Pericare- which way is correct?

[WannaBeNrse]

Hi, sorry for the maybe stupid question, but my state test is this friday and i am sooooo nervous.... so here's my question: i know you wash from front to back, but do you wash the inside (labia minora) first or the outside (labia majora)? For some reason i think i remember our instructor in the lab telling us to wash the inside first, then the outside, but now my classmates say its the other way around..... the skills book and video i have doesnt specify, except that you have to wash from front to back. sorry if this is a dumb question but i am really confused... thanks!

[KYCNM]

I reviewed Perry and Potter which is a standard nursing skills text, but I disagree with what it says. It says to wash the labia majora to the orifice on one side with the washcloth wrapped around the hand. Reposition the washcloth, wash the labia majora to the orifice on the opposite side, reposition the washcloth. Seperate the labia majora and wash the labia minora, urethra and clitoral area. According to the rationale stated this prevents contamination of the urethra with bacteria from the rectal area.

IMHO, you have contaminated the washcloth once you have washed over the anal area the first time. It doesn't matter if you reposition the cloth after that. I was taught to wash labia majora and minora and urethral area and rinse, then move to the anal area, but that was 45 years ago.

What I believe is that if you demonstrate through the procedure that you have a working knowledge of medical asepsis (working from clean to dirty), you will be correct.

[lovingtheunloved, ASN, RN]

Labia minora first. Labia majora have bacteria too, that you don't want contaminating the urethra.

[adeem22]

Hi WannaBNrse,

I just passed my exam and drew pericare as one of my skills. In class we were taught to wash the labia minora 1st - one wipe down towards the orifice, reposition the wash cloth and wipe a 2nd time, and repeat for a 3rd time. Basically you work from the inner areas to the outer ones (cleanest to dirtiest). Then we were taught to change the water, obtain a fresh washcloth and then handle the back side. Remember to wipe away from the urthera and to reposition the wash cloth with each wipe.

Oh and don't do what I did and forget the bath blanket!!

Good luck:)

[Scrubz]

Proper perineal care is most important for women because of their much shorter urethra. On average men's are about 20cm while women's are about 4cm, so from a bacteria's standpoint you can see how making the 4cm journey would be much easier.

So you really want to avoid wiping more "dirty" into the urethra because women are much more prone to developing UTIs. Front to back is very important because you don't want bacteria from the behind (namely E.Coli) to get into the urethra. If you ever see anyone wiping the wrong way, show them the proper way because it's important.

But for women, wipe front to back, clean to dirty, start from the labia minora and work out towards the majora. It's definitly okay to wash the urethra, so don't be afraid of that or anything, just follow the steps to avoid more contamination than you want.

I mean, do you think girls clean themselves the proper way all the time? From their standpoint they probably just throw the rag down there and.. You see where I'm going with this. But from a CNA's standpoint, do it the right way.

(For the record, I'm a guy)

[WannaBeNrse]

Thank you all!! I took my state exam last friday, and I passed :-) and guess what- i did get peri-care;) so i did inside tooutside and i guess it was right now i am officially a CNA

[KYCNM]

Congratulations on your first step!!!!!:balloons: