Patient Comfort and Hygiene: A Comprehensive Guide

Posted on Sep 17, 2024 in Physical Education

Patient Comfort and Hygiene

Comfort

Comfort encompasses physical, psychological, and spiritual well-being.

Objectives

  • Provide relief from potential distress.
  • Maintain adequate circulation to all tissues and organs.
  • Maintain skin integrity to prevent injuries.
  • Maintain muscle activity to prevent contracture and atrophy.
  • Facilitate and maintain respiratory function.

Techniques for Enhancing Comfort

  • Roll comfort: Maintain alignment and body positioning.
  • Cotton rings: Avoid pressure on bony prominences.
  • Pillow: Avoid friction in areas of bony prominences.
  • Positioning the patient in bed: Maintain body alignment, prevent deformities, maintain skin integrity, assist in the drainage of secretions, and improve gas exchange.
  • Comfort massage: Stimulates circulation, prevents pressure sores, and allows muscle relaxation.
Massage Techniques
  • Effleurage: A sedative massage technique. Touch the palm or the pads of your fingers over the area in a centripetal direction or accompanying the muscle fibers.
  • Friction: Deep massage of skin layers. The massage therapist’s hand rubs against the underlying tissues. Should be made in the longitudinal direction when applied to a limb and in a circular direction when applied over an extensive region (back and anterior chest wall) or a rounded area (shoulder).
  • Petrissage: Applied only to regions with bulky muscle mass. Involves holding the skin, muscles, or underlying organs, lifting them, and then moving them across the top with a twisting motion.
  • Pinch: Similar to petrissage, but the region is massaged by being caught between the thumb and index fingers like pincers.

Other Comfort Measures

  • Mattress (air/water): Relieve pressure on areas, preventing injuries.
  • Position change: Change the patient’s position in bed at regular intervals.

Exercises

Exercises aim to enhance the functions of muscles, nerves, bones, and joints, as well as the cardiovascular and respiratory systems. They can be performed provided there is no restriction to movement.

Types of Exercises

  • Passive: Performed by nurses without the help of the patient to retain the maximum possible range of motion and maintain circulation.
  • Active-assisted: Performed by the patient with the help of nurses to establish normal muscle function.
  • Active: Performed by the patient without help to activate muscle strength.
  • Resistive: Accomplished by working with resistance produced by the patient to increase muscular strength.
  • Isometric/Twitch: Performed by the patient, where the muscle contracts and relaxes at the same time that the limb remains in a position to maintain physical strength when a joint is immobilized.

Patient Positioning

Different positions are used for comfort, examinations, surgery, and therapy.

Common Positions

  • Fowler’s: Provides comfort, facilitates lung expansion and cardiac output, and is the proper position for feeding. Raise the backrest 45 to 60 degrees. Use comfort pillows and towels.
  • Decubitus Dorsal (Horizontal or Supine Position): Maintains body alignment, allows for physical examination, and promotes abdominal muscle relaxation. Use comfort pillows and towels.
  • Prone Position: Relieves pressure on the back of the body, allows for examination of the spine and buttocks, and provides comfort. Use pillows.
  • Sims’ Position (Right and Left): Used for vaginal and rectal examinations and enema application. Use pillows.
  • Lateral Position (Right and Left): Provides comfort, prevents pressure sores, and prevents deformities. Use pillows, gloves, water, and roll comfort.
  • Gynecological Position: Used for vaginal and rectal examinations and treatments. Use pillows, blankets, and leggings.
  • Trendelenburg Position: Facilitates drainage of bronchial secretions, improves venous return, prevents miscarriage in cases of isthmus-cervical insufficiency, and is used for surgery of the pelvic region. Elevate the lower limbs 30 to 45 degrees.

Body Hygiene

Body hygiene involves providing hygiene care.

Factors that Influence Hygiene Practices

  • Self-concept
  • Socioeconomic status
  • Knowledge
  • Cultural variables
  • Social preferences

Hygiene Procedures

  • Spray bath or shower
  • Bath in bed: Includes cleaning the following areas in order: face, eyes, ears, front of the neck, hands, arms, armpits, chest, abdomen, legs, feet, back of the neck to the buttocks, genitals. Finish by cleaning the bed and storing bedding.
  • Sitz bath: Cleanses and reduces inflammation of the perineal and anal areas.
  • Cold-water bath: Relieves tension and lowers body temperature.
  • Hair care: Prevents infestations and injuries, stimulates circulation, and promotes cleansing of the scalp.
  • Treatment of pediculosis, seborrhea, ticks, and lice.
  • External wash: Cleaning of the genitals for specific procedures – catheterization, specimen collection, and preparation before surgery or elimination.
    • Dry external male wash
    • Dry external female wash
  • Use of bedpan, urinal, and commode: Bedpans and commodes are used for adults and children over 5 years old. Urinals are used for children under 5 years old and older than 1 year.

Oral Hygiene

Oral hygiene involves cleaning the teeth, gums, palate, cheeks, and tongue.

Oral Hygiene Procedures

  • Oral hygiene for patients capable of self-care.
  • Oral hygiene for patients incapable of self-care.
  • Oral hygiene for critically ill or unconscious patients.
  • Care of removable bridges or dentures.