HYGIENE:

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
A. COMPLETE BED BATH Practice
Satisfactory Comments

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:

1. Spread towel across

patient’s chest.

1. Make mitt out of

washcloth.

1. Wash patient’s face. 

1. Remove patient’s gown.

1. Place towel under far

arm and bathe, rinse,
and dry near hand, and
axilla.

2. Place towel under near

arm and bathe, rinse,
and dry near hand, arm,
and axilla.

3. Spread towel across

patient’s chest and
wash, rinse, and dry
chest to waist.

4. Wash, rinse, and dry

abdomen.

5. Place towel under far

leg.

6. Place patient’s foot in

bath basin.

7. Wash, rinse, and dry far

leg.

8. 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.

b. Help him put on clean garment.

c. Assist with hair care.

d. Assist with nail care.

e. Assist male patient with shaving.

f. Make occupied bed and return to

low position.

g. Tidy up area.

Needs more
A. ORAL CARE Practice
Satisfactory Comments

B. 1. Toothbrushing for Conscious Patients

1. Place a towel under the patient’s chin,

tucking behind the shoulders.

1. Put on clean gloves.

1. Moisten the toothbrush with water and

spread a small amount of toothpaste on it.

1. 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.

1. Allow the patient to rinse the mouth with

water followed by a mouthwash, if
desired.

1. Wipe the patient’s mouth.

Needs more
B.2 Flossing Satisfactory Comments
Practice

2. Floss the teeth and between the gums

and each individual tooth.

2. Rinse the mouth after.

Needs more
B.3 Toothbrushing for Unconscious Patients Satisfactory Comments
Practice

1. Wash hands.

1. 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.

1. Place a towel under the patient’s chin,

tucking it behind the shoulders.

1. Put on clean gloves.

1. Place a padded tongue blade in the

patient’s mouth. 

1. Brush all tooth surfaces, tongue and

mouth surfaces.

1. Clean all surfaces of the mouth, including

the palate, inner cheeks and tongue by
using an oversized cotton-tipped
applicator. 

1. Rinse the patient’s mouth with small

amount of water.

1. Wipe the patient’s mouth.

1. Lubricate the lips as needed.

1. Return the bed to the low position.

1. Wash hands.

B. 4. Care of the Dentures.

1. Put on clean gloves.

 1. Assist patient with removal by applying
downward pressure with the index finger
above the denture.

1. Handle dentures with care.

1. Take the dentures to the sink in the

denture cup. Use a denture brush, if
available, for cleaning. Rinse them
thoroughly.

1. Have the patient rinse out the mouth

before reinserting the dentures.

1. Return the dentures to the patient, filling

the upper dentures in first.

1. Dry the patient’s mouth.

A. HAIR CARE

Needs more
C.1. Brushing and Combing Satisfactory Comments
Practice

1. Place a face or bath towel over the

pillow. 

1. 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.

1. 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.

1. 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.

1. Turn the patient;s head in the opposite

direction and repeat step 4.

1. Arrange the hair. Braiding may be the

most appropriate style for the long hair.

1. Remove towel.

1. Place towel in a laundry hamper bag.

1. Clean the comb and brush and return

them to the bedside stand.

Needs more
C.2. Shampooing Satisfactory Comments
Practice

1. Fanfold the top linen to the foot of the

 bed 

1. Position a bath blanket over the patient.

1. Place a pillow under the patient’s

shoulders.

1. Place the towel around the patient’s

shoulders and neck with the ends of the
towel coming together in front.

1. Place a Kelly pad under the patient’s

head with the trough extending to the
receptacle for water.

1. Plug the ears with dry cotton balls. Protect

the eyes with a folded washcloth, then
wet the hair.

1. Shampoo and rinse twice, using only a

small amount of shampoo and rinsing
thoroughly. Squeeze the hair of dripping
water.

1. 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.

1. Replace wet pillow with dry one.

1. Remove the washcloth from client’s eyes,

and cotton plugs from ears.

1. Further dry the patient’s hair, ears and

neck with a towel.

1. Comb or brush and arrange the hair.

1. Remove the plastic square, towels,

trough, pitcher and basin.

1. Replace the top bed linen, removing the

bath blanket after the top sheet is in
place.

1. Allow the patient to rest.

Needs more
A. EYE CARE Practice
Satisfactory Comments

1. Wash hands.

1. 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.

1. If artificial tears are ordered, instill into the

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

1. Gently close each eyelid and hold it

closed while the eyepad is placed over it.

1. Secure the eyepad with tape so that it

holds the eye closed.

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

1. Put away or dispose of equipment.

1. Wash hands.

Needs more
A. PERINEAL CARE Practice
Satisfactory Comments

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.

1. 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.

1. Rinse and dry area thoroughly.

1. Assess for redness, swelling, discharge,

irritation or skin breakdown.

MALE:

1. Gently grasp shaft of penis and if client is

not circumcised, retract foreskin.

1. Wash tip of penis at urethral meatus first.

Using circular motion, cleanse away from
meatus. Replace foreskin to its natural
position.

1. Cleanse shaft of penis and scrotum,

washing underlying skin folds.

1. Rinse and dry.

Needs more
A. BACK RUB Practice
Satisfactory Comments

1. Place patient on prone position.

1. Assess for sign of skin irritation or lesions.

1. 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.

1. End massage with long stroking

movements and tell client you are ending
massage.

1. Knead skin by grasping tissue between

thumb and fingers. Knead upward along
each side of spine and around muscles of
neck, avoiding bony prominences.

1. Observe skin for redness and skin

breakdown. Remove excess lotion from
back with bath towel.

1. Apply clean gown or pajamas, dressing

the affected side first.