PERINEAL CARE

Perineal care involves thorough cleansing of the client’s external genitalia and the
surrounding skin.

PURPOSES OF THE PROCEDURE

1. To remove normal perineal secretions and odors.
2. To promote client comfort.

FEMALE PERINEAL CARE ON BED

Materials Needed:
1. Bath Blanket or topsheet
2. Protective pad
3. Wash cloth
4. Pitcher of warm water
5. Bedpan
6. Cotton balls soaked in warm soapy solution
7. Ovum forcep or pick up forcep with jar

Expected Behavior Rationale

Assessment
1. Assess the client’s mobility and Determine whether the client will be able
activity tolerance. to assist with the perineal care. Doing as
much self-care as possible increases the
client’s sense of independence and
maintains modesty.
2. Check for positioning or activity Prevents injuring the patient during the
restrictions, such as maintaining procedure.
hip abduction following a total hip
replacement.
3. Assess for psychosocial issues that Cultural norms must be considered when
may be of concern to the patient providing perineal care to ensure that it is
regarding perineal care. appropriate for that patient. For example,
in some cultures a woman would find it
completely unacceptable for a male nurse
to perform her perieneal care.
4. Assess for any specific client For any lesions or skin breakdown, you
needs for perineal care. may need to use special soaps and/or
lotions. Incontinence or drainage requires
assessment and follow-up to prevent
Impaired Skin Integrity.

5. Assess for the presence of a You may need to adapt the procedure to
urinary drainage catheter, perineal clean around an indwelling urinary
 surgery or lesions. catheteror surgical incisions.

Planning
6. Assemble equipment needed. Having equipments available saves time
and facilitate accomplishment of tasks.
7. Plan for any assistance necessary.
Implementation
8. Identify patient and explain what
you are going to do, why it is
necessary, and how he or she can
cooperate, being particularly
sensitive to any embarrassment
felt by the patient.
9. Provide privacy by drawing the To lessen anxiety and gain cooperation
curtains around the bed or closing from the client.
the door to the room
10. Adjust room temperature and Assisting the patient with elimination
assist with elimination needs prior to beginning perineal care helps
prevent interruptions during the procedure
and allows for thorough perineal care.
Adjusting room temperature prevents
chilling.
11. Wash hands and wear clean To protect the nurse from contamination
gloves.
12. Place bed on high position and To prevent falling injury to the patient
lower side rail nearest you.

13. Position the patient on her back A bedpan allows for using additional
(supine). Place waterproof pads water when needed and raises the hips to
under the patient. Place a bedpan increase visualization and allows for
or portable sitz tub, especially if thorough cleansing.
the perineum is grossly soiled

14. Drape the client to protect privacy.

For Women:
a. Position the female client in a This draping technique covers the patient
back-lying position with the as much as possible which helps maintain
knees flexed and spread well privacy and prevents chilling during the
apart procedure. The client can also relax her
b. Drape the bath blanket so that legs against the bath blanket.
one point faces the patient’s
head ( diamond shape)
c. Take one of the side points of
the diamond and wrap it
around the patient’s leg.
Anchor the end of the blanket
 under the patient’s foot.
d. Repeat on the other leg with
other point of the diamond.
e. Fold the center lower point of
the diamond up to expose the
patient’s perineum
For Men:
a. Place the bath blanket over
the client’s chest.
b. Fold the bed linens down
to expose only the client’s
groin
15. Remove any fecal material with Prevents contamination of the perineum
toilet paper. with feces which can lead to bladder,
vaginal, or incisional infections

16. Dip cotton balls in warm soapy Prevents contaminating the urethra with
water. fecal material. Any fecal particles that are
left can cause skin breakdown and may
For Female: Using long, gentle increase the risk of a urinary tract
strokes, wipe the perineum starting infection because of the presence of E.
from the symphysis pubis and coli in the feces.
proceeding to the rectal area
observing the Rule of 7.
To adequately clean the hed of the penis
For Male: Retract the foreskin, if in an uncircumcised male, the foreskin
present, and gently cleanse the must be retracted. After cleaning, replace
head of the penis using a circular the foreskin to prevent constriction and
motion. Replace the foreskin, and edema of the penis. Firm strokes may help
finish cleaning the shaft of the to prevent an erection.
penis, using firm strokes and the
scrotum. Handle the scrotum with
care, because the area is sensitive.
17. In both female and male, cleanse Detects and prevents excoriation in
the skinfolds of the groin area skinfold areas, where moisture
thoroughly and pat dry. Examine ccumulates.
the skin creases for redness or
excoriation.
18. Rinse and pat dry. Prevents skin injury secondary to
maceration.
19. Turn the patient to her side, Fecal contamination of the perineum can
separate the buttocks and wash the lead to urinary tract infections and skin
posterior region. Give special irritation. Therefore, the anal area is
attention to the anal area. cleansed last.
20. Remove gloves and gently Decubitus ulcer usually occurs over bony
massage the bony prominences in prominences of the heels, sacrum, hip and
 order to promote circulation and shoulder.
help prevent decubitus ulcer.

21. Do after care. Change linen as Ensures patient safety, comfort and
needed, including soiled linen or privacy.
linen that became damp during
perennial care.
Evaluation
22. Assess client’s responses.
23. Observe for difficulty with
movement or ROM during the
procedure.
24. Note the condition of the skin,
including redness and other
abnormal findings.
Documentation
25. Chart on the nurses notes that
perineal care was given, any client
responses to the procedure, and the
condition of the perineal area.

RETURN DEMONSTRATION EVALUATION TOOL FOR:

PERINEAL CARE

Name: _____________________________________ Grade: _____________

Time started:____________ Time ended:____________ Date of

RD:________________________
 AREA FOR EVALUATION RATING COMMENTS
SKILLS (35%) 5 4 3 2 1 0
ASSESSMENT /PLANNING
1. Assess the client’s mobility and
activity tolerance.
2. Checks for positioning or activity
restrictions.
3. Assess for psychosocial issues that
may be of concern to the patient
regarding perineal care.
4. Assess for any specific client
needs for perineal care.
5. Assess for the presence of a
urinary drainage catheter, perineal
surgery or lesions.
Planning
6. Assemble equipment needed.
7. Plan for any assistance necessary.
Implementation
8. Identify patient and explain what
you are going to do, why it is
necessary, and how he or she can
cooperate.
9. Provide privacy.
10. Adjust room temperature and
assist with elimination needs.
11. Washes hands and wear clean
gloves.
12. Places bed on high position and
lower side rail nearest you.
13. Position the patient on her back
(supine).

14. Place waterproof pads under the

patient and bedpan.
15. Drape the client to protect privacy.
For Women:
a. Positions the female client in a
back-lying position with the knees
flexed and spread well apart
b. Drapes the bath blanket so that one
point faces the patient’s head
( diamond shape)
 c. Take one of the side points of the
diamond and wrap it around the
patient’s leg. Anchor the end of the
blanket under the patient’s foot.
d. Repeat on the other leg with other
point of the diamond.
e. Fold the center lower point of the
diamond up to expose the patient’s
perineum
For Men:
a. Place the bath blanket over the
client’s chest.
b. Fold the bed linens down to
expose only the client’s groin
16. Dip cotton balls in warm soapy
water.

For Female: Using long, gentle

strokes, wipe the perineum starting
from the symphysis pubis and
proceeding to the rectal area
observing the Rule of 7.

For Male: Retract the foreskin, if

present, and gently cleanse the
head of the penis using a circular
motion. Replace the foreskin, and
finish cleaning the shaft of the
penis, using firm strokes and the
scrotum. Handle the scrotum with
care, because the area is sensitive.
17. In both female and male, cleanse
the skinfolds of the groin area
thoroughly and pat dry. Examine
the skin creases for redness or
excoriation.
18. Rinse and pat dry.
19. Turn the patient to her side,
separate the buttocks and wash the
posterior region.
20. Remove gloves and gently
massage the bony prominences in
order to promote circulation and
help prevent decubitus ulcer.
21. Do after care. Change linen as
needed, including soiled linen or
 linen that became damp during
perennial care.
Evaluation
22. Assess client’s responses.
23. Observe for difficulty with
movement or ROM during the
procedure.
24. Note the condition of the skin,
including redness and other
abnormal findings.
Documentation
25. Chart on the nurses notes that
perineal care was given, any client
responses to the procedure, and the
condition of the perineal area.
KNOWLEDGE: (15%)
1. Gives rationale of the procedure.
2. Explains the elements and
mechanics of the procedure.
3. Knows the elements of nursing
process as applied.
4. States principles applied in the
procedure.
ATTITUDE: (10%)
1. Is well groomed.
2. Wears prescribed, neat, and clean
uniform.
3. Arrives on time for the RD.
4. Speaks to CI and client tactfully.
5. Minimizes use of energy, time,
and effort
6. Utilizes supplies efficiently.
7. Considers client’s safety, privacy,
and comfort.
8. Is well organized.
9. Keeps working area clean at all
times.
10. Gives high value for aesthetics.

Comments: _______________________________________________________________
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Clinical Instructor’s signature: ____________________________________