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First aid and nursing

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Theme 4. Personal hygiene of the patient.

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Alexey Alexandrovich Frolov
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PhD, physician
 Types of patient care.
• General care - measures that any patient needs regardless of the

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type of disease (taking medication, bed linen changing, etc.)

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• Special care - measures that apply to patients with a certain type

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of disease (for example, washing the bladder of a patient with

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diseases of the urogenital organs).

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 Components of care
• Patient Safety • Feeding

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• Gymnastics • Therapeutic procedures

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• Leisure • General care procedures

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• Infection control • Rehabilitation

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• Control of the intake of drugs • Patients regime

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• Massage • Health worker safety
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• Monitoring of patients
• Patient education
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• Communication
 The principles of care
• security

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• confidentiality

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• respect for dignity

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• communication with the patient

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• promotion of patient autonomy

• infectious safety ba Al
The purpose of patient care is personal hygiene, ensuring comfort,
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cleanliness and safety.

 Importance of patient personal hygiene
• Skin care is an important part of personal hygiene. It is necessary to wash

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daily in the morning and in the evening and take a hygienic bath once a

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week. It is necessary to brush patient's teeth twice a day.

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• A nurse is engaged in the personal hygiene of a seriously ill patient. It is

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necessary to wipe the patient’s skin with soap and water daily and brush the

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patient’s teeth twice a day. It is also necessary to care for the eyes, ears and
nasal cavity. ba Al
• Of great importance is the cleanliness of the patient's bed. Bed sheets need
to be changed as they become soiled and wrinkles should be carefully
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straightened.
 Requirements for bedclothes storage and
transportation

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• In hospitals there are central pantries for clean and dirty bedclothes.

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• In the pantry for dirty bedclothes, the walls, floor and ceiling must

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be moisture resistant, easy to clean and disinfect.

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• Transportation of clean and dirty bedclothes is carried out in special
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containers or bags, separately.

• Containers or bags for dirty bedclothes must be moisture resistant

and have a special label.
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 Issuing and change of bedlinen
• Upon admission to the hospital, the patient receives a set of clean

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linen.

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• Patients leave personal clothes and shoes in a storage room or pass

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on to relatives.

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• It is allowed to wear home clothes (in a non-infectious hospital).
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• Personal clothing of infectious patients is disinfected.

• Patients undergo linen changes as they become dirty, regularly, at

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least 1 time in 7 days.

 Clothes and bedlinen disinfection
• Disinfection of dirty clothes and bedlinen is carried out in a hospital

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laundry. Before washing, the laundry is soaked in a disinfectant solution

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or special washing machines are used.

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• After discharge of patients (or if dirty), mattresses, pillows, blankets

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should be disinfected in the chamber. When using moisture-resistant

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covers, disinfection is carried out by wiping.

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Rooms and equipment of laundries and pantries are washed and
disinfected daily.
• Cleaning equipment should be labeled in accordance with the
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assignment.
 Medical staff clothing
• Medical staff should be provided with replaceable clothing.

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• Changing clothes of staff in the surgical and obstetric departments is

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carried out daily.

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• Change of clothes in the therapeutic departments is carried out 2

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times a week.
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• The clothes of medical personnel are washed centrally and
separately from the patient’s clothes and bedlinen.
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• It is forbidden to wash work clothes at home.

 Disinfection of care items
• Wear protective clothing, gloves.
• Prepare a disinfectant solution of the required concentration.

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• Perform the disinfection procedure using one of the methods.

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• Full dive method:

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– Fully dive the care item in a disinfectant solution.

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– Stand for 60 minutes (or the required time specified in the instructions).

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– Wash the item under running water using detergents. Dry item.

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• Double wipe method:
– Wipe the subject of care twice with a disinfectant solution at intervals of 15 minutes (see the
instructions for the disinfectant).
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– Dry item.
– Wash the item under running water using detergent. Dry item.
Bed linen changing: first way

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1. Roll a dirty bedsheet into the roller

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under the patient’s lower back.

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2. Carefully lift the patient and remove

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the dirty sheet.

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3. Place a clean bedsheet rolled into the
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and straighten it.
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Bed linen changing: second way
1. Move the patient to the edge of

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the bed.

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2. Roll the dirty sheet into the roller

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from the edge of the bed towards

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the patient.

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3. Spread a clean sheet (half of the

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sheet is rolled into a roll near the
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4. Move the patient to the spread
half of the clean sheet, remove
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the dirty sheet, and spread the

clean sheet.
 Change of underwear

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1. Lift the edge of the patient’s shirt to the axillary region and the back of the head.
2. Remove the shirt over the patient’s head, and then from the patient’s hands.
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3. Put on the shirt in the reverse order: first put on the sleeves, then put the shirt on the
patient’s head, then straighten the shirt under the patient’s back.
 Bedsores
• Bedsores – necrosis of soft tissues (skin, subcutaneous tissue,

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walls of a hollow organ or blood vessel, etc.) that occurs due to

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ischemia caused by prolonged continuous mechanical pressure on

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them.

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Areas of bedsores formation

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• sacrum

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• shoulder blades

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• heels
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 Risk factors of bedsores formation

• obesity

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• exhaustion of the patient

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• dysproteinemia

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• anemia

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• diabetes

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• dry skin
• excessive sweating ba Al
• fecal and urinary incontinence
• factors causing increased bed moisture
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• peripheral circulation disorder

Risk assessment of bedsores formation: NORTON scale
Criterion Points Criterion Points
Physical state Mental condition

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Good 4 Active 4

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Satisfactory 3 Apathetic 3

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Bad 2 Confusion 2

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Very bad 1 Stupor 1

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Activity Mobility

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Walking 4 Full 4

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Walks with help 3 Bit limited 3
Sedentary 2 Very limited 2
Recumbent ba Al
1 Motionless 1
Incontinence
No 4
14 points or less - increased risk of
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Sometimes 3
Urine 2
bedsores formation
Urine and feces 1
 Stages of bedsores formation

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Stage of ischemia
redness, edema, soreness
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Stage of superficial
necrosis
Suppuration stage
deep necrosis, ulceration,
epidermal exfoliation, infection
blistering
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+ sepsis development is possible

 Prevention of bedsores
• Every 1.5-2 hours, the patient's position should be changed.

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• It is necessary to straighten folds on a bed and linen.

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• Wipe the skin with a disinfectant solution.

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• Immediately change wet or soiled laundry.

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• It is necessary to wash patients in a timely manner.

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It is recommended to use special pneumatic mattresses.
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 Bedsores treatment
The appearance of bedsores is evidence of poor patient care!

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• When a reddening area appears, wipe it 2 times a day with a 10% camphor

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solution, brilliant green alcohol solution, 5-10% potassium permanganate

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solution or irradiate with a quartz lamp.

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• In the case of bedsores, they are treated with a 0.5% potassium

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permanganate solution.
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• When an infection is attached, the wound is treated with ointments
(antiseptics; enzymes; repair stimulants).
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• In the case of severe necrosis, surgical necrectomy is performed.

Care for patients with limited mobility

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bedpan matrass
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 Bedpan use
1. To fence off the patient with a screen, put an oilcloth under a pelvis.

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2. Rinse the bedpan with warm water.

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3. With the left hand, help the patient raise the pelvis (the patient's legs are bent at the knees).

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4. With the right hand bring the bedpan under the buttocks of the patient.

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5. Cover the patient with a blanket and leave him alone for a while.

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6. Pour the contents of the bedpan into the toilet,
rinse the bedpan hot water. ba Al
7. Wash the patient, drain the perineum, remove the
oilcloth.
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8. Disinfect the bedpan with a disinfectant solution.

 Janet Syringe
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Ear canal flushing

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Thanks for attention!