Component Task: Vulval toileting of a Puerperal Client

This is a procedure performed by the midwife daily between 1-3weeks to clean the vulva/perineum after delivery of the baby to optimise the health of the puerperal woman.

Aims

·         Help prevent infection

·         Keep vulva dry and free from irritant

·         Promote healing of the vulva

·         Assess lochia

Types

·         Swabbing

·         Jug Douching

Requirements

Trolley containing the following:

a.      Sanitary pad

b.      Sterile gloves

c.      HLD Gloves

d.      Galipot

e.      Jug with warm water

f.        Bed pan

g.      Savlon, Dettol or Hibitane)

h.      Macintosh

i.         Draw sheet

j.         Drapes

k.       Sponge holding forceps (Sterile)

l.         Sterile swabs

m.   Receiver

Steps

1.        Establish rapport (refer steps)

2.      Explain procedure to client (refer steps)

3.      Provide privacy and let client assume dorsal position with knees flexed

4.      Wear rubber apron

5.      Send trolley to bedside

6.      Mix warm water for swabbing with lotion

7.       Test the water temperature with elbow

8.      Place mackintosh under client and drape her

9.      Wear gloves and place bedpan under client

10.    Remove perineal pad using one hand

11.      Inspect the lochia (colour, amount, odour)

12.    Discard soiled perineal pad

13.    Inspect vulva and perineum

14.    Remove glove, perform hand hygiene and wear sterile gloves

15.    Pour water gently over vulva and clean the vestibule

16.    Clean the labia minora, majora and then pour water gently over the vulva

17.    Clean and dry client and remove bedpan  

18.    Place clean pad at the vulva and make client assume desirable position

19.    Educate client on proper perineal care

20.  Communicate findings and appreciate client for her cooperation

21.    Disposed off and decontaminate used items

22.  Perform hand hygiene

23.  Record into Maternal and Child Health Record Book (Manual and Electronic)

24.  Record and report findings to the officer in-charge

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