frequent oral care to a person who is unconscious helps to prevent infection and promotes comfort to provide oral care for an unconscious person begin by washing your hands taking any necessary standard precautions and gathering your supplies gloves paper towels paper cups a padded tongue blade and a Mises basin a towel and lip lubricant if the person is in dental is a player and saline if the unconscious person has natural teeth as demonstrated here you will also need a toothbrush and toothpaste or saline cover the over bed table with paper towels then put your supplies on the paper towels hi mrs. Berger I'm here to brush your teeth now fill a paper cup with water begin by positioning the bed at a comfortable working height to promote good body mechanics make sure the wheels are locked you might need to lower the side rail on the working side of the bed raise the head of the bed as high as the person can tolerate next put on your gloves turn the person's head to the side facing you in an unconscious person you must take care to prevent aspiration of fluids so the head should be turned to the side so that fluids will run out of the mouth not back towards the throat if the person's condition permits gently lift her head and place a towel on the pillow as demonstrated place a towel under the person's chin place the Amissah spacing on the towel level with the person's chin open the person's mouth using the padded tongue blade be gentle don't force the person's mouth open insert the blade between the upper and lower teeth at the back of the mouth to hold the mouth open then clean inside of the person's mouth brushing the teeth or if the person is a dentist cleaning the gums tongue and the inside of the cheeks with a foam tip applicator dipped in water or saline finish by drying the person's mouth and chin with the towel applying lip lubricant and repositioning the person comfortably to complete this procedure gather any soiled linens and place them in the soiled linen hamper clean and store the equipment and supplies dispose of disposable items remove your gloves wash your hands then complete your finishing up steps as described in the final section of this video while assisting with oral care be sure to notify the nurse if you observe any of the following cold sores or bleeding of the lips swollen or bleeding gums loose or broken teeth chipped cracked or poorly fitting dentures red sores or canker sores inside the mouth pus or white spots inside the mouth bad breath not improved by oral care fruity smelling breath or a red or swollen tongue or a white coating on the tongue clean skin is essential to health in the remaining segments of this video we will discuss bathing showers and tub baths are the preferred methods of bathing because they allow both for thorough cleansing and for sour rinsing whirlpool type baths go further and stimulate circulation which can help to maintain skin health in addition to being very relaxing as you assist a patient or resident with bathing be aware of how the person might feel the person might be embarrassed about needing help or about being touched by a stranger acknowledge those feelings by providing as much privacy as possible to help a person with a shower or tub bath prepare the room in advance first place a non-skid mat on the floor of the tub or shower place a towel over the chair in the tub room where the person will sit while drying off gather your supplies for the bath or shower soap washcloths towels clean clothing and any personal care products the person uses such as lotion powder deodorant or antiperspirant if you are planning to wash the person's hair remember to gather shampoo and conditioner if the person will be taking a bath fill the tub halfway with warm water before going to get the person many modern tub units have controls that preset the water temperature if the unit you are using does not have this feature use a bath thermometer to measure the water temperature it should be between 105 and 115 degrees Fahrenheit if the person is elderly the water temperature should be at the lower end of this range if the person will be taking a shower have demonstrated here the temperature should be the same and you'll need to make sure there is a shower chair in the room escort the person to the shower room and assist as needed if the person will be taking a shower help the person into the shower chair consider the use of a safety belt in accordance with the person's care plan and your facility's policy and remember to protect the person's privacy whenever possible if the person is unable to bathe himself or requires assistance put on the gloves then for mam it around your hand with one of the washcloths if you're assisting wash in this order pausing to rinse each area in turn before proceeding eyes face neck and ears arms and armpits chest and abdomen legs and feet back and buttocks and the perineal area remove your gloves and dispose of them in a facility approved waste container put on a clean pair then help the person to the towel cover chair wrap a towel around the person and then use another towel to help the person dry off paying special attention to areas where skin meets skin such as between the toes and fingers and underneath a woman's breasts after the person has been thoroughly dried assist him in applying any personal care products as requested assist the person in dressing as needed then assist the person back to his room to complete this procedure gather any soiled linens and place them in the soiled linen hamper clean and store the equipment and supplies remove your gloves wash your hands then complete your finishing up steps as described in the final section of this video some patients or residents are too weak or too ill for shower or tub baths in this case you'll bring bath supplies to the bedside and assist the person with bathing in bed to give a person to complete bed bath begin by washing your hands taking any necessary standard precautions and gathering your supplies gloves paper towels bed protectors oral hygiene supplies a bath thermometer a wash basin a bedpan or urinal soap washcloths towels a bath blanket and clean clothing you might also need lotion powder and deodorant or antiperspirant begin the bed bath by covering the over bed table with paper towels then put your supplies on the paper towels next put on your gloves position the bed at a comfortable working height to promote good body mechanics make sure the wheels are locked before the bath offer the person the bedpan or urinal then clean and store the item if necessary then wash your hands and put on a clean pair of gloves before proceeding help the person with oral hygiene as demonstrated earlier then remove the bedspread and blanket from the bed if they are to be reused fold them and place them on a clean surface spread the bath blanket over the top linens and the person either have the person hold the blanket or tuck it beneath his shoulders fan fold the top linens to the foot of the bed then assist a person with undressing lower the head of the bed so that the bed is flat as tolerated that okay position the pillow under the person's head fill the wash basin with warm water 110 to 115 degrees Fahrenheit and put it on the over bed table water in the basin can be hotter than water in a bathtub or shower because it cools off quickly and the person will not be immersed in it you might need to lower the side rail on the working side of the bed place a towel over the person's chest then for mam it around your hand with one of the washcloths wet the mitt with warm clean water from the basin ask the person to close his eyes place your washcloth mitt wet with water but without soap at the inner corner of the eye and Stroke outward use a different part of the washcloth for the other eye then dry both eyes but we all right if I use soap on your face or would you rather I did if soap is approved rinse the washcloth and apply soap to it then wash the face neck and ears during the bed bath you can prevent the water in the basin from becoming soapy too quickly by using two washcloths one to wash with soap and one to rinse without soap use the same two washcloths until you change the water in the basin then start with a new set rinse thoroughly and Pat the person's face neck and ears dry with a towel place a bed protector under the person's forearm to keep the linens dry continuing to use your washing washcloth for ma'am it around your hand wet it and apply a bit more soap start at the shoulder and work down towards the hand with long firm strokes then wash the hand next wash the axilla helping the person raise his arm if necessary rinse with the other non soapy washcloth then pat dry then repeat the procedure on the other arm then for privacy and warmth place a towel across the person's chest then fold the bath blanket beneath it down to the person's waist wet the mitt and apply soap reach under the towel and wash the person's chest be sure to look under the towel as you wash to check the skin for abnormalities rinse and pat dry next fold the bath blanket down further to the pubic area leaving the towel in place reach under the towel and wash the abdomen in the same fashion replace the bath blanket by unfolding it over the towel then slide the towel out from underneath if the water in the wash basin becomes cool or soapy change it you will need to raise the side rails if you are leaving the bedside next fold the blanket so that the person's far leg is completely exposed place a bed protector under the person's leg form a mitt wet the washcloth and apply soap start at the top of the thigh and Stroke towards the foot rinse and pat dry put the washbasin on the bed protector and put the person's foot in it wash the person's foot including between the toes rinse then pat dry being careful to dry thoroughly between the toes remove the bed protector and set up to wash the person's opposite leg and foot then repeat the wash rinse and dry change the water in the wash basin fill the wash basin with warm water 110 to 115 degrees Fahrenheit turn the person onto his side facing away from you help the person to move toward the working side of the bed adjust the bath blanket to keep the person mostly covered while exposing the area you are washing place a bed protector along the person's back starting with a fresh washcloth form another washcloth mint wet it and apply soap wash the person's back and buttocks moving from the top of the spine to the bottom rinse and pat dry at this point a back massage may be given if the person is able to wash his own perineal area place the bed protector under the person's buttocks and assist him into Fowler's position make sure the call line control Andover bed table are within easy reach how is that is that okay for you ask the person to call you when perineal care is complete go ahead and hit your call light for me whenever you're ready if the person is unable to wash the perineal area independently assist the person onto his back and complete perineal care as described later in this video when you return remove the bed protector can you let that remove your soiled gloves then help the person apply personal care products as requested such as lotion powder deodorant or antiperspirant help the person into clean clothing then remove the bath blanket at this time change any wet or soiled linens and perform range of motion exercises as ordered in the person's care plan to complete this procedure gather any soiled garments and linens and place them in the soiled linen hamper clean and store the equipment and supplies then complete your finishing up steps as described in the final section of this video nowhere is respect for your patients or residents privacy more important than when you provide care of the perineum that is cleaning around the anus and genitals in men the perineum extends from the root of the penis to the anus peroneal care involves cleaning this area as well as the penis and anus in women the perineum extends from the bottom of the vagina to the anus perineal care involves cleaning this area as well as the vulva and anus perineal care is included as a routine part of all bathing and showering regimens and is often provided more frequently on an as-needed basis the getting ready procedures for providing perineal care are very similar to those for a complete bed bath first wash your hands and take any necessary standard precautions gather your supplies for perineal care these will include gloves paper towels bed protector a bath thermometer wash basin bedpan or urinal soap washcloths towels a bath blanket and clean clothing position the bed at a comfortable working height and make sure the wheels are locked off of the bed pan or urinal lower the head of the bed to a flat position as tolerated and fill the wash basin with warm water 110 to 115 degrees Fahrenheit begin the procedure by asking a person to in his legs and if possible bend his knees if he can't bend his knees help him spread his legs as much as possible position the bath blanket over the person so that one corner can be wrapped around each leg position the bed protector under the person's buttocks lift the corner of the blanket to expose the perineal area form it around your hand with one of the washcloths wet the washcloth and apply soap using your other hand hold the man's penis away from his body if the man is circumcised used the washcloth to wash from the tip of the penis to the base moving in a circular motion repeat using a different part of the washcloth each time until the penis is clean there are two ways to rinse form another mint with a clean washcloth wet the washcloth and wipe the penis from the tip to the base using a different part of the cloth each time until the penis is rinsed or hold a clean washcloth soaked in warm water over the area squeeze water from the cloth onto the area then dry if the man is uncircumcised retract the foreskin by pushing it towards the base of the penis wash rinse and dry the tip and shaft of the penis as demonstrated then pull the foreskin back to its normal position over the head of the penis continue by forming a washcloth mitt wetting it and applying soap wash the scrotum and perineum rinse and dry when providing perineal care to a female patient or resident spread the labia then use your washcloth to Stroke from the top of the vulva down to the anus on one side then clean the other side using a different part of the washcloth then clean the center using another part of the washcloth each region should be individually cleaned with an unused section of the washcloth again there are two ways to rinse with a clean wet washcloth on one hand separate the labia with the other stroke the washcloth from the top of the vulva down to the anus in the same fashion as washing change to a different part of the cloth and repeat until the area is rinsed or hold a clean washcloth soaked with warm water over the area and squeeze water from the washcloth onto the area after rinsing dry with a towel to continue with perineal care turn the person on his side facing away from you help him toward the working side of the bed and adjust the bath blanket to cover form a mitt with the wash cloth wet it and apply soap with your other hand separate the buttocks use the washcloth to Stroke from the front of the body to the back repeat with a different part of the cloth each time until clean rinse and dry remove the bed protector remove and dispose of your gloves reposition the pillow under the person's head and help the person into clean clothing then remove the bath blanket if the bedding is wet or soiled change the bed linens to complete this procedure gather any soiled garments and linens and place them in the soiled linen hamper clean and store the equipment and supplies then complete your finishing up steps as described in the final section of this video when you have finished with a procedure always follow a routine of finishing up to ensure your patients are residents safety and comfort first confirm comfort and good body alignment whether the person is seated or in a bed leave the person's call light control within easy reach and do the same for any other items the person may want such as remote control devices the telephone or fresh water next seem to safety if appropriate return the bed to its lowest position then make sure the wheels are locked for safety and place the side rails in ordered or requested positions if desired open the curtain or door and ask whether the person would like for visitors to return if you use gloves first discard them according to your facility's policy then wash your hands finally report and record all pertinent information about the procedure including the date and time of the procedure and your full name and title you

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3 comments on “Hygiene

Thank You for posting all of these. You are a life saver!

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Excellent basics skills thank you

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