TRINITY VALLEY COMMUNITY COLLEGE

ASSOCIATE DEGREE NURSING

RNSG 1216

PROCEDURE GUIDE AND CHECK-OFF SHEET

PERINEAL CARE

Perineal care promotes patient comfort and removes secretions and odors.

Delegation: This procedure may be delegated to unlicensed assistive personnel that have proper training. The
nurse retains the responsibility of the assessment.

Procedure Scientific Rationale

1. The following equipment is needed for this
skill:
a. towels
b. gloves
c. bath basin & warm water
d. soap
e. washcloth
f. protective pads/linen
g. cotton balls/gauze.
2. Prepare the patient by folding the top bed
linen to the foot of the bed and fold up the
gown to expose the perineal/genital area.
3. Place a bath towel under the patient’s hips.
4. Position and drape the patient.
Females:
5. Have the patient lie on their back with knees
flexed and spread apart.
6. Drape the legs by covering the torso with an
additional sheet or blanket and tuck the
corners under to inner sides of the legs. Allow
some of the sheet to cover the pubic area
until cleaning commences.
7. Clean the labia majora, then spread the labia to
wash the folds between the labia majora and
the labia minora.
8. Clean in direction from perineum to rectum.
9. Using separate quarters of the washcloth for
each stroke, wipe from the pubis to the
rectum.
10. For menstruating patients or those with
indwelling catheters, disposable cloths, gauze,
or cotton balls may be useful. Use a clean area
for each stroke.
Water is to be warm to allow comfort. Too hot may
damage skin and cold may be startling and uncomfortable.
Some facilities may have bath blankets and prepared
cleansing tissues or towels.
Assessment cannot be completed unless the genital area
is visible.
Prevents the bed from becoming soiled.
Draping the patient minimizes exposure and provides
additional warmth for the patient.
Allows adequate visibility and access and flexing the knees
decreases the stress on the lower back.
A separate top sheet may be used to provide additional
warmth and comfort to the patient. Decreasing the upper
thigh exposure and allowing a loose drape to cover the
pubic area decreases the sense of exposure on the part of
the patient.
Secretions in this area tend to collect and facilitate
bacterial growth.
Wiping in this manner prevents cross contamination of
areas.
Using clean portions of the cloth discourages transmission
of microorganisms from one area to another. Wiping
from an area of least contamination to one of more
contamination prevents spreading microorganisms.
Additional soiled areas may require the use of additional
clean supplies that promote easy disposal of soiled
surfaces.

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11. With a catheter, wipe in the direction away from
entry site.
12. Rinse well. May use a peri-wash bottle or
container to flow warm water over the perineal
area. Having the patient on a bedpan allows
collection of the draining fluid.
13. Dry thoroughly, paying attention to the folds
between the labia.
14. Assess the area for evidence of redness,
irritation, and drainage, especially between the
labia in females and around indwelling
catheters.
15. Reposition the patient on the side facing away
and clean between the buttocks. May use tissue
first if heavily soiled.
Males:
16. Assist the patient to a supine position, knees
flexed, and hips slightly rotated externally.
17. Wash and dry the perineal area. Clean the inner
thighs and general perineal area first.(Clean to
Dirty)
18. Wash and dry the penis, using firm strokes.
Begin in circular motion at the glans penis and
wash toward the base, using separate quarters
of the cloth.
19. For uncircumcised patients, retract the foreskin
exposing the tip of the penis, clean the glans
penis, and replace the foreskin.
20. Wash and dry the scrotum. (The posterior folds
of the scrotum may be cleaned more easily
when the rectum is cleaned).
21. Inspect the perineal orifices for intactness,
especially in catheterized patients.
22. Reposition the patient on the side facing away
and clean between the buttocks. May use tissue
first if heavily soiled. Pay particular attention to
the posterior scrotal folds.
23. Dry the area well.
24. Assess for redness, excoriation, tenderness,
discharge, or drainage.
25. Document condition of skin.
26. Report any abnormal data to the appropriate
personnel.
N:ADN/ADN Syllabus/CBC Curriculum/Level I/1216/Performance Checklist for Basic Skills - Perineal Care
Revised 04/16
Wiping away from the body portal prevents
microorganisms from entering into the body cavity.
Soap residue may act as an irritant and harbor
microorganisms. Allowing a free flow of fluid is soothing to
the patient and increases the effectiveness of removing
residue from the area.
Moisture supports and promotes the growth of many
microorganisms.
Indicates skin breakdown.
Provides visual inspection of the area. Tissue is more
readily disposable and reserves the washcloth for the final
cleaning.
Provides for access and prevents stress on the lower back.
Cleaning from an area of least contamination to one of
more contamination prevents spreading of
microorganisms.
Using clean portions of the cloth discourages transmission
of microorganisms from one area to another. Wiping from
an area of least contamination to one of more
contamination prevents spreading microorganisms.
Smegma collects under the foreskin, which can harbor
bacteria and should be removed. Replacing the foreskin
prevents constriction of the penis, which may cause
edema.
The scrotum may be more soiled than the penis since it is
in closer proximity to the rectum. Therefore, the penis is
usually cleaned first.
Indwelling catheters may cause excoriation around the
urethra from pressure and friction.
Provides visual inspection of the area. Tissue is more
readily disposable and reserves the washcloth for the final
cleaning.
Moisture supports bacterial growth.
Indicates skin breakdown.
All data must be entered in patient’s record.
Any abnormal finding must have a corresponding nursing
action.
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