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

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.

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.

Handwashing for CNAs

Handwashing is considered the single most important practice to prevent the spread of infection. Even when hands look clean, they could potentially be crawling with dangerous microorganisms and pathogens. Using soap and friction during handwashing helps loosen the oils on the skin, allowing dirt and pathogens to be rinsed away.

Supine Position

Supine position is a natural and comfortable position for most people. For this reason, it is a highly utilized position for nursing procedures. Unfortunately, this position puts pressure on many bony prominences that can lead to discomfort and/or pressure ulcers if the pressure is not relieved every so often (typically every two hours or less).

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.

Partial Bed Bath

Bathing is an important part of a patient’s health routine. A partial bed bath focuses on bathing sensitive areas that cause discomfort if not cleansed frequently, such as the face, hands, axillae, back, and perineum. Though patients receiving a bed bath are typically confined to the bed, some are able to wash themselves and should be encouraged to do so to promote independence.