Good afternoon, I am Marilyn Casuya and today I am going to perform
external douching return demonstration. External douching involves
cleaning or washing of genitals and anal area with water, soap or
medicated solution. This is done for the purpose of cleansing the area of
secretion and excretion, reduce unpleasant odors, prevent skin irritation
and excoriation, control the potential for infection and to promote
comfort to the patient
(name the equipments)
First, is to assess the need for external douche. This is to determine any
contraindication for the procedure
Next, identify patient and explain the procedure. Exchanging information
allays fear and promotes cooperation (Hi ma’am I am marilyn casuya your
student nurse for today, can you state your full name… okay ma’am thank
you, so today ma’am we will be doing external douching so basically this is
to remove the normal perennial secretion, odor and prevent some
infection and contamination, and of course it will bring comfort to you, so
I will be touching some of your body parts especially your private part or
your genitals, is that okay with you?) yes..
Next is to wash our hands. This is to reduce the spread of microorganisms
to self and others… assuming that I am done washing my hands
Next is to assemble and bring equipment to the bedside. Organization
promotes efficient time management (name the equipment one by one)
After putting our equipment to the bedside close the door of the room if
you are in a private room or close the windows if in the ward. To ensure
privacy of the patient
Adjust the bed to working height If possible to ensure proper body
mechanics
After doing so, we will don our gloves now to prevent contamination
Next, is to position the patient in supine position to make the patient
comfortable
Place waterproof underpad, as well as change the top sheet with bath
blanket if available this is to protect the bed from being wet or soiled
Drape the patient, minimum exposure lessens embarrassment and helps to
provide warmth
Place the patient on dorsal recumbent
Remove adult diaper/sanitary pad and examine quickly. Roll with the
contaminated parts inside and wrap with a piece of paper. Place it on the
paper lining under the bed. It will prevents contamination and for proper
disposal
Place the patient on a bedpan. It collects the water used during perineal
cleansing
Change working gloves. It ensures aseptic technique
Open sterile pack with a sterile bowl or kidney basin. Place seven or more
cotton balls soaked in soap suds solution. Open sterile working forceps
and place it on the sterile field with the handle at the edge. Prepare tissue
wipes at the edge of the sterile field. Sterility of materials prevents
contamination
Lift the cover of the flushing can and fold with sterile side inside. To
protect the inner side of the flushing can from contamination.
Test the water temperature, it should be 105F or 41C by pouring small
amount of water over back of your hand and then the patient’s thigh.
Testing the temperature of water prevent burns
Flush the are with warm water or a soapy solution until the area is clean
(farther side first). water dissolves or dilutes dried secretions. Soap
emulsifies fatty substances in the skin and reduces the ability of microbes
to grow and multiply.
With one cotton ball soaked in soap sud solution, wast the mons veneris in
zigzag motion going upward toward the lower portion of the
hypogastrium
Use a second ball in soap sud solution to wash the inner part of the father
thigh in a zigzag motion, begin in the crease of the groin outward the mid-
thigh. Thorough cleansing and care should be taken to avoid introducing
secretions and bacteria into the opening through which is urine is released.
Contamination of this area can lead to a urinary tract infection
Using the third cotton ball in soap sud solution, do the same on the nearer
thigh
A fourth cotton ball in soap sud solution to wash the farther labia majora
in a downward stroke toward the perenium
do the same on the other labia using the fifth cotton ball
With the sixth cotton ball in soap sud solution, wash with one downward
stroke from the clitoris, meatus, vaginal opening to perineum.
Repeat the step, with 7 th cotton ball in soap sud solution extending up to
the anus.
Rinse the area well with sterile water starting from the center to the
farther leg, back to the center to the nearer leg and pat dry using toilet
paper from front to back. It promotes drying and prevents skin irritation
Remove the bedpan. Loosen the drape from the legs. Turn to side and dry
the buttocks
Remove the soiled waterproof underpad and put on diaper or sanitary
pad and underwear. Diaper or sanitary pad absorbs vaginal discharges
Reposition patient and replace the bath blanket with top sheet. It will
promote patient’s comfort
Bring the equipment back to the utility room and do the aftercare. It keeps
the area clean and tidy
Remove gloves and wash hands. Reduces the spread of microorganisms to
self and others
Document the procedure, objective and subjective findings, and the
patient’s response. Timely documentation communication among health
care team