Perineal Care for a Female Client (Nursing)

00:00 Now let's take a look specifically at perineal care for a female. Now we want them on their back and assist them in bending their knees or spreading their legs, wherever they can lay comfortable and we can reach their perineal area for cleansing. Now, we want to take one hand and we want to keep this as what we call the dirty hand and spread the labia with one hand. Then we want to take our cleansing cloth and gently stroke downward from front to back and always remember on a female go front to back and avoid the anus. Now once we do this, once we use one swipe, we want to use the clean portion of the cloth. So, if you need to do a new stroke, you want to make sure that you use another clean portion of the cloth.

00:50 And now we want to pat the area dry. Now typically when you're using cleansing cloth, you usually can allow them to air dry but if you're using mild soap or water, you want to pat the area dry with a clean towel. Let's take a look at perineal care for female client. So as soon as I've entered the room, I've explained the procedure, I did hand hygiene upon entering the room, and I put on my gloves. So we'll do that now. So now, once we've got our gloves on, we've explained the procedure to our client and one thing we also want to make sure is that we place them in a comfortable position from her perineal care. Now, once we've done this, we want to do our best to provide as much dignity as possible. So, we like to drape a towel or maybe a bath blanket over the patient to make sure that they're covered. The other thing about this is we're exposing their skin so it can be really cold and they could be chilled, so this is also great for also trying to keep the patient warm. Okay, so now once we've got our patient ready and draped, then I'm going to use my disposable cleansing cloth. So these are really great because they've got a cleanser in them, they dry really quickly, and they're very soft cloth and we're going to use this to clean our client. So this is typically what you're going to see in most facilities. Now, these are really great for maybe minor incontinent episodes especially urine and maybe a small amount of stool, but I do recommend if someone has a large incontinent episode a lot of the times it's best just to use a bath basin, mild like lukewarm water and mild soap. And at that point, you're going to need some extra towels and washcloths but I always like to have that handy just in case I need it.

02:57 Okay, so now we can go ahead and get started. So once my patient's been on their back and they're in a comfortable position, it's important at this point that we maintain that we use professional language, have a conversation with our patient, try to make them feel as comfortable as possible. So once we're ready, I'm going to go ahead and expose our client and notice I'm doing my best to try to keep them covered as much as possible. So now I'm going to go ahead and get my disposable cleansing cloth. Okay, so you want to get in the best position or have the client in the best position so you can reach their perineal area.

03:39 So maybe a good idea to maybe have them frog leg or spread their legs out. And also know and warn your client these cloths are pretty chilly. So, I do want you to see these cloths though, they're good size, they've got a little bit of moisture on them, they're hypoallergenic, and really gentle to the patient's skin. So, when I'm going to cleanse my client, I have this and so it's important to make sure on a female client you're always going front to back.

04:07 So I'll typically take my one hand, my left hand, that's my non-dominant hand and I'll spread the labia and then I'll take my cleansing cloth and go front to back. So I'll go front to back and cleanse, and it's important that we're doing this and trying to make sure that we don't reach the anus at this point. So next, what I can do if it's a minor incontinent episode, I need to make sure I use another clean portion of the cloth if I can use the same cloth. Now sometimes some messes we may need another cloth, so use your judgment here. Main point is just to make sure you're using clean supplies and cloth on your patient. So now I'm going to take the clean portion of my cloth and wipe again from front to back. And I'm going to dispose of this one. And just for good measure, I'm going to clean again all the way from front to back, and get rid of that. Now these cloths are great, they really air dry very quickly but if need be you can always have a hand towel or something like that just to pat dry your client. So now after I've completed this, I'm going to make sure and give privacy back to my client. And once I've done with this section, it's really important to make sure that I perform my hand hygiene, remove my gloves, and return the bed to the lowest position. Now once we've cleaned their front side, we want to assist the patient to their back side and expose the buttocks and the anal region. Now here we also want to go front to back when we clean from the posterior vaginal area and moving backwards. Now each time that we cleanse, we want to make sure we use a clean portion of the cloth with each stroke and if necessary pat the area dry. So if needed, this is a great time to apply barrier cream if it's indicated. Now we like to use barrier cream if the patient is having lots of incontinent episodes and there are lots of contacts of maybe stool, feces, or urine to the patient's skin.

06:21 Barrier creams can be really important to protect the integrity of the patient's skin. To finish up the perineal care for our patient, we want to assist them on to their side to expose the buttocks and the anal region. Now, depending on the male or female, either one, we want to make sure we always clean front to back. So it depends on what you want to use and it also depends how much the incontinent episode is that we can use either a like washcloth with mild soap and water or you can use cleansing cloth. I'm going to use cleansing cloths today. So when I take my cleansing cloth, I want to make sure I go front to back.

07:03 Now, if it's a female I want to make sure, especially if we're talking about stool, to go from the posterior vaginal area and move backwards because we don't want to move any of the feces upwards so we want to make sure again we go front to back. Now everytime I wipe I want to make sure I'm using a clean portion of the cloth. Now sometimes it's not able to that, we're going to be able to use the same cloth so we may need a new one. So if need be, you can toss it, for example, in a trash can or a basin that's close. So after we've cleansed our patient properly, we want to make sure we pat the area dry and if the patient has several incontinent episodes it's a great time to apply barrier cream as needed as well.