Perineal Care Observation

In all areas of healthcare, particularly in acute care settings, patients may be unable to care for their nutritional and/or hygienic needs properly. One area that is especially important to address is the perineal care of patients who are incapacitated, or otherwise unable to care for their hygienic needs independently. Normal bacterial flora can develop into an opportunistic infection if the bacteria reaches certain areas of the body. For example, a common cause of urinary tract infections (UTI) is due to Escherichia coli from the colon coming into contact with the urethra (Copstead & Banasik, 2013). If the patient is immunocompromised, elderly, sedentary, or otherwise compromised in their abilities to void, this can predispose the patient

This paper will outline the instance of improper perineal care observed during a clinical shift, the appropriate actions that followed, the importance of proper perineal care, and the lessons learned from this

As a nursing student, I need to ensure I am performing my tasks, including perineal care, to the highest standard, and addressing areas of concern that I observe during my shifts. As mentioned by Marshall & Bailey (2008), incontinence can greatly impact the quality of life of a patient, as well as increases their risk of potential perineal skin breakdown. Improper perineal care following incontinence can lead to painful skin irritation, UTIs, and pressure sores. Frequent monitoring, and management of incontinence are the first steps in appropriate management. Seeing as I was diligent in observing and reporting the incident of improper perineal care, I was able to follow these crucial first steps in preventing a potential UTI in this geriatric patient. Even with being observant and watching for the obvious signs and symptoms of a UTI, it is important we also are aware that UTIs can be symptomatic or asymptomatic (Hälleberg Nyman, Johansson, Persson & Gustafsson, 2011). Signs and symptoms of a UTI can include frequent pain and/or burning during urination, polyuria, increased urgency, nocturia, hematuria, incontinence, and suprapubic, back, or pelvic pain (Paul, Day & Williams, 2016). UTIs need to be treated promptly to prevent renal damage, and/or potential septic shock. We also need to be aware of the different risk factors that