Preparation of Articles:
A Tray containing
Purpose: To protect the bed.
Wet cotton ball or rag pieces in a bowl.
Purpose: To clean perineum.
A jug with warm water or antiseptic solution.
Purpose: Gauze or rag pieces in a container.
Long artery forceps in kidney tray.
Purpose: To hold swabs for cleaning.
Purpose: To receive wastes.
Clean linen, pads, dressing etc as needed.
Purpose: To keep patient clean.
Purpose: if the patient is in need to passing urine or stool.
Preparation of Patient:
1. Explain procedure to the patient.
2. Provide privacy by screens and drapes. Drape the patient as for vaginal examinations.
3. Remove all articles that may interfere with the procedure e.g. air cushion.
4. Give extra pillows to raise the head.
5. Roll the draw sheet to opposite side to prevent soiling when bedpan is placed under buttocks, over draw sheet.
6. Offer bed pan. Keep the clean bed-pan on the bed on your working side.
7. Untie the pads, if any and observe the discharges its color, odor, amount etc.
8. Leave the patient for sometime so that she may pass urine or stool if necessary.
9. Get the toilet tray and arrange the articles conveniently on bed side table.
1. Wash hands
Reason: To prevent cross infection.
2. Pour water over perineum.
Reason: To wash off the discharge from the perineal area.
3. Clean the perineum using the wet swabs.
Reason: To prevent the entrance of bacteria from the colon into urinary tract.
4. Hold the swabs with forceps and clean from above.
5. Use one swab for one swabbing.
6. Clean perineum from the midline outward in following order
a. The vulva
b. The labia
c. Inside of labia on both sides.
d. Outside of labia on both sides.
7. Clean the perineal region and anus thoroughly.
8. Remove the bed pan by supporting the hip as before. Turn the patient to one side and dry the buttocks with dry rag piece.
1. Apply the medicine and pad if necessary.
2. Remove the mackintosh if extra one is used.
3. Change linen if necessary straighten the bed clothes. Arrange the bed linen.
4. Make patient comfortable.
5. Take the bed pan to sanitary annex. Remove cotton swabs, and empty the contents into toilet.
6. Clean all articles.
7. Boil forceps.
8. Replace articles.
9. Remove screen and tidy up the unit.
10. Wash hands.
11. Record the procedure with date and the observations made.
It is also defined as perineal-genital care. The perineal area is condusive to the growth of pathogenic organisms because it is warm, moist and it is not well-ventilated. Since there are many orifices example, urinary meatus, vaginal orifice and the anus situated in this area, the pathogenic organisms can enter into the body. Thoroughly cleanliness is essential to prevent bad odor to promote comfort.
Perineal care involves washing the external genitalia and surrounding with soap and water or with water alone or in combination with any commercially prepared peri-wash.
Clean the perineum from the cleanest to less clean area.
Patient who require special attention to perineal area.
1. Patient who are unable to do self-care.
2. Patient with genitor-urinary tract infection.
3. Patient with incontinence of urine and stool.
4. Patient with indwelling catheters.
5. Postpartum patients.
6. Patients after surgery on the genitor-urinary system.
7. Patients with injury, ulcer or surgery on perineal area.
Preliminary Assessment: (For Female Client)
1. Assess the condition of perineal skin-any itching, irritation, ulcers, oedema, drainage etc.
2. Assess the need and frequency of perineal care.
3. Assess whether perineal care should be done under an aseptic technique or a clean technique.
4. Check the physician’s order for any specific instructions.
5. Assess the patient ability for self care.
6. Assess the patient mental state to follow instructions.
7. Check the articles available in patients unit.
Perineal Care – A Simple Nursing Procedure.
AUTHOR: SONA SAJI E.S