Policy Manual sample

MDT Home Health Care Agency, Inc. 77 NAIL CARE PURPOSE: To provide proper guidelines for nail care and to aid cleanliness, prevent skin abrasions and infections, improve appearance and enhance comfort. Patients with severely compromised circulation should be assessed, instructed and cared for by an RN/LPN only . Nails of a diabetic patient should be trimmed only with a physician's order. The RN may order the HHA to soak, file and clean nails on patients who do not fit the above criteria upon assignment by the nurse. RESPONSIBLE PERSONNEL: RN, LPN, HHA EQUIPMENT: Towel or Chux Pads; water basin, file, lotion PROCEDURES: 1. Wash hands. 2. Explain procedure to the patient. 3. Assess general condition of surrounding skin and nail base. 4. Place Chux or towel beneath area to be treated. 5. Soak nails in a basin of warm water approximately 10-15 minutes. You may soak the alternate foot or hand while filing nails. 6. Remove hand or foot from basin and place on towel. Dry foot or hand. 7. File nail evenly across beyond the end of the toe or finger. RN’S and LPN’S may trim with a physician’s order. 8. Clean under nail with orange stick or blunt instrument. 9. Push back the cuticle gently with towel. 10. Apply lotion to nail area. 11. Clean and store equipment or discard if disposable. 12. Wash hands. DOCUMENTATION: FOR HHA: Document care given on note. Record any abnormalities (i.e., changes in color of surrounding skin, areas of breakdown, points of pressure). Report any abnormalities to the Nursing Supervisor. FOR NURSING STAFF: Document care and teaching provided along with the patient's or caregiver's response. If further action is indicated, document follow-up/notification of clinical manager and/or physician.