Bathing and Bedmaking
Giving Male Perineal Care
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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 incontinent of urine or feces.
- Are uncircumcised (have the foreskin covering the head of the penis).
- 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 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.
Wash basin
Paper towels
Bath blanket
Bath towel
Gloves
At least four washcloths
Bath thermometer
Waterproof pad
Soap
PrintableDelegation
Follow delegation guidelines. Before giving male 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. Arrange items on top of them.
- 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 he 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 his 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 he understands what to do.
- Place the call light within reach. Ask him 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.
Procedure Video
Audio Description: OFFFollow-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 linens.
- 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
Review Questions
Select the best answer.
1. During male perineal care, what areas are cleaned?
The genital and anal areas
The lower abdomen and thighs- The area from the waist to the knees
- The urethra and colon
CORRECT. Perineal care involves cleaning the genital and anal areas. These areas provide a warm, moist, dark place for microbes to grow.
INCORRECT. Perineal care involves cleaning the genital and anal areas. These areas provide a warm, moist, dark place for microbes to grow.
INCORRECT. Perineal care involves cleaning the genital and anal areas. These areas provide a warm, moist, dark place for microbes to grow.
INCORRECT. Perineal care involves cleaning the genital and anal areas. These areas provide a warm, moist, dark place for microbes to grow.
Select the best answer.
2. When should perineal care be performed for an incontinent person?
- Once daily during morning grooming
- After each passage of urine or feces
- Once every evening with bedtime care
- Twice each shift if requested by the person
INCORRECT. Perineal care is done daily during the bath. For an incontinent person, it is also done when the area is soiled with urine or feces.
CORRECT. Perineal care is done daily during the bath. For an incontinent person, it is also done when the area is soiled with urine or feces.
INCORRECT. Perineal care is done daily during the bath. For an incontinent person, it is also done when the area is soiled with urine or feces.
INCORRECT. Perineal care is done daily during the bath. For an incontinent person, it is also done when the area is soiled with urine or feces.
Select the best answer.
3. During male perineal care, which technique should you use?
- Clean from the anus toward the urethra.
- Use water that is at least 125˚F for proper cleansing.
- Wash the tip of the penis in a circular motion from the meatus out.
- Force the foreskin back over the penis so the meatus is visible.
INCORRECT. Clean the tip of the penis, using a circular motion. Start at the meatus of the urethra and work outward.
INCORRECT. Clean the tip of the penis, using a circular motion. Start at the meatus of the urethra and work outward.
CORRECT. Clean the tip of the penis, using a circular motion. Start at the meatus of the urethra and work outward.
INCORRECT. Clean the tip of the penis, using a circular motion. Start at the meatus of the urethra and work outward.
Select the best answer.
4. Which technique should you use to clean the shaft of the penis?
CORRECT. For male perineal care, use firm downward strokes to clean the shaft of the penis.
INCORRECT. For male perineal care, use firm downward strokes to clean the shaft of the penis.
INCORRECT. For male perineal care, use firm downward strokes to clean the shaft of the penis.
INCORRECT. For male perineal care, use firm downward strokes to clean the shaft of the penis.
Select the best answer.
5. During male perineal care, how should you clean the rectal area?
- From the anus to the scrotum
- From the anus to the urethra
- From the urethra to the anus
- From the scrotum to the anus
INCORRECT. To clean the rectal area during male perineal care, clean from the scrotum to the anus with one stroke.
INCORRECT. To clean the rectal area during male perineal care, clean from the scrotum to the anus with one stroke.
INCORRECT. To clean the rectal area during male perineal care, clean from the scrotum to the anus with one stroke.
CORRECT. To clean the rectal area during male perineal care, clean from the scrotum to the anus with one stroke.
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