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Perineal Care of the Male Resident

Written by Hollie Finders, RN
Hollie Finders is a registered nurse with years of experience working in the health care field. She has degrees in both biochemistry and nursing. After working with patients of all ages, Hollie now specializes in pediatric intensive care nursing. Hollie’s LinkedIn

Procedure

Equipment needed: gloves, washbasin, soap, washcloths, bath towel, waterproof pad, and bag for soiled laundry

  1. Perform hand hygiene and put on gloves.
  2. Explain the procedure to the patient and ask for his assistance in following directions. Provide privacy.
  3. Fill a basin with warm water. Ensure the water is a comfortable temperature.
  4. Raise the bed to a comfortable working height.
  5. Gently clean around the perineal area, including the inner thighs and the scrotum.
  6. Rinse the entire area with a clean washcloth. Pat dry with a bath towel.
  7. If the resident is uncircumcised, retract the foreskin to expose the tip of the penis.
  8. Using a circular motion, begin washing at the tip and work down and around the shaft of the penis until you reach the base. Use a clean section of the washcloth for each stroke.
  9. Rinse and dry the penis in the same pattern.
  10. If present, return the foreskin to its original position.
  11. Assist the resident onto his side to expose the buttocks.
  12. Wash the buttocks and the anal area. Rinse and pat dry.
  13. If needed, change the linens and/or place a clean waterproof pad underneath the patient.
  14. Assist the resident into a comfortable position and lower the bed.
  15. Place all used washcloths, towels, and linens into a bag for soiled laundry.
  16. Dispose of the water and clean the washbasin.
  17. Remove gloves and perform hand hygiene.
  18. Document the procedure in the patient’s chart and report any changes in the patient’s condition to the nurse.

Important Information

Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Special care should be used when performing perineal care on an uncircumcised male. Failure to retract and wash the area under the foreskin can result in infection. Failure to return the foreskin to its normal position can result in paraphimosis. This condition causes discomfort, swelling, and possible necrosis of the tip of the penis [1].

It is important to be respectful and professional when providing this care. Many patients find this procedure awkward and uncomfortable. If a patient is able to perform this care independently, then allow him to do so and provide him with privacy.

References

1. https://www.ncbi.nlm.nih.gov/pubmed/7755835

More Resources

Applying a Condom Catheter

Condom catheters are used for men who are incontinent. These catheters are external and are meant to be used short-term and changed daily.

Making an Occupied Bed

If a patient is bedridden or on bedrest, the bed linens will need to be changed while the patient is in the bed. For safety reasons, the nurse’s aid should avoid making an occupied bed if the patient is able to get out of bed. Bed linens should be changed according to the facility’s policy or anytime they are wet or soiled.

Feeding the Patient

Not all patients will need help feeding themselves. Some patients will only need assistance opening cartons or cutting their food. To promote independence, always let the patient do as much as he or she can before assisting. It is vitally important that the nurse’s aide verifies that the patient receives the correct meal tray. Patients may have special diets that play a critical role in their health (i.e., pureed diet, gluten-free diet, food allergies, etc.). Feeding the wrong food to the wrong patient could result in serious complications.

Applying Elastic Support Hose

Elastic stockings are worn to prevent deep vein thrombosis (DVT) and reduce the pooling of blood in vessels. Many hospitals and care facilities use elastic stockings in patients with reduced mobility, such as surgical patients and/or the elderly. There are a few risks in wearing elastic stockings; however, these risks can be prevented with proper application and care.

person wearing orange and white silicone band

Applying Restraints

Restraints have very strict guidelines for use due to the number of complications that can result. Use of restraints is associated with increased physical and psychosocial health issues. Restraints are only considered necessary when restraint-free alternatives have failed and the patient or others are at risk of harm without the restraints. It is illegal to use restraints for the staff’s convenience or to punish the patient.

Sim’s Position

The position a patient is placed in is often ordered by the physician, or recommended by a speech, occupational, or physical therapist. The position dictates whether a patient is sitting, lying, standing; or if they are on their side, back, or prone (face-down). Positioning is also determined by the patient’s current needs, such as: Are they eating? Sleeping? Having surgery on their back? Are they receiving nutrition through a nasogastric tube?

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