Hair wash, Fundamentals of Nursing

Procedure for hair wash of patients admitted at hospitals or at at home

1. Hair wash Prepared by: Pooja Koirala Lecturer NMCTH

2. Hair The appearance of the hair often reflects a person’s feelings of self concept and socio cultural well being. Becoming familiar with the care needs and practices that may be different than our own is an important aspect of providing competent nursing care to all clients A dirty scalp and itchy, uncomfortable hair can have an odor

3. Introduction cont…. The hair may also reflect state of health (e.g. excessive coarseness and dryness may be associated with endocrine disorders) A wide toothed comb is usually used because finer combs pull and break the hair

4. Developmental variations In adolescence, the sebaceous glands increase in activity due to increase in hormone level. So the adolescent's hair are usually more oily In older adults, the hair is usually thinner, grows slowly

5. Nursing assessment History taking : Hair care habits History of scalp problems History of hair loss (alopecia) Physical examination Dandruff Hair loss Ticks (small gray brown parasite) Pediculosis (Lice) Scabies (skin infection by itch mite: Sarcopetes scabiei )

6. Diagnosis Impaired skin integrity Pruritus secondary to scabies Pruritus secondary to head lice Insect bite Risk of infection Scalp laceration

7. Diagnosis cont…. Dressing self care deficit Activity intolerance Imposed immobility (bed rest) Pain in upper extremity Altered level of consciousness Lack of motivation Disturbed body image

8. Hair wash Hair washing means washing and cleaning hair with soap or shampoo and water. Ambulatory patient can wash their hair in the bathroom but bed ridden patients need to wash their hair in the bed.

9. Purposes To keep hair clean, healthy and tidy To provide the sense of well being To observe the scalp To increase circulation to the scalp and hair To prevent accumulation of dirt, dandruff and oil To promote growth of hair To prevent itching, infection and lice To prevent loss of hair To promote mental relaxation

10. Common hair and scalp problems Dandruff: sealing of scalp accompanied by itching Pediculosis : lice infection Alopecia: hair loss

11. Principles Maintain privacy Empty the bladder before washing Combing hair should be done first before doing hair washing Hair must be kept free from snarls, combed and brushed without hurting the patient Prevent the eyes and ears from soapy water Water temperature should be around 110 degree F. check the temperature by placing a small amount of water on the inner aspect of forearm

12. Principles cont… Avoid hair wash for the patient who has just taken meal at least for an hour Consider religious, cultural and personal preferences of the patient Special precaution should be taken in positioning the patient, if central venous lines are present Teeth of the comb should be dull to prevent scratching of the scalp Unbroken skin acts as barrier of infection

13. Principles cont…

14. Principles cont… Practice of good techniques saves time and energy Cotton socked in oil is used to seal the ear as it does not absorb water and thus prevent water from entering the ear Neglected hair and scalp contain dirt and micro organisms also produce infection at the scalp A well combed and attended hair provides comfort to the patient and makes appearance more attractive

15. Articles required A trolley containing: Bucket with warm water: 1 Bucket for waste water: 1 Big towel:1 Big mackintosh: 1 Jug:1 A tray Containing: Cotton with oil: for ear plug Shampoo or soap with soap dish Brush or comb Oil Plastic apron Screen

16. Procedure Before washing a client’s hair, determine that there are no contraindications to this procedure Certain medical conditions such as head and neck injuries, spinal cord injuries and arthritis could place the client at risk, for injury during shampooing because of positioning and manipulation of client’s head and neck Assess the general condition of the patient and inspect the hair and scalp prior to initiating the procedure . This determines the presence of any conditions that may require the use of special shampoo or treatments (dandruff or the removal of dried blood)

17. Procedure cont… Check the patient’s preference for soap or shampoo Close the windows and put off the fan Empty the bladder of the patient Explain the purposes and procedure to the patient Wash hands with soap and water Prepare and bring the articles to the working side of the patient Screen the patient

18. Procedure cont… Unless contraindicated, help the patient move his / her head towards the edge of the bed. Remove the pillow and place it in a shoulder if not contraindicated Roll the mackintosh sheet from both sides in a slanting way, to make the shape of a funnel. The narrow end should be folded and put under the patient’s head and the free end should be put in bucket to act as a drain for the water

19. Procedure cont… Place the towel around the neck and shoulder of the patient Help the patient to assure in a comfortable position

20. Procedure cont… Ask the patient to close his / her eyes to prevent the soap water getting into the eyes Brush the hair Insert cotton swab into the ears Mix hot and cold water and test the temperature with the back of the hand Wet the hair by warm water

21. Procedure cont… Apply the shampoo to the hair and massage using fingertips (do not use nails) Rinse the hair repeatedly with warm water till thorough cleanliness is ensured Ask the patient if he / she is comfortable Remove the trough or rolled mackintosh and place it in the bucket.

22. Procedure cont… Remove the cotton plugs from ears into paper bag or kidney tray Dry the patient’s hair with towel Reposition the patient in proper alignment Massage the hair with oil and the comb the hair Make the patient tidy and comfortable. Change the linen if needed

23. Procedure cont… Clean the article and place them in a proper place Record the procedure including the conditions of the scalp, hair and any abnormalities in the patient’s chart Report to the senior staff if any abnormalities found

24. Any queries???

25. Thank you