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STUDENT: ________________________________________________________________ DATE: _________________________

INSTRUCTOR: _____________________________________________________________ DATE: _________________________

SKILL PERFORMANCE CHECKLIST

Skill 34-2 Perineal Care

S U NP Comments
1. Assess client’s risk for developing infection
of genitalia, urinary tract, or reproductive
tract.
2. Assess client’s cognitive and musculoskeletal
function.
3. Apply disposable gloves. Assess client’s
genitalia for signs of inflammation, skin
breakdown, or infection.
4. Assess client’s knowledge of the importance
of perineal hygiene.
5. Explain procedure and its purpose to client.
6. Prepare necessary equipment and supplies.
7. Provide privacy. Assemble supplies at bedside.
8. Raise bed to comfortable working position.
Lower side rail, and assist client in assuming
a side-lying position. Place towel lengthwise
along client’s side and keep client covered
with bath blanket or top sheet.
9. Apply disposable gloves.
10. Remove any fecal matter in a fold of
underpad or toilet tissue. Cleanse buttocks
and anus, washing from front to back.
Clean, rinse, and dry area thoroughly. Place
an absorbent pad under client’s buttocks.
Remove and discard underpad and replace
with clean pad.
11. Change gloves when they are soiled.
Perform hand hygiene.
12. Fold top bed linen down toward foot of bed.
Raise client’s gown so genital area is exposed.
To protect client’s privacy, “diamond”
drape client.
13. Raise side rail. Fill washbasin with
warm water.
14. Place washbasin and toilet tissue on overbed
table. Place washcloths in basin.
15. Provide perineal care:
A. Female perineal care:
(1) Assist client to dorsal recumbent
position.
(2) Lower side rails, and help client
flex knees and spread legs. Note
limitations in client’s positioning.

Continued

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S U NP Comments
(3) Fold lower corner of bath blanket
up between client’s legs onto
abdomen. Wash and dry client’s
upper thighs.
(4) Wash labia majora. Use non-dominant
hand to gently retract labia from
thigh. With dominant hand, carefully
wash in skinfolds. Wipe from
perineum to rectum (front to back).
Repeat on opposite side using a
different section of the washcloth.
Rinse and dry area thoroughly.
(5) Separate labia with non-dominant
hand to expose urethral meatus
and vaginal orifice. With dominant
hand, wash downward from pubic
area toward rectum in one smooth
stroke. Use separate section of cloth
for each stroke. Cleanse thoroughly
around labia minora, clitoris,
and vaginal orifice.
(6) Pour warm water over perineal area
if client uses bedpan. Dry perineal
area thoroughly, using front-to-back
method.
(7) Fold lower corner of bath blanket
back between client’s legs and over
perineum. Ask client to lower legs
and assume comfortable position.
B. Male perineal care:
(1) Lower side rails, and assist client to
supine position. Note any restriction
in client’s mobility.
(2) Fold lower corner of bath blanket up
between client’s legs and onto
abdomen. Wash and dry client’s
upper thighs.
(3) Gently raise penis and place bath
towel underneath it. Gently grasp
shaft of penis. Retract foreskin if
client is uncircumcised. Defer
procedure until later if client has
an erection.
(4) Wash tip of client’s penis at urethral
meatus first. Using circular motion,
cleanse from meatus outward.
Discard washcloth and repeat with
clean cloth until penis is clean.
Rinse and dry area gently.

Continued

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S U NP Comments
(5) Return foreskin to its natural position.
(6) Wash shaft of penis with gentle but
firm downward strokes. Pay special
attention to underlying surface. Rinse
and dry penis thoroughly. Instruct
client to spread legs apart slightly.
(7) Gently cleanse scrotum. Lift it
carefully and wash underlying skin
folds. Rinse and dry.
(8) Fold bath blanket back over client’s
perineum, and assist client to a
side-lying position.
16. Apply thin layer of skin barrier containing
petrolatum or zinc oxide over anal
and perineal skin of incontinent clients.
17. Remove gloves and dispose of them in
proper receptacle. Perform hand hygiene.
18. Assist client in assuming a comfortable
position, and cover client with sheet.
19. Remove bath blanket and dispose of all
soiled bed linen. Return unused equipment
to storage area.
20. Inspect surface of external genitalia
and surrounding skin after cleansing.
21. Ask if client feels a sense of cleanliness.
22. Observe for abnormal drainage or discharge
from client’s genitalia.

Copyright © 2006 Elsevier Canada, Inc. All rights reserved.