Perineal & Catheter Care

The perineal area is a dark, moist environment where bacteria love to live.  As a result, the number one healthcare associated infection is the urinary tract infection. Most healthcare associated UTI's are the result of catheterization or incontinence and can be avoided by providing regular peri-care and cath-care using proper technique.

TIPS FOR PROVIDING PERI-CARE

• The perineal area should be cleaned EVERY DAY, whether the client gets a complete bath or not.
• It is important to use a clean area of the washcloth for each wipe because reusing the same area can cause infection.
• As you wipe from front to back, the wash cloth picks up bacteria.  If you wipe again with the contaminated section of the washcloth, you are dragging that bacteria to the urethra where it can enter the opening, migrate up to the bladder and cause infection.
• Observe for redness, white discharge, pain or foul odor.  Report any of these abnormal observations to the nurse right away!

TIPS FOR PROVIDING CATHETER CARE

• The urinary drainage bag should be emptied at least once on every shift.  It should always be emptied before becoming more than 3/4 full. 
• If you notice you client is putting out less than 30ml per hour, check the tubing for kinks.  Make sure the client is not laying on the tubing and cutting off the flow.  If no visible obstructions are found, notify the nurse immediately!
• Notice the color, clarity and odor of the urine.  If any of your findings are abnormal, report verbally to the nurse right away in addition to your documentation.
• The drainage bag should always remain below the level of the bladder. This is particularly important to pay attention to when the client is ambulating or being transferred.
• Peri-care for the client with a catheter is the same as routine peri-care of other clients with one added step—cleaning the tubing.  To clean the catheter tubing, hold the tubing firmly at the point of insertion with one hand.  With your other hand, clean at least the first four inches of the tubing with a soapy washcloth.  Use a clean area of the wash cloth for each swipe of the tubing, and move in only one direction (away from the body).  Rinse with clean water in the same manner.  Dry the tubing and the perineal area completely.