NEW ERA UNIVERSITY

College of Nursing
Performance Evaluation Tool
URINARY CATHETERIZATION
Name:__________________________________Date:___________Grade:_________________
INSTRUCTION: Rate the student’s performance utilizing the scale below:
3-Demonstrated procedure accurately, correctly stated rationale.
2-Demonstrated procedure accurately, incomplete rationale stated.
1-Demonstrated procedure inaccurately, incorrect/no rationale stated.
0-Not Demonstrated
COMPETENCIES 3 2 1 0 Remarks
1. States the purpose of the procedure. To monitor urinary function,prevent or relieve
bladder distention and provide a means for
irrigating the bladder with fluids or medication.
2. Checks the Physician’s order. Prevents potential errors.
3. Greets the client and introduces self. To gain trust of the client.
4. Identifies client using two identifiers. Which facilitates the procedure and is more
comfortable for client.
5. Explains the procedure to the client. Information facilitates acceptance and compliance
in the therapy.
6. Performs hand hygiene. Prevents transmission of microorganism.
7. Provides for client privacy. Preserves the client’s dignity.
8. Assessment: Allows you to clarify misunderstandings and
8.1 Determines the most appropriate promotes patient cooperation.
method of catheterization based on
the purpose.
9. Preparation: The materials in the kit are arranged in sequence o
9.1 If using catheterization kit, reads the use.
label carefully to ensure that all
necessary items are included.
9.2 Dons cleans gloves and performs Reduces microorganisms near urethral meatus and
routine perineal care. allows further opportunity to visualize perineum
and landmarks.
9.3 Locates the urinary meatus relative to Allows for visualization of the urinary meatus.
surrounding structures (for women).
9.3 Removes and discard gloves. Prevents transmission of microorganisms.
9.4. Performs hand hygiene. To reduce the number of microorganisms.
10. Places the client in the appropriate The drape provides a large sterile field.
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.

11. Establishes adequate lighting. Stands on
the client’s right if right-handed, on the
client’s left left-handed.
12. Opens the drainage package and places
the end of the tubing within reach.
Adequate lighting and correct positioning are
crucial for clear visualization of the urinary meatus
Prepares system for eventual connection with
catheter.
13. If agency policy permits, dons gloves and
inject 10-15mL of Xylocaine gel into the
urethra of the male client. Wipe the
underside of the penile shaft to distribute
the gel up to the urethra and wait at least
5 minutes for the gel to take effect before
inserting the catheter.
14. Removes and discards gloves.
14.1 Performs hand hygiene.
15. Opens catheterization kit observing
sterile technique.
16. Places a waterproof drape under the
buttocks for female and under penis for male
without contaminating the center of the drape
with your hands
17. Dons sterile gloves.
18. Organizes the remaining supplies:
18.1 Removes specimen container
and place it nearby with the lid
loosely on top.
18.2 Opens lubricant package.
18.3. Soaks cotton balls with
antiseptic solution.
19. Attaches prefilled syringe to the
indwelling catheter hub and pretest the
balloon.
20. Lubricates the catheter 2.5cm-5cm for
females, 15cm-17.5cm for males, and
place it with the drainage end inside the
collection container.
21. Places the fenestrated drape over the
perineum, exposing the urinary meatus.
22. Cleanses the meatus:
22.1 Female:
22.1a. Uses non-dominant hand to
spread the labia to expose meatus.
22.1b. Establishes firm but gentle
pressure on the labia.
22.1c. Holds a cleansing ball with the
forceps in your dominant hand.
22.1d. Wipes side of the labia majora
one at a time with different cleansing
ball in an anteroposterior
direction. Repeats for the labia minora.
22.1e Uses the last cleansing ball to
cleanse directly over the meatus.
22.2 Male
22.2a. Uses non-dominant hand to grasp
the penis just below the glans.
22.2b. Holds the penis firmly upright
with slight tension.
22.2c. Holds a cleansing ball with the
forceps in dominant hand.
Xylocaine Jelly are used to stop pain and used to
ease pain from skin irritations.
To prevent transmission of micro
organisms.
To reduce number of microorganisms.
To create environment to prevent the transfer of
microorganisms during sterile procedures.
Maintains aseptic techniques during procedure.
To prevent transmission of microorganisms.
Retains sterility of inside of container and prevents
spillage of urine.
Maintains principles of surgical asepsis and
organizes work area.
Note: Pretesting of balloon is no longer
recommended because catheters are pretested
during manufacturing and inflation may distort the
balloon leading to increased trauma(Smith, 2006)
Makes insertion of the catheter by decreasing
friction.
Avoids unnecessary exposure of body parts and
maintains patient’s comfort.
Full retraction prevents contamination of urethral
meatus during cleansing.
Maintain position of non dominant hand throughou
procedure.
Cleansing reduces number of microorganisms at
urethral meatus.
Cleansing for each of the three areas proceeds from
area of least contamination to that most
contamination.
Use of single cotton for each wipe prevents transfe
of microorganisms.
Straightens urethral canal to ease catheter insertion
Relaxation of urethral sphincter and pelvic floor
aids in insertion of catheter.
Cleansing reduces number of microorganisms at
urethral canal.
 22.2d. Wipes from the center of the Cleansing for each of the three areas proceeds from
meatus in the circular motion area of least contamination to that most
around the glans. Uses a new contamination.
cleansing ball and repeat three
more times.
23. Inserts the catheter:
23.1. Grasps the catheter firmly Relaxation of urethral sphincter and pelvic floor
5cm-7.5cm from the tip. Asks the aids in insertion of catheter
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.
22.2 Advances the catheter 5cm farther Appearance of urine indicates that the catheter tip
after the urine begins to flow in bladder or lower urethra.Further advancement o
through it. catheter ensures bladder placement.
24. Holds the catheter with the non-
dominant hand.
25. Inflates the retention balloon with the Catheter may be expelled accidentally by bladder
designated volume. or sphincter contraction.
25.1 Without releasing the catheter
holds the inflation valve between
two fingers of non-dominant hand
while attaching the syringe.
25.2 Inflates with dominant hand. Inflation of balloon anchors the catheter tip in plac
If the client complains discomfort, above the bladder outlet to prevent the catheter’s
immediately withdraw the instilled removal.
fluid, advance the catheter farther,
and attempt to inflate the balloon
again.
25.3 Pulls gently on the catheter If resistance is felt, the catheter balloon is properly
until resistance is felt to ensure that inflated in the bladder.
the balloon has inflated and to place
it in the trigone of the bladder.
26. Collects urine specimen if needed.
Note:
 Straight catheter. Allow 20-30mL. to As always, you should monitor the client’s
flow into the bottle without touching the condition; if the vital signs change or bleeding
catheter to the bottle. Allows the occurs, temporarily stop the flow of urine and
remaining urine to continue draining continue when the client’s condition warrants
into the urine receptacle. In some cases,
only 750-1,000mL. of urine are to be
drained from the bladder at one time.
Removes the straight catheter when
urine flow stops.
 Indwelling catheter. Pre-attached to a Allows sterile specimen to be obtained for culture
drainage bag, a specimen may be taken analysis.
from the bag this initial time only.

27. Attaches the drainage end of an
indwelling catheter to the collecting
tubing and bag.
28. Examines and measures the urine.
29. Secures the catheter tubing to the thigh
for female clients or to the upper thigh
or lower abdomen for male clients to
Attaching to the bed frame prevents accidental
pulling of the catheter.
It might contain infectious organisms.
Anchoring catheter to lower abdomen reduces
pressure on urethra, thus reducing possibility of
tissue injury.
 prevent movement on the urethra or
excessive tension or pulling on the
retention balloon.
30. Hangs the bag below the below the level In-dwelling catheters the bladder by gravity.
of the bladder. No tubing should fall
below the top of the bag.
31. Wipes any remaining antiseptic or Cleaning protects the area from contamination.
lubricant from the perineal area. Replaces
the foreskin if retracted earlier.
32. Places the client to a comfortable Provides for client comfort.
position. Instruct the client on positioning
and moving with catheter in place.
33. Discards all used supplies in appropriate Reduces transmission of microorganisms.
receptacle.
34. Removes and discard gloves. Reduces transmission of microorganisms.
35. Performs hand hygiene. Reduces transmission of microorganisms.
36. Documents the catheterization procedure Maintains legal record and communicates with
including size and relevant findings. members of health care team

EVALUATED BY: CONFORME:

___________________________ _________________________
Clinical Instructor Student’s Signature