PERINEAL CARE FOR A FEMALE RESIDENT WITH HAND WASHING (one of the possible first mandatory tasks)

1) Perform hand hygiene.

a. Cover all surfaces of the hands with hand sanitizer.

b. Rub hands together to dry.

2) Explain the procedure to be performed to the resident [manikin].

3) Fill a basin with warm water.

4) Provide privacy for the resident; pull the privacy curtain.

5) Raise the side rail on the side of the bed opposite the working side or request the RN Test Observer or Actor to stand on the side of the bed opposite the working side.

6) Raise the bed to between mid-thigh and waist level.

7) Place a bath blanket or clean sheet over the resident.

8) Put on gloves.

9) Place a waterproof pad under the resident’s buttocks by turning the resident side-to-side or raising the hips.

10) Expose the perineum only.

11) Use water and a soapy washcloth.

12) Clean both sides and the middle of the labia from top to bottom with a clean portion of the washcloth for each stroke.

13) Use a new, clean washcloth.

14) Using a new, clean washcloth, rinse the area from top to bottom, using a clean portion of the washcloth with each stroke.

15) Pat dry the area with a clean portion of the towel for each pat.

16) Cover the exposed area with the bath blanket or clean sheet.

17) Assist resident in turning onto their side away from the working side of the bed.

18) With a new clean washcloth with water and soap, clean the rectal area.

19) Clean the rectal area from the vagina to the rectal area using at least two single strokes with a clean portion of the washcloth for every single stroke.

20) Use a new, clean washcloth.

21) Using a new, clean washcloth, rinse the rectal area from the vagina to the rectal area. Use at least two single strokes. Use a clean portion of the washcloth for each stroke.

22) Pat dry area from vagina to rectal area.

23) Remove the waterproof pad from under the buttocks, without friction, by turning resident [manikin] side-to-side or raising hips.

24) Position the resident on her back.

25) Remove the bath blanket or sheet.

26) Place all soiled linen in a designated container.

27) Empty, rinse, dry, and return equipment to storage.

28) Remove gloves, turn inside out as they are removed, and dispose of them in the designated container. 

29) Lower bed.

30) Lower side rail(s) if side rails were used.

31) Open the privacy curtain.

32) Maintain respectful, courteous interpersonal interactions at all times.

33) Place the call light or signaling device within easy reach of the resident.

34) Turn on water.

35) Wet all surfaces of hands BEFORE applying soap.

36) Wet wrists BEFORE applying soap.

37) Apply soap to wet hands.

38) Rub hands together using friction.

39) While hands are not under running water, rub hands together for at least 20 seconds.

40) Interlace fingers pointing downward.

41) Wash all surfaces of hands and wrists with soap.

42) Rinse hands and wrists thoroughly under running water with fingers pointed downward.

43) Dry hands and wrists with a clean paper towel(s).

44) Immediately discard paper towel(s) in a trash container.

45) Turn off the faucet with a clean, dry paper towel.

46) Do not re-contaminate hands at any time during the handwashing procedure. (Using a wet paper towel to turn off the faucet is considered recontamination.)