Performing Hair care

Hair care is again a significant part of the grooming process and the attention given to this activity often reflects how a client feels. The condition of the hair and scalp can also be a good indicator of a client’s general health; therefore regular attention to this aspect of care is important.

The client’s gender, cultural and racial preferences need to be taken into account when assisting in grooming of the hair, and under no circumstances should a client’s hair be cut without their express permission. The client’s level of independence needs to be considered when undertaking your initial and subsequent assessments, along with any contra-indications to this procedure, such as arthritis or head and neck injuries, which may affect their ability to become involved.

Washing the client’s hair may take place whilst they are confined to bed or, if mobile, the client can be accompanied to the washroom and sit at the sink.

Equipment:
In order to wash a client’s hair in bed, the following equipment is needed:
• face flannel
• towels
• shampoo/hair conditioner
• bowl of warm water for pouring
• container or inflatable shampooette to collect used water
• jug of water
• waterproof sheeting to protect bed
• plastic apron
• brush/comb
• surface for equipment
• hairdryer.

Two nurses can best perform this procedure, as one can support the client’s head whilst the other pours the water, shampoo, etc. The procedures and rationales for washing hair are given below.

Procedure	Rationale
Explain procedure to the client	Gain consent and co-operation
Gather all the equipment at the bedside	Ease of access, ready for use
Put on apron, wash hands. Ensure client’s privacy	Reduce risk of cross-infection
Adjust the height of the bed, remove bed head and assist the client into a supported, comfortable position with their head protruding over the top edge of bed	Ease of procedure
Place waterproof sheeting under client’s shoulders, neck and head	Protection of pillows, bedclothes and client’s clothing
Place towel over client’s chest, up to the chin and around the shoulders. You may need to place a rolled towel underneath the client’s neck for support	Support and comfort
Place bowl or shampooette under the client’s head	To catch water as it is poured over the client’s head
Inspect the client’s hair and scalp, removing any hair accessories	To assess the necessity for special shampoos/treatments. Ease of access. To prevent trauma
Brush and/or comb client’s hair through	To remove tangles and allow shampoo to permeate through the hair
Talk client through each step of the procedure. Assess the temperature of the water with the client. Ask client to hold face flannel over the eyes as water is poured over the client’s head. Completely wet head and then apply shampoo, lather well. Monitor client’s condition throughout the procedure and stop if any sign of undue distress	Client co-operation, client safety. Prevent water and shampoo irritating the eyes. To maintain comfort
Massage scalp by applying fingertip pressure all over the head. Rinse thoroughly and repeat. Apply hair conditioner if desired	To ensure thorough distribution of shampoo
Rinse hair thoroughly and dry face using clean tissues	Residual shampoo can dry the scalp and increase the potential for dandruff
Towel the hair dry	To prevent cooling
Assist the client into a comfortable position and comb hair through	Client comfort. Removal of tangles
Dry the hair using a hairdryer and/or assist to style in client’s preferred style; show in mirror	Promote client choice. Maintain body image and self-esteem
Remove all equipment, leaving area clean and dry	Maintain a safe environment
Remove apron and wash hands	To prevent cross-infection
Evaluate care delivery and document in nursing care records	Legal requirement and promotion of continuity of care

Infestation with head lice can be successfully treated with proprietary medications such as Benzyl Benzoate, Malathion, Carbaryl or Permethrin.