ASSISTING WITH PERSONAL HYGIENE

Introduction

The caring is referred to the practice of looking after individuals who are unable to take care of themselves due to age-related issues or illness. The assistance with personal care for the individuals who are ill led to ensure their hygiene which is a vital part of living a healthy and dignified life. In this essay, the assisting regarding personal care to be discussed is providing bed bath to the patients who are unable to move. For this purpose, the nursing skills required, and knowledge of care needed is to be discussed. Moreover, the professional values to be demonstrated while providing nursing care for bed bath to the patients is to be discussed. In the end, the constitutes of care and way they are linked with my knolwdege development and skill for bed bath delivery and NMC Code is to be explained. Additionally, seeking nursing dissertation help can offer valuable insights into the effective integration of these concepts into your practice.

Main Body

In the healthcare environment, some patients due to their deteriorated health condition or age-related issues are unable to safety move out from their beds for performing bathing to maintain personal hygiene. In this case, the nurses by arranging bed bath for the patients helps to keep the patient’s skin healthy, control body odour and enhanced their comfort (Veje et al., 2019). Therefore, bed bath is important to keep the patients who are unable to move off their bed to be able to maintain enhanced personal hygiene. The general principle of providing bed bath is keeping the patients to remain warm all the time and position them on linen which is to be disposed after the bath for reducing dispersal of any dead skin cells or microorganisms from the patient in the environment. The exposed area of the body is to be washed and the water for bathing is to be changed after it turns dirty. During the bed bath, it is to be ensured that the skin remains clean and any damage present on the skin is to be checked to avoid further damage in the area. The skin is to be pat dried and friction is to be reduced to avoid damage on the skin and separate towels are to be used for cleaning different areas of the skin (Groven et al., 2017).

One of core nursing value is maintaining human dignity of patients as it led the patients to feel independent, respected and autonomous in taking own decision (Er et al., 2018). The presence of enhanced interaction between patients and nurses helps the nurses to promote dignity of the service users as it leads them to address patients with respect and interact with patients at personal level to understand their need and preference in care to be fulfilled (Asmaningrum and Tsai, 2018). Thus, effective communication with the patient to be provided bed bath is to be developed by me as a nurse so that their preferences in the care such as if they wish to open clothes on own or need assistance, of doors are to be closed with curtains, separators to be used, washing which part of body are to be supported or not and others are identified. It is important to make them feel independent and respected in taking care decision that eventually leads to promote their dignity. The failure to maintain dignity in bed bath would lead the patients avoid complying with the nurses and develop lack of trust towards their efficiency in delivery care with dignity (Martin-Ferreres et al., 2019).

In order to gain trust and consent of the patient by the nurses to provide them bed bath, the nurses are to mention in detail and with honesty the procedure of bed bath, way the procedure is to be followed and its importance for the patient’s health. This is because it would make the patient understand the importance of the act and the reason behind it is been provided (Prado et al., 2017). Moreover, it would help in meeting the nursing value of integrity by making the nurse be honest with information of the process of care to be followed for the patient (Kim and Lee, 2017). It would also allow the patient to develop clarified ideas regarding the way the nurses is going to act in the situation, in turn, allowing the patient to develop gradual trust as their doubts and confusion of privacy and other values in the process are resolved. This, in turn, would lead them to provide consent regarding the care action out of clarification of their doubts and well-defined knowledge regarding the way the act is to be performed (de Lima Lopes et al., 2015).

The usual hygiene routine of the patient is to be identified by the nurse in providing them bed bath (Groven et al., 2017). This is because it makes the patient ensure that the person is been effectively bathed and no compromise towards the person’s hygiene due to the individual’s lack of participation in the act of care is made. Moreover, it promotes precision and accuracy in care which is one of the nursing values (Al-Banna, 2017). This is because the knolwdege of the routine of hygiene of patient leads nurses to accordingly customise the bed bath care that best suits the needs and demand of the patients. Therefore, as nurse providing bed bath to the patient, I need to interact with the patient to know their hygiene routine to be followed during bath so that satisfactory care can be provided. As a nurse, before the initiation of the bed bath, assessment of the patient is to be made to determine if they have pain in any area and accordingly analgesia is to be provided ensuring it has affected the area to relive the pain before the initiation of the bath. This is important as it would make the nurse relive any pain and assist the patient to move without hindrance during the bed bath procedure (Groven et al., 2017). In effectively assisting patient for bed bath, the nurses require to initially ask if the patient with to empty their bowel or bladder before initiating the procedure. This to ensure the patients remain comfortable during the bath and does not require the nurse to stop in the middle of the care to provide them time in excreting (Miranda et al., 2017). Thus, as a nurse, I need to check with the patient before their bed bath if they need to excrete or others to ensure no termination is made in the middle of the procedure and the patient remains clean and hygiene after the bath.

During the initiation of the bed bath, the nurses require to have knowledge and skill to identify and understand all the equipment required during the process to be kept in handy. This is to avoid wastage of time and leaving the patient in the middle of the bath to arrange the equipment and resources later which may make the patient feel unsatisfactory care and ignorance in effectively supporting them (de Lima Lopes et al., 2015). It would also help the nurse to promote their value of commitment and competency in care because it would help them to show the level of careful they are to avoid wastage of time and ensure quality care in bed bath is reached to the patients by previously ensuring all resources are present adequately with skills (Karami et al., 2017). Therefore, as a nurse to provide bed bath, I would keep all the resources and equipment required handy to avoid leaving the patient in the middle of bath which may make them feel vulnerable and ignored.

The nurse in providing bed bath to the patients is required to have increased patience and calmness. This is because the patients may not always comply with the care actions required during the bed bath and may show tantrum along with non-compliance to allow the nurse to smoothly provide them care (Bastos et al., 2019). Therefore, as a nurse, I need to calm and patient so that I avoid being angry and tackling any annoying nature of the patient in an appropriate way, so the procedure of care is effectively fulfilled without any hindrance. In order to maintain hygiene during bed bath, a disposable apron is to be wore and any additional thing such as watch, ring, glasses and others to be removed. Moreover, hands are to be decontaminated in front of the patient before initiating their bed bath to ensure them that effective hygiene is been maintained to provide care to the patient (Jeong and Kim, 2016). It is also beneficial to avoid transmission of any infection from the nurse to the patient during their bath in which most of the body is exposed and there are high chances of easy entry of germs into the body of the patients (Groven et al., 2017).

In maintaining safety of the patient during bed bath, the nurses required to maintain effective height of the bed and install supporting railings to avoid the patient to fall from the bed during the care (Groven et al., 2017). This is because the railing would act as support to avoid the patient from falling and lower height of the bed would help the nurse to get proper access to the patient to provide them bath in comfortable manner. The access to consent to remove clothes of the patient to prepare them for the bed bath is required to be taken by the nurse. This is to ensure the patient show effective willingness to accept the care and does not blame the nurse for violating their privacy by removing clothes without their permission (Richter et al., 2019).

In order to maintain privacy of the patient during bed bath, the body parts to be washed are to be exposed at a time while cleaning and other parts are to be covered with the towel. This is because it would make the patient avoid being fully exposed in front of the nurse which may be shameful for them and violates their feeling of dignity and respect (Groven et al., 2017). The position of the patient while providing bed bath is to be effectively managed by the nurse to ensure they do not experience pain due to manhandling or face unnecessary fall during the care process (Groven et al., 2017). This indicates that as a nurse while providing bed bath to the patient it is to be ensured that the patient is positioned on the abdomen or lateral recumbent side, as well as the individual's back and buttock, are exposed to help in providing effective bath to the patient and make them move less to avoid fall (Rahn et al., 2016).

In nursing, caring is referred to the moral ideal of nurses where they are responsible in delivering protection to patients from harm and abuse, enhance care delivery and preserve the dignity of the patients in aspects of care (Suhonen et al., 2018). The constitutes of good care include effective clinical assessment, identification of care goals, risk assessment, development of comprehensive care plan and review along with change of care plan as per patient condition (Zwakhalen et al., 2018). The clinical assessment in care is essential so that the detailed diagnosis of the health condition of the patient is understood along with their holistic needs in care can be fulfilled (Figaji, 2017). It effectively links to how I developed knowledge and skills in delivery of bed bath to the patients. This is because effective clinical assessment of the patients to be provided bed bath was made by me as the nurse to determine their needs to be fulfilled in the session (avoiding lifting arm where they are perceiving pain, taking care of any blisters or wound if present to avoid them from further bruise, etc) and nature of support to be provided. This action fits with the “Prioritise People” aspect of NMC Code as it mentions holistic clinical assessment of the patient is to be made so that their psychological, physical and social needs are appropriately identified which are to be fulfilled in care (NMC, 2018).

The identification of care goals is essential because it acts as guidance for nurses to fulfil different decision of care for the patient (Simamora, 2020). However, the lack of care goals leads the nurses to doubt and become confused regarding the way care is to be fulfilled for the patient as they cannot identify any direction of care (Jain and Bernacki, 2020). This element of care links with the way I developed knowledge and skills of delivering bed bath because as a nurse I ensured I have detailed information of the care goals of patients to be reached through bed bath such as which individuals has to be shaved after from bath, disinfectant to be used in bath for which patients and others. The also links with the “Prioritise people” aspect of NMC Code as it informs care goals are to be well-defined, understood and applied in care by nurse (NMC, 2018). In care, comprehensive care plan and its change with review help to deliver continuous quality care to the patients (Nekhlyudov et al., 2017). This is effectively understood by me a nurse and I accordingly developed knolwdege of bed bath delivery to patient as I made comprehensive care plan to be followed for each individual and changes in bed bath ways to be made with time for each patient to ensure them effective care delivery.

The risk assessment in care is important to identify the risky components present for the patient in the care environment and the actions to be executed or avoided to preserve safety and reducing risk pf deterioration of care for the patient (Piscaglia and Ogasawara, 2018). It is linked with the way I developed skills and knolwdege regarding bed bath because I as a nurse did perform risk assessment for each of allocated patients before bath to determine the actions to be avoided or made to ensure safety of them from any risk. This is evident as identified if any patient has transmissible infection so that I can use PPE (personal protection equipment) kit and offer them separate bed bath along with disinfect the towel so that the infection does not spread to others through contamination. Moreover, I performed risk assessment to determine which position of the patients are to be maintained during bed bath so that no falls occurs during the care. It also links with the NMC Code which under “Preserve Safety” aspect mentions risk assessment of the patients are to be executed and care is to be allocated accordingly to reduce the risk (NMC, 2018).

Conclusion

The above discussion informs that bed bath is provided to patients who are unable to move and manage their own care. The nurses responsible in providing bed bath is required to frame effective communication with the patients to determine their need and preference to be fulfilled in the care. The communication skills essential for the nurses while interaction with the patient for bed bath is showing compassion, educating patient importance and benefit of bed bath, inform the procedure to be performed and acquire trust. The values to be focused for the patients while providing them bed bath is maintaining their privacy, respect and dignity. The psychological aspect for the client to be focussed is to ensure they remain comfortable while having the bed bath and approve for the actions to be performed by the nurse during bath. The elements of care are seen to have been effectively linked with the knowledge and skill developed during the delivery of bed bath to the patient as enhanced clinical assessment, care goals, risk assessment and others are made or identified in delivering bed bath.

References

Al-Banna, D.A., 2017. Core professional and personal values of nurses about nursing in Erbil City hospitals: a profession, not just career. Nurs and Care Open Access J, 2(6), pp.169-173.

Asmaningrum, N. and Tsai, Y.F., 2018. Nurse perspectives of maintaining patient dignity in Indonesian clinical care settings: A multicenter qualitative study. Journal of Nursing Scholarship, 50(5), pp.482-491.

Cruz, J.P. and Bashtawi, M.A., 2016. Predictors of hand hygiene practice among Saudi nursing students: a cross-sectional self-reported study. Journal of infection and public health, 9(4), pp.485-493.

de Lima Lopes, J., Barbosa, D.A., Nogueira-Martins, L.A. and de Barros, A.L.B.L., 2015. Nursing guidance on bed baths to reduce anxiety. Revista brasileira de enfermagem, 68(3), pp.437-443.

Er, R.A., İncedere, A. and Öztürk, S., 2018. Respectful care of human dignity: how is it perceived by patients and nurses?. Journal of medical ethics, 44(10), pp.675-680.

Figaji, A.A., 2017. Anatomical and physiological differences between children and adults relevant to traumatic brain injury and the implications for clinical assessment and care. Frontiers in neurology, 8, p.685.

Groven, F.M., Zwakhalen, S.M., Odekerken-Schröder, G., Joosten, E.J. and Hamers, J.P., 2017. How does washing without water perform compared to the traditional bed bath: a systematic review. BMC geriatrics, 17(1), p.31.

Jain, N. and Bernacki, R.E., 2020. Goals of Care Conversations in Serious Illness: A Practical Guide. Medical Clinics, 104(3), pp.375-389.

Jeong, S.Y. and Kim, K.M., 2016. Influencing factors on hand hygiene behavior of nursing students based on theory of planned behavior: A descriptive survey study. Nurse education today, 36, pp.159-164.

Karami, A., Farokhzadian, J. and Foroughameri, G., 2017. Nurses’ professional competency and organizational commitment: Is it important for human resource management?. PloS one, 12(11), p.e0187863.

Kim, J. and Lee, J., 2017. Intergenerational program for nursing home residents and adolescents in Korea. Journal of Gerontological Nursing, 44(1), pp.32-41.

Koutoukidis, G., Stainton, K. and Hughson, J., 2016. Tabbner's Nursing Care: theory and practice. Elsevier Health Sciences.

Martin-Ferreres, M.L., Pardo, M.Á.D.J., Porras, D.B. and Moya, J.L.M., 2019. An ethnographic study of human dignity in nursing practice. Nursing outlook, 67(4), pp.393-403.

Miranda, R.P.R., Chaves, É.D.C.L., Lima, R.S., Braga, C.G., Simões, I.A.R., Fava, S.M.C.L. and Iunes, D.H., 2017. The effectiveness of a simulated scenario to teach nursing students how to perform a bed bath: A randomized clinical trial. Nurse Education Today, 57, pp.17-23.

Nekhlyudov, L., O'malley, D.M. and Hudson, S.V., 2017. Integrating primary care providers in the care of cancer survivors: gaps in evidence and future opportunities. The Lancet Oncology, 18(1), pp.e30-e38.

NMC 2018, The Code, Available at: https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf [Accessed on: 5January 2021]

Piscaglia, F. and Ogasawara, S., 2018. Patient selection for transarterial chemoembolization in hepatocellular carcinoma: importance of benefit/risk assessment. Liver Cancer, 7(1), pp.104-119.

Prado, A.R.D.A., Ramos, R.L., Ribeiro, O.M.P.L., Figueiredo, N.M.A.D., Martins, M.M. and Machado, W.C.A., 2017. Bath for dependent patients: theorizing aspects of nursing care in rehabilitation. Revista Brasileira de Enfermagem, 70(6), pp.1337-1342.

Rahn, A., Jones, T., Bennett, C. and Lykins, A., 2016. Conflicting agendas: The politics of sex in aged care. Elder L. Rev., 10, p.1.

Richter, G., Borzikowsky, C., Lieb, W., Schreiber, S., Krawczak, M. and Buyx, A., 2019. Patient views on research use of clinical data without consent: Legal, but also acceptable?. European Journal of Human Genetics, 27(6), pp.841-847.

Simamora, R.H., 2020. Learning of Patient Identification in Patient Safety Programs Through Clinical Preceptor Models. Medico Legal Update, 20(3), pp.553-556.

Suhonen, R., Stolt, M., Habermann, M., Hjaltadottir, I., Vryonides, S., Tonnessen, S., Halvorsen, K., Harvey, C., Toffoli, L. and Scott, P.A., 2018. Ethical elements in priority setting in nursing care: A scoping review. International journal of nursing studies, 88, pp.25-42.

Zwakhalen, S.M., Hamers, J.P., Metzelthin, S.F., Ettema, R., Heinen, M., de Man‐Van Ginkel, J.M., Vermeulen, H., Huisman‐de Waal, G. and Schuurmans, M.J., 2018. Basic nursing care: The most provided, the least evidence based–A discussion paper. Journal of clinical nursing, 27(11-12), pp.2496-2505.

Dig deeper into Assessing And Planning Patient Centred Care with our selection of articles.