Proper perineal care is essential to urinary health. Without proper care, the patient is susceptible to constant bladder infections and bottom bedsores. Proper perineal care also maintains the patient's dignity and keeps her feeling clean and in charge. Perineal cleansing is one of the first techniques you will learn as a nurse's assistant or home health aide.
Proper Technique
Having a stranger clean the perineal area can be embarrassing for a patient unable to help himself. Always approach your patient kindly and explain what you are going to do and why you have to do it. If your patient is able to clean parts of himself independently, let him do so, but make sure he is doing it correctly.
Upon arriving in the room, tell your patient what you need to do and get his permission to proceed. If he does not want you to perform the care even after persuasion, ask a nurse or doctor to come in and talk to him about the importance of perineal cleanliness. Once you gain permission, wash your hands thoroughly and put on rubber gloves. Draw the curtain around the bed for privacy and set your supplies out on a table near the bed. Help undress his bottom half.
Some health facilities use washbasins and rags for perineal care but most have switched to using disinfectant and soft wipes to heighten the sterility, cleanliness and ease of the process. Take a wipe and spray it with disinfectant until it is damp but not dripping. Gently begin cleaning and wiping the area, working from the outside in and wiping from the front of the genital area to the back. Never wipe from the anus towards the urethra. It is an easy way to encourage a nasty bladder infection. Wipe the entire area, throwing out the cloth and using a new one after every wipe. Then ask the patient to roll to one side and clean the newly exposed area in the same manner as before. Ask him to roll to the other side and clean that area as well. For men, always clean from the tip of the penis downward. If the man in uncircumcised, be sure to clean underneath the foreskin. For women, wipe from the pubis to the anus and be sure to clean between all folds of the vagina.
When the , front and back, is clean, make sure the skin is completely dry before putting the underwear or briefs on. Damp skin within the underwear induces bacterial infections and can create or exaggerate existing pressure ulcers or bedsores. Make sure the patient is comfortable before you leave and thank him for cooperating. Wash your hands before you leave.
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