Perineal Care — Practice Checklist

Step-by-Step Procedure (16 steps)

1. 1.

   Gather equipment: basin with warm water, washcloths, towel, gloves, waterproof pad (Chux).

2. 2.

   Wash hands and put on gloves.

3. 3.

   Identify the resident and explain the procedure.

4. 4.

   Provide maximum privacy: close door, draw curtain.

5. 5.

   Lower the head of the bed to a flat or slightly elevated position.

6. 6.

   Place a waterproof pad (Chux) under the resident's buttocks.

7. 7.

   Expose only the perineal area; drape the legs and abdomen.

8. 8.

   For female residents: separate the labia and wash from front to back (pubic area to rectum) using a clean area of the washcloth for each stroke. Never wash from back to front.

9. 9.

   For male residents: if uncircumcised, gently retract the foreskin; cleanse the tip of the penis in a circular outward motion; replace the foreskin. Wash the shaft from tip to base. Wash and dry the scrotum.

10. 10.

    Rinse the area thoroughly with clean water.

11. 11.

    Pat dry the entire perineal area; do not rub.

12. 12.

    Remove the waterproof pad.

13. 13.

    Reposition the resident for comfort and re-drape.

14. 14.

    Remove gloves and wash hands.

15. 15.

    Lower the bed; ensure the call light is within reach.

16. 16.

    Document care and any observations of skin condition, discharge, or odor.

Evaluator Pass Criteria (5 checkpoints)

All of these must be observed for you to pass this skill.

• Front-to-back direction is maintained for female perineal care.

• Separate clean area of washcloth is used for each stroke.

• Privacy is maintained throughout.

• Foreskin is replaced after cleansing in uncircumcised male residents.

• Area is patted dry rather than rubbed.

Critical Mistakes — Avoid These

• ⚠

  Washing back to front in female residents — this introduces fecal bacteria to the urinary area.

• ⚠

  Using the same washcloth surface for multiple strokes without using a clean section.

• ⚠

  Not replacing the foreskin in uncircumcised male residents — paraphimosis risk.

• ⚠

  Rubbing rather than patting dry — rubbing irritates delicate skin.

• ⚠

  Not placing a waterproof pad under the resident before beginning.