Vulva Toilet / Swabbing (PEX 2.1.6: Perform Vulval Toilet (Swabbing))
Objectives:
- State the indications for vulva swabbing.
- Identify the requirements for vulva swabbing.
- Prepare requirements for vulva swabbing.
- Perform vulva swabbing procedure.
- Prepare requirements for vulva swabbing.
- Perform vulva swabbing procedure.
Indications:
- To remove vaginal discharge.
- To keep the vulva clean and dry.
Requirements:
A Trolley (Top Shelf):
- 3 Bowels
- 2 Receivers
- Sponge holding forceps (or artery forceps)
- Sims speculum (if needed for inspection/discharge)
- 1 Drum of swabs
- 1 Drum of cotton balls
- 1 Drum of drapes
- Antiseptic solution (e.g., warm sterile water, saline, or mild soap solution as per policy)
Bedside:
- Bedpan (if patient is unable to use the toilet)
- Mackintosh (or waterproof sheet)
- Sanitary towels (or pads)
- Screens (for privacy)
- Hand washing equipment (access to sink, soap, water, towel)
- Waste receptacle (for soiled swabs and pads)
- Adequate lighting
- Clean gloves
Procedure:
| Steps | Action | Rationale |
|---|---|---|
| 1. | Observe the general rules. | Promotes adherence to standards and patient safety. |
| 2. | Offer a bed pan if necessary. | Promotes patient comfort and avoids interruption during procedure. |
| 3. | Position the patient in a dorsal position and cover the trunk. | To enable easy performance of the procedure and provide privacy. |
| 4. | Place the dressing mackintosh and towel under the patient's buttocks. | To expose the required part and protect the bed linen from soiling. |
| 5. | Assemble the equipment on the top shelf. | To save time and ensure efficiency. |
| 6. | Wash hands and put on clean gloves. | Prevents cross infection. |
| 7. | Drape the thighs. | To minimize exposure and provide a sterile area. |
| 8. | Observe the vulva for any discharge or any abnormality. | To provide appropriate intervention and assess the need for swabbing. |
| 9. | Separate the labia majora and minora with the left hand (non-dominant). Swab the vulva using a fresh swab held with forceps for each part, wiping from front to back (anterior to posterior). | To provide a sterile area and prevent contamination from the anal region. |
| 10. | Swab the following areas, using a fresh swab for each stroke and discarding each used swab into the waste receptacle: - Left labia Majora - Right labia Majora - Left labia Minora - Right labia Minora - The vagina introitus - Perineum (if necessary) | To ensure thorough cleaning and prevent spread of microorganisms. |
| 11. | Dry the vulva and perineum using a fresh swab or cotton ball for each stroke, wiping from front to back. Apply a sanitary pad as required. | Promotes hygiene and comfort. |
| 12. | Turn the patient on her left hand side, clean and dry the perianal area with fresh swabs using a front to back motion. | To prevent irritation and promote comfort. |
| 13. | Leave the patient in a comfortable position and ensure their privacy. | To promote rest and comfort. |
| 14. | Clear away the equipment and wash hands thoroughly. | Promotes hygiene and infection control. |
| 15. | Document the procedure, including the amount and nature of discharge, the patient's response, and any abnormalities observed. | To promote follow-up and ensure continuity of care. |
Points to Remember:
- In case of too much discharge or if internal inspection is needed, a Sims speculum may be used to visualize the vaginal walls and cervix.
- Always wipe from front to back (anterior to posterior) to prevent contamination of the urethra and vagina with fecal microorganisms.
- Dispose of soiled materials immediately and appropriately in the designated waste receptacle.
- Maintain clear communication with the patient throughout the procedure to ensure comfort and cooperation.
Nurses Revision