This article will review how to perform peri-care (perineal care) on a female patient with a Foley catheter.
For a complete demonstration on this nursing procedure, you can watch the video below:
Perineal and catheter care are an important part of patient care. This helps maintain the patient’s personal hygiene and decreases the risk of a catheter associated urinary tract infections (CAUTIs).
Before performing this procedure, verify your hospital’s protocols (the sequence of the procedure may vary depending on your facility) and inform the patient about the procedure and its importance.
If the patient is able, they should perform as much of the care as possible. However, many patients who have a Foley catheter are unable to do this. Therefore, the procedure must be completed by nursing staff.
First, perform hand hygiene and gather supplies:
- Washcloths
- Towels
- Soap
- Water
- Basin
- Waterproof pad
- New StatLock securement device (if needed)
Don clean gloves, and then prepare the supplies and position the patient for the procedure. During patient positioning, place a waterproof pad under the patient. The patient can be placed in the dorsal recumbent or Sims’ position, depending on their mobility.
Once this is done, remove the catheter from its securement device. Note the skin around the device for any breakdown and the integrity and cleanliness of the device.
If it needs to be replaced (most facilities require the StatLock securement device to be changed every 7 days), then replace it when the procedure is completed. Here is a video on how to remove and replace a Statlock device when a patient has a Foley catheter.
To perform perineal care, follow your facilities sequence guidelines. Some may suggest doing catheter care before perineal care. While others may suggest doing the opposite.
For this demonstration, perineal care will be performed first.
Female Perineal Care (Peri-care)
First, wet a washcloth with warm water and place soap on it. Then, fold the washcloth in half twice. This creates “four leaves” so each “leaf” can be used to clean different areas of the perineum. Be mindful of the catheter in place so that as you clean you don’t tug or place tension on it since it has been removed from its securement device. Slightly brushing up against it is okay as long as no tension is placed.
Start with the cleanest areas and work to the dirtiest. Therefore, start with the inner thighs and clean from top to bottom with each soap “leaf”. Clean the inner thigh farthest away by cleaning from top to bottom. Then pull back the “leaf” and clean the inner thigh closest to you from top to bottom. Repeat this for the next two leaves and discard the cloth.
Now rinse the area in the same way as you cleaned with soap and water. To do this, take a washcloth and wet it with warm water only (no soap) and create “four leaves” with the cloth. Rinse the inner thigh farthest away by rinsing from top to bottom and pull back the “leaf”. Then rinse the inner thigh closest to you by rinsing from top to bottom and pull the “leaf” back. Repeat this for the next two leaves and discard this cloth.
Obtain a dry towel and dry the inner thighs in the same way you cleaned and rinsed them.
Next, clean the labia majora in the same way. Then, clean the labia minora (including the urethra and vaginal opening). Remember to always use a new cloth with “four leaves” for cleaning, rinsing and drying. In addition, start with the labia farthest away first, and then clean the labia closest to you.
Once you are done with the front areas, turn the patient over onto their side to clean the bottom. As you turn the patient, again be mindful of the catheter so that no tension is placed on it.
When cleaning the backside (just as with the front) use new washcloths that have “four leaves”. You will be cleaning each buttocks and the anus.
First, use a washcloth with soap and water to clean the buttock farthest away. Be sure to clean from front to back, and then pull back the “leaf”. Then, clean the buttock closest to you from front to back and pull back the “leaf”. Then, clean the anus from front to back with the next two leaves and discard the washcloth.
After these areas have been cleaned with soap and water, rinse and dry them in the same sequence.
Once completed, make sure the patient is safe on their side for a moment and doff your gloves, perform hand hygiene, and don clean gloves. Then, turn the patient back over. Now, it is time to perform catheter care.
Catheter Care for the Female Patient
The reason you want to clean the catheter is because it gets germs on it, and these germs can ascend and migrate up into the bladder. This could cause a urinary tract infection.
To clean the catheter, get a washcloth with soap and water on it and fold it in half twice to create four leaves.
Spread the labia minora to access the catheter line, which is inside the urinary meatus. First, with one of the washcloths leaves, clean at the meatus-catheter junction (where the catheter is entering the urinary meatus). You will be cleaning the first two inches of the catheter at this junction. Do this a second time.
Then, clean the rest of the catheter down to the bifurcation. To do this, gently hold the catheter with your non-dominant hand by grasping it with your index finger and thumb. Then, take the third leaf and clean down the catheter line in a circular motion. Be sure to clean down to the bifurcation. Repeat again with the next leaf. Then, use new washcloths to rinse and dry the meatus-junction and catheter line in the same sequence. When done, release your hold on the catheter.
Once done, secure the Foley catheter back into its securement device. Cover up the patient and reposition them. Doff gloves, perform hand hygiene, and document.
You may be interested in: How to Insert a Foley Catheter in a Female Patient
References:
Bard Medical. (2016). SureStep Post Insertion Foley Catheter Care. Covington, Georgia; C.R. Bard Inc.
Lynn, P. (2014). Unit II Chapter 7 Promoting Healthy Physiologic Responses. In Skill checklists for Taylor’s clinical nursing skills : a nursing process approach (4th ed., pp. 358–359). essay, Wolters Kluwer.
Perry, A. G., Ostendorf , W., & Laplante , N. (2022). Chapter 18 Personal Hygiene and Bed Making . In P. A. Potter (Ed.), Clinical nursing skills & techniques (10th ed., pp. 528–529). essay, Elsevier.