To give every patient a regular perineal care a lot of times in a day is among the prior responsibilities of the nursing aides. Perineal care is essential for a patient, who becomes incontinent, micturates or makes use of a bedpan. The task of a CNA is to clean the perineal areas of such patients immediately. CNAs also provide perineal care to the patient to keep them clean, safe and active.

A CNA has to check such patients frequently on a daily basis, so make sure that the patient stays away from the ailments and infections. The CNA also comes across with several problems occurring in perineal areas of a patient, while giving them the daily perineal care. CNAs become capable of catching symptoms like, swelling, lesions and other symbols of infections in their perineal parts. This way, the patients get protected from more severe diseases or contaminations that can take place in the future. Providing regular and proper care to the patients can also decline the probabilities of infectivity in the urinary zone. This also decreases the future problems that might affect the kidney and bladder areas. 

Points to Remember

  • To start with this process, you must clean your hands in a correct way.
  • Afterwards, you have to wear hands gloves.
  • Do not forget to greet the patient well.
  • Prior to starting the activity, it is vital to explain the patient that you will be providing perineal care to him/her.
  • Things required are-1washcloth, warm water, water basin,

Step-wise Procedure to carry on during giving the Perineal Care to the patient

Step 1- Open the legs of the patient
To begin with this activity, you have to ask the patient to spread his/her legs from the middle if they are physically able of doing so. But in case, if they aren’t able to do this, then you need to open their legs in a tender way.

Step 2- Clean the skin with a washcloth
You must start the cleaning process of the surface in the perineal area with the help of a washcloth and some warm water.

Step 3- Be cautious with the wiping method
The cleaning method is to wipe the washcloth from the front portion of the Urethra to the back. Never take the wiping cloth moving from back part to front, as this may cause the bacteria from the anal area to get inside Urethra. As a nursing aide, you must pay attention to this, for the fact that the Urethra is considered as a vital source of causing contagion in the urinary region.

Step 4- Dry the skin properly
Once, you have completed the cleaning process of the perineal area, you also have to dry the portion properly with the use of a neat and dry washcloth. This prevents the skin from being chapped.

Step 5- Use clean washcloth every time
While, cleaning the perineal portions, you cannot apply the same cloth every time or take in use for cleaning other body parts. You have to take a fresh washcloth for particularly cleaning the perineal areas. This helps in preventing the dissemination of germs into the other parts of the patient’s body.

Step 6- Replace the dirty linens with clean ones
When, the linens spread on the bed become wet or dirty, then you need to change them with fresh ones immediately.

Step 7- Dispose the linens
Remove the gloves and dispose along with the linens properly.

Step 8- Make the patient comfortable
After, the entire perineal care activity gets over, check that the patient should be in a comfortable position. If the patient is feeling uneasiness, then bring him/her in a comfortable condition. Check that sheet or the blanket should be properly spread.

Step 9- Do not forget to cleanse your hands
After the care process is over and you have disposed the used gloves and dirty linens, once again you need to wash your hands thoroughly.

What does the evaluator checks when you carry out this skill?

Below given are the pointers that can assist you about what the examiner notices when you will perform this skill in the assesment:

1. Have you started the process properly?
Tip- Make sure, you have done all the steps properly at the time of starting the process.

2. Have you taken the right amount of water in the water basin?
Tip- Measure the quantity of water, while loading it in the water basin.

3. Do you let the patient check the water temperature at first?
Tip- Always, give this priority to the patient to decide whether the water temperature is suitable for him/her or not.

4. Do you check the water temperature for the patient suiting to their convenience, if they are not capable of doing so?
Tip- When the patient is not capable of doing so, in that case,  you must do it in his/her place.

5. Have you maintained the patient’s privacy properly?
Tip- You need to maintain the patient’s privacy by covering their genitals respectively. So that their self-respect should not be hurt and the patient should not feel uneasy during the entire process.

6. Have you placed the protected pad or not?
Tip- The placing of a waterproof sheet below the buttocks of the patients is necessary for this process.

7. Do you position the patient correctly during this process?
Tip- You must keep the patient in the correct position (as mentioned above) for this process, so that the whole process can be carried out appropriately.

8. How do you do the perineal care of a female patient?
Tip- To perform the perineal care of a female client, firstly, you need to widen the labia by opening both the legs opposite sides. Now, start doing the downward wipes for cleaning in front to back motions. Take tidy clothes for every single downward motion. If required, take additional wash clothes to clean the genitals.

9. How do you clean the perineal areas of a male patient?
Tip- When you do the cleaning of male’s perineal parts, firstly you need to see, whether he is uncircumcised. If not, then you need to retract the foreskin. Hold his male part and use a circular movement to cleanse the tip of his penis. Wash the shaft and the testicles of his male part properly.

10. Do you rinse the perineal portions of a patient accurately, if applicable?
Tip- If it can be applied, then you must also rinse the perineal portions properly.

11. How do you clean the anal area of a male patient?
Tip- Firstly, let the patient lie down on with his face away from your face. Using a front to back stroke, clean his anal parts.

12. Have you dried the perineal zone?
Tip- You need to dry the perineal parts properly with a clean dry cloth, if applicable.

13. Have you disposed the used stuffs?
Tip- Disposing the waterproof sheet in a correct manner is also vital.

14. Have you disposed the gloves?
Tip- Make sure, you have disposed the gloves after completing the perineal care activity.

15. Have you washed your hands and done the activities, you supposed to do in the ending?
Tip- Wash your hands at least for one minute. This ends the risks of getting infected with germs, which you might get when you hold the anal area. Make sure you end this process by conducting proper ending steps.

Expert Tips:

  • It is essential for CNA to keep on observing the signs of infections in a patient’s genital regions, during the course of his/her treatment.
  • The different symptoms of infections are sores, tenderness, boils or rashes, which you must always remember.
  • While noticing any of these signs, you must notify the nurse immediately regarding this.
  • Good and regular care of the patient will help such persons in getting comfort and recover soon.

Video Demonstration

We are providing you the video regarding the perineal care activity, so that you may learn and understand CNA skill in a better way and get qualified in the CNA skills test.