Personal Hygiene In The Health Care Sector
Personal Hygienein the Health Care Sector- The Road to Health and Well-beingAUTHORSusanne B. Andersen, Nurse specialist, Abena A/SThe focus on good personal hygiene is growing due to the increasing number of antibiotic-resistantbacteria. Inadequate personal hygiene may result in contagious diseases spreading, resulting insick days, reduced ability to work, poor quality of life – or worst case premature death.For the individual, good personal hygiene provides a feeling of cleanliness and well-being, whereaspoor personal hygiene can lead to dry skin, sweaty and dirty skin, unpleasant smells and the risk ofdeveloping complications like for instance ulcers.This document describes a holistic and structured approach to good personal hygiene for caregivers and other people participating in personal hygiene tasks.20171PERSONAL HYGIENE IN THE HEALTH SECTOR
Personal Hygiene inthe Health Care Sector:The Road to Health and Well-beingAUTHORSusanne B. Andersen, Nurse specialist, Abena A/SDISCLAIMER: This whitepaper is for informational purposes only and serves as inspiration to select and apply solutions for personal hygiene.The know-how and practices presented in this paper are not exhaustive and can never substitute medical advice. Each user is responsible forindependently evaluating his or her own particular use of the know-how and practices provided in this paper.The focus on good personal hygiene is growing due tothe increasing number of antibiotic-resistant bacteria.Inadequate personal hygiene may result in contagiousdiseases spreading, resulting in sick days, reducedability to work, poor quality of life – or worst casepremature death.Content Table:How to perform good personal hygiene?1.Take a structured approach to personalhygiene from top to toe1.1 disposable wash-without-water productsFor the individual, good personal hygiene provides afeeling of cleanliness and well-being, whereas poorpersonal hygiene can lead to dry skin, sweaty anddirty skin, unpleasant smells and the risk of developingcomplications like for instance ulcers.1.2 Wear protective clothing2How to perform a good body wash from topto toe2.1 Intimate hygieneThis document describes a holistic and structuredapproach to good personal hygiene for care givers andother people participating in personal hygiene tasks.2.2 Hair wash2.3 Mouth and teeth2.4 Take good care of nails and skin on handsand feet2.5 Special attention to shavingDid you know that.?Hospital infectionsaffect 14 out of every100 patients admitted.3.Pay special attention to hand hygiene4.How do deal with resistant bacteria4.1 Clostridium difficileSimple and low-cost infection prevention andcontrol measures, such as appropriate handhygiene, can reduce the frequency of healthcare-associated infections by more than 50%.4.2 MRSA4.3 NorovirusSource: WHO5.20172Take responsibilityPERSONAL HYGIENE IN THE HEALTH SECTOR
How to perform good personal hygiene?1. Take a structured approach to personalhygiene from top to toeGood personal hygiene implies that the whole body,hands, feet, skin, hair and nails are cleaned and caredfor. Good personal hygiene is based on the followingthree focus areas:1. Take a structured approach to personal hygienefrom top to toeIIn order to avoid infections it is extremely importantto take a structured approach from top to toe. Thisimplies that you always have to perform the dailyhygiene tasks:¡¡ From clean to dirty skin2. Pay special attention to hand hygiene¡¡ From inside to outside3. How do deal with resistant bacteria¡¡ From the top to the bottomThis paper takes a closer look at each of the topics,helping individuals, care givers and other professionalsunderstand the importance of personal hygiene andhow to practice good hygiene in the daily care routines.It is important to remember that the areas with mostbacteria are the anus, groin , hands, feet, and armpits.The urethral opening and the eyes are the mostsensitive areas to infections. Make sure that you donot move bacteria from other parts of the body to theurethral opening or the eyes.Structured Approach in Hygiene:1.1 Disposable wash-without-water productsare preferred by patients and care giversUse of disposables for body wash and intimate hygienereduces the risk of infections, simply because youavoid moving bacteria from one place to another whenyou throw away the disposable cloths or gloves as youperform the personal hygiene routines.1. From clean to dirty skinThe quality of bed baths using wash-without-waterproducts is ranked very high among patients andnurses. In fact, a study from 2014 has shown that 61%of patients and nurses would permanently trade waterand soap bed baths for washing without water.2. From inside to outsideThe use of disposables is easy and less timeconsuming, leaving more time for other care tasks.Also, it eliminates the use of water and water bowl,which are known to increase the risk of infections anddevelopment of skin irritation.3. From the top to the bottomWash-without-Water solutions20173PERSONAL HYGIENE IN THE HEALTH SECTOR
1.2 Wear protective clothing to avoidcontagionUse masks, face shields, safety glassesIn case of risk of splashes, sprays, and spatter of bodyfluids it is adviced protect the face with a mask, faceshield or safety glasses.It is strongly recommended that care givers performingpersonal hygiene tasks wear protective clothingand gloves to avoid spreading infectious diseases.Protective clothing and gloves protect the care giverfrom contamination of clothing, hands or other bodyparts. It also prevents bacteria spreading from onepatient to another.Masks must fulfil the requirements of DS/EN14683:2014; shields/glasses must be CE-marked.Use protective covers to avoid contamination ofthe beddingProtective covers can be used when bed baths orintimate care has to be performed in the bed. Thecovers prevent that bacteria spread to bedding, bed,mattress, pillow, quilts, etc. Remember to throw awaythe disposable cover after use.Disposable,protective clothing comprises:¡¡ Gloves¡¡ Apron¡¡ CoverallsHandle waste with careWaste such as diapers, wash cloths,disposables, etc., where excretions havebeen absorbed can be treated as part ofthe normal waste system. However, it isvery important that this kind of waste istreated and disposed of in a responsibleway to prevent other people handling thewaste getting infected. This means thatyou should:¡¡ Masks, faceshields, safetyglasses¡¡ Handle, wrap and dispose of thewaste where you perform the task¡¡ Use one waste bag per taskGloves are your best friend for all tasksGloves must always be used by care givers whenperforming tasks related to personal hygiene orhandling of excretions. Gloves are used for both cleanand unclean tasks to protect care giver and patientfrom contagion. Remember to:¡¡ Put on the gloves just before you start the task¡¡ Do not move one bag to another– this may increase the risk ofspreading bacteria¡¡ Use pedal bins toavoid bacteria on hands¡¡ Change the gloves when you go from an uncleantask to a clean task¡¡ Throw away the gloves right after use¡¡ Wash and or disinfect your hands immediatelyafter completion of the taskGloves must be CE-marked and fulfil requirements ofDS/EN 455-1,2,3Use aprons or coveralls for special unclean tasksAprons or coveralls protect your clothes when handlingexcretions, doing intimate care routines, cleaning tasksor handling dirty textiles. Remember to:¡¡ Avoid the contaminated side of the apron/coveralltouching your clothes¡¡ Throw away your apron/coverall right after use¡¡ Wash your hands or desinfect your handsimmediately after completing the task20174PERSONAL HYGIENE IN THE HEALTH SECTOR
2. How to perform a good body wash fromtop to toe2.1 Intimate hygiene requires specialattentionA full body wash should be performed daily, in the A fullbody wash should be performed daily, in the bathroom, inthe shower or in the bed. It is important that you performthe body wash from clean to unclean areas, using thissequence:¡¡ Eyes, face, ears, neck¡¡Arms, armpits, breast, stomach¡¡Legs and feet –¡¡Intimate areas, first in front, then at the back. In thecase of faeces on the skin, start from the backNormally, intimate hygiene should be performed once aday. In case of urine/faeces incontinence and/or diaperchanges, the intimate parts should always be rinsed.Use of wash-without-water tissues or gloves is by far thegentlest way of cleaning, since the products supply caresubstances to the skin while at the same time cleaning theskin efficiently and removing dirt and smell.Wash cream also provides a gently cleansing of theskin and does not require rinsing with water. Use highquality disposable and soft cloths to minimize the risk ofdamaging the sensitive skin and mucous in the area. Itmay be necessary to dry skin folds.If you use wash-without-water products you don’t haveto rinse off with water, or use , bowls and towels. It may,however, be necessary to dry skin folds.NOTE: Remember to take a new cloth or reverse the wetwash glove during the body wash.If you want to use soap, you should use products forintimate care with a pH of 4-6 to protect the sensitive skinand mucous. Use high-quality and soft disposable clothsto protect the skin. Always rinse off the soap with cleanwater and dry the skin to avoid dampness that may causeskin irritation.If you wash with water and soap, you may have to changethe water during the process to ensure the right soap/water balance and that the water is not dirty.Intimate hygiene – especially for women¡¡ If using disposables: Start by cleansing the urethral opening and thenthe vagina opening. Then take a newcloth (or reverse the glove) and cleanse the labia majora, pubic hair, groinand then the perineum. Throw awaythe cloth.Make bed bathing a pleasant experiencewithout waterIf the patient needs a hair wash:¡¡ Start or end with the hairwash¡¡ Put hair in Shampoo Cap¡¡ Pre-heat Shampoo Cap¡¡ Take off and brush hair12734 8¡¡ Massage for 2 minutesThe packagecontains 8 glovesfor a full body wash,remember to reversethe wet wash gloveduring the body wash:1 Face, Neck and chest2Left arm, armpit and sideof body3Right arm, armpit and sideof body4Front and intimate parts5Right leg and foot6Left leg and foot56If using soap and water: Use the same procedure asfor disposables and then rise of the soap by using amoist cloth without soap using the same procedureas above. When you are done rinsing, dry the skinwith a towel using the same sequence.¡¡Take care that skin folds are dry no matter whatprocedure you are using.Intimate hygiene – especially for men¡¡ Start with the penis. Wash the glanswithout soap, since the mucous ishighly sensitive. Wash-without-watergloves or cloths can be used. Pullthe foreskin down to allow cleansingaround the urethral opening and thenwash downwards making sure that all impurities areremoved. Remember to pull the foreskin back.Turn patient7 Back – upper part8¡¡¡¡Take a new cloth or reverse the glove and wash theremaining part of the penis, pubic hair, scrotum andgroin using the procedure described above usingeither disposables or soap/water.¡¡Make sure that the skin is dry in all places (exceptunder the foreskin) and pay special attention to skinfolds.Back – lower part andbuttocksRemember!Disposeeach gloveafter useUse protectivegloves whenneededRead more at www.wash-without-water.com20175PERSONAL HYGIENE IN THE HEALTH SECTOR
2.3 Mouth and teeth deserve carefulattentionThere are several reasons for paying special attention tomouth and teeth. First of all, it stimulates the productionof saliva, and secondly, it maintains healthy mucousin the mouth and throat. It also prevents infections inmouth, teeth and respiratory tracts. And finally, goodmouth hygiene supports good health and quality of life.Intimate hygiene – for men and womenNow it is time to wash the backside, and the sameprocedure can be used for men and women:¡¡ First, wash the buttocks, then between thebuttocks and lastly around anus.Pay special attention to care of mouth and teeth incases where:¡¡ People eat and drink less than average¡¡ People are tube-fed, since their production ofsaliva is not stimulated by eating and drinking¡¡ If needed, take a fresh cloth and repeat theprocedure or reverse the glove and repeat theprocedure.¡¡ People receive oxygen treatment, since oxygendries out the mucousIf you have used soap, rinse ofwith clean water using the samesequence from buttocks toanus. Make sure to dry the skin,especially skin folds.¡¡ People use sprays or vaporizers as treatment forrespiratory diseases¡¡ People are treated with radiation therapy or othercancer therapy damaging mucous and causing drymouth syndrom¡¡ People have weak muscles in mouth and/or jaw¡¡ People are terminal ill¡¡ People have infections of the mouthIf you are performing tasks related to mouth and teethhygiene to others, you have to wear gloves to avoidspreading of bacteria.2.2 Hair wash is important for comfort andwell-beingWhen brushing teeth:¡¡ Brush teeth twice a day using a softbrush with small headHair wash is carried out according to need or patientwish. Remember that nice and clean hair is animportant factor in comfort and well-being. If thepatient cannot get into the shower, it is a good idea touse a shampoo cap. In case you perform a hair washin bed, you need to cover the bedding with a liquidproof sheet to avoid that liquid – and thereby possiblybacteria – are transferred to the bedding, pillow, quilt,mattress, etc.¡¡ Before brushing of teeth, removedentures¡¡ Check mouth, teeth, gums, mucous andtongue for remains of food, sores, rashes,bleeding, bad smell, dry lips, etc.¡¡ Brush teeth thoroughly and use dentalfloss if necessary¡¡ Rinse mouth, gums and tongue if anycoating occurs by using mouth caresticks, sprinkling water, or a specialmouth rinse liquid. Liquids should onlybe used when the patient is awake.¡¡ Use lip balm¡¡ Reinsert dentures, whenyou have completed theother tasks20176PERSONAL HYGIENE IN THE HEALTH SECTOR
2.4 Take good care of nails and skin onhands and feetYou should take care of the nails as part of the dailyhygiene regime. Use cream to care and protect the skinon feet, hands and around the nails. Use an extra fatcream during night, if hands and feet require intensivecare.Good care of nails on fingers and feet ensures ahealthy skin and removes bacteria from under the nails.Besides, it is very important that the skin on hands onfeet is clean and healthy to avoid dry, chapped skinand development of ulcers. Ingrowing nails may resultin ulcers that can be difficult to heal. If you care forpeople with reduced blood circulation in the feet, it isof particular importance to pay special attention to skincare on the feet in order to reduce the risk of ulcers.Care givers should wear disposable gloves duringcare tasks, and you should use a waterproof cover toprevent bacteria from spreading.When choosing products for skin cleansing andcare:¡¡ Choose right products, e.g. special products forintimate partsDon’t forget!¡¡ Check hands and feet for ulcers, chappedskin, rashes, pain and impurities under andaround the nails and check if the cuticlesrequire extra care¡¡Never cut toe nails closely on the edges; ifyou do, it may cause ingrowing nails andulcers¡¡Use scissors of high quality¡¡Remove impurities with care to avoid theutensils damaging the skins¡¡Dry, rough or chapped skin requires regularskin care – use a cream high in fat everyday¡¡¡¡¡¡2017¡¡ Choose eco-labelled products or dermatologictested products.¡¡ Choose products without perfumeAfter cleansing, apply skin moistening products –lotion, cream or oil. In case of rashes or irritation, applybarrier cream, lotion or spray to help restore the skin1Use of soap can dry out the skin. Whenwashing/bathing feet and hands, add oil toluke warm water and only soak for a shorttime. Dry carefully and always use cream.GENTLECLEANSINGMOISTURIZINGTake special care of the cuticles thatprotect the mails from bacteria, whichmay cause inflammation or damage thenails. If the cuticles are rough, chapped orfractured, they should be treated every daywith a cream high in fat.3BARRIERAPPLICATIONAlways consult a doctor or podiatrist ifyou encounter ulcers, pains or rashes.Ulcers on the feet always require specialisttreatment.72Cleanse the skin gently,preferably without waterApply moisture cream,lotion to protect theskinApply barrier cream,lotion or spray tohelp restore the skinPERSONAL HYGIENE IN THE HEALTH SECTOR
2.5 Special attention to shaving3 . Good hand hygiene is pivotalShaving may cause skin irritation, if it is not done in theright way. Before starting the shave, it is important thatthe skin is clean and free of bacteria. Shaving leavesa small hole in the skin, where bacteria may penetratethe natural skin barrier when hair is removed. This cancause spots, irritation or pseudofolliculitis barbae alsoknown as barber’s itch.Good hand hygiene has been proven to be the bestway of preventing the spreading of infectious diseases.You must always wash and/or disinfect your hands:¡¡ Before all clean tasks, e.g. before contact withmucous membranes, ulcers, catheters, cleaninstruments and food/beverages¡¡ After all unclean tasks, e.g. after change of diaper,going to the toilet, blowing your nose, coughing orcontact with contaminated surfaces or materials.Shaving is performed according to need using eitheran electric razor or manual razor blades. After showeror bath is a good time for shaving, since the skin issoftened and makes gentle shaving easier. In general,care of face and neck using moisture cream needs tobe done every day.¡¡ Before and After the use of glovesInsufficient hand hygiene is one of the most commoncauses of infectious diseases. Good hand hygiene isthe most important precaution to prevent bacteria fromspreading. If you encounter the flue, colds, coughing,running noses or diarrhea in your surroundings, youhave to be extra careful with the hand hygiene.Care givers must use disposable gloves duringshaving, and if the shaving is performed in bed,protective covers should be used.Whether you are a caretaker, a patient, a relative orvisitor in the caresector, always observe the basic rulesfor good hand hygiene:¡¡ Wash/disinfect your hands when you arrive fromthe outsideIf you are using a razor blade,you should observe the followingprocedure:¡¡ Apply a thin layer of shaving foam;take care not to use too much, since itmay block the razor blade and reducethe efficiency of the razor.¡¡ Wash/disinfect your hands before participating inmeals¡¡ Wash/disinfect your hands when you have been tothe toilet¡¡ Start by the whiskers and continueto chin and neck before you shavecheeks and around the lips.Hand disinfection is the first choice. Hand disinfectionis performed when the hands are visibly clean and dry.Hand wash is performed if the hands are visibly soiledor wet. After wash, disinfect the hands.¡¡ Rinse the blade in between to ensuresharpness and efficiency.¡¡ Use a sharp and clean blade.NOTE: Always ask for advice if you have any questionsabout hand hygiene or if you need instructions.¡¡ Rinse the face with cold water and drygently after the shave.¡¡ After shaving, the skinis more sensitive andyou should avoid usingaftershave or otherproducts containingalcohol or perfume.Instead, use a goodcream to care for andprotect face and neckto prevent rashes orinfections from occurring.20178PERSONAL HYGIENE IN THE HEALTH SECTOR
Hand washing - when the hands are visibly dirty or after using gloves1. Wet your hands with clean,2. Apply enough soap to cover all3. Rub rotationally both thumbs.4. Wash the surface of the nails5. Wash in between the fingers with6. .and from the palms.7. Rinse hands with water. Dry8. Use the same towel to turn offrunning water.the right palm over left dorsum withinterlaced fingers and vice versa.hand surfaces and wrist. Rub handsand wrist at least for 15 seconds.throughly with a single use towel.with the hands closed.the faucet.Hand disinfection shall take place when the hands are visibly clean and dry1. Use enough disinfectant so that2. First rub the palms against each3. Rub the nails against each other.4. Disinfect the fingers with the right5. . and from the palms.6. Disinfect the surface of the nails7. Rub rotationally both thumbs.8. Finalize by disinfecting bothyour hands keep wet at least for 30seconds.2017other.with the hands closed.9palm over left dorsum wit interlacedfingers and vice versa.wrists. Rub the hands and wristsuntil dry.PERSONAL HYGIENE IN THE HEALTH SECTOR
4. How to deal with resistant bacteriaIn healthy people, the symptoms of MRSA infectionsare ulcers and cuts, impetigo, boils and cuticleinfections. In older and weak people, the symptoms arethe same with the added risk of inflammations, UTI, RTIor worst case inflammations of bones or septicemia.Antibiotic-resistant bacteria sicken millions of peoplearound the world every year and account for anincreasing number of serious infections and deaths.The problem of resistant bacteria is that commonlyused antibiotics no longer can be used to treatcommon infections. Some examples of hazardousbacteria are:¡¡ Clostridium difficileContagion by MRSAMRSA is transmitted by direct or indirect contact, e.g.by hand, equipment, handles, keyboards and otheritems touched by hand. The primary source of infectionis through contact with people, but the MRSA bacteriacan survive for months in bedding, furniture, floor andother things.¡¡ MRSA¡¡ NorovirusEverybody can contribute to curbing the transmissionof these dangerous bacteria and virus. In the followingsection we will take a closer look at what you can do.What to do to avoid infectionsHealthy and sick people may carry MRSA. The bestway to prevent contagion is frequent hand wash anddisinfection.4.1 Clostridium DifficileClostridium Difficile (CD) is an anaerobic bacterium thatcan cause severe diarrhea, especially in older peopleand people suffering from serious illnesses. Ultimately,infections with CD can be fatal. CD is difficult tocombat, and diarrhea caused by CD is often closelyrelated to treatment with antibiotics.The symptoms are bloody diarrhea, change of faecescolour, fever, stomach cramps, nausea and vomiting.4.3 NorovirusThe highly contagious norovirus, also known as thevomiting bug, can tear through hospitals, institutionsand classrooms, leaving vomiting, diarrhea andstomach cramps in its wake. Norovirus is sturdy, cansurvive for long in the environment and is resistant tosome means of disinfection. The disease caused byNorovirus is highly contagious, difficult to deal with, butfortunately only rarely serious lasting only a few days.Contagion by CDCD bacteria is present in faeces and is transferredvia direct and indirect contact, by hand, equipment,handles, keyboards, often in connection with visits tothe toilet. The primary source of infection is contactwith other people, but the CD bacteria can survivefor months, e.g. in bedding, furniture, floors, andhousehold appliances.Symptoms comprise nausea, acute and violentvomiting, diarrhea, stomach pains and cramps. Slightfever, headache and muscle pain can also accompanythe virus. The incubation time is from 24 to 48 hours,and the sickness lasts from 24 to 60 hours.Although the disease is not serious in itself, thedehydration that follows can be dangerous for olderand weak people. In some cases, people have to behospitalized, and in a few cases Norovirus has beendocumented to be fatal.What to do to avoid infections with CDPatients can still be contagious even though they showno sign of sickness. Transmission of bacteria via handsis by far the most common source of infection, whichis why good hand hygiene is the best way to preventcontagion. Hand wash and disinfection are requiredto avoid contagion, since CD is not fully receptible toalcohol.Even when the patient no longer feels sick and thesymptoms have gone, the patient may still carry thevirus up to 48 hours.4.2 MRSAContagion by NorovirusNorovirus is transmitted through direct or indirectcontact with faeces or vomit from an infected person.30-80 % of people that come into contact withNorovirus become ill. Indirect contact is the typicalsource of infection, e.g. inadequate hand hygiene,contamination of food, kitchen equipment, doorhandles, taps, beds, etc.MRSA (Methicillin-Resistant Staphylococcus aureus) isof the staphylococcus family and resistant to the typesof antibiotics normally used to treat infections withstaphylococcus.MRSA has rapidly spread across the world, therebyincreasing the risk of being MRSA positive. 15 yearsago, new types of MRSA were found in livestock, pigs,chickens, turkeys and calves.2017What to do to avoid infectionsNorovirus is highly contagious and correct handhygiene is the best way to prevent contagion. Handwash and disinfection is required to avoid contagion,since CD is not fully receptible to alcohol.10PERSONAL HYGIENE IN THE HEALTH SECTOR
5. Take responsibilitySources:We all have a role to play in fighting bacteria that canspread infectious diseases. You cannot leave it todoctors, nurses and other care givers. Everybody hasto do his and her part by knowing and practicing goodpersonal hygiene – every day.We cannot avoid bacteria and infections. They willalways be present in our surroundings, but we can doa lot to curb the spreading of infectious bacteria.It does not require a whole lot of effort to follow theguidelines for good personal hygiene. Basically, it is aquestion of basic everyday habits. And although bacteriaand infections are more or less invisible until the damagehas been done, everybody can make a big differenceby simply washing the hands or by handling waste withcare. For everybody, it is rewarding to know that bypracticing good personal hygiene you may help improvehealth and well-being for the people around you.¡¡Nationale infektionshygiejnisk retningslinie; om generelleforholdsregler i sundhedssektoren, http://www.ssi.dk/ www.medscape.com/viewarticle/586213 4 Patients’ BathBasins as Potential Sources of Infection: A Multicenter SamplingStudyIR/NIR%20Generelle.ashx” http://www.ssi.dk/ oven L, van Gaal BG, Teerenstra S, Adang E, van derVleuten C, van Achterberg T. Cost-consequence analysis of“washing without water” for nursing home residents: a clusterrandomized trial. Int J Nurs Stud. 2015 Jan;52(1):112-20. doi:10.1016/j.ijnurstu.2014.08.001. Epub 2014 Aug 10.¡¡Completeness of assisted bathing in nursing homes relatedto dementia and bathing method: results from a secondaryanalysis of cluster-randomised trial data, Theo van AchterbergRN, PhD, FEANS, 8 June 2015¡¡Cost-consequence analysis of “washing without water” fornursing home residents: A cluster randomized trial, Theo vanAchterberg a.o. , August 2014Achieve optimum hygiene conditionsthrough specialist advice.Leading supplier of incontinence and healthcareproducts, Abena, offers specialist advice whenpurchasing the wide range of solutions needed toensure a hyginic setup, both for your staff and patients.Abena’s assortment of products ranges from; washwithout-water gloves and wipes to soaps, creams,lotions and sprays for cleansing, moisturizing andrestoring skin to high-quality, breathablediapers and bed protection sheets.201711PERSONAL HYGIENE IN THE HEALTH SECTOR
12www.abena.comPERSONAL HYGIENE IN THE HEALTH SECTORBR836/GLOBAL/05.2018/Abena Group Marketing2017
2017 3 PERSONAL HYGIENE IN THE HEALTH SECTOR How to perform good personal hygiene? Good personal hygiene implies that the whole body, hands, feet, skin, hair and nails are cleaned and cared for. Good personal hygiene is based on the following three focus areas: 1. Take a s
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