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Scissors/nail clippers

Emery boards

Manual handling equipment

Urinal, bedpan or commode

Preprocedure

Action Rationale

1 Assess and plan care with the patient and family/friend as suitable. Note personal preferences, addressing religious and cultural beliefs; offer analgesia as appropriate. To plan care and encourage participation and independence (Hollins 2009, C; NMC 2008b, E, C; Pegram et al. 2007, E).

2 Clear the area of any obstacles, ensure the environment is warm and draw curtains/close doors to guarantee privacy and dignity. To maintain comfort and a safe environment and promote privacy and dignity (NMC 2008b, C).

3 Offer patient the opportunity to use a urinal, bedpan or commode. To reduce any disruption to procedure and prevent any discomfort (NMC 2008b, C).

4 Collect all equipment by the bedside. To minimize time away from patient during procedure.

Disposable flannels are preferable as this reduces the risk of infection. To meet patient preference during procedure (NMC 2008b, C).

5 Ensure wash bowl is cleaned with hot soapy water before use, fill bowl with warm water, check temperature with patient and adjust if necessary. To minimize cross-infection (Fraise and Bradley 2009, E; Parker 2004, C). To promote patient comfort. E

6 Ensure the area is safe; check that the bed brakes are on and adjust the bed to an appropriate height. To prevent the bed moving unexpectedly and to avoid poor manual handling techniques (Pegram et al. 2007, E).

7 Wash hands; use disposable gloves and aprons in accordance with local guidelines. To minimize risk of cross-infection (Fraise and Bradley 2009, E; Parker 2004, C).

Procedure

8 Assist the patient with the removal of clothing, wristwatches and any other items of personal property. Cover patient with bath towel or fleece and fold back bedclothes, incorporating appropriate manual handing procedures. To maintain privacy and dignity, body temperature (NMC 2008b, C), and safety (Pegram et al. 2007, C).

9 Ask patient whether they use soap on their face; wash, rinse and dry face and neck, with a gentle wipe around and inside the outer ears. To promote cleanliness and independence (NMC 2008b, C).

10 Assist male patients with facial shaving, apply chosen shaving foam/soap. Ensure skin is taut; begin shaving from cheeks down to neck in short strokes. Rinse razor as required. Change water and rinse face with clean water (or use electric shaver). To promote positive body image (NMC 2008b, C).

11 Wash, rinse and pat dry top half of body, starting with the side furthest away from you. Care needs to be taken not to wet drains/dressings and IV devices. Apply toiletries as required. To promote patient well-being and cleanliness and reduce the risk of cross-infection (NMC 2008b, C).

12 Change the water and your disposable gloves. Inform the patient that you are going to wash around the genitalia, gain verbal consent from the patient or ask the patient if they wish to wash this area themselves. Using a separate flannel or wipe, wash around the area and then dry it. Remove gloves, dispose as per hospital policy. When washing this area, remember that female patients wash from the front to back. Male patients should draw back the foreskin, if uncircumcised, when washing the penis.

If there is an indwelling catheter, put on clean gloves and wash the tubing, moving the disposable cloth down the tube away from the genitalia area, then dry tubing and remove gloves as per hospital policy. (Patients may prefer to do this themselves.)

To reduce risk of infection and to maintain a safe environment (NMC 2008b, C; Pegram et al. 2007, C).

13 Ensure the patient is covered and has nurse call bell within easy reach. Change water and gloves. To maintain cleanliness, preserving dignity and privacy (NMC 2008b, C).

14 Remove antiembolic stocking if present. Wash legs, rinse and pat dry, starting with the side furthest away from you. If necessary, request assistance from colleagues. Assess the need for possible chiropody referral. Re-fit antiembolic stocking as necessary, measuring according