Insertion and Removal of Indwelling Catheter Procedure

Western Mindanao State University
College of Nursing
Zamboanga City
Level III - SKILL POCEDURES
NAME: _________________________________ ROTATION: _____________________

SECTION: _______________________________ DATE: _________________________
Evaluation Checklist
URINARY CATHETER INSERTION (Female & Male)
and URINARY CATHETER REMOVAL
Legend:
❖ 4 – Excellent - Able to perform correctly all task at a given time
❖ 3 – Very Satisfactory – Able to perform correctly almost all task at a given time
❖ 2 – Satisfactory – Able to perform correctly some/moderate task at a given time
❖ 1 – Unsatisfactory - Unable to perform correctly all task at a given time.
STEPS 4 3 2 1
Assessment
1. Verify Written prescription by the physician
2. Identify the patient for the procedure using the required two (2) patient identifiers.
3. Explain procedure to patient and/or significant others.
4. Verify if the patient has an allergy to latex or iodine.
5. Secure Consent.
6. Perform hand hygiene.
7. Prepare the materials needed
4.1 Non- sterile gloves
4.2 Sterile gloves
4.3 Lubricating gel
4.4 Urine Catheter F12
4.5 Urine bag
4.6 Syringe 10cc,5cc with water for injection or Normal Saline Solution (NSS)
4.7 Cotton balls will betadine
4.8 Sterile gauze 2x2
4.9 Plaster
4.10Scissors
4.11 Underpad
4.12 Dressing Trolley / Tray
9. Provide privacy
Implementation
10. Put on non-sterile gloves.
11. Place the client in the appropriate position
Female: dorsal recumbent position- supine with knees flexed, feet about 2 feet apart, and hips slightly
externally rotated
Male patient: supine with legs extended and slightly apart.
12. Place an under pad beneath the patient.
13. Wash genital area with warm, soapy water, rinse and pat dry with towel according to agency
policy
14. Remove gloves and discard.
15. Wash hands or do hand hygiene after washing the patient’s genital area.
16. Place a blanket or sheet to cover patient and expose only required anatomical areas.
17. Establish adequate lighting.
18. Stand on the client’s right if you are right-handed, on the client’s left if you are left-handed.
19. Add supplies and cleaning solution to catheterization kit, and according to agency policy.
20. If using a urine bag not contained within the catheterization kit, open the drainage package,
and place the end of the tubing within the reach.
21. Open catheterization kit if available.
22. Place a waterproof drape under the buttocks (female) or penis (male) without contaminating
the center of the drape.
23. Don on sterile gloves.
24. Drape patient with drape found in catheterization kit, by touching the outer edges of the drape.
Ensure that any sterile supplies touch only the middle of the sterile drape (not the edges), and
that sterile gloves do not touch non-sterile surfaces. Drape patient to expose perineum or
penis.
25. If desired, place the fenestrated draped over the perineum, exploring the urinary meatus
26. Organize the materials :

27. Saturate the cleansing balls with the antiseptic solution
28. Open the lubricant package
29. Remove the specimen container and place it nearby, with the lid loosely on top.
30. Attach the prefilled syringe to the indwelling catheter inflation hub, and test the balloon using
a sterile syringe.
31. Lubricate the catheter tip 6-7 inches (male), 3-4 inches (female) and place it with the drainage
end inside the collection container
32. Place sterile tray with urine specimen container with catheter between patient’s legs.
Note: The non-dominant hand is considered contaminated once it touches the client skin
33. Clean perineal area as follows.
Female patient:
34. Separate labia with fingers of non-dominant hand (now contaminated and no longer sterile).
35. Pick up a cleansing cotton balls with sterile forceps in your dominant hand, wipe one side of
the labia majora in an antero- posterior direction.
36. Begin on a labia further from you and move on labium closer to you.
37. Use a new ball on the opposite side.
38. Repeat for the labia minora.
39. Use the last ball to cleanse once down center of the meatus.
40. Clean it at least three times the perineal area.
Male patient:
41. Gently grasp penis at shaft and hold it at right angle to the body throughout procedure with
non-dominant hand (now contaminated and no longer sterile).
42. Using sterile technique and dominant hand, clean urethral meatus in a circular motion working
outward from meatus.
43. Use sterile forceps and a new cotton swab with each cleansing stroke. If necessary retract the
foreskin
KEEP DOMINANT HAND STERILE
44. Pick up catheter with sterile dominant hand 2-3 inches below the tip of the catheter.
45. Insert catheter as follows.

Female patient:
46. Ask patient to bear down gently (as if to void) to help expose urethral meatus.
47. Advance catheter 5 to 7.5 cm (2-3 inches) until urine flows from catheter, then advance an
additional 5cm. (2 inches) or until it reaches nearest to the Y port.
Male patient:
48. Hold penis perpendicular to body and pull up slightly on shaft.
49. Ask patient to bear down gently (as if to void) and slowly insert catheter through urethral
meatus.
50. Advance catheter 6 to 8 inches or until urine flows from catheter.
51. Slowly inflate balloon for indwelling catheters according to catheter size, using prefilled
syringe.
52. 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.
53. Place catheter in sterile tray and collect urine specimen if required.
54. Connect urinary bag to catheter using sterile technique.
55. Secure catheter to patient’s leg using securement device at tubing just above catheter
bifurcation.
Female patient: Secure catheter to inner thigh, allowing enough slack to prevent tension.
Male patient: Secure catheter to upper thigh (with penis directed downward) or abdomen (with penis
directed toward chest), allowing enough slack to prevent tension. Ensure foreskin is not retracted.
56. Also secure the collecting tubing to the bed linens, and hang the bag below the level of the
bladder.
57. Wipe the perineal area of any remaining antiseptic or lubricant. Replace foreskin, if retracted
earlier.
58. Return the client to a comfortable position.
59. Discard all used supplies following agency policy.
60. Remove gloves dispose according to agency policy.
62. Acknowledge patient cooperation.

63. Document procedure according to agency policy, including patient tolerance of procedure, any
unexpected outcomes, and urine output.
REMOVAL OF URINARY CATHETER
Assessment
64. Check the chart for the doctor’s order.
65. Identify the patient for the procedure using the required two (2) patient identifiers.

67. Prepare the materials needed
66.1Non sterile gloves
66.2Disposable syringe
66.3Trash bin
66.4OS pad
68. Explain the procedure to the patient (catheter removal and post-urinary catheter care.)
69. Ensure patient’s privacy
70. Apply principles of asepsis and safety technique.
71. Don on non-sterile gloves.
72. Measure, empty, and record contents of catheter bag.
73. Remove gloves, perform hand hygiene.
74. Don on new non-sterile gloves.
75. Remove catheter securement/anchor device.

76. Insert syringe in balloon port and aspirate fluid from balloon. Verify balloon size on catheter
to ensure all fluid is removed from balloon.
77. Pull catheter out slowly and smoothly. Catheter should slide out slowly and smoothly.
78. Discard equipment and supplies according to agency policy.
79. Provide perineal care as required.
80. Reposition patient to a comfortable position.
81. Review post-catheter care, fluid intake, and expected and unexpected outcomes with patient.
82. Lower bed to safe position.
83. Remove gloves.
85. Document procedure according to agency policy.
TOTAL SCORES
Ratings: ______________________
Prepared By: LEVEL III-FACULTY
Noted By: Nerissa C. Mariga, MAN, RN

Level III- Coordinator
Recommending Approval: Desdimona C. Sakandal, RN,RM,MN

Clinical Coordinator
Approved By: Hashim N. Alawi Jr., RN, MN

Dean

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Western Mindanao State University

Level III - SKILL POCEDURES

NAME: _________________________________ ROTATION: _____________________

17. Establish adequate lighting.

26. Organize the materials :

45. Insert catheter as follows.

54. Connect urinary bag to catheter using sterile technique.

59. Discard all used supplies following agency policy.

60. Remove gloves dispose according to agency policy.

61. Perform hand hygiene.

62. Acknowledge patient cooperation.

66. Perform hand hygiene.

69. Ensure patient’s privacy

70. Apply principles of asepsis and safety technique.

71. Don on non-sterile gloves.

72. Measure, empty, and record contents of catheter bag.

73. Remove gloves, perform hand hygiene.

74. Don on new non-sterile gloves.

75. Remove catheter securement/anchor device.

78. Discard equipment and supplies according to agency policy.

79. Provide perineal care as required.

80. Reposition patient to a comfortable position.

82. Lower bed to safe position.

83. Remove gloves.

84. Perform hand hygiene.

85. Document procedure according to agency policy.

Prepared By: LEVEL III-FACULTY

Noted By: Nerissa C. Mariga, MAN, RN

Recommending Approval: Desdimona C. Sakandal, RN,RM,MN

Approved By: Hashim N. Alawi Jr., RN, MN

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NAME: _____________ ROTATION: _