Personal Care Skills
Work clean to dirty, front to back
Personal care follows a few durable rules: provide privacy, explain what you are doing, keep the resident covered except for the area being washed, and work from cleanest to dirtiest. Perineal care always goes front to back to keep feces away from the urethra, and a soiled washcloth is never reused. Change gloves and wash hands between dirty and clean phases. Bath water is warm, never hot, and you check it first.
Specific skills with specific rules
Oral care: brush teeth and gums at least twice daily; for an unconscious resident, position on the side, use no water, and use suction per facility policy. Dentures: clean over a basin lined with a towel or with water in the sink, and store in a labeled cup when out of the mouth. Nails: file only; do not clip the nails of a resident with diabetes or poor circulation without nurse direction. Shaving: use an electric razor for residents on blood thinners. Dressing: put the garment on the weak or affected side first and remove it from the strong side first. Ostomy: empty the pouch when it is about one-third to one-half full. Catheter: clean from the meatus outward with soap and water, and keep the bag below bladder level.
The traps
Do not force a joint past resistance during range of motion, do not cut toenails of a diabetic resident, and never perform a task that is not on the care plan or beyond your training - ask the nurse. Report skin redness, breaks, or a resident who suddenly refuses care.
Rule of thumb: clean to dirty, front to back, and never force a joint.