Don Mariano Marcos Memorial State University

South La Union Campus

COLLEGE OF COMMUNITY HEALTH AND ALLIED MEDICAL SCIENCES
Agoo, La Union
Tel. 072.682.0663 / ichams.dmmmsu-sluc.com
Embracing World-class Care to learn, learn to
Standards care

Name: _________________________________ Date: _____________ Section/Group:________

URINARY CATHERIZETAION
CHECKLIST
Legend:
3-Very Satisfactory 0- Did not perform the procedure
2- Satisfactory 1- Needs Improvement

SKILL RATIONALE 3 2 1 0
PREPARATION:
If using a catheterization kit, read the label carefully to
ensure
that all necessary items are included.

Equipment:

For a straight catheterization:

Straight catheterization kit:

• Sterile straight catheter of appropriate size
• Sterile gloves
• Waterproof drape(s)
• Antiseptic solution
• Cleansing balls
• Forceps
• Water-soluble lubricant
• Urine receptacle
• Specimen container.
(An extra catheter should also be at hand in case of a break in
aseptic technique.)
• Sterile gloves
• Waterproof drape(s)
• Antiseptic solution
• Cleansing balls
• Forceps
• Water-soluble lubricant
• Syringe prefilled with sterile water in amount specified by
catheter manufacturer
• Collection bag and tubing
For an indwelling catheter:

Closed catheterization kit:

• Sterile indwelling catheter of appropriate size
• 5–10 mL 2% Xylocaine gel or water-soluble lubricant for
male urethral injection (if agency permits)
• Clean gloves
• Supplies for performing perineal cleansing
• Bath blanket or sheet for draping the client
• Adequate lighting (Obtain a flashlight or lamp if necessary.)
(An extra catheter should also be at hand in case of a break in
aseptic technique.)
Apply clean gloves and perform routine perineal care to
cleanse
the meatus from gross contamination.

- For women, use this time to locate the urinary meatus

relative to surrounding structures. To expose the urinary
meatus, separate the labia minora and retract the tissue
upward
Remove and discard gloves.
Perform hand hygiene.
PERFORMANCE
Prior to performing the procedure, introduce self and verify
the client’s identity using agency protocol. Explain to the
client what you are going to do, why it is necessary, and how
to participate.
Perform hand hygiene and observe other appropriate
infection prevention procedures.
Provide for client privacy.
Place the client in the appropriate position and drape all areas
except the perineum.

• Female: supine with knees flexed, feet about 2 feet apart,

and hips slightly externally rotated, if possible

• Male: supine, thighs slightly abducted or apart

Establish adequate lighting. Stand on the client’s right if
you are right-handed, on the client’s left if you are left-
handed.
If using a collecting bag and it is not contained within the Because one hand is
catheterization kit, open the drainage package and place the needed to hold the catheter
end of the tubing within reach. once it is in place, open the
package
while two hands are still
available.
If agency policy permits, apply clean gloves and inject 10 to
15 mL Xylocaine gel into the urethra of the male client. Wipe
the underside of the penile shaft to distribute the gel up the
urethra. Wait at least 5 minutes for the gel to take effect
before inserting the catheter.
Remove and discard gloves.
• Perform hand hygiene.
Open the catheterization kit. Place a waterproof drape under
the buttocks (female) or penis (male) without contaminating
the center of the drape with your hands.
Apply sterile gloves.
Organize the remaining supplies:
• Saturate the cleansing balls with the antiseptic solution.
• Open the lubricant package.
• Remove the specimen container and place it nearby with
the lid loosely on top.
• Remove plastic covering of indwelling catheter.
Lubricate the catheter 2.5 to 5 cm (1 to 2 in.) for females, 15
to 17.5 cm (6 to 7 in.) for males, and place it with the
drainage end inside the collection container.
Attach the prefilled syringe to the indwelling catheter Pre-inflation is no longer
inflation hub. Do not pre-inflate the balloon. recommended and may cause
microtears, risking infection.
If desired, place the fenestrated drape over the perineum,
exposing the urinary meatus.
Cleanse the meatus.
Note: The nondominant hand is
Considered contaminated once it touches the client’s skin.

• Females: Use your nondominant hand to spread the labia so

that the meatus is visible. Establish firm but gentle pressure
on the labia. The antiseptic may make the tissues slippery but
the labia must not be allowed to return over the cleaned
meatus.

Note: Location of the urethral meatus is best identified

during the cleansing process. Pick up a cleansing ball with
the forceps in your dominant hand and wipe one side of the
labia majora in an anteroposterior direction. Use great care
that wiping the client does not contaminate this sterile hand.
Use a new ball for the opposite side.
Repeat for the labia minora. Use the last ball to cleanse
directly over the meatus.

• Males: Use your nondominant hand to grasp the - Lifting the penis in this
penis just below the glans. If necessary, retract the manner helps straighten
foreskin. Hold the penis firmly upright, with slight tension. the urethra.
Pick up a cleansing ball with the forceps in your dominant
hand and wipe from the center of the meatus in a circular
motion around the glans. Use great care that wiping the client
does not contaminate the sterile hand. Use a new ball and
repeat 3 more times. The antiseptic may make the tissues
slippery but the foreskin must not be allowed to return over
the cleaned meatus nor the penis be dropped.
Insert the catheter.
• Grasp the catheter firmly 5 to 7.5 cm (2 to 3 in.) from the
tip. Ask the client to take a slow deep breath and insert
the catheter as the client exhales. Slight resistance is
expected as the catheter passes through the sphincter. If
necessary, twist the catheter or hold pressure on the catheter
until the sphincter relaxes.

• Advance the catheter 5 cm (2 in.) farther after the urine - This is to be sure it is
begins to flow through it. For male clients, fully in the bladder, will
advance the catheter to the “Y” bifurcation of the not easily fall out, and
catheter. the balloon is in the
bladder completely.
• If the catheter accidentally contacts the labia or slips into
the vagina, it is considered contaminated and a new, sterile
catheter must be used. The contaminated catheter may be
left in the vagina until the new catheter is inserted to help
avoid mistaking the vaginal opening for the urethral meatus.

Hold the catheter with the nondominant hand.

For an indwelling catheter, inflate the IUC balloon with the

designated volume.
• Without releasing the catheter (and, for females,
without releasing the labia), hold the inflation valve
between two fingers of your nondominant hand while
you attach the syringe (if not left attached earlier) and
inflate with your dominant hand. If the client complains
of discomfort, immediately withdraw the instilled fluid,
advance the catheter farther, and attempt to inflate the
balloon again.

• Pull gently on the catheter until resistance is felt to ensure

that the balloon has inflated and to place it in the trigone of
the bladder.
Collect a urine specimen if needed. For a straight catheter,
allow 20 to 30 mL to flow into the bottle without touching
the catheter to the bottle. For an indwelling catheter
preattached to a drainage bag, a specimen may be taken from
the bag this initial time only.
Allow the straight catheter to continue draining into the urine
receptacle. If necessary (e.g., open system), attach the
drainage end of an indwelling catheter to the collecting
tubing and bag.
Examine and measure the urine. In some cases, only 750
to 1000 mL of urine are to be drained from the bladder at
one time. Check agency policy for further instructions if this
should occur.
 Remove the straight catheter when urine flow stops. For an This prevents unnecessary
indwelling catheter, secure the catheter tubing to the thigh trauma to the urethra.
for female clients or the upper thigh or lower abdomen for
male clients to prevent movement on the urethra or excessive
tension or pulling on the indwelling balloon. Adhesive and
nonadhesive catheter-securing devices are available and
should be used to secure the catheter tubing to the client.
Next, hang the bag below the level of the bladder. No tubing
should fall below the top of the bag
Wipe any remaining antiseptic or lubricant from the perineal
area. Replace the foreskin if retracted earlier. Return the
client to a comfortable position. Instruct the client on
positioning and moving with the catheter in place.
Discard all used supplies in appropriate receptacles.
Remove and discard gloves.
• Perform hand hygiene.
Document the catheterization procedure including
catheter size and results in the client record using forms
or checklists supplemented by narrative notes when
appropriate.

For the next items, evaluate the students in general according to the criteria. (5 as the highest score)

5 4 3 2 1
Mastery
Orderliness
Proper attitude in assessing the client followed.
Ability to answer questions
Proper reporting observed.

Student’s signature: __________________

Evaluator’s Signature: __________________
Comments:___________________________________________________________________________
________________________________________________________________________