Perineal Care (Peri Care)

What Is Perineal Care?

Perineal care involves cleaning the perineal area (genitalia and rectal area) using proper technique to prevent infection, skin breakdown, and odor. This is one of the most commonly tested CNA clinical skills and requires sensitivity, professionalism, and strict adherence to infection control principles.

When Perineal Care Is Performed

Key Principles (Critical Steps on Skills Exam)

1. Provide privacy: Close door, pull curtain, drape appropriately
2. Wear gloves (standard precautions)
3. Use warm water with mild, pH-balanced cleanser (or facility-approved perineal wash)
4. ALWAYS clean from front to back (clean to dirty) to prevent UTI
5. For females: Wipe from the urethral area toward the rectum; use a clean area of the washcloth for each stroke
6. For males: Clean the tip of the penis first using a circular motion, then the shaft, then the scrotum, then the rectal area; if uncircumcised, retract the foreskin, clean, and REPLACE the foreskin
7. Rinse thoroughly to remove all soap (soap residue causes irritation)
8. Pat dry (do not rub)
9. Apply barrier cream if ordered (for incontinence-related skin protection)
10. Remove gloves, wash hands

Infection Control Critical Points

• Front to back (ALWAYS) to prevent E. coli from the rectal area entering the urethra
• Clean area of washcloth for each wipe (never re-use a soiled section)
• Change gloves if heavily soiled
• Observe and report any redness, rash, swelling, discharge, or skin breakdown
• For catheter patients: Clean around the catheter insertion site during peri care

Exam Alert

Perineal care is one of the most frequently tested CNA skills. Critical points: ALWAYS clean front to back (clean to dirty), provide privacy, use warm water, wear gloves, use a clean area of the washcloth for each wipe, pat dry. For uncircumcised males: retract foreskin, clean, REPLACE foreskin. Report skin changes to the nurse.