ASSISTING-WITH-PERINEAL-CARE.pptx

PERINEAL CARE
PERINEAL CARE (Peri-Care) – cleaning the perineum &
anus as well as the vulva (women) & the penis (in
men).
2 MAIN REASONS OF PROVIDING
GOOD PERINEAL CARE:
 PREVENTION OF INFECTION
 PREVENTION OF SKIN BREAKDOWN & ODOR
 Perineal care is routinely done at least once daily as
part of the bath.
 Patients/residents who can manage their own
perineal care should be encouraged to do so.
 Be sure to provide for the person’s modesty during
the procedure by closing the door & the curtain &
draping the person with bath blanket.

PARTS OF THE BODY THAT ARE CLEANED
DURING PERINEAL CARE
FEMALE: MALE:

TELL THE NURSE!
 Any unusual redness, inflammation or skin
rashes in the perineal area.
 Any unusual discharge from the vagina and
penis
 Any bleeding from the vagina (especially in a
postmenopausal woman)
 Any abnormal odor

GUIDELINES FOR PROVIDING
PERINEAL CARE
I. Obtain the person’s consent before beginning
the procedure. Tell the person what you are
going to do using professional yet
understandable words (such as “crotch”,
“privates”, “bottom” or “the area between your
legs”) and ask the person’s permission to begin.
If there is a language barrier, you may need an
interpreter.
RATIONALE: To prevent misunderstandings, it
is important for the person to understand where
you are going to be touching him & why.

PERINEAL CARE
II. Take care to protect the person’s modesty by closing
the door & curtain and draping the person with a
bath blanket.
RATIONALE: Receiving perineal care can be very
embarrassing. Properly draping the person may help
the person to feel less “exposed”.
III. Always take the temperature of the water using a
bath thermometer. The water temperature should be
between 110°F (43.3°C) and 115°F (46.1°C).
RATIONALE: Water that is too cold is
uncomfortable & water that is too hot could burn the
person.

PERINEAL CARE
IV. Follow standard precautions when providing perineal
care.
RATIONALE: Providing perineal care places you at
risk for exposure to urine, feces & other body fluids
(example: blood, vaginal secretions, semen).
V. Perineal care is the last part of a person’s bathing
routine. Washcloths, towels & the water in the wash
basin (if a bed bath is being given) are discarded & not
used on any other body parts after the perineal care is
completed.
RATIONALE: The anus is a source of pathogens. To
prevent spread of these pathogens to other parts of the
body, where they may gain access & cause infection,
the perineal area is washed last.

PERINEAL CARE
VI. Always wash toward the anus, away from the external
urinary opening.
RATIONALE: This helps to prevent the spread of
pathogens from the anus into the urethra (and vagina, in
women), where they could cause infection.
VII. When you are assisting an uncircumcised man with
perineal care, pull the foreskin back to clean the head of
the penis. After cleaning & rinsing the penis, always
remember to pull the foreskin back up over the end of the
penis.
RATIONALE: Pulling the foreskin back allows you to
clean & rinse the head of the penis thoroughly. Pulling the
foreskin back into place after the head of the penis is
cleaned prevents the foreskin from forming a band around
the penis, which can cause pain and swelling.

PERINEAL CARE
VIII. Rinse the skin thoroughly to remove all soap.
RATIONALE: The skin in the perineal area is very
delicate. Soap is drying & can irritate the skin if not rinsed
away.
IX. Gently pat the skin dry. Do not rub vigorously. Dry the skin
thoroughly.
RATIONALE: The skin in the perineal area is very
delicate. Vigorously rubbing the skin with a towel is
uncomfortable for the person & can create friction, which
in turn can cause skin breakdown. Moisture in areas where
skin comes contact with skin can also lead to skin
breakdown.
X. Remove your gloves & wash your hands before touching
clean clothing or linens
RATIONALE: Gloves worn while providing perineal care
are considered contaminated.

HOW TO DRAPE THE PERSON
1. The bath blanket is placed over the person’s
body so that one corner is pointing toward the
person’s head & the other is between the
person’s legs, covering the perineum.
2. The right corner is brought under & around the
person’s left leg & the same is done on the
right.
3. The top corner is lifted up to expose only the
perineal area.

PROCEDURE: PROVIDING FEMALE
PERINEAL CARE
1. Complete the “pre-procedure” steps.
SUPPLIES:
 Gloves - Soap
 Paper towels - Bath blanket
 Bed Protector - Washcloths
 Bath thermometer - Towels
 Wash Basin - Clean clothing
 Bedpan - Clean linens (if necessary)
2. Cover the over-bed table with paper towels. Place
the wash basin, toiletries, clean clothing & clean
linens on the over-bed table.

PERINEAL CARE
3. Make sure that the bed is positioned at a
comfortable working height & that the wheels are
locked.
4. Put on the gloves.
5. Because bathing often stimulates the urge to
urinate, offer the bedpan. If the person uses the
bedpan, empty & clean it before proceeding with
the perineal care. Remove your gloves & dispose of
them in a facility-approved waste container. Wash
your hands & put on a clean pair of gloves.
6. Lower the head of the bed to a flat position (as
tolerated).

PERINEAL CARE
7. Fill the wash basin with warm water [110°F (43.3°C)
to 115°F (46.1°C) on the bath thermometer]. Place
the basin on the over-bed table.
8. If the rails are in use, lower the side rail on the
working side. The side rail on the opposite side of the
bed should remain up.
9. Spread the bath blanket over the top linens (and
person). If the person is able, have her hold the bath
blanket. If not, tuck the corners under the person’s
shoulders. Fanfold the top linens to the foot of the
bed.

PERINEAL CARE
10. Assist the person with undressing.
11. Ask the person to open her legs & bend her
knees, if possible. If she is not able to bend her
knees, help her spread her legs as mush as
possible.
12. Position the bath blanket over the person so
that one corner can be wrapped under & around
each leg.
13. Position the bed protector under the person’s
buttocks to keep the bed linens dry.

PERINEAL CARE
14. Lift the corner of the bath blanket that is
between the person’s legs upward, exposing only
the perineal area.
15. Form a mitt around your hand with one of the
washcloths. Wet the mitt with warm, clean water
& apply soap.
16. Using the hand, separate the labia. Clean the
vulva by placing your washcloth-covered hand at
the top of the vulva & stoking downward to the
anus. Use a different part of the washcloth for
each stroke. Repeat until the area is clean.

PERINEAL CARE
17. Rinse the vulva & perineum thoroughly:
METHOD “A” : Form a mitt around your hand with a
clean, wet washcloth. Using the other hand, separate
the labia. Rinse the vulva by placing your washcloth-
covered hand at the top of the vulva & stroking
downward to the anus. Use a different part of the
washcloth for each stroke. Repeat until the area is
free of soap.
METHOD “B” : Hold a clean, warm water over the vulva.
Squeeze the water from the washcloth onto the vulva
& allow it to run over the vulva & perineum. Repeat
until the area is free of soap.

PERINEAL CARE
18. Dry the perineal area thoroughly using a towel.
19. Turn the person onto her side so that she is
facing away from you. Help the person toward the
working side of the bed so that her buttocks are
within easy reach. Adjust the bath blanket to keep
the person covered.
& apply soap.

PERINEAL CARE
21. Using the other hand, separate the buttocks.
Place your washcloth-covered hand at the front of
the body & stroke toward the back. First clean one
side, then the other side and finally the middle,
using a different part of the washcloth each time,
until the anal area is clean.
22. Rinse & dry the anal area thoroughly. Remove
the bed protector from underneath the person.
23. Remove your gloves & dispose of them in a
facility-approved waste container. Put on a clean
pair of gloves

PERINEAL CARE
24. Assist the person into the supine position.
Reposition the pillow under her head. Remove the
bath blanket & help the person into the clean
clothing.
25. If the bedding is wet or soiled, change the bed
linens.
26. If the side rails are in use, return the side rail to
the raised position. Raise the head of the bed as
the person requests. Make sure that the bed is
lowered to its lowest position & that the wheels
are locked.

PERINEAL CARE
27. Gather the soiled linens & place them in the
linen hamper or linen bag. Dispose of disposable
items in a facility-approved waste container. Clean
equipment & return it to the storage area.
facility-approved waste container.
29. Complete the “post-procedure” steps.

PROCEDURE: PROVIDING MALE
PERINEAL CARE
1. Complete the “pre-procedure” steps.
SUPPLIES:
 Gloves - Soap
 Paper towels - Bath blanket
 Bed protector - Washcloths
 Bath thermometer - towel
 Wash basin - clean clothing
 Bedpan or urinal - clean linens (if necessary)
2. Cover the over-bed table with paper towels. Place
the wash basin, toiletries, clean clothing & clean
linens on the over-bed table.

PERINEAL CARE
3. Make sure that the bed is positioned at a
comfortable working height & that the wheels are
locked.
4. Put on the gloves.
5. Because bathing often stimulates the urge to urinate,
offer the bedpan or urinal. If the person uses the
bedpan or urinal, empty & clean it before proceeding
with the perineal care. Remove your gloves & dispose
of them in a facility-approved waste container. Wash
your hands & put on a clean pair of gloves.
6. Lower the head of the bed to a flat position (as
tolerated).

PERINEAL CARE
7. Fill the wash basin with warm water [110°F (43.3°C)
to 115°F (46.1°C) on the bath thermometer]. Place
the basin on the cover-bed table.
8. If the side rails are in use, lower the side rail on the
working side. The side rail on the opposite side of the
bed should remain up.
9. Spread the bath blanket over the top linens & the
person. If the person is able, have him hold the bath
blanket. If not, tuck the corners under the person’s
shoulders. Fanfold the top linens to the foot of the
bed.

PERINEAL CARE
10. Assist the person with undressing.
11. Ask the person to open his legs & bend his
knees, if possible. If he is not able to bend his
knees, help him spread his legs as much as
possible.
12. Position the bath blanket over the person so
that one corner can be wrapped under & around
each leg.
13. Position the bed protector under the person’s
buttocks to keep the bed linens dry.

PERINEAL CARE
14. Lift the corner of the bath blanket that is
between the person’s legs upward, exposing only
the perineal area.
& apply soap.
16. Using the other hand, hold the penis slightly
away from the body.

PERINEAL CARE
A. If the person is circumcised: Place your washcloth-
covered hand at the tip of the penis & wash in a
circular motion, downward to the base of the penis.
Repeat using a different part of the washcloth each
time, until the area is clean. Rinse & dry the tip &
the shaft of the penis thoroughly:
METHOD “A” : Form a mitt around your hand with a
clean, wet washcloth. Using the other hand, hold
the penis slightly away from the body. Place your
washcloth-covered hand at the tip of the penis &
wipe in a circular motion, downward to the base of
the penis. Repeat using a different part of the
washcloth each time, until the area is rinsed. Dry the
penis thoroughly.

PERINEAL CARE
METHOD “B” : Hold a clean washcloth saturated with
clean, warm water over the area. Squeeze the water
from the washcloth onto the area. Dry the penis
thoroughly.
B. If the person is uncircumcised: Retract the foreskin
by gently pushing the skin toward the base of the
penis. Place your washcloth-covered hand at the tip
of the penis & wash in a circular motion, downward
to the base of the penis. Repeat using a different part
of the washcloth each time until the area is clean.
Rinse & dry the tip & shaft of the penis thoroughly
before gently pulling the foreskin back into its normal
position.

PERINEAL CARE
washcloths. Wet the mitt with warm, clean water &
apply soap. Wash the scrotum & perineum. Rinse &
dry the scrotum & perineum thoroughly.
18. Turn the person onto his side so that he is facing
away from you. Help the person toward the working
side of the bed so that his buttocks are within easy
reach. Adjust the bath blanket to keep the person
covered.
washcloths. Wet the mitt with warm, clean water &
apply soap.

PERINEAL CARE
20. Using the other hand, separate the buttocks.
Place your washcloth-covered hand at the front of
the body & stroke toward the back. First clean one
side, then the other side & finally the middle,
using a different part of the washcloth each time
until the anal area is clean.
21. Rinse & dry the anal area thoroughly. Remove
the bed protector from underneath the person.
22. Remove the gloves & dispose of them in a
facility-approved waste container. Put on a clean
pair of gloves.

PERINEAL CARE
23. Assist the person into the supine position.
Reposition the pillow under the person’s head.
Remove the bath blanket & help the person into
the clean clothing.
24. If the bedding is wet or soiled, change the bed
linens.
25. If the side rails are in use, return the side rail to
the raised position. Make sure that the bed is
lowered to its lowest position & that the wheels
are locked.

PERINEAL CARE
26. Gather the soiled linens & place them in the
linen hamper or linen bag. Dispose of disposable
item in a facility-approved waste container. Clean
equipment & return it to the storage area.
facility-approved waste container.
28. Complete the “post-procedure” steps.

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