Checklist for Skill 1



Checklist for Skill 29. Urinary Catheterization

Name _________________________________________________________________ Date ____________________________

School ________________________________________________________________

Instructor ______________________________________________________________

Course ________________________________________________________________

|Skill 29. Urinary Catheterization |Able to |Able to Perform |Unable to |Initials and |

| |Perform |with Assistance |Perform |Date |

|Recommended Size and Type of Catheter | | | | |

|< 3 Kg 5 French feeding tube or straight catheter | | | | |

|3–8 Kg 5–8 French straight or indwelling catheter | | | | |

|8–11 Kg 8–10 French straight or indwelling catheter | | | | |

|11–14 Kg 10 French straight or indwelling catheter | | | | |

|14–24 Kg 10–12 French straight or indwelling catheter | | | | |

|24–32 Kg 12 French straight or indwelling catheter | | | | |

|Procedure | | | | |

|1. Check chart for order. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|2. Gather equipment. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|3. Wash hands. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|4. Provide for privacy. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|5. Explain procedure to child and family. | | | | |

|a. Explanation should include that povidone-iodine or cleansing solution may feel cold, as |[pic] |[pic] |[pic] | |

|catheter is passed may feel urge to urinate, and deep breathing or “panting” will help to | | | | |

|pass catheter. | | | | |

|Comments: | | | | |

|6. Place child on back in a recumbent position. Place a chux or other protection under the | | | | |

|child’s buttocks. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|7. Adjust light source to provide maximum lighting. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|8. If needed, put on nonsterile gloves and cleanse perineum of stool. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|9. Remove gloves. Wash hands. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|10. Prepare sterile field maintaining strict aseptic technique. Open catheterization tray or | | | | |

|sterile gloves, and drop sterile catheter and syringe onto sterile field. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|11. Put on sterile gloves. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|12. If using catheterization tray, unfold waterproof underpad and place under child’s | | | | |

|buttocks. DO NOT contaminate gloves while doing this. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|13. Prepare povidone-iodine or agency-prescribed cleansing solution and cotton balls or have | | | | |

|asssistant open povidone-iodine swabs. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|14. Open sterile lubricant. If lubricant not part of catheterization tray have assistant open| | | | |

|and squeeze lubricant onto sterile field. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|15. Maintaining sterile technique fill syringe with sterile water. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|16. Check catheter balloon prior to insertion by inflating and deflating it with sterile | | | | |

|water. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|17. Cleanse area and insert catheter. | | | | |

|a. Male | | | | |

|1. Grasp shaft of penis gently but firmly with nondominant hand. This hand is now |[pic] |[pic] |[pic] | |

|contaminated and stays in place throughout the procedure. A firm pressure rather than a light| | | | |

|pressure helps avoid an erection. | | | | |

|NOTE: Never catheterize a child with an erection. | | | | |

|2. Clean the meatus and then clean outward in a circular motion. Use each swab or cotton ball|[pic] |[pic] |[pic] | |

|(generally held with forceps) only once. Be careful not to touch the penis with the sterile | | | | |

|glove. | | | | |

|NOTE: If child is uncircumcised retract the foreskin. Do not leave the foreskin retracted | | | | |

|following the procedure. | | | | |

|3. Pick up the catheter with free (sterile) hand and lubricate the tip. |[pic] |[pic] |[pic] | |

|4. Hold the penis shaft perpendicular to the body and insert the catheter slowly and gently. | | | | |

|5. Insert the catheter to the hub. |[pic] |[pic] |[pic] | |

|6. Inflate the balloon with the recommended amount of water. | | | | |

|b. Female |[pic] |[pic] |[pic] | |

|1. Separate labia using thumb and forefinger of nondominant hand. This hand is now |[pic] |[pic] |[pic] | |

|contaminated and stays in place during the procedure. | | | | |

|2. Clean the labia and meatus from front to back using each swab or cotton ball (generally |[pic] |[pic] |[pic] | |

|held with forceps) only once. Cleanse each side and then directly over the meatus. Be careful| | | | |

|not to touch area with sterile glove. | | | | |

|3. Pick up the catheter with the free (sterile) hand and lubricate the tip. |[pic] |[pic] |[pic] | |

|4. Align catheter opposite the meatus and insert gently downward. | | | | |

|5. Insert to the hub. | | | | |

|6. Inflate balloon with the recommended amount of water. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

| |[pic] |[pic] |[pic] | |

| | | | | |

| |[pic] |[pic] |[pic] | |

| |[pic] |[pic] |[pic] | |

|18. Connect catheter to closed drainage system. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|19. Attach drainage bag to bed below level of bladder and position catheter tubing in a loop | | | | |

|on the bed. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|20. Secure catheter with tape or tube holder. | | | | |

|a. Male: On abdomen or outer thigh. |[pic] |[pic] |[pic] | |

|b. Female: Inner thigh. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|21. Clean the perineum to remove all Betadine. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

|22. Make child comfortable. |[pic] |[pic] |[pic] | |

|NOTE: The procedure for a straight catheterization (not indwelling) is the same as described | | | | |

|above. However, the catheter is inserted only long enough to obtain a urine specimen or to | | | | |

|completely drain the bladder. | | | | |

|Comments: | | | | |

|Documentation | | | | |

|1. Procedure and time done. |[pic] |[pic] |[pic] | |

|2. Size of catheter. |[pic] |[pic] |[pic] | |

|3. Amount of urine output. |[pic] |[pic] |[pic] | |

|4. Color and character of urine. |[pic] |[pic] |[pic] | |

|5. Child’s response and how tolerated. |[pic] |[pic] |[pic] | |

|Comments: | | | | |

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