Needs more

GENERAL PROCEDURE FOR HYGIENE Satisfactory Comments

Practice

Assessment

1. Gather information related to patient’s ability to participate in the procedure. 

2. Assess for specific symptoms. 

3. Check for available supplies.

Planning

1. Determine assistance and supplies needed. 

2. Wash hands.

3. Obtain needed supplies, including clean gloves if you may come in contact with
body secretions. 

Implementation

1. Identify the patient.

2. Explain procedure to patient.

3. Provide for patient’s privacy.

4. Raise bed to appropriate working level.

5. Carry out hygiene procedure planned.

6. Watch patient for adverse reactions.

7. Care for equipment and supplies.

8. Wash hands.

Needs more
COMPLETE BED BATH Satisfactory Comments
Practice

1. Follow steps 1-6 of General Procedure

2. Obtain supplies: basin, soap, hamper, clean linen, bath blanket, clean garment, toilet
articles, gloves.

3. Follow steps 8-11.

4. Carry out the bed bath.

a) Remove top linen and place bath blanket. 

b) Give Oral Care if not yet done.

c) Obtain water at room temperature. 

d) Position patient in supine. If unable to tolerate, use semi-Fowler’s for

comfort and safety.

e) Bathe patient in the following order:

 Spread towel across patient’s chest.

  Make mitt out of washcloth.

 Wash patient’s face. 

 Remove patient’s gown.

 Place towel under far arm and bathe, rinse, and dry near hand, and
axilla.

5. Place towel under near arm and bathe, rinse, and dry near hand, arm, and axilla.

6. Spread towel across patient’s chest and wash, rinse, and dry chest to waist.

7. Wash, rinse, and dry abdomen.

8. Place towel under far leg.

a) Place patient’s foot in bath basin.

b) Wash, rinse, and dry far leg.

c) Wash, rinse, and dry far foot.

9. Wash near leg and foot.

10. Change bath water and put on gloves.

11. Wash genital area or encourage him to do it.

12. Remove and dispose of gloves.

13. Change water.

14. Assist him to turn and drape.

15. Wash, rinse, and dry back.

16. Put on gloves.

17. Wash, rinse, and dry buttocks.

18. Remove and discard gloves.

19. Give back rub if desired.

a) Help him put on clean garment.

b) Assist with hair care.

c) Assist with nail care.

d) Assist male patient with shaving.

e) Make occupied bed and return to low position.

f) Tidy up area.

Needs more
ORAL CARE Satisfactory Comments
Practice

A. Toothbrushing for Conscious Patients

1. Place a towel under the patient’s chin, tucking behind the shoulders.
2. Put on clean gloves.

3. Moisten the toothbrush with water and spread a small amount of toothpaste on it.

4. Brush the teeth allowing the patient to expectorate into the emesis basin:
a. Hold the brush at a 45 degree angle. Use a small, vibrating, circular motion with
the bristles at the junction of the teeth and gums.
b. Use the same action on the front and back of the teeth.
c. Use back-and-forth brushing motion over the biting surfaces of the teeth.
d. Brush the tongue then rinse the mouth.

5. Allow the patient to rinse the mouth with water followed by a mouthwash, if desired.

6. Wipe the patient’s mouth.

Needs more
B. Flossing
Practice
Satisfactory Comments

1. Floss the teeth and between the gums and each individual tooth.

2. Rinse the mouth after.

Needs more
C. Toothbrushing for Unconscious Patients
Practice
Satisfactory Comments

1. Wash hands.

2. Raise the bed to a comfortable working height and place the patient in semi-fowler’s
position with the head turned toward you. If the patient’s head cannot be raise, leave
the patient flat and turn the head toward you.

3. Place a towel under the patient’s chin, tucking it behind the shoulders.

4. Put on clean gloves.

5. Place a padded tongue blade in the patient’s mouth. 

6. Brush all tooth surfaces, tongue and mouth surfaces.

7. Clean all surfaces of the mouth, including the palate, inner cheeks and tongue by
using an oversized cotton-tipped applicator. 

8. Rinse the patient’s mouth with small amount of water.

9. Wipe the patient’s mouth.

10. Lubricate the lips as needed.

11. Return the bed to the low position.

12. Wash hands.

D. Care of the Dentures.

1. Put on clean gloves.

2. Assist patient with removal by applying downward pressure with the index finger
above the denture.
3. Handle dentures with care.

4. Take the dentures to the sink in the denture cup. Use a denture brush, if available, for
cleaning. Rinse them thoroughly.

5. Have the patient rinse out the mouth before reinserting the dentures.

6. Return the dentures to the patient, filling the upper dentures in first.

7. Dry the patient’s mouth.

HAIR CARE

Needs more
A. Brushing and Combing
Practice
Satisfactory Comments

1. Place a face or bath towel over the pillow. 

2. Place patients who are able to comb and brush hair own hair items on the overbed
table. The helpless or unconscious patient may be flat or in a semi-fowler’s position.

3. Turn the patient’s head away from you and bring the hair back toward you. Brush
hair with few tangles in two or three large sections.

4. Hold a section of hair 2-3 inches from the end. Comb the end until it is free of
tangles. Gradually move toward the scalp, combing 2-3 incles at a time until the
hair is tangle-free.

5. Turn the patient;s head in the opposite direction and repeat step 4.

6. Arrange the hair. Braiding may be the most appropriate style for the long hair.

7. Remove towel.

8. Place towel in a laundry hamper bag.

9. Clean the comb and brush and return them to the bedside stand.

Needs more
B. Shampooing
Practice
Satisfactory Comments

1. Fanfold the top linen to the foot of the bed 

2. Position a bath blanket over the patient.

3. Place a pillow under the patient’s shoulders.

4. Place the towel around the patient’s shoulders and neck with the ends of the towel
coming together in front.

5. Place a Kelly pad under the patient’s head with the trough extending to the
receptacle for water.
6. Plug the ears with dry cotton balls. Protect the eyes with a folded washcloth, then
wet the hair.

7. Shampoo and rinse twice, using only a small amount of shampoo and rinsing
thoroughly. Squeeze the hair of dripping water.

8. Support the head with your hand, lift gently, and get the towel from the shoulder
and wrap the hair around. Remove Kelly pad and drop to the water receptacle.

9. Replace wet pillow with dry one.

10. Remove the washcloth from client’s eyes, and cotton plugs from ears.

11. Further dry the patient’s hair, ears and neck with a towel.

12. Comb or brush and arrange the hair.

13. Remove the plastic square, towels, trough, pitcher and basin.

14. Replace the top bed linen, removing the bath blanket after the top sheet is in place.

15. Allow the patient to rest.

Needs more
EYE CARE Satisfactory Comments
Practice

1. Wash hands.

2. Wash eyelids if not clean. Use clean washcloth and clear warm water. Wipe the
exterior of eye from the medial aspect to the lateral aspect. Dry the eyes.

3. If artificial tears are ordered, instill into the eyes.

4. Observe the surface of the eyes for irritation & inflammation.

5. Gently close each eyelid and hold it closed while the eyepad is placed over it.

6. Secure the eyepad with tape so that it holds the eye closed.

7. Repeat steps 4&5 for the second eye.

8. Put away or dispose of equipment.

9. Wash hands.

Needs more
PERINEAL CARE Satisfactory Comments
Practice

A. FEMALE:

1. Place client on supine position and put water-proof pad under his buttocks. Wash
labia mjora using wash cloth, soap and warm water. Then gently retract labia from
thigh and wash groin from perineum toward rectum.
2. Separate labia and expose urethra and vagina. Wash from pubic area toward rectum
cleansing thoroughly. If there is an indwelling catheter, clean area around it
thoroughly.

3. Rinse and dry area thoroughly.

4. Assess for redness, swelling, discharge, irritation or skin breakdown.

B. MALE:

1. Gently grasp shaft of penis and if client is not circumcised, retract foreskin.

2. Wash tip of penis at urethral meatus first. Using circular motion, cleanse away from
meatus. Replace foreskin to its natural position.

3. Cleanse shaft of penis and scrotum, washing underlying skin folds.

4. Rinse and dry.

Needs more
BACK RUB Satisfactory Comments
Practice

1. Place patient on prone position.

2. Assess for sign of skin irritation or lesions.

3. Provide back massage using lotion. Begin at sacral area. Massaging in circular
motion, stroke upward from buttocks to shoulders and upper arms and over scapulas
with smooth, firm strokes. Keep hands on skin and continue massage pattern for 3-4
minutes.

4. End massage with long stroking movements and tell client you are ending massage.

5. Knead skin by grasping tissue between thumb and fingers. Knead upward along each
side of spine and around muscles of neck, avoiding bony prominences.

6. Observe skin for redness and skin breakdown. Remove excess lotion from back with
bath towel.

7. Apply clean gown or pajamas, dressing the affected side first.