Personal Hygiene

Personal Hygiene

A series of actions taken for the preservation of health is called hygiene. "Hygiene refers to situations and behaviors that assist to preserve health and prevent the spread of illnesses," the World Health Organization (WHO) states.

Personal hygiene refers to grooming and cleanliness practices that support both physical and mental health. Good personal hygiene habits are a sign of responsibility and a healthy lifestyle. Personal hygiene upkeep is essential for one's comfort, safety, and overall wellbeing. Personal cleanliness and good hygiene are crucial for maintaining a positive self-image as well as for halting the spread of diseases and sickness.

Maintaining cleanliness is important, but it also has an impact on your self-esteem and how people perceive and interact with you. Personal hygiene includes keeping up with your look and cleansing every region of your body on a daily or frequent basis to prevent stink. Bathing, hand cleaning, maintaining neat hair, brushing teeth, and taking care of the nails, perineum, ears, and nasal cavities are all examples of personal hygiene habits.

Factors Affecting Skin Integrity

Different persons have different levels of skin and mucous membrane damage resistance. The number of underlying tissues, the person's age, and their medical problems are all factors that affect resistance. Skin integrity and appearance are impacted by both internal and external variables, including exercise and factors like age, heredity, and the person's underlying health. People who find it difficult to move or to shift positions when seated or in bed run the risk of having poor tissue integrity. Here are a few elements that might contribute to compromised skin integrity.

Nutrition: Body cells that are properly hydrated and fed are resistant to damage. A client's risk of skin disintegration due to weight loss, muscular atrophy, and loss of subcutaneous tissue is increased by inadequate nourishment.

Trauma: Physical trauma, such as thermal injury (such as frostbite), chemical injury, such as medication responses, particularly those from chemotherapeutic agents, radiation, and ischemia are just a few of the factors that can result in injury or tissue destruction.

Disease condition: Skin integrity is impacted by several chronic disorders and their therapies. Jaundice patients are more inclined to scratch their skin, which can lead to an open lesion that could get infected and is frequently dry and uncomfortable. Skin conditions like eczema and psoriasis, which frequently result in lesions, may have a hereditary tendency.

Age: In children younger than 2 years, the skin is thinner and weaker so the child's skin and mucous membranes are easily injured. Ageing process alters skin thin, wrinkle and loose making it more vulnerable to damage.

Tissue perfusion and oxygenation: It need a healthy circulation to keep cells alive. When cells are devoid of oxygen and nutrition for a predetermined amount of time, along with an accumulation of metabolic waste products, tissue damage results. People with poor peripheral artery circulation may have easily damaged skin on their legs.

Dehydration: Dehydration makes the skin appear loose and flabby.

Edema: Hypoproteinemia results in the development of edema that decreases the skins elasticity, flexibility, and strength. Very thin and very obese people tend to be more susceptible to skin irritation and injury.

Moisture: Moisture macerates the surrounding skin, causing superficial erosion of the epidermis. Primary sources of skin moisture include perspiration, urine, feces, and drainage from wounds or fistulas.

Impaired sensory perception: Reduced sensation like paralysis, local nerve damage cause patient's inability to sense temperature extremes, pressure, friction and other such factors can easily result in injury.

Chemical irritants: Toxic agents such as drugs, acids, alcohols, metals and substances may alter the skin integrity.

Radiation: Ultraviolet light or radiation exposure may cause skin damage.

Temperature: High or low temperatures may cause skin damage and cellular necrosis as a possible result.

Care of skin: Hygiene practices at every age have a direct influence on the status and appearance of the skin. 

Factors Influencing Hygiene

Physical, psychological and social factors can affect a person's ability or willingness to perform the self-care tasks necessary for good hygiene.

Physical Factors: people with conditions that limit mobility such as back problems, obesity or arthritis may have difficulty getting in or out of a bathtub or shower. In many cases, people understand the importance of good hygiene and wish to practice it, but are prevented from doing so by physical factors that make them unable to accomplish the mechanics of bathing.

Psychological Factors: Mental and psychological issues can affect both a person's ability and motivation to perform basic hygiene. Hygiene problems can arise in later stages of Alzheimer's disease, with apathy, fearfulness, depression, inability to plan or remember and inability to perform tasks in sequence all reducing the person's ability to practice good hygiene. Psychological disorders such as schizophrenia and borderline personality often cause a pronounced lack of interest in hygiene, and poor hygiene can sometimes be a diagnostic tool pointing toward a certain condition.

Social Practice: Social groups influence hygiene preferences and practices, including the type of hygiene products used and the nature and frequency of personal care practices. Family customs play a major role during childhood in determining hygiene practices such as the  frequency of bathing, the time of day bathing is performed, and even whether certain hygiene practices such as brushing of the teeth or flossing are performed.

Personal Preferences: Patients have individual desires and preferences about when to perform hygiene and grooming care.

Body Image: Body image is a person's subjective concept of his/her body, including physical appearance, structure, or function. Body image affects the way in which individuals maintain personal hygiene. Most cases in hospitals, nurses notice that patients with altered body image proper and impaired physical condition will have difficulties in performing hygiene practices. The limitations and disabilities that they have restrict them from personally taking charge of hygienic care. 

Socioeconomic Status: Social and economic factors can have an impact on personal hygiene as well. Hygiene expert says some cases of poor hygiene can stem from lack of understanding or training in the fundamentals of hygiene. He/she may not able to afford desired basic supplies such as shamphoo, soap and towels and inability to pay a water bill.

Cultural Variations: An individual's hygiene practice is also influenced by culture. In some cultures, it is customary to bathe only once a week, while in others it is common to shower daily. As such, self-care practices align closely with their cultural beliefs.

Health Belief and Motivation: Knowledge about the importance of hygiene and its implications for well-being influences hygiene practices. Motivation also plays a key role in a patients hygiene practices.

Developmental Stage: The normal process of aging influences the condition of body tissues and structures. A person's developmental stage affects the ability of the patient to perform hygiene care and the type of care needed.

Safety Guidelines

• Ensure the security of the patient. When making choices about a patient's treatment, consider and include the patient's priorities for care and preferences, communicate openly with the healthcare team, and use the best available evidence.
• Moving from the cleanest to the least clean or unclean regions, always practice good hygiene. During care tasks, this frequently necessitates changing gloves and completing hand hygiene.
• When doing hygienic tasks that might include contact with non-intact skin or mucous membranes or when it's likely that drainage, secretions, or blood will be present, use clean gloves.
• Always check the temperature before using water or other solutions for hygiene care to avoid harm.
• Use safe patient handling techniques and body mechanics concepts to prevent injuries when providing hygiene treatment.
• Be cautious of the invasion of privacy and potential loss of self-esteem when providing or aiding with hygiene care.
• Using therapeutic communication strategies, privacy-creating drapes, and warning the patient before touching private or sensitive body regions can all help to promote acceptance and comfort.
• When assigning hygiene care to nursing assistants, keep in mind that you are liable and accountable for monitoring the patient both before and after care to discover unexpected outcomes and provide the necessary guidance.

Oral Care

The scientific maintenance of the teeth and mouth is referred to as mouth/oral care. It encompasses the oral mucosa, lips, tongue, and teeth, including any artificial dentures. Typically, dental care is provided twice a day, after eating in the morning and at night. Assure the patient receives treatment as frequently as required to maintain a clean, moist mouth if they are unable to do oral hygiene.

It's crucial to maintain good oral health for both physical and mental wellbeing. Food enters the body through the mouth, where it begins to be digested. So the conditions of mouth can directly affect the health of an individual. Oral problems can cause localized pain and systemic disease. Loss of teeth affects self-image and halitosis can influence social interaction.

Complications (a danger of neglected mouth care):

Offensive Breath: bad smelling

Halitosis: foul breath

Stomatisis: inflammation of the mucus membrane of the mouth. 

Glossitis: inflammation of the tongue pus formation in the sockets of the teeth

Pyorrhoea: pus formation in the sockets of the teeth

Tonsillitis: inflammation of the tonsils 

Otitis Media: inflammation of the middle ear

Sinusitis: inflammation of the sinuses 

Cracked lips/cheilosis:  involves cracking of the lips/brown crust formed on lips

Parotitis: inflammation of the parotid glands

Gingivitis: inflammation of gums

Dental Carries: forms cavity in the teeth

Anorexia: loss of appetite

Gastritis: inflammation of the stomach

Bleeding Gums: deficiency of vitamins C and use a hard brushing of the teeth

Purposes

• to maintain the mucosa, teeth, gums, and lips in good condition.
• to alleviate discomfort brought on by unpleasant tastes and odors.
• to eliminate food fragments that might serve as a breeding ground for microorganisms.
• to avoid the mucus membrane becoming damaged and dry.
• to increase appetite.
• to make someone salivate.
• help stop tooth decay and dental caries.
• to eliminate bad breath by clearing out the oral debris.
• help avoid or cure oral infections such parotitis, glossitis, and stomatitis.
• to increase gum tissue's blood flow and retain its suppleness.
• to keep people who are bedridden clean in their mouths.
• help revitalize the patient and improve wellbeing.

Scientific Principles

• A healthy, balanced diet can aid in tooth maintenance and the prevention of dental disease.
• A diet high in fiber can aid in preventing salivary gland atrophy and raising saliva's protein content.
• Saliva production and function contribute to the reduction of mouth infections. Lemon juice and chewing gum help keep the flow going.
• Microorganisms thrive in the mouth when food remnants are still present.
• Hot water damages dentures whereas cold water decreases friction.
• The patient feels worry whenever they receive a new therapy or are exposed to an unexpected setting.
• The cough reflex is suppressed in a patient who is unconscious.

Tooth Brushing and Flossing

• By vigorously cleaning the mouth and promoting gingival circulation while without causing irritation, tooth brushing and flossing dental plague.
• Costly dental procedures, cavities, gum diseases including gingivitis and periodontal disease, and poor breath can all be avoided with healthy teeth.
• To prevent harming your gums, brush at least twice a day using a soft-bristled toothbrush and fluoride toothpaste.
• Use the method your dentist recommends to gently floss your teeth once a day.
• All teeth should be accessible with a tooth brush.
• Between usage, brushes should be cleaned and dried.
• Breath is made fresher and microorganisms are removed by brushing the tongue.
• Powders and tooth pastes make brushing easier.

Prevention of Complication

• Every patient's teeth require thorough cleaning and brushing with a dependable tooth paste and brush, or salt, soda, and bicarbonate, at least twice a day.
• Every four hours, the teeth and gums that are in poor condition must be brushed and cleaned with dental paste, salt, or soda-bicarbonate, followed by mouthwash and gargling.
• The patient's diet should contain enough calories and a variety of vitamins, including vitamins B and C.
• Citrus fruits should be consumed often since they help build resistance.

Indications

The patients who may require special mouth/oral care are:

• Patients who breathe through their mouths and have a fever.
• Patients who do not take oral feeds or are on a liquid diet.
• Patients with oral infections and diseases.
• Those who have been heavily sedated.
• Patients with dehydration
• Patient who is paralyzed after surgery.
• Patient is not conscious.
• Critically unwell patients.
• The individual receiving oxygen treatment.
• The person receiving cytotoxic treatment.

Various Oral Care Agents Used for Oral Hygiene

The choice of oral care agent is depend on the aim of the care, need, interest and condition of the clients.

• Tooth paste: It can dry the oral cavity if not adequately rinsed.
• Nystatin: Used to treat fungal infections
• Chlorohexidine gluconate: It is a compound with broad spectrum anti-microbial activity. It helps to suppress the growing of bacteria.
• Sodium chloride/sodium bi-carbonate: It should dilute before used: 1 teaspoonful to a pint of water [500ml]. It may bring burn if not diluted adequately.
• Potassium permanganate: 1:5000 [1 crystal to a glass of water]
• Potassium chloride: 4 to 6 percent
• Fluconazole: It is used for treatment of candidiasis of the oropharynx, esophagus.
• Fluoride: It is used to prevent and arrest tooth decay.
• Hydrogen peroxide [H2O2]: 1:8 solution
• Glycerin with lime
• Neem stick
• Other commercial preparations are also available which is prescribed by dentists [betadine gargle]

Assisting Clients for Oral Care

For a conscious patient who is able to gargle or rinse his mouth, a toothbrush and toothpaste may be used to clean his teeth. Help only if necessary or assist the weak or debilitated patient for cleansing mouth by mechanical brushing of the teeth and rinsing of the mouth.

Articles

A tray containing:

• Clean gloves.
• Small mackintosh and towel.
• Glass or feeding cup with water.
• Kidney tray.
• Sputum mug.
• Brush and paste/tooth powder.
• Mouth wash solution according to patient's preference, availability and necessary.
• Sodium chloride/Potassium chloride/Sodium bi-carbonate as needed.
• Emollient in a container- glycerin, liquid paraffin, Vaseline, coconut oil.

Screen

Suction apparatus if needed

Procedure