The document outlines essential hygiene, care, and grooming practices for patients unable to care for themselves, including bed baths, mouth care, and perineal care. It emphasizes the importance of comfort, cleanliness, and preventing infections, detailing procedures, precautions, and necessary equipment for various care tasks. Special attention is given to techniques for specific patient needs, such as those who are unconscious or post-operative.

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HYGIENE, CARE AND GROOMING
By Mr. Abraham A.(BScN,MScN)

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Bed bath
• Is a bath given to a patient who is unable to
give care for him/her self.
Purposes
• To promote comfort, relaxation and
cleanliness
• To stimulate circulation
• To prevent bad body odors feel
• To prevent pressure sores
• To relax and refresh the patient

3. 3
• To improve self image
• To give an opportunity for the nurse to
assess patients
• To prevent multiplication of pathogenic
micro organisms on the skin surface.

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Indication:
• Patients who are weak
• seriously ill and for pt that has
certain heart conditions
• unconscious, paralyzed or confused
patient

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Precautions
• Avoid scratching the skin with jeweler or long
sharp fingernails.
• Avoid harsh scrubbing, use of rough towel or
wash clothes.
• Assess the status & level of mobility.
• Maintain adequate privacy and warmth
throughout the procedure and drape
appropriately.
• Identify if there are limitation of movements
or position for pt.

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• Bath water must be warm enough and change
throughout the procedure when it becomes
cool, too soapy, dirty or after washing the
genital area
• Always wash from clean to dirty.
• Determine allergies to soap and other cream
lotion.
• Clean the eyes with water from the inner to
the outer cantus.

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Giving tub bath
• Type of bath that allow direct washing and
rinsing by using shower
• Shower: - The pt is assisted to the bathroom,
sits or stands and spray of water is usually
directed on to the body.

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Purpose
• To promote comfort relaxation and
cleanliness
• To stimulate circulation
• To prevent bad body odors
• To relax and refresh the patient
• Maintain muscle tone & joint mobility
• To prevent multiplication of pathogenic
micro organisms on the skin surface.

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Precautions
• Adjust temperature and flow of the water
• Avoid chilling
• Always keep bath room un locked
• Check pt frequently for sign of exhaustion.
• Make sure that the tub shower clean and
functioning
• Place disposable rubber or plastic materials on the
floor of the shower
• Instruct patient not to use oil during bath
• If sensation is normal, ask client to test water, and
adjust temperature if water is too warm

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Giving back care
• Is purpose full manipulation (massage) of the
muscle and tissues.
• It is also known as back message, back rub.
Purpose
• Provide psychological & physical comfort
(reduce tension, anxiety stress, stimulate and
relax muscles)
• Increase general and local circulation

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• Improves muscle and skin functioning
• Prevent bedsore.
• To relieve insomnia(inability to sleep)
• It provides opportunity for the nurse to
assess the patient condition.

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Precautions
1.Massage pressure areas gently, massage the
back by using appropriate technique.-duration
of massage should not exceed 20 minutes
2. Repeated back massage may possibly cause
subcutaneous tissue degeneration.
3. Frequent positioning is preferable to back
massage
4. Inspect skin areas of pressure points for
whitened or reddened areas that do not
disappear after rubbing.

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5. Covering areas not being massaged &
prevent unnecessary exposure
6. Lubricating palms to decreases friction
on skin during massage.
7. Identify location of bony prominences to
avoid direct pressure
NB- Circular movement should be used on
bony prominences.

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Mouth care
Mouth care: - Care of the mouth which
includes brushing the teeth, mouth and
tongue with mouth wash solution and rinse it
with water
Routine mouth care:- is providing oral care at
least three times a day for hygienic purpose.
Special mouth care: - Is a care given to entire
mouth, teeth, tongue and gum in an increased
frequency using mouthwash solution for
helpless patient.

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Purpose
• Keep the mouth clean and fresh, which
provide the pt sense of well being.
• Stimulate appetite
• Prevent dental decays & halitosis (bad
breath)
• Remove food particles, dead epithelial cells,
microorganisms from around and b/n the
teeth tongue & lips.
• Prevent inflammation of tongue, gums & oral
mucous.

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• Prevent spread of infection to other parts
of the body
Indications for special mouth care
• Is un conscious
• Is not taking oral food or fluid
• Has mouth infection or inflammation
e.t.c.

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Equipment
• Solutions
Sodium bicarbonate solution ½ Tsp in
250 ml, of water
Hydrogen per oxide solution
Glass of Clean water
Normal saline solution
Lemon juice
Other mouth wash solution if a specially
ordered.

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• Mouth gag
• Emesis basin
• Glycerin/petrolatum
• Cotton tipped application
• Receiver
• Towel
• Tissue paper or piece of gauze
• Denture care cup

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• Toothbrush and paste
• Forceps
• Sputum mug
• Tongue depressor wrapped with gauze
bandage
• Lubricate (liquid paraffin or mineral oil,
cold cream, glycerin , Vaseline)
• Drinking tube (straw)

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Procedure
1. Explain procedure to the patient and
wash your hands
2. Have all equipment read on the bed side
table
3. Set on the semi sitting position and up
the head of the bed
4. Place towel under patient’s chin across
his/her chest
5. Turn patient’s head to the side and
arrange basin at corner of the mouth

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6. Dip applicator in mouth washes solution
and cleans the inside of the mouth, the
tongue, and the teeth gently and
carefully.
7. Discard the swab.
8. If the teeth are difficult to clean, a larger
swab can be used. This is done by
Wrapping several turns of cotton around
a tongue depressor.

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9. If the tongue or lips are dry and cracked,
moisten an applicator with lubricant and
gently wipe them with mineral oil, liquid
paraffin, Vaseline or any suitable cream.
A mixture of lemon and glycerin is also
good.
10. If he/she is unconscious, hold the
mouth open with a tongue depressor
padded with gauze.

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11. This care should be done in the morning, at
night and after each meal if possible.
12. Wait at least ten minutes after patient has
eaten to prevent nausea. Do not go far back
on the patient’s tongue as it may gag him.
13. Chart – procedure, time and observation.

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Care of dentures
• it is a care for artificial teeth.
Purpose
• To Freshens mouth and facilitates intake
of solid food.
• To remove microorganisms

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Assist client with denture removal:
Top denture:
• With tissue, grasp the denture with thumb and
forefinger and pull downward.
• Place in denture cup.
Bottom denture:
• Place thumbs on the gums and release the
denture. Grasp denture with thumb and
forefingers and pull upward.
• Place in denture cup
After cleaning assist client in replacing dentures

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Giving bedpan and urinals
• Giving bedpan and urinals is the process of
giving bedpan or urinal for pts in bed.
Purpose
• To provide receptacle for elimination of waste
material for clients confined to bed.
• To obtain specimen of urine or stool for
laboratory examination.
• To obtain an accurate measurement or
assessment of the client’s urine or stool.

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Indication
• Bed ridden patients
• Patient with problem of the spine
• Patient with cast or fracture
• For critically ill patients
• Post operative patients

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Type of bed pans
• Regular bed pans-made of metal or hard
plastic ,has a curved smooth upper end
and tapered lower end
• A fractured pan- designed for clients
with body or legs casts or clients
restricted from raising their hips

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Type of urinals:
• Males
• Females
Time
• Early morning, after each meal and at bed
time-PRN (when required).
• For maternity patients four hourly during the
day.
• For patients with diarrhea or dysentery-PRN
(when ever necessary).
• In case of frequency of urine-PRN

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Perineal care
• Perineal care:- is a cleaning procedure
prescribed for cleansing the perineum and
genitalia of male or female patient. It can be
clean or sterile procedure.
• Routine Perineal care: - Is done for hygienic
purposes routinely twice a day and more
frequently during menstruation and excess
vaginal discharge.

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• Special Perineal care: - Is a care given after
various procedures for therapeutic and
preventive purpose using strict aseptic
technique.
Purpose
• To remove normal perinea secretions and
odors
• To prevent infection
• To promote client comfort
• To facilitate healing

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• To prevent irritation and ulceration of the
genitalia
Indication
• Infection on the genital and perineum
• Surgery of the genitalia and perineum
• Post delivery
• Incontinent patients
• pts with indwelling catheter
• Abnormal or un pleasant discharge from the
genitalia

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Equipment
1. Pitcher or container with warm water
2. Prescribed solution
3. Sterile forceps or glove
4. Protecting materials ,draw sheet
5. Gauze swabs
6. Perineal pad
7. Bowl or kidney basin
8. Bed pan/urinals
9. Screen

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Procedure
1. Prepare tray or trolley with the above
equipment, cover & take to patient’s room.
2. Explain procedure to patient.
3. Assist patient to use bedpan.
4. Remove soiled pad and place in bowel or
kidney basin.
5. Move tray or trolley near bed.
6. Fold the blanket to foot of the bed

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7. Flex patient’s knees and cover with top sheet.
8. Take the sterile cotton swabs with forceps,
pour solution on the cotton and clean
perineum using downward strokes. Use only
one cotton swab for each strokes.
9. Repeat cleansing the perineum pouring the
solution over the genitalia.
10. Avoid hurting the perineum with the
forceps. Be careful with episiotomies stitches

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11. Dry perineum and genitalia thoroughly using
cotton swabs. If patient has episiotomy
observed for any signs of infection – swelling,
discharge etc. medicated powder or solution
may be applied according to the orders.
12. Remove bedpan
13. Turn patient on one side and dry anal area.
14. Place perineal pad across perineum.

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15. Avoid contaminating the inner side of pad
16. Apply T – Binder ( as needed)
17. Straighten bed and leave patient
comfortable
18. Remove soiled article, clean and return to
their proper places. Perineal swabbing should
be done at least three times daily and each
time following bowl movement.

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Sitz bath
• A sitz bath can refer to a bath where the
pelvic region is immersed in warm water
Purpose
• To cleanse perineal area
• To soothe perineal area
• To reduce sign of inflammation of
perineal ,vaginal area after child birth

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• Cleanse and soothe and reduce inflammation
after vaginal or rectal surgery
• Hemorrhoids or fissures
Indication
• Following surgery in anorectal region
• Following incision in the perineal(episiotomy)
• Swollen painfull hematoma

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Contraindication
• DM
• Impaired peripheral sensory function
• Immediate post hemorroidioctomy

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Equipment
1. Large Basin
2. Fenestrated chair (sitz bath chair)
3. Glove
4. Bath thermometer
5. Tissue paper or towel
6. Common Medication (Common salt,KMnO4,
Betadine solution)

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Procedure
1. Check for specific order
2. Assemble equipment and take to the bath
room ( may be given in the room in mobile
sitz bath chair if available)
3. Clean tub and fill half – full.
4. Check temperature of water (must be as
patient can bear).
5. Close windows and explain procedure to
patient

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6. Take patient to the bathroom and assist to
undress as necessary.
7. Assist patient to sit in a big bowl of warm
water or in a tub.
8. Observe patient’s condition and check pulse.
Discontinue treatment if patient feels dizzy.
9. Avoid chilling, drape shoulders with bath
towel.
10. Allow pt to stay in the water for about 20 –
30 minutes, check patient frequently.

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11. Assist patient to dry, dress and return
to room.
12. Clean bowl or tub and discard used
linen.
13. Apply dressing if needed.

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Hand and foot care
• Feet and nail often need special attention.
• Assess the appearance of feet & nail to
identify existing problems or clients at risk of
developing foot or nail problems.
Purpose:
• To prevent the client’s hands and feet odour
• To have soft, hydrated skin.
• To maximized functional ability of hands and
feet.

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• To make client comfort and relax.
Indication:
• Paralyzed client and geriatric .
• People with diabetic mellitus and clients with
poor circulation are at high risk for foot
difficulties/ problems.

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Facial hair shaving
• facial hair removal of male client that un
able to complete self-care.
Purpose :
• to well groomed the client.
• To keep skin integrity

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Assisting individuals to dress
Purpose:
1. To maintain client self esteem
2. To providing protection
3. To promote the client’s dignity
• Equipment
1. Suitable clothes
2. Mirror
3. Screen

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Procedure
1. Assist the client to select suitable clothes. This
may be their own personal clothing or
clothing from the clinical area’s supplies.
2. Ensure privacy
3. Assist client to remove soiled clothing, outer
garments first. If necessary assist in cleansing
prior to redressing.

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4. Have clothing available and ready to use. If
client has limited mobility or limb injuries as
identified during their mobility assessment
remove clothing from unaffected side first.
5. Be aware of wounds, drains and indwelling
catheters when removing clothing and re-
dressing client.
6. Give the client time, and encourage them to
perform as much of the activity as possible.

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7. Remove clothing in a systematic way,
e.g. top to bottom, replacing with clean clothing
as each item is removed.
8. Choose clothing with easy fitting fastenings.
9. Give client access to mirror to check overall
appearance
10. Ensure client is left comfortable. Record any
changed care needs in nursing record.

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Giving hair Care
• Hair care is an important part of daily hygiene
care it includes brushing and combing of the
hair.
Purpose
• To stimulate scalp circulation
• To maintain cleanliness of the hair & scalp
• To prevent the presence of lice & nits
• To provide pleasure and feeling of self-stem.

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Equipment
• Brush and comb
• Towel & oil or Vaseline
Procedure
1. Place patient in comfortable position
2. Place towel on top of pillow under patient’s
head and shoulder.
3. If hair is badly tangled, comb small part at a
time. Oil or Vaseline may be applied to
untangle the hair.

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4. If the hair is long, it should be braided and
fastened with rubber band.
5. Observe carefully for pedicli or nits
6. Remove towel and leave patient comfortable.
7. Remove hair from comb & brush, wash and
dry.

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Hair shampoo
• Hair shampooing is the washing of the hair in
bed or out of bed
Purpose
• To remove dirty
• To prevent offensive odour
• To stimulate circulation of the scalp
• To keep the hair and scalp cleaned and
healthy
• To treat condition of the hair and scalp

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• To provide comfort and good appearance
Precaution
• Determine the facilities available for the
procedure and the pts condition (pt may have
their hair shampoo during a bath or a shower. If
pt is bed ridden the shampoo may be performed
with the pt in bed or lying on a trolley)
• Use devices to protect neatness of the bed and
pts gown
• Observe condition of the pt. throughout the
procedure.

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Giving pediculosis treatment
• Pediculosis is a condition in which the hair is
infested with lice or pedicles.
• pediculosis treatment: - is an application of
pesticides such as gamma benzene hexachord
(BHC)
Purpose
• To kill and remove pedicles and nits from head
and hair
• To prevent transmission of pedicles.
• To make patient comfortable

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Precaution
• Avoid treatment from interring the eyes, nose
and throat
• Apply Vaseline on the fore head to prevent
irritation
• Instruct the pt not to wash before 12 – 24 hrs
• Contact family member of the pt and treat
them as well.
• Teach the pt and pts relative the importance
of keeping the hair and the body clean.
• Hands must be washed after scratching the hair.

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Equipment
1. Gown and cap (for the nurse)
2. Rubber sheet and cover
3. Bowel with swabs -
4. Gauze or cotton
5. Bowel with Vaseline
6. Bowel with medicine to be applied
7. Kidney tray
8. Comb or fine-toothed comb
9. Dustbin
10. Cape to cover patient after treatment

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Procedure
1. Position patient conveniently
2. Wear gown and cap to protect yourself.
3. Place towel and rubber sheet over pillow.
4. Apply Vaseline to forehead and around the
edges of hair to prevent skin reaction.
5. Apply medication on entire head

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6. Wrap head with head cover or clean scarf and
leave for several hours (12-24hrs) wash hair.
7. Comb hair with fine tooth comb to remove
dead lice.
8. Chart – treatment, time and observation
9. Repeat treatment as needed.
10. Collect used rubber and cover, Send to the
laundry separately.

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Care of eyes
• a care given for eyes with aseptic technique
Purpose
• To prevent infection
• To remove foreign bodies
Indication
• client’s with artificial eye
• Comatose patients

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Equipment
1. Sterile eye-dressing packs
2. Sterile 0.9 per cent sodium chloride
3. Tray for equipment
4. Clinical waste bag
5. Gloves (if risk of contact with blood or body
fluids).
6. Apron

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Procedure
1. Explain procedure to client
2. Apply apron and wash hands
3. Gather all equipment
4. Ensure privacy for the client
5. Ensure good light source
6. Assist the client into a comfortable position
7. Prepare equipment, wash hands
8. Cover the client’s chest using the towel from
dressing pack

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9. Instruct client to close their eyes
10. Moisten swab in the solution and gently
swab from the inner canthus outwards, using
one wipe. Repeat in the same direction until
the eye is free from crusts/discharge. Repeat
on the other eye, all the time observing the
general condition of the eyes
11. If the client has an infection, wash hands
before moving from one eye to the other and
always swab the non-infected eye first

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12. If the eye is to be touched to remove a
foreign body, a cotton bud should be used
13. Gently dry the client’s eyelids
14. Remove and dispose of equipment safely
15. Leave the client comfortable. Remove apron
and wash hands
16. Evaluate care delivery, document and report
any change in client’s condition
17. Update care plan as necessary

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Ear care/irrigation
• Ear irrigation is the process of flushing the
external ear canal with sterile water or sterile
saline.
Purpose
• To remove ear wax or foreign object lodged
in the ear canal.
• Less invasive than using an instrument

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Precautions
• The ear canal should be examined with an
otoscope prior to ear irrigation
• Ear irrigation is contraindicated if the
eardrum is ruptured, because the procedure
may force bacteria through the perforation
into the inner ear

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• Ear irrigation is also contraindicated in
patients with fever and ear pain, as these
symptoms may indicate an inner ear infection.
• If a foreign object is made of vegetable
matter (e.g., a bean or pea), irrigation is
contraindicated because the water will cause
the object to swell and complicate extraction
of the object.

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Equipments
• Irrigating solution at room temperature:
Example Luke water
• A container for the solution.
• A syringe or bulb suction(50–60-cc syringe
(20–30-cc syringe for children) or ear
irrigation set)
• A small basin/kidney dish as receiver

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• A towel
• cotton ball
• Hydrogen per oxide solution
Procedure
1. Wash your hands
2. Wipe out the ears with a clean wash cloth
and remove the excess wax. Usually you can
loosen the wax by pulling the ear lobe
downward.

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3. If the wax can still not be dislodged, you may
need to irrigate the ear canal.
4. To irrigate ear
a) Fill the syringe or bulb suction with the
irrigating solution
b) Gently pull the ear lobe up and back to
straighten out the ear canal, so that the
solution can flow through the whole canal.

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c) Put towel on shoulder at the side of ear
to be clean
d) Insert the tip of the syringe or bulb
suction into the ear and very gently
direct the solution into the canal.
e) Let the solution drip out with the kidney
dish at the ear side and be sure the
syringe does not block it

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5. When you have finished, wipe the
outside of the ear and ask the patient to
turn onto one side with the ear down.
6. Put a towel under the ear to keep the
bed dry.