Hygienic care for bedridden patients
May 25, 2018
Taking care of lying patients means having some skills - for example, you need to know what means to treat the skin with bedsores, how to organize oral care, what care means will not harm the weakened body.Table of contents:
Specialists recommend that in the hygienic care of bed patients pay attention to the following:
- skin cleansing;
- prevention of decubitus and inflammatory processes in the anus, genital and natural folds;
- therapy for the restoration of skin.
Hygiene of recumbent patients
Such procedures for recumbent patients should be performed twice a day and the optimal time for this will be the period immediately after awakening and before breakfast, before bedtime. To ensure that the hygiene procedure does not present a problem for people caring for the lying patient, it is worthwhile to prepare the following facilities in advance:
- Inflatable head wash bath;
- jug, or any other vessel, for warm water;
- two pelvis for water;
- stand for the pelvis;
- cosmetics and "tools" - gels, foams, mittens and sponges;
- absorbent diapers;
- gauze wipes;
- medical gloves and for cleaning;
- cotton wool;
- paper and / or fabric towels;
- toothbrushes( if the patient alone can not perform tooth cleaning, then you will need to purchase special brushes);
- diapers, rubberized and disposable oilcloth;
- subjects for a hairstyle, shaving and manicure / a pedicure;
- special devices for the prevention of pressure sores - rollers, circles or mattresses.
This list may vary depending on how difficult the patient is. For example, you may need:
- gynecological and urological pads;
- disposable underwear;
- device for the care of the stoma;
- shower chairs or special handrails for bathing;
- toilet seats.
Note: a more specific list of necessary facilities and devices for the care of bed patients will help make up his attending physician, as everything depends on the diagnosis.
Before starting to perform skin cleansing procedures, it is necessary to get rid of drafts in the room, the air temperature should be at least 20 degrees.Such rules must be observed, as fluctuations in temperature and drafts can lead to an exacerbation of chronic diseases in a recumbent patient, deterioration of his condition - the immunity in such patients is very weak.
Sequence of procedure
Having prepared all the devices and facilities, having provided the necessary temperature in the room, it is necessary to put on rubber gloves and protect the bed with absorbent or waterproof oilcloth / sheets.From the patient remove the linen and conduct hygienic procedures in strict sequence.
Step 1 - Oral Care
If the patient is able to sit, then it is placed on a chair or attached to a sitting position directly in the bed.If you change the position of the body to the patient is prohibited, you just need to turn his head to one side.Cotton buds cleared the buccal space from accumulated mucus and saliva, but for this you can use disposable spatulas that will move your cheeks and facilitate the procedure.
Teeth cleaning is carried out by the same rules as for a healthy person, but only more carefully, without applying effort.After the buccal spaces and teeth are cleared, it is necessary to rinse the oral cavity of the patient - this is done with a syringe with a soft tip, in which there is either pure warm water or a hygienic solution( hydrogen peroxide, baking soda).
Note: , when rinsing the oral cavity, needs to lift the head above the surface of the bed( if the patient lies) to prevent fluid from entering the esophagus and the respiratory tract.
Special attention should be given to the choice of toothbrush and paste, as in bedridden patients, the oral mucosa becomes vulnerable and sensitive to the action of stiff bristles.For patients after a stroke, a toothpaste is recommended, which has astringent and blood-resurfacing properties, but such recommendations should be given by the attending physician.
After the procedure for cleansing the mouth, the patient should get wet lips with an absorbent napkin and apply hygienic lipstick or moisturizing balm to them - this will prevent drying and cracking of the lips.Choosing such a tool, you need to be sure of their hypoallergenicity.
Step 2 - washing
The sponge is soaked in warm water and the face of the lying patient is wiped.Then the eyes are treated - using two wet wadded discs( for each eye separate), wipe them with movements from the outer corner to the inner one.
Cleaning of the inner surface of the auricles and the ear canal is done with the help of cotton buds, and then it is necessary to wipe the skin behind the ears, the neck and chest area with a moist sponge, paying special attention to the folds under the chest, the side surface and the stomach of the lying patient.In parallel with the described actions, the cleansed areas of the skin are dabbed with a cloth( it must have absorbent properties) and covered with a blanket or towel, as they move down, clothes are put on the upper part of the trunk.
After this, the patient lying down gently rotated to the side and wiped the back area.Immediately need to get wet treated areas and apply to the skin to protect against pressure sores, which contains zinc or arginine.
Stage 3 - hand washing
Each patient's hand is alternately placed in a basin with warm water and washed with a sponge or gloves.Particular attention should be paid to cleansing the interdigital space - it is in these places that a large number of pathogenic microorganisms accumulate.
After washing, each hand is dried with a towel, and the moisturizing cream is applied to the elbows - it is in these zones that coarsening of the skin is often observed, therefore it is necessary to prevent the appearance of cracks.It only remains to cut the nails and nail them with a nail file, but this is done not every day, but as the nail plates grow.
Step 4 - hygiene of intimate places
Before you start this step, you need to remove the gloves and put on clean, prepare new warm water. Hygiene of intimate places is carried out according to the following algorithm:
- under the pelvis of the patient lay a waterproof diaper;
- diaper is removed from the patient;
- on hand put on a mitten for washing, but you can use a special soft sponge;
- soak the mitten or sponge in warm water and squeeze;
- to spread the patient's legs, arrange them so that they are bent at the knees, and the heels - as close as possible to the pelvis;
- treat the perineum with a sponge / mitten, the movements should be directed from the pubic to the anus;
- dry the treated area with a disposable towel, or fabric, but specifically for this purpose;
- rotate the patient on its side and dry by blotting the skin of the body;
- take a clean diaper and put it on the patient.
Step 5 - Foot Wash
After the treatment of the crotch, the feet are moved to washing, but first you need to change the water in the pelvis and put on clean gloves, take a clean sponge or mitten. The procedure for washing the feet is performed as follows:
- rubs the feet to the ankle joint;
- stops in the pelvis, thoroughly washed, paying special attention to the areas between the fingers;
- feet are dried with a towel;
- the patient turns sideways, the skin of the back of the legs is treated with a special anti-decubitus product;
- put the patient on his back, cut his nails on the toes, process the edges of the nails with a nail file for a pedicure.
Please note: all hygienic procedures described must be carried out daily.This is the only way to prevent the occurrence of pressure sores and to alleviate the plight of a bed-patient.
This hygienic procedure should be carried out as the hair of the lying patient is soiled. The following should be prepared:
- an inflatable bath, but you can do with an ordinary basin;
- the support for the pelvis;
- jug, or any other vessel, for warm water;
- comb;Headscarf or cap.
The recumbent patient should be in the supine position on the back, an inflatable bath is placed under the head.If you use a pelvis, then you need to put an inflatable small pillow under your head, and under the neck - a roller so that the head was thrown back.The head of the bed should be covered with an oilcloth or a waterproof diaper, and install a basin with water.
The wash head procedure is carried out in the following order:
- on the patient's head pour warm water from the jug and moisten all hair;
- is applied by shampoo, foaming;
- rinses hair;
- wraps the head with a towel and gently removes the basin, oilcloth or inflatable tub;
- carefully, but gently, wipe the hair;
- combs the hair;
- on the head of a lying patient put on a kerchief or hat.
Taking care of bed patients is a difficult and troublesome procedure.But it is the proper organization of conducting hygienic care that will facilitate the work of those who care for the patient, and will have a beneficial effect on the state of health of the latter.
Tsygankova Yana Aleksandrovna, medical reviewer, therapeutist of the highest qualification category