Personal Care

last authored: Jan 2009, Brett Nissen
last reviewed:

 

 

beds and bedmaking

perineal care

 

Introduction

 

*** REMEMBER TODAY: Dignity Independence Privacy Preferences Safety***

 

 

AM and PM Care Tasks

#1 ALWAYS CHECK CARE PLAN FIRST.

#2 Collecting all required equipment ( Clean linens, Preventative _and_ Procedural
Equipment )Preparing for asepsis ( Clean , Disinfected , Sterile ) Predict potential difficulties and variables, SOLVE PROBLEMS WELL

#3 ** Knock on door. Address client according to employer policy.

#4 ** WASH HANDS and WEAR GLOVES

#5 ** Offer Hearing Aids and Eyeglasses

#6 "RAISE BED to Appropriate Working Height" for CCA Compassionate Caregiving

ALWAYS OFFER CALL BELL CLOSE BY

ALWAYS remember to LOWER BED EVERY TIME when exiting the client's room

 

 

 

 

Giving a Partial Bath

  • pre-procedure
  • procedure
  • post-procedure

Pre-Procedure

** REMEMBER TO ENCOURAGE THE CLIENT TO BE INVOLVED WITH THEIR CARE. ASSIST THEM AS THEY CAREFULLY CLEAN THEIR BODY. FOCUS ON ABILILITIES. **

Procedure

#2 See the care plan to ensure bed positioning. Make sure bed is at appropriate working level.

#3 ASSIST CLIENT WITH ORAL HYGIENE.

#4 Remove top linen. Cover the client with a bath blanket.

#5 Place paper towels on the overbed table (in facilities) or on a work are the client can easily reach from the bedside.

#6 Fill the wash basin with water. Water temperature should be warm as directed by the supervisor and client's care plan. Test the temperature by dipping your elbow into the water basin.

#7 Place the basin on the overbed table or work area.

#8 Position the client in Fowler's position OR assist him or her to the bedside.

#9 Adjust the overbed table so that the client can reach the basin and supplies.

#10 Help the client undress. Remember: Remove Unaffected arm and leg First (R.U.F.)

#11 ASK the client to wash easy-to-reach body parts.

#12 Place the CALL BELL within reach. REMIND the client to use it when they need help and are done bathing.

#13 WASH HANDS and STAY WITHIN HEARING DISTANCE (ONLY if it is safe to do so.)

#14 Return when the client calls for assistance. KNOCK BEFORE ENTERING.

#15 Change the bath water.Test the temperature by dipping your elbow into the water basin.

#16 Raise the bed to a comfortable working height.

#17 ASK the client to specify which parts were washed by him or her. Wash and DRY areas the client could not reach. Be sure to dry the client well to ensure skin integrity. The face, hands, underarms, back, buttocks, and genital and rectal areas (perineal area) are washed for the partial bath. Wear gloves for perineal care.

#18 Give a back massage.

#19 Apply deodorant as requested by the client.

#20 Help the client put on clean garments.

#21 Assist with hair care.

#22 Assist the client to a chair. Otherwise, turn the client onto the side away from you.

#23 Make the bed.

#24 Return the bed to its lowest position.

Post-Procedure

#25 Provide for safety and comfort.

#26 Place the CALL BELL within reach.

#27 Follow the CARE PLAN for bed rail use.

#28 Empty and clean the basin. Return the basin and supplies to their proper places.

#29 Wipe off the overbed table with paper towels. Discard the paper towels.

#30 Follow the employer policy for dirty linen.

#31Wash hands.

#32 Report and record your actions and observations, according to the employer policy.

return to top

 

p. 593 GIVING CATHETER CARE

 

<pre-procedure>

 

#1 Identify the client, according to the employer policy.

#2 Explain the procedure to the client.

#3 Wash Hands and Wear Gloves when necessary.

#4 Collect items for perineal care p. 544

#5 Provide for privacy (draw curtians on windows, privacy curtain, and close door according to employer policy)

#6 Raise bed to a comfortable working height. Follow the care plan for bed rail use.

 

<procedure>

 

#7 Lower the bed rail near you.

#8 PUT ON GLOVES.

#9 Cover the client with a bath blanket. Fanfold top linens to the foot of the bed.

#10 Drape the client for perineal care (position blanket like a diamond shape draped from corner of blanket at chest and other corner of blanket at the private area).

#11 Fold back the bath blanket to expose he genital area.

#12 Place the bed protector under the buttocks. ASK the client to flex the knees and raise the buttocks off the bed.

#13 Give perineal care (use clean wet soapy cloth with one gentle swipe down labia on both sides and one gentle swipe down the centre on a female client OR retract the foreskin on a male client, wiping once at the tip of the penis and clean the shaft of the penis with two gentle firm downward strokes, clean the scrotum and rinse well).

 

#14 Be sure to rinse and dry well the perineal are of each client while checking for the presence of crusts and abnormal drainage, or secretions.

#15 Hold the cather near the meatus insertion point (to ensure the catheter is not pulled).

#16 Clean the catheter from the meatus down the catheter about 4 inches (double finger length) with clean wash cloth. DO NOT TUG OR PULL THE CATHETER.

#17 Rinse the catheter. Clean from the meatus down the catheter with one stroke. DO NOT TUG OR PULL THE CATHETER. Ensure the outside of the catheter tubing is dry.

#18 Secure the catheter to the fitted sheet on the bed and hang catheter bag in appropraite spot on lower bed rail. (When reporting and recording of urine is requested by supervisor, include:

#19 Remove the bed protector.

#20 Cover the client with top sheet and bed spread. Remove the bath blanket.

#21 Remove gloves and wash hands.

 

<post-procedure>

 

#22 Provide for safety and comfort.

#23 Place the call bell within reach.

#24 Return the bed to its lowest position. Follow the care plan for bed rail use.*

#25 Clean and return equipment to its proper place. Discard disposable items. (Wear gloves for this step).

#26 Remove privacy measures.

#27 Follow employer policy for soiled linen.

#28 Wash hands with soap and water approximately 20 seconds.

#29 Report and record your actions and observations, according to employer policy.

 

p. 623 Changing and Ostomy Pouch (Colostomy and Ileostomy)

 

<pre-procedure>

 

#1 Identify the client, according to the employer policy.

#2 Explain the procedure to the client.

#3 Wash Hands and Wear Gloves when necessary.

4 Collect the following:

5 Arrange paper towels on a work area. Place items on top of paper towels.

6 Provide for privacy.

7 Raise bed to a comfortable working height. PROTECT YOUR BACK USING PROPER BODY MECHANICS. Follow the care plan for bed rail use.*

8 Lower the bed rail near you, if it is up.

9 Cover the client with a bath blanket. Fanfold linens to the foot of the bed.

10 Place the waterproof pad under the client's buttocks.

11 Put on gloves.

12 Disconnect the pouch from the belt if one is worn. Remove the belt.

13 Remove the pouch gently. Genlty push the skin down and away from the skin barrier. Place the pouch in the bedpan.

14 Wipe around the stoma with toilet tissue or a guaze square. This removes mucus and feces. Place soiled tissue in the bedpan.

15 Ensure skin integrity. Protect skin (it is the largest organ in the body). Moisten a guaze square with adhesive remover. Clean around the stoma to remove any remaining skin barrier. Clean from the stoma outward.

16 Raise bed rails, Cover the bedpan, and take it to the bathroom. (Be sure to raise bed rails before leaving the bedside.)

17 Measure the feces, as directed by the care plan.

18 Note the colour, amount, consistency, and odour of feces. Report any abnormal feces. Then empty the pouch and bedpan into the toilet. Put the pouch in the disposable bag.

19 Remove gloves. WASH HANDS WITH SOAP AND WATER AT LEAST 20 Seconds.

20 Fill the wash basin with warm water. (Check temperature with your wrist or elbow. FOLLOW THE CARE PLAN FOR THE CORRECT TEMPERATURE.) Place basin on paper towels in work area. Lower the bed rail near you, if it it up.

21 Using soap or other cleansing agent, clean the skin around the stoma with water. Rinse and pat dry.

22 Observe the stoma and skin around the stoma. Report and Record any irritation or skin breakdown.

23 Apply the skin barrier, if it is a separate device.

24 Put a clean ostomy belt on the client (if belt is worn).

25 Add deodorant to the new pouch.

26 Remove adhesive backing on the pouch.

27 Centre the pouch over the stoma. The drain points downward.

28 Press around the skin barrier so the pouch seals to the skin. Apply gentle pressure from the stoma outward.

29 Maintain pressure for 1 to 2 minutes.

30 Connect the belt to the pouch (if a belt is worn).

31 Remove the waterproof pad.

32 RAISE BED RAILS ACCORDING TO CARE PLAN AND EMPLOYER POLICY. Remove gloves and WASH HANDS FOR AT LEAST 20 Seconds.

33 Cover the client and remove the bath blanket.

 

<post-procedure>

 

34 Provide for safety and comfort.

35 PLACE THE CALL BELL WITHIN REACH.*

36 Return the bed to its lowest position. Follow the care plan for bed rail use.*

37 Remove privacy measures.

38 Clean the bedpan, wash basin, and other equipment. PUT ON GLOVES FOR THIS STEP.

39 Return equipment to its proper place.

40 Discard the disposable bag, according to employer policy. Follow employer policy for soiled linen. REMOVE GLOVES AND WASH HANDS WITH SOAP AND WATER FOR AT LEAST 20 seconds.

41 REPORT and RECORD your actions and observations, according to employer policy.

 

p. 544 Giving Perineal Care to a Female Client

 

<pre-procedure>

 

#1 Identify the client, according to the employer policy.

#2 Explain the procedure to the client.

#3 Wash Hands and Wear Gloves when necessary.

#4 Collect the following:

#5 Place paper towels on an overbed table (in a facility) or on a work area within easy reach from the bedside. Arrange items on top of the paper towels.

6 Provide for privacy.

7 Raise the bed to a comfortable working height. Follow the care plan for bed rail use.*

8 Lower the bed rail near you, if it is up.

9 Cover the client with a bath blanket. Move top linens to the foot of the bed.

10 Position the client on her back. Remove garments from the waist down.

11 Position waterproof pad under the client's buttocks.

12 Drape the bath blanket in a diamond shape from top corner at chest and other corner at private area for simpler access.

13 Raise the bed rail to ensure safety.

14 Fill the wash basin. Measure water temperature according to employer policy. Test temperature also by using your wrist or your elbow.

15 Place the basin on the overbed table or work area.

16 Lower the bed rail.

17 Help the client flex her knees and spread her legs. If she cannot flex her knees, help her spread her legs as much as possible with her knees straight. *BE VERY CAREFUL AND GENTLE WITH CLIENTS WHO HAVE HAD HIP AND/OR KNEE SURGERY.*

18 PUT ON GLOVES.

19 Fold the corner of the bath blanket between the client's legs on to her abdomen.

20 Wet the wash cloths. Squeeze our excess water from wash cloths before using them.

21 Apply soap to a wash cloth.

22 Separate the labia. Clean downward from front to back with one stroke. Clean downward with different finger for each stroke.

23 Use a clean part of the wash cloth for each stroke. Use more than one wash cloth if needed.

24 Rinse the perineum with a clean wash cloth. Separate the labia. Stroke downward from front to back. Both sides and the centre. Use a clean part of the cloth each time.

25 Pat the area dry with a towel.

26 Fold the blanket back between the client's legs covering their private area.

27 Help the client lower her legs and turn on to her side away from you.

28 Apply soap to a wash cloth.

29 Clean the rectal area. Separate buttocks and clean from the vagina to the anus with one stroke. REPEAT UNTIL CLEAN, USING MORE THAN ONE WASH CLOTH WHEN NEEDED.

30 RINSE THE RECTAL AREA WITH A WASH CLOTH. Use more than one wash cloth when needed.

31 Pat the area dry with the towel.

32 Remove the waterproof pad.

33 REMOVE GLOVES AND WASH HANDS AT LEAST 20 SECONDS WITH SOAP AND WATER.

 

<post-procedure>

 

34 Provide for safety and comfort.

35 Cover the client.

36 Remove the bath blanket.

37 Place the call bell within reach.*

38 RETURN BED TO ITS LOWEST POSITION. FOLLOW THE CARE PLAN FOR BED RAIL USE.*

39 Empty and clean the wash basin. Return basin and supplies to proper places.

40 Wipe off the overbed table working are with paper towels, and discard paper towels.

41 Follow employer policy for dirty linen.

42 WASH HANDS WITH SOAP AND WATER AT LEAST 20 seconds.

43 ** Report and Record your actions and observations, according to employer policy.

 

p. 583 Giving the Bedpan (for clients/patients/residents with casts, clients in traction, clients with limited back motion, clients with fragile bones or painful joints, clients who have had a hip fracture or hip replacement)

 

<pre-procedure>

 

1. Identify the client, according to employer policy.

2. Explain the procedure to the client.

3. Provide for privacy.

4. WASH HANDS at least 20 seconds with Soap and Water. PUT ON GLOVES.

5. Collect the following:

6. Arrange equipment on the chair or bed.

 

 

<procedure>

 

7. Warm and dry the bedpan, if necessary.

8. Lower the bed rail near you.

9. Place the client in the supine position, keeping the bed as flat as possible. You may use pillows to raise the client's head and shoulders.

10. Fold the top linens and the client's gown out of the way. Keep the lower body covered.

11. ASK the client to flex the knees and raise the buttocks by pushing against the mattress with the feet.

12. Slide your hand under the lower back, and help raise the buttocks.

13. Slide the bedpan under the client.

14. If the client cannot assist in getting on the bedpan:

15. Cover the client.

16. Raise the head of the bed so that the client is in the sitting position. If the bed is not adjustable, assist the client into the sitting position, USING PILLOWS FOR SUPPORT.

17. Make sure the clinet is correctly positioned on the bedpan.

18. Raise the bed rail.

19. Place the toilet tissue and call bell (in facilities) within reach.

20. ASK THE CLIENT TO CALL WHEN DONE OR WHEN HELP IS NEEDED.

21. WASH HANDS.

22. Leave the room, and close the door.

23. Return when the client calls. Knock before entering.

24. WASH HANDS AND PUT ON GLOVES.

25. Raise the bed to a comfortable working height. Lower the bed rail and the head of the bed. Or remove the pillows, and place the client in the supine position.

26. ASK the client to raise the buttocks, and remove the bedpan. If the client cannot raise the buttocks, hold the bedpan securely, and turn the client onto the side away from you.

27. Clean around the genital area, if the client cannot do so. Clean from the front (urethra) to the back (anus) with toilet tissue, using a fresh tissue for each wipe. Provide perineal care.

28. Cove the bedpan and take it to the bathroom. Remember to lower the bed and raise the bed rail before leaving the bedside.

29. Note the colour, amount, and character of urine or stool.

30. Empty the bedpan, rinsing with cold water. Clean it with a disinfectant.

31. Remove soiled gloves. WASH HANDS AT LEAST 20 SECONDS THOROUGHLY WITH SOAP AND WATER. Dry well.

32. Put the bedpan and lid away.

33. Help the client WASH THEIR HANDS WITH SOAP AND WATER AT LEAST 20 SECONDS (Sing "Happy Birthday" twice)

34. Remove gloves. WASH HANDS WITH SOAP AND WATER AT LEAST 20 SECONDS.

 

 

<post-procedure>

 

35. Provide for safety and comfort. Place the call bell within reach.**

36. Follow the care plan for bed rail use.

37. Remove privacy measures.

38. Follow employer policy for soiled linen.

39. Wash hands at least 20 seconds with soap and water (sing "Happy Birthday" twice).

40. ** Report and record your actions and observations, according to employer policy.

 

 

 

 

 

 

Dressing

DAF ( Dress Affected side First )

RUF ( Remove Unaffected side First )

return to top

 

 

 

Nail Care

Foot care specialists are required for nail care 

return to top

 

 

 

 

 

Additional Resources

 

 

return to top