Hygiene And Personal Care. Nail Care. By Sharon Leverton
DefinitionPersonal hygiene is the physical act ofcleaning the body to ensure that theskin, hair and nails are maintained in an optimum condition
Areas Of Care To Consider• Skin• Perineal/Perianal• Hair• Eyes• Mouth• Ears and nose• Nails and feet
Skin• This is the largest organ of the body. Maintaining its integrity is essential to the prevention of infection• Its made up of three layers: Epidermis, Dermis and Deep subcutaneous
Considerations• Nutritional state• Incontinence• Age, health and mobility status• Treatment therapies• Any current conditions
Pressure Sores• A pressure ulcer is localised injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear/friction.
Common Areas Of Pressure Sores BEST SHOTB- ButtocksE- Ears and elbowsS- SacrumT- TrochanterS- SpineH- HeelsO- Occipital areaT- Toes
Stage 1 Pressure SoreIntact skin with non-blanchable redness of alocalised area usually over a bony prominence.Darkly pigmented skin may not have visibleblanching; its colour may differ from thesurrounding area. The area may be painful, firm,soft, warmer, bluish tinge.
Stage 2 Pressure SorePartial thickness loss of dermis presenting as ashallow open ulcer with a red pink wound bed.May also present as an intact or open/rupturedserum-filled blister.Presents as a shiny or dry shallow ulcer withoutslough or bruising- Bruising indicates deeptissue injury.
Stage Three Pressure SoreFull thickness tissue loss. Subcutaneous fat maybe visible but bone, tendon or muscle are notexposed. Slough may be present but does notobscure the depth of tissue loss. May includeundermining and tunnelling.
Preventative Measures SSKINS- Surface. Get the right supportS- Skin inspectionK- Keep movingI- Incontinence/moistureN- Nutrition and fluid
Cleansing An Area And Things To Consider• Soap/water• Emollient creams• Moisturisers• Level of independence• Consent• Respect, culture, religion• Privacy
Perineal/perianal area- problems arising fromtreatment therapy i.e radiotherapy, fistula,diarrhoea, constipation and UTI’sPatients should be encouraged to perform this taskfor themselves if at all possible.Hair- Grooming hair is an ideal opportunity toobserve, dandruff, psoriasis, flaky skin and headlice. The way we look has an impact on our generalwellbeing.
Eye care- with age and some conditions eyes can sufferfrom dryness. Prescribed eye drops and gentle cleaningcan prevent infection and help keep the eyes moist.Consider-glasses and contact lensesMouth- common problems with this area are dry mouth,chewing and swallowing difficulties, infection, halitosisConsider- illness/medication, dental/denture problems,nutrition and fluid intake, smoking cessation. OralHygiene and mouth washes.
Ears and nose- lack of attention to cleaning the ears andthe nose can lead to impairment of senses. Gentlecleaning with wool or gauze should be sufficient to keepthe areas clean and free from wax and deposits. DO NOTPUSH COTTON BUDS INTO THE EAR CANAL.Consider- hearing aids, piercings, infections and otherillnesses i.e vertigoNails and feet- these areas need special care to avoid painand infection. Nails should be clean and trimmed withappropriate equipment. Get advice from a chiropodist ifappropriate. Always wash between toes and ensure areais completely dry to avoid fungal infection.Consider- Diabetes, skin integrity, ulcers, corns andbunions, hardening of the nails and body image.
Final wordThere is a risk that personal hygiene of patientsmay become devalued or just another routine,however personal hygiene is an integral part of the holistic approach to treatment care.How would you feel if you were unable to wash,dress and cleanse yourself to the standard that you were used to?