newborn eyecare and perineal care in pregnancy procedure

1. EYE CARE
PROCEDURE
PREPARED BY:
NIKITA SHARMA

2. DEFINITION
■ It is the process of cleaning eyes with normal
saline for removing secretions and for preventing
infections.

3. PURPOSES
■ To prevent any further injury to eye
■ To prevent infection
■ To relieve pain and discomfort
■ To provide instillation of eye drops/eye
ointments

4. POINTS TO REMEMBER
■ Always clean the uninfected eye first (cross -
infection)
■ Clean each eye with one swab in single stroke
■ Is crust is there, repeat the procedure until the
crust is removed.

5. ARTICLES
■ Sterile dressing pack
■ Normal saline
■ Kidney tray
■ Pair of
Sterile gloves

6. PRE-PROCEDURE STEPS
■ Identify the infant
■ Collect and prepare articles
■ Position the infant comfortably. Preferably in the supine
position
■ Ensure adequate light to enables maximum observation of the
eye without causing infant’s harm and discomfort
■ Open the sterile dressing pack

7. INTRA-PROCEDURE STEPS
■ Wash and dry hands to prevent infection
■ Prepare cotton balls

8. • Lightly moisten the cotton ball with normal saline solution, if
the swab is too wet, the solution will run down the baby’s
cheek thus increasing the risk of cross infection
• Separate the cotton ball into two swabs without touching the
inner side of swab
CONTINUE…..

9. • Squeeze the two swabs by pressing by not touching the inner
side of swab
• Gently swab from the inner canthus to outer canthus of the
eye using each swab only once until all discharge has been
removed.
CONTINUE…..

10. POST-PROCEDURE STEPS
■ Ensure that the baby is comfortable
■ Replace the equipment safely
■ Wash hands and dry
■ Document the procedure appropriately and
report any abnormal findings

11. PROCEDURE
PERINEAL CARE

12. ■ Perineal care is the procedure of cleansing the
patient’s external genitalia and surrounding skin
using antiseptic solution.
DEFINITION

13. PURPOSES
■ To remove normal perineal secretions and odours.
■ To promote client comfort.
■ To cleanse the perineal skin.
■ To reduce chances of infection of episiotomy wound.
■ To stimulate circulation.
■ To reduce body odor and improve self-image.
■ To promote the feeling of well-being.

14. PRINCIPLE
The most pertinent principle for the perineal care is to
clean the perineum from the more clean area to the less
clean area.
ASSESSMENT
Assess for the presence of-
■ Irritation, excoriation, inflammation, swelling
■ Excessive discharge
■ Odor, pain or discomfort
■ Urinary or fecal incontinence
■ Recent recall or perineal surgery
■ Indwelling catheter

15. POINTS TO REMEMBER
■ Bladder should be empty before perineal care.
■ Pay special attention to aseptic technique and maintain
privacy.
■ Use one swab for one stroke only.
■ Don’t touch side of pad which will be directly over
vulva and perineum.
■ Don’t apply pressure over lower abdomen in caesarean
section.

16. EQUIPMENT
A clean tray containing
■ Sterile antiseptic lotion- 2% dettol or savlon/ betadine solution
■ Sterile normal saline in a bottle.
■ Cheatle forceps.
■ Antiseptic or antibiotic medication if ordered.
■ Sterile sanitary pad.
■ Sterile gloves.
■ Mackintosh.

17. Sterile pack or tray containing
■ Artery forceps- 2
■ Dissecting forceps-1
■ Cotton balls.
■ Gauze pieces.
■ Sterile towel to wipe hands after surgical scrub.
Additional items
■ Infrared light
■ Bedpan (if the procedure is done at the bedside)

18. PROCEDURE
■ Explain the procedure to the patient
■ Assemble articles at the bedside or in the treatment room
■ Ask the patient to empty her bowel and bladder and wash the perineal
area before coming for perineal care.

19. CONTINUE…..
■ Screen the bed or close the doors as appropriate.
■ Assist the patient to assume dorsal recumbent position with
knees bend and drape the area using diamond draping method.
■ Open sterile tray, arrange articles with cheattle forceps and
pour antiseptic solution in the sterile gallipot in the tray.

20. CONTINUE…..
■ Scrub hands and dry with the sterile towel
■ Put on sterile gloves.
■ Position waterproof pad under client’s buttocks or place
bedpan under client.
■ Raise client’s gown up above genital area.

21. CONTINUE…..
■ Help the client to flex her knees and spread legs apart
■ With the swab clean mons pubis and thigh folds in “7 shape”
manner on each side. Clean the thighs from thigh folds towards
the thighs discard the swab after each stroke. Strokes are to be
in the following order:

22. CONTINUE…..
■ Clean the labia majora from upward to
downward manner on each side.
■ Clean the labia minora from upward to
downward manner on each side.
■ With the swab, clean from urethra towards anus.
■ Separate the vestibule with non-dominant hand
and clean vestibule starting from clitoris to
fourchette.
■ After that clean anus with one swab in a circular
manner

24. CONTINUE…..
■ Wipe all traces of antiseptic away with sterile normal
saline swabs in the same manner as described above
using thumb forceps.
■ Discard the gloves and used items in the kidney tray,
wash forceps and tray and keep ready for
sterilization.
■ Replace other articles in designated places.
■ Make the patient comfortable and leave the unit
clean.
■ Record procedure in the patient’s chart including
details regarding status of lochia and condition of
episiotomy wound.

25. AFTER CARE
■ Apply the medicine and pad if necessary.
■ Remove the mackintosh if extra one is needed.
■ Change linen if necessary, straighten the bed clothes. Arrange the bed
linen.
■ Make the patient comfortable.
■ Take the bedpan to sanitary annex. Remove cotton swabs and empty the
contents into toilet.
■ Clean all articles.
■ Replace articles.
■ Remove screen and tidy up the unit.
■ Wash hands.
■ Record the procedure with date and time and the observations made.