Purpose

• Perineal care (pericare) involves cleaning the genital and anal areas. These areas provide a warm, moist, dark place for microbes to grow. Cleaning prevents infection and odors and promotes comfort.
• Perineal care is done daily during the bath. It is also done when the area is soiled with urine or feces. Perineal care is very important for persons who:
  • Have urinary catheters.
  • Have had rectal or genital surgery.
  • Are menstruating.
  • Are incontinent of urine or feces.
• The person does perineal care if able. Otherwise, it is given by the nursing staff. It can be embarrassing.
• Work from the cleanest area to the dirtiest (from “front to back”). This helps prevent the spread of bacteria from the anal area to the vagina and urinary system.

Equipment

Roll cursor over items to see labels. For the purposes of clearly depicting the equipment, a barrier is not shown in this photo. When providing care, a barrier should always be placed on the surface before placing the equipment.

Waterproof pads

Bath towel

Gloves

At least four washcloths

Paper towels

Bath thermometer

Soap or other cleaning agent as directed

Wash basin

Wash basin

Bath blanket

Delegation

Follow delegation guidelines. Before giving female perineal care, obtain this information from the nurse and care plan:

• When to give perineal care
• What terms the person understands—perineum, privates, private parts, crotch, area between the legs, and so on
• How much help the person needs
• What water temperature to use—usually 105˚F to 109˚F (40.5˚C to 42.7˚C)
• What cleaning agent to use
• Any position restrictions or limits
• What observations to report and record
• When to report observations
• What patient or resident concerns to report at once

Preparation

• Observe quality-of-life measures.
• Review the information under Delegation and Safety and Comfort.
• Practice hand hygiene.
• Collect the equipment.
• Cover the over-bed table with paper towels or a waterproof pad. Arrange items on top.
• Identify the person. Check the ID bracelet against the assignment sheet. Also call the person by name.
• Provide for privacy.
• Raise the bed for body mechanics. Bed rails are up if used.

Safety

• Hot water can burn perineal tissues. To prevent burns, measure water temperature according to agency policy. If the water seems too hot, ask the nurse to check it.
• To prevent infection, follow Standard Precautions and the Bloodborne Pathogen Standard. Contact with blood, body fluids, secretions, or excretions is likely.
• Protect an incontinent person and dry garments and linens from wet or soiled items. Remove wet or soiled incontinence products, garments, and linen. Then apply clean, dry ones.

Comfort

• If you provide perineal care, explain how you protect privacy. Act professionally.
• Always obtain the person’s consent for perineal care. If she prefers, get someone of the same sex to provide this care, ask a family member or another staff member to be present, and keep the call light within her reach to call for help.
• To promote privacy and reduce embarrassment, let the person perform perineal care, if able. You need to:
  • Provide clean water.
  • Adjust the over-bed table so the person can reach the needed items.
  • Make sure she understands what to do.
  • Place the call light within reach. Ask her to signal when finished.
  • Lower the bed to the lowest level.
  • Remove and discard gloves. Practice hand hygiene.
  • Leave the room.
  • Answer the call light promptly. Knock before entering the room.
  • Raise the bed for body mechanics.
  • Practice hand hygiene. Put on gloves.
  • Make sure the person has cleaned thoroughly.
  • Finish the bathing procedure.

Follow-up Care

• Cover the person. Remove the bath blanket.
• Provide for comfort.
• Place the call light within reach.
• Lower the bed to the low position. Raise or lower bed rails. Follow the care plan.
• Empty, clean, rinse, and dry the wash basin.
• Return the basin and supplies to their proper place.
• Wipe off the over-bed table with the paper towels. Discard the paper towels.
• Unscreen the person.
• Complete a safety check of the room.
• Follow agency policy for dirty linen.
• Remove and discard the gloves. Practice hand hygiene.

Reporting/Recording

Report and record your observations, including:

• Odors
• Redness, swelling, discharge, bleeding, or irritation
• Complaints of pain, burning, or other discomfort
• Signs of urinary or fecal incontinence