Brown Beige Doodle Notes Group Project Presentation .pdf

Health sciences

1. PERINEAL
CARE
by: Rachael Ann E. Pacamarra,RM,BSM

2. Learning Outcomes

3. Project Overview
Assess the patient effectively to determine the
need for assistance with perineal care.
Analyze data to determine special needs,concerns
and self care abilities in completing perineal care.
Determine appropriate patient outcomes of the
perineal care procedures and recognize the
potential for adverse outcomes.
Choose the appropriate procedure and equipment
for the specific perineal care needed.
1.
2.
3.
4.

4. 5. Determine the assistance needed to
complete the procedure.
6. Demonstrate the proper techniques for
assisting with perineal care.
7. Evaluate the effectiveness of the
perineal care techniques for specific
patient.
8. Document the procedure in the patients
plan of care as well as specific
observations of any abnormal findings
and the patients comfort level.
Learning Outcomes

5. Perineal Care
Task Name
Task Name
Task Name
•involves thorough cleansing of the clients external
genitalia,anal area and surrounding skin.
•”peri-care or “perineal-genital” care
•involves washing the external genitalia with soap
nd water or with water alone or in combination with
any commercially prepared periwash.
•can be delegated to nursing assistive personnel

6. •Carried out as a part of patients bath or as a
separate procedure.
•Perineal area is conducive to the growth of
pathogenic organism because it is warm,moist and
is not well ventilated.
•Cleanliness is essential to prevent bad odor and
promote comfort.

7. Purpose
01 02
To prevent or eliminate infection,odor
and promote healing
Removes secretions,and provide
comfort

8. Principle
Task Name
Task Name
01 02
03 04
To clean the perineum from the
cleanest to the less clean area.
Follow Standard Precautions.
Maintain patient’s privacy. Proximal level of functioning

9. Patients who needs
frequent perineal care?
-Who are unable to do self care
-Patients with genito-urinart tract infections.
-With fecal& urinary incontenence
-An indwelling catheter
-Who are recovering from rectal or genital surgery or childbirth.
-Patient with excessive vaginal discharge.
-Patients with injury and ulcers
-Uncircumcised males
-Morbid obesity

10. Task Name
Task Name
Delegation Considerations
importance of not
massaging reddened
dkin areas during
bathing.
02
01
Recognizing early
signs of impaired
skin integrity
A
B
C
A
Proper ways to position male and female
clients with musculoskeletal limitations
or who have an indwelling catheter or
other equipment (eg. iv tubings)
D
When to report changes in
the skin or perineal area to
the nurse

11. Assess presence of
Irritation, excoriation,inflammation, swelling
Excessive discharge
Odor; pain or discomfort
Urinary or fecal incontinence
Recent rectal or perineal surgery
Indwelling catheter
1.
2.
3.
4.
5.
6.

12. Equipments
Washcloth (6) and bath towels (2)
Bath blanket
Soap and soap dish
Toiletry items
Toilet tissue or diaper wipes
Waterproof pad or bed pan
Disposable gloves

1.
2.
3.
4.
5.
6.
7.
8.
8. Laundry bag
9. Rinsing solution
10. Cotton balls or
swabs
11. Perineal pad

13. Equipments
Bedpans- are made of
metal or plastic and come
in two sizes (pedia and
adult)
-standard bed pan or
fracture pan

14. Equipments
Urinals- made of plastic or
metal with a bottle like
configuration.

15. Assesment
Introduce self and identify patient using two identifiers (eg.Name and
birthday;name and medical record number)
Ensure to client what are you going to do, why it is necessary and
how or she can cooperate,being particularly sensitive to any
embarrasment felt by the client.
Asses clients tolerance for perineal care; activity tolerance; comfort
level during movement,cognitive ability, muscoloskeletal
function,presence of shortness of breath.
1.
2.
3.

16. Assesment
4. Assess clients visual status,ability to sit without support,hand
grasp,ROM of extremeties.
5.Assess for presence of equipment.
6. Assess for allergy or sensitivity
7. Ask if the patient has noticed any problems related to condition of
genitalia,excess moisture, inflammatiin,drainage or secretions from
lesions or wound.
8. Assess patients knowledge of perineal hygiene in terms of its
importance,preventive measures to take and common problems.

17. Assesment
9. If patient is able to manuever and handle washcloth, allow them to clean
perineum on their own.

18. Planning
Review orders for specific precautions concerning patients movement
or positioning.
Explain procedure and ask patient for suggestions on how to prepare
supplies. If using CHG,explain benefit of reducing infection and that
soluntion leaves sticky feeling.
Prepare equipment and supplies. if it iss necessary to leave room,be
sure that call light is within patients reach.
1.
2.
3.

19. Implementation
Assess environment for safety (eg. Check room for spills,make sure
that equipment is working properly and that the bed is functional.
Close room,door and windows,draw room divider curtain. Offer
patient bed pan or urinal. Provide toilet tissue.
Perform hand hygiene. If patient has non-intact sken or skin is soiled
with drainage,excretions or bod secretions,apply clean gloves. Ensure
patient is not allergic to latex.
Lower side rail. Help patient into doral recumbent position.Note
restrictions or limitations in patients positionins. Drape patient with
blanket placed in shape of diamond. Lift lower edge of blanket to
expose perineum
1.
2.
3.
4.

20. Implementation
5. Fold lower corner of bath blanket up between patient’s legs onto
abdomen. Wash and dry patients upper thighs.

21. Draping the patient for
perineal-genital care

22. Female Genitalia

23. Procedures
6. Wash labia majora. Use non dominant hand to gently retract labia
from thigh, with dominant hand wash carefully in skin folds. Wipe
direction from perinuem to rectum. Repeat on opposite side with
separate section of washcloth. Rinse and dry thoroughly.
7. Gently separate labia with nondominant hand to expose urethral
meatus and vaginal orifice. With dominant hand,wash downward from
ubis area toward rectum in one smooth stroke. Wash middle and both
sides of perineum. Use separate sectiin of cloth for each stroke. Clean
thoroughly around labia minora,clitoris and vagibal orifice. Avoid placing
tension on indwelling catheter if present and clean area around it
thoroughly.

24. Procedures
8. Provide catheter care if needed.
9. Rinse thoroughly. May use bedpan and pour warm water over perineal
area. Dry thoroughly from front to back.
10. Fold lower corner of bath blanket back between patient’s legs and over
perineum. Ask patient to lower legs and assume comfortable position.

25. Document the procedure,describing the client’s skin condition
(redness,excoriation, skin breakdown,discharge or drainage,any
localized areas or tenderness) and tolerance to the care.

Sign the chart.

26. THANK YOU