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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

Offering the Bedpan

When a resident is bed-bound, they must use a bedpan to urinate and defecate. This can be embarrassing for the resident, so it should be done with sensitivity to the resident’s privacy and dignity. There are two types of bedpans. A regular bedpan is the deeper and more rounded of the two. A fracture pan has a relatively flat upper end with a trough at the lower end. Fracture pans are used for residents who have difficulty, or restrictions against, moving their hips and/or backs.

Transferring the Resident from a Bed with a Mechanical Lift

A mechanical lift is used to transfer residents who cannot support their own weight. When used properly, mechanical lifts prevent injuries for both residents and health care workers. It is important that a nurse’s assistant be trained to use the mechanical lift before attempting to operate it. Most facilities require at least two health care workers to assist when using a mechanical lift.

Performing Ostomy Care

Residents who have had a portion of their intestines removed due to illness or trauma may have a temporary or permanent ostomy, which is an opening in the abdomen that is created for the elimination of urine or feces. The portion of the intestine that is connected to the abdominal wall and is visible is called the stoma. A pouch is placed over the stoma to collect feces.

Removing Personal Protective Equipment

It is important to follow the correct procedure while removing personal protective equipment to avoid contaminating your skin or clothing. The most common source of contamination in this process stems from improper removal of gloves. Gloves are often the most soiled piece of equipment. To avoid contaminating your skin or the other equipment worn, gloves should always be removed first. Then remove the goggles, gown, and mask, in that order.

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.

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