Patient Hygiene: Step-by-Step Procedures

Procedure: Inform the patient that it is bath time and request their cooperation. Offer the bedpan or urinal before you start cleaning. Gather all materials so that they are within reach. Wash your hands and put on gloves. Place the patient in a supine position.

1. Head - Hair and Face

Hair

From the recumbent position, remove the patient's pillow and place a towel under their head. Roll another towel around the neck. Place a waterproof sheet under the patient's head and shoulders, securing the towel and a rubber grip. Create a channel with the sheet leading to a container or basin to collect water. Protect the patient's eyes with a washcloth. Wet the hair and apply shampoo. Scrub, making circular motions to massage the scalp gently with your fingertips. Rinse the hair thoroughly, protecting the eyes. Repeat twice. Dry the hair gently with a towel. Remove the waterproof sheet, taking care not to spill any remaining water on the bed. Dry the hair thoroughly with the towel. Comb and style the hair, and reposition the patient comfortably. Gather materials and note any possible incidents.

Face

Undress the patient and cover them with a sheet to preserve their privacy. When starting to clean the face (do not use soap on the face), take wipes and water. Clean the face with gentle dabs. Clean the eyes with gauze, applying physiological saline solution, from the inner to the outer corner. Discard or change the gauze. If the eyes are open (for unconscious patients), moisten them. Use eye drops to moisten the mucosa.

Mouth

• Conscious patient: If the patient is conscious, have them brush their teeth.
• Unconscious patient: Prepare a swab in the form of a ballot (quickly using a tongue depressor) with an antiseptic mouthwash. Aspirate any mucus from the mouth (using a suction device if available). Finally, clean the tongue.

2. Ears and Neck

Using a sponge, lather with outward circular motions. Rinse and dry (with gentle dabs using gauze, removing all remaining soap).

3. Upper Extremities (Arms)

Clean downwards, starting with the shoulders and armpits, and ending with the hands. Pay close attention to the elbows, checking for any rashes, and clean the interdigital folds. Dry thoroughly. For the nails: use a nail brush, soap, and water. Apply moisturizing cream to each zone. Cut the nails straight across, and use a lemon wedge (optional).

4. Thorax

Clean with circular motions. Thoroughly hydrate the area (especially the submammary unit). Clean the belly button (with gauze and soap; discard the used gauze).

Abdomen

Clean from the center outwards (circular motion). Rinse, dry, and hydrate.

5. Lower Extremities (Legs)

Clean the front of the legs. If the patient can bend their knees, have them draw their legs upwards. Assess the appearance of the heels (check for erythema). Apply a hyperoxygenated oil massage. Clean the interdigital spaces and dry them thoroughly. Change the water, sponge, and gloves.

6. Genitals

Reposition the patient in the supine position and wash the genital area. Retract the foreskin to clean the glans. Place a bedpan beneath the patient. If the patient is able, they can clean themselves; otherwise, the caregiver should do it. Rinse from the glans downwards towards the testes, ensuring no moisture remains. Avoid touching the anus with the cleaning materials used for the genitals.

For Women

Clean the labia majora and minora carefully, lathering from the inside out. Rinse with water from front to back.

7. Buttocks and Back

Change the water. Turn the patient to a lateral position. Ensure there are no erythemas. Clean from top to bottom, including the scapular and sacral areas. Apply a warming cream. Clean the heels. Clean the anus from the inside out. Change the bedding and the patient's clothing (pajamas or gown). Leave the patient in a comfortable position.