Perineal Care - Male

Begin by gathering supplies: linens, washcloths, and a towel. Introduce yourself to the resident, explain the procedure (washing their bottom), provide privacy, and wash your hands. Raise the side rail away from you and elevate the bed to a comfortable working height. Prepare a basin with warm water, testing the temperature with the resident or on your hand. Put on gloves.

Place all washcloths in the water. Expose only the area to be washed, using a bath blanket for comfort if needed. Place a dry towel under the resident to keep the bed dry. Fold the soaped washcloth into four sections, using a thumb to keep track of unused areas for infection control. For an uncircumcised male, retract the foreskin. Start at the urethra and clean in a circular motion, covering as much surface as possible, including the scrotum. Use a fresh section of the washcloth when approaching the rectum. Dispose of the used washcloth in a linen bag.

Using a rinse washcloth, folded similarly, repeat the process: retract foreskin, start at the urethra, and rinse towards the rectum, using new areas of the washcloth as needed. Dispose of the rinse washcloth. Use the towel to thoroughly pat dry all skin folds in the perineal area. If uncircumcised, bring the foreskin back over to prevent discomfort.

Help the resident roll onto their side, grabbing the side rail for support, while keeping them covered. Expose only the necessary area. Again, prioritize infection control by moving from clean to dirty, away from the urethra towards the rectum. Apply soap to a washcloth, fold it, and clean the outer buttocks first, then the middle. Use a clean section of the washcloth for each pass. Disposable wipes can be used for significant bowel movements. Rinse in the same manner, observing for any skin issues, especially at the coccyx. Pat dry thoroughly, paying attention to skin folds to prevent breakdown.

Remove and dispose of gloves immediately after peri-care and sanitize hands, as E. coli may be present. If the resident can remain on their side, do so; otherwise, return them to their back first. Return the resident to their back using the lift sheet, lower the bed, and ensure side rails are down (except one if needed). Provide the call light. Remove dirty linens. Don gloves again to clean the basin, dumping water, washing with soap, rinsing, drying, and returning it to the resident's keeping place. Wash hands, and report any skin concerns or pain to the nurse.