Perineal Care
Perineal care, which includes care of the external genitalia and the anal area, should be performed during the daily bath and, if necessary, at bedtime and after urination and bowel movements. The procedure promotes cleanliness and prevents infection. It also removes irritating and odorous secretions, such as smegma, a cheeselike substance that collects under the foreskin of the penis. For the patient with perineal skin breakdown, frequent bathing followed by application of an ointment or cream aids healing.
Follow standard precautions when providing perineal care, and give great consideration to the patient’s privacy.1
Equipment
Gloves ▪ bath blanket ▪ bathing supplies (disposable cleaning cloths, prepackaged bath product, or washcloths, a towel, and mild soap) ▪ linen-saver pad ▪ trash bag ▪ Optional: facility-approved disinfectant, bath basin, toilet tissue, antiseptic soap, petroleum jelly, zinc oxide cream, vitamin A and D ointment, surgical pad.
After genital or rectal surgery, you may need to use sterile supplies, including sterile gloves, gauze, and cotton balls.
Preparation of Equipment
Obtain ointment or cream as needed. If using a basin, fill it two-thirds full with warm water.
Nursing Alert
Studies have shown that patients’ bath basins are a reservoir for bacteria and may be a source of transmission of health care facility–acquired infections.2 Follow your facility’s policy regarding cleaning of bath basins. Many facilities require staff members to clean the basin with a facility-approved disinfectant before and after use.
Implementation
Confirm the patient’s identity using at least two patient identifiers according to facility policy.6
Gather the equipment at the patient’s bedside and provide privacy.
Explain the procedure to the patient. Answer all questions to decrease anxiety and increase cooperation.
Adjust the bed to a comfortable working height to prevent back strain, and lower the head of the bed, if allowed.
Provide privacy and help the patient to a supine position. Place a linen-saver pad under the patient’s buttocks to protect the bed from stains and moisture.
Drape the patient’s legs, using a bath blanket, to minimize exposure and embarrassment and expose the genital area.
Wet the washcloth with warm water from a running spigot or the bath basin and apply mild soap. If using disposable cleaning cloths or a prepackaged bath product, open the packages and obtain the wet cloths.
For Female Patients
Ask the patient to bend her knees slightly and to spread her legs.
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