Nursing & Healthcare Programs

Perineal Care of the Female 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

Perineal Care Procedure

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

  1. Perform hand hygiene and put on gloves.
  2. Explain the procedure to the patient and ask for their assistance in following directions. Provide privacy.
  3. Raise the bed to a comfortable working height.
  4. Fill a basin with warm water. Ensure the water is a comfortable temperature.
  5. Assist the resident in spreading her legs.
  6. Gently clean around the perineal area, including the inner thighs and outside the labia.
  7. With one hand, separate the labia.
  8. With the other hand, wipe down the center of the inner labia with a soapy washcloth. Only wipe in a front to back motion.
  9. Using a clean area of the washcloth for each stroke, wipe from front to back on both sides of the vulva.
  10. Rinse the entire area with a clean washcloth. Pat dry with a bath towel.
  11. Assist the patient onto her side to expose the buttocks.
  12. Wash the buttocks and the anal area using the same front to back technique. 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 soiled laundry bag.
  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. Proper technique is important for maintaining hygiene, preventing infection, and avoiding skin breakdown. Because of the close proximity between a woman’s urethra, vagina, and anus, it is essential to only wipe in a front to back motion. Wiping in the opposite direction is associated with a greater risk for developing a urinary tract infection [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 them to do so and provide them with privacy.

By: Hollie Finders RN

References

1. https://www.ncbi.nlm.nih.gov/pubmed/17091423

More Resources

Axillary Temperature with Electronic Thermometer

Compared to other temperature measurement methods, the axillary measurement is considered the least reliable. An axillary temperature measurement typically reads 0.5 to 1 degree Fahrenheit lower than an oral temperature reading [1]. For this reason, it is recommended to use this method only when other methods are contraindicated or when taking an axillary temperature is the safest method for 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?

Prone Position

Prone position is not used as commonly as other patient positions. This position allows for full extension of the hips and the knees and gives many bony prominences a break from continuous pressure. However, placing patients in prone position does not come without the risks of pressure ulcers.

Fowler’s Position

Fowler’s position is used when a patient is eating, is having difficulty breathing, or is ordered by a doctor. This position is easily recognized because the patient will be sitting “straight up.” Semi-Fowler’s is sitting “half-way up,” and is used when patients cannot be laid flat, but wish to be in a more relaxed position than Fowler’s.

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.

Caring for a Patient’s Dentures

For patients with dentures, care of the dentures is just as important as brushing natural teeth. Good denture hygiene and fit helps prevent oral irritation and infection.