{"id":1607,"date":"2024-09-26T18:29:34","date_gmt":"2024-09-26T22:29:34","guid":{"rendered":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/chapter\/perineal-care-2\/"},"modified":"2024-09-27T17:11:07","modified_gmt":"2024-09-27T21:11:07","slug":"perineal-care","status":"publish","type":"chapter","link":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/chapter\/perineal-care\/","title":{"raw":"4.4 Perineal Care","rendered":"4.4 Perineal Care"},"content":{"raw":"The [pb_glossary id=\"529\"]perineum[\/pb_glossary]\u00a0is the tiny patch of sensitive skin between the genitals (vaginal opening or scrotum) and anus, and it\u2019s also the bottom region of the pelvic cavity. The perineum may refer to just the part of your body you can see (the skin in between your genitals and your anus). Some might refer the perineum as the perineal area, genital area, or the triangle area between the legs.\r\n\r\n[pb_glossary id=\"518\"]Perineal care (peri-care)[\/pb_glossary]\u00a0is bathing the genitalia and surrounding area. Some clients may be embarrassed, but this is part of client care. It is important to maintain a professional, matter-of-fact attitude. As with all good caregiving efforts, remember to allow the client to do as much as they can on their own. You can start by providing the client with a wet washcloth, soap, and a towel and then instructing them to wash the perineal area. You may need to say it in simpler terms so they understand, such as, \u201cI\u2019ll give you a washcloth so you can wash between your legs or your private area.\u201d Remind clients with uncircumcised penises to retract the foreskin to cleanse the penis.\r\n\r\nCleanliness of the genital area is an important part of everyone's care, particularly if the client is having difficulty controlling bowel and bladder function. This procedure is part of personal hygiene care and must be done whenever the client is soiled or wet.\r\n

Perineal Care for a Client with a Vulva<\/h1>\r\nThis procedure should always be a part of A.M. care.\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
Table 4.4.1 Procedure: Perineal Care for a Client with a Vulva<\/caption>\r\n
STEP<\/th>\r\nACTION<\/th>\r\nREASON<\/th>\r\n<\/tr>\r\n<\/thead>\r\n
1.<\/th>\r\nWith the client lying on their back, uncover the perineal area only.<\/td>\r\nProvides privacy and warmth.<\/td>\r\n<\/tr>\r\n
2.<\/th>\r\nPut on gloves.<\/td>\r\nMedical asepsis to avoid contact with mucous membranes.<\/td>\r\n<\/tr>\r\n
3.<\/th>\r\n\r\n
    \r\n \t
  • Separate the labia and use a clean part of the washcloth for each stroke.<\/li>\r\n \t
  • Wash from [pb_glossary id=\"592\"]urinary meatus[\/pb_glossary] down to perineum (from front to back) as many times as needed.<\/li>\r\n \t
  • Use a clean part of the washcloth for each stroke.<\/strong><\/li>\r\n<\/ul>\r\n<\/td>\r\n
\r\n\r\n[caption id=\"attachment_1605\" align=\"aligncenter\" width=\"300\"]\"\" Figure 4.4.1 <\/strong>Perineal care on a client with a vulva[\/caption]\r\n\r\nAsepsis: Wash from top to bottom and clean to dirty to prevent cross-contamination.<\/strong><\/td>\r\n<\/tr>\r\n
4.<\/th>\r\n\r\n
    \r\n \t
  • Wash down the [pb_glossary id=\"1332\"]labia[\/pb_glossary] minora and majora.<\/li>\r\n \t
  • Far then near, top to bottom.<\/li>\r\n \t
  • Rinse all areas well, using a clean part of the cloth for each stroke.<\/li>\r\n<\/ul>\r\n<\/td>\r\n
<\/td>\r\n<\/tr>\r\n
5.<\/th>\r\n\r\n
    \r\n \t
  • Wash across supra-pubic area (far to\u00a0near).<\/li>\r\n \t
  • Wash groin, starting on the farthest side, including the upper and inner thigh (top to bottom).<\/li>\r\n \t
  • Rinse and dry all areas well.<\/li>\r\n<\/ul>\r\n<\/td>\r\n
<\/td>\r\n<\/tr>\r\n
6.<\/th>\r\nTurn the client on their side facing away from you.<\/td>\r\n<\/td>\r\n<\/tr>\r\n
7.<\/th>\r\nWash and rinse buttocks.<\/td>\r\n<\/td>\r\n<\/tr>\r\n
8.<\/th>\r\n\r\n
    \r\n \t
  • Wash anus using a \u201cJ stroke\u201d action.<\/li>\r\n \t
  • Then rinse using a corner of the towel or a fresh washcloth.<\/li>\r\n<\/ul>\r\n<\/td>\r\n
Asepsis<\/strong>. Do not rinse or place the washcloth in the basin after washing the anal area.<\/strong><\/td>\r\n<\/tr>\r\n
9.<\/th>\r\nDry buttocks then dry anus.<\/td>\r\n<\/td>\r\n<\/tr>\r\n
10.<\/th>\r\nRemove gloves.<\/td>\r\n<\/td>\r\n<\/tr>\r\n
11.<\/th>\r\nWash hands or use hand sanitizer.<\/td>\r\n<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n

Perineal Care for a Client with a Penis<\/h1>\r\nThis procedure should always be a part of A.M. care.\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
Table 4.4.2 Procedure: Perineal Care for a Client with a Penis<\/caption>\r\n
STEP<\/th>\r\nACTION<\/th>\r\nREASON<\/th>\r\n<\/tr>\r\n<\/thead>\r\n
1.<\/th>\r\nWith the client lying on their back, uncover the perineal area only.<\/td>\r\nProvides privacy and warmth<\/td>\r\n<\/tr>\r\n
2.<\/th>\r\nPut on gloves.<\/td>\r\n[pb_glossary id=\"537\"]Medical asepsis[\/pb_glossary] to avoid contact with mucous membranes.<\/td>\r\n<\/tr>\r\n
3.<\/th>\r\n\r\n
    \r\n \t
  • Draw back foreskin, if uncircumcised.<\/li>\r\n \t
  • Wash the head of the penis from the [pb_glossary id=\"592\"]urinary meatus[\/pb_glossary] outward in a circular motion, using a clean part of the cloth for each stroke<\/strong>.<\/li>\r\n \t
  • Rinse well using the same method.<\/li>\r\n \t
  • Return the foreskin.<\/strong><\/li>\r\n<\/ul>\r\n<\/td>\r\n
\r\n\r\n[caption id=\"attachment_113\" align=\"aligncenter\" width=\"300\"]\"\" Figure 4.4.2 <\/strong>Perineal care for a client with a penis[\/caption]\r\n\r\nPrinciples of asepsis: wash from near to far and top to bottom to prevent cross-contamination.<\/strong><\/td>\r\n<\/tr>\r\n
4.<\/th>\r\nWash shaft of penis from head of penis toward the body, using a clean part of the cloth for each stroke.<\/td>\r\nTo prevent cross-contamination.<\/td>\r\n<\/tr>\r\n
5.<\/th>\r\nWash down the upper surface of the scrotum.<\/td>\r\n<\/td>\r\n<\/tr>\r\n
6.<\/th>\r\n\r\n
    \r\n \t
  • Wash across supra-pubic area.<\/li>\r\n \t
  • Wash groin starting on farthest side, including upper and inner thigh.<\/li>\r\n \t
  • Rinse and dry all areas well.<\/li>\r\n<\/ul>\r\n<\/td>\r\n
Principles of asepsis: wash from near to far and top to bottom to prevent cross-contamination.<\/strong><\/td>\r\n<\/tr>\r\n
7.<\/th>\r\nTurn the client on their side facing away from you.<\/td>\r\n<\/td>\r\n<\/tr>\r\n
8.<\/th>\r\nWash and rinse the buttocks.<\/td>\r\n<\/td>\r\n<\/tr>\r\n
9.<\/th>\r\n\r\n
    \r\n \t
  • Wash the anus using a \u201cJ stroke\u201d action.<\/li>\r\n \t
  • Then rinse using a corner of the towel or a fresh washcloth.<\/li>\r\n<\/ul>\r\n<\/td>\r\n
Asepsis. Do not rinse or place the washcloth in the basin after washing the anal area.<\/strong><\/td>\r\n<\/tr>\r\n
10.<\/th>\r\nDry buttocks, then dry the anus.<\/td>\r\n<\/td>\r\n<\/tr>\r\n
11.<\/th>\r\nRemove gloves.<\/td>\r\n<\/td>\r\n<\/tr>\r\n
12.<\/th>\r\nWash hands\/use hand sanitizer.<\/td>\r\n<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n

Additional Notes and Adaptations for Perineal Care<\/strong><\/h2>\r\n

If the client is very difficult to turn or finds it painful to turn, you can use an adaptation to personal hygiene care and perineal care.<\/p>\r\n

After washing the face, axilla, and hands, you may then wash the perineal area. You then remove your gloves, change the wash water, and obtain a new washcloth and towel. Then position the client on their side (Sim's position), wash their back, and then put on new gloves and wash the anal area. By doing hygiene care in this sequence, you reduce the number of times you must turn the client, but you are still following all the principles of\u00a0asepsis.<\/p>\r\n

If the client wears an incontinent brief, you can then put that on while the client is on their side. Fanfold one side of the brief and tuck it under the client. Check for correct placement of the brief. It should cover their buttocks and groin area. The top part of the brief will be about 2.5\u20137.5 cm (1\u20133 inches) above their buttocks. Roll the client to the other side. Let them know they will feel a \u201cbump\u201d from the brief as they roll over it. Ensure the bed rails are up. Move to the other side of the bed. Pull the other half of the brief from under the client. Assist the client back to the supine position (client is lying on their back). Pull the brief up between their legs. Peel tape from tabs and fold each side inward toward the front. Secure tape to the front of the brief.<\/p>\r\n\r\n

\r\n

The \u201cPersonal Care - Health Care\" video playlist demonstrates the techniques for Personal Hygiene Care.<\/p>\r\n\r\n<\/header>\r\n

\r\n\r\nFrom the Personal Care - Health Care Playlist<\/a> videos, watch Chapters 8\u201310. These videos are from BCcampus, written and produced by Chantal Lortie and Natasha Fontaine (2022), from Selkirk College and COTR, and licensed under a CC BY-NC 4.0<\/a> licence.\r\n\r\n<\/div>\r\n<\/div>","rendered":"

The perineum<\/a>\u00a0is the tiny patch of sensitive skin between the genitals (vaginal opening or scrotum) and anus, and it\u2019s also the bottom region of the pelvic cavity. The perineum may refer to just the part of your body you can see (the skin in between your genitals and your anus). Some might refer the perineum as the perineal area, genital area, or the triangle area between the legs.<\/p>\n

Perineal care (peri-care)<\/a>\u00a0is bathing the genitalia and surrounding area. Some clients may be embarrassed, but this is part of client care. It is important to maintain a professional, matter-of-fact attitude. As with all good caregiving efforts, remember to allow the client to do as much as they can on their own. You can start by providing the client with a wet washcloth, soap, and a towel and then instructing them to wash the perineal area. You may need to say it in simpler terms so they understand, such as, \u201cI\u2019ll give you a washcloth so you can wash between your legs or your private area.\u201d Remind clients with uncircumcised penises to retract the foreskin to cleanse the penis.<\/p>\n

Cleanliness of the genital area is an important part of everyone’s care, particularly if the client is having difficulty controlling bowel and bladder function. This procedure is part of personal hygiene care and must be done whenever the client is soiled or wet.<\/p>\n

Perineal Care for a Client with a Vulva<\/h1>\n

This procedure should always be a part of A.M. care.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Table 4.4.1 Procedure: Perineal Care for a Client with a Vulva<\/caption>\n
STEP<\/th>\nACTION<\/th>\nREASON<\/th>\n<\/tr>\n<\/thead>\n
1.<\/th>\nWith the client lying on their back, uncover the perineal area only.<\/td>\nProvides privacy and warmth.<\/td>\n<\/tr>\n
2.<\/th>\nPut on gloves.<\/td>\nMedical asepsis to avoid contact with mucous membranes.<\/td>\n<\/tr>\n
3.<\/th>\n\n\n
\"\"
Figure 4.4.1 <\/strong>Perineal care on a client with a vulva<\/figcaption><\/figure>\n

Asepsis: Wash from top to bottom and clean to dirty to prevent cross-contamination.<\/strong><\/td>\n<\/tr>\n

4.<\/th>\n\n<\/td>\n<\/tr>\n
5.<\/th>\n\n
    \n
  • Wash across supra-pubic area (far to\u00a0near).<\/li>\n
  • Wash groin, starting on the farthest side, including the upper and inner thigh (top to bottom).<\/li>\n
  • Rinse and dry all areas well.<\/li>\n<\/ul>\n<\/td>\n
<\/td>\n<\/tr>\n
6.<\/th>\nTurn the client on their side facing away from you.<\/td>\n<\/td>\n<\/tr>\n
7.<\/th>\nWash and rinse buttocks.<\/td>\n<\/td>\n<\/tr>\n
8.<\/th>\n\n
    \n
  • Wash anus using a \u201cJ stroke\u201d action.<\/li>\n
  • Then rinse using a corner of the towel or a fresh washcloth.<\/li>\n<\/ul>\n<\/td>\n
Asepsis<\/strong>. Do not rinse or place the washcloth in the basin after washing the anal area.<\/strong><\/td>\n<\/tr>\n
9.<\/th>\nDry buttocks then dry anus.<\/td>\n<\/td>\n<\/tr>\n
10.<\/th>\nRemove gloves.<\/td>\n<\/td>\n<\/tr>\n
11.<\/th>\nWash hands or use hand sanitizer.<\/td>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Perineal Care for a Client with a Penis<\/h1>\n

This procedure should always be a part of A.M. care.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Table 4.4.2 Procedure: Perineal Care for a Client with a Penis<\/caption>\n
STEP<\/th>\nACTION<\/th>\nREASON<\/th>\n<\/tr>\n<\/thead>\n
1.<\/th>\nWith the client lying on their back, uncover the perineal area only.<\/td>\nProvides privacy and warmth<\/td>\n<\/tr>\n
2.<\/th>\nPut on gloves.<\/td>\nMedical asepsis<\/a> to avoid contact with mucous membranes.<\/td>\n<\/tr>\n
3.<\/th>\n\n\n
\"\"
Figure 4.4.2 <\/strong>Perineal care for a client with a penis<\/figcaption><\/figure>\n

Principles of asepsis: wash from near to far and top to bottom to prevent cross-contamination.<\/strong><\/td>\n<\/tr>\n

4.<\/th>\nWash shaft of penis from head of penis toward the body, using a clean part of the cloth for each stroke.<\/td>\nTo prevent cross-contamination.<\/td>\n<\/tr>\n
5.<\/th>\nWash down the upper surface of the scrotum.<\/td>\n<\/td>\n<\/tr>\n
6.<\/th>\n\n
    \n
  • Wash across supra-pubic area.<\/li>\n
  • Wash groin starting on farthest side, including upper and inner thigh.<\/li>\n
  • Rinse and dry all areas well.<\/li>\n<\/ul>\n<\/td>\n
Principles of asepsis: wash from near to far and top to bottom to prevent cross-contamination.<\/strong><\/td>\n<\/tr>\n
7.<\/th>\nTurn the client on their side facing away from you.<\/td>\n<\/td>\n<\/tr>\n
8.<\/th>\nWash and rinse the buttocks.<\/td>\n<\/td>\n<\/tr>\n
9.<\/th>\n\n
    \n
  • Wash the anus using a \u201cJ stroke\u201d action.<\/li>\n
  • Then rinse using a corner of the towel or a fresh washcloth.<\/li>\n<\/ul>\n<\/td>\n
Asepsis. Do not rinse or place the washcloth in the basin after washing the anal area.<\/strong><\/td>\n<\/tr>\n
10.<\/th>\nDry buttocks, then dry the anus.<\/td>\n<\/td>\n<\/tr>\n
11.<\/th>\nRemove gloves.<\/td>\n<\/td>\n<\/tr>\n
12.<\/th>\nWash hands\/use hand sanitizer.<\/td>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Additional Notes and Adaptations for Perineal Care<\/strong><\/h2>\n

If the client is very difficult to turn or finds it painful to turn, you can use an adaptation to personal hygiene care and perineal care.<\/p>\n

After washing the face, axilla, and hands, you may then wash the perineal area. You then remove your gloves, change the wash water, and obtain a new washcloth and towel. Then position the client on their side (Sim’s position), wash their back, and then put on new gloves and wash the anal area. By doing hygiene care in this sequence, you reduce the number of times you must turn the client, but you are still following all the principles of\u00a0asepsis.<\/p>\n

If the client wears an incontinent brief, you can then put that on while the client is on their side. Fanfold one side of the brief and tuck it under the client. Check for correct placement of the brief. It should cover their buttocks and groin area. The top part of the brief will be about 2.5\u20137.5 cm (1\u20133 inches) above their buttocks. Roll the client to the other side. Let them know they will feel a \u201cbump\u201d from the brief as they roll over it. Ensure the bed rails are up. Move to the other side of the bed. Pull the other half of the brief from under the client. Assist the client back to the supine position (client is lying on their back). Pull the brief up between their legs. Peel tape from tabs and fold each side inward toward the front. Secure tape to the front of the brief.<\/p>\n

\n
\n

The \u201cPersonal Care – Health Care” video playlist demonstrates the techniques for Personal Hygiene Care.<\/p>\n<\/header>\n

\n

From the Personal Care – Health Care Playlist<\/a> videos, watch Chapters 8\u201310. These videos are from BCcampus, written and produced by Chantal Lortie and Natasha Fontaine (2022), from Selkirk College and COTR, and licensed under a CC BY-NC 4.0<\/a> licence.<\/p>\n<\/div>\n<\/div>\n

definition<\/span>