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

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.

Moving the Resident to the Side of the Bed

Residents are usually kept in the center of the bed for safety reasons. However, moving a resident to the side of the bed is an important step to take before turning a resident onto his or her side. Performing this action allows the resident to end up side lying in the center of the bed and not smashed up against the side rail.

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.

Measuring the Respirations

Respiration is a vital sign that is measured frequently in the healthcare setting. Taking this measurement requires no equipment and relatively little time. However, it is a measurement that must be taken accurately, as a change in respiration may indicate the worsening of a patient’s condition.

Passive Range of Motion Exercises

Range of motion exercises are used to help prevent or decrease contractures, improve flexibility of joints, and improve strength [1]. Bedridden patients as well as those with reduced mobility may greatly benefit from passive range of motion exercises. However, do not perform these exercises without an order to do so, as it may be contraindicated in certain situations.

Tympanic Membrane Temperature with Electronic Thermometer

A tympanic membrane thermometer uses an infrared sensor to measure the temperature of the tympanic membrane (ear drum). This type of thermometer is considered an accurate and reliable predictor of a patient’s core temperature because the tympanic membrane’s blood supply is sourced from the carotid artery, which is the same artery that carries blood to the hypothalamus in the brain.