Provide Peri-Care to an Incontinent Resident
Care Plan: Provide perineal care to a female resident who is incontinent of urine. The resident is lying in bed on an underpad that will be considered wet. The resident’s gown and bedding is dry. The role of the resident will be played by a mannequin.
Click on each question below to view the answer…
Should I raise the entire bed to a comfortable working level when performing this skill?
You may raise the bed if you wish, but it is not required for the exam. However, if you do raise the entire bed to a comfortable working height, you MUST remember to lower it at the end of the skill. If the bed remains elevated, the floor is much further away than the patient will expect it to be when they get out of bed, which can result in a fall. The head of the bed is adjusted to patient comfort at the end of every skill and does not need to remain in the low position.
What if the patient does not want this skill performed?
The student should make every effort to remain professional when describing the skill to be performed to minimize patient anxiety. However, most patients that need this service have been receiving peri-care frequently and should not object to it. If the patient does object, notify the nurse.
Why do we have to change the chux under the patient twice?
The patient is lying on a wet chux at the beginning of the skill and that chux needs to be changed to increase comfort. But the patient’s soiled backside will make that chux dirty and it may get wet during the cleaning, so the chux needs to be changed again so that the clean patient is on a clean chux.
How do you describe this skill to the patient? Will the patient know what peri-care is?
You may describe this skill any way you wish, as long as you remain professional. You may say, “I am going to perform peri-care on you”, “I am going to provide personal care”, “I am going to wash down below” or any other description that you choose, without using slang words or being inappropriate. Most patients that receive peri-care will know what that term means.
Do I still have to explain what I am doing if the patient can’t hear me or understand me?
Yes! Patients with hearing problems, language barriers, dementia and even unconscious patients MUST be told what you are going to do before you touch them. Don’t assume that the patient cannot understand what you are saying. Often, patients understand more than staff members give them credit for. Touching a patient without their permission may result in a legal charge of battery and will usually make the patient combative, because they don’t understand what you are doing. Take the time to explain the skill and use techniques to help them understand, if possible!
Do we always have to wipe from top to bottom when performing female peri-care?
Yes. Wiping from top to bottom keeps bacteria from the rectum from being transported to the urethra. Once the stroke reaches the rectum, you must withdraw the washcloth. Never move upward during cleaning!