Certified Nursing Assistants (CNA) have an extensive set of skills. Providing perineal care is one of those skills that all CNAs must know, as it is essential to keeping a patient in good health. Those working with the elderly or with individuals who are disabled often must provide perineal care.
Perineal care, also known as peri-care, involves cleaning the private areas of a patient. This practice is common in bedridden patients and those with incontinence. Since the perineal region is prone to infection, patients with these conditions must receive peri-care daily.
The perineal region is located between the tailbone and the pubic arch. It is a diamond-shaped area between the anus and scrotum in males, and between the anus and vulva in females.
Perineal care is needed for patients who urinate on the bed or require a bedpan. After urination, CNAs clean the patient’s perineal region to keep them comfortable and avoid infection. This practice is a common task for CNAs working in home care and may be performed while bathing a patient.
Remember that perineal care also means checking for signs of infections in the region every time you clean. Infections can appear as swelling, lesions, rashes, sores, or boils. If you notice any sign of infection, promptly call your supervisor.
Below are step-by-step instructions for providing perineal care:
For female patients, separate the labia and then use downward strokes to clean the region. Use a new washcloth for each downward stroke, or a clean area of the same washcloth.
For male patients, retract the foreskin (if necessary) and then use a washcloth in a circular motion from the top to the bottom of the penis, making sure to clean the testicles as well.
There are many infections and conditions CNAs must keep an eye out for when providing perineal care to patients. Symptoms can vary, but generally include pain, discomfort, changes in urination frequency or color, rash, swelling, or discharge.
Below are a few of the more common infections and conditions:
In order to negate the risk of infection, CNAs should adhere to the following safety recommendations when providing perineal care: