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Perineal Care Procedure

1. The document provides guidelines for nurses on performing perineal care, which involves cleaning the external genitalia and surrounding area of patients after childbirth or gynecological procedures. 2. Key steps in perineal care include preparing the patient and environment, wearing gloves, cleaning the perineum with antiseptic solution from upward to downward using separate swabs for each area, inspecting for infections or abnormalities, applying antiseptic ointment, and securing a dressing over the cleaned area. 3. Proper perineal care aims to promote healing, prevent infections, and make patients comfortable after experiencing trauma in the birth canal or from medical procedures.

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72K views8 pages

Perineal Care Procedure

1. The document provides guidelines for nurses on performing perineal care, which involves cleaning the external genitalia and surrounding area of patients after childbirth or gynecological procedures. 2. Key steps in perineal care include preparing the patient and environment, wearing gloves, cleaning the perineum with antiseptic solution from upward to downward using separate swabs for each area, inspecting for infections or abnormalities, applying antiseptic ointment, and securing a dressing over the cleaned area. 3. Proper perineal care aims to promote healing, prevent infections, and make patients comfortable after experiencing trauma in the birth canal or from medical procedures.

Uploaded by

priyanka
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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government COLLEGE OF

NURSING

SUBJECT: OBSTETRIC & GYNECOLOGICAL


NURSING
Procedure
on
Perineal care

SUBMITTED TO: SUBMITTED BY:


Mrs. SUMI MATHEW GEETA DHAKA
HOD OBG M.Sc. NSG PREV
GCON, JODHPUR BATCH 2018-20

PERINEAL CARE PROCEDURE

Introduction:
Perineal injury is the most common maternal morbidity associated with vaginal birth. Anal
sphincter injury is a major complication that can significantly affect women’s quality of life.
Perineal hygiene involves cleaning external genitalia and surrounding area. The perineal area is
conductive to growth of pathogenic organisms because so the pathogenic organisms enter into
body many orifice in situated in this area .it is less ventilated. Since Delivery is the physical
strengthen, effort done by the mother during their delivery period and suffer from birth canal
injuries, episiotomy incision, perineal tear laceration may be occur so staff nurses provided
perineal care to the patient in the hospital at least minimum twice a day and try to recover the
patient in early healing

Definition:
Perineal care is an aseptic irrigation of the vulva and perineum after voiding or defecation in
specified period following delivery or an operation of birth canal, perineum, urinary meats or
anus.
cleansing the area between the anus and vulva in female, or the anus and scrotum in male;
promotes comfort and prevents odor kin excoriation, and infection. usually given along with a
complete bed bath, but may have to do more often (e.g. incontinent of urine or feces)
Perineal care is the term applied to the external irrigation or cleansing of the vulva and perineum
region as a means of prevent infection, promote healing of the stitched perineum and making the
patient comfortable.
It cleansing procedure prescribed for the genital and anal areas as part of the daily bath or after
various obstetrical and gynecological procedures

PURPOSE
1. To clean the skin and mucous membrane of the vulva and perineum.
2. To eliminate the bacterial growth by application of antiseptic solution.
3. To increase the healing of perineal tissues.
4. To relieve itching, pain, discomfort of the perineal area.
5. To prevent the infection in to the genital area.
6. To minimize pain, tenderness and edema due to operational trauma after Episiotomy
7. To observe the colour, nature and characteristics of lochia.

 Indication Of Perineal Care:

1) Postpartum patients especially with stitches in the perineum.


2) Persons with surgery of the genitourinary tract.
3) Patients with lesions, ulcer or surgery of the perinea area or rectum.
4) Patient having indwelling catheter.
5) Patients having excessive vaginal discharges.
6) Patients with incontinence of urine or stool
7) Patient should not perform the perineal care by herself.

 General Instruction:
1) Maintain strict aseptic technique during the procedure.
2) Provide privacy to the mother.
3) Observe the colour, nature and characteristics of lochia.
4) Don’t touch inner area of the sterile tray.
5) Use the one swab for each stock from upward to downward.
6) If the glove is soil before procedure change it.
7) To observe the patient for discomfort during procedure.
8) Discard all the swabs and pad in the paper bag or dustbin
9) Used mild antiseptic solution or plain warm water for perineal care.

 Preliminary Assessment:
1) Identify the patient.
2) Check the doctor’s order for any specific precautions.
3) Identify any specific contraindications present.
4) Any contra indications to the applications of perineal care in the patient.
5) General condition of patient and ability to follow instruction.
6) Check the articles available in patient unit.

 Preparation Of The Articles :-

Sr no. Articles Use


1. Soap dish, towel For hand washing before and after procedure
2. Curtain To maintain privacy
3. Spot light / torch For focusing the perinea area
4. Plastic apron To protect her self
5. Bath blanket To cover the patient
6. Mackintosh ,draw sheet To protect the bed linen
7. Paper bag and Kidney tray To receive the waste
8. Sterile tray:
 Gloves  To maintain sterile technique
 Artery forcep  To remove the previous dressing
 Sponge holder  To hold the swab and clean the perineum To
clean the perineum
 Bowl containing savlon  To clean the vulva and perineum
solution
 Cotton swab  To clean the perineum with antiseptic solution
 apply the antiseptic cream on sutures
 Gauze piece
 To apply over the perineum
 Cotton pad
9. Bandage or under garments To support the cotton pad and bind T bandage
10. Bed pan To collect the excreta if needed

 Preparation Of Patient And Environment:


1) Identify the patient with the name and explain the procedure to the patient to win the
confidence and co-operation.
2) Advice the patient to empty the bladder and bowel.
3) Provide privacy.
4) Arrange the articles at the bed side locker
5) Position the patient in dorsal recumbent.
6) Place the mackintosh and towel under the patient to protect the bed.
7) Provide adequate light by placing extra spot light.
8) Drape the patient and open only vaginal area.
9) Give extra pillows to raise the head.
10) Use the bed pan if you perform the procedure in bed.

 PROCEDURE

STEPS RATIONAL

Explain the procedure to the patient. To gain the confidence and co-operation of the
patient.
Spread the mackintosh and draw sheet To prevent soiling of bed.
under the buttocks.
Pour lotion into the bowl To clean the perineum
Hand wash To prevent cross infection
Wear the gloves To prevent cross infection. To maintain
universal precaution
Holding the perineal pad or dressing with To identify any abnormality.
artery forceps and observe characteristics
of the secretion, lochia, amount colour,
odour and discard soil pad
Hold the swab with swab holder To clean the perineum
Clean the perineum with sterile wet swab To prevent Ascending infection
from upward to downward.
First clean the stitches and then other To prevent infection as stitches consider more
area. sterile than the other area.
Clean vulva and perineum using each To clean the perineum and to prevent infection.
sponge once only and start from upward
to downwards making as little pressure as
possible on the tissue work from the
midline outward.
STEPS RATIONAL

Inspect perinea stitches for infection To give the treatment


Turn the patient on one side Clean and dry the buttocks
Apply antibiotics ointment To discourage of bacterial growth

Apply the dressing and avoid touching To prevent contamination of area this will come
the surface of dressing that comes in in contact with the perineum.
contact with vulva and perineum.
Apply dressing, cotton pad and “T” To secure the pad
bandage.

 After Care of The Patient And Articles:


1) Remove the mackintosh and bedpan.
2) Change the linen if necessary. Straighten the bed Arrange the bed linen.
3) Give the comfortable position to the patient.
4) Take the bedpan to the sanitary use. Remove the cotton swabs If any And empty the
contents into the toilet. Rinse the bedpan with cold water using a brush. Immerse It In
lotion to disinfect it.
5) Wash and dry well and keep it on the bedpan rack. Ready for the next use.
6) Take all the articles to the utility room, clean it and replace it.
7) Boil the forceps. Replace the articles.
8) Remove the screen and tidy up the unit.
9) Wash hands.
10) Record the procedure with date and time and the observations made.

 Recording and Reporting:


Record the procedure in patient's chart.
1) Record amount, colour and odours of lochia.
2) Note consistency of uterus.
3) Record if dry heat is applied.
4) Record the condition of stitches.
5) Report any abnormality if observed.

BIBLIOGRAPHY:
a) Inamdar Madhuri, Nursing Arts (Principles and Practice) Part-II; 1st edition, 1998;
Vora Medical Publication, Bombay; Pp: 98-100
b) Sr. Nancy, Principles and Practice of Nursing; Volume-1; 5 th edition, reprinted ,
2001; N.R. Publication, Indore; Pp: 234-233
c) Spencer May and Tait Katherine M., Introduction to Nursing; 4th edition, 1978;
Blackwell scientific publication, oxford London; Pp: 87
d) Thresyamma C. P., Fundamentals of Nursing Procedure Manual for General
Nursing And Midwifery Course; 1st edition, reprint 2004; Jaypee Brothers
Medical Publishers, New Delhi; Pp: 392-395

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