CATHETERIZATION
Instruction: Check under Correctly Done if identified skill is correctly performed; Incorrectly Done if skill
is not performed correctly; and Not Done if the student failed to perform the skill.
Correctly Incorrectly Not Done
Procedure Done Done
1. Identify the patient. Discuss procedure with patient and assess
patient’s ability to assist with the procedure. Discuss any allergies
with patient, especially to iodine and latex. Review chart for any
limitations in physical activity.
2. Bring the catheter kit and other necessary equipment to
bedside. Obtain assistance from another staff member, if
necessary. Perform hand hygiene.
3. Close curtains around bed and close door to room if possible.
4. Provide for good light. Artificial light is recommended (use of a
flashlight requires an assistant to hold and position it). Place a
trash receptacle within easy reach.
5. Raise the bed to a comfortable working height. Stand on the
patient’s right side if you are right-handed, patient’s left side if
you are left handed.
6. Assist patient to dorsal recumbent position with knees flexed,
feet about 2 feet apart, with her legs abducted. Drape patient.
Alternately, the Sims’, or lateral, position can be used. Place the
patient’s buttocks near the edge of the bed with her shoulders at
the opposite edge and her knees drawn toward her chest. Allow
the patient to lie on either side, depending on which position is
easiest for the nurse and best for the patient’s comfort. Slide
waterproof pad under patient.
7. Put on clean gloves. Clean the perineal area with washcloth,
skin cleanser, and warm water, using a different corner of the
washcloth with each stroke. Wipe from above orifice downward
toward sacrum (front to back). Rinse and dry. Remove gloves.
Perform hand hygiene again.
8. Prepare urine drainage setup if a separate urine collection
system is to be used. Secure to bed frame according to
manufacturer’s directions.
9. Open sterile catheterization tray on a clean overbed table using
sterile technique.
10. Put on sterile gloves. Grasp upper corners of drape and unfold
drape without touching unsterile areas. Fold back a corner on
each side to make a cuff over gloved hands. Ask patient to lift her
buttocks and slide sterile drape under her with gloves protected
by cuff.
11. Place a fenestrated sterile drape over the perineal area,
exposing the labia.
12. Place sterile tray on drape between patient’s thighs.
13. Open all the supplies. Test the catheter balloon by removing
protective cap on tip of syringe and attaching syringe prefilled
with sterile water to injection port. Inject appropriate amount of
fluid. If balloon inflates properly, withdraw fluid and leave syringe
attached to port.
14. Fluff cotton balls in tray before pouring antiseptic solution
over them. Alternately, open package of antiseptic swabs. Open
specimen container if specimen is to be obtained.
15. Lubricate 1" to 2" of catheter tip.
16. With thumb and one finger of nondominant hand, spread
labia and identify meatus. Be prepared to maintain separation of
labia with one hand until catheter is inserted and urine is flowing
well and continuously. If the patient is in the side lying position,
lift the upper buttock and labia to expose the urinary meatus
17. Use your dominant hand to pick up a cotton ball. Clean one
labial fold, top to bottom (from above the meatus down toward
the rectum), then discard the cotton ball. Using a new cotton ball
for each stroke, continue to clean the other labial fold, then
directly over the meatus.
18. With your uncontaminated, dominant hand, place drainage
end of catheter in receptacle. If the catheter is pre-attached to
sterile tubing and drainage container (closed drainage system),
position catheter and setup within easy reach on sterile field.
Ensure that clamp on drainage bag is closed.
19. Using your dominant hand, hold the catheter 2" to 3" from
the tip and insert slowly into the urethra. Advance the catheter
until there is a return of urine (approx. 2"–3" [4.8–7.2 cm]). Once
urine drains, advance catheter another 2"–3" (4.8–7.2 cm). Do
not force catheter through urethra into bladder. Ask patient to
breathe deeply, and rotate catheter gently if slight resistance is
met as catheter reaches external sphincter.
20. Hold the catheter securely at the meatus with your
nondominant hand. Use your dominant hand to inflate the
catheter balloon. Inject entire volume supplied in prefilled syringe.
21. Pull gently on catheter after balloon is inflated to feel
resistance.
22. Attach catheter to drainage system if not already pre-
attached.
23. Remove equipment and dispose of according to facility policy.
Wash and dry the perineal area as needed.
24. Remove gloves. Secure catheter tubing to the patient’s inner
thigh with Velcro leg strap or tape. Leave some slack in catheter
for leg movement.
25. Assist the patient to a comfortable position. Cover the patient
with bed linens. Place the bed in the lowest position.
26. Secure drainage bag below the level of the bladder. Check
that drainage tubing is not kinked and that movement of side rails
does not interfere with catheter or drainage bag.
27. Put on clean gloves. Obtain urine specimen immediately, if
needed, from drainage bag. Label specimen. Send urine specimen
to the laboratory promptly or refrigerate it.
28. Remove gloves. Perform hand hygiene.
Comment:
_____________________________________________________________________________
___________________________________________________________________________
Score: _____________________
Name of Student: Date
Performed:
(Signature Over Printed Name)
Evaluated by: Date of Evaluation:
(Signature Over Printed Name)
