Clinical Skills day 23.1.13 Peepul Centre Leicester

1. Hygiene And Personal Care.
Nail Care.
By Sharon Leverton

2. Definition
Personal hygiene is the physical act of
cleaning the body to ensure that the
skin, hair and nails are maintained in
an optimum condition

3. Areas Of Care
To Consider
• Skin
• Perineal/Perianal
• Hair
• Eyes
• Mouth
• Ears and nose
• Nails and feet

4. 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

5. Considerations
• Nutritional state
• Incontinence
• Age, health and mobility status
• Treatment therapies
• Any current conditions

6. 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.

7. Common Areas Of
Pressure Sores
BEST SHOT
B- Buttocks
E- Ears and elbows
S- Sacrum
T- Trochanter
S- Spine
H- Heels
O- Occipital area
T- Toes

8. Stage 1 Pressure Sore
Intact skin with non-blanchable redness of a
localised area usually over a bony prominence.
Darkly pigmented skin may not have visible
blanching; its colour may differ from the
surrounding area. The area may be painful, firm,
soft, warmer, bluish tinge.

9. Stage 2 Pressure Sore
Partial thickness loss of dermis presenting as a
shallow open ulcer with a red pink wound bed.
May also present as an intact or open/ruptured
serum-filled blister.
Presents as a shiny or dry shallow ulcer without
slough or bruising- Bruising indicates deep
tissue injury.

10. Stage Three
Pressure Sore
Full thickness tissue loss. Subcutaneous fat may
be visible but bone, tendon or muscle are not
exposed. Slough may be present but does not
obscure the depth of tissue loss. May include
undermining and tunnelling.

11. Preventative Measures
SSKIN
S- Surface. Get the right support
S- Skin inspection
K- Keep moving
I- Incontinence/moisture
N- Nutrition and fluid

12. Cleansing An Area
And Things To Consider
• Soap/water
• Emollient creams
• Moisturisers
• Level of independence
• Consent
• Respect, culture, religion
• Privacy

13. Perineal/perianal area- problems arising from
treatment therapy i.e radiotherapy, fistula,
diarrhoea, constipation and UTI’s
Patients should be encouraged to perform this task
for themselves if at all possible.
Hair- Grooming hair is an ideal opportunity to
observe, dandruff, psoriasis, flaky skin and head
lice. The way we look has an impact on our general
wellbeing.

14. Eye care- with age and some conditions eyes can suffer
from dryness. Prescribed eye drops and gentle cleaning
can prevent infection and help keep the eyes moist.
Consider-glasses and contact lenses
Mouth- common problems with this area are dry mouth,
chewing and swallowing difficulties, infection, halitosis
Consider- illness/medication, dental/denture problems,
nutrition and fluid intake, smoking cessation. Oral
Hygiene and mouth washes.

15. Ears and nose- lack of attention to cleaning the ears and
the nose can lead to impairment of senses. Gentle
cleaning with wool or gauze should be sufficient to keep
the areas clean and free from wax and deposits. DO NOT
PUSH COTTON BUDS INTO THE EAR CANAL.
Consider- hearing aids, piercings, infections and other
illnesses i.e vertigo
Nails and feet- these areas need special care to avoid pain
and infection. Nails should be clean and trimmed with
appropriate equipment. Get advice from a chiropodist if
appropriate. Always wash between toes and ensure area
is completely dry to avoid fungal infection.
Consider- Diabetes, skin integrity, ulcers, corns and
bunions, hardening of the nails and body image.

16. Final word
There is a risk that personal hygiene of patients
may 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?

17. Any Questions?