Like all the other responsibilities of a CNA, giving perineal care to a patient on daily basis is also a prior responsibility. Giving perineal care to the patients who uses bedpan or becomes incontinent is very essential. When a patient urinates or uses bedpan, it is necessary for a nurse to clean the patients’ perineal regions immediately to keep them comfortable and active. It is also very important to check the patients for any lesions, swelling or any other kind of infection. If any rash or infection is found it is essential to take necessary precautions or inform the concerning doctor before the infection spreads further. Note that a CNA can also get caught up by symptoms like swelling, lesions and other hazardous infection when providing perineal care to its patient. To avoid such situation it is necessary to daily check the patient and provide perineal care immediately when needed. This will decrease the chances of future problem that might damage kidney or bladder areas.
Perineal care can be embarrassing and uncomfortable for both CNA and patient because it requires hands to come in contact with the genital organs of a patient. Therefore, a CNA should keep the process professional, follow standard precautions and protect the privacy of the patient at all times. Most of the patients recovering from rectal or genital surgery require frequent perineal care to avoid future skin infection or bad odor.
Steps to Perform Perineal Care:
The following steps should be followed to properly handle a patient and carry out perineal care.
- Use an anti bacterial soap to wash your hands properly before you begin with your perineal care.
- Dry your hands properly and wear gloves to cover from any germs.
- Start your procedure with greeting your patient and explaining him/her the whole process that you are about to perform.
- Before starting the process, ask your patient to simply separate the legs if they can. If they don’t then you will have to gently spread the legs
- Now take a washing cloth and soak it in warm water. Gently start cleaning the skin at the perineal area with front to back movement. Be careful not to move from back to front as it may cause germs from anal area to transfer into urethra which may cause urinary infection. You can use as much washcloths as you require.
- Now that you are done with cleaning, take a separate washcloth to wipe dry the body part and perineal area.
For Male patients: Move in a circulation motion and go from top to bottom to properly clean the perineal area.
For Female patient: Move downwards to clean the area. Use a new washcloth for every movement.
- After the cleaning process is over, you must now remove the bed linens and change it with new one. While changing the linen, make sure that the patient is moved to a comfortable position.
- Take off the gloves and dispose them along with the used linen. Wash your hands again with antiseptic soap and wear another pair of fresh gloves.
- Reposition the patient to his/her bed and make them comfortable by making possible adjustments.
- After all the work is done, dispose your gloves and wash your hands properly using an antiseptic soap.
Note that when you are cleaning the perineal area look for any sign of infection such as rashes, sores or pain at any particular area. If you find any, take immediate necessary steps or report it to the concerning doctor. Keeping a regular check will reduce the chances of infection.
List of Skills that Examiner Monitors
You should keep in mind the following steps that an examiner will monitor when you perform your perineal care.
- Remember to properly wash your hands with anti bacterial soap and lukewarm water
- Protect the privacy of the patient at all times by covering the patients private parts and make sure that you don’t do anything that makes the patient and yourself feel embarrassed.
- Make sure to place a waterproof pad below the patient’s hips.
- Comfortably position the patient for the procedure.
- Make sure you clean the perineal area properly and use separate washcloths for every step.
- Apply a cleansing lotion to the perineal area of the patient after you are done with cleaning.
- Remove the waterproof pad from below after cleaning and change the bed linen.
- Dispose the gloves and the bed linen and wash your hands again with an anti bacterial soap.
Perineal care can be very discomforting for a newbie nurse but you should know that the patient doesn’t enjoy the procedure either. No one would want to clean their private area; it’s embarrassing. But as it is your job to do so, you must protect the privacy of the patient as they trust you with their privacy. You must make them feel comfortable even if it takes hiding your discomfort in the process.