Hair care for a bedridden patient

Authors: V.Rednenko 

Editor: V.Rednenko 

Equipment for the practical skill:

• Simulated patient (patient manikin)
• Hospital bed with bedding
• Over-bed table
• Comb and brush
• Mirror
• Paper towels
• Towels
• Washcloth
• Gloves (optional)
• Bed protector
• Shampoo tray
• Two wash basins
• Paper cup
• Bath thermometer
• Shampoo and other desired hair care products

Clinical situation:

Patient N. is in the neurological department with acute cerebrovascular accident, he is assigned to the hair care. The patient is bedridden.  Carry out the prescribed procedure.

Order of the skill performance:

Preparatory stage:

• Introduce yourself
• Identify patient
• Obtain informed consent to the procedure (if the patient's condition allows it)
  • Give all the information to the person about what the procedure involves, including the benefits and risks, whether there are reasonable alternative, and what will happen without this procedure
  • Explain what you are going to do.
  • Ask the patient to consent to procedure.
  • Explain to the patient how he can help.
• Make sure you have the necessary equipment and put it on the over-bed table (the chair next to the bed)
• Sanitize your hands, put on gloves
• Prepare the patient bed:
• Raise the bed to a comfortable working height.
• Make sure the wheels on the bed are locked

Main stage:

Brushing and Combing a Person’s Hair

• Cover the over-bed table with the paper towels and arrange your supplies.
• Position the person in high Fowler's position. If the person cannot tolerate having the head of the bed raised, you can comb her hair while she is lying in the supine position by turning her head to one side, and then to the other.
• Place the towel over the person’s shoulders (or under the shoulders if the person is in bed).
• If the person wears glasses, remove them. Remove any hairpins or other styling aids from the hair.
• Comb or brush the hair gently, beginning at the ends, and work up in sections to the scalp.

• Style the person’s hair the way she likes it.
• Give the person the hand mirror so that she can see the way her hair is styled.

Shampooing a Person’s Hair in Bed

• Cover the over-bed table with the paper towels and arrange your supplies. Fill one of the wash basins with warm water. Use the bath thermometer to verify that the water temperature is between 105° F and 115° F (40-45 °C) . Place the wash basin on the over-bed table. Place a chair close to the head of the bed, and place the empty wash basin on the chair.
• Position the person in high Fowler's position. Remove any pins or clips from the hair. Brush or comb the hair to remove any tangles.
• Lower the head of the bed as low as the person can tolerate.
• Assist the person to raise her head and shoulders off the pillow. Reposition the pillow under the person’s shoulders. Cover the head of the bed and the pillow with a bed protector, and place the shampoo tray on the bed protector. Gently lower the person’s head and shoulders so that the person’s head is resting on the shampoo tray. Make sure the runoff from the shampoo tray is directed into the wash basin on the chair.
• Place a towel across the person’s chest. Ask the person to hold the washcloth over her eyes. Put on the gloves, if you are using them.

• Wet the hair with cups of water from the wash basin until it is fully wet.
• Apply a small amount of shampoo to the hair and massage the scalp with your fingertips, starting at the hairline and working toward the back of head, until the scalp is completely lathered.
• Rinse the person’s hair with cups of water from the wash basin until all shampoo is removed.

• Apply conditioner if the person likes to use it. Work the conditioner through the hair with your fingertips. Rinse the hair until the conditioner is removed.
•  Unfold a clean, dry towel and dry the hair. Wrap the person’s head in the towel.
• Assist the person to raise her head and shoulders. Remove the shampoo tray and bed protector. Reposition the pillow under the person’s head. Gently lower the person’s head and shoulders so that the person’s head is resting on the pillow.
• Remove and dispose of your gloves, if used.
• Raise the head of bed so that the person is almost in a sitting position. Comb the person’s hair to remove tangles. Dry and style the hair as the person prefers.
• Replace any wet linens.

Final stage:

• Ensure the person’s comfort and good body alignment.
• Adjust equipment for safety: Lower the bed to the level specified in the person’s care plan. Make sure the wheels on the bed are locked. Place the person’s method of calling for help within reach. Lower or raise the side rails according to the person’s care plan.
• Clean up your work area.
• Wash your hands.