Procedure for hair wash of patients admitted at hospitals or at at home

1. Hair wash
Prepared by: Pooja Koirala
Lecturer
NMCTH

2. Hair
• The appearance of the hair often reflects a
person’s feelings of self concept and socio
cultural well being.
• Becoming familiar with the care needs and
practices that may be different than our own is an
important aspect of providing competent nursing
care to all clients
• A dirty scalp and itchy, uncomfortable hair can
have an odor

3. Introduction cont….
• The hair may also reflect state of health (e.g.
excessive coarseness and dryness may be
associated with endocrine disorders)
• A wide toothed comb is usually used because
finer combs pull and break the hair

4. Developmental variations
• In adolescence, the sebaceous glands increase
in activity due to increase in hormone level.
• So the adolescent's hair are usually more oily
• In older adults, the hair is usually thinner,
grows slowly

5. Nursing assessment
• History taking:
– Hair care habits
– History of scalp problems
– History of hair loss (alopecia)
• Physical examination
– Dandruff
– Hair loss
– Ticks (small gray brown parasite)
– Pediculosis (Lice)
– Scabies (skin infection by itch mite: Sarcopetes
scabiei)

6. Diagnosis
• Impaired skin integrity
– Pruritus secondary to scabies
– Pruritus secondary to head lice
– Insect bite
• Risk of infection
– Scalp laceration

7. Diagnosis cont….
• Dressing self care deficit
– Activity intolerance
– Imposed immobility (bed rest)
– Pain in upper extremity
– Altered level of consciousness
– Lack of motivation
• Disturbed body image

8. Hair wash
• Hair washing means washing and cleaning hair
with soap or shampoo and water.
• Ambulatory patient can wash their hair in the
bathroom but bed ridden patients need to wash
their hair in the bed.

9. Purposes
• To keep hair clean, healthy and tidy
• To provide the sense of well being
• To observe the scalp
• To increase circulation to the scalp and hair
• To prevent accumulation of dirt, dandruff and oil
• To promote growth of hair
• To prevent itching, infection and lice
• To prevent loss of hair
• To promote mental relaxation

10. Common hair and scalp problems
• Dandruff: sealing of scalp accompanied by
itching
• Pediculosis: lice infection
• Alopecia: hair loss

11. Principles
• Maintain privacy
• Empty the bladder before washing
• Combing hair should be done first before doing hair
washing
• Hair must be kept free from snarls, combed and brushed
without hurting the patient
• Prevent the eyes and ears from soapy water
• Water temperature should be around 110 degree F. check the
temperature by placing a small amount of water on the inner
aspect of forearm

12. Principles cont…
• Avoid hair wash for the patient who has just taken
meal at least for an hour
• Consider religious, cultural and personal
preferences of the patient
• Special precaution should be taken in positioning
the patient, if central venous lines are present
• Teeth of the comb should be dull to prevent
scratching of the scalp
• Unbroken skin acts as barrier of infection

13. Principles cont…

14. Principles cont…
• Practice of good techniques saves time and energy
• Cotton socked in oil is used to seal the ear as it
does not absorb water and thus prevent water
from entering the ear
• Neglected hair and scalp contain dirt and micro
organisms also produce infection at the scalp
• A well combed and attended hair provides
comfort to the patient and makes appearance
more attractive

15. Articles required
• A trolley containing:
– Bucket with warm water: 1
– Bucket for waste water: 1
– Big towel:1
– Big mackintosh: 1
– Jug:1
• A tray Containing:
– Cotton with oil: for ear plug
– Shampoo or soap with soap dish
– Brush or comb
– Oil
– Plastic apron
• Screen

16. Procedure
• Before washing a client’s hair, determine that there are
no contraindications to this procedure
• Certain medical conditions such as head and neck
injuries, spinal cord injuries and arthritis could place
the client at risk, for injury during shampooing because
of positioning and manipulation of client’s head and
neck
• Assess the general condition of the patient and inspect
the hair and scalp prior to initiating the procedure . This
determines the presence of any conditions that may
require the use of special shampoo or treatments
(dandruff or the removal of dried blood)

18. Procedure cont…
• Check the patient’s preference for soap or shampoo
• Close the windows and put off the fan
• Empty the bladder of the patient
• Explain the purposes and procedure to the patient
• Wash hands with soap and water
• Prepare and bring the articles to the working side of the
patient
• Screen the patient

19. Procedure cont…
• Unless contraindicated, help the patient move his
/ her head towards the edge of the bed.
• Remove the pillow and place it in a shoulder if
not contraindicated
• Roll the mackintosh sheet from both sides in a
slanting way, to make the shape of a funnel. The
narrow end should be folded and put under the
patient’s head and the free end should be put in
bucket to act as a drain for the water

20. Procedure cont…
• Place the towel around the neck and shoulder
of the patient
• Help the patient to assure in a comfortable
position

24. Procedure cont…
• Ask the patient to close his / her eyes to prevent
the soap water getting into the eyes
• Brush the hair
• Insert cotton swab into the ears
• Mix hot and cold water and test the temperature
with the back of the hand
• Wet the hair by warm water

25. Procedure cont…
• Apply the shampoo to the hair and massage using
fingertips (do not use nails)
• Rinse the hair repeatedly with warm water till
thorough cleanliness is ensured
• Ask the patient if he / she is comfortable
• Remove the trough or rolled mackintosh and
place it in the bucket.

26. Procedure cont…
• Remove the cotton plugs from ears into paper bag
or kidney tray
• Dry the patient’s hair with towel
• Reposition the patient in proper alignment
• Massage the hair with oil and the comb the hair
• Make the patient tidy and comfortable. Change
the linen if needed

28. Procedure cont…
• Clean the article and place them in a proper
place
• Record the procedure including the conditions
of the scalp, hair and any abnormalities in the
patient’s chart
• Report to the senior staff if any abnormalities
found

29. Any queries???

30. Thank you