INTRODUCTION:

PERSONAL HYGIENE

MARY GRACE L. ARAULLO RN MSCPD

 OBJECTIVES

1. Describe hygienic care that nurses provide to clients.

2. Identify factors influencing personal hygiene.

3. Identify normal and abnormal assessment findings while providing

hygiene care.
WHAT IS HYGIENE?

• Hygiene is a highly personal

matter determined by individual
values and practices. It involves
care of the skin, feet, nails, oral
and nasal cavities, teeth, hair,
eyes, ears, and perineal-genital
areas.
 WHAT IS PERSONAL HYGIENE?

Affects patients' comfort, safety, and well-being.

Is the self-care by which people attend to such functions as bathing,

toileting, general body hygiene, and grooming.

Personal hygiene activities such as taking a bath or shower and brushing and flossing the
teeth also promote comfort and relaxation, foster a positive self-image, promote healthy
skin, and help prevent infection and disease. Healthy people are usually able to meet their
own hygiene needs.
 IMPORTANCE

It is important for nurses to know Physical or cognitive impairments

exactly how much assistance a client and emotional challenges often
needs for hygienic care. Clients may cause individuals to need some
require help after urinating or degree of assistance with hygiene
defecating, after vomiting, and care. A variety of personal, social,
whenever they become soiled, for and cultural factors influence
example, from wound drainage or hygiene practices.
from profuse perspiration.
 IMPORTANT THINGS TO CONSIDER

Assess a patient's ability to perform self–hygiene care according to individual needs and preferences.

Adaptations may be needed for hygiene techniques and approaches for patient care.

Integrate nursing assessments and interventions during hygiene care with nursing activities such as range
of motion (ROM), dressing changes, and inspection and care of intravenous (IV) sites.

Because hygiene care requires close contact with your patients, use communication skills to build caring,
therapeutic relationships.

Provide any needed teaching or counseling for patients. During hygiene care ensure privacy, convey
respect, and provide safety and comfort.
HYGIENIC CARE • EARLY MORNING CARE is provided to clients as they awaken in
the morning. This care consists of providing a urinal or bedpan to
the client confined to bed, washing the face and hands, and giving
oral care. Morning care is often provided after clients have
breakfast, although it may be provided before breakfast. It usually
includes providing for elimination needs, a bath or shower, perineal
care, back massages, and oral, nail, and hair care. Making the
client’s bed is part of morning care.
• HOUR OF SLEEP OR PM CARE is provided to clients before they
retire for the night. It usually involves providing for elimination
needs, washing face and hands, giving oral care, and giving a back
massage.
• AS-NEEDED (PRN) CARE is provided as required by the client. For
example, a client who is diaphoretic (sweating profusely) may need
more frequent bathing and a change of clothes and linen.
FACTORS
INFLUENCING
INDIVIDUAL HYGIENIC
PRACTICES
 SOCIAL PRACTICES
Social groups influence hygiene preferences and practices, including the type of hygiene products
used and the nature and frequency of personal care practices. An example is the choice by
adolescent girls of the type of sanitary pads used during menstruation (Kamaljit et al., 2012).

Parents and caregivers perform hygiene care for infants and young children. Family customs play a
major role during childhood in determining hygiene practices such as the frequency of bathing, the
time of day bathing is performed, and even whether certain hygiene practices such as brushing the
teeth or flossing are performed.
As children enter adolescence, peer groups and media often influence hygiene
practices. For example, some young girls become more interested in their personal
appearance and begin to wear makeup.
During the adult years involvement with friends and work groups shapes the
expectations that people have about personal appearance. Some older adults' hygiene
practices change because of changes in living conditions and available resources.
 PERSONAL PREFERENCES

Patients have individual Patients select different hygiene

preferences about when to and grooming products according
perform hygiene and grooming to personal preferences. Knowing Culture plays a role in sensitivity to
care. Some patients prefer to patients' personal preferences personal space and gender.
shower, whereas others prefer to promotes individualized care.
bathe.

Help a patient develop new

hygiene practices when indicated Safe and effective patient-
by an illness or condition. For centered nursing care improves
example, you may need to teach a patient satisfaction and health and
patient with diabetes proper foot reduces costs (Burman et al.,
hygiene or a bariatric patient 2013).
adaptive bathing methods.
 BODY IMAGE

Body image is a person's subjective concept of his or her body, including physical appearance, structure, or function.

Body image affects the way in which individuals maintain personal hygiene. If a patient maintains a neatly groomed
appearance, be sure to consider the details of grooming when planning care and consult with the patient before making
decisions about how to provide hygiene.

Patients who appear unkempt or uninterested in hygiene sometimes need education about its importance or further assessment
regarding their ability to participate with daily hygiene.

Surgery, illness, or a change in emotional or functional status often affects a patient's body image.

Discomfort and pain, emotional stress, or fatigue diminish the ability or desire to perform hygiene self-care and require extra
effort to promote hygiene and grooming.
 SOCIOECONOMIC STATUS
A person's economic resources influence the type and extent of hygiene practices used. Be
sensitive in considering that a patient's economic status influences the ability to regularly
maintain hygiene. He or she may not be able to afford desired basic supplies such as
deodorant, shampoo, and toothpaste.

A patient may need to modify the home environment by adding safety devices such as
nonskid surfaces and grab bars in the bath to perform hygiene self-care safely.

When patients lack socioeconomic resources, it becomes difficult for them to participate and
take responsible roles in health promotion activities such as basic hygiene.
 HEALTH BELIEFS AND MOTIVATION

Knowledge about the importance of hygiene and its implications for well-being influences hygiene practices. However,
knowledge alone is not enough. Motivation also plays a key role in a patient's hygiene practices.

Patient teaching is often needed to foster hygiene self-care. Provide information that focuses on a patient's personal health-
related issues relevant to the desired hygiene care behaviors.

Patient perceptions of the benefits of hygiene care and the susceptibility to and seriousness of developing a problem affect the
motivation to change behavior (Pender et al., 2011).

For example, do patients perceive that they are at risk for dental disease, or that dental disease is serious, and that brushing
and flossing are effective in reducing risk? When they recognize that there is a risk and that they can take reasonable action
without negative consequences, they are more likely to be receptive to nurses' counseling and teaching efforts.
 ➢People from diverse cultural backgrounds (e.g., level of
education, gender preference, geographic location) frequently
follow different self-care practices.
➢For example, maintaining cleanliness does not hold the same
importance for some ethnic or social groups as it does for
others (Giger, 2013). In North America many are fortunate to
be able to bathe or shower daily and use deodorant to
prevent body odors. However, people from some
CULTURAL socioeconomic or cultural groups are not sensitive to body
VARIABLES odors, prefer to bathe less frequently, and do not use
deodorant.
➢Do not express disapproval when caring for patients whose
hygiene practices differ from yours. Avoid forcing changes in
hygiene practices unless the practices affect a patient's health.
In these situations use tact, provide information, and allow
choices. Some homeless people may be reluctant to remove
shoes for bathing or to check for skin breakdown. Their feet
may be edematous or have neuropathic symptoms
 • The normal process of aging
affects the condition of body
tissues and structures. A patient's
DEVELOPMENTAL
STAGE developmental stage affects the
ability of a patient to perform
hygiene care and the type of
care needed.
 PHYSICAL CONDITION

Patients with certain types of physical limitations or disabilities associated with disease and
injury lack the physical energy and dexterity to perform hygiene self-care safely. A
patient whose arm is in a cast or who has an IV line needs help with hygiene care. A
weakened grasp resulting from arthritis, stroke, or muscular disorders makes using a
toothbrush, washcloth, or hairbrush difficult or ineffective.

Sensory deficits not only alter a patient's ability to perform care but also place the patient
at risk for injury. Safety is a priority for a patient with a sensory deficit. For example, the
inability to feel that the water is too hot can lead to a burn injury during bathing.
 PHYSICAL CONDITION

Chronic illnesses such as cardiac, pulmonary, and neurological diseases; cancer; dementia; and some mental
health illnesses often exhaust or incapacitate patients.

Patients who become tired or short of breath frequently need to have complete hygiene care provided.
Include periods of rest during care to allow patients who are tired the opportunity to participate in their
care.

Pain often accompanies illness and injury, limiting a patient's ability to tolerate hygiene and grooming
activities or perform self-care. Pain frequently limits ROM, resulting in impaired use of the arms or hands or
limited ability to move about in the environment, impairing the ability to perform hygiene self-care.

Sedation and drowsiness associated with analgesics used for pain management also limit a patient's ability
to safely participate in care.
 PHYSICAL CONDITION

Limited mobility caused by a variety of factors (e.g., obesity, physical injury,

weakness, surgery, pain, prolonged inactivity, medication effect, and presence
of medical devices [e.g., indwelling catheter, feeding tube, or IV line]) decreases
a patient's ability to perform hygiene self-care activities safely.

Individualized care considers a patient's ability to perform care, the amount of

assistance needed, and the need for assistive and safety devices to facilitate
safe hygiene care.
 PHYSICAL CONDITION
Acute and chronic cognitive impairments such as stroke, brain injury,
psychoses, and dementia often result in the inability to perform self-care
independently.

When people with cognitive impairments are unaware of their hygiene and
grooming needs, they become fearful and agitated during hygiene care,
resulting in aggressive behavior (Zimmerman et al., 2014).

Safe, effective patient care takes the effect of cognitive impairment on

hygiene care into consideration and allows for appropriate modifications.
DEFINITIONS AND
DESCRIPTORS FOR
FUNCTIONAL LEVEL