This chapter addresses the fundamental nursing role in managing hygiene. The ability to maintain personal and oral hygiene forms some of the activities of living that everyone undertakes every day, but which are often taken for granted until a deterioration in a person’s physical or mental state, such as illness or ageing, prevents individuals from meeting these needs independently. Being able to assess the need for nursing intervention accurately, and to deliver appropriate evidence-based care, requires considerable skill. It draws on many of the core competencies of professional nursing, such as observation, communication, and clinical decision-making. Therefore it is inappropriate that, in a majority of care settings, these activities are often delegated by the registered nurse to those with the least experience. It is important to remember that, registered nurses retain professional accountability for the quality and effectiveness of the interventions provided or delegated to the patients under their care. Increasingly, this fundamental aspect of care is viewed as an overall indicator of the quality of the care provided. Assisting individuals to maintain their personal hygiene needs promotes comfort, safety, well-being, and dignity, and also plays an important part in the prevention of infection. It is also an important aspect of many religions, such as the ritual washing performed by Muslims before prayer. Indeed Young (1991) suggested that cleanliness is a basic human right rather than a luxury. There has been criticism over the past decade that aspects of nursing care relating to the maintenance of patient hygiene have become neglected, and the Healthcare Commission (2007) reported that 30% of complaints received against UK hospitals related to issues of personal care and dignity, including:…● patients being left in soiled clothing or bedding; ● hygiene needs not being met (patients not being washed or mouthcare given); ● hair and nails not being cared for….In response to these criticisms, both the Nursing and Midwifery Council (NMC) and the Department of Health (DH) worked to improve the quality of personal care provided by nurses.
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