Pre‐procedure

ActionRationale

1. 1.Show
   Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed. Assess and plan care with the patient. Note personal preferences, addressing religious and cultural beliefs.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent, and to plan care and encourage participation and independence (NMC [162], C; Tobiano et al. [226], R).
2. 2.Show
   Determine the type of shampoo to be used. Arrange for any prescribed care, e.g. medicated shampoo, to be administered.
   To ensure the necessary products are utilized. E
3. 3.Show
   Assess the patient's ability to lie flat throughout the procedure.
   To ensure patient stability, comfort and safety. E
4. 4.Show
   Collect all the equipment listed and place it by the bedside.
   To minimize time away from the patient during the procedure. E
5. 5.Show
   Clear the area of any obstacles, ensuring that the environment is warm. Draw the curtains around the bed or close the doors to ensure privacy and dignity. Use available signage as appropriate.
   To maintain comfort and a safe environment and promote privacy and dignity (NMC [162], C).
6. 6.Show
   Wash your hands and put on disposable gloves and apron in accordance with local guidelines.
   To minimize the risk of cross‐infection (NHS England and NHSI [148], C).

Procedure

1. 7.Show
   Remove the pillows from under the patient's head, and lower or remove the bed head.
   To gain access to the patient and give the nurse more control during the procedure, thus reducing the risk of water entering the patient's eyes and ears (Seray‐Wurie [207], E).
2. 8.Show
   Place the plastic sheet under the patient's head and tuck a bath towel around their shoulders, bringing it towards their chest.
   To keep the bed and patient dry. To prevent unnecessary disruption to the patient by having to change bed linen and clothes. E
3. 9.Show
   Gently lift the patient's head and slide in the shampoo tray with the U opening under the neck. Place a towel underneath the patient's neck for support.
   The shampoo tray allows water drainage into a receptacle and prevents spills onto the floor. Padding supports the muscles of the neck and prevents undue strain and discomfort (Seray‐Wurie [207], E; Windle [241], E).
4. 10.Show
   Fold the top bedding down to the waist and cover the upper part of the patient with a towel.
   To maintain patient dignity and prevent them from becoming cold (Seray‐Wurie [207], E; Windle [241], E).
5. 11.Show
   Place the receptacle for the shampoo water on the floor with an absorbent sheet underneath. Put the spout of the shampoo basin over the receptacle.
   The receptacle must be lower than the bed to collect used water. Not using an absorbent sheet increases the risk of spills and slips (Peate [174], R).
6. 12.Show
   Protect the patient's eyes and ears. Place a washcloth over the patient's eyes. Place cotton balls in the patient's ears if indicated.
   The washcloth protects the eyes from soapy water (Spencer [217], E).

   The cotton balls keep water from collecting in the ear canals (Peate [174], E; Seray‐Wurie [207], E).
7. 13.Show
   Ensure the patient is covered and has a call bell within easy reach. Fill the basin with warm water. Check the temperature of the water with the patient and adjust it as necessary.
   To preserve dignity, privacy and patient safety, and to promote patient comfort (NMC [162], C).
8. 14.Show
   Fill a jug with water from the basin, carefully wet the patient's hair and make sure the water drains into the receptacle.
   To ensure there is minimal spillage of water. E
9. 15.Show
   Apply a small amount of shampoo to the hair and scalp, and gently massage with your fingertips.
   Massaging stimulates the blood circulation in the scalp. The pads of the fingers are used so that fingernails cannot scratch the scalp (Windle [241], E).
10. 16.Show
    Using fresh water from the basin, rinse the hair thoroughly. Start at the top of the head and let the water work its way down to the bottom of the head.
    To ensure all the shampoo is removed (Windle [241], E).
11. 17.Show
    Apply conditioner if desired and rinse using warm water until the water runs clear.
    Soapy residue causes the appearance of soap scum in the hair and the scalp will become irritated and dry. E
12. 18.Show
    Squeeze excess water from the hair into the shampoo tray before removal. Gently rub the hair dry with a towel. Dry the patient's face.
    To facilitate optimal drying of the hair. E

    To ensure patient comfort. E
13. 19.Show
    Remove any equipment and return the patient back to a comfortable position.
    To ensure patient comfort (Seray‐Wurie [207], E; Spencer [217], E).
14. 20.Show
    Replace any wet linen and ensure that the patient is appropriately clothed.
    To ensure patient comfort and warmth. E
15. 21.Show
    Style the patient's hair. Use a hairdryer on a cool or warm setting if the patient wishes and if it has had all appropriate safety checks.
    To prevent drying of the scalp. To prevent the discomfort of prolonged heat on the scalp (Seray‐Wurie [207], E; Windle [241], E).

Post‐procedure

1. 22.Show
   Clear away the equipment from the patient's bedside. Place the call bell within the reach of the patient.
   To maintain a safe environment and promote patient independence (NMC [162], C).
2. 23.Show
   Remove your apron and gloves, disposing of them according to local regulations.
   To prevent cross‐infection (NHS England and NHSI [148], C).
3. 24.Show
   Document any changes in planned care.
   To provide recorded documentation of care and aid communication to the multiprofessional team (NMC [162], C).