Explain the Main Determinants of Health and Explain How to Promote Health

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Patient Hygiene

The aim of this assignment is to explain a nurse’s role in relation to assisting patient’s with meeting their hygiene needs. In order to accomplish this, the following areas of the subject will be highlighted; why hygiene is so important and the various aspects of hygiene such as; what influences hygiene, assessing a patient, bed bathing, oral hygiene and eye care. Oxford dictionary describes hygiene as “the conditions or practices conductive to maintaining health and preventing disease especially through cleanliness”. Hygiene and cleanliness are a basic human right. According to the National Health Service (NHS) “if an individual becomes unwell, either physically or mentally and where unable to meet their hygiene needs they may require someone else to assist them in such needs”.1 In a hospital setting this is a duty of care from the nurse to his/her patients.

According to the Roper-Logan and Tierney model, cleansing and dressing are one of the twelve activities of daily living also known as ADL’s.2 This model also describes other possible contributing factors which may influence the activity of living such as; biological (this varies from skin pigmentation and hair to gender and physical disability) psychological (such as the knowledge people have about cleansing and dressing and why hygiene is so important to prevent infection) environmental (such as if a person has running water where they live, also if a person is living in a tropical climate they may need to bath or shower more often due to excessive perspiration).2 This model also talks about politico economic; this is where a person may have all the facilities necessary to meet hygiene needs but due to rising costs of fuel cannot afford to use them.2

When a patient is admitted to hospital, a nurse will usually create a care plan for him/her. Using the ADL’s the nurse will identify the patient’s personal hygiene routine, their ability to carry out this routine and products the patient may want to use, this will help the nurse to identify existing or potential problems which may arise for example; how much assistance the patient may need to carry out this activity of daily living.3 It is important for a nurse to communicate adequately with his/her patient in order for them both to have an understanding on what the patient does and does not need or want assistance with, this will maintain and promote as much independence as possible.3

When a patient is admitted to hospital their skin should be assessed especially if they are elderly as elderly skin is thinner. Skin care involves the care of skin, hair and nails. According to Dingwall 2010 “the skin is the largest organ of the body and one of the most important”.4 Skin is important because it is the body’s first line of defence and therefore it should be looked after. In elderly people the structure of the skin changes and cells may not be replaced as easily. Skin also becomes looser and is at risk of developing pressure sores. 5 When on placement the author got to help assess patients using the waterlow chart, which is a risk assessment chart that tries to prevent the development of pressure sores it is based on the following, weight and build, continence, skin type, mobility, gender age and appetite. (www.health.vic.gov.au) It is important to try and prevent pressure sores as it will take elderly skin longer to recover.4

Bed bathing is one aspect of hygiene a nurse may need to assist a patient with. Before giving a patient a bed bath a nurse must discuss the procedure to gain co-operation and consent. 5 On placement if a patient was unable to talk due to stroke we would explain what we were doing step by step, maintaining privacy, warmth and dignity throughout. It may require two nurses to carry out a bed bath. Nurses should wear an apron and any other necessary health and safety items. According to essential nursing skills, “gloves are not necessary unless required by the patient’s...
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