Perineal Care/ Genital Care – Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other healthcare providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialisms with differing levels of prescriber authority.
Many nurses provide care within the ordering scope of physicians, and this traditional role has shaped the public image of nurses as care providers. However, nurses are permitted by most jurisdictions to practice independently in a variety of settings depending on training level. In the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.
Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient’s family, and other team members, that focus on treating illness to improve quality of life. Nurses may help coordinate the patient care performed by other members of an interdisciplinary healthcare team such as therapists, medical practitioners, and dietitians. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals.
Perineal Care/ Genital Care
Definition of Perineal care
Perineal care may be defined as the Cleansing of the external genitalia, perineum, & surrounding area. Perineal care is also referred to as “peri-care” or “perineal-genital” care.
or
It is part of complete bed bath. Clean the perineum from the cleanest to the less clean area. The urethral orifice to the anal orifice.
“Genital care involves through cleaning of external genitalia and surrounding skin”
Purposes of Perineal/ Genital Care:
1. To promote patient comfort.
2. To prevent infection in high risk patients.
3. To prevent contraindication and sepsis.
4. To clean and remove the discharge.
5. To prevent foul smell from the ova.
6. To assist better and quick heal of the wound.
7. To relieve from itching scratches and providing comfort.
Indications of Perineal Care
1. Patient who unable to perform self-care
2. Unconscious patient.
3. Semiconscious patient
4. Patient with indwelling catheter.
5. Patient with incontinence of urine and stool
6. All normal delivery cases
7. All episiotomy cases.
8. All D & C cases,
9. All vaginal operation cases.
10. Any vaginal bleeding cases or cases with abnormal vaginal discharge.
Procedure of Perineal Care:
A. Articles required:
1. Mackintosh and towel
2. A jug with warm antiseptic lotion
3. Gauge pieces or old cloths
4. Sterile cotton swabs
5. Long artery forceps
6. Paper bag or kidney tray
7. Soap, soap dish, towel and wash cloth
8. Bed pan
B. Steps of procedure
1. Assemble supplies at bed side
2. Provide privacy
3. Explain the procedure to the patient
4. Wash hands
5. Raise the bed to a comfortable working position
6. Place the patients in lithotomy position
7. Place a mackintosh over to draw sheet
8. Offer a bed pan
Figure: Cleaning male perineal area.
Figure: Cleaning female perineal area.
9. Drape the patient by placing the sheet with one corner between the legs, one corner position toward each side of bed, one corner over chest. Tuck side corners around legs and under hips.
10. Untie the pads and allow the patients to urinate or defecate if needed.
11. Pour water over the perineum.
12. Wash and dry upper thighs
13. Clean perineum by using wet swabs.
14. Hold the forceps downwards, towards anal canal
15. Use one swab for one swabbing
16. Clean urinary meatus first, then vulva, labia, minora, majora and lastly the anal region.
17. Remove the bed pan
18. Dry the perineal area thoroughly
19. Place the patient in a comfortable position.
C. After care of the patients and articles
1. Apply the pad if necessary
2. Remove the mackintosh
3. Make bed with fresh linen, if necessary
4. Place the patient in a comfortable position
5. Take all articles to the utility room, disinfect, sterilize and place them in a proper place
6. Remove the screen, and tidy up the unit
7. Wash hands
8. Record the procedure in nurses records and reports any abnormalities if present, to the ward sister and doctors
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