The process of providing perineal care to a female is a significant part of the day to day task of a CNA. Perineal care is one of the most sensitive tasks that a health care worker can perform as it involves cleaning the private body parts of the patient as well as making sure that they are sufficiently cleaned in order to prevent any disease or infection from developing. At times, it can be hard for a patient to allow a CNA to do this task especially if she does not know the person well. It is therefore important to assure the patient that you are doing it for health purposes and that you are providing them with sufficient privacy for their own sake.
First, the CNA has to greet the patient and introduce themselves as well as their purpose of being there in the patient’s room. They have to be clear that they will be providing perineal care to the female patient and they should also inform the patient as to the step-by-step process with which it will be done. The worker then gathers all the materials that will be needed for the process such as clean towels, a basin of water, soap, and lotion. After this, the worker then proceeds to wash their hands thoroughly and to apply the appropriate personal protective equipment for the process.
After this, the CNA then proceeds to the bed of the patient and removes any dirty underpads from the patient. Replace the waterproof underpads with fresh and clean ones in order to avoid getting the bed wet from the process. The nurse aide then asks the patient to part their legs in order to gain access to the front perineal area more easily. Part the folds of the labia and clean the inner sides using a clean piece of washcloth which has been dipped in warm water and applied with soap.
Clean the inner labia with a front to back motion using a gentle pressure. Use a different spot from the washcloth for each stroke that will be done. This is to ensure that the labia is well-cleaned and to prevent the transfer of bacteria from one point to another. The front to back motion also ensures that bacteria from the anal area would not be transferred to the urethra of the patient which can cause some serious infection.
The next step is to rinse the area with a new piece of washcloth which has been dipped in warm water. Use a different area in the washcloth for each rinsing stroke as well. When this is finished, pat the perineal area dry with a clean piece of towel and apply some lotion if the patient wishes to or if it is required.
Make sure that you have provided sufficient covering for the patient during the whole process to protect her privacy. Dispose of any non-reusable items in the proper container and put dirty linens in the hamper. Put the patient in a comfortable position and make sure that their call lights are within their reach. Wash your hands thoroughly.
The first step is to introduce yourself to the patient and to explain to them why you are there. Try to give them a mental picture of the step-by-step process which will be performed and try to inform them of the materials that will be used.